Particulars Acknowledgement 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Introduction to Training Training Objective Introduction to HRM Background Scenario of the Training Classification of Training Company

Profile-PCS Research & Methodology Formulation of Hypotheses Data Analysis Findings From the study Suggestions& Recommendations Conclusion Bibliography Annexure & Questionnaires

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07 10 12 15 22 31 37 40 51 67 69 71 74 76

Article no.1 HOSPITAL (ITY) ISSUES: ATTITUDE TOWARDS HOSPITALITY IN HOSPITAL SETTINGS Review of literature: Basically this article talks about the research done in Netherlands
hospitals and it is found in this article that Changes in financing induce Dutch hospitals to become more market-driven; they aim at high customer (patient) satisfaction. The following research questions are raised: To what extent is hospitality related to patient satisfaction? Does this hospitality refer to traditional hospitality? What is the attitude of hospital organizations, managers, and (nursing) staff towards hospitality? A mixed-method approach was applied, including a survey, brainstorms, and interviews and as desk research a sample of annual reports of Dutch hospitals. Results show that hospitality in health care and the traditional hospitality industry overlap but differ. Personal attention and politesse are regarded most important. We conclude that a truly hospitable attitude in healthcare requires a meaningful translation of traditional hospitality and a shared understanding of the concept of hospitality in hospital settings.

Improving Employee Satisfaction and Engagement at Your Hospital: 11 Leadership Best Practices From John Singerling, COO of Palmetto Health Richland

Hospitals rely on many people to ensure that they are running smoothly and are able to provide quality and effective care to their patients. However, if a hospital's staff is dissatisfied or not unified towards achieving a shared vision, many parts of daily operations can suffer. This was the case with Palmetto Health Richland, a 649-bed academic medical center, affiliated with the University of South Carolina School of Medicine, located in Columbia, S.C., and part of the three-hospital Palmetto Health system. With a history of substandard employee satisfaction performance, in 2006, the hospital made a strong commitment to engage and improve the relationship with their workforce. Challenges with trust, leadership, communication and participation in decisions led to low employee satisfaction which placed the hospital near the bottom quartile nationally, according to a national survey.

However, over a two-year period, Palmetto Health Richland was able to incorporate several evidenced-based leadership practices that greatly improved employee satisfaction and secured the hospital's positive reputation. John Singerling, COO of Palmetto Health Richland, shares the following 11 best practices which his organization followed to improve employee satisfaction. 1. Identify areas of improvement Identifying areas of improvement is the first step in developing better employee satisfaction, and in order to identify these areas, your hospital must collect information from employees. Palmetto Health Richland, for example, periodically participated in Press Ganey's employee satisfaction survey, now called the "Employee Partnership" survey. "The results were so embarrassing in 2005, we decided not to survey in 2006," Mr. Singerling says. The hospital ranked in the 26th percentile in the nation when it came to employee satisfaction. In 2007, Palmetto Health CEO Charles D. Beaman, Jr., made the commitment to conduct the survey annually and to use the results to improve relationships with employees across the entire health system. He also challenged every leader to achieve his expectation of 100 percent participation by all 9,000 employees in the system, including full- and part-time staff. "[Palmetto Health hospitals] started doing the surveys in 2001, and we averaged around 34 percent participation," Mr. Singerling says. "We thought it was an ambitious goal, but we've averaged 94 percent participation the last three years in a row, and we've received ample feedback from our employees." From these surveys, Mr. Singerling says Palmetto Health Richland was able to identify the areas where employees were least satisfied and then develop systems to respond to these concerns. The top areas the hospital identified were:

lack of a clear vision and focus; accountability (tolerating low performers at all levels of the hospital); trust; transparency; and communication.

According to Mr. Singerling, the surveys also found that Palmetto Health Richland rated in the bottom 20 percent nationally on several questions related to effective supervisory leadership. "We've all heard the statement: Employees don't quit their employer; they leave their supervisor. This was clearly the case in our organization," Mr. Singerling says. There was a direct

