September 2003
With the beginning of the school year comes a challenge for
both hospitals and those employees who have children in elementary school:
parents’ difficulty in finding alternative child care when schools
unexpectedly close for weather emergencies often translates into difficulty in
staffing hospitals.
Doctors Community Hospital in Prince George’s County
has, however, found the answer — or rather, created an answer. Charlene
Lundgren, vice president for human resources, explains: “About eight years
ago, we decided to develop our own on-site child care center for staff who
didn’t have other arrangements when schools closed for emergencies.”
Lundgren, who as a parent once struggled with just this issue, championed the
idea.
It’s a practical idea, since much of what is needed to
equip a child care center is already on hand at hospitals. “As soon as a
school closing announcement is broadcast, our departments go into action,”
says Lundgren. “Housekeeping staff vacuums the space, and material
services personnel bring in chairs, tables, blankets, and pallets. Food service
workers begin to prepare extra breakfasts, lunches, and two snacks.”
In the center’s first few years, hospital HR staff,
along with supervisors and managers from non-patient care areas, were converted
into child care staff as their schedules allowed. Over time, however, as the
center attracted more participants (any employee scheduled to work who has a
child 5-12 years of age may use it at no cost), Lundgren and Lark Dobson,
director of employee relations, decided that hiring non-hospital staff for the
center would work better: hospital departments wouldn’t be drained of
personnel, and the children would have a more consistent set of care
givers.
A convenient solution was provided by the Prince
George’s County school system, which identified two teacher’s aids
who agreed to work at the center when school was closed because of inclement
weather. Lundgren says that the teacher’s aids have brought a little more
formality to the program: “They bring workbooks, and they lead songs the
children already know from school.” In addition, Lundgren has what she
calls the “luxury” of center coordinator Lark Dobson’s
background in elementary education to draw from; Dobson spends her day in the
center when it is operating.
The child care center is a hit with both parents and
children, says Lundgren. “The children love the program; they look forward
to school being closed and coming here.” And she adds, “Parents
don’t have to make that difficult call to work, saying they won’t be
in because their children are too young to be left alone and no alternative
child care is available.”
Discipline at the center is typically not a problem: When
children arrive with their parents, they are given an ER band with their name
and their parent’s name — and their parent’s extension number.
The only missteps, says Lundren, have involved the kind of
food to serve. “At first our food service department prepared generous
deli trays with a lot of variety,” she explains. “But the children
just looked at the choices and said ‘Yuk.’ Now we stick to
tried-and-true peanut butter and jelly sandwiches, hamburgers, and hot
dogs.” Another course correction involved breakfast: “While the
pastries we served in the beginning were lovely, we soon learned that they
resulted in boisterous children as a sugar high kicked in,” says Lundgren.
“Now we serve cornflakes and bananas, and things stay calmer.”
As the child care center has become more professional, the
hospital has begun mentioning it in its employee recruitment materials.
Although Lundgren says she’s not sure that it has made a big contribution
to recruitment, she believes that it does contribute to staff retention.
“Admittedly, I have only anecdotal evidence, but the number of parents who
tell me how grateful they are for the peace of mind the child care center
provides is pretty impressive,” Lundgren says. “It may help with the
burnout and stress that figures prominently in surveys of why nurses leave
hospital nursing.”
Contact:
Charlene Lundgren
Vice President for Human
Resources
Doctors Community Hospital
Phone: (301) 552-8088
E-mail:
clundgren@dchweb.org (Back to the top)
Brooks McBurney and his human resources colleagues at
Hagerstown’s Washington County Hospital have come up with a creative
answer to a basic complaint of part-time hospital employees: If part-timers
work more hours than they’re scheduled for—which health care
facilities often need them to do—there may not be much of a reward in it
for them. While the classic incentive for full-time staff members to work more
than their full-time hours is overtime, part-time employees’ extra work
may not trip the overtime wire.
So McBurney and his colleagues began looking for ways to
motivate part-time employees to take on more hours when the health system
needed them to. “We chewed on it,” is how McBurney describes the
process. The brainstormers did have a positive human resource benefit to build
on. “We have a history of providing health care coverage to part-time
employees,” he says. “It’s a popular benefit—two-thirds of
our part-time staff take advantage of it.” The group therefore began
focusing on the health care benefit as something that was obviously important
to part-time workers. “We asked ourselves,” says McBurney, “Is
there something we can do with the premium to reward part-timers for flexing up
when we need them to?”
It turned out there was: Although it seems complex,
beginning in 2001 the health system began adjusting the health care premium
paid by part-time employees according to their work record over the preceding
six months. (Which means hours paid for, not hours worked, so part-timers
aren’t penalized when the preceding six months includes vacation time, for
which they are paid.)
Those part-time employees who have averaged more hours than
specified by their FTE status over the preceding six months have their health
insurance premium lowered for the next six months. Those who work at the level
of hours specified as their official FTE keep the same premium. And the sliding
scale works in the other direction too: if part-time employees work less than
their official FTE, they pay a higher premium.
The incentive is working: For the first six months of 2003,
of the 344 people in the medical plan who work part time, just over
half—51 percent—were paid for more hours than their FTE status, and
thus are paying a lower health care premium for the last six months of this
year. Roughly 40 percent worked their official FTEs and are therefore paying
the same health care premium. And just over 10 percent were paid for less than
their FTE status and are paying a higher premium in the last half of 2003.
The increased number of part-time employees who are now
working more than their official FTE status is having a beneficial impact on
agency use, says McBurney. “Our agency usage is now down to 1-2 FTEs for
nursing from a high in September 2001 of 55 FTEs,” he says. The decline
has resulted in big savings for the hospital, he adds.
