Salary Surveying in Healthcare

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Courtesy of http://thedo.osteopathic.org/2017/03/national-physicians-week-extending-doctors-day/

In healthcare, the salaries of employees make up the bulk of expenses for health organizations. Health professions often require intense training, long years of schooling, and licensing and credentialing. Because of these factors, healthcare professionals are paid high salaries, especially physicians who average approximately $195,000 for primary care physicians and $284,000 for specialists. Salary history requests have been coming under fire for the past few years by lawmakers. Many locations have been banning due to equal pay discrepancies based off of salary histories (O’Brien, 2017). Despite the bans, there are pros and cons to salary history amidst the controversy that surrounds it. I will be briefly describing some of these and how they relate to healthcare.

Salary history is a method used by HR departments to gauge how much an employee may need to be compensated, but may studies now link salary history to wage disparities suffered by minorities. In many cases, female physicians are still paid approximately $15,000 less that their male counterparts (Laff, 2016). There is no true explanation for the wage gap, but recruiters inquiring about salary histories often contributes to the issue. Many companies use salary history in deciding the salary offered to candidates which sometimes don’t benefit minorities who may have been subjected to lower wages and less pay advances in previous jobs. Because of incidents such as this, many lawmakers have moved to remove barriers such as salary histories to promote equal pay among everyone.

Despite the shortcomings that salary histories may have, they do provide important insights for both potential candidates and HR departments. Salary histories can give HR recruiters insight on a candidate’s performance history based off salary increases and bonuses. Pay bumps and bonuses can indicate a candidate that has high potential to perform at a high level, which could be advantageous for a health organization looking for innovative leaders. This could also prove beneficial for candidates that are looking for a larger salary to reward their hard work. HR Departments could also identify candidates that may be too expensive before wasting time in the hiring process. Although a candidate may have all the qualifications for a job, a health organization may not be able to afford that health professional.

Salary history has as many pros as cons. It should be every health organization’s mission to aim for equal pay of all employees. The discussion of salary does not always guarantee  candidate will paid their ideal salary despite having a previously high salary. Many employers still view salary history as an instrumental part of the hiring process, and companies have pushed back against lawmakers (O’Brien, 2017). Going forward, hiring salary will continue to be a hot topic concerning the hiring process.

References:

O’Brien, M.J. (2017). Salary-History Bans Expanding. Human Resource                   Executive. Retrieved from http://www.hreonline.com/HRE/view/story.jhtml?id=534362014

Laff, M. (2016). New Study Examines Physicians’ Gender Pay Gap. AAFP. Retrieved from http://www.aafp.org/news/practice-professional-issues/20160824salarygap.html

 

 

Workforce Planning in Healthcare

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Photo courtesy of pixabay.com

 

Healthcare is a field that is not foreign to continuous change. Being a dynamic field, it is important that a health organization be capable of assessing the need for health professionals. That is exactly what workforce planning is for. Human Resources (HR) utilizes workforce planning to anticipate the number of healthcare professionals in an organization. Workforce planning ranges from identifying tasks and roles, to training requirements, to shortage and surplus anticipation. These decisions can impact an organization financially and the community in the form of available medical services and capabilities.

Workforce planning involves the use of methodologies to develop strategies for health organizations. These methodologies vary between countries, and they also differ between health organizations as well. The lack of a standard in regarding workforce planning does not improve  the accuracy of projections (Lopes, Almeida, & Almada-Lobo, 2015). Two of the most interesting methodologies in my opinion is the demand-based assessment and population-based assessments (supply-based assessment).

Demand for medical services greatly depend on the ability for people’s ability to afford healthcare. In the case of the United States that would involve people being enrolled in Medicaid & Medicare, insured, or able to pay out-of-pocket. Presently, the ACA has increased coverage and demand for healthcare. Demand-based assessment strategies allow health organizations to gauge the need for health professionals in the future. Changes in healthcare laws is currently unpredictable, which complicates workforce planning for many healthcare organizations. This can be seen in hiring freezes in response to uncertainty of future trends.

In the United States certain areas suffer from shortages of medical professionals. Many areas around the country experience a shortage in nursing staff and general practitioners. Many physicians are often specialized, but the future number of physicians could potentially decrease. This issue is compounded with the coming wave of retirees and increase in the elderly population. Population-based estimating analyzes the ratio of medical professionals to the population number. Although it is beneficial to decrease patient to physician ratio, the data varies per source which brings the reliability of population-based estimates into question.

