Leading with soul/retaining employees. Authors of new book explore keys to employee satisfaction

In today's competitive health care market, finding and keeping good employees is important to an organization's success. Take a look at some ways that managers can show an interest in their employees' welfare and help retain highly valued health care workers.

Outcomes of crew resource management training

Participants' self-reports and measures of attitudes regarding flightdeck management indicate that crew resource management training is favorably received and causes highly significant, positive changes in attitudes regarding crew coordination and personal capabilities. However, a subset of participants reacted negatively to the training and showed boomerangs (negative change) in attitudes. Explorations into the causes of this effect pinpoint personality factors and group dynamics as critical determinants of reactions to training and of the magnitude and direction of attitude change. Implications of these findings for organizations desiring to enhance crew effectiveness are discussed, and areas of needed additional research are described.

We don't need another hero

Everybody loves the stories of heroes like Martin Luther King, Jr., Mother Teresa, and Gandhi. But the heroic model of moral leadership usually doesn't work in the corporate world. Modesty and restraint are largely responsible for the achievements of the most effective moral leaders in business. The author, a specialist in business ethics, says the quiet leaders he has studied follow four basic rules in meeting ethical challenges and making decisions. The rules constitute an important resource for executives who want to encourage the development of such leaders among their middle managers. The first rule is "Put things off till tomorrow." The passage of time allows turbulent waters to calm and lets leaders' moral instincts emerge. "Pick your battles" means that quiet leaders don't waste political capital on fights they can't win; they save it for occasions when they really want to fight. "Bend the rules, don't break them" sounds easier than it is--bending the rules in order to resolve a complicated situation requires imagination, discipline, restraint, flexibility, and entrepreneurship. The fourth rule, "Find a compromise," reflects the author's finding that quiet leaders try not to see situations as polarized tests of ethical principles. These individuals work hard to craft compromises that are "good enough"--responsible and workable enough--to satisfy themselves, their companies, and their customers. The vast majority of difficult problems are solved through the consistent striving of people working far from the limelight. Their quiet approach to leadership doesn't inspire, thrill, or provide story lines for uplifting TV shows. But the unglamorous efforts of quiet leaders make a tremendous difference every day in the corporate world.

HR customer service--FedEx.com or BUST!

As the "customers" of the benefits department, employees, beneficiaries and retirees deserve best practice service delivery. This article describes a benefits administration operating model that can deliver high levels of customer service by furnishing accurate, consistent and timely information. Performance measurement is a key element in this type of customer satisfaction, particularly when outsourcing vendors are involved in the provision of benefits.

Human resource management

The occupational health physician can take advantage of the broad functions of human resource management to offer care and treatment in a very practical way in the day-to-day workplace. Understanding the capabilities and services of the human resource department can aid the occupational health practitioner in maintaining employee health and productivity. Thus, the individual is helped as well as the organization. This article describes the functions of the human resource department and delineates the close connection between it and the occupational health physician.

The balanced scorecard: an integrative approach to performance evaluation

In addition to strict financial outcomes, healthcare financial managers should assess intangible assets that affect the organization's bottom line, such as clinical processes, staff skills, and patient satisfaction and loyalty. The balanced scorecard, coupled with data-warehousing capabilities, offers a way to measure an organization's performance against its strategic objectives while focusing on building capabilities to achieve these objectives. The balanced scorecard examines performance related to finance, human resources, internal processes, and customers. Because the balanced scorecard requires substantial amounts of data, it is a necessity to establish an organizational data warehouse of clinical, operational, and financial data that can be used in decision support. Because it presents indicators that managers and staff can influence directly by their actions, the balanced-scorecard approach to performance measurement encourages behavioral changes aimed at achieving corporate strategies.

Organizational ethics in Catholic health care: honoring stewardship and the work environment

Organizational ethics refers to the integration of values into decision making, policies, and behavior throughout the multi-disciplinary environment of a health care organization. Based upon Catholic social ethics, stewardship is at the heart of organizational ethics in health care in this sense: stewardship provides the hermeneutic filter that enables basic ethical principles to be realized practically, within the context of the Catholic theology of work, to concerns in health care. This general argument can shed light on the specific topic of non-executive compensation programs as an illustration of organizational ethics in health care.

