In the five years Anne Hargrave-Thomas has spent as CEO of West Bloomfield (Mich.) Surgery Center, the facility has moved from last place to first place for employee satisfaction within National Surgical Hospitals' facilities. Here are 10 ways the center increased employee engagement and moved to the head of the pack.
1. Stabilize leadership. When Ms. Hargrave-Thomas arrived at her facility, the center had already gone through two administrators in two years. "That's a lot of change in a short period of time," she says. "Once I came on board, it was really about getting the right leadership team." Between Ms. Hargrave-Thomas and a new director of nursing who was hired at the same time, the center was able to stabilize and set goals. If your center has seen significant employee turnover in the past, you need to establish a strong culture and work to keep employees in their current positions. If leadership is constantly changing, staff will feel disconnected from the center and wonder why administrators don't want to stay.
2. Involve staff in the interview process. Happy employees like their colleagues; it's that simple. Your staff satisfaction will plummet if you introduce team members who shirk their responsibilities or act rudely towards your other employees. Ms. Hargrave-Thomas says she invites staff members to participate in interviews for candidates in their department."The staff participate fully in the interviewing process, which allows them to get sense of skill level and how they will fit in," she says. After the interview, Ms. Hargrave-Thomas and her staff would discuss the candidate and air any concerns.
3. Initiate regular reviews. In an ideal world, every person you hire would be a perfect fit for the center — but that isn't always the case. Once you have hired a candidate, make sure to initiate regular reviews in their first few months to assess how well they are adapting to the center. This benefits the center in two ways: If the candidate is a bad fit, you will find out quickly, and if they are a good fit, they will appreciate the advice and special attention during the confusing first months on the job. If a candidate seems dissatisfied or you are displeased with their work ethic, let them know. "We don't keep them hanging around if it's not the right fit," Ms. Hargrave-Thomas says.
4. Develop regular staff meetings. "Communication, communication, communication," says Ms. Hargrave-Thomas about her motto as an administrator. Staff meetings are a great way to keep staff connected; By holding a monthly staff meeting employees can gather to set goals, talk about problems and interact with people from departments they may not see as regularly. This also presents a good time to go over benchmarking rates such as infection control, physician satisfaction, patient satisfaction and financials.
5. Consider moving people into other roles. Occasionally you will realize that certain staff members are not happy or effective in their position. In this case, you have two options: Ask them to leave the center, or try to find room for them somewhere else. Ms. Hargrave-Thomas says the second option can let you keep valuable staffs member who may just be ill-suited to their current positions. For example, Ms. Hargrave-Thomas noticed an employee who was assigned to lead an area and didn't seem suited to the position. "I met with them and asked, 'Do you need education or mentoring on my part, or is this [position] something you think you want to do?'," she says. "I did have a few employees say, 'Nobody has ever asked me before, and I don't like it. Can I go back to just being a nurse?'"
6. Ask team members to "walk a mile in each other's shoes." Many ASC administrators promote cross-training as a way to save money on staffing. But Ms. Hargrave-Thomas can think of another benefit — the ability to show staff members what it's like to work in another part of the facility. "In a lot of surgery centers, you have the OR crew and the pre-op crew and the PACU crew and the front desk, and nobody talks to the other one," she says. "I made cross-training absolutely mandatory for my staff, and they get to see that maybe it's not as easy in pre-op as they think it is. They have a better appreciation for why something might not have been done."
7. Deal with gossip immediately. Surgery center teams can function as tight-knit families — and with every family comes strife. If you notice your surgery center employees engaging in negative gossip, you need to take action before the chatter causes real problems. "I've had some very frank discussions," Ms. Hargrave-Thomas says. "I've said, 'Look, I don't tolerate gossip. There's no reason for it, and if you have a concern, come and talk to me about it.'" She says administrators should not be afraid to talk to individual employees about their behavior. Once you mention that gossip may be cause for a write-up, your staff should understand the negative impact on the facility and tone it down.
8. Lay out clear criteria for merit increases. If your center can afford to distribute merit increases, make sure to lay out a clear rubric for increases in advance. Explaining the criteria for increases will incent employees to work harder, and staff members will not feel cheated out of an increase when they do not achieve the goals. Ms. Hargrave-Thomas uses a combination of individual and center-wide metrics to judge merit increases. Staff members are giving the criteria one year ahead of time so they have plenty of time to achieve the goals.
9. Develop a "teamwork team." Ms. Hargrave-Thomas says her center has benefited from installing a teamwork team that involves one staff member from every area of the ASC. The team meets once a month to discuss any problems with the ASC, as well as how to fix them. "That has been very successful because they feel part of the process," she says. "We have someone from every area — front desk, pre-op, post-op, OR and central sterile department." The team is led by a non-clinical manager — not Ms. Hargrave-Thomas — to give employees the opportunity to speak frankly about topics that could be improved.
10. Explain rationale for tough decisions. If your surgery center is struggling because of the economy, don't hide it from your staff. Ms. Hargrave-Thomas presents the center's financials at her monthly staff meeting, so employees know when the center needs to cut costs to achieve profitability. One year, the center was unable to offer merit increases because of the Michigan economy. "I said, 'I need you to hear this from me. It was a painful decision, this is why we're doing it and this is how long it's going to last,'" she says. The employees thought about whether the costs could be cut elsewhere and eventually determined that eliminating the merit increase was the best option for the center.
