A challenging but realistic workload, a sympathetic and motivational supervisor, a strong team atmosphere, decent working conditions, above-average pay and benefits—most employees share the same list of desires when it comes to finding a job, perhaps in a different order depending on their priorities.
Best Places to Work: Life at the top
The top organizations in Modern Healthcare's inaugural Best Places to Work in Healthcare competition provide multiple reasons for employees to come, stay
The employers who landed on Modern Healthcare's first Best Places to Work in Healthcare ranking, conducted in conjunction with Best Companies Group of Harrisburg, Pa., provide most if not all of these qualities, in somewhat different quantities depending on their institutional priorities.
The 1,160-employee, 64-bed Waynesboro (Pa.) Hospital topped the list, and healthcare providers dominated the list overall: 162-bed Indiana (Pa.) Regional Medical Center ranked second; 254-bed St. Francis Medical Center in Cape Girardeau, Mo., ranked fourth; and 385-bed King's Daughters Medical Center in Ashland, Ky., ranked fifth, with three others in the top 10.
FGP International in Greenville, S.C., a career placement firm with 57 employees—perhaps not surprisingly, given its business focus—ranked highest among suppliers, and it was third overall. Other suppliers in the top 10 included Awarepoint Corp. of San Diego (eighth) and Geonetric of Cedar Rapids, Iowa (10th).
Fewer payers ranked on the list, with Amerigroup Corp., a 4,352-employee firm in Virginia Beach, Va., placing 48th overall, and HealthPartners of Bloomington, Minn., next at 63rd.
Sizes of employers ranged dramatically, from the 25-employee Advanced ICU Care, St. Louis, (which placed 26th) to the 69th ranked Beryl Cos. of Bedford, Texas, which employs a veritable small city of 42,417 to staff call centers and offer Web-based feedback to customers of healthcare organizations.
The aggregate survey results showed few dramatic differences among employers chosen for the ranking of 100 vs. those who weren't. Only five quantifiable questions showed differences of more than 5% (See chart at left).
John Challenger, chief executive officer of Chicago-based global outplacement firm Challenger, Gray & Christmas, says there's no one answer to what's most important for employers to stress, but he shared several thoughts.
“It's crucial that the workplace have a strong culture, that it gives employees meaningful work, that it values and recognizes them for their accomplishments, that it promotes strong relationships across company lines, up and down the management chain, and across intergenerational lines and other kinds of cultural barriers,” Challenger says. “People want a fair environment, where people who are the most productive are rewarded.”
While those qualities would be critical anywhere, Challenger cites certain criteria that he figures healthcare employees would be especially interested in, such as continuing education, programs to reduce stress in the workplace, top-notch information technology infrastructure and an emphasis on work-life balance.
“Ongoing support of education to stay up with developments in the field is really crucial,” Challenger says. Healthcare workers “often deal with highly charged emotional situations in their daily work; giving people the means to relieve that stress is important. Depending on the setting, access to good technology and strong medical information systems are important to people—to be in an environment that provides the kind of healthcare technology and service people can be proud of.”
Employee surveys conducted by Careerbuilder.com, which has a team focused on healthcare, have shown that transparency, flexible schedules, reputation and opportunities
for career advancement are among the critical criteria when evaluating potential employers, says Jason Ferrara, senior career adviser.
“Seventy-five percent of people expect their employer to be open and honest,” Ferrara says. “Their expectation is that their employers offer some type of flexible schedule, which ranges from certain days of the week off to hourly flexibility to 'Can I take my lunch at a nontraditional time?' … Career advancement is always something that's important—either a career path or further education.”
Healthcare employers need to pay closer attention than those in other sectors to such concerns, if only because of the economy, Ferrara says. “Healthcare is still vibrant and still needs people,” he says. “If you're in a financial services firm, you're probably less worried about flexible schedules and more worried about keeping the lights on.”
Top employers in each of Modern Healthcare's three categories cite many of the same qualities as Challenger and Ferrara in describing what they do to attract and retain the highest quality employees (the top finishers in each category, Waynesboro Hospital, FGP International and Amerigroup are profiled separately on pp. 22, 24 and 26, respectively).
Second-ranked Indiana Regional Medical Center has doubled its revenue in the past 10 years while raising its Press Ganey patient-satisfaction scores from the 20s to above the 90th percentile, says Steve Wolfe, president and CEO.
