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Confronting a Crisis: VITAS Uses Recognition to Address Serious Labor Issues
“We pay attention. We listen. We know what they need from us to thrive because we asked and we will continue to ask.” Kal Mistry, Senior Vice President of Human Resources, VITAS
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MIAMI — hen VITAS Innovative Hospice Care accepts the responsibility of helping a patient with end of life care, they endeavor to treat the whole patient — body, mind, spirit and family. When the company accepts the responsibility of providing a nurse with a rewarding career, they stop at nothing less than providing a wholly fulfilling experience. “When we treat our patients we provide a team: chaplains, social workers, nurses, home health aides, grief counselors,” explains Kal Mistry, senior vice president of human resources for VITAS, the largest hospice provider in the U.S. “We anticipate our patients’ needs and provide ways to meet those needs.” “Our employees are no different,” says Mistry. “We pay attention. We listen. We know what they need from us to thrive because we asked and we will continue to ask. That enables us to put programs in place, to train managers, to communicate to employees about the things that matter most to them and meet their needs in a more proactive way.” Being proactive has been Mistry’s method of operation since she came to VITAS in 2002. When she discovered the organization had not done an employee survey in at least 10 years, Mistry went to work. “I remember discussing the decision to do the survey,” says VITAS President, David Wester. “As a management team we talked about the notion that if you’re going to do a survey you have to take action, because if you don’t take action you’ll lose credibility with employees. We needed to be prepared to deal with the results before we ever committed to do the survey.” Fortunately for VITAS and its employees, the senior management team had the courage to find out what they didn’t know and went forward with the survey. “The results were very encouraging and very informative,” says Mistry. “We found out our workforce was extremely committed to our mission, and they identified 10 issues where we could improve. For the most part, it came down to the fact that they wanted more attention. They felt that management was not quite in touch with them.” As a result of the survey Mistry set a multi-year (continued on page 2)
Excuse Me, Nurse?
The numbers are staggering. As the U.S. population ages, the projected shortage of nurses grows more severe. The shortage is expected to reach 800,000 nurses in 2020 (a shortfall of 29 percent). Employers are doing all they can to attract and retain nurses and change the reputation of nursing in the job market. Currently, surveys indicate 20 to 35 percent of nurses are unsatisfied with their jobs. The lowest job satisfaction is reported by nurses working in hospitals and nursing homes, where the sickest and most needy patients are. Source: Marilyn Biviano, Ph.D., Director National Center for Health Workforce Analysis, Health Resources and Services Administration
INSIDE
this issue: 2007 Carrot Culture Executive Summit Summary: Page 4 Retirement Service Provider OPRS Measures Recognition: Page 5
two VITAS (continued from page 1)
of the award decisions for our national employee recognition awards program are project in motion designed to formalize performance programs, enhance retention based on how well people live the values. Nobody gets the nurse of the year award initiatives, update technologies, develop innovative recruiting methods and create because somebody sends in a nomination form that says, ‘Susie is a great nurse.’ That doesn’t do it. What wins the award is, ‘Susie is a nurse who lives the VITAS compelling employee recognition opportunities. values by doing . . .’ Everything is focused on the values and that helps our She began by assembling an employee satisfaction and trust committee. Members were asked to talk to people all over the organ- employees understand their significance in the scheme of things.” And examples of great work are exactly what VITAS is hoping to pass on to a ization and find out what they really wanted. The new generation of nurses. committee discovered VITAS employees felt there Since Mistry joined the company in 2002 VITAS has experienced explosive growth that continues today. Currently the company has more than 9,000 employees in 16 states and revenues of over $700 million. VITAS expects to double in size in the next five years, adding thousands of nurses and many new locations. “We are at a critical time for HR at VITAS,” says Peggy Pettit, EVP and Chief Operating Officer. “Like all other healthcare providers we are faced with a labor shortage at just the time we are David Wester, President, VITAS expecting unprecedented growth. We must do all we can to face that challenge head on and plan for it. Strong recognition practices are something we can do to keep the nurses we have and create the type of work was a greater need for a formal recognition and reward program. environment that is attractive to employees looking for a place to begin a career.” As a result Mistry, partnered with O.C. Tanner recognition advisor Dan Currently, nurses make up 40 percent of the VITAS workforce. Their average Norman to institute recognition programs at several levels in the organization. age is 48 years old and many of the most senior nurses are expected to retire withFrom daily recognition practices to recognition for years of service, quarterly performance recognition at the local level, and an annual national recognition award, in six to eight years. “The competition for skilled nurses is unbelievably intense. There is a crisis in recognition has become a main event at VITAS. nursing today,” says O’Toole. “We are doing everything we can to minimize “To be great, we have to hold our employees to high standards,” says Tim turnover and attract the right people. We are making a strategic investment in O’Toole, CEO of VITAS. “By using recognition to reinforce actions that reflect solid recognition practices because it’s the right thing to do for our people, our those high standards we are able to show our appreciation of the stars in the shareholders, the taxpayer’s dollars we work with, everyone. organization while we motivate underperformers by giving concrete examples of “It’s a labor-intensive business; a people-intensive business,” continues O’Toole. the VITAS values in action.” “Obviously if we can reduce turnover and attract new employees by recognizing The survey also revealed that VITAS values are a major factor in why people the actions of our people and making sure they feel rewarded for their efforts, the choose to join