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Staffing Management: The Patient Approach

Steve Taylor  10/1/2006
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Vol. 2, No. 4

Griffin Hospital attracts workers by giving them the opportunity to provide health care the way they envisioned it when they started their careers..

Griffin Hospital has seven major competitors nearby, including the much-better-known Yale New Haven Medical Center. Griffin pays its employees less than the average for its primary market, central Connecticut’s Lower Naugatuck Valley.

Yet, says hospital Vice President William Powanda, “We project to have 6,200 applications for about 140 open positions this year.” In an industry where nurses often jump from hospital to hospital in search of signing bonuses, Powanda says, “We have just two nursing positions open.”

The hospital does minimal advertising and rarely posts jobs except on its own web site, according to HR Director Stephen Mordecai. “Most people learn about us by word of mouth.”

How does Griffin maintain a generous flow of applicants, especially for such hard-to-fill positions as nurses and clinical care specialists? By giving prospective employees “an opportunity to provide health care the way they envisioned it when they started their careers,” says Powanda.

Griffin practices patient-centered medicine. It’s a claim that is common to many hospitals, Powanda says, but he adds that Griffin is different because management “walks the talk of commitment to that model” and believes that employee satisfaction grows out of patient satisfaction.

At Griffin, patients may review their own medical records.

They’re encouraged to ask questions of doctors and nurses.

The patient-to-nurse ratio is kept low to ensure responsive care. Patients may be visited at all hours. When they and their families arrive, they find a pianist playing in the lobby, and arts and entertainment programs along the corridors. The irritating blare of overhead paging is minimized. Frightened patients calm themselves with the help of friendly pet therapy dogs decked out in candy-striped and white coats. Often, the smell in the air comes not from medical odors but from the fragrance of cookies baked by volunteers.

“It’s an environment that’s appealing to staff as well as to patients,” Powanda observes. Nurse Melody Martin-Newman says, “It really is what they say it is, a different concept of care. It’s very holistic. We’re able to spend quality time with our patients.”

With a chuckle, she adds, “I can’t turn down the free massages they offer, either.”

Griffin Hospital is listed by Fortune magazine as one of the 100 Best Companies to Work For. It is the highest-ranking small company on the Fortune list and was fourth overall for 2006, its highest position ever. Griffin is the only hospital named to the list seven years in a row.

At other hospitals, says Mordecai, “You’re just a number collecting a paycheck. We’ve created an environment that’s nurturing, that’s pleasant to come to. And most of our employees had a share in developing the culture that’s here.”

Letting Employees Do It Right

Before constructing a new building in 1994, “we rented a warehouse across the street and built full-scale mockups of private, semi-private and critical care rooms,” recalls Powanda. “Four hundred employees went through suggesting changes. It drove the architects nuts, getting 400 little slips of paper, but when the employees saw [the results], it was amazing. It created a sense of ownership and pride.”

“We have primary nursing,” says Martin-Newman. “You’re assigned to one section of the floor and those rooms are your rooms. You really get to know the patients. Their families rely on us. We get very involved in their care.”

Griffin’s goal is to have 4 to 4.5 patients assigned to every day-shift nurse, with ratios of 6 to 1 on the evening shift and 8 to 1 on the night shift. Powanda acknowledges that those ratios increase the total salary cost for nurses, but says they make for more satisfied employees and patients.

Martin-Newman says that, at other hospitals, day nurses may handle eight patients each, and those working overnight might have 15 to 20. “They don’t have time [to give adequate care],” she says. “I don’t think they have this good communication between patient, nurse and doctor.”

Some doctors left Griffin after the new policies were introduced in 1992, balking at the enhanced status of nurses, the open medical records and other patient-centered practices, but, Mordecai says, “The ones who stayed—it’s OK with them, and they prospered.”

“I can’t stress enough how much the doctors value and listen to our opinions,” confirms Martin-Newman. “They really want our perspective. They don’t want to get information just by reading a [medical chart].”

“The co-workers here really truly like each other. We want to help each other out,” says Donna Gramolini, the secretary for Griffin’s Department of Medicine. “Here, everybody pulls together.”