“We started out early with patient satisfaction,” says James Kinneer, Indiana Regional's vice president of people and organizational development. “How do we make it a better place for patients? How do we make it a better place for employees? Those two things coming together have helped us create that climate.”
Wolfe recalls his first day on the job, when he met with the hospital's labor attorney about an upcoming labor election that Indiana Regional lost by single digits. “It was a very tough time getting to our first contract,” he says, recalling a “public meeting with a couple hundred angry people who said we were not negotiating in good faith.” If measured, employee satisfaction would not have been high then, Wolfe wryly notes.
Management has worked hard on employee communications, inviting a nonmanagement representative from each department to monthly question-and-answer sessions from which they take back information to their departments, Kinneer says.
“The communications piece opens up the doors to everything else,” Kinneer says. “What do people need to do their job? What do they like? Beyond that, we've worked very hard at aligning awards and recognition with key success factors. We set very challenging goals to hit in terms of patient satisfaction. It's engaged employees and gotten them excited. They see that, 'If I put forth effort, there's a reward.' ”
Kinneer says that Wolfe has shifted the organization away from a traditional, hierarchical leadership style toward more of a servant-leader, participative style. “We've gotten plenty of feedback that we've empowered people to a higher level,” he says. “That's a major (satisfier), when we look at employee comments.”
Employees feel they can approach senior leadership with requests, Kinneer says, even if they can't always get what they want. He recalls one employee who wanted a raise, more staff and a more responsive supervisor. Management said “no” to the first two, but “we were able to switch their reporting relationship to someone who was able to pay more attention to them,” he says.
Staff hired at fifth-ranked King's Daughters Medical Center are vetted during interviews to see if they share the organization's values, embodied in the hospital's mission, “To care, to serve, to heal,” and if they understand the right balance among the center's five key priorities: customer, quality, community, finance and culture. “We look for those behaviors in potential applicants,” says Ryan Finch, service excellence supervisor.
Larry Higgins, vice president of human resources, says that people—rather than facilities or technology—are what differentiates King's Daughters. “We have a cheerful, talented group of high achievers,” he says. “When we hire people, they can feel it when they walk through our organization. It's not that we put it in a printed brochure. It's our daily reality. … It's a culture of success.”
Human Resources Director Tim Holbrook mentions several specific reasons why employees at King's Daughters might be cheerful, from 18-month interest-free loans to purchase home computers, to a 120-child on-site day-care facility, to bonuses for referring candidates for highly sought-after positions.
“We focus heavily on recognizing our team members for their contributions,” says Mona Thompson, King's Daughters' vice president of patient services. “We train our leaders that the most powerful form of recognition is immediate verbal recognition in front of the team members.” To augment that, “Each leader has a tackle box of nominal-value amenities that they can use as a thank-you gift to someone who has gone above and beyond.”
“We're doing a lot to educate our leadership team on the concept of servant-leadership,” Higgins adds. “The leader is here to meet the needs of their team members.”
The medical center recognizes work-life balance in a variety of ways, ranging from organizing outings to amusement parks and college football games to providing valet parking for staff members in the third trimester of their pregnancies, Thompson says.
The hospital also uses prime parking spaces to show its commitment to the environment by designating some for carpoolers only. “Not only does (carpooling) save money, but it promotes building relationships,” Finch says.
Fourth-ranked St. Francis Medical Center puts its money where its mouth is when talking about financial and patient-service excellence. The hospital has paid out $32 million in gain-sharing bonuses during the past six years whenever Press Ganey scores climb above the 80th percentile and the center simultaneously overshoots its quarterly financial goals. “It has truly aligned patient satisfaction and the hospital's financial performance,” says St. Francis President and CEO Steven Bjelich.
“If we don't have patient satisfaction, it doesn't make any difference if we've gone above our financial budget. We do not get” the bonus, says surgical project director Dottie Worley, a 40-year employee of the hospital. “The medical center is very driven to stay on the top, both with our employees and our patients.”
St. Francis prides itself on financial transparency, placing “key indicator” boards outside each department that keeps employees abreast of financial performance, patient satisfaction and other statistics.
“Whether it's good or bad, we share” information, Worley adds. “Where we are with our budget, where we are with our Press Ganey.” A monthly letter is also sent to every employee's home keeping them updated, in case they missed it in the hallway.