correlation between high turnover and lower employee satisfaction in several departments. Interestingly, surveys found one area where Palmetto Health Richland was doing well: patient satisfaction. "This finding bucks the national trend," Mr. Singerling says. "Typically, employee satisfaction and patient satisfaction are correlated. We were fortunate to have respectable patient satisfaction performance despite our challenges with employee satisfaction." 2. Recognize the need for improvement In order to make effective changes to improve employee satisfaction, the management at your hospital must not only identify the need for improvement, but acknowledge that improvement is necessary. According to Mr. Singerling, this was the next step Palmetto Health Richland took in its journey toward improving its staff's satisfaction. "We had plenty of opportunity for improvement," Mr. Singerling says, regarding the results from the Press Ganey survey. "We realized we were not as focused [as an organization] and were not holding ourselves accountable for improving our performance. In many respects, we were a good organization, but not a great one." Although patient satisfaction remained high, Mr. Singerling notes that other areas of the hospital's operations were hindered by the employee's low level of satisfaction with working at the hospital. Palmetto Health Richland experienced high turnover in certain departments and used a significant amount of high-cost external agency staff to keep the facility operating. "The use of external agency staff was not only hurting our financial performance, it was affecting departmental morale. We were stable and operating in the black; however, we were spending millions of dollars per year on external agency staff," Mr. Singerling says. By creating a better environment for employees to work, Palmetto Health Richland has been able to improve their retention rate and reduce their external agency cost by 70 percent in three years. Hospital patient volumes were also stable but not growing at the rate necessary to sustain the rate of investment needed to meet the healthcare needs of the community, according to Mr. Singerling. 3. Benchmark against other hospitals Using other hospitals as examples or benchmarks can help you decide what some of the next steps when looking to improve employee satisfaction. Palmetto Health Richland turned to two organizations to see what improvements those hospitals had made to improve their employee satisfaction: its sister hospital, Palmetto Health Baptist Easley (S.C.) and Baptist Healthcare in Pensacola, Fla. "Four years prior, our sister hospital was in a similar position," Mr. Singerling says. "They were in the 40th percentile nationally and their culture changed dramatically over a short period of time. Their COO, Roddey Gettys, made the decision to change their culture and after a lot of

hard work their employee satisfaction increased to the 99th percentile. Their leadership team accomplished great things and we noticed. They paved the way for us to get on board in Columbia," Mr. Singerling says. For example, one step Palmetto Health Baptist Easley took was to partner with an outside consulting firm to help them on their journey in their case, it was The Studer Group. In 2007, the other two hospitals in the Palmetto Health system followed this example, which allowed them access to look at other high performing hospitals outside of the Palmetto Health system. 4. Create a unified vision Having a vision statement that is vague or unclear can often leave employees uncertain of the aspirations and direction of the hospital. As a result, it can be difficult for employees to work toward a common goal, according to Mr. Singerling. "We had a vision statement that meant very little to our employees," Mr. Singerling says. "It was fair to say our employees were not inspired by our vision." As a result, Mr. Beaman led the development of a new vision for the entire health system. The new vision statement: "To be remembered by each patient as providing the care and compassion we want for our families and ourselves." This change resulted in a huge step forward for Palmetto Health. "The new vision statement means something to our employees. They understand, relate and get excited about it: We must give every patient the care and compassion we expect to receive when we're in the hospital and any less is not good enough," Mr. Singerling says. "If you ask our employees, they know and feel connected to our vision." 5. Develop standards of behavior and hold staff to them Creating hospital-wide standards of behavior can help ensure that employees are working in line with your hospital's vision and help weed out employees who cannot meet the expectations of the hospital, according to Mr. Singerling. "We saw this in action at the Baptist Hospital in Pensacola," Mr. Singerling says. "We had disparities in our standards of behavior across our campus and health system, so we developed new ones that we expected our staff to live up to, and future employees must agree to this in writing before an interview is granted." The standards of behavior that Palmetto Health Richland uses today were developed by a group of more than 20 frontline, high performing employees, according to Mr. Singerling. The group of employees then brought the standards to the executives and then the standards were distributed to the more than 9,000 employees across the hospital system. Mr. Singerling says that after these standards were put into place, more than 300 employees have been asked to leave the hospital because they couldn't meet the expectations of the standards. "Those who struggled with our standards were placed on 90-day action plans. After 90 days, if their performance did not fall within our standards they were asked to leave. We let people go on

