DEVELOPMENT & PROMOTION OF NORTH ATLANTIC HOSPITAL

On last 2009 September the chair of the Department of

Anesthesiology of NA make look into her latest employee satisfaction survey result. A year ago, Harris had joined the prestigious teaching hospital

as department chair. After years as a leading research

physician and administrator at a large west coast

university hospital, the challenge of running one of the largest departments at the nations leading medical center presented a rare opportunity.

Her challenges
Department was understaffed and overworked.

morale was low, and high turnover indicated low engagement

A lack of commitment amongst her physicians. Had one of the lowest promotion rates in the hospital.

As Harris took stock of the departments state, along with DA Vice Chair Dr. Lesley Cook, she administered a staff satisfaction survey to assess conditions. Early results confirmed that Harris faced some significant challenges, including a staff of physicians that felt overworked and undervalued, had little sense that the institution was

aware of their needs in terms of professional development, had a low sense of

workplace satisfaction and engagement, and struggled with issues of work/life balance. . Further, many felt there was a perceived lack of transparency and fairness around the UMS promotion process; a perceived lack of clarity around the UMS promotion criteria; and a perceived bias towards investigators over clinicians and educators. Many physicians expressed concerns that the hospital and department leadership were

unable to provide long- or short-term career guidance. Historically high turnover in the
department, signaling low commitment and engagement with their employer, confirmed the surveys findings.

The Department of Anesthesiology (DA) was one of NAHs largest services, with 200

physicians. Under its auspices, patients received a comprehensive range of clinical

services, including preoperative anesthesia services, critical care, and pain medicine. Clinicians were involved in patient care in the obstetrical unit, the critical care units, in interventional treatments for pain management, and operating room locations in the departments of Radiology, Gastroenterology, Gynecology, Neurosurgery, General Surgery, Cardiology, and Pediatrics, as well as several off-site locations. Clinicians focused about 80% of their time serving patients and about 20% of their time was spent conducting research or engaged in administrative duties.

The Department supported an extensive research program encompassing critical care and pain medicine, neurosciences, biomedical innovation, and ethics. Research physicians (also known as investigators) typically spent about 80% of their time doing bench

research and a portion of the remaining 20% was spent treating patients, educating
residents and medical students, and contributing to the departments administration; approximately 30% of the physicians were researchers.

Promotion at UMS
Typically physicians were hired as Assistant Professors, and were put up for promotion to

Associate Professor, depending on performance, within a variable amount of time (fiveto-fifteen years). Promotion decisions considered regional and eventually national reputation, demonstration of scholarship and publications of research results, or for educators, educational materials that have been adopted locally, and eventually regionally or nationally. To become a full professor, a physician had to attain a national and international reputation, influencing research, education or clinical practice in a significant way.

Across the UMS hospitals, the promotion rate for all physicians was
acknowledged as low when compared with national averages; this was especially true for the clinician and educator tracks. Recent changes in the UMS promotion criteria had attempted to improve successful promotion.

Main Issues Career development

1 - Lower level employees dont know how to get up there level of performance for that they needed:
More guidance needed Job description/actual responsibilities Reduce the Bias Know the right people Conference(formal structure, no alignment, no follow up on plans, not really helpful in addressing the problem) Performance is not assessed fairly

No feedback , motivation

Department heads giving minimal feedback and they support

dont give constructive feedback Low level (clinicians & educators) are not receiving feedback Performance is not assessed fairly

Even if given a feedback, it is not correlated to the

progress One way conversation

Performance measurement criteria

No training for feedback givers

3 Work/life balance Affects progress Different expectations and perception on work/life balance Between roles and generations 4 Culture Politics/ who you know -Highly competitive/ no cooperation

5 Conference Too formal ( no flexibility) It takes a lot of time (planning) No focus on the real issues (high level) Only opportunity for feedback, doesnt happen that often No follow up, just a check list No motivation form department heads because it doesnt tie into their recognition or rewards Not everyone go for these conferences Not helping with the main issue ( employees want individual attention) No alignment with organization goals

SOLUTION
Managing People for Organizational Effectiveness

Aligning People, Organizational Culture, and Strategy

Designing Work and Organizations

Talent Management: Recruiting and Hiring

Building Employee Engagement

Motivating Employees Performance Management and Rewards Fostering a Learning Culture Dealing with Stressful People and Situations Managing People in a Global Environment

CONCLUSION

The hospitals mandate for career conferences was very broad, and each department had the flexibility to develop, or augment existing, programs to best suit their facultys needs. Harris knew designing a uniform career conference program across the diverse DA physicians would prove challenging. Several prior unsuccessful career conference efforts meant her department was skeptical of a new initiative. Some senior physicians (division chiefs and research lab heads, for example) claimed to hold somewhat regular meetings with their teams to discuss performance evaluation and career development, yet an informal survey of these teams revealed they did not know these meetings were supposed to be about their career development. Feedback sessions, if they happened, were spotty. Others claimed that they did not have a sense that the senior physicians cared about their development needs. Still others expressed a lack of awareness that these conversations were aimed at their performance evaluation and career development.