the organization. company’s financial situation will improve. But you know what’s even more impor“The values are a major factor why people choose to build a career here,” says tant than that? If we keep more nurses, the same nurse can go to the same patient Mark Cohen, senior vice president of communications and public relations. “All — and that improves the quality of the care we offer.” And improving quality of care is what matters most to VITAS employees at every level of the organization. “Our recognition programs, all of them, are really critical to our retention effort. And they do make a difference. We’ve had a significant impact in reducing Mark Cohen, Senior Vice turnover, and the recognition programs have been a President of Communications and Public Relations big part of that,” says Bob Miller, senior vice president of clinical development and bioethics. “Being proactive about making sure nurses, staff and aides feel content about where they work, translates into better patient care. The more nurtured our nurses feel, the more confident they feel in the organization, the more they project that to patients and families.
“If you’re going to do a survey you have to take action, because if you don’t take action you’ll lose credibility with employees.”
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Patients co We’re p a di I’ll do m and e tom We ta eac
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And it’s a good cycle — the better they are feeling about themselves and their work, turnover and producing positive business results really starts with good management and supervision. The VITAS CARES initiative teaches our managers that if you treat the more they create that kind of environment for patients and families, and then they get that feedback from patients and families about how good they are at provid- employees well and recognize what they are doing, they are more likely to be happy ing the care the families need, and it in the workplace.” Quarterly recognition award recipient Maria Gonzalez agrees, “VITAS constantly creates a really nice cycle of caring. says thank you in many ways, but to be recognized among colleagues, supervisors The bottom line is that if we don’t and senior executives at a formal event, makes it extra special. I think it’s important do a good job of taking care of each other and recognizing the value each for managers to recognize great performance for retention, but also to improve the quality of work. When people are happy, they work better.” person brings, we won’t do a good Each manager receives regular CARES training and a kit that contains tips and job of taking care of patients and tools for implementing each of the five pillars of CARES in their work areas. The kit families either.” covers everything from behavioral interviewing guidelines and tips to best practices Susan Phillips, VITAS director of in managing a multi-generational workforce. employee relations says recognition “Recognition is a practice that creates a circle of care, particularly for our nurses can often make the difference at critiand support staff,” says Dian Johnson, general manager of VITAS’ Dade-Monroe cal moments for employees. “Nurses are often asked to stop by facility. “Because of the nature of what we do — go into people’s homes and give the care they need, we’re very spread out geographically. Recognition is a way to connect Front: Team manager Magaly Gousse, RN, with her and visit an additional patient on team at VITAS’ Dade-Monroe facility. their way home from work. That can VITAS employees back to the organization and let them know that what they are be frustrating when they are trying to doing is important. Hopefully, the recognition and connection they feel turns this get home to their own families,” says Phillips. “But what makes the difference at the into more than just a job.” end of the day in how that employee feels about the extra effort they’ve been asked For many recognition recipients, VITAS’ decision to to give is whether or not their manager recognizes them for it. If they get a phone implement recognition as a regular practice is a refleccall from the manager saying, ‘You saved the day, you came through, because of you the patient was cared for by a VITAS nurse and we made a difference,’ it makes all the difference in whether or not that employee who goes home feeling stressed, thinking this job is just too much, or instead goes home and tells their family how much they love their work because they really Bob Miller, Senior VP of Clinical Development and Bioethics feel like they made a difference and that they’re appreciated. To work in an organization where management wants to do those things is really a great thing.” tion of the company’s commitment to its values. Because VITAS realizes the value that employee recognition brings to its business “As an employee, the recognition is significant because it makes you want to do better and give the best of yourself,” says recognition recipient Lorena Ortiz. “If results and the quality of their employees, work experience, they have made recognicompanies don’t recognize, employees get tired and look for another job that’s going tion one of the five strategic pillars of the VITAS CARES initiative. CARES, which stands for Coach, Assist, Recognize, Engage and Satisfy, is a man- to fulfill them. But a company that’s constantly recognizing the employees and showing them that they care is not only showing that we want to keep you as an employagement training program launched by Mistry ee, but that they live up to their values, their mission as a company.” and the senior management team to offer In the end, recognition is an important way Mistry and her team help the organicompany leaders the training and tools zation realize important business results such as reduction in turnover and improved they need to better support VITAS communication. But even more important is the bond it creates between managers, employees. employees and the VITAS mission. “Recognition acts as a catalyst for the “The main reason people join employee-manager relationship,” says us is because of our reputation Mistry. “If employees leave us, we find Left to right: Peggy Pettit, EVP and Chief Operating Officer, Lorena Ortiz, recognition in the industry,” says Mistry. it is most often because of issues with recipient and Tim O’Toole, “But the reason they continmanagers and supervisors. So reducing CEO, VITAS ue to stay with us is because of the relationships with their managers, supervisors and their team of co-workers. Strong recognition practices help us in both areas — to s and families attract and retain in a very ome first. competitive labor market.” proud to make
AS VALUES
ifference. my best today even better morrow. ake care of ch other.
