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Creating and Driving Value
Now that we have determined which group of employees can have the greatest impact on patient outcomes, and thus represent key drivers of value within the organization, our next task is to decide what they can do to achieve their goals. In order to answer these questions, we must develop an understanding of what determines patient outcomes, and the overall impressions of the hospital. We must ask which elements of the patient's experience are likely to result in a return to the facility for future treatments and procedures, or which ones are likely to make them recommend the facility to others. These questions are at the heart of driving value for the organization.
There are several methods that could be used to determine the answers to these questions. One way would be to conduct a patient survey. Another way would be to examine records of complaints that were filed in the past. Regardless of the method used to determine which factors are most important in determining patient value, this is an important step in creating value. Once these items have been identified, one must then ask what staff can do to help promote patient satisfaction. Identification of specific actions that staff can take to improve patient outcomes can be used to develop certain goals directly related to human resources actions.
For the purposes of the development of this dashboard, certain assumptions will be used to develop the dashboard. The following elements will be used as key metrics in the development of the dashboard: percentage of patients that return within one year for additional services, overall patient satisfaction survey scores, reduction in number of medical mistakes, number of patient referrals on patient survey. These measures represent elements of customer satisfaction. However, in order to tie customer outcome to human resources, other things must be taken into consideration.
Staff attitudes and satisfaction are directly tied to organizational outcomes. Job satisfaction among staff is directly related to perceived organizational value and performance (Reisel, Chia, & Maloles et al., 2007). Attitudes are contagious, which can work for benefit or harm to organizational outcomes. Job satisfaction has a direct impact on other metrics used to measure human resources department performance. The most obvious areas to be affected involve employee retention and advancement.
At the current time, the U.S. faces a nursing shortage. Many impacts on patient outcomes, job satisfaction among nurses, and other effects on departmental efficiency have been linked to the nursing shortage (Cowin, Johnson, & Craven et al., 2008). The human resources department has a direct impact on helping to resolve staff shortages and to increase staff retention at their facility. Many factors have been linked to the nursing shortage. Many of these factors tend to compound one another. For instance, the nursing shortage means increased load for the current staff, which can lead to burn out and staff retention problems (Al-Hussami, 2008).
Many factors were found to be related to job satisfaction and retention of nursing staff. Aside from increase responsibilities and workload, the amount of support that they felt they received from upper management was found to have a significant impact on job satisfaction (Al-Hussami, 2008). An experienced nursing staff that is happy in their jobs is a valuable asset in both human resources and organizational goals. Retaining staff goes beyond incentive packages and bonuses. In order to retain an excellent staff, human resources must take measures to help improve organizational effectiveness on all levels.
This discussion has focused on nursing staff, rather than on others on the same level of the organization, in terms of patient contact. This is largely because the greatest effort needs to be placed on the element of the equation that will have the greatest impact on improving patient outcomes and satisfaction. Doctors, cleaning personnel, and other caregivers have a high degree of patient contact, but it is felt that the patient has a much greater amount of contact with the nursing staff. The nurse spends more time with the patient than other staff members. Other caregivers, including doctors, often only spend a few minutes of each day with an individual patient. It is the nursing staff with which the patient forms the closest bond. The nursing staff has the greatest impact on forming bonds with the patient and on ensuring their quality of care. Nurses are key drivers of value in a hospital organization.
Now we have established the elements of the staff that can have the greatest impact on overall organizational goals. Human resource goals, which focus on the retention and satisfaction of nursing staff, are in alignment with organizational goals. We found several key factors that have a direct impact on the ability to promote job satisfaction, and thus create value, for the organization. These elements will be discussed in greater detail, along with the established goals of leading and lagging indicators.
Job Satisfaction and Company Attitudes
Job satisfaction and company attitudes will be measured via a survey. The survey will take the form of Likert-type questions that can be easily transformed into numerical data and scales. This survey will explore nursing staff satisfaction with management, communication between other nurses, between nurses and patients and between nurses and administration. The survey will also explore their satisfaction with pay, benefits, workload, working hours, and other elements of their working conditions. It will also explore their amount of job satisfaction, attitude toward the organization, and opportunities for personal and professional growth. These factors will be combined into an average score, which will be used to determine an overall Human Resources Scorecard Value. This single numeric value will appear on the dashboard as a single element. This element will be used as a leading indicator and measured quarterly. The overall lagging goal will be to achieve a score of 4.0 or better within one year.
Staff performance will be measured by a combination of employee retention. It is the goal of the human resources department to achieve a 90% retention rate in the next year. As assessment of retention rates will be performed quarterly as a leading measurement to the lagging goal. The surveys mentioned previously are designed to help evaluate specific items that could be improved in order to improve retention rates.
Customer satisfaction is the final element to be included on the dashboard. This element will be measured through the accumulative averages of patient satisfaction surveys, presented to all patients at the time of discharge. Like the job satisfaction and company attitudes survey, these will be conducted in Likert-style and will result in a final average customer satisfaction rating. However, the measures will go from 1-10, with a possible 100 points per questionnaire. The lagging goal will be to retain a 95% or better customer rating. Leading measurements on this goal will occur on a monthly basis so that problems can be addressed as quickly as possible.
These three measures will provide the basis for achieving company goals and driving human resource value. The measures in themselves are complex, but they are combined into three easy metrics that administration can use to quickly make needed changes. It is apparent that achievement of short-term goals is an essential element in the achievement of long-term growth and stability of the organization. These metrics will provide the basis for continued improvement and grown of this hospital.
Human Resources Dashboard 2010
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Cowin, L., Johnson, M., & Craven, R. et al. (2008). Causal modeling of self-concept, job satisfaction, and retention of nurses. International Journal of Nursing Studies. 44 (10):
1149-1459. Retrieved January 31, 2010 from http://www.journalofnursingstudies.com/article/S0020-7489%2807%2900253-2/abstract
Reisel, W., Chia, SL., & Maloles, C. et al. (2007). The effects of job insecurity on satisfaction and perceived organizational performance. Journal of Leadership & Organizational
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Russell, J. (2004). Building and Using the HR Scorecard/Dashboard. Retrieved January 30, 2010
Job Satisfaction and Company Attitudes
Goal - 90% Retention
Goal - 4.0 Overall Rating
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