The hospital shares its strategic plan with employees and asks department staff to sign off on the blueprints for major construction projects affecting their daily work life, Bjelich says. “They truly are integrated into the decisionmaking process,” he says.
The organization tries to create an environment where employees feel free to share their thoughts in other ways, conducting periodic surveys in conjunction with the firm Management Science Associates. The last of those surveys, conducted in spring 2006 and completed by 1,500 employees, showed that St. Francis ranked in the top 10% in 15 out of the 16 categories that Management Science measures.
This feedback loop is furthered by senior management continuously making the rounds, Bjelich says. “I do it because I get a great sense of what's going on in the organization,” he says. “You've got to be disciplined about it. It's beneficial.”
Rob Grayhek, who began as a staff nurse nearly 14 years ago and has risen to manager of trauma and disaster services, appreciates the educational opportunities that St. Francis provides. “We look at our employees as customers,” he says. That attitude carries through to supervisor feedback, which Grayhek describes as “educational, not punitive.” He adds, “I'm sure you're familiar with, 'If you mess up, you'll know about it. If you do good, you did your job.' Here, we celebrate those successes, whether it's passing the Joint Commission (standards) or meeting those satisfaction goals. That raises morale.”
Co-workers at St. Francis have the opportunity to show their love for one another through an Employee Caring Fund, which provides emergency financial assistance for those who experience tragedies like a house fire, Bjelich says. More than $600,000 has been donated during the past several years, he says.
Eighth-ranked Awarepoint Corp., the second-highest supplier on the list and a wireless technology manufacturer, appeals to potential and current employees in several ways, starting with its “cutting edge” products, says CEO Jason Howe. “They love what we're doing. Technology folks love to get into what they're going to be doing day-to-day,” he says. “From a sales perspective, it's an attractive market segment because you can make a lot of money here.”
Second on Howe's list of selling points is salary. “I pay in the top 10th percentile. Period,” he says. Awarepoint's chief financial officer earns $250,000 and salespeople make between their base of $125,000 and a maximum of $300,000, he says. Plus, the company offers stock options.
Howe says he works to be an “open-door CEO” by holding weekly Friday meetings at which he provides the good news and the bad news. “The company knows how much money we have at all times. The company knows exactly what our risk factors are,” he says.
Awarepoint has a track record of promoting internally, Howe says, with two former receptionists who have become the director of marketing and sales operations coordinator. “I like to get people out of their comfort zones,” he says. “I pay for continuing education. I pay for classes. I have reimbursement programs.”
Geonetric, ranked 10th overall and third among suppliers, is another technology company that invests heavily in continuing education, says CEO Eric Engelmann. “We're a little bit obsessed with training here,” he says. “It's very important that we're pushing the envelope on technical growth. The technology I learned 10 years ago is obsolete. We spend an incredible amount of time, multiple thousands of hours per year. For a small company with 60 people, that's a big investment.”
The second-ranked payer and 63rd ranked organization overall, HealthPartners places a great deal of emphasis on making sure employees understand their mission, “To improve the health of our patients, our members, and the community,” says Liz Swanson, vice president of human resources. An employee survey showed that 92% of those who responded valued that mission, felt strongly about it, and saw how their role connected.
“We ask line-of-sight questions: 'Do you know how what you do contributes to the mission? Do you have confidence in your leaders?' We have very high and increasing marks. It's because we've put together a very tightly knit communication process.”
Beyond that central focus, HealthPartners tries to provide competitive pay and core benefits along with additional features like educational assistance, Swanson says. The company tries to build work-life balance by offering flexible schedules where possible, a benefit that's perhaps won greater support because of its 80% female workforce, she says. “That's a nice advantage, as an employer, to have a female perspective.”
The organization's leaders work to make themselves visible and accessible and to solicit employee feedback, Swanson says. “We work very hard at having an open, honest dialogue.”
HealthPartners works to recognize and reward employees on key “foundational elements” of workplace culture, which “helps us communicate to our employees that these are things that matter to us,” Swanson says. They include promising themselves and their
co-workers that they will be reliable, dependable and meet their responsibilities.
“We make it clear, from Day One, that these are the things that are most important to us,” Swanson says. “It's never easy to give 100% when the person next to you isn't.”
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