1. Stabilize leadership. When Ms. Hargrave-Thomas arrived at her facility, the center had already gone through two administrators in two years. "That's a lot of change in a short period of time," she says. "Once I came on board, it was really about getting the right leadership team." Between Ms. Hargrave-Thomas and a new director of nursing who was hired at the same time, the center was able to stabilize and set goals. If your center has seen significant employee turnover in the past, you need to establish a strong culture and work to keep employees in their current positions. If leadership is constantly changing, staff will feel disconnected from the center and wonder why administrators don't want to stay.
2. Involve staff in the interview process. Happy employees like their colleagues; it's that simple. Your staff satisfaction will plummet if you introduce team members who shirk their responsibilities or act rudely towards your other employees. Ms. Hargrave-Thomas says she invites staff members to participate in interviews for candidates in their department."The staff participate fully in the interviewing process, which allows them to get sense of skill level and how they will fit in," she says. After the interview, Ms. Hargrave-Thomas and her staff would discuss the candidate and air any concerns.
3. Initiate regular reviews. In an ideal world, every person you hire would be a perfect fit for the center — but that isn't always the case. Once you have hired a candidate, make sure to initiate regular reviews in their first few months to assess how well they are adapting to the center. This benefits the center in two ways: If the candidate is a bad fit, you will find out quickly, and if they are a good fit, they will appreciate the advice and special attention during the confusing first months on the job. If a candidate seems dissatisfied or you are displeased with their work ethic, let them know. "We don't keep them hanging around if it's not the right fit," Ms. Hargrave-Thomas says.
4. Develop regular staff meetings. "Communication, communication, communication," says Ms. Hargrave-Thomas about her motto as an administrator. Staff meetings are a great way to keep staff connected; By holding a monthly staff meeting employees can gather to set goals, talk about problems and interact with people from departments they may not see as regularly. This also presents a good time to go over benchmarking rates such as infection control, physician satisfaction, patient satisfaction and financials.
5. Consider moving people into other roles. Occasionally you will realize that certain staff members are not happy or effective in their position. In this case, you have two options: Ask them to leave the center, or try to find room for them somewhere else. Ms. Hargrave-Thomas says the second option can let you keep valuable staffs member who may just be ill-suited to their current positions. For example, Ms. Hargrave-Thomas noticed an employee who was assigned to lead an area and didn't seem suited to the position. "I met with them and asked, 'Do you need education or mentoring on my part, or is this [position] something you think you want to do?'," she says. "I did have a few employees say, 'Nobody has ever asked me before, and I don't like it. Can I go back to just being a nurse?'"
6. Ask team members to "walk a mile in each other's shoes." Many ASC administrators promote cross-training as a way to save money on staffing. But Ms. Hargrave-Thomas can think of another benefit — the ability to show staff members what it's like to work in another part of the facility. "In a lot of surgery centers, you have the OR crew and the pre-op crew and the PACU crew and the front desk, and nobody talks to the other one," she says. "I made cross-training absolutely mandatory for my staff, and they get to see that maybe it's not as easy in pre-op as they think it is. They have a better appreciation for why something might not have been done."
7. Deal with gossip immediately. Surgery center teams can function as tight-knit families — and with every family comes strife. If you notice your surgery center employees engaging in negative gossip, you need to take action before the chatter causes real problems. "I've had some very frank discussions," Ms. Hargrave-Thomas says. "I've said, 'Look, I don't tolerate gossip. There's no reason for it, and if you have a concern, come and talk to me about it.'" She says administrators should not be afraid to talk to individual employees about their behavior. Once you mention that gossip may be cause for a write-up, your staff should understand the negative impact on the facility and tone it down.
8. Lay out clear criteria for merit increases. If your center can afford to distribute merit increases, make sure to lay out a clear rubric for increases in advance. Explaining the criteria for increases will incent employees to work harder, and staff members will not feel cheated out of an increase when they do not achieve the goals. Ms. Hargrave-Thomas uses a combination of individual and center-wide metrics to judge merit increases. Staff members are giving the criteria one year ahead of time so they have plenty of time to achieve the goals.
9. Develop a "teamwork team." Ms. Hargrave-Thomas says her center has benefited from installing a teamwork team that involves one staff member from every area of the ASC. The team meets once a month to discuss any problems with the ASC, as well as how to fix them. "That has been very successful because they feel part of the process," she says. "We have someone from every area — front desk, pre-op, post-op, OR and central sterile department." The team is led by a non-clinical manager — not Ms. Hargrave-Thomas — to give employees the opportunity to speak frankly about topics that could be improved.
10. Explain rationale for tough decisions. If your surgery center is struggling because of the economy, don't hide it from your staff. Ms. Hargrave-Thomas presents the center's financials at her monthly staff meeting, so employees know when the center needs to cut costs to achieve profitability. One year, the center was unable to offer merit increases because of the Michigan economy. "I said, 'I need you to hear this from me. It was a painful decision, this is why we're doing it and this is how long it's going to last,'" she says. The employees thought about whether the costs could be cut elsewhere and eventually determined that eliminating the merit increase was the best option for the center.