If President Clinton thinks Americans are in a national funk, he should stay out of the hospital, where the atmosphere is positively morose.
Poor morale is by far the worst human resources problem in the hospital industry, according to a survey of 681 hospitals conducted in October by Deloitte & Touche for MODERN HEALTHCARE.
Morale has been a problem for several years. But as downsizing, restructuring, belt-tightening and layoffs have taken their toll, the degree of concern has risen. Some 81% of respondents list employee morale as the No. 1 human resources issue in hospitals today, up from 75% in 1994 and 69% in 1993.
Ranking second among respondents' concerns is the impact of downsizing, cited by 52%; followed by reduction in staff, 49%; managing benefit costs, 49%; control of salary increases, 46%; and reduction in staff, 46%. The survey also explored benefit trends.
"The main cause of the morale problems is layoffs," said Anthony Ledden, an actuary with Deloitte & Touche. "One-third are still reducing. But over half are not reducing. So look at job restructuring and uncertainty in the marketplace" as causes of low morale, he said. Human resources people "are basically picking up the pieces."
Tina Filoromo, a human resources manager at Toledo (Ohio) Hospital, sees that firsthand. "My hunch is that morale is going down, vs. going up," she said. "People are concerned about job security, the way their jobs are changing in focus, being asked to do more with less."
To feel the hospital's internal pulse, the human relations department is taking an internal opinion survey. "It's a repeat of one we did 18 months ago. We do it to find out what people feel about their employer....We try real hard to keep our finger on the pulse because a satisfied worker gives better customer service," Filoromo said. Since the last survey, her hospital, like institutions everywhere, has made some organizational changes.
For one thing, total employment has dropped to 4,200 from nearly 5,000 in the last two years, mainly through attrition. Mass layoffs have been avoided. With a pilot federal re-education grant, many employees have become "multiskilled." For example, respiratory therapists have been cross-trained as electrocardiograph technicians. "With appropriate preparation and education of the staff, we're hoping (such changes) will be accepted," Filoromo said.
Still, Filoromo's sense is that her hospital isn't that different from others. "Throughout the country, there is a change in what people feel about their Now those ample staffing levels are deflating like tires. Only 2% of religious hospitals plan to enlarge their staffs.
Most investor-owned hospitals, to the contrary, are going to hold constant, and in some cases-9%-even expand. That's because, Cooper said, for-profit companies frequently "are picking up hospitals that are in trouble, that have already gone through downsizing."
Finally, if employees get laid off, what kind of severance benefits are they likely to receive? For one, most shouldn't count on much more than the legally mandated extension of their healthcare insurance-at their own cost, of course. That's all that's given at more than two-thirds of responding hospitals.
That may reflect the survey's heavy weighting of stand-alone hospitals of fewer than 100 beds, Cooper said. Larger systems may provide more ample severance benefits.
"The severance compensation package is typically meager, too. Almost half of all hospitals pay out accrued vacation only. Another 43% pay severance based on service," Cooper added.