Banner
ASHHRA Spring Events

Dear ASHHRA Colleagues:

Happy Spring! What an exciting time of year it is. The first ASHHRA regional conference was a great success. The two-day event, held in Milwaukee, Wisc. (Region 5) attracted more than 100 attendees and presented powerful presentations on leadership. In addition, many of our loyal consultant members supported the event by exhibiting and sponsoring activities. Thanks to Carol Bank, Region 5 consultant, who stepped up in true leadership form to lead this effort.

The ASHHRA 10th Annual Chapter Leadership Conference gets underway in two weeks, with the largest attendee registration in recent history. We’re thrilled that so many of our chapter leaders are planning to join us in Chicago for this great learning and networking opportunity. This year, participants will spend more time with one another sharing knowledge and discussing member and chapter issues. It's a great time for me and the Board of Directors to listen to what our members need. Please be sure to communicate feedback to your chapter president prior to the conference, April 24 and 25.

As many of you know, the ASHHRA Awards Program is an important and valued member benefit. I encourage you to participate. Go to www.ashhra.org and click on “Awards” to access the application and requirement materials. All award winners will be announced at the annual conference.

Speaking of the conference, please register while you can still receive the early bird discount. And reserve your hotel room online using our new Passkey system. Go to the conference Web site for both registration and room reservations.

Special thanks to everyone who voted on the ASHHRA Bylaws changes. Members overwhelmingly agreed to the revisions and additions. A complete copy of the latest version is available in the Governance section of the ASHHRA Web site.

And as always, if you have questions or concerns, please feel free to contact me. This is your organization. We want to respond to your professional needs.

Regards,
Jeanene Martin, M.Ed., MPH, SPHR
2008 ASHHRA President


Headlines

ASHHRA News
New Member Resources on the Web!

Legal
"Potential Penalties for Healthcare Professionals Who Refuse to Work During a Pandemic"
"Plaintiffs v. Fiduciaries"

Workforce
"The Keys to Nurse Staffing"
"Informatics Competencies for Perinatal Nurses"

Compensation
"An Uneven Playing Field?"

General HR
"Special Report: Background Checking--Digging Deeper"
"Retention Tension: Keeping High-Potential Employees"
"Training for Success"
"Are Your Employees Truly Engaged?"

Benefits
"Health Insurance Audit Brings Relief to Bankrupt Hospital"
"Go for the Gold"

Physicians
"National Standards to Rank Physicians Planned"
"Rise in Specialists Puts General Surgery in a Bind"

Management and Leadership
"In Troubled Waters, Hospitals Need an Able Captain"
"Leadership's Role in Execution"
"Beat the Clock"
"Awakening the Leader Within"


ASHHRA News

New Member Resources on the Web!

You asked for it - you got it! In a recent ASHHRA member survey, you indicated that you want easy-to-access templates, policies, best practices, and other valuable resources. ASHHRA now gives you online resources and tools, specific to health care HR. Take a look.

Go to www.ashhra.org and click on "Resources" on the top navigation bar. Return to Headlines


Legal

"Potential Penalties for Healthcare Professionals Who Refuse to Work During a Pandemic"
Journal of the American Medical Association (JAMA) (03/26/2008) Vol. 299, No. 12, P. 1471; Coleman, Carl H.; Reis, Andreas

The question of whether healthcare professionals should work during a pandemic raises ethical issues, but now some states could penalize healthcare professionals who refuse to work during a pandemic. Maryland and South Carolina are two states with laws permitting license revocations, fines, and jail time for healthcare workers refusing to work during a pandemic. While some experts insist that individuals with the qualifications necessary to treat patients have not promised to do so, lawmakers could contend that in the process of becoming a healthcare professional, they made an inherent promise to treat patients in emergencies during their graduation oaths and through their professional associations' mission statements. Some experts argue healthcare workers should be penalized as they would for not treating contagious patients in a nonpandemic situation, with penalties such as the loss of their jobs or hospital privileges or being dropped from a managed care network. State licensing laws also carry penalties or disciplinary action if current patients are abandoned. However, in the event of a pandemic, some healthcare professionals may be able to make the case that their workplaces are "abnormally dangerous," and labor statutes would allow them to refuse to work without risking their jobs. Experts recommend governments consider incentives to reward healthcare professionals that volunteer to work during pandemics, such as hazard pay or immunity from civil and criminal liability.
Return to Headlines

