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					  Healthcare @Work
Creating a Reason to Stay
Labor Front Headlines

 Tightest labor market in 30 years -     Newsweek

 Young entrants will change jobs nine times
 before age 32! - DOL
 Quitting? 17M this year -   Saratoga Institute
US Workforce Growth Rates

       1965         2.50
       1975         1.80
       1985         1.70
       1995         0.90
       2005         0.65
       2015         -0.01
       2025         -0.15
       2035          —
Change in Number of US
Workers
    Age of Worker   1970-1980   1996-2006
        16-19        30.6%       14.3%
        20-24        50.0%       14.0%
        25-34        72.4%        -8.8%
        35-44        23.6%        -3.0%
        45-54         0.0%       25.1%
        55-64         5.3%       54.0%
        65+           -6.1%       9.2%
The Hospital Perspective -#1

  The Hospital Workforce:
    •   20% annual turnover is common
    •   Primarily female: 70-85%
    •   Stratified diversity
    •   24x7x365
    •   Guild based
    •   Many licensed and regulated

                                Source: Jim Bentley
                                AHA Strategic Policy Planning
The Hospital Perspective -#2

  Not a ―Nursing Shortage‖
  A shortage of:
    •   Nurses
    •   Pharmacists
    •   Rad Techs/Lab Techs
    •   Housekeepers
    •   Food service workers
    •   Information Services
The Hospital Perspective -#3

  Dual timeframes:
    • Historically- short term shortages
    • Short-term shortage AND long-term
      shortage
      – Baby boomers moving to retirees
      – Inadequate pipeline
The Hospital Perspective -#4

  Healthcare employment: ASHHRA
    • From high tech to low tech
    • From security to insecurity
    • From limited to multiple choices for women
    • From psychic compensation to compliance and
      documentation
    • From self-scheduled to 24x7

  Bottom line: from favored to avoided
Healthcare @Work 2000 Study

 • Follows design of Aon’s @Work research
 • Questionnaire design completed in
   partnership with ASHHRA and Aon
   Healthcare Alliance
 • Web based data collection—January-March
 • Over 3,300 respondents
Respondent Profile - Gender


                   Male
                   22%




        Female
         78%
Respondent Profile - Age

                       18-24
          60 or over    2%     25-29
              3%                7%

       50-59                   30-34
        24%                     11%


                               35-39
                                14%

       40-49
        39%
Respondent Profile - Education

                    High
                   School
          Post
                     6%     Vocational/
        Graduate
                            Technical
         Degree
                               6%
          22%

                             Some
                            College
                              31%
     Graduated
      College
        35%
Respondent Profile - Employees
in Organization

                   99 or fewer
                       4%
                                 100-499
        5000 or
                                   14%
         more
         28%

                                   500-999
                                     16%


       1000-4999
          38%
Respondent Profile - Type of
Healthcare Organization
                          Physician's
                            Office
     University   Other
                             2%
      Medical     18%
      Center                        Ambulatory
       24%                            Care
                                       2%


                            Long-term
                            Care Center
     Community
                                3%
      Hospital
        51%
How much commitment exists?

  • Workforce Commitment Index (WCI)
    standardized at 100 in 2000
  • Based on responses to six WCI items
  • Track and trend by item and
    demographic variable
WCI Questions

                     PRODUCTIVITY   •People improve skills
                                    •People make sacrifices


                           •Recommend products & services
             PRIDE
                           •Recommend as a place to work




 RETENTION
                 • Intend to stay several years
                 • Intend to stay even if offered more
                   money elsewhere
Workforce Commitment Index

                             Productivity

 People Improve Skills to Make a
                                                    40%
       Better Contribution


  People Make Sacrifices to Help
                                                    40%
         Group Succeed

                                   0% 10% 20% 30% 40% 50% 60% 70% 80%
                                             Percent Agree
Workforce Commitment Index


                                     Pride

 Recommend the Organization as One of
                                                           36%
the Best Places to Work in the Community



  Recommend the Products/Services as                         41%
     the Best a Customer Could Buy


                                           0% 10% 20% 30% 40% 50% 60% 70% 80%

                                                    Percent Agree
Workforce Commitment Index

                               Retention

  Intend to Stay for                                   51%
    Several Years

 Would Stay Even if
 Offered Similar Job                     32%
 with Slightly Higher
         Pay
                    0%   10%    20%   30%   40%   50%    60%   70%   80%
                                       Percent Agree
What does a WCI of 100 mean?

