Morale-challenged? Take these extra steps
Promote relationships, control rumors
The merger that created Upper Chesapeake/St. Joseph Home Care in Baltimore contributed to so many staff satisfaction issues that the agency felt it had to include the entire staff in its staff morale quality improvement (QI) process.
The action team, formed as part of the QI process, sent a survey to all employees, asking them to prioritize the problems the action team had identified. There were more than 30 items on the list.
"We said, Help us identify which of these are truly problems,’" says Debbie Chisholm, BSN, RN, CRNH, quality and staff development manager for the hospital-based agency that serves three counties in the Baltimore area.
The query served two important purposes. One, it helped the action team further narrow the list of potential problems, and two, it encouraged the staff to invest in the quality improvement process. Nearly 60% of the staff responded.
"By going back to the entire staff, there’s a feeling that you’re getting their buy-in because you care enough to listen to what they have to say," Chisholm explains.
Each of the problems listed on the survey fell into one of four categories: orientation process, relationships, satellite offices, and issues with compensation and performance.
The action team decided to consider any problem listed on the survey a top priority if the problem was cited by at least 30% of the staff who completed the survey. Those would be the problems the team would attack.
That effort narrowed the 30-plus items to 10 problem areas, listed here:
• poor and/or mixed communications;
• lack of clear directives;
• inappropriate and negative communication;
• rumors, lies, and gossip;
• lack of follow-up after meetings and conferences;
• withholding of information from lower-level staff;
• lack of trust among team members, administration, and staff;
• staff’s perception that they volunteered a lot of their time;
• rate of pay;
• feeling demeaned as a professional.
The action team found that the problem areas most important to the staff were not in the categories of the satellite offices or orientation process. In fact, nearly all of the problems fell into the category of relationships.
Kudos’ for staff excellence
After mulling over these top 10 problem areas, the action team came up with a variety of potential solutions, including one solution that has turned out to have the biggest impact. The team developed a "kudos" program that bridges all levels — managers giving kudos to staff, staff giving kudos to managers, and staff giving kudos to each other.
"We thought it would help build relationships and increase the overall bond team members have with one another," Chisholm says. "We thought it also would help to overcome the feeling of isolation that some staff members have."
Anyone who would like to give kudos to another employee only has to fill out a postcard that has the kudos graphic and the words, "Kudos to you because . . . ." The employee who receives the postcard can save it and turn it in at a staff meeting for a chance to win a prize. Prizes include such items as free lunches, gift certificates, decorative candles, and movie tickets.
"You wouldn’t imagine the response we’ve gotten from this and the number of employees sending these to one another," Chisholm says. "The staff say these little cards mean the world to them, and to receive one makes a difference in their day."
Kudos recognition is handed out for many different reasons, such as when a therapist or nurse goes above and beyond for a patient, or when one employee fills in for another during a vacation. Some months, prizes are given to the holder of the postcard that touches the heart the most. One winning example read, "You light up the room every time you show up for work."
The kudos notes are an easy way to make the staff feel better about their jobs and themselves, Chisholm says. It is important for the staff to get that kind of recognition for what they might think is an unnoticed kindness, she adds. "That program has made a big difference in relationships and building trust between administration and staff."
Another solution was to add a new column to the monthly newsletter, featuring stories about different team members as a means of introducing the staff to one another.
"In each newsletter, we profile several different team members, discussing who they are and what are their hobbies and interests," Chisholm says. "This way, employees can identify common interests such as sailing, and then they have a common ground where they [can] approach one another."
Managers get communication clues
The action team and quality council worked on the problem of poor communication between staff and managers through coaching sessions with managers whose scores on the staff’s satisfaction survey indicated the need. They also had a speaker talk to managers about open and honest communication techniques and ways to improve communication and build trust.
"He was a dynamic speaker and did a great job," Chisholm recalls. "He used different tools to identify what kind of communicators we were and then showed us our weaknesses and ways to overcome those weaknesses."
The action team also suggested that the agency stop holding separate field staff and office staff meetings because this was divisive, she says. Now there’s a combined meeting. Instead of having some of the same issues brought up and discussed at separate meetings, they can be discussed at one meeting and solutions can be found that pertain to both field and office staff. The combined meeting also has improved communication between the field and office staff, eliminating misperceptions about what might have been said at one meeting and not at the other.
"We publish the minutes of that combined meeting and make the minutes accessible on the computer system so everyone has access to them," Chisholm adds.
Keeping gossip in check
Another solution involved forming a rumor control hotline on voice mail that staff could call anonymously about any rumors, such as a rumor that the agency would close or one that management was receiving a huge raise while hourly workers were not.
The hotline number is listed at the top of the staff employee phone list for easy access. Employees merely call and leave a message describing the rumor they have heard circulating. Then the agency’s president, Shawn McNamara, MSN, RN, CRNH, tells the entire staff the truth. For example, one rumor was that the president was looking for a new job.
McNamara responded to the rumor with a staff e-mail that dispelled the myth and reiterated that he had every intention of staying at the agency.
A final solution to poor communication and lack of trust was to implement an open-door policy among top management. As a result, the president keeps his door propped open so any employee with a concern can walk in and ask if the president has a minute to discuss concerns. The door is only closed during confidential meetings.
"It’s good to have a leader who is easily accessible and encourages communication," Chisholm says.
Source
• Debbie Chisholm, BSN, RN, CRNH, Quality and Staff Development Manager, Upper Chesapeake/St. Joseph Home Care Inc., 8003 Corporate Drive, Suite G, Baltimore, MD 21236. Telephone: (410) 931-0990, ext. 129. Fax: (410) 931-2144. E-mail: bchisholm44@ hotmail.com.
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