"Plaintiffs v. Fiduciaries"
Institutional Investor (03/08) Vol. 42, No. 3, P. 86; St. Goar, Jinny

Last month the U.S. Supreme Court ruled that employees enrolled in 401(k) plans have the right to sue their employer for actions that decrease the value of their plans. Although defined-contribution plan sponsors were sued in the past, experts estimate that the Supreme Court's decision could lead to a large number of new lawsuits. "About 50 million people have 401(k) accounts and all are doing badly in this market," said Consultant Peter Demmer. In the Supreme Court case, James LaRue contended that his employer had cost his plan $150,000 by not following his investment instructions. The court's ruling opens up lawsuits for employees who claim that their employer is charging excessive fees, neglecting the choice of investment options, and poorly administrating the plan. Questions over plan costs and disclosure have some questioning whether the Employee Retirement Income Security Act (ERISA) needs to be reformed to include defined-contribution plans, which now hold more assets than defined-benefit plans. The U.S. Department of Labor recently proposed a regulation requiring defined-contribution plan sponsors to disclose certain fees, though bundled providers would not have to separate charges for investment management and administration.
Return to Headlines


Workforce

"The Keys to Nurse Staffing"
Trustee (03/08) Vol. 61, No. 3, P. 17; Miller, Phillip

Because patients have the most contact with nurses throughout their hospital stays, hospital executives and trustees must ensure the nurses on staff are competent and available. Nurses play a critical role in care from dispensing medications and monitoring treatment plans to providing assistance in the operating room. Adequate staffing can help curb hospital-acquired infection rates among patients, which reduces the length of stay for patients and minimizes potential losses for the hospital's bottom line. For instance, Medicare reimburses hospitals the same sum for cardiac patients whether they stay in the hospital one day or five days. Without adequate nurse staff, relations between physicians and hospitals suffer as well as patient care. Without proper staffing levels, hospitals may conduct fewer operations or other procedures, generate more patient complaints, and damage their own reputations. Chief nursing officers can help trustees and executives by assessing staffing needs by compiling patient volume, turnover rates, overtime payments, skill sets, and scheduling data; these assessments should be updated yearly. Hospitals must develop nurse retention programs, which ensure nurses take part in policy decisions, receive competitive salaries, and build trusting relationships between physicians and nurses. To recruit additional nurses, hospitals should target nursing schools with paid internships, consider hiring foreign nurses from abroad, using travel nurses to fill in unexpected gaps, offering scholarships or grants to nursing students, and hiring retired nurses with flexible schedules.
Return to Headlines

"Informatics Competencies for Perinatal Nurses"
Nursing for Women's Health (03/01/08) Vol. 12, No. 1, P. 62; Ivory, Cathy

Information technology is constantly changing the way the healthcare system operates, and these changes can overwhelm hospital staff. Assessing informatics competency in nurses can be just as essential to good patient care as standard competencies, like interpreting heart rates or putting in an IV. The Technology Informatics Guiding Information Reform (TIGER) initiative, created to better determine the IT knowledge levels of the nation's nurses, provides nurses with the information and skills necessary to ensure they are capable of utilizing technology efficiently. According to a TIGER initiative, hospitals need to focus on certain priorities to improve IT competency among nurses, including national and facility-focused programs. One pillar focuses on the need for informatics competencies that begin in nursing education programs at all levels of practice, but each organization must develop the methods used to inform nurses about informatics competency throughout orientation, practices, and annual assessments. Key competencies include computer literacy, data management, standard nursing language and terminologies, the ability to define some technological terms, and the ability to conduct online literature searches to evaluate sources being used by patients. One step in this process includes a questionnaire to discern nurses' comfort levels with computers and technology, which will reveal if additional training is necessary. A second step in the process is to provide nurses with in-services on technology topics, and lastly, evaluations of resources used in patient care should be mandated for completion by nurses. Experts say pursuing these initiatives will go a long way towards helping nurses overcome any hesitation they have in dealing with new technology. Once nurses are informed about technology and understand how to best use it, they are equipped with the knowledge necessary to contribute to hospital technology investment discussions.
Return to Headlines


