EMPLOYEE ENGAGEMENT STRATEGIES AND THE IMPACT ON THE VALUE EQUATION

Presented by:

Ryan Wilson-Flores, MBA, LNFA – Principal , Healthcare

Workforce Insight

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With ever-changing reimbursement models, increased margin pressure, and forecasted staffing shortages, employee engagement (retention) will be imperative to controlling costs and improving outcomes. This session will explore the following:

WHAT YOU WILL DISCOVER

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• Case study to discuss current state environment and reveal impact of employee turnover to financial and quality outcomes within Valley market

• Discuss strategies for achieving employee engagement as it relates to Maslow’s hierarchy of employee needs

• Explore by what methods financial leaders can evaluate the efficacy and support employee engagement initiatives

CURRENT STATE & FUTURE PROJECTIONS, PRESSURES &

CHALLENGES

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CURRENT ENVIRONMENT

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Physician Shortages

Nursing Shortages

EXPENSE PER CMI ADJUSTED DISCHARGE

$4,855

$2,292

$690

$3,685

$1,967

$618

$- $1,000 $2,000 $3,000 $4,000 $5,000 $6,000

Operating Expense

Salary Expense

Supply Expense

50th Percentile - Valley Sample

QUALITY

99

75

99

71

66

0 20 40 60 80 100 120

Infection from a Urinary Catheter

Central-Line-Associated Blood Stream Infections

Surgical Site Infection from Colon Surgery

Clostridium Difficile Infection

Methicillin-Resistant Staphylococcus Aureus Infection

HOSPITAL ACQUIRED INFECTION PERCENTILE

QUALITY

71

74

5

67

81

87

84

40

0 20 40 60 80 100

Stroke

Pneumonia

Hip/Knee

Heart Failure

Heart Attack

COPD

CABG

All Cause Hospital-Wide

READMISSION RATE PERCENTILE

SATISFACTION

31

9

7

8

9

16

26

0 5 10 15 20 25 30 35

Patients who reported yes they would definitelyrecommend the hospital

Patients who reported that their nurses Alwayscommunicated well

Patients who reported that their doctors Alwayscommunicated well

Patients who reported that they Always received helpas soon as they wanted

Patients who reported that their pain was Always wellcontrolled

Patients at each hospital who reported that yes theywere given information about what to do during…

Patients who reported that their room and bathroomwere Always clean

PATIENT EXPERIENCE PERCENTILE

0 1 2 3 4 5

Summary Star Rating

SUMMARY STAR RATING

EFFICIENCY

19

69

8

7

21

0 20 40 60 80

LEFT WITHOUT BEING SEEN:Percentage of patients who left the Emergency Department before being seen

MINUTES BETWEEN INPATIENT DECISION AND LEAVING ED: Average (median) number of minutes patients spent in the Emergency Department after the Doctor decided to admit them as an inpatient before leaving the ED for their inpatient room

MINUTES IN ED - BEFORE INPATIENT ADMISSION: Average (median) number of minutes patients spent in the Emergency Department before they were admitted to the hospital as inpatient

BEFORE SEEN BY HC PROFESSIONAL: Average number of minutes patients spent in the Emergency Department before they were seen by a healthcare professional

BEFORE BEING SENT HOME: Average number of minutes patients spent in the Emergency Department before being sent home

EMERGENCY DEPARTMENT THROUGHPUT PERCENTILE

EXPENSE PER CMI ADJUSTED DISCHARGE

$4,855

$2,292

$690

$3,685

$1,967

$618

$- $1,000 $2,000 $3,000 $4,000 $5,000 $6,000

Operating Expense

Salary Expense

Supply Expense

50th Percentile - Valley Sample

$18.1 M

COST OF CARE &INEFFICIENCIES IN THE COST OF CARE

DELIVERY

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COST PER CASE

MANY ASPECTS OF CARE DELIVERY IMPACT LABOR COSTS

OVERHEAD & SHARED SERVICES COSTS

SUPPLY UTILIZATION & PHYSICIAN PREFERENCE

ANCILLARY & CLINICAL SUPPORT SERVICES PROCESSES

LABOR MANAGEMENT & PRODUCTIVITY

PHYSICIAN EFFICIENCY & PRODUCTIVITY

CLINICAL UTILIZATION VARIATION (level of care, clinical services, etc.)

SURGICAL & PROCEDURE SERVICES PROCESSES

LENGTH OF STAY & PATIENT THROUGHPUT

SALARY EXPENSE PER CMI ADJUSTED DISCHARGE

$325

$26

$40

$- $50 $100 $150 $200 $250 $300 $350

Salary Expense

Contract Premium Overtime Premium 50th Percentile Variance

$7.3 M

$18.1 M

STRATEGIES THAT IMPACT OVERTIME & CONTRACT LABOR

1) Staffing resources by skill needs to volume demand

2) Scheduling resources by skill needs to volume demand

3) FTE hiring needs by skill, FTE status and recruitment process

4) Orientation requirements by service line, skill and experience level

5) Staff occurrences of incidental time

6) Staff occurrences of missed meals

7) Management of 1:1 observation patients

8) Management of absenteeism process

9) Management of non-productive utilization

10) Employee engagement and retention

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FOCUS OF THE FUTURE IN LABOR COST OPTIMIZATION & IMPROVEMENT

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Employee Engagement

Patient Satisfaction

Patient Volume

Financial Results

SHIFT FROM VOLUME BASED TO VALUE-BASED CARE

Continuous improvement and “Lean thinking” will be fundamental to an organization’s success

Quality & Outcomes

Graban, Mark. "Lean: Transforming Healthcare Delivery by Uncovering Opportunities Within Your Greatest Asset." Kronos. Webinar, . 27 Jan. 2015. Lecture.

