Healthcare HR: Problems and solutions
A massive training market is opening up thanks to the huge world shortages of health and care staff. Dr Kate Tulenko, CEO of Corvus Health, a global workforce services company, talked at HBI 2018 about the HR problems operators can face – and the solutions to those problems.
Labour is usually the single largest expense in the health sector, Tulenko says – and health labour costs are growing faster than other health sector inputs, 3% a year compared to 2% for other expenses.
Here are the main HR problems she sees – and her proposed solutions.
High Turnover
“If your hospital gets the reputation of having a revolving door, people will figure there’s something the matter, and it affects patients too if every time they go to the hospital there’s a new receptionist and a new nurse”, says Tulenko.
The problem
If staff are unhappy or see greener pastures elsewhere, it lowers morale, increases recruitment and training costs, can lead to poor patient care, and affects the ability to attract new staff and the facility’s reputation with patients.
The solution
Analyse the root cause – so you can implement a solution.
- Do succession planning – if you have people leave, who will replace them?
- Improve your HR team. People leave if they don’t feel respected.
- Do focus groups and interviews to find out why people are leaving.
- Improve recruitment – offer evidence-based recruitment packages. Ask people, “what would make you stay, make you happy here for the next five to ten years?”
Extended vacancies
“If you have extended vacancies, you have trouble attracting staff, and you probably don’t have the HR team you need”.
The problem
If you overload existing teams they will be overworked, stressed out and you’ll have more absenteeism. You might have more costly overtime too, along with low morale and poor customer service. Happy workers lead to happy patients. Stress can lead to medical errors.
The solution
- Do succession planning
- Improve your HR team
- Improve recruitment – offer evidence-based recruitment packages. Ask people, “what would make you stay, make you happy here for the next five to ten years?”
Low productivity
“The first thing you need to do is to define what low productivity is.”
The problem
Low productivity affects profitability and may impact patient satisfaction if there are long wait times or low availability of staff for appointments.
The solution
- Analyse the root cause
- Improve your team design – are physicians doing tasks at the top of their abilities? Could some tasks be delegated to nurses?
- Adjust job descriptions – in emerging markets in particular it’s surprising how many people don’t have a job description or whose job description is long out of date.
- Have clear clinical pathways for common diagnosis
- Improve support supervision. Are people getting on-the-spot mentoring?
- Optimize workflow. Look at who does what, when.
- Improve the practice environment – could be something simple like is the room too hot? Is it clean? Is it somewhere to be proud of.
- Address morale issues.
Missed opportunities
“Physicians are practising medicine from the 1990s and this is an issue especially for surgeons. Any physician in his or her 60s may have been out of training for 40 years and not learned techniques that have developed.”
The problem
Missed opportunities to provide needed care, to distinguish a facility, and to improve physician can be costly. Patients may fly abroad for the latest treatment and physicians may seek work elsewhere if they do not have continuous training.
The solution
- Assess physician competencies – compare them with other services offered in your country and the latest developments in their speciality – and train them.
- Prioritise the services where there is a demand. If no one is doing gastric sleeve surgery in your region, and people are travelling elsewhere, it’s worth investing in training in that procedure and tying the physician into staying one or two more years in return.
- Train the team around these new services
Poor customer service
Staff might be rude. Inexperienced. Unwelcoming to patients. Patients questions may not be answered. Physicians may not smile. If you look at the customer feedback data, you will see where the problems are.”
The problem
Patients tell their family and friends and stop patronising your facility, they post on social media and damage your brand reputation and that hits profitability and can affect morale. Physician behaviour towards patients effects compliance with a prescribed regiment.
The solution
- Integrate customer service awareness and training into orientation and annual training. It should be written into job descriptions and people should be evaluated on it.
- Create a work environment that supports customer service.
Poor quality of care
“This is the number one health workforce risk for private health facilities”
The problem
A lack of use of evidence-based medicine. Every physician does what they think is best. This leads to inconsistent care and increased medical errors – more patient deaths, negative morbidity, more law suits, reduced referrals. Ultimately it can lead to potential loss of accreditation and licence.
Solutions
- Work out what quality looks like and what the KPIs you are aiming for are. Establish quality standards.
- Have a quality improvement programme – so everyone knows how to reach these goals. Review periodically.
- Train people to achieve quality. Everyone wants to recruit healthcare workers but no one wants to invest in them.
Click here to see the presentation from Dr Kate Tulenko.
Click here to see the presentation by Unilabs’ Samantha Laurent from Unilabs in the same session on how cultural change delivers.
We would welcome your thoughts on this story. Email your views to David Farbrother or call 0207 183 3779.