For every 100 employees. . .
  •   13 don’t improve their skills
  •   15 won’t sacrifice for the team
  •   15 would not recommend products and services
  •   23 would not recommend as a place to work
  •   17 do not intend to stay for the next several years
  •   30 would leave for a slight pay increase
Profiles of Commitment
             WCI by Type of Healthcare Organization

 2000 Healthcare                            100.0
   WCI Overall

  University                                 101.4
 Medical Center

    Community                               100.5
     Hospital

          Other                            99.1


                   60   70   80     90    100       110   120
Profiles of Commitment

                        WCI by Tenure
  2000 Healthcare WCI Overall                         100.0
             Less than 1 year                       97.6
                    1-3 years                       96.7
                    4-6 years                       96.2
                    7-9 years                        98.8
             10 or more years                              104.7

                                60   70   80   90   100     110    120
Profiles of Commitment

                          WCI by Age

  2000 Healthcare WCI Overall                              100.0
                       18-24                          97.0
                       25-29                        92.3
                       30-34                         94.4
                       35-39                          96.5
                       40-49                               100.5
                       50-59                                 105.3

                                60   70   80   90    100 110 120
Profiles of Commitment

                    WCI by Profit/Not-for-
                     Profit/Government

   2000 Healthcare WCI Overall                           100.0

                    For Profit                        94.5

                 Not-for-Profit                              102.7

                  Government                          94.0

                                  60   70   80   90   100 110 120
Profiles of Commitment

                 WCI by Organization Size

   99 or fewer                        96.3
       100-499                         98.7
       500-999                          100.2

     1000-4999                           101.5
  5000 or more                          100.1

                 60   70   80    90   100     110   120
The @Work Research Model
Commitment IndexTM                Performance PyramidTM


   RETENTION                                Work
                                            Life
                      Workforce
                                           Growth
                     Commitment
     PRIDE
                                          Affiliation


  PRODUCTIVITY                           Rewards


                                       Safety/Security
Security
75% agree that their organization’s effort to provide them
with job security is meeting or exceeding their expectations.
                    Well below
                   expectations
                                        Well above
                        7%
                                       expectations
                                            9%

             Below
          expectations
              18%
                                           Above
                                        expectations
                                            21%
                  Meets
               expectations
                   45%
Rewards
56% report that the one reward they would most like to
receive in the future is a significant salary increase.

             Promotion to
                                     Chance to be
               a higher
                                     a shareholder
               position
                                          9%    Bonus plan
                 14%
                                                 based on
                                                individual
                                               performance
                                                   14%
            Significant
              salary                    Bonus plan
             increase                    based on
               56%                         group
                                        performance
                                             7%
Rewards
51% report that the recognition and rewards they receive
from doing their jobs are below expectations.


                                   Well above
                                  expectations
            Well below                 5%
           expectations
               18%                         Above
                                        expectations
                                            16%



                                           Meets
                                        expectations
                  Below                     28%
               expectations
                   33%
Rewards
Compared to people in similar jobs WITHIN their
organizations, 30% disagree that they are fairly paid.


                                 Disagree
                                   16%
                 Agree
                  31%
                                       Somewhat
                                        disagree
                                          14%
                                       Neither
             Somewhat
                                      agree nor
               agree
                                      disagree
                31%
                                         8%
Rewards
43% disagree that they are fairly paid compared to people in
similar jobs at DIFFERENT organizations.

                   Agree
                                     Disagree
                    21%
                                       26%


                                          Somewhat
        Somewhat                           disagree
          agree                              17%
           24%                       Neither
                                    agree nor
                                    disagree
                                      12%
Rewards
41% believe to a little or very little extent that the retirement
plan will provide them with an adequate income.

                                       To a very
                                         great
                                        extent
              To a very                   2%
            little extent                          To a great
                 22%                                extent
                                                      12%



            To a little
             extent                          To some
              19%                             extent
                                               45%
Affiliation
39% of respondents say their work environment’s providing
of open, candid communication is below expectations.

                                   Well above
              Well below          expectations
             expectations             13%
                 17%

                                           Above
                                        expectations
                                            20%
         Below
      expectations
          22%

                                     Meets
                                  expectations
                                      28%
Affiliation
46% of respondents say their organization’s encouragement
to challenge the way things are done is below expectations.

                                    Well above
               Well below          expectations
              expectations              5%
                  19%
                                              Above
                                           expectations
                                               19%




              Below                         Meets
           expectations                  expectations
               27%                           30%
Affiliation
52% say their organizations are not meeting expectations
with having employees participate in planning changes.

                             Well above
                            expectations
                                 5%           Above
              Well below                   expectations
             expectations                      17%
                 21%




               Below                           Meets
            expectations                    expectations
                31%                             26%
Growth
79% agree or somewhat agree that patient care is the
number one priority at their organization.

