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What a Conference - What a Year!

Dear ASHHRA Members:

I can't believe we are already into the fourth quarter of 2007. What an incredible year it has been for ASHHRA. We just concluded the most successful conference in our history, with more than 680 attendees, and some of the best speakers and learning sessions ever. The Centre for Excellence proved to be the perfect location for participants to network with colleagues in between visits to exhibitors, and our sponsors, AIG Valic and MetLife did an outstanding job of providing us with two unbelievable social events.

One of the biggest thrills for me during the conference was unveiling our new ASHHRA Foundation. As part of the ASHHRA mission, our society exists to help promote the professionalism and development of healthcare HR leaders. Our new Foundation helps us further that journey. The ASHHRA Foundation represents the opportunity to support and fund education, research, and development that supports the evolution of healthcare HR leaders. We are grateful to MetLife who stepped up to the challenge and became the first financial supporter of our Foundation. At the beginning of November, you will receive a full packet of information about the Foundation. Please consider the variety of ways you and your organization can support the Foundation, as well as benefit from the resources.

I was also pleased to present the ASHHRA 2008-2010 Strategic Plan during the ASHHRA 43rd Annual Conference and Exhibition. If you missed the presentation at the business meeting lunch, look for an article in the upcoming HR Pulse and learn more about the direction and priorities for ASHHRA in the next three years. In addition, please consider completing the volunteer interest form - available on the ASHHRA Web site - and let us know how you can contribute to the future of ASHHRA.

Two exciting new items ASHHRA recently launched are the ASHHRA Healthcare HR Career Center and the ASHHRA Healthcare HR Buyers Guide - both online services available free to all healthcare HR professionals. These new tools are great resources that can help us be more efficient and effective in our roles. Please spread the word among your colleagues.

And as always ... Commit to the Journey and Accelerate Your HR Leadership.

Regards,
Molly Seals
ASHHRA 2007 President


Headlines

ASHHRA News
Legislative Recap from ASHHRA Conference

Legal
"Fourth Circuit Invalidates FMLA Waivers"
"Charges of a Different Kind"

Workforce
"Wellness vs. Privacy: Companies' Health Surveys Get Cool Reception"
"Health Systems Cut Nursing Shortage"
"Luck of the Visa Draw"

Compensation
"How Transparent Should Healthcare Compensation Be?"

General HR
"Beyond Day One"
"Appraising the Appraisal System"
"Giving Employees the Power to Thrive"

Benefits
"Solving the Benefits Puzzle: Fitting the Pieces Together for the Right Mix"
"A Guide to the New Proposed Rules for Cafeteria Plans"

Physicians
"A Local Solution for Hospital-Physician Relationships"
"Cutting Doctors' Hours May Not Reduce Medical Errors, Studies Find"

Management and Leadership
"Human Resource Safety Practices and Employee Injuries"
"16 Ways to Keep Your Best Employees--Without Breaking the Bank"


ASHHRA News

Legislative Recap from ASHHRA Conference

At the recent 43rd Annual ASHHRA Conference and Exposition, the Advocacy Committee sponsored a “Legislative and Labor” update. The session, with almost 100 in attendance, was co-presented by Jeff Payne, chair of the Advocacy Committee, and Jim Trivisonno, of IRI Consultants to Management, Inc. The session was divided into two segments. During the first half, Jeff recapped the legislative issues that had been or were still being watched by AHA, ASHHRA, and SHRM. These issues included the “Employee Free Choice Act,” which ASHHRA and SHRM oppose. Participants were told about the Coalition for a Democratic Workplace (myprivateballot.org) and encouraged to become more familiar with it. Undoubtedly, the Free Choice Act, which stalled this year in Congress, will be resurrected next year.

The issue surrounding the definition of a nurse supervisor is currently being debated in Congress. ASHHRA will continue to update its members and ask for help as events unfold. Also mentioned was the Nurse and Patient Safety Protection Act of 2007, which would mandate lifting restrictions. ASHHRA and the American Organization of Nurse Executives (AONE) feel this bill is an example of another unnecessary and burdensome regulation.

The Healthy Families Act would create mandatory sick days. ASHHRA and SHRM oppose this primarily because it would layer additional mandated time off onto existing FMLA provisions. Until the FMLA itself can be properly reinterpreted, we don’t feel the time is right to debate bills like the Healthy Families Act.

