Healthcare @Work Creating a Reason to Stay

1. Healthcare @Work Creating a Reason to Stay

2. Labor Front Headlines Tightest labor market in 30 years - Newsweek Quitting? 17M this year - Saratoga Institute Young entrants will change jobs nine times before age 32! - DOL

3. US Workforce Growth Rates 1965 1975 1985 1995 2005 2015 2025 2035 2.50 1.80 1.70 0.90 0.65 -0.01 -0.15 —

4. Change in Number of US Workers 1996-2006 14.3% 14.0% -8.8% -3.0% 25.1% 54.0% 9.2% Age of Worker 16-19 20-24 25-34 35-44 45-54 55-64 65+ 1970-1980 30.6% 50.0% 72.4% 23.6% 0.0% 5.3% -6.1%

5. The Hospital Perspective -#1 The Hospital Workforce: • 20% annual turnover is common • Primarily female: 70-85% • Stratified diversity • 24x7x365 • Guild based • Many licensed and regulated Source: Jim Bentley AHA Strategic Policy Planning

6. The Hospital Perspective -#2 Not a “Nursing Shortage” A shortage of: • Nurses • Pharmacists • Rad Techs/Lab Techs • Housekeepers • Food service workers • Information Services

7. The Hospital Perspective -#3 Dual timeframes: • Historically- short term shortages • Short-term shortage AND long-term shortage • Baby boomers moving to retirees • Inadequate pipeline

8. The Hospital Perspective -#4 Healthcare employment: ASHHRA • From high tech to low tech • From security to insecurity • From limited to multiple choices for women • From psychic compensation to compliance and documentation • From self-scheduled to 24x7 Bottom line: from favored to avoided

9. Healthcare @Work 2000 Study • Follows design of Aon’s @Work research • Questionnaire design completed in partnership with ASHHRA and Aon Healthcare Alliance • Web based data collection—January-March • Over 3,300 respondents

10. Respondent Profile - Gender

11. Respondent Profile - Age

12. Respondent Profile - Education

13. Respondent Profile - Employees in Organization

14. Respondent Profile - Type of Healthcare Organization

15. How much commitment exists? • Workforce Commitment Index (WCI) standardized at 100 in 2000 • Based on responses to six WCI items • Track and trend by item and demographic variable

16. WCI Questions PRODUCTIVITY • People improve skills • People make sacrifices PRIDE • Recommend products & services • Recommend as a place to work RETENTION • Intend to stay several years • Intend to stay even if offered more money elsewhere

17. Workforce Commitment Index Productivity People Improve Skills to Make a 40% Better Contribution People Make Sacrifices to Help 40% Group Succeed 0% 10% 20% 30% 40% 50% 60% 70% 80% Percent Agree

18. Workforce Commitment Index Pride Recommend the Organization as One of 36% the Best Places to Work in the Community Recommend the Products/Services as 41% the Best a Customer Could Buy 0% 10% 20% 30% 40% 50% 60% 70% 80% Percent Agree

19. Workforce Commitment Index Retention Intend to Stay for 51% Several Years Would Stay Even if Offered Similar Job 32% with Slightly Higher Pay 0% 10% 20% 30% 40% 50% 60% 70% 80% Percent Agree

20. What does a WCI of 100 mean? • For every 100 employees. . . • 13 don’t improve their skills • 15 won’t sacrifice for the team • 15 would not recommend products and services • 23 would not recommend as a place to work • 17 do not intend to stay for the next several years • 30 would leave for a slight pay increase

21. Profiles of Commitment

22. Profiles of Commitment

23. Profiles of Commitment

24. Profiles of Commitment

25. Profiles of Commitment

26. The @Work Research Model Workforce Commitment Performance PyramidTM Commitment IndexTM RETENTION Work Life Growth PRIDE Affiliation PRODUCTIVITY Rewards Safety/Security

27. Security 75% agree that their organization’s effort to provide them with job security is meeting or exceeding their expectations.

28. Rewards 56% report that the one reward they would most like to receive in the future is a significant salary increase.

29. Rewards 51% report that the recognition and rewards they receive from doing their jobs are below expectations.

30. Rewards Compared to people in similar jobs WITHIN their organizations, 30% disagree that they are fairly paid.

31. Rewards 43% disagree that they are fairly paid compared to people in similar jobs at DIFFERENT organizations.

32. Rewards 41% believe to a little or very little extent that the retirement plan will provide them with an adequate income.

33. Affiliation 39% of respondents say their work environment’s providing of open, candid communication is below expectations.

34. Affiliation 46% of respondents say their organization’s encouragement to challenge the way things are done is below expectations.

35. Affiliation 52% say their organizations are not meeting expectations with having employees participate in planning changes.

36. Growth 79% agree or somewhat agree that patient care is the number one priority at their organization.

37. Growth 34% of respondents believe their organization’s readiness to make changes to stay competitive is above expectations.

38. Growth 41% of respondents report opportunities for personal growth provided by their job as not meeting expectations.

39. Work/Life Harmony 26% of respondents said that the ability to balance work and life most impacts their decision to STAY at their current job.

40. Work/Life Harmony 32% disagree that management recognizes the importance of their personal and family life.

41. The @Work Research Model Workforce Commitment Performance PyramidTM Commitment IndexTM RETENTION Work Life Growth PRIDE Affiliation PRODUCTIVITY Rewards Safety/Security

42. Maslow Revisited — The Hierarchy of Needs Self Actualization Esteem Social Safety Physiological

43. Aon’s Workplace View —The Performance Pyramid Work-Life Harmony Growth Affiliation Rewards Safety / Security

44. Aon’s Performance Pyramid • Based on meta-analyses of over 60,000 cases • Hierarchy of organizational practices • The WCI rose progressively when expectations were met at each level • When safety/security issues were below expectations the WCI was 80 • When employees indicated that all levels were met, including work/life harmony, the WCI was 114

45. Learnings from the Pyramid • Addressing higher level needs will not create a commitment/retention advantage unless lower level needs are met • You must MEET Expectations — Exceeding Expectations comes later • Priority attention levels can and will fluctuate — merger/downsizing, etc. • Best Bet — Back to the Basics

46. Workplace Practices Summary Drivers of Commitment with Positive Performance • Understanding how my performance is evaluated • Patient care being the number one priority at my organization • Skill levels of the people I work with are keeping pace with demands of the job

47. Workplace Practices Summary Drivers of Commitment with Positive Performance • Being covered by an organization-provided retirement plan • Organization satisfying our patient’s needs

48. Workplace Practices Summary Drivers of Commitment with Performance Challenges • Managing and Communicating organizational changes • Being fairly paid compared to people in similar jobs at different organizations • Having a retirement plan which provides an adequate retirement income

49. Workplace Practices Summary Drivers of Commitment with Performance Challenges • The organization’s support of employees’ interest outside of work • Management recognizing the importance of personal and family life • Management’s allocating resources in a way that meets or exceeds patient’s needs

50. Performance Pyramid • Executive Coaching • Selection & Assessment • Professional Development • Performance Mgmt Systems • Life Stage Benefits • Flextime, PTO Bank, etc. • Job Sharing • Leadership Assessment and Development • HR Practices Review • Large Scale Cultural Change • Internal and External Benchmarking • Health & Welfare Plan Mgmt • Benefits Communications • Executive Comp Design • Absence Management • Property and Casualty • Workers’ Compensation