Compensation

"An Uneven Playing Field?"
Modern Healthcare (03/17/08) Vol. 38, No. 11, P. 32; Vesely, Rebecca

Some healthcare experts are worried that pay-for-performance initiatives cause hospitals and physicians to focus more on their performance scores than on offering quality care to patients. Some say the programs also do not address racial and ethnic disparities in healthcare, and others argue hospitals no longer treat very ill patients because their deaths would lower performance scores. Though a recent study shows that there are now major differences in quality care for different races at hospitals, pay-for-performance programs can increase health disparities if providers in low-income communities are paid less. A study of California's pay-for-performance program showed that providers in richer areas got larger bonuses than hospitals that serve low-income areas. Experts say these providers already are disadvantaged because of inadequate reimbursements, high administrative costs, physician shortages, and unfair quality comparisons. Proposed improvements to the pay-for-performance model include rewarding both overall scores and score improvements, giving out rewards for minority-specific scores, and using methods that do not force hospitals to focus only on treatments that are rewarded. Adjusting risk for different ethnicities is another option, but this could lead to a provider being rewarded despite giving poor care to minority groups. Experts say implementing electronic health records will allow the system to receive better data and prompt hospitals to standardize their care methods.
Return to Headlines


General HR

"Special Report: Background Checking--Digging Deeper"
Workforce Management (03/08) P. 35; Heller, Matthew

Background screenings of workers are the norm in most cases, but now employers are looking beyond criminal backgrounds into civil litigation and divorce histories as well. However, experts caution that looking into non-criminal backgrounds can be hazardous for employers if the screenings are not handled carefully. Most firms use civil background investigations when hiring executive-level personnel, though some screening firms will recommend civil record checks for lower-level workers with access to corporate bank accounts. Screening firms and experts suggest a person's civil history might provide incite into the potential hires' integrity. A recent ChoicePoint survey indicated most workers were comfortable with employers conducting criminal background checks, but not civil investigations; most workers believed civil record screenings were an invasion of their privacy. Employers can use civil and financial histories as part of their evaluation process, but the federal Bankruptcy Act prevents workers from rejecting hires based solely on past financial history alone. Moreover, the Fair Credit Report Act requires an employer to disclose to a job candidate why he or she is being denied a job position if it stems from the individual's civil history. Legal experts also caution that civil records are often hard to track down, lack specific identifiers, and contain language that requires a legal expert to decipher them.
Return to Headlines

"Retention Tension: Keeping High-Potential Employees"
T+D (03/08) Nancherla, Aparna

Employers have difficulty hanging on to some of their crucial workers, according to a recent survey from ClearRock. The firm surveyed 94 companies and found that 37 percent had an increase in the turnover of frontline employees, with another 31 percent reporting a turnover increase among high-potential employees. The most difficult employees to keep were operations and production workers, with information services and computer-related workers ranking second, followed by sales and marketing and customer services workers. The results do not reflect a lack of trying on the part of employers: 51 percent said they installed new or revised retention programs for frontline employees and 56 percent did so for high potential employees. The efforts were slightly more successful on high potential employees, with companies reporting an 84 percent success rate, compared to 81 percent for frontline workers. Some approaches employers use include careful selection, better compensation and benefits, better orientation and assimilation programs, coaching, exit interviews, and better training. Turnover had a major effect on quality and customer service, which is why organizations are working hard to retain future leaders, as well as entry-level and customer-contact workers, the survey's authors concluded.
Return to Headlines

"Training for Success"
Health Facilities Management (03/08) Vol. 21, No. 3, P. 45; Griffin, William R.