all levels of the hospital, including supervisors and management," he says. Once these low performing employees were let go, Mr. Singerling says the hospital saw marked improvements. Holding on to low performers was a major factor in employee dissatisfaction. "I recall talking to Quint Studer, and he said if you spend 90 percent of your time dealing with the bottom 10 percent of your workforce, you're doing a disservice to the 90 percent who came to work every day intending to do the right thing," Mr. Singerling says. Although low performers still exist at Palmetto Health Richland, the standards help to bring these problems to the attention of supervisors so they can be appropriately addressed. "If you don't live our standards of behavior, you won't have the privilege of serving as a member of Palmetto Health," Mr. Singerling says. 6. Open lines of communication As was the case with Palmetto Health Richland, a lack of communication or transparency can make employees frustrated or feel out of the loop when it comes to the operations of your hospital. Mr. Singerling says his hospital employs the following methods of keeping its staff members informed with what is expected of them and of what is going on in the hospital and Palmetto Health. E-mail lines. Both Mr. Singerling and the CEO of Palmetto Health, Mr. Beaman, have open email lines employees can use to send questions directly to them. Mr. Beaman also sends out bimonthly e-mail updates to all members of the Palmetto Health system that address questions employees have asked him and discussed topics that may be of concern to employees, such as the economy or healthcare reform. "By having this real-time feedback, we have greatly reduced any anxiety employees may have regarding the future and direction of the hospital," Mr. Singerling says. Televised leadership meetings. Another way Palmetto Health Richland increased its transparency and communication was by videotaping monthly leadership connection meetings. In these meetings, Mr. Singerling says many topics relevant to the operation of the hospital are discussed and achievements are celebrated. The meetings are broadcast throughout the hospital and run on the hospital's television network. "Our employees, physicians, guests and patients can see the meetings and what is discussed," he says. Communication boards. Each department of the hospital uses Five Pillar communication boards to post goals and updates relevant to issues within the hospital. According to Mr. Singerling, these boards help to keep employees informed and focused. Additionally, issues are communicated down from the executives to vice presidents and directors, who then use these boards as means to communicate these issues to their staff members. As a result of these measures, the hospital is in the top 1 percent of the nation when it comes to employee communication, according to the Press Ganey survey.

7. Conduct employee forums One technique for communication that has worked extremely well for Palmetto Health is employee forums, quarterly or bi-annual meetings that are led by senior members of the hospital. "The forums are an opportunity to connect with employees," Mr. Singerling says. "It helps employees know what the goals of the hospitals are and know what they are working towards." At the meetings, Mr. Singerling provides updates related to the hospital and how the hospital is performing. He recognizes achievements and praises employees and departments within the hospital. Members of Palmetto Health Richland also produce entertaining videos that address issues within the hospital. Another main objective of the employee forums is to provide a "connect to purpose" for employees, helping employees to understand why they choose to work in the hospital setting and how to connect their daily work to the goals of the hospitals. "It helps all of us connect to purpose, worthwhile work and helps us understand how we make a difference in our various roles," he says. One of the biggest challenges for Mr. Singerling was how to communicate the information to all 4,000 members of the hospital. "I conduct 35 meetings across all shifts over a three week period twice a year," he says. "Each meeting consists of around 100 staff members in our auditorium." Although participation is not mandatory for staff members, Mr. Singerling does make it mandatory for the leadership to get their staff members to the meetings. "We had some skeptics at first but I believe people now enjoy coming to the sessions," he says. "We see around 93 percent participation. It shows that leadership and staff members care about the hospital and what is happening." 8. Enable leadership to respond to employee concerns A source of employee dissatisfaction can often stem from a leader's or supervisor's inability to address a problem or a concern efficiently. To improve this level of communication, Palmetto Health Richland developed the Leadership Institute. This is a series of one-day, off-site sessions designed to improve performance by supervisors and leaders and to improve their communication with their staff members. In the meetings, basic expectations, concepts and principles of leadership are addressed to help improve this relationship. "Approximately 10 percent of the employees at our hospital are in leadership positions," Mr. Singerling says. "Our goal was to be in the top 10 percent of hospitals in the Press Ganey database within three years, and the satisfaction results are driven by the relationship between supervisors and their employees. "We want to equip our leaders with the tools and competencies they need to be effective leaders," he says. 9. Be prepared to address and handle skepticism

According to Mr. Singerling, a big hurdle your hospital management will have to overcome when implementing these new initiatives and strategies is skepticism from employees. This can come from all levels of employees, including management. "A lot of people may say that the leadership is trying to implement to latest program of the month to improve the work environment, and they will not totally buy-in or commit to the new practices," Mr. Singerling says. "The best way to combat this is to be extremely transparent and hold people accountable for the new standards." At Palmetto Health Richland, Mr. Singerling said that this transparency was accomplished by providing constant updates regarding the progress and an ongoing process of leaders communicating the new culture and expectations to the employees. Mr. Singerling notes that for most employees and leaders, making these changes will cause no problems. However, for low performers and skeptics, it may pose a challenge. "I was surprised how challenging something so simple could be," he says. Some of the low performers at Palmetto Health Richland made excuses instead of trying out the new policies. Others made a good effort and saw improvements. Mr. Singerling says the key to succeeding is by fully engaging leaders and staff members in the changes, and then letting them decide if they can meet what is expected of them. "Most people were in the right seats on our bus, some had to change seats, while over 300 others were asked or volunteered to get off," he says. 10. Make the commitment and lead by example Most of all, to ensure that the new policies and culture succeed at your hospital, leadership must lead by example, showing that the new policies apply to everyone across the board. Mr. Singerling also notes that a successful change in employee satisfaction and culture starts with fully engaged leaders. "If you don't hold yourself to the same expectations, you create a double standard that will sabotage the transformation," Mr. Singerling says. "If we tell staff members to pick up trash when they see it or to personally escort visitors to where they need to go, then all leaders including me need to do the same. You need to make yourself a model of the new standards and live them," he says. 11. Engaged employees make the difference Employees make the changes happen and make them successful, says Mr. Singerling. Once employees are committed and involved in the improvement process, results can be seen. As a result of the employees' hard work, Palmetto Health Richland has seen a good deal of success. This September, the hospital met its three-year goal when employee satisfaction rates placed them in the top 10 percent nationally. In addition, Mr. Singerling says the hospital also saw a 22 percent reduction in mortality over a two-year period and quality improved dramatically overall.