Attendees were encouraged to become familiar with The National Coalition to Protect Family Leave, an organization that ASHHRA and SHRM supports, and who’s objective is to return FMLA to its original intent. Several bills aimed at expanding FMLA coverage were mentioned. Also mentioned was the DOL's recent report summarizing the comments they requested and received from across the country about the FMLA. In short, the DOL thinks the law is working largely as planned, but that it might have caused unintended problems and friction with its subsequent interpretations on intermittent leave and serious health condition definitions.

The immigration issue was characterized as enormously complicated and compounded by attempts in Congress to deal simultaneously with legal and illegal immigration. The STRIVE (Security Through Regulated Immigration and Vibrant Economy) Act was mentioned. Participants were encouraged to visit the “HR Initiative for a Legal Workforce” Web site. ASHHRA and SHRM support an automated I-9 verification process as long as the system is easy to use, fully integrated, and did not represent an additional cumbersome requirement to HR departments.

Also mentioned was the recent passage of the Mental Health Parity Act, which was supported by ASHHRA and the AHA.

For more advocacy resources, go to the advocacy section of the ASHHRA Web site. Return to Headlines


Legal

"Fourth Circuit Invalidates FMLA Waivers"
Inside Counsel (09/07) P. 75; Laird, Lorelei

In Taylor v. Progress Energy Inc. (Taylor II), the Fourth Circuit Court concluded that employees cannot waive their right to sue under the Family Medical Leave Act (FMLA) unless they obtain permission from the U.S. Department of Labor (DOL) or a court. The decision upset many employers habitually asking departing employees to waive claims, and it prompted the DOL to request a rehearing. The DOL argued that a waiver of retrospective rights would be valid according to the DOL’s understanding of FMLA, but the Fourth Circuit claimed the regulation clearly does not discriminate between prospective and retrospective rights. The court’s majority added that FMLA’s purpose would be undermined without the right to sue retrospectively. Though the case may go to the Supreme Court, employers for now will have to come up with innovative methods for restricting their liability. When handling workers who might file such claims, employers should refrain from taking waivers to the DOL or to a court because those strategies would be costly and could take a long time to resolve. Instead, employers should urge workers to sue and settle, as filing settled cases is one technique for managing these liabilities. Another option involves asking workers for written declarations that their FMLA rights were not infringed upon. Companies that intend to keep FMLA in waivers should incorporate a severability clause, which will keep the rest of the contract valid if the FMLA section is thrown out, according to legal experts.
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"Charges of a Different Kind"
Modern Healthcare (10/01/07) Vol. 37, No. 39, P. 6; Blesch, Gregg

Healthcare providers are anxious about recent criminal litigation and other cases against hospitals, administrators, physicians, and other staff with regard to medical misjudgments, negligence, and mercy killings. Recent cases include the charging and clearing of administrators at New Orleans's St. Rita's Nursing Home for deaths related to Hurricane Katrina; a suit by the city of Los Angeles against the Kaiser Foundation for allegedly dumping a demented patient on Skid Row; a Los Gatos, Calif. urologist charged with ordering unnecessary radiation treatments; and a transplant surgeon charged with hastening the death of an organ donor. The latter surgeon, Hootan Roozrokh, was accused of administering drugs to a donor to speed his death in order to salvage the heart, and his lawyer Gerald Schwarzbach says such litigation has "done significant damage to organ donation programs." A case by the Wisconsin attorney general against Julie Thao, whose medication error caused the death of a 16 year-old pregnant girl in 2006, drew sharp criticism from state healthcare agencies that similarly did not see the case as legal fodder. "Will the people that are here [in the healthcare profession] stay?" questions Wisconsin Hospital Association's Vice President for Quality Initiatives Dana Richardson, who said litigation like Thao's leaves physicians feeling defenseless. Larger firms also are being swept up by the wave of lawsuits. In 2006, Los Angeles City Attorney Rocky Delgadillo targeted Kaiser Foundation Hospitals in response to multiple accounts of patient dumping on Skid Row, including the highly publicized incident where former Kaiser patient Carol Ann Reyes was caught by a security camera wandering the streets in a hospital gown.
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Workforce

"Wellness vs. Privacy: Companies' Health Surveys Get Cool Reception"
San Francisco Chronicle (10/11/07) Colliver, Victoria