                 Disagree
                    6%                    Agree
                                           46%


          Somewhat
           disagree
             10%

                  Neither               Somewhat
                 agree nor                agree
                 disagree                  33%
                    5%
Growth
34% of respondents believe their organization’s readiness to
make changes to stay competitive is above expectations.


                Well above      Well below
               expectations    expectations
                   11%             10%

                                        Below
           Above                     expectations
        expectations                     22%
            23%
                                        Meets
                                     expectations
                                         34%
Growth
41% of respondents report opportunities for personal
growth provided by their job as not meeting expectations.

                        Well above     Well below
                       expectations   expectations
                            7%            13%
                 Above
              expectations
                  19%

                                             Below
                                          expectations
                                              28%
                     Meets
                  expectations
                      33%
Work/Life Harmony
26% of respondents said that the ability to balance work and
life most impacts their decision to STAY at their current job.

                         Benefits
                         provided         Opportunities
                           11%           for growth and
          Job security                    development
              16%                              21%



      Reputation of
          the                               Ability to
                                          balance work
      organization
                                             and life
          9%
                                              26%
                      Wages paid
                         17%
Work/Life Harmony
32% disagree that management recognizes the
importance of their personal and family life.


               Disagree
                 19%                  Agree
                                       29%

          Somewhat
           disagree
             13%

             Neither
            agree nor                Somewhat
            disagree                   agree
              11%                       28%
The @Work Research Model
Commitment IndexTM                Performance PyramidTM


    RETENTION                               Work
                                            Life
                      Workforce
                                           Growth
                     Commitment
     PRIDE
                                          Affiliation

   PRODUCTIVITY                          Rewards


                                       Safety/Security
Maslow Revisited —
The Hierarchy of Needs

                  Self
              Actualization


              Esteem

               Social

              Safety

           Physiological
Aon’s Workplace View —
The Performance Pyramid

               Work-Life
               Harmony


              Growth

             Affiliation

             Rewards

         Safety / Security
Aon’s Performance Pyramid
 • Based on meta-analyses of over 60,000 cases
 • Hierarchy of organizational practices
 • The WCI rose progressively when expectations were
   met at each level
 • When safety/security issues were below
   expectations the WCI was 80
 • When employees indicated that all levels were met,
   including work/life harmony, the WCI was 114
Learnings from the Pyramid
  • Addressing higher level needs will not create
    a commitment/retention advantage unless
    lower level needs are met
  • You must MEET Expectations — Exceeding
    Expectations comes later

  • Priority attention levels can and will fluctuate —
    merger/downsizing, etc.

  • Best Bet — Back to the Basics
Workplace Practices Summary
       Drivers of Commitment with
           Positive Performance

  • Understanding how my performance is
    evaluated
  • Patient care being the number one priority at
    my organization
  • Skill levels of the people I work with are
    keeping pace with demands of the job
Workplace Practices Summary
       Drivers of Commitment with
           Positive Performance


  • Being covered by an organization-provided
    retirement plan
  • Organization satisfying our patient’s needs
Workplace Practices Summary
       Drivers of Commitment with
         Performance Challenges

 • Managing and Communicating organizational
   changes
 • Being fairly paid compared to people in similar
   jobs at different organizations
 • Having a retirement plan which provides an
   adequate retirement income
Workplace Practices Summary
      Drivers of Commitment with
        Performance Challenges

• The organization’s support of employees’ interest
  outside of work
• Management recognizing the importance of
  personal and family life
• Management’s allocating resources in a way that
  meets or exceeds patient’s needs
Performance Pyramid
                                      • Executive Coaching
                                      • Selection & Assessment
         • Life Stage Benefits        • Professional Development
         • Flextime, PTO Bank, etc.   • Performance Mgmt Systems
         • Job Sharing




• Leadership Assessment and              • Internal and External
  Development                              Benchmarking
• HR Practices Review                    • Health & Welfare Plan Mgmt
• Large Scale Cultural Change            • Benefits Communications
                                         • Executive Comp Design



                                               • Absence Management
                                               • Property and Casualty
                                               • Workers’ Compensation
Survey Client Experience

        Department permits open, candid                                  3.35
                                                               2.67
               communications                                         3.09

      Recognition and rewards from doing                              3.00
                                                             2.43
                   your job                                     2.73

                                                                                3.80
        Opportunities for personal growth                                    3.56
                                                                                       4.25

                                             1           2        3             4             5
                                                             Performance
           Company 1999   Company 1998   National Norm




@Work survey conducted two years in a row.
Re-invent Commitment

  • Back to the Basics—lower level needs of the
    Performance Pyramid
  • Competitive Strategies (not tactics) at each
    level
  • Don’t accept as an HR objective—lead the
    team
May the WorkFORCE Be With You

   Employees can always find a reason
               to leave.
      The organization must create

				
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