As far a McBurney knows, his health system is the only one
in the state that uses such a flexible premium plan. “We pretty much
latched onto the idea ourselves,” he says. “We’re proud of it as
an innovative program. I don’t believe there are many others like it, even
nationwide.”
Contact:
Brooks McBurney
Vice President, Human
Resources
Washington County Hospital Association
Phone: (301)
790-8500
E-mail: Mcbrooks@wchsys.org
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top)
For two and a half years, the Anne Arundel Medical Center
has offered a “shared” benefit to its Latino employees: the Medical
Center underwrites instruction costs and allows the employees to take the last
half hour of their work day twice a week to attend on-site “English as a
Second Language” (ESOL) classes. For their part, class
participants—most of whom are recent immigrants and members of the
housekeeping staff—stay for the other half hour of the one-hour class on
their own time.
The schedule works well, says Audrey Davis, manager of
organizational effectiveness and change management for the Medical Center,
since many of the employees have second jobs and would find it difficult to
return for an evening class. And to help reinforce the learning, the Medical
Center’s library offers participants who don’t have computers at home
access to an Internet-based course in both Spanish and English, complete with
sound, so that they can review English pronunciation.
The class has been well received, says Davis: “We
typically have 10 to 15 participants, with wonderful success stories now
emerging from our first group of students.” She cites as an example a
participant who had been a physical therapist in her home country. After taking
Anne Arundel’s ESOL classes—a more advanced version is offered on
Saturdays—and doing additional course work at the local community college,
she is now employed by the Medical Center as a physical therapy aid. And the
employee is continuing her studies, with the goal of earning her physical
therapy license.
Davis says that offering the classes was the idea of Anne
Arundel’s director of environmental services, who had noticed that
although recent immigrants from Latin America are typically hard workers who
want to do a good job, their difficulty in understanding instructions in
English can undermine the quality of their work.
There were other factors that led Davis to organize the
on-campus ESOL courses. “We wanted to show a level of commitment to a
growing segment of our county’s population,” she says.“We wanted
to convey that we see these positions as valuable in themselves, while also
demonstrating that they can be avenues for growth.”
In addition, Davis says there is a separate course on using
the in-house intranet and the Internet. The Medical Center offers this course
to eliminate staff “outliers” in computer literacy, since both the
organization’s intranet as well as the Internet are becoming important
avenues for disseminating employee information—from announcing staff
meetings to offering on-line classes in such non-clinical areas as career
planning.
The more advanced computer-based ESOL class runs for 14
weeks on Saturday morning. If space allows, employees are welcome to bring
their children with them, if they are old enough to benefit from the
experience. “I love seeing a parent and child work together,” says
Davis. “Sometimes the child is receiving computer instruction at school,
and can help the parent navigate the course more easily.”
There is a flip side to the story as well: Hospital
supervisors take a special course in Spanish, designed to help them explain to
Latino employees what needs to be done in their work, with particular attention
to safety procedures.This, too, has been well received, says Davis, even though
it involves a significant commitment of time—two hours a week for 12
weeks. Time for the course is carved out of supervisory meetings.
“Given our increasingly diverse workforce,” says
Davis, “we think the supervisor’s course provides a real benefit.It
also lets Latino employees know that we recognize and value their contribution
to our organization.”
Contact:
Audrey Davis
Manager, Organizational
Effectiveness and Change Management
Anne Arundel Medical Center
Phone:
(443) 481-1963
E-mail: Adavis@aahs.org
(Back to the top)
While Maryland’s most severe nursing shortage since the
1980s continues to be a problem, Shore Health System in Easton, is trying to
recruit not only more female nurses, but working to add to the male nursing
population as well.
Shore Health supports the Mid-Shore Regional Health Career
Club for high school and college students enrolled in health career
prerequisite courses. The club covers a five-county area and meets once a
month, averaging a turnout of about 20 students per month. Every month the club
has a presentation in a different area of health care. For example, one night
might be devoted to surgical services and the next to alternative medicine
techniques. But regardless of what the monthly presentation is, Shore Health
has made it a point to feature nursing every month.
Cynthia Watson, nurse support program specialist at Shore
Health System, says, “We try to keep the students involved by dressing
them up in scrubs and giving them plenty of hands-on activities. We also try to
bring in at least four nurses to club meetings, both male and female, to
attract students of both sexes to the profession.” In addition to this,
Shore Health plans to begin work on a promotional calendar, which could feature
male nurses, to help make role models for future male nurses.
Shore Health also will target paramedics, EMT’s and
volunteer firefighters as a new source of potential nurses. They will emphasize
better pay, job availability, and career mobility as a means to lure them into
the profession, as well as making them feel as if the field will be
strengthened if they are a part of it. Shore Health has two male nurses, both
former paramedics. One works in critical care and the other in the ER.The task
of tapping into this potential pool of future nurses will take collaborative
efforts on everyone’s part, including working with nursing schools to have
creative scheduling to accommodate alternative students.
It is unclear how long it will take before there is a major
increase in both male and female nurses. The percentage of male nurses in
Maryland is very close to the national average, ranging from 2 percent to 5
percent. What is certain is that Shore Health will continue to encourage people
from both genders to enter the nursing profession.
Contact:
Cynthia Watson, RN MSN
Nurse Support
Program Specialist
Shore Health System
219 S. Washington Street
Easton, MD 21601
410-822-1000 ext. 5457
cwatson@shorehealth.org
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