Health organizations utilize data gathered through payroll, volumes, and clinical data to assess the demand of services and the needed supply of personnel (2015, September 29). Despite the data being available to HR departments to analyze future trends, many companies still manage to let workforce planning fall through the cracks. As mentioned before regarding population-based estimates, many health organizations struggle getting valid data (Harden & Fraher, 2010). The consistency of data presents an impediment to workforce planning because many health professionals are concerned with the now and clinical outcomes.

Demand-based assessment and population-based estimates assess two critical aspects of health care. It is important for health executives to understand the trend of demand for service. If there is a decrease in demand, employees’ jobs could be at stake and the financial well-being of the health organization could be at stake. Comprehending the supply of doctors is pertinent to health executives and stakeholders as well. Supply dictates the amount of services a health organization can provide. Adequate service affects whether a hospital is meeting the needs of the community it serves as well.

In conclusion, workforce planning is needed in order for an organization to better prepare for the future. The need for certain professionals is always changing due to population, community needs, political pressure, etc. Health organizations in the United States still struggle with workforce planning as there are still many barriers to success. One main barrier is the political scene and the issues dealing with the ACA and the future of the insurance agency.  Other impediments include an aging workforce, decline in health professional numbers, and extensive training of future health professionals (Harden & Fraher, 2010). Implementing a concrete workforce plan can save money on labor, increase the quality of medical care, and improve a health organization’s ability to prosper in such a dynamic field.

References:

Harden, B., Fraher, E. (2010). Workforce planning in the context of service redesign, workforce migration and changing demographics. International Journal of Therapy and Rehabilitation, 17(4), 195-202.

Lopes, M.A., Almeida, A.S.,  & Almada-Lobo, B. (2015). Handling healthcare workforce planning with care: where do we stand. Human Resources for Health, 13(38), 1-19.

White, D. (2015). 3 Key Steps to Healthcare Workforce Planning. Retrieved from http://www.beckershospitalreview.com/human-capital-and-risk/3-key-steps-to-healthcare-workforce-planning.html

Nursing Retention in Healthcare

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Photo courtesy of htttp://blog.diversitynursing.com/blog

Nurses play an integral part in the provision of health care the United States. In America, there is a shortage of nurses across the country that is estimated to increase within the next few years. The nursing shortage is only compounded by the increasing number of Baby Boomers and the numerous amount of nurses expected to retire in the coming years. With that being said, health systems are struggling to retain a satisfactory number of nurses per year. The turnover rate regarding nurses is higher in healthcare than any other field. In the coming years, HR managers will be tasked with dealing with the recruitment and retention of talented nurses who by and large greatly affect health system finances.

In 2014, nursing turnover rates reached 17.2% according to Nursing Solutions (2015), which was a 4% increase from 2010. Hospital RN vacancies increased to 20.6% in 2014 and are expected to rise significantly with the retirement of many experienced nurses. Filling vacancies for hospitals now takes between 53 to 110 days for recruiters (Nursing Solutions, 2015).

Studies show that the loss of one nurse costs anywhere between $22,000 to $64,000 (Jones & Gates, 2007).

Why should hospitals be concerned with nursing retention? Studies show that the loss of one nurse costs anywhere between $22,000 to $64,000 (Jones & Gates, 2007). When one considers the average turnover percentage of nurses, hospitals can suffer millions of dollars lost to recruiting replacements, advertising vacancies, loss of experience, training, and most of all, patient care.

High turnover rates have been attributed to a number of things within the healthcare field. The top complaints for job dissatisfaction include burnout and high nurse to patient ratios, high workloads, increased paperwork, lack of acknowledgement and appreciation, and lack of decision-making opportunities. These issues play a large role in the culture of an organization and have adverse effects on the patient care and quality of care. If career dissatisfaction continues, it could very well affect the outlook of potential nurses in the future which could further exacerbate the nursing shortage.

The top complaints for job dissatisfaction include burnout and high nurse to patient ratios, high workloads, increased paperwork, lack of acknowledgement and appreciation, and lack of decision-making opportunities.

Human resources can employ several tactics to deter nurses from leaving and assess the discrepancies that nurses in their specific hospital experience. Decreasing the amount of turnover in turn decreases the amount of money spent on recruitment, increases the organization’s productivity, increases patient safety and health outcomes, and also improves the work environment and satisfaction of all workers.

