Human Resources' Role in Improving Patient Safety & Quality of Care
The following article is written by Michael DiPietro, vice president of marketing and product management at HealthcareSource, a provider of talent management software for the healthcare industry based in Woburn, Mass.
Patient safety and quality care are top priorities for healthcare organizations. In the age of healthcare reform, every healthcare organization is focused on how to quickly develop better processes for providing quality care and improving their patient safety ratings. Starting in October of this year, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results will be tied to Medicare and Medicaid reimbursements, and patient satisfaction and patient outcomes will start to impact the financial solvency of hospitals across the country.
As a revenue saving department, rather than a revenue generating department, human resources should demonstrate its value by implementing initiatives to hire and retain employees who will provide the best possible care, in turn increasing patient satisfaction. In this article, we'll review the following critical HR functions that can be revised and improved to enhance patient care and increase patient safety:
- Reduce turnover
- Hire for fit
- Focus on retention of top performers
- Improve employee engagement
Take steps to reduce turnover
Organizations that frequently lose employees and are in a constant mode of replacing them are more likely to struggle with maintaining patient satisfaction and safety. According to Miranda Maynard, employment supervisor at EMH Healthcare in Elyria, Ohio, "By definition, a new person is less productive. A new person is going to not only be less productive, but less efficient. If an organization is constantly reorienting employees because of turnover, that means more new employees are interacting with patients in an unproductive and less efficient manner. Patient safety and satisfaction decrease as a result."
How can healthcare organizations ensure a reduction in turnover? It starts with hiring the right employees — patient-focused caregivers who are a good cultural match for the organization. Ms. Maynard recommends using behavioral assessment software to evaluate potential employees based on behavior. Through their behavioral assessment solution, Ms. Maynard and her team at EMH Healthcare have been able to show correlations between the interview and the end result — the quality hire. "As we continue to use this tool, we'll see a meaningful decrease in terminations based on behaviors that are not in line with providing quality care for our patients and do not match the 'patient first' values of our organization."
In addition to evaluating competencies, when hiring for fast-paced environments, such as emergency room care, organizations need to bring employees on board who will take the time to consider what they're doing and follow the correct processes no matter the situation. "Even though it's a fast-paced ER environment, employees need to consider what they're charting and follow the process," says Jason Gallo, recruiter strategist at Loma Linda (Calif.) University Medical Center. "Same goes for hiring employees to work in the OR — you want to know they're committed to following a chain of command and not just shooting from the hip." Mr. Gallo and his team follow behavioral based interviewing practices and gear interview questions around past experience to predict future patient-centric behavior.
To implement a successful strategy around hiring for patient-focused behaviors, organizations should consider providing leadership training on the interview process. "We created a Leadership Development Institute and every quarter, all of our leaders, directors, managers, supervisors and client leads attend our leadership seminar," says Tyler Newton, recruiter at Sonora (Calif.) Regional Medical Center. "Last spring, HR presented on behavioral interviewing at our leadership seminar and provided our managers with training on how to utilize these techniques."
Merely reviewing previous experience and employing an unmeasured approach to evaluating candidates may not provide organizations with the employees they need to ensure patient safety. Implementing a consistent and structured interview process across departments based on hiring for patient focused behaviors will ensure organizations are staffed with employees who positively impact patient safety.
Retain and engage top performers
Creating a patient-centric culture can only happen by increasing employee engagement and retention. Through playing a role in retaining high-performing caregivers, HR is not only providing a cost savings to their organization, it is also improving patient safety. One way to improve retention and increase engagement is to education employees.
"When employees are engaged in the work they're performing, they are going to perform better, and they care more about the patient experience," says Ms. Maynard.
Mr. Newton agrees. "If your employees are satisfied and they really like their job, they're going to treat their patients well, which will increase patient satisfaction and the quality of care they're providing," he says.
However, as the market becomes more competitive, the basic required continuing education for healthcare may not be enough to retain top performers. Organizations need to provide employees with learning opportunities that go beyond what's required by The Joint Commission. For example, diversity training could play a key role in providing a higher quality of care. According to Ms. Maynard, "Whether it's religious or cultural or linguistics, I think organizations need to give employees the opportunity to give better, safer, higher quality care by educating them on how to do so for a diverse population."
When it comes to ambulatory care and emergency surgery, this becomes particularly important since caregivers have to act fast but still communicate with patients in a respectful and highly productive manner. HR can lead the way for an organization by putting continued education programs in place that will benefit patient safety. "Show as an organization that you're investing in your employees, and in turn they will invest in you," Ms. Maynard says.
Mr. Gallo believes employee satisfaction is not just about pay raises — it's about involving them in more organizational processes and decisions. "If someone's not challenged, you can give them a raise but it won't keep them," he says. "Finding a balance of paying them fairly and providing opportunities to learn, grow and challenge their clinical or professional skills is a good way to retain top performers."
To further engage employees, HR has taken the lead at Loma Linda University Medical Center by instituting a peer interviewing strategy. According to Mr. Gallo, "It challenges them to have a buy-in not only in the interview process but with who we hire. That buy-in is important because with our employees involved in the interview process, we've developed more cohesive teams overall." Structured peer interviewing should result in employee engagement, quality hires, and in turn patient satisfaction and safety will improve.
Build and encourage a patient-focused culture
When it comes to patient safety, HR can impact a hospital's bottom line by sourcing and hiring employees who fit into the organization's culture, focusing on retention and contributing to learning initiatives that increase employee engagement. In the end, the most important component of maintaining patient safety is making sure employees buy in to a healthcare organization's values and culture.
As Mr. Newton says, describing the environment at Sonora Regional Medical Center, "Our employees are really committed to the mission of the hospital — you can't walk down the halls without someone looking at you and smiling and saying good morning and good afternoon." Hiring the right people and retaining them will create the best possible environment to ensure quality care and exemplary patient satisfaction and safety ratings.
To summarize, here are seven critical steps HR should take to help improve care quality and patient safety:
- Hire the right employees
- Conduct leadership and diversity training
- Structured interviewing including peer-to-peer interviews
- Educate employees
- Involve employees in organizational processes and decisions
- Ensure employee buy-in to your organization's values and culture
- Develop and encourage a patient-focused culture
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