Companies that invest time, money, and resources into a quality training program for environmental services workers will reap the benefits of a highly-skilled staff and low turnover rates. Quality training can bolster morale, control costs, develop skilled workers, and increase employee retention. A one-year training program--led by qualified supervisors, managers, and employees--must include some discussions and presentations, though sessions are most helpful when they include hands-on training. Hands-on activities allow trainees to demonstrate their skills, while a supervisor watches and offers guidance. To make training programs successful, trainers must supervise sessions, hold at least one half-hour review session monthly, and take attendance. Course material should cover safety, cleaning procedures, health, and employee issues either through visual materials, guest speakers, hands-on exercises, or written documents. However, trainers also must ensure that trainees are assessed in terms of hands-on abilities rather than merely on written skills. Experts suggest maintaining small class sizes whenever possible. Finally, trainers should reward all workers for their efforts and extend additional opportunities to those workers demonstrating a willingness to learn and take on further responsibility.
Return to Headlines

"Are Your Employees Truly Engaged?"
Chief Executive (03/08) No. 232, P. 42; Engen, John

Employers must determine the level of engagement among workers to pinpoint how to improve worker morale and bottom lines, say experts. Employee engagement can be determined through discussions, surveys, and other means; but once problems or suggestions are raised, it is up to employers to address open issues. A standard engagement program begins with a survey of employees, who answer a set of between 12 and 50 questions about their job. The responses are used to guide discussions and actions that aim to improve the workplace; workers are surveyed periodically to determine the success of the program. For a large corporation, the cost of an engagement program can run into the tens of millions because they require training programs, overhauled policies, and investment in new materials. Though some people question whether engagement programs are a waste of time and money, there is research showing that engagement is a problem in the corporate world. A 2007 Towers Perrin study showed that almost 40 percent of workers are at least partly disengaged from their jobs, with just 21 percent believed to be fully engaged. Another study showed that companies with the highest percentage of engaged employees made a net profit almost 4 percent higher than other companies, illustrating the value of an engaged work staff. Some argue that direct superiors play the largest role in determining employee engagement, while others believe that the corporate board sets the tone of engagement and it trickles down to the rest of the company. Each company tailors their own engagement program based on its culture and business strategies.
Return to Headlines


Benefits

"Health Insurance Audit Brings Relief to Bankrupt Hospital"
Employee Benefit News (03/08) Vol. 22, No. 3, P. 38; Mahdevan, Dev

Many hospitals are fighting for survival as insurance rates have skyrocketed 93 percent since 2000. During that time, operating costs also escalated 5 percent annually, while revenues only rose 3 percent per year. The cost of offering employees affordable health insurance also increased between 6 percent and 8 percent annually. It is this situation that led Doctors Medical Center in San Pablo, Calif., to file for Chapter 9 bankruptcy. When the hospital filed for bankruptcy, the hospital's insurance carrier threatened to drop its health coverage for employees. To prevent the carrier from making good on its threat, doctors underwent an audit regarding the hospital's finances and insurance coverage. After scouring the insurance market, the hospital selected Liberty Benefit Insurance to provide the hospital with worker benefits at a lower cost. The audit revealed the true risks of the hospital's health insurance plan, allowing administrators to negotiate lower premiums. As a result, the hospital's short-term disability, long-term disability, and life insurance coverage costs fell 11.3 percent, saving the hospital nearly $32,000 annually. Experts recommend employers conduct health insurance audits periodically.
Return to Headlines