n Johnson, General nager of VITAS’ Dadenroe facility
“The bottom line is that if we don’t do a good job of taking care of each other and recognizing the value each person brings, we won’t do a good job of taking care of patients and families.”
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Creating a Carrot Culture: The Executive Recognition Summit
Sharing best practices to strengthen cultures, develop leadership and engage people in the success of their organizations
World-class leaders. World-renowned location.
Comments:
Organization-changing results. The 2007 Creating a Carrot Culture: Executive Recognition Summit held October 4, 2007, in New York City brought together some of today’s most influential HR business and thought leaders to discuss how recognition is improving business results in their organizations. The conference, sponsored by O.C. Tanner Company, explored themes of leadership development, organizational culture, managing generational diversity, cultivating talent, reducing turnover and developing an organizational brand. In addition to sharing new recognition strategies and successes, attendees learned why some of the world’s most successful organizations are putting unprecedented emphasis on engaging employees to achieve better business results. Leaders discussed how strategic recognition is changing today’s business environment and fielded questions about the impressive results of their recognition efforts. The gathering included presentations and panel participation by: David Ulrich, Best-selling Author and renowned HR Consultant; Bruce Pfau, Vice Chair, Human Resources at KPMG; Kent Murdock, CEO of O.C. Tanner, Nancy Koury King, Chief Operating Officer and Executive Vice President of Community Services for Ohio Presbyterian Retirement Services (OPRS); Michele Cox, Director of Employee Initiatives and Effectiveness at Quest Diagnostics; Joan Kelly, Vice President of Global Compensation and Benefits at DHL; Amanda Merriman, Senior Organizational Development Specialist for McLane Company; Kal Mistry, Senior
Vice President of Human Resources for VITAS Innovative Hospice Care and Chester Elton, Bestselling Author of The Carrot Principle. Also at the Summit, the 2007 Carrot Culture award was given to the organization that has best implemented the spirit of the Carrot Culture and enjoyed business results because of it. DHL was awarded the honor as a result if its success in engaging its employees in achieving the goals of the organization, training its managers to become more relevant to their employees and driving business results from the ground up. DHL has also been overwhelmingly successful in raising overall awareness and utilization of the recognition program as evidenced by a 330 percent increase in program participation in 2006. The Executive Recognition Summit is a oneof-a-kind event that has become the premier recognition conference for HR thought leaders. It provides its select group of attendees a candid look behind the scenes of some of today’s most respected organizations and the people practices that help them gain and maintain market leadership.
“I appreciate that The Recognition Summit was what it was billed to be — a high level forum for sharing ideas and getting the practice of recognition right in our organizations. Personally, I have so many events to choose from that it is critically important that I make the most of the events I choose to attend ... The Summit provided me with key takeaways.” Jeff Shuman, Vice President Human Resources and Corporate Relations Recipient 2007 Stevie 姞 for Best Human Resources Executive, American Business Awards Harris Corporation
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“I thoroughly enjoy the work I’m doing and the people I work with. I plan to be here until God or Mother Nature makes other plans.” Juanita Taylor
Joan Kelly, global vice president of compensation and benefits for DHL, accepts the 2007 Carrot Culture award from Dave Peterson, president, O.C. Tanner.
