Three Key Components Of A Human Resources-oriented Culture Can Afford Any Company Big Payoffs In The Long Run.
By Jerry Roche
Scripps Health is by no means your average organization. But its employee-focused corporate philosophy has the potential to help turn any average company or organization into a “career destination.”
Since the passage of the Patient Protection and Affordable Care Act (ACA or “Obamacare”) in 2010, there has been a massive change in the health-care industry. They have impacted Scripps, the largest health-care organization in the San Diego area with four hospitals on five campuses, 26 outpatient and specialty centers, almost 14,000 employees, 1,500 volunteers, 158 medical residents and fellows, and 2,600 contracted physicians. But Scripps has developed a formula that will enable it to be not only competitive but dominant as more of the ACA is rolled out in the coming months and years.
“We’re dealing with making a lot of moving parts come together,” says Veronica Zaman, the Scripps vice president of Human Resources and Learning. “We are finding that our reimbursement rates are declining. It is so incredibly important that we have staff that are well-trained, that understand how to work collaboratively, how to drive toward teamwork, and how to maximize the work we used to do, in a different way. The culture of Scripps is one that has been created to enhance our capacity to make sure we have the right people in the right place with the right skillsets.”
Amanda Kienast, director of Talent Acquisition, adds: “We think of ourselves as a career destination employer, and we’re committed to offering our employees every opportunity to realize their professional goals [at Scripps]. If we do it right, there’s no need for employees to leave the organization. We take pride in providing an environment where our employees can enjoy a supportive, collaborative workplace with a united vision.”
To that end, Scripps Health is making every attempt to stay ahead of the talent curve. Its talent management team works to be proactive in hiring, developing and supporting employees to create the best opportunities for both them and the organization. It all starts with the hiring process.
“We strive to hire candidates with characteristics closely aligned with our values of quality, respect and efficiency,” notes Kienast. “As part of our career destination philosophy, we’ve developed several innovative hiring and retention practices. We seek to hire top talent and then develop their skills and knowledge to do the following: provide quality clinical care and service; innovate new services and care models; and lead and manage change.”
To attract potential candidates, Scripps uses social media, Web campaigns, search engine marketing and optimization, and more. On a more traditional level, it sends recruiting representatives to campus career and other off-site events. It also has a robust employee referral program.
Then, “we use a variety of analytical and online tools to assess candidates and talent for the best organizational fit,” Kienast notes. Scripps provides education, training and development programs to help employees and the organization stay competitive and successful: “We work with our talent managers on how to identify and grow talent within their depts. Our talent management team meets with employees to promote growth opportunities and assist them in discovering educational or financial resources that they would need to succeed in career development.”
Because Scripps is so large, there are plenty of chances for any employee to move either horizontally or vertically within the organization. That gives them a chance to take on new projects, new responsibilities and new challenges.
“The [internal] pipeline process was very well thought-out,” says Zaman. “It’s built on a prescriptive process. We use the same assessment tools and the same criteria that we use when we hire. It’s not so much about the skills. It’s really about making sure people have those characteristics that make them a strong team player.”
Starting At The Top
“Heading us in this journey is Chris Van Gorder, our president and CEO, who’s a key member of our team,” Zaman continues. “At a time when health care is feeling the tightening reins of the reform and reimbursement that is diminishing, we have at our helm a leader with his passion for learning.
One of Van Gorder’s strengths is that, every day, he asks himself and he charges every employee to ask the question: “Did I make [our founders] proud today of what I’ve done?”
When Van Gorder became president, Scripps had a first-year turnover rate of 30 percent. In other words, a revolving door. Morale was at its lowest point ever, but his commitment to his employees and his focus on learning helped turn everything around.
“At a time when health care is feeling the tightening reins of the reform and reimbursement that is diminishing, we have at our helm a leader with his passion for learning,” notes Zaman. “He is hands-on, at the front line, with our patients, and a big piece of our success is the collaboration among Chris and all our team members.”
‘Value By Design’
Scripps managers list four strategies for success:
1 Innovate to manage the health of the people it serves.
2 Transform delivery of clinical care.
3 Move to new payment models.
4 Implement “Value by Design.”
“‘Value by Design’ is our term internally to describe how we are developing and engaging our workforce to reduce cost, eliminate waste and create value,” says Stephanie Becerra, a senior corporate director. “We are utilizing lean principles to help adapt to the rapidly changing health-care environment. It requires employees to innovate, to engage, and to behave in a different way.
“We are providing learning to help them. Learning starts from day one in new employee orientation.” Then, “all employees actively participate, share their expertise and become creative thought leaders — not just identify problems but to solve them and take ownership of their solutions. They also must speak up and have courage to expose challenges, to not create work- arounds, because work arounds won’t get us to where we need to go as an organization. They must help us to see what the challenges are that inhibit them from performing at their maximum.”
Another key part of this forward-thinking approach is the active participation of leadership.
“Our expectation of our leaders is to work with their staff in a new way,” Becerra notes, “involving them in problem-solving, hearing from them, listening and coaching them to identify better ways to work.”
In the end, it’s getting cooperation at every level, Becerra continues:
“Our expectations are for staff to engage in higher levels of trust with each other, and to try new ways of doing things. Right now, we have a culture that thinks outside of the box. We have formal learning to help create that culture, classroom settings, workshop settings. We’re also taking learning out to staff and management in the units, coaching and helping them understand this lean way of thinking.”
A Successful Program
Last year, Scripps Health was not only named to Elearning! magazine’s “Learning 100” list, it was at the top of the private sector list. One of the programs that helped Scripps attain that lofty position was its new Graduate RN Residency Dedicated Education Unit — a perfect example of how the company treats its valued employees.
Scripps designed the DEU program to achieve higher levels of satisfaction and retention among new graduate nurses and improve performance. The 12-month program is divided into two phases.
Phase One consists of nine months on a dedicated education unit with emphasis on developing knowledge and critical thinking skills while building a confident and competent practice within the Scripps care model. It also ensures standardization of practice in the training and development of the new nurse. A critical aspect of this experience is pairing the new grad with a dedicated clinical coach who has specialized training to provide structured support. These coaches validate skills and knowledge needed to practice independently and provide consistent feedback on the resident’s strengths, needs and individual performance goals.
Phase Two of the program consists of a facilitated transition plan to the new graduate’s assigned home unit.
In 2013, 147 new graduate nurses were placed in the Scripps system, and 132 were on target for placement in 2014. Both mentors and participants have given the program glowing reviews.
New graduate Bridgid McGowan, RN, says: “The clinical coaches have made the transition from student to new grad RN, while not easy, definitely less painful than I imagined. The support I’ve felt from the program is what has gotten me through many a difficult shift, and I am eternally grateful to have been a part of this educational new grad program.”
Onward And Upward
“We know there will be challenges ahead: an aging workforce, new generations with different preferences, a continued shift in health-care reform; forecasting and planning for service expansion, growth, turnover and retirement,” Kienast notes.
But if the past is prologue, Scripps Health will be on the cutting edge of innovation, employee growth and patient care. It will continue to be a “career destination employer.”