Communication key at Texas Health Flower Mound

Texas Health Flower Mound has worked mightily to give employees a voice in operations and provide them with transparency of information. Senior leaders say those are the most important factors that have reduced the hospital's turnover rate from 50% in its first year after opening in 2010 to only 4% two years later.

“Most of us have been in a situation where we don't know what's going on in an organization and don't have a voice. (Employees at Texas Health Flower Mound) know everything from the bottom line, to the strategic plan, to what are we going to do with the landscaping,” says Spencer Turner, the hospital's CEO. Through “meetings, forums, a newsletter, our online bulletin, they know it in every way possible.”

The 72-bed, 398-employee Texas Health Flower Mound provides a gain-sharing program to reward employees for reaching measurable targets or providing a “Bright Idea” that helps the hospital's bottom line. More broadly speaking, Turner stresses that the open lines of communication in the hospital are a two-way street. “You have to participate in staff meetings, you have to be there in forums,” he says. “If we do that, we're going to create a great place to work.”

And for its array of employee-friendly initiatives and cultural attributes, Texas Health Flower Mound has been named No. 1 in the 100 Best Places to Work in Healthcare for 2013, as chosen by Modern Healthcare and Best Companies Group, as well as the top employer among midsized companies, those with 100 to 999 employees.

The 3-year-old hospital, which is a joint venture between Texas Health Resources and physicians, had a rocky start with its employees, not only because of poor communication but also lack of compensation, Turner says. After starting at $90,000 for exempt employees and $45,000 for nonexempt, today Texas Health Flower Mound pays an average of $103,000 to exempt employees and $55,000 to nonexempt, while covering 85% of health premiums, which he describes as “top of the line” compensation for the market.

“Our pitch to the board was, 'We're spending a fortune on turnover,' ” Turner recalls. “If they would allow us to use that money to pay people, we could get it to where we don't have turnover. We've got the right people in place; let's reimburse them for it. That strategy has paid off in spades.” He adds, “It's a competitive market, and we've got to be able to keep them.” It was an easy financial pitch, he says, because temporary staffing and turnover costs were “eating us alive.”

The strategy has helped Texas Health Flower Mound to achieve and surpass its goals of 90% retention, 90% employee-satisfaction scores and a successful application for the 100 Top Hospitals program conducted by Truven Health Analytics. Savings from reduced turnover and higher retention has been rolled back into benefit plans, Turner says.

Registered nurse Corey Terbeek, who's been at Flower Mound for three years, has worked her way up from medical-surgical floor nurse to charge nurse and most recently to house supervisor. She found the compensation surprisingly competitive at the outset with hospitals closer in to Dallas. “One of the things I appreciated is that they do encourage advancing from within the team,” Terbeek says. “It definitely is a team approach. The CEO, CFO, CNO actually get out on the floors, get into the units, know every employee by name.”

Nicole Schweigert, human resources director, says the hospital is one of few in the market that pays 100% of short-term disability premiums, and it also pays 100% of the costs of “robust wellness programs,” which she says sets the hospital apart. Texas Health Flower Mound partners with the nearby Cooper Clinic to provide an on-site registered dietician, Schweigert says, and offers on-site fitness opportunities, gym discounts, “couch to 5K programs,” Zumba dancing, aerobics and “other fun ways to keep employees engaged.”

To offer staff nurses the opportunity to gain specialized hands-on experience, the Flower Mound hospital partners with another Texas Health Resources facility, Schweigert says. “We felt we specifically needed to grow … in critical-care areas,” she says, “to provide the practicum and the ability for nurses to get that critical-care experience.” Three employees have gone through that program, the latest of whom will pursue her goal to become a labor-and-delivery nurse. “That was an employee request, and it's a good retention metric,” she says.

Texas Health Flower Mound has used a variety of job boards and recruiting tools to specifically target a diverse workforce, including minorities, women, people with disabilities, veterans and the gay community, Schweigert says. Probably 30% of the leadership and 45% of employees overall are people of color, she says, while women account for half the leadership and 79% of the total workforce. The company has offered domestic partnership benefits since its inception, she says.

“Our workforce has blended itself pretty nicely,” Turner says. “The (Dallas-Fort Worth) Metroplex is a very diverse community. That effort falls in place regardless, but we watch it pretty closely to make sure that things are what they should be.”

Building an environmentally aware workplace also can be a recruiting tool. The hospital kept a close watch on the construction of its 182,000-square-foot facility and 12-acre campus to ensure compliance with the highest environmental standards, working in collaboration with the town of Flower Mound to pursue certification in Leadership in Energy and Environmental Design, or LEED, from the U.S. Green Building Council, Turner says.

“That's not something you do, and it sits on a shelf,” he says. From windows to lighting to cups in the break room, “You have to watch the supplies you buy, and maintain your landscape and walking paths. Whenever we've added on, we go back to LEED certification requirements and adhere to those.”

The hospital works hard to create camaraderie both among line employees, and between them and senior leadership, Turner says.

“It's a tremendous list of things we always do around reward and recognition,” including an annual employee gala, monthly “Shining Star” celebrations to recognize top employee contributors, and “carpet days” when all leaders close their office doors and walk the hallways to meet with and talk to staff. “The interaction is second to none here,” he says.

Ed Finkel is a freelance writer based in Evanston, Ill.