“We are at the beginning stages of forming a reward program and came to The Summit to better understand non-monetary rewards. My aha’s have come from the myriad of little things that companies are doing at little or no cost that have an impact on employees.” Rima Dagia, Marsh USA Inc.
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SIXTY YEARS OF SERVICE
O.C. Tanner wishes to congratulate Juanita Taylor of Rockingham Memorial Hospital, located in Harrisonburg, VA, who recently celebrated 60 years of service to the organization. Taylor was hired in 1947, and has played important roles in everything from medical records to radiology to quality review in her decades at the hospital. In addition to her work, she continues to donate more than 1,000 volunteer hours to the hospital each year. “I thoroughly enjoy the work I’m doing and the people I work with. I plan to be here until God or Mother Nature makes other plans,” says Taylor.
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RECOGNITION AND WELLNESS: Retirement Services Provider Measures the Connection W
COLUMBUS, OHIO — hile many may not consider recognition a matter of life and death, leaders at Ohio Presbyterian Retirement Services (OPRS), have discovered that for the 3,000 residents and 50,000 clients it serves, it truly is. “We have been able to go beyond connecting great recognition practices of the typical metrics — turnover, satisfaction, engagement,” says Dana Ullom-Vucelich, vice president of human resources for OPRS. “Not that those things are unimportant — they are very important. But what really caught our attention is that when locations have high recognition scores, their residents also have fewer incidences of infections and pressure sores, they have improved health department scores and there is greater continuity of care.” The tie between effective recognition practices and better patient health seemed almost too good to be true. OPRS, an 80-year-old, not-for-profit employer of 3,000 people, focuses on offering quality care to older adults in services ranging from retirement living options to hospice care. So at UllomVucelich’s urging, the organization has amassed an impressive body of internal data that definitively correlates recognition practices to improvements in important outcomes such as employee satisfaction, nurse retention and overall patient wellness indicators. “Practical experience typically fuels HR executives to tout the importance of employee recognition,” says Ullom-Vucelich. “But not everyone in the organization comes from an HR perspective. That’s why I felt it imperative to find a way to relate the importance of recognition to other leaders in a compelling way so that they would feel as passionate about recognition as I do.” Ullom-Vucelich partnered with OPRS Senior Independence Executive Vice President and COO, Nancy Koury King to cultivate an employee opinion survey and further evaluate the data in a way that gives leaders operationally significant results. “Often the only stakeholder for recognition is HR,” says Ullom-Vucelich. “Our partnership and our data convinces and involves every other business partner in the organization — from the financial stakeholders to the quality healthcare stakeholders — they see how recognition makes a difference for the outcomes they care about most.” The data King and Ullom-Vucelich regularly gather and evaluate compels even their biggest critics. “Five of our top 11 indicators of job satisfaction are recognition related,” shares King. “In short, those OPRS locations that are more effective at using recognition have lower turnover, better health department reviews, greater resident satisfaction and higher wellness indicators than locations that don’t. Everyone here cares about results like that.” King emphasizes the importance of communicating to people in the organization “at the level at which they can hear us — meaning that if it’s data they want, share it; if it’s stories they need, tell them.” She shares the example of a Director of Nursing for OPRS who did not believe in taking the time to “recognize nurses for just doing their job.” As King discovered, the manager’s reluctance was based on a singular focus on the well being of OPRS clients. In order to win her over and educate this key manager on the importance of recognition, Nancy showed her the statistics — the impact recognition has had on improved patient wellness measures in locations with greater recognition. According to King, this manager, and many other managers like her, have been won over and are now recognition advocates at OPRS because of the Nancy Koury King, OPRS Executive Vice President and COO
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research that proves the case for recognition. “This data screams to our nurse managers,” says King. “There is an overwhelming preponderance of evidence that the recognition initiative works. It results in overall better patient care, happier nurses, and fewer headaches for our managers. It’s a win for everyone.” The biggest financial win for OPRS has been in its ability to reduce turnover at those locations where recognition is used most effectively. “When recognition is present and practiced effectively, our nursing turnover is reduced by 23 percent,” says King. “No matter how you figure your turnover Left to right: Linda Knapp, Resident Assistant, Steve costs, 23 percent is a big LeMoine, Executive Director of the Westminsterdeal. And it’s an even bigger Thurber facility, Jennifer Howell, HR Director for OPRS’ Westminster-Thurber Community. deal when you’re dealing with a population as important and scarce as nurses. We do everything