Companies on the top quartile of employee engagement report:

• 22% higher profitability

• 21% higher productivity

• 37% less absenteeism and employeeturnover

• 48% fewer safety incidents

• 41% fewer defects

SHIFT FROM VOLUME BASED TO VALUE-BASED CARE

Shift to Value Based Care

Emp

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nga

gem

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Shift to value-based care will increase emphasis on patient satisfaction and employee engagement at every level of the organization

"Business Results Through Recognition | Globoforce." Globoforce. N.p., n.d. Web. 09 Oct. 2015.

ENROLLED

IMPACT OF ENGAGEMENT ON RETENTION

18"Employee Engagement and Organisational Performance." Performance Magazine Employee Engagement and Organisational Performance Comments. N.p., n.d. Web. 09 Oct. 2015.

ENGAGED

DISENCHANTED15%

35%28%

15%

DISENGAGED

UNDERSTAND EMPLOYEE NEEDS & ENGAGEMENT STRATEGIES

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MASLOW’S HIERARCHY OF NEEDS

Progress:According to Maslow, to move up the pyramid each lower need must be met.

Needs:Failure to meet the needs at a lower level disrupts a person’s ability to progress.

Self-Actualization

achieving one’s full potential, creativity

Esteem prestige and feeling of

accomplishment

Belongingness and loveintimate relationships, friends

Safetysecurity, safety

Physiologicalfood, water, warmth rest

MASLOW’S HIERARCHY OF NEEDS

Self-Actualization

achieving one’s full potential, creativity

Esteem prestige and feeling of

accomplishment

Belongingness and loveintimate relationships, friends

Safetysecurity, safety

Physiologicalfood, water, warmth rest

Basic needs

Psychological needs

Self-fulfillment needs

Self-Actualization

achieving one’s full potential, creativity

Esteem prestige and feeling of

accomplishment

Belongingness and loveintimate relationships, friends

Safetysecurity, safety

Physiologicalfood, water, warmth rest

MASLOW’S HIERARCHY OF EMPLOYEE NEEDS

Compensation & Benefits

Positive Working

Environment

Personal Development

Self-Actualization

Esteem

Belongingness and love

Safety

Physiological

MASLOW’S HIERARCHY OF NEEDS & EMPLOYEE ENGAGEMENT

"How Maslow's Hierarchy of Needs Influences Employee Engagement." Scancapture RSS. N.p., n.d. Web. 09 Oct. 2015.

What can I do for others?I inspire others to do their best.

I love working here. I’m a high flyer.

I’m a vital part of the business. I feel important at work. I’m really busy and very likely highly stressed.

I’m an achiever. I’ll leave if something better comes along.

I know I am part of something bigger. I like working here but wouldn’t shout it from the roof tops.

I might leave if I’m tempted. There are no career development prospects here.

I am interested in overtime. I have more sick days than I should. I have poor working conditions.

I don’t like my manager/ working in my team. I don’t like my job much but I can get on with it.

I’m here for the money. I’m leaving when I can.I’m not satisfied with the job I do.

My work doesn’t excite me. I’m a clock watcher.

Self-Actualization

Esteem

Belongingness and love

Safety

Physiological

STRATEGIES FOR EMPLOYEE ENGAGEMENT

"How Maslow's Hierarchy of Needs Influences Employee Engagement." Scancapture RSS. N.p., n.d. Web. 09 Oct. 2015.

• Recognition of achievement from organization, management and peers

• Career pathways/ladders to pursue career advancement

• Respect and trust from peers and management• Gym discounts for physical well being• Training and development to ensure

confidence in role• Team building activities and socials• Means of recognition from work peers

• Medical/Healthcare benefits• Employee assistance programs• Personal security of employee

and property

• Base compensation• Cafeteria/meal discounts

and payroll deductions• Shopping discounts, car

pooling programs, etc.

• Facilitation & encouragement of creativity & problem solving• Facilitation and encouragement of personal development• Succession planning and leadership development• Training and development to achieve goals outside of role• Mental/financial well being initiatives

EVALUATE THE EFFICACY OF ENGAGMENT

INITIATIVES

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EVALUATION OF EMPLOYEE ENAGEMENT INITIATIVES

Cost Impact?

• Does the initiative meet or exceed the community standard?

• What need does it meet in Maslow’s hierarchy of needs?

• Is the identified need on the higher end of Maslow’s hierarchy pyramid?

Employee Benefit?

WHERE DOES YOUR ORGANIZATION FALL?

AWARENESS

UNMANAGED

ADOPTION

CONTROL

L A B O R C O N T R O L C O N T I N U U MTM

$5 Million -$15+ MillionLabor Cost Reductions

AWARENESS

UNMANAGED

ADOPTION

CONTROL

H E A LT H C A R E W F M M AT U R I T Y C O N T I N U U MTM

Q & A

Questions & Answers