About 50 percent of all large employers have their insurance carriers or independent firms administer health assessment surveys to identify potential health risks among employees to steer them into programs to improve their overall health. While the use of insurance carriers and independent firms should shield workers from privacy violations, many workers are still concerned. The debate of health assessments is one of the central issues facing hospital managers in California where over 1,400 registered nurses walked off the job in protest of the assessments. Nurses agreeing to fill out the surveys would be referred to specific programs to improve their health, and those refusing to take the surveys could experience higher healthcare costs. The Milken Institute estimates that chronic ailments cost the U.S. economy up to $1 trillion in medical expenses and lost productivity for companies, which is why many employers are turning to disease management and wellness programs to create a healthier workforce. Alta Bates Summit hospital in California urged nurses to participate in the health assessment survey, which would allow them access to a wider range of hospitals, but nurses declining to fill out the assessments would either see contributions to health insurance premiums rise or see greater restrictions in their hospital network access. Alta Bates Summit Chief Nursing Officer Viki Ardito said, "While nurses know what's health and what's not, a very small percentage of them go to their doctors every year and get a wellness checkup. We know that because we pay for those visits." The hospital hoped to hire an outside firm to conduct the surveys and administer the disease management program, which would provide nurses with confidentiality, but critics are concerned the survey results could lead to discrimination or privacy violations in the future.
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"Health Systems Cut Nursing Shortage"
Detroit News (10/02/07) Kosmetatos, Sofia

Michigan, like many other states, will experience a significant shortfall in the number of nurses, reaching 18,000 vacancies by 2015. To stave off a staffing crisis, a number of hospitals are retraining and attracting nurses through various strategies to fill their ranks, including Henry Ford Hospital. Henry Ford Hospital turned to trained nursing professionals from the Philippines and other countries, but hospitals also have vacancies in respiratory therapy and other specialties on the horizon. Human resource experts indicate to fill these impending gaps, hospitals will have to improve the work-life balance workers experience. Henry Ford Hospital partnered with Henry Ford Community College to create undergraduate nursing programs, which require students to commit two years of their career at the hospital; the hospital also offers up to $8,000 in loans for staff members interested in a bachelor's degree in exchange for a three-year commitment with the facility. Henry Ford partners with a number of universities to offer degree programs clinical rotation students need for graduation, as well as internships they can have after graduation. The hospital spent about $1.2 million on the nursing program at the community college, but officials note the program and the other investments will ensure they have the staff necessary to meet patient care needs. Staff also have greater flexibility with their work schedules and are able to engage in policy decision-making processes at Henry Ford Hospital. Vacancy rates at Henry Ford Hospital have fallen to 3 percent from 10 percent in the last three years, and Oakwood Healthcare experienced similar improvements in staff levels when it opted to offer mentoring for new employees, reward nurses for employee referrals, and sponsor and train students. St. John Health Senior Vice President of Work Life Services Mary Naber recently indicated the hospital's use of foreign nurses, training programs, and centralized equipment locations helped reduce employee turnover from 15.6 percent to 11.6 percent in one year.
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"Luck of the Visa Draw"
Hartford Courant (CT) (09/09/07) Peters, Mark

In the past several years, a rising number of U.S companies have turned to foreign workers to fill professional positions. Unfortunately, many of those prospective hires are unable to get the H-1B visa required to work in this country. Even medical offices and facilities in desperate need of doctors and other professionals in scarce supply around the United States are unable to overcome the H-1B visa quagmire. Currently, U.S. Citizenship and Immigration Services limits the number of H-1B visas they distribute annually to 65,000. But last year demand for these visas was so high, the agency announced it would award visas on a lottery basis. Employers, especially those in science and technology, argue this method of choosing visa candidates is insufficient. Instead they want the government to substantially raise the visa cap. Many companies contest the cap limits their ability to find skilled workers for jobs that cannot be filled by U.S citizens; proponents disagree. They say raising the H-1B limits would take jobs away from U.S. residents because employers will replace them with less-expensive, foreign-born workers. Whether the visa regulations will be raised or not still remains to be seen. In the meantime, some corporations are looking to avoid the lottery by partnering with universities and other organizations who are not subject to H-1B limits.
Return to Headlines


Compensation

"How Transparent Should Healthcare Compensation Be?"
HR Pulse (10/01/07) P. 26; Bernat, John

