A RURAL HOSPITAL SUCCESS STORY

1
A RURAL HOSPITAL SUCCESS STORY

• Persistence Prevails
• When All Else Fails
• Morris Eagleman, VP Patient Care Services
• Mercy Medical Center Mt. Shasta

2
Background

• Seven Years Ago..
• Multiple openings
• DOC Scores of 59
• Lower third of CHW in Patient Satisfaction
• High turnover rate

3
The Road to Recovery

• Management Right People on the Bus in the Right
  Seats
• Recruitment Retention A Systematic Approach
• System Processes for Success

4
ManagementRight People on the Bus in the
Right Seat
5
Organization Development Program

• See Handout 1
• Mercy Medical Center Mt. Shasta is dedicated to
  providing outstanding care to our community. As
  such, Mercy Medical Center Mt. Shasta believes
  that it is imperative to recruit, retain, and
  train excellent supervisors, managers, and
  directors who will guide our hospital into the
  future.
• As a Christian based hospital Mercy Medical
  Center Mt. Shasta has the following management
  philosophy

6
Management Philosophy

• The leadership team at Mercy Medical Center Mt.
  Shasta will direct and guide care to the
  community we serve with our core values and
  mission evident in all that they do. They
  embrace a respectful, trusting, collegial
  relationship among our entire health care team.
  Our leaders are of good character and lead with
  integrity. They are honest, diligent, credible,
  consistent, and demonstrate a good work ethic.
  Our leaders are able to make decisions, accept
  the consequences without blaming others, admit
  mistakes, and standby their decisions. The
  leaders at Mercy Medical Center Mt. Shasta
  utilize the following principles

7
Performance Principles

• Leaders support the team approach. They promote
  interdependence and cooperation, not independence
  and rivalry.
• Leaders use resources wisely. They dedicate
  these resources wisely. They dedicate these
  resources to the success of the organization, not
  just specific department. Resources are expended
  in accordance with the mission and vision.
• Decisions are made in a timely manner.
• All decisions are communicated to those affected.
• Communication in all directions is open, clear,
  timely, and direct.

8
Performance Principles Contd

• There is no third party communication.
• Leaders continually seek advice, perspectives,
  and participation from all.
• When a decision is made the leaders support it
  and strive for its success.
• Leaders create an environment free from fear of
  reprisal and unwarranted insecurity.
• All team members are treated with respect,
  dignity, and compassion.
• Leaders apply standards for performance and
  conduct evenly and fairly. They personally abide
  by these standards themselves.

9
Performance Principles Contd

• Leaders assist those they serve by helping them
  reach their potential in their personal and
  professional lives.
• Leaders are visible, accessible and actively
  engage in supporting caregivers on a daily basis.
• Leaders encourage and support action, creativity
  and problem solving
• Leaders view mistakes as lessons and
  opportunities for improvement.
• Leaders celebrate the contributions and
  achievements of individuals, teams, and the
  organization.

10
Organizational Development Classes

• Examples of Classes
• Leadership
• A Culture of Safety
• Working in a Union Environment
• Positive Discipline
• Mercy Medical Center Mt. Shasta has 4 6
  organizational development classes each year.
  Each manager must attend each class and share the
  content with their staff.

11
Recruitment RetentionResearch Review

• General Information
• According to the Nursing Executive Survey
• Nurses are extremely dedicated to their
  profession, not to the employers.
• Nurses will migrate to facilities that have an
  environment that is conducive to delivering good
  care to patients.
• Only 51 of RNs intend to stay at their present
  position for the next several years.
• These findings are consistent with A.O.N.
  consulting and AHA surveys which also found that
  few nurses plan to stay with their current
  employer more than 3 years.
• Survey for RN Magazine Why RNs Change Jobs
  Reported
• Number one reason workload, staffing
• Inadequate managerial skills from their frontline
  manager
• Lack of flexible scheduling (being able to see
  little Johnnies ballgame)

12
Recruitment RetentionResearch Review Contd

• Healthcare Advisory Board Summary
• According to their survey there is a strong
  correlation with their direct manager, 84 are
  strongly considering leaving their employer (most
  do leave)
• Research indicates very high turnover rates of
  RNs when one is recruited from an urban area to
  a rural areas

13
Recruitment and RetentionPrograms

• Job Shadowing see handout 2
• Work Study
• Scholarship
• Forgivable Loan see handout 3
• Work with the local Junior College
• Expansion of existing programs
• Grant
• R.N. program Fall 2007

14
Recruitment Retention Programs

• Hiring Practices
• Hire for attitude, train for skills
• H.R. Screen
• Vice President meeting with the applicant
• Interview by manager and staff (focus on are
  they a fit for the organization)
• Employee Recognition Program
• STAR Program
• Line 100 Program
• Cards and Letters to employees homes
• Small gifts e.g. gift certificates, candy

15
Recruitment Retention Programs

• Work Environment
• Bad Apple Syndrome
• Medical Staff Relationships
• Positive Discipline Coaching not Punishment
  see handout 4
• Remediation Process
• Retention Questions

16
Systems Processes For Success

• Rounding of Employees see handout 5
• Rounding by Nursing Managers
• Hourly Rounding by Staff
• Discharge Phone Calls
• Annual Patient Satisfaction Classes Mandatory for
  all Staff
• Key Words
• Scripting
• 5 Fundamentals of Service AIDET
• Managing Full Circle
• Rounding
• Recognition Program
• Staffing Models

17
Results

• DOC Score
• Organizational Effectiveness 86
• Overall Score 82
• Low Turnover Rate
• No Nursing Openings
• Patient Satisfaction Jan 06 Sept 06
• Likely to Return Score 95.79 /Rank 1
• Likely to Recommend Score 94.47 /Rank 1
• p.19
• Overall Satisfaction Score 95.17 /Rank 1
• Nursing Score 94.44 /Rank 1