Also, since the new policies took effect, Palmetto Health Richland has had the strongest financial year the hospital had seen in a number of years and the highest patient volume it has had in its 117-year history. Mr. Singerling notes that this could not have been accomplished unless everyone, from the board of directors to the CEO to the entire staff, was aligned with the new vision. "We've seen a lot of growth because our employees believe in our vision, are proud to work here and find purpose in their work," Mr. Singerling says. "One piece of advice I received when we began our journey was, 'If you take care of your employees, physicians will want their patients to be served in your hospital, and your biggest challenge will be creating ample capacity to care for your increasing volume of patients.'" That scenario is now reality at Palmetto Health Richland as they grapple with trying to ramp up capacity to meet the needs of those who want to be served in their hospital.

Hospital Surveys
Assess your healthcare organization and discover how to improve it.
Hospital Employee Survey Case Study

A West Coast Hospital with over 1,800 employees contacted NBRI for assistance in assessing the thinking of its employees. Being a leading healthcare provider, the client understands the importance of routinely evaluating the psychological health of its employee base. In addition, it is a well-known fact that hospital employee surveys are a best practice of global leaders. The NBRI standard hospital employee survey was deployed by paper over a two-week period in order to cover all shifts, as well as weekend and weekday employees. Job title was another important demographic segregation of the data. A 93% response rate provided preliminary indications of an involved and committed workforce. The NBRI Root Cause Analysis identified a forbearing management style at work within the Hospital as the driver of 48% of all survey items. This single root cause was driving employees to be forthcoming about reporting patient errors, which in turn lowered employee stress and organizational liability, and enabled management to take corrective systemic action and reduce the number of errors made. NBRI recommendations to leverage this positive finding were followed, resulting in increased scores of the root cause as well as all items driven by it within one year of the initial assessment. Indeed, when asked if employees would recommend the Hospital to family and friends for healthcare, the scores were above the 90th percentile for all job titles at the second assessment, an increase of over 15 normative percentiles.

Is the healthcare you provide meeting patient expectations?

How willing are physicians to make referrals to your hospital? What is the likelihood that patients will recommend your hospital to others? How are you viewed in relation to your competitors? Do you have the data to make informed decisions about patient loyalty and physician referrals?

Patient Satisfaction and Hospital Employee Surveys Identify the factors that enhance loyalty and increase revenues.

Patient satisfaction and hospital employee surveys are becoming increasingly important within the healthcare industry. Everyone in the healthcare industry is faced with two simple facts: they have to cut costs while maintaining high quality services. Patients, employers, business groups, health plans, and insurers are scrutinizing the delivery of healthcare from both a quality and cost perspective. Among other quality measurements, a patient satisfaction survey is a critical component in monitoring your quality of care and will help you gain and retain patients. Our hospital employee surveys and patient satisfaction surveys can help you find out what people think about your hospital which allows you to take steps to retain your personnel and patients.

Hospital employee and patient surveys provide improved medical facility performance and profitability by identifying the root causes of medical personnel and patient behavior, allowing action targeted directly at those root causes. NBRI hospital employee surveys assess how medical personnel think, feel, and behave. NBRI analyses identify the root causes of behavior from the employee and patient satisfaction survey data, and NBRI interventions target those root causes resulting in improved medical facility performance and profitability.

Hospital Surveys White Papers Hospital Service Survey Related Topics

Are You Engaged? You or someone you know goes to work, they get through the day and pick up their check, but they fail to feel connected to their work and to the organization in which they work. Sound familiar? The business diagnosis for this malady is low employee engagement. Patient Satisfaction Surveys Should Focus on Meaningful Information In todays highly competitive market, tracking patient satisfaction levels is absolutely critical to practice success. The patient satisfaction survey is an increasingly essential and useful tracking tool. Meaningful customer satisfaction surveys designed for a patient target a variety of operational issues ranging from wait time to physician style and demeanor