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Creating a Culture

Health First wanted its employees to feel that it was the best place to work. This was the wellspring from which came quality, service and customer satisfaction.

November 26, 2003
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Management consultant Jac Fitz-enz cites Health First, a nonprofit chain of hospitals based in Rockledge, Florida, as the best example of a company that successfully matches corporate goals with the actions of individual employees. Ten years ago, he notes, Health First was "falling apart because of terrible patient care, out-of-line costs, lousy morale and high turnover."

    Health First set five goals at the top, including improving patient care and managing costs. "They cascaded these goals down to each operating unit," Fitz-enz says. "At the beginning of the year, each boss sat down with each individual employee and said here are our five imperatives and here is your part of it. You need to reduce the operating cost of your position by 5 percent, and we’re going to check that you have done so on July 1." The hospital formed teams on the issue, and half of people’s pay was based on individual and team performance. In the space of a year, patient satisfaction nearly doubled.

    Bob Suttles, vice president of human resources for Health First, says the company continues to align human resources initiatives with the organization’s strategic objectives. Three years ago, it identified as its major human resources issue a challenge that is endemic to the health-care industry: finding adequate numbers of professional and technical staff. The solution, Health First decided, was to become branded as the employer of choice in its area. In this case, the branding was internal; the company wanted its own employees to feel that this was indeed the best place to work so they would communicate that message in a grassroots way. Health First sensed that employee satisfaction was the wellspring from which came quality, service and customer satisfaction.

    "We are using a methodological approach and survey tools to build a specific culture where people feel they can make a difference and their input matters," Suttles says.

    The key tool is the Gallup National Survey C12, an employee-satisfaction survey using 12 questions that carry many of the same themes as the Cardinal Health questionnaires, such as "my opinion seems to count" and "my supervisor cares about me as a person." Managers’ merit increases are tied to their survey results. HR teams perform "interventions" with low-scoring managers, giving them input on how they can make the work environment more positive. "The monitoring system holds managers accountable to motivate their staffs to their highest performance," Suttles says. "The average workplace does a poor job of recognizing people and aligning compensation with results."

    In three years, Health First’s employee-satisfaction rating has jumped from a mediocre 68 percent to a high 84 percent. As a result, nursing vacancies now run at approximately 3.5 percent at the company’s three hospitals, about a third of the state average of 9.9 percent. In addition, turnover rates are 75 percent below the state norm. Health First’s approach is to keep managers focused on a handful of high-priority items that are measurable. "Managers who are open and approachable tend to have a great relationship with their staff," Suttles says. "Those who have a dictatorial style and are not open to constructive criticism probably aren’t even aware they shut the door to input.

    "So much of this is common sense, and how slow some managers are to recognize the value of creating an incredibly positive work environment," Suttles adds. "Innately, people say you need to do it, but it isn’t a priority."

Workforce Management, December 2003, p. 45 -- Subscribe Now!

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