"Go for the Gold"
CDHC Solutions (03/08) Vol. 4, No. 1, P. 34; Lyons, Susie

As the Baby Boomers begin to retire, organizations must develop new wellness and disease management programs to motivate younger employees. Wellness and disease management incentives are designed to increase productivity, create a better work environment, and cut down on the number of sick days taken by employees. For employers who are self-insured, wellness programs also cut down on healthcare expenses. Companies taking steps to be more proactive in disease management offer free flu shots, risk assessments, and health fairs at the workplace. Vanderbilt University successfully used the Recognition Professionals International's Recognition Strategy Model to design a new health and wellness incentive program for its faculty and staff. The "Go for the Gold" program, which rewards employees for taking steps to reduce health risks, was implemented over four years beginning in 2003. There are three different levels of performance--bronze, silver, and gold. Employees achieving the gold level receive an extra $20 a month in their paycheck and can earn an addition $10 per month if their spouse or domestic partner completes an online health risk assessment. In the years since the program was started, Vanderbilt has seen a decrease in sick time, depression, smoking, and stress among its workers. Employees also report being more satisfied with their job, and the percentage of overweight individuals is far below the national average. In 2006, almost 80 percent of program's participants were considered low risk. The success of Vanderbilt's program shows the importance of carefully planning and seeking input from employees about wellness initiatives.
Return to Headlines


Physicians

"National Standards to Rank Physicians Planned"
New York Times (04/01/08) Abelson, Reed

State regulators continue to examine the issue of doctor rankings from a distance, while New York's attorney general devises an agreement with health insurers as to how doctors should be ranked. Doctors, who were opposed to health insurance plan rankings, now say they are interested in a collaborative approach to creating a national standard of performance for physicians. Doctors accused health insurers of focusing too much on treatment costs and paying little attention to quality care. The American Medical Association, America's Health Insurance Plans, and others collaborated to create a set of national standards that take into account cost and quality care when doctors are ranked; independent parties also will be hired to review the rankings. National Partnership for Women and Families President Debra Ness said, "Consumers and patients are desperate for information to make better decisions and better choices." While Aetna says the national standards under discussion are similar to its current ranking system, a single, uniform system of ranking physicians will simplify the process for patients and doctors alike.
Return to Headlines

"Rise in Specialists Puts General Surgery in a Bind"
Hospitals & Health Networks (03/08) Thrall, Terese Hudson

General surgeons are essential to any hospital, but particularly in small and rural hospital settings because those surgeons are the ones who attend trauma and intensive-care patients, perform routine surgeries, and conduct specialized surgeries, like gastrointestinal or appendix procedures. However, the number of general surgeons is on the decline; according to the Association of American Medical Colleges, of the residents finishing their general surgery training yearly, 70 percent choose a subspecialty as their field of choice. The American Medical Association reports that the number of general surgeons per 100,000 people fell to 12.8 percent in 2005 from 14.7 percent in 1980; and general surgeons only accounted for 4.2 percent of all doctors in 2005, compared to 6.9 percent of all doctors in 1980. Observers caution that if changes are not made, general surgeons will be unable to retire because there is no one to replace them, and those surgeons who do retire will not be replaced. Dr. Josef Fischer of Beth Israel Deaconess Medical Center in Boston, Mass., says low reimbursement rates and poor lifestyle balance are the main reasons why younger physicians are not interested in general surgery positions. Hospitals and physician practices interested in recruiting general surgeons must have on-call management practices in place and offer adequate salaries and other benefits because without general surgeons, hospitals may have to close down emergency departments or operating suites.
Return to Headlines


Management and Leadership

"In Troubled Waters, Hospitals Need an Able Captain"
Trustee (03/08) Vol. 61, No. 3, P. 32; Sandnes, Michael