Tougher regulations under the Sarbanes-Oxley Act, combined with public outrage following the Enron and WorldCom scandals, have led to a trend of increasing transparency in the business world. In the healthcare industry, higher-than-average compensation for executives continues to be painted as rewards for increased responsibility and competition, even though many CEOs earn a high salary and bonuses despite poor financial performance. For individual workers, healthcare managers are allowed to hire people within a range of pay, resulting in salary inequalities within an organization that discourages transparency of individual pay. However, if the move toward full disclosure continues, it could benefit a healthcare facility. A transparent system can increase trust between an employee and employer, which helps organizations retain good employees and effectively recruit the best new employees who are committed to the organization. While having an open compensation program that fully explains the pay ranges and rules regarding bonuses and raises can benefit a company, some managers may feel uncomfortable answering new questions or unable to change compensation rules to react quickly to an unexpected circumstance.
Return to Headlines


General HR

"Beyond Day One"
Human Resource Executive (10/07) Greenstein, Louis

Companies are beginning to see the value of an electronic onboarding system for incoming employees, with 76 percent of companies either currently using or planning on creating a formalized onboarding system. The many benefits of an electronic onboarding system include saving money on paper and postage when employees fill out financial forms online. Onboarding also can take care of many traditional first day tasks, such as assigning a desk or computer, to allow new employees to become productive members of a company faster. While this is cost-effective for companies, onboarding can help companies keep employees. An Aberdeen Group report reveals employees who are productive on the first day of a new job are more likely to stay with their new employer. Companies are still split over whether onboarding is a stand-alone function for bringing in a new employee or should be integrated with recruitment and extended past the first day of work. While some companies still believe that e-onboarding is not as important as other potential IT investments, a good system can cut down on additional administrative expenses, saving more than it costs to implement the technology.
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"Appraising the Appraisal System"
Health Management Technology (09/07) Stewart, Kristoffer L.

Though paper-based appraisal systems are common in human resources (HR) departments, the CentraState Healthcare System in Freehold, N.J., found their new electronic database system increases efficiency, allows employees to receive financial compensation on a timely basis, and saves time and money. The Group's Manager of Organizational Development Debbie Whalen recalls the dilemma of processing appraisals for over 2,300 staff before the March 31 deadline, which became increasingly difficult and occasionally caused employees to be overlooked for achievement awards. Specifically, Whalen noted procrastination from managers and the enormity of the appraisals, which often averaged 10 pages in length, caused an overburdened HR department to miss 10 percent of all appraisals each year. Whalen sought out a solution to reduce the amount of paperwork processed by the HR department, which in turn would allow them to focus on other important objectives. "The solution also needed to provide functionality for automating HR email reminders to managers for completing the appraisals, and a quick way to see the percentage of appraisals completed at any given moment," she says. Whalen and a selection committee chose a system tailored exclusively to the healthcare sector to electronically archive and service employee appraisals. Though the new system saves managers the monotonous task of computing appraisal scores, Whalen says some of system's features, including electronic signatures, posed a difficult adjustment for some. Nevertheless, CentraState HR says the database allows them to significantly compress the appraisal process, saving an average of 15 minutes per employee appraisal, or 575 hours of time annually. Whalen adds email reminders and smaller appraisal deadlines help managers submit information in a more timely manner, allowing the company to increase its completed appraisals--93 percent for 2007, an accomplishment Whalen calls "fantastic."
Return to Headlines

"Giving Employees the Power to Thrive"
Hospitals & Health Networks (09/07)

Singing River Hospital System CEO Chris Anderson indicates a hospital can only set itself apart from the competition by providing excellent patient care, and in order to accomplish this, he set about creating a management training program, run by the human resources department, to provide clinical supervisors with the business knowledge they needed to run their departments. Over 200 employees have undergone the training to learn hiring, managing, motivational, and financial skills. The hospital system collaborated with area community colleges and the Mississippi workforce development program to improve the training program, which consists of 12 classes, each four hours long. Trainees are tested on employee selection and interviewing, collaborative workplace principals, customer service, coaching, and other aspects of hospital management and finance. Final exams require trainees to apply real-life examples to three course-related questions orally. Anderson touts the program as a way to generate internal leaders, and supervisors nominate candidates for the training program. The AHA reports 1 percent reductions in turnover rates at hospitals, which currently average about 23 percent, could save a 500-bed hospital about $379 per worker or $1.325 million annually.
Return to Headlines


Benefits

"Solving the Benefits Puzzle: Fitting the Pieces Together for the Right Mix"
Health Insurance Underwriter (10/07) Vol. 55, No. 10, P. 38; Delisi, Scott A.