Organizational justice principles and large-scale change: the case of program management

Many of the barriers to implementation of large-scale change in healthcare organizations seem to be related to a lack of attention to the human change that needs to occur. One element of this human dimension that change agents overlook is the role that perception of fairness to employees plays in implementing large-scale organizational change. This article uses program management (an organizational design that has been implemented in many healthcare facilities across Canada) as an example of large-scale structural change and demonstrates the importance of applying procedural and interactional justice principles to enhance the implementation of organizational change.

An analysis of managerial skills for the current and future health care environment

A survey questioned 503 experienced practitioners about managerial tasks and responsibilities of senior professionals in four allied health fields: physiotherapy, speech-language pathology, occupational therapy, and medical radiation science. Participants worked in a range of settings, including the private and public sectors, small and large departments/units, and community and hospital-based work sites. Factor analysis identified eight managerial areas of functioning: department running, staff relations management, legislative knowledge, career path management, implementation and change, quality assurance, management of future planning, and prioritizing work. The professional field of the practitioner influenced the importances attached to these areas, while work setting and gender of practitioner had minimal impact. Level of involvement in managerial tasks had no bearing on the importance attached to competency areas. Open-ended comments added depth to the results of the factor analysis. The findings are discussed with respect to the changing requirements being placed upon health service personnel.

Voices from the trenches: nurses' experiences of hospital restructuring in Ontario

Nurses, the largest occupational group in health care, have been disproportionately affected by health care restructuring initiatives. A survey of registered nurses in Ontario was conducted in the fall of 1998 to examine factors influencing their work life quality in hospital settings. As a part of this survey, respondents were provided with an opportunity to share their concerns about work conditions in an open ended section of the questionnaire. Almost sixty percent of the nurses chose to respond to the open ended question (n = 230), divided equally between males and females. The purpose of the qualitative component of the study was to obtain a more in depth analysis of the effects of hospital restructuring initiatives on staff nurses' working conditions. All geographic areas of the province were represented in the responses. A content analysis of the data was conducted to determine major themes. Similar themes were found across all geographic areas. The four major categories of concerns that emerged from the qualitative analysis were quality of worklife, quality of patient care, relations with management, and cumulative impact of work conditions on feelings and attitudes. Nurses' perceptions of their quality of work life, concern for the quality of patient care and their emotional and attitudinal responses were very similar to those reported in a recent study of hospital staff nurses in the United States. The decade of the 1990's has been characterized as one of constant change bordering on chaos within the health care system in Canada and the United States. In Canada, government fiscal policies have resulted in less money being directed toward health care forcing the system to reorganize in order to meet new financial realities. Many of the organizing efforts have been directed toward the acute care sector of the health care system. Nurses, as the largest occupational group within the health care system, have been disproportionately affected by these efforts. The purpose of this study was to tap nurses concerns about the effects of these changes on their personal and work experiences.

Compliance plans within the organizational context of physician practices. What may need to change?

The Office of the Inspector General's (OIG's) compliance guidelines for individual and small group practices will require a range of operational changes. This is part 2 of a two-part article describing the guidelines' impact on small--and in some cases large--practices, and the ways to meet their requirements. Part 1 appeared in the September/October 2000 issue of MGM Journal. The author presented questions that practices can use to assess the extent of operational and organizational changes necessary to integrate a compliance program. This second part addresses operational changes that may be necessary.

Ready: how to keep your customers coming back

Customer service is a major, but often overlooked, issue in health care today. While other industries and organizations recognize how good customer relations can affect long-term success, many health care providers have yet to learn this valuable lesson. The Ritz-Carlton, which won the prestigious Baldridge Award for service, has a well-earned reputation for excellent customer service. Like health care providers, this hotel industry icon hires hourly workers, puts them in uniform and has them work in teams. Unlike health care, however, The Ritz-Carlton seems to be able to generate a much higher level of customer satisfaction. How? This chapter illustrates the techniques the hotel chain uses to accomplish its goal and how these important tools can apply to the health care industry.

