Yes, Healthcare Employees Keep Score
The nurses were in trouble, and they knew it.
Covid-19 patients in the Critical Care Department were piling up at Ohio State University’s Wexner Medical Center. But the amount of Personal Protection Equipment (PPE) available to the nursing team was dwindling. Every time a nurse entered a room to administer medication or check equipment, fresh PPE was required. And with supply closet shelves increasingly bare, that was a problem.
A big problem.
But several nurses had heard about an innovation tried elsewhere that made life more convenient for staff and patients. Maybe, if done right, the technique could also solve their PPE shortage. What if the hospital used externalized IV pumps and placed them outside patient rooms? Nurses who do not step into rooms do not require fresh PPE. A two-week pilot test, new protocols, and a round of training later, the new approach was on its way to saving more than 4,500 full sets of PPE, as well as conserving expensive IV extension tubing.
Teams can solve only the problems they see
Wexner Medical Center was not the only health care facility blindsided by the Covid-19 pandemic. The need for more PPE was felt throughout the healthcare industry and health care workers responded in a dozen different ways. Some found ways to sanitize disposable masks for reuse. Others enlisted community support and lobbied Facebook friends to donate gear. And at Wexner, IV pumps were pulled into hallways.
Because the shortage was obvious and transparent, empty shelves need no explanation, teams rallied to search for solutions. But what about problems workers do not know about? Ones not on their radar because staff are never told about them? What solutions might staff suggest if health care managers were transparent about what is working, what is breaking, and what challenges are sneaking up over the horizon?
The power of data transparency
“Transparency is the new standard in business, including the health care business,” says Jon Thompson, author of The Dashboard Effect.
“Being transparent about challenges engages staff and acknowledges their value. It invites them to become active problem-solvers and helps them embrace accountability. Plus, transparency inspires trust in organizations and their leaders. When staff knows the score, they are far likelier to feel and act like a part of the team.”
Data transparency, especially about quickly evolving situations, might feel dangerous. Managers sometimes wonder how staff will react if it becomes clear all is not smooth sailing. Besides, health care facility spreadsheets are confusing. The metrics that keep a facility humming along profitably, including Treatment Costs, Readmission Rates, Wait Times, and Payer Reimbursement, quickly get complicated.
Thompson smiles when he hears this concern. “A simple dashboard tracking the metrics that matter most, and showing how you are doing today compared to last week and last month, is what you are after,” he says. “What your team wants and needs is actionable information, not to drown in data.”
And if anyone questions the power of data transparency in health care, Thompson suggests they consider what happens when transparency is not valued.
You’re transparent, whether you like it or not
Registered Nurse Bonnie Castillo was named to TIME magazine’s 2020 list of the world’s 100 Most Influential People not for curing cancer or championing a vaccine. She made the list because she insisted on transparency.
As executive director of National Nurses United, Castillo has advocated for many nursing-related reforms. But what landed her on TIME’s list was drawing national attention to the shortage of PPE for frontline nurses during the Covid-19 pandemic. She did so at a time when, at some hospitals, healthcare workers who went public with information about shortages were censured or fired. Castillo essentially outed health care organizations that were trying to suppress the severity of their situations, and she empowered nurses by the thousands to march, protest, and insist institutions make public information that directly impacted their lives.
There are two lessons to be learned here.
1. Transparency is not really optional.
Health care workers are educated, curious, and willing to do their homework. You are far better off providing information than being suspected of hiding it.
2. When providing data, make it data workers want to see.
Before the pandemic, no one besides the Supply Chain Office was keeping count of face masks. Front line workers just assumed they would get what they needed. But when it became clear that was not the case, front-liners looked for meaningful metrics about what was realistic to expect. Smart institutions quickly made providing that information a priority.
“That is the beauty of a data-driven, easily accessed dashboard,” says Thompson. “Once it is in place it is possible to swiftly add relevant metrics.” Speaking of the progress-measuring dashboards created by Blue Margin, Thompson says, “If it can be measured, we can create a way for reams of data to turn into simple, straightforward, actionable information. It is all in the execution.”
Be transparent, but about the right things
Be transparent. But what exactly do your healthcare workers want to know? How can you tell? Thompson suggests the obvious: ask them.
Engagement surveys
Provide insight into what is impacting employee satisfaction and engagement. Administered online these can be anonymous and collected within just a few days, providing a relatively tight snapshot of current morale and concerns. Include a length of employment indicator and run an extra report of what your most recent hires have to say. They are likely to see issues that more seasoned staff have learned to overlook or work around.
Pulse surveys
Contain just a few questions and permit gathering more targeted information. “On a scale of 1 to 10, how do you rate our response to the Covid-19 pandemic?” followed by a “Why did you give that rating” comment box provides a lightning-fast view of how staff is feeling. The American Medical Association offers several no-cost surveys to help monitor the impact of Covid-19 on frontline staff.
Employee roundtables with management
More time-consuming but capable of surfacing a rich list of concerns. It is important to listen only. Management defensiveness will not prove helpful as you compile hot issues to address. Follow up by thanking staff who participated and summarizing what you heard. It proves you were listening.
Address issues that arise in studies of nurses considering switching jobs or leaving their profession.
Nurses and midwives account for nearly 50 percent of all health care workers and their concerns are usually relevant to other workers. There is already transparency around some issues, such as benefits and professional memberships, but why not provide information that mutes dissatisfaction about other concerns such as workload distribution and scheduling options?
Once topics are selected and data sifted, this is where a Blue Margin dashboard will save you endless hours. Present the results in an easily digested fashion. Nobody knows what it means that you have 4,333 PPE in-house, but staff does know what it means that a three-week supply is on hand and more is on order. They know that means they can relax, and you have got their back.
Building trust with transparency
“Being open and transparent is one of the best ways to build trust and engagement,” says Scott Abel, the co-founder of Spiceworks. The trust comes with knowing what is really going on. And the engagement arrives when employees realize their daily behavior can move the needle on key numbers.
Note that last sentence: it is key numbers that count. Anything else is just noise, unimportant, and perhaps even irritating.
Now, more than ever, you need an informed, engaged workforce. That you are providing transparency regarding accomplishments, processes, and challenges signals your team is just that: a team. Everyone matters and everyone’s contributions are significant.
The transparency you provide will set you apart from many other healthcare employers, and that is a significant advantage for employee retention in a tight healthcare labor market. Nursing shortages have been a persistent challenge across the United States, and healthcare organizations that build cultures of trust and shared accountability are better positioned to retain the staff they have trained and invested in.
Now is the time to engender loyalty as you cement a culture of trust and shared effort. And one powerful way to make that happen is consistent, proactive data transparency. If you would like to explore how Blue Margin can help your healthcare organization build that visibility, contact our team here.
Three Key Thoughts
“Transparency is the new standard in business, including the health care business.”
“You are far better off providing information than being suspected of hiding it.”
“The transparency you provide will set you apart from many other healthcare employers, and that is a significant advantage for employee retention.”
