Friday, February 26, 2010

So, my workplace has been invaded by consultants. Of course there are myriad rumors and stories circulating throughout the hospital as to what kind of recommendations are being doled out. None of them are very popular. This is no shock. No big surprises. What really hurts about the whole process is that the rank and file employees look around and we realize that we are the only ones suffering the cuts. The lab has been told we have to "lose" three-four FTE's (Full Time Employees), that our couriers are going to be outsourced and that the registrars are going to be pulled from our outpatient drawing stations... In the middle of all this the hospital installs a 50'+ flatscreen HD TV as a "message board" that plays the hospitals advertising in a loop.

Our president and CEO of our president when he took the job a few months ago said that he wanted an open dialog with the employees. In this vein he started a blog and invited the staff of the hospital to comment. Today, on the blog, he announced that hospital will no longer be awarding the employees longevity bonuses. Well, I took him up on his invitation and commented on his blog post.

Here is what I told him:
"Look, I understand that we are in tight financial times. I understand that we want to become a leaner organization in anticipation of loss of revenue that might occur because of healthcare reform.

"What I do not understand is the places we’re (and when I say we, I am certainly not included, nor are most of the employees of the hospital) choosing to make cuts. We’re losing our longevity bonuses… fine. We’ve lost our pensions in favor of a more volatile, market-driven 403b… fine. We’ve lost our annual employee picnic… fine. We cannot even get coffee served during our annual in-service… I could go on and on about all the things the employees have and are forgoing for the financial health of the hospital. I get it; it’s not unreasonable. We’ve enjoyed a lot of benefits and perks you just don’t get at other jobs. But on the flipside, you’ve basically done away with any incentive to excel or enticements to retain your employees.

"This wouldn’t be so unpalatable if we didn’t have these efficiency "experts" here (whom we are paying assumptively a hefty sum for their sage advice) telling us we cannot keep blankets on the floors for the patients; cannot give them Italian Ice for their parched throats after surgery; that we have to shed FTE’s; that we might have to close laboratory drawing stations; that we’re going to outsource our couriers just as we have our employee health services; that we’re going to send out our Lyme testing to a third-party lab; that we’re going to centralize registration, increasing patients’ waiting time; and probably plenty more we’re probably not privy to just yet.

"So we’re cutting back on employee benefits and cutting corners in addressing the needs and comfort of our patients. This would be understandable if we were falling on hard financial times. But we’re not really, are we? Not yet… The hospital operated in the black this past year, in the face of the worst financial downturn in generations. I’m sure there are lessons we can learn from this economic slow-down; cuts to waste and improvements in efficiency we can implement that this recession opened our eyes to.

"All that would still be a bitter pill for most of us to swallow but I would like to think that if the need presented itself the staff of this hospital would make painful sacrifices. Well, that bitter pill becomes a slap in the face when the employees walk throughout the hospital and see the waste that’s evident everywhere we turn. The big-screen HD TV (and the man hours need to install it and pay the designers who create the content), the plexiglass signs everywhere; the fact that we’ve added two new members to the board of directors; the two new departments (”Organizational Excellence” and “Philanthropy and Development”); the fact that we have not only a Communications Dept but also a Corporate Communications dept, each with their own department head; the fact that the hospital employees a photographer and two graphic designers; that the physicians can still have their meetings catered while the employees cannot get coffee during our in-service; and on and on…

"I love this organization. It’s been one of the most fulfilling jobs I’ve ever labored at. But, sadly, those days and those feelings are behind me now."

This was his response:

Dear Matt:

Thank you for openly raising these issues. That’s the culture of openness we need.

You raise some issues, but there are facts that need to be addressed.

">> 'you’ve basically done away with any incentive to excel or enticements to retain your employees.'
Really, we’re trying to create greater incentives to excel. When everyone gets the same raise regardless of performance, that’s hardly an enticement or a reward. So we’re moving to a pay-for-performance model. When no one knows how or why the hospital makes (or loses) money, that’s no impetus to help us succeed. I want to make sure everyone understands what is important and what is expected. Retention is rewarded through solid performance and reflected in our ability to provide a very competitive retirement plan. The best retention plan we can provide is to continue to position ourselves in uncertain times for job preservation.

">> 'if we didn’t have these efficiency “experts” here…'
I have been here 10 years, and have seen any number of good ideas for efficiency and effectiveness get discussed, but too few get implemented. So, yes, we’re using experts (of course, they get paid), so we can grow more efficient and stay solvent. These “experts” are here to help all of us understand the data that drives decision to improve effectiveness through increased efficiencies. Direction 2010 is our program, not theirs. We have rejected certain ideas that may have worked elsewhere and might not be best here. Among those are some proposals to outsource services.

">> cannot give [patients] Italian Ice for their parched throats after surgery…
Maybe not Italian ice, but Popsicles, yes.

">> if we were falling on hard financial times. But we’re not really, are we? Not yet… The hospital operated in the black this past year.
We had a solid year last year, and many hospitals did not. We’re not off to a solid year this year (we’re $2,614,000 behind budget). The recession may be winding down, but uncertainly, and not for healthcare — and we are getting hit harder than ever with pressures to reimbursement. We saw, for the first time, surgical volume significantly drop-off in December. The burning platform is here, and the time to take action is now, when we can use an X-Acto knife, not when it’s too late and we need a chainsaw.

">> The big-screen HD TV (and the man hours need to install it and pay the designers who create the content)…
The Message Board has generated some question. Allow me to explain: It cost $1,500, which will be sponsored by a local business. The folks who design the content were designing posters, banners and flyers beforehand. They work for us, and they’ve retooled their jobs to make this messaging possible. The people who installed the Message Board are the people we pay to install items all over the hospital. This is a modern, very inexpensive, way to get our message out. This is a strategic communication investment and it is also a waste reduction initiative and “green” initiative. Through the use of sponsored message boards the goal is to reduce the high number of 8.5×11 flyers that get distributed, and unfortunately, taped to walls throughout the hospital and our off-site locations. The printed flyers cost money and use a large quantity of paper.

">> the plexiglass signs everywhere
As to signs, these are a direct result of employees’ comments following the Town Hall meetings where they felt it was important to display the pride we all share in being Backus team members and wanting the general public who visit us and our patients to understand “what we stand for.” This is a strategic investment in our team strength goal. These take the place of unsightly easels everywhere. They cost about $70 apiece. I think they send an important message to our staff, our patients and our visitors.

">> we’ve added two new members to the board of directors
Board members are volunteers. They don’t get paid. We are fortunate to have their expertise and commitment of their time.

">> the two new departments ('Organizational Excellence' and 'Philanthropy and Development')
These are new names for existing departments that have been re-focused: Quality Improvement and Backus Foundation, Inc.

">> we have not only a Communications Dept but also a Corporate Communications dept, each with their own department head
Corporate Communications is (and has been) a Division that includes Marketing, Public Relations, Volunteer Services and Development. It is, and has been, overseen by a Vice President. Communications is a department with one department head, when it formerly had two: one each for Marketing and Public Relations.

">> the hospital employees a photographer and two graphic designers
Starting last year, we hired a photographer and one designer and began to produce all our communications materials (newsletters, ads, videos, signs, magazines) in-house. We no longer use an external advertising and marketing agency. We are saving a great deal of money and producing high-quality work.

"We will continue to look for ways to improve our effectiveness with increased efficiencies and make the necessary strategic investments to be the leading source of healthcare services for the communities we serve, for decades to come.

"I hope this helps. I appreciate this chance to respond, and say thanks for putting these issues out there.


Frankly, no it doesn't help and no, I am not reassured...

No comments:

Post a Comment