Insurance agents are a valuable resource for both companies and employees striving to review and understand their benefit options. Agents should begin by posing numerous questions to employers to discover the employer's ultimate vision for the benefit plan. The employer's benefits philosophy, business strategies, and growth projections are key pieces of information for agents to gather, as well as which benefits are crucial for the company's recruitment of top talent. Next, agents should distinguish the company's current trends in benefits usage by asking which features are most popular, what fraction of workers choose single coverage versus family coverage, and other questions. Because pre-made plans rarely include all the requisite features for employers' unique needs, agents and carriers must collaborate to design a comprehensive plan that satisfies all the needs identified during the information-gathering phase. In addition, many employers ask for benefits to be implemented in a painless and seamless manner, which means agents carefully should question insurance carriers to assess their levels of expertise. Ideally, carriers will display commitment, flexibility, and a willingness to create innovative solutions; large provider networks, numerous product options, and the capacity to handle employee data precisely and efficiently are other key considerations. Finally, it is important to support employees as they make decisions by clearly conveying the benefits' value, which can be accomplished by contrasting premium costs to the expenses sustained without coverage, for example.
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"A Guide to the New Proposed Rules for Cafeteria Plans"
Health Insurance Underwriter (10/07) Vol. 55, No. 10, P. 64; Joyner, Ric

In 1978, cafeteria plans were established as an option for the newly created defined-contribution plan, and remain a vital part of consumer-driven health, particularly in terms of maximizing benefits' tax status. Newly issued regulations on cafeteria plans codify verbal comments made by the U.S. Internal Revenue Service (IRS) over the years, and reshape cafeteria plans into practical benefits for the future. As a result, agents and employers must begin revising their plan documents to bring them up to date. Professionals should remember that cafeteria plans are akin to group insurance plans in many ways. For example, written plans must include the coverage term and the benefits offered, among other information. Like group insurance, cafeteria plans are irrevocable, transfer risk to the employer, and forfeit unused benefits. However, the new regulations have changed certain aspects of the plan. A safe-harbor test is a valuable addition for companies that provide one health plan to workers, as it will save both time and money. The new rules also define payment of individual insurance premiums within a discrete flexible spending plan, and premiums must now be verified through a claims review. Alterations to a plan year or short plan years are now permitted for legitimate business purposes, as well. The new rules, which also amend elements of long-term care insurance, deadlines for new employees, non-discrimination testing requirements, daycare rules, and debit care rules will go into effect on January 1, 2009.
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Physicians

"A Local Solution for Hospital-Physician Relationships"
Frontiers of Health Services Management (Quarter 4, 2007) Vol. 24, No. 1, P. 31; Perry, Michael R.

To foster productive relationships with physicians, hospitals must realize physicians efficiently use their time and make decisions with incomplete information, which is the opposite of how administrators make decisions. Relationships with physicians require buy-in and harmony, which is why administrators need to make an extra effort to explain the prioritization process for capital expenditures and other decisions facing the hospital. Educating physicians about management priorities and processes can improve relations greatly, according to experts. Moreover, some indicate having a few executives with medical or clinical experience can foster easier relationships with affiliated physicians, though listening and communication skills are still essential. To recruit the best physicians, hospitals need to review their programs to ensure scheduling flexibility, appropriate compensation, and call centers to capture physicians' calls. Long work hours, greater liabilities, and electronic medical records continue to complicate the healthcare landscape as hospitals seek improvements in care quality. Dr. Michael Perry indicates employing physicians can stave off obstacles to smoother physician-hospital relations, particularly when reimbursements decline, collaboration among healthcare workers become increasingly important, and negotiating clout is essential to reducing medical malpractice insurance and other costs. As care improves, both physicians and hospitals should be able to enjoy the rewards and meet systemwide goals.
Return to Headlines

"Cutting Doctors' Hours May Not Reduce Medical Errors, Studies Find"
Insurance Journal (09/06/07) Mattheessen, Keith