The healthcare industry faces a number of issues, such as a slowing economy, increased government regulation, an aging workforce, and aging facilities. However, an executive leader has the ability to build commitment and professionalism, unite management teams and boards, and contribute to reaching goals and improving public trust to help an organization navigate these challenges. One of the key traits of successful CEOs is the ability to encourage and challenge everyone to fulfill their roles. CEOs also help devise new approaches to help the organization adjust to changes in quality, cost, customer service, marketplace relationships, and compliance, while making sure the board remains on track with the organization's strategic mission and vision without becoming bogged down in daily operations. Employees must understand the overarching goals for the organization, which is why CEOs must have the ability to clearly communicate what roles each worker plays in the overall healthcare strategy. Other key traits include employing the best talent, staying ahead of the competition, valuing marketing and customer service, replacing inefficient financial systems, staying abreast of changes in the industry, and thinking creatively. These skills could determine the future success of a healthcare organization, say experts.
Return to Headlines

"Leadership's Role in Execution"
Healthcare Executive (03/08) Vol. 23, No. 2, P. 66; Bisognano, Maureen

The Institute of Healthcare Improvement (IHI) offers healthcare organizations a framework for achieving organization-wide results for improving patient care, and within this framework are will, ideas, and execution. A survey of boards and senior staff shows more than 90 percent believe performance problems are rooted in failed execution strategies. One of leadership's main roles in executing change is to make sure the organization settles on a set of chosen objectives. To be successful, each part of the organization needs to feel as though it is responsible in some way for meeting these goals. The three core elements of IHI's theory are the achievement of strategic goals, a plan for management of local improvement projects, and the continual development of leaders. These leaders are in charge of setting system-level improvement goals, closely tracking their process. The organization also must be able to prioritize their goals, using limited resources on the most important projects. The healthcare organization's core strategy must be focused on improving the experience of patients inside and outside the hospital. Every member must commit to this strategy to ensure its successful implementation.
Return to Headlines

"Beat the Clock"
Business Week SmallBiz (Quarter 1, 2008) P. 56; Gutner, Toddi

Time management can help managers maximize their productivity at a time when emails, sudden problems, and scheduled projects compete for attention. Experts say cluttered managers should follow "The D System," which requires every document or email to be dealt with immediately so that managers handle each document only once to reduce wasted time. Experts also recommend that managers develop time budgets daily to ensure they remain on task for what needs to be completed in a given day and know how much time each task needs. These time budgets can provide managers with an overview of their tasks and how long it takes them to complete specific tasks, so that future tasks can be planned out more efficiently. Experts also indicate the most difficult or involved tasks should be scheduled for managers when they are the most alert. It is estimated that over 25 percent of a manager's workday is spent dealing with unplanned interruptions, with the average interruption keeping a manager from their original task for 25 minutes. Managers should consider these interruptions for a minute or two, then schedule to handle it another time if it does not require immediate attention. Managers also will want to schedule time during their day where interruptions are not allowed, encouraging them to finish the most important work at hand. In the final minutes of the day, managers should be planning out the next day's schedule.
Return to Headlines

"Awakening the Leader Within"
Nurse.com (03/24/08) Gonzalez, Roxana

Leadership does not necessarily involve a specifically carved out position, but it does entail a willingness among workers to step up and fulfill needs or empower other workers to perform better. In the healthcare sector, there are many obstacles facing leaders, especially nursing leaders, including strained resources, larger workloads, and higher patient acuity. These obstacles tend to cause job dissatisfaction, poor performance, and apathy among nurses, experts say. Nurses interested in becoming leaders must recognize their fears and apathy and recommit themselves to caring and transforming the healthcare environment. These individuals must learn to overcome their fears, speak up about care recommendations, and become a "care innovator." Lessons learned from care mistakes or other situations should be shared with other nurses and caregivers to create an internal and informal mentorship with colleagues. Nurses also should voice their concerns and suggestions through one-on-one conversations, multidisciplinary rounds, and committee meetings, though conversations must remain professional in manner and tone. Building these relationships can empower others in the facility to offer suggestions, recommendations, and innovations that improve quality care. Experts also recommend that nurses become involved in professional organizations and the policy-making process at healthcare facilities because those policies determine how and what resources are allocated.
Return to Headlines




© Copyright 2008 INFORMATION, INC.

subscribe :: unsubscribe