Here are some of the possible strategies recommended to reduce nursing turnover:

  1. New Hire Check-ins – Identifying concerning issues early on can decrease the likelihood of new nurses leaving. The percentage of first-year nurses that changed jobs peaked at 13% (Nursing Solutions, 2015).
  2. Employee Satisfaction Surveys and Assessments – Directly engaging employees about their satisfaction with their job will allow HR to improve the working environment and work to solve issues that plague the nursing staff. Interviewing current employees also allows employers to develop compensation packages that deter employee departure.
  3. Exit Interviews – Every HR department should conduct exit interviews to assess why the employee departed organization. This allows the HR department to gather data on issues that cause nurses to leave.
  4. Job Analysis – HR departments should conduct a periodic job analysis of nursing positions to assess the positives and negatives of the job. Is the job satisfying, does the job allow the employee to exercise all their skills, and do the activities of the job fit the compensation package?

Developing an efficient retention plan for nursing positions could increase the financial outcomes and quality of care in hospitals. Conducting interviews for currently employed nurses and employee satisfaction surveys can allow HR departments the resources and data to better retain nurses. Nurse dissatisfaction has shown to produce more clinical mistakes and adverse patient outcomes. High burnout rates and patient overloading have contributed to increasing turnover rates within the nursing field. The effects that nurse vacancies and shortages have on patient outcomes and safety also affect health expenditures which are also on the rise. HR can effectively play a role in retaining nurses which can in turn allow hospitals to invest financial resources in other areas to increase satisfaction for customers, nurses, and the healthcare organization overall.

Resources:

Jones, C., Gates, M., (September 30, 2007)  “The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention” OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 3.

Beaulieu-Volk, D. (2014, October 27). Nurse retention strategies: Keys to empowerment, ownership and support. Retrieved February 26, 2017, from http://www.fiercehealthcare.com/healthcare/nurse-retention-strategies-keys-to-empowerment-ownership-and-support

Writer, L. S. (2016, January 22). Nursing Shortage Statistics. Retrieved February 26, 2017, from http://strategicprogramsinc.com/nursing-shortage-statistics/

How Can Affirmative Action Help Healthcare?

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Photo courtesy of (https://pixabay.com/en/workplace-team-business-meeting-1245776/)

Human Resources takes on a plethora of tasks within a healthcare system. Duties range from recruitment and retention to credentialing. Often, one overlooks the many employment laws that HR has to comprehend and abide by. Many of these employment laws include Consumer Credit Protection Act (Title III), Equal Pay Act of 1963, and Drug-Free Workplace Act of 1988, just to name a few. These laws have been passed over the years to ensure that employees have a level playing field when interacting with employers, but even with the passing of these laws, there are still some gray areas and misinterpretations.

Affirmative Action is an executive order that was passed that stated federal contractors are required to “take affirmative action to recruit and advance qualified minorities, women, persons with disabilities, and covered veterans” (Department of Labor, 2017). Healthcare systems must abide by the law and update their affirmative action strategy in order to continue to receive federal funding.

Affirmative action is often confused with meeting a quota in order to become a more diverse organization, but that is far from the truth. Although HR is often tasked with expanding diversity within a health system, quotas do not benefit the health system in the long run. HR’s main goal is to acquire the highest quality of talent which will increase profits and performance for the company overall. The goal of affirmative action is to give certain groups an equal opportunity for employment regardless of their race, creed, or sexuality.

The diversity within the health field has long shown to have effects on the population that health systems serve. Sassi, Carrier, and Weinberg (2014) state that a lack of diversity decreases the distribution of health care to ethnic minorities. It has been noted that people respond better to physicians that look like them, and the quality of care is often rated higher as well. Affirmative action was intended to help organizations reflect the diversity of the population, but according to Sassi, Carrier, and Weinberg (2014), that is not the case. Health disparities still vary between ethnicities, especially minorities.

Going forward, HR may seek to work closely with medical school recruitment teams in order to increase the diversity of new physicians coming into the job market. There are benefits to collaborating with other schools that develop other health professionals such as nurses, technicians, and assistants. Affirmative action must be present on all levels in the medical field to be effective. Cohen, Gabriel, and Terrell (2002) all agree that “interventions to improve diversity begins long before medical school.” Let’s use affirmative action to our advantage to benefit those that we serve, the patients.

Cohen JJ, Gabriel BA, Terrell C. The case for diversity in the healthcare workforce. Health Aff (Millwood). 2002;21(5):90-102

“Office of Federal Contract Compliance Programs (OFCCP).” DOL.gov. N.p., 2017. Web. 29 Jan. 2017

Sassi, F., Carrier, J., & Weinberg, J. (2004). Affirmative action: the lessons for health care: Governments are becoming more assertive about reducing ethnic inequalities. BMJ: British Medical Journal, 328(7450), 1213–1214.