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Training’s “Lasting Effect” at Baptist Health Care

February 18, 2003
In 1996, patient satisfaction and employee morale at Baptist Health Care wereon life support. Nurses and medical staff, traditionally in short supply, wereleaving in droves. Those who stayed were unhappy.

    Today, the Pensacola, Florida-headquartered facility is a health-careindustry role model. Patient satisfaction has jumped nearly 90 percent, to the99th percentile. Staff turnover has been halved, to the teens. Employee moraleis at 83 percent, among the highest tracked by Sperduto & Associates, anAtlanta industrial-psychology firm. Baptist Health Care found a competitive edgeamong its employees.

    The turnaround earned Baptist a slew of awards, including being named one ofTraining Magazine's 100 best training organizations, the USA Today/RochesterInstitute of Technology Quality Cup Award, and The Herman Group's Employer ofChoice designation. For the past two years, Fortune Magazine has included itamong the top 100 best places to work.

Service as a battleground
    With salaries and perks at the market average, the big overhaul came in theform of ongoing leadership training and a system that recognized thecontributions of individuals, giving each a voice in the corporation. "We're anonprofit community-based organization that had lost its focus," says PamBilbrey, senior vice president of corporate development. "Instead of being aplace to provide the best health care, we became mired in the financial aspectsof staying afloat. The organization committed itself to a complete culturaltransformation. The health-care industry is such a competitive environment, babysteps wouldn't cut it."

    The one thing the hospital had going for it was a management team that wasmature enough to recognize that it was in trouble and would keep trying until itfixed the problem.

    "We were in the worst location of three hospitals in what ought to be atwo-hospital town," says CEO Al Stubblefield. "We realized we were nevergoing to outspend, outequip, or outprogram our competitors, which were part oflarger organizations with deep pockets. So we decided to build our competitiveedge in service and make that our battleground."

    Initially, the cultural overhaul enraged some of the workforce. "We lostsome people," Stubblefield says. "I remember one meeting where I told theboard we would arrive at the 75th percentile in customer service, when we werestill in the 20th. One of our senior officers said to me, ‘I don’t believewhat you just did to us. You just set us up for failure.’ Well, nine monthslater, we were there, but he wasn't. The point is, when you start down a journeylike this, there will be some people who don't get on board."

    After an initial stab at an 18-month leadership training program, themanagement revamped it into an ongoing process that taught staff new ways ofinteracting with each other--namely, supervisors had to be just as accountableto their staff as their staff was to them. While initially tough for supervisorsused to having the final word, it gave voice to previously "invisible"workers. Such behavior, the company decided, has to be constantly reinforced.

    The solution was Baptist University, which offers mentoring and new stafforientation; classes for its 5,200-member workforce on time management, team-and skill-building, resolution conflict, and effective meeting strategy; andsurveys to determine personal and institutional weaknesses. Staff earn frequentrecognition, both serious and silly, ranging from gift certificates forexemplary work to Incredible Hulk dolls for helping to move office furniture.

    At the same time, employees consistently assess superiors through anonymousprogress reports. There are even courses to help people weather criticalfeedback and look at that feedback as an opportunity for improvement, "so theydon't go off the deep end," says Bilbrey.

    Every three months, 500 supervisors from the organization's five hospitalsand two medical parks in Florida and Alabama come together for a full day ofworkshops, keynote speakers, and activities packaged in themes like football orthe movies. Stubblefield says that people dressed up as different moviecharacters, and he did his quarterly report in full Superman regalia, wearingtights and a red towel pinned to his back.

A lasting effect
    Baptist is now moving toward each employee getting 60 hours of education andtraining a year--a goal it hopes to reach by 2005.

    "We don't just train to train," says Bilbrey. "It has to have a lastingeffect. We have a strong belief that leaders are teachers." Leaders walk outwith kits that summarize what they have just learned and provide exercises,transparencies, and scripts to impart that information to their staffs within 60days, with the goal of raising their entire knowledge base.

    While it costs Baptist $120,000 a year to maintain the University,cost-saving ideas generated from the programs have shaved $2.3 million fromoperations, and the system's market share has risen every year for the past fiveyears. It has even created a consulting division, Baptist Health Care LeadershipInstitute, to help other companies achieve similar goals. The Institute puts onseminars for outside hospitals and sells 15-minute training videos.

Money may be overrated
    John Sullivan, a San Francisco State University management professor, saysthat non-monetary incentives--like a feeling that one’s work is helping theorganization--are a strong driver in a hospital. "People who go into nursingdo so to make a difference, as opposed to more finance-oriented professions,"Sullivan says. "How they are treated and the kind of impact they can have onan organization will often attract and retain them more strongly than marginallybetter salaries."

    Two years ago, Sullivan says, the gap between demand and supply of nurses wasabout 6 percent. As the baby boom generation ages and the general populationgrows, that shortage could more than triple to nearly 20 percent in 10 years. In2000, less than 10 percent of the nursing workforce was under 30. "You don’thave to look behind closed doors to find out that the health-care industry isreally scared about this," he says.

    More immediately, Baptist Health Care is trying to smoothly transitionbetween old and new work environments. "We're now looking at generationaldifferences in workplace culture," Bilbrey says. "Boomers tend to live towork, and are used to a limited number of careers, while Gen-Xers work to live,change careers every five to seven years, and prefer everything electronicbased."

One employee’s story
    Bilbrey says, "People who come to the organization say that when you walkin the door, you can feel the difference. People seem happy--they speak to youand smile. There's just a more caring environment."


People who come to the organization say that when you walk in the door, you can feel the difference.

    One who’s smiling now is Lynn Pierce, a critical-care nurse. In 1995,Pierce had just gotten promoted to a supervisory position and wasn't in the moodfor some newfangled approach to barking orders. "I didn’t always want toserve my staff," she says. "Based on what I'd seen of how past leadersapproached the job, I was the boss. It was more ‘You did this wrong’ insteadof ‘What can I do to help you fit into our culture?’ "

    Pierce assumed that the University would be a huge waste of time. "Myattitude was, You gave me a job, now let me do it. I did not want to get onboard. If I hadn't just purchased a car and needed to keep up my car payments,I'm not sure I would have stayed."

    Slowly, the training won her over. "I began learning the true definition ofaccountability," she says. A pivotal moment came when Pierce's staff unjustlyaccused her of playing favorites in scheduling Christmas shifts. "In truth,"she says, "it was my assistant who made the schedule, but I signed off on it,so I was ultimately responsible. I was really hurt and wanted to shout, ‘Howdare you accuse me!’ Instead I told my staff, ‘I have failed you as aleader. You have the perception that I am unfair and biased. Help me understandthe behavior I exhibited to give you that impression.’ It won my staff over."

    Today, Pierce is the first to admit that great nursing skills are not enough.You also need a good attitude, humility, and respect for coworkers.

    "Baptist University helped me become not only a better leader, but also abetter person," she says. "I have no problem now pulling a coworker aside totell them their behavior doesn't fit into our corporate culture. Before, themethod would have been to ignore it, then trash the person when they left. We'reless passive-aggressive and more caring of each other. It gives us such a senseof pride to work for an organization that respects its people."

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