Benefits Level the Field

Now consider the salaries. HR Director Mordecai says, “In clinical areas (nurses, radiologists, medical technicians, etc.), we pay below market.” VP Powanda agrees: “Our average pay rates are about 5 percent below competing hospitals.”

Monetary incentives and other benefits are substantial, however. Registered nurses certified in their area of specialty receive an additional $3 an hour ($6,240 annually), the highest such differential in the state. By mid-2006, Powanda says, Griffin’s annual cost of the certification differential was about $525,000.

Griffin’s pay differentials for nurses working evening, night and weekend shifts, and for those advancing professionally, are competitive, as are its hiring bonuses. The annual allotment of 12 days of sick time may accumulate to a six-month maximum that many long-term employees have attained. (The hospital reports an average job absence rate of 0.95 percent, which Powanda asserts is 35 percent lower than the national rate for hospitals.)

Griffin pays employees a $3,000 recruitment bonus for filling certain positions. Early in 2006, there was a $5,000 recruitment bonus for physical therapists.

Smaller bonus programs are widely subscribed. At the end of each quarter, CEO Patrick Charmel presents $25 checks to every employee if the hospital hits institutional and departmental performance goals and $25 to every employee in departments that hit department goals. (In 2003, based on exceptional financial and operating performance, every employee received a crisp $100 bill.) A separate program provides $50 after-tax checks to department-of-the-quarter staffers and $250 checks to employees of the month. Managers have a variety of smaller rewards they may bestow, from lunch passes to Dunkin’ Donuts gift certificates to free car washes. Cafeteria meals are subsidized.

There’s a tuition reimbursement program, a wellness program and free use of a full-service fitness center for staff and family members. Parking is free for all employees. “Parking in New

Haven would be $150 per month,” Mordecai says.

Do the benefits balance the lower base pay? Mordecai says yes: “We are paying as much if not more than competing hospitals, when taking into account the total employment package.”

Powanda agrees, “particularly if you consider the defined benefit [pension] plan. Last year, in a $100 million budget, we put close to $4.5 million into the pension plan.” He reports that Griffin has contributed $18 million over the past five years and claims the plan is in the top quartile of the industry.

Employees who feel valued and respected, who are allowed and trusted to do good work, will be happy and productive. “A lot of businesses say, ‘That’s nice, but this is the real world,’ ” says Joseph Burnett, Griffin’s emergency medical services and emergency preparedness coordinator. “Well, the real world is what you make of it.”

Powanda says, “We asked employees what they would want an ideal hospital to be. What they described is foreign to most hospitals: open visiting, more information, a caring and friendly staff. Obviously, they are the staff, but they saw rules that prevented them from being friendly and caring.”

Now, says Gramolini, “It’s not just a job here. People take ownership in it.”

And nurse Martin-Newman says, “At the end of the day I feel like I’ve done what I wanted to do when I went into nursing… like I’ve really taken care of somebody completely, from head to toe.”

Steve Taylor broadcasts the news on the ABC Radio Networks.

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 At a Glance


Griffin Hospital

President and CEO: Patrick Charmel

Size and type: 160-bed, 15-bassinet acute care hospital

Employees: 1,098 full- and part-time

Budget (2005): $92 million

Employee compensation and benefi ts (2005): $55 million

Admissions (2005): 7,226

Outpatient Visits (2005): 164,640

Griffin Hospital is a not-for-profit, tax-exempt subsidiary of the Griffi n Health Services Corp. It is the flagship institution of Planetree, a formal affiliation of 110 hospitals in the United States, two in Canada and one in the Netherlands, committed to humanizing health care.


 Visiting Hours


As Griffi n Hospital’s success has grown, so has the number of requests from other hospitals for visits and consultations.

“We’re probably now at 580 hospital tours since 1995,” says Vice President William Powanda. “As a result of the interest in visits to Griffi n, we decided to implement a fee, principally to ensure that people who are coming to Griffi n are serious. We were getting a lot of tire-kickers.”

The fee is $3,000. Powanda says, “It did eliminate those who were just curious.”


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