The result of two recent, comprehensive studies about the effects of sleep on doctors' performances surprised researchers, who found that only one of the four groups studied showed a decrease in patient mortality when physician-in-training work hours were reduced. Around 318,000 VA patients and more than 8.5 million Medicare patients around the country were involved in the studies, which examined patient mortality rates within 30 days of entering the hospital, before and after the rules took effect in 2003. Doctors expected to see an obvious positive shift in patient care after passage of the new laws, say Dr. Kevin Volpp, lead author of the study and a physician at the Philadelphia Veterans Affairs Medical Center. Not all doctors were surprised by the results, citing the sleep rules--limiting medical residents to 80-hour work weeks and restricting them from working more than 24 hours straight--as just one element in improving patient care. Volpp believes that "handing patients off" as doctors switch shifts can counter the benefits of sleep, and says it's possible some hospitals just are not adhering to the rules. The one positive study looked at VA patients being treated for heart attack, stroke, gastrointestinal bleeding or congestive heart failure. In larger hospitals, there were 11 percent to 14 percent fewer deaths in the two years following the sleep regulations, though surgical patients and patients in smaller hospitals saw no change, results which mirrored those in a similar study of Medicare patients. Dr. David Meltzer at the University of Chicago says of the studies, "There just wasn't any big effect on mortality one way or the other."
Return to Headlines


Management and Leadership

"Human Resource Safety Practices and Employee Injuries"
Journal of Managerial Issues (Quarter 4, 2007) Vol. 19, No. 3, P. 397; Lauver, Kristy J'Lyn

Human resources (HR) safety practices with regard to employee selection, training, evaluation, and compensation can impact organizational injury frequency and improve overall organizational safety, according to researchers. During the selection process, HR personnel should examine safety records of applicants, ask safety-specific questions to determine their breadth of knowledge, and emphasize safety values to new workers. The selection process should gauge prior work experience--which includes machinery and equipment and safety knowledge as well as skills used and learned--personality, intelligence, alcohol and drug abuse potential, and physical abilities. Adept training programs enable employers to ensure workers are abreast of the proper work and safety procedures for the organization and industry, but these programs also need to ensure workers are confident about their own abilities to head off potential injuries and to inform supervisors through open communication channels of behaviors and actions that should change to prevent unforeseen injuries. Performance evaluations need to emphasize safety values and procedures to gauge worker performance because these evaluations will prompt greater compliance and workplace injury declines, according to researchers. However, using bonuses and other incentives to foster greater safety improvement should not primarily focus on reduced injury rates, and companies can use individual or group incentive plans to improve safety, though some analysts believe a collaborative environment would benefit more from a group incentive plan tied to safety. A study of survey results from 54 firms regarding HR safety practices and five years of U.S. Occupational Safety and Health Administration accident reporting sheets yielded mixed results. For instance, while the data supported the use of selection, training, and compensation programs for individuals and groups to improve safety and found they were beneficial, performance evaluations tied to safety improvements and behaviors were not beneficial in reducing workplace injuries. Researchers stipulate, "Some HR safety practices were found to have an association with employee injuries, indicating improvements in safety go beyond ergonomics and engineering aspects. Oftentimes safety outcomes are potential indicators of managerial practices rather than indicators of an ergonomically unsafe environment."
Return to Headlines

"16 Ways to Keep Your Best Employees--Without Breaking the Bank"
ITWorld.com (10/08/07) Sujansky, Joanne G.

Employers need to prevent "greener pasture" syndrome among workers to retain and recruit top talent, and Dr. Joanne G. Sujansky indicates employers need to create a Vibrant Entrepreneurial Organization (VEO), in which employees believe they have an ownership stake in the firm. Step one in creating a VEO is to be honest about the organizational culture, and if the values currently represented by the group do not reflect the goals of the organization, new hires should be told and informed about the organization's plans to transform into the company it chooses to be. Once employees are hired, they need to be challenged or understand their employer is interested in their growth potential, which can be illustrated through tuition reimbursement programs aimed at getting workers to learn new skills or skills to improve their positions within the firm. Diverse workforces also foster employee satisfaction and loyalty because they enable the "free flow" of ideas, suggestions, and possible reforms. Another consideration is the creation of corporate social responsibility policy because many more workers are deciding on which employers to work for based upon their ability to positively affect their communities, the environment, and other concerns. Managers and executives should also develop employee recognition programs that praise good work to workers, their colleagues, and their customers; organizations also will want to have creative benefits programs in place beyond traditional health insurance and retirement savings plans, which could include catered lunches for workers after hours or on-site dry cleaning and other services. Employees needs evolve over time, which is why experts indicate managers and executives should give additional leeway to workers who genuinely need it and will not abuse it. Other organizational changes that could create a VEO include the use of "stay" interviews to allow workers to express what they like and do not like about their work environment, the periodic review of managers and weeding out of poor leaders and workers, the establishment of a work-life balance for workers, requiring workers to take vacations to decompress, and creating internships and mentoring programs that foster skills among workers that can fill in talent gaps should colleagues retire or workers need to be replaced, among other innovative strategies.
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