[Expectations of nursing managers and assistants as to the managerial style of an executive director of a teaching hospital]

The present study focussed the expectations of 13 nurses from a University hospital regarding to the executive director's managerial style. The Managerial Grid of BLAKE & MOUTON (1987) was used as a theoretical reference and a questionnaire was applied based on the Grid & Leadership in Nursing Instrument elaborated by TREVIZAN (1993). Results evidenced that the most expected style corresponds, considering the Managerial Grid, to "team management", or 9.9. The second style was the "management of men organization", or 5.5. Authors concluded that there are important expectations for these nurses related to a management that enhances values such as trust, respect, commitment, personal investment and team work in order to achieve the organization goals.

Why physicians are often disappointed with their practice administrators and managers

This article provides a close look at why physicians often are disappointed with the practice administrator or manager they have hired or promoted. Reasons include: the wrong person was hired, such as one without the necessary qualifications and know-how, or the right person was hired, but wasn't given the authority to do the job. The article also provides practical tips on how to avoid mis-hires, how to evaluate the practice's managerial needs, and general differences between types of managers.

The art of forgiveness

The art of forgiveness is a significant managerial process for dealing with intrapsychic and interpersonal injury and error in the health care environment. The ability to forgive is essential if healthy relationships are to be maintained and job productivity is to be enhanced. This article outlines who needs to be forgiven, the process of forgiveness, why forgiveness is difficult, and strategies for the manager in the art of forgiveness.

Facilitating skills: the art of helping teams succeed

Empowering and guiding the team has become crucial to the long-term success of any business. Today, an important measurement for leaders is their ability to facilitate a group of people to work together as a team and successfully accomplish their task. What will separate a good leader from a great leader will be the understanding and development of his or her facilitation skills.

Building human resources capability in health care: a global analysis of best practice--Part II

This paper is the second from a series of three, addressing human resource practices using best practice examples. The analysis covered is based on the experiences of organisations that have won the Malcolm Baldrige National Quality Award (MBNQA) in the USA. The subcriteria covered in this benchmarking comparative analysis covers the following areas: human resource planning and management; employee involvement; employee education and training; employee performance and recognition; employee wellbeing and satisfaction. The paper concludes by reflecting on the likely implications for health-care professionals working in the human resource field.

Europe supports UK government in putting quality at the heart of health care

The new government drive for quality to be at the heart of health care is discussed, following which an insight into the membership and remit of the new European Health-Care Working Group is given. The article also provides a brief description of the European Foundation for Quality Management model and the benefits associated with applying self-assessment as a tool for attaining business excellence. Finally, the first stages of the work proposed by the European Health-Care Working Group is highlighted along with the potential effect on health care within the UK.

Managing human resources in healthcare: learning from world class practices--Part II

This is part II of an analysis of world class practices adopted by model organisations known for their excellence in terms of people management and their superior competitiveness based on harnessing the potential of their employees. This paper continues by addressing best practices adhered to by organisations using the NASA framework, such as Rockwell Space Systems Divisions. In addition and quite comprehensively, the paper examines the personnel function and how it is managed in Japan. Finally, the paper describes two cases of model organisations and the human resource practices adopted and concludes by drawing some useful pointers that professionals who are in a healthcare setting and who are concerned with human resources can learn from.

Building human resources capability in health care: a global analysis of best practice--Part I

This paper is one of a series of three, covering very comprehensively human resource practices in a global and generic context. The series of papers presents practices which are directly of relevance to the health-care context, and which are based on proven, effective and pioneering approaches. The first paper covers practices based on British and European experiences, gathered from world-class organisations that have either been finalists or went on to win prestigious quality awards such as the British and European Quality Awards. The benchmarking analysis presented in this paper is based on the sub-criteria prescribed by the European Quality Awards Model, which include: how people resources are planned and improved; how the skills and capabilities of people are preserved and developed through recruitment, training and career progression; how people and teams agree targets and continuously review performance; how the involvement of everyone in continuous improvement is prompted and people empowered to take appropriate action; how effective top-down and bottom-up communication is achieved.