Last summer Pat Woodrum was re-engineered out of her job.
It came as no surprise. She was on the team that recommended abolishing the position.
"It's one thing to intellectually know this is a good thing," she said. "It's a lot different when they hand you the letter and you see it in black and white."
The terms "re-engineering," "job restructuring" and "departmental consolidation" sound straightforward enough-praiseworthy, even-to those who understand that the hospital industry must change.
However, the way in which these academic concepts touch individual workers, including the managers who carry them out, is quite another matter. The psychic costs can be devastating, not only for the employee, but for the whole organization.
Woodrum saw firsthand how a well-intentioned redesign of work processes and internal organization had unforeseen consequences for the people who worked in the hospital.
Woodrum, 50, worked at Baptist Medical Center in Kansas City, Mo., for 19 years, rising from technician to director of cardiology.
She was assigned to the re-engineering team in October 1993. The team interviewed people throughout the hospital and observed them at work. During this time, Woodrum recalls, morale in the hospital was upbeat. "People were very excited. There was lots of participation. People really felt that what they were saying was being listened to and addressed," she said.
But the atmosphere was changing. Two years earlier, in 1991, Baptist had merged with another large Kansas City hospital, Research Medical Center, to form Health Midwest. As hospital operations began to be combined, employees felt threatened and became anxious. And that came out as dissatisfaction.
Woodrum calls this "loss of ownership" and thinks it contributed to lower morale. "It used to be that I was loyal to Baptist Medical Center as an entity. Now Baptist is part of a system. They tell us Baptist is going to maintain its own identity. But it isn't, because everybody has to have the same computer; everybody has to have the same care plan. You don't have any ownership," she said.
Inside Baptist, the re-engineering team considered whether separate directors were needed to supervise diagnostic departments with as few as five people. "It was pretty obvious the answer was no," Woodrum said.
The team wrote a report and submitted it to top management in February 1994. Six weeks later directors and employees in the departments received a letter explaining the changes and how the consolidation would be structured.
Whereas there had been directors of radiology, the catheterization laboratory, cardiology and neurodiagnostics, there now would be one director of the center of diagnostic services. "We were told as a group that our positions were being eliminated," Woodrum said.
Her colleagues reacted as though they had no idea what was coming. "People were devastated," she said. "Same with me. I knew my job was being eliminated. I knew what the meeting was going to be, yet my heart raced. I didn't have the shock the other people had. But boy, it really felt final."
As the consolidation was carried out, morale took a nose dive. The workload increased for remaining employees, and uncertainty clouded their outlooks.
"One of the things we recommended was that all of the diagnostic services be offered in a central location," Woodrum said. "Departments that had been on the second floor, i.e., cardiology, now needed to find a space downstairs."
For employees, that had unexpected repercussions. "Not only did they not have the emotional support of the person they knew as their manager, but they no longer had the support of the physical area they'd known as home. It's like you wake up one day, and your family's gone and you're homeless," she said.
"We often talk about (how) `the patient got lost in healthcare.' I think the employees get lost, too," Woodrum said. "How can you as a healthcare worker give compassionate care when you don't feel that anyone's compassionate toward you? When you feel, `I'm a number in an equation. Maybe I work here today and I work somewhere else the next time."'
When her job was phased out, Woodrum was offered a position through the end of the year at Research Medical Center in management engineering, as a facilitator and data collector. "Those were skills I had. But I don't think it was playing to my strong suits," she said.
So she declined that position and took a six-month severance package instead. Her last day at Baptist was July 10. She's still deciding what to do. She may work again in healthcare.