we can to hang on to them and, aside from the basics, it looks like recognition is having the biggest impact.” OPRS recognition practices range from daily “huddles” (where managers and employees gather for a short time to share company news and thanks for team support and accomplishments), to recognition for years of service and most recently the organization has added a values-based performance recognition program. Local sites also use on-the-spot recognition such as “Caring Hearts” and “Power of One” cards to recognize outstanding employee actions. “Recognition is not a program for us, but a culture we’re trying to instill,” says Ullom-Vucelich. “O.C. Tanner is the company that helps our vision take flight. Our advisor, John Cassell, and his team have been instrumental in connecting our values to how we reward in relation to who we are as a company.” Training for OPRS managers begins at the top where Ullom-Vucelich and King use executive planning retreats to present their findings on the impact of recognition on important measures for the organization. They then encourage senior leadership to model recognition behavior with specific suggestions and challenges. Leaders take those suggestions back to their managers and explain the impact recognition can have at their individual sites. “The core leadership team at OPRS gets it,” says OPRS Senior Independence registered nurse Julie Maynard. “Of course we know we are all replaceable in one sense or another, but I’ve never really felt that way here. Management always goes out of their way to remind you that you’re important. And at the end of the day, that goes a long way.” Many locations build in opportunities to help managers be successful in recognition practices. “Each week during our management meeting we designate time for our 17 leaders to send thank you notes to employees they see making a difference,” says Jennifer Howell, HR director for OPRS’ Westminster-Thurber Community. “It is not our goal to be punitive with managers who need help learning about recognition (continued on page 6)
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Dana Ullom-Vucelich, Vice President of Human Resources for OPRS
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OPRS (continued from page 5) and understanding its impact. We must give them every opportunity, every tool possible to help them be successful.” Steve LeMoine, executive director of the OPRS Westminster-Thurber facility says recognition is making a big difference for his staff. “I have seen such an improvement in the attitudes of our staff to move towards consciously saying, ‘I am not a dictator,’ to, ‘I am a facilitator and a coach,’” says LeMoine. “These programs really enable our managers to be all they can be.” “People will often not have any remembrance of the name of the organization, but they will always remember the name of the nurse or aide that offered the care — they are the face of our organization,” says Linda Artis, executive director of OPRS’ Columbus Senior Independence office. “Money for increased salaries is very limited. But praise and having people feel bonded Nursing Recognition and Nursing Job Satisfaction Locations with High Recognition = 75% satisfaction Locations with Low Recognition = 62% satisfaction Nursing Recognition and Nursing Turnover Locations with High Recognition = 39% turnover Locations with Low Recognition = 62% turnover
13%
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Employee Satisfaction and Health Department Scores Locations with High Employee Satisfaction = 18.3 scope and severity points (the lower the better) Locations with Low Employee Satisfaction = 26.6 scope and severity points
A W A R D
to the organization and giving them the opportunity to feel like what they do is worthwhile, those things are unlimited. And that’s what recognition gives people.” For Ullom-Vucelich and King the fact that recognition can make a difference at every level in the organization, from the resident to the nurse to the success of each manager, makes it one of OPRS’s most important priorities. “If HR is the only one talking recognition, then it can quickly become just another HR program, not a company-wide philosophy,” says Ullom-Vucelich. “At OPRS, HR partners with operations and opens the door for employee recognition to be a widely held core value.” It’s hard to argue with OPRS results:
8.3
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Employee Satisfaction/Turnover and Resident Medical Condittions Locations with High Employee Satisfaction = 4% reduction in urinary infections Locations with Low Employee Turnover = 6.5% reduction in pressure sores Location with Low Employee Turnover Reduced Patient = 3.25% reduction in Turnover Wellness resident falls
Background: Linda Artis, Executive Director, Senior Independence
COMPANY Kudos Volume 11 Number 4 Publisher Managing Editor Design/Layout Graphic Supervisor Award Photographer
O. C. Tanner Recognition Co. Mindi Cox Janice Takagi Shauna Raso Rick Hayward
KUDOS is published by O.C. Tanner Recognition Company, 1930 S. State St., Salt Lake City, UT 84115. Copyright 2007 by O.C. Tanner. All rights reserved. Reproduction in part or whole without written permission is prohibited. Not responsible for unsolicited materials. Second-class US postage paid at Salt Lake City, UT 84101 and additional offices. Postmaster send address changes to above address.
KudOs ku-dos — It may sound a bit exotic to your ear, but it’s a great word. It’s of Greek origin, and means to acclaim or praise someone for their achievements. Kudos to Alice on her 15 years of service.
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