These two issues are related, and I am seeing some movement. At staff levels I see more mentoring, stretch responsibilities, cross-training, and other activities that help diversify skill sets of those who have traditionally done only one job. These activities will become more important in the future— and future leaders will have to think more broadly from day one. They will have to know how to influence across not only their organization but also across different settings or geographies— from acute to non-acute, and from the ER to the home or hospice. They will also need more“ jack-of-all-trades” skill sets to be successful.
How far does HR go to influence partners or affiliate employees?
In a traditional setting, there is very little influence. If you are a part of an integrated delivery network, where those settings are a part of system, then you have much more influence. For McLaren, we have different facilities that provide acute care, long-term acute care, home care, nursing assistance, residential / home hospice, and others. With these facilities all within the same system, HR can have a broader influence. In this situation, we do feel we have more ability to influence most aspects of talent management. Incentives for others to listen are also important; if they are not your employees, you will have a tough time influencing them to a high degree.
Even as part of a system, this influence requires great strategies to achieve a global / local balance across all care settings. For example, employee engagement data shows that engagement fluctuates widely across them.
How do employees in these different settings perceive their accountability toward their partners?
Accountability can be difficult to manage. The literature talks about challenges in managing remote workforces. When you see people every day, you can develop relationships. The in-person relationship itself tends to create more accountability versus someone who is remote and only occasionally sees his / her manager. In many ways, individuals who are on their own must have high degrees of self-motivation. The key for these remote or non-acute staff is to support them the best you can, and to help them solve challenges. We try to emphasize the importance of communication for those who are managing people in remote locations, such as our home care group.
How do you manage the performance appraisal process across different care settings?
We try to manage different care settings according to metrics that make sense for that setting. If you have a traditional performance appraisal, remote and nonacute employees would question how accurate that appraisal is since they are not observed often.
For example, our home care group does annual appraisals. There are some aspects of the appraisal that are based on observation, and other aspects are based on documentation— patient surveys, feedback from surveys, patient outcomes, number of calls answered in a day, and time spent in each home visit. Yet this documentation varies, and there is no single way of coming up with all the evaluative data on a person.
Within care across the continuum, does HR have more or less influence over patient outcomes?
I think HR might have more influence and an even more important role to play. There must be a high degree of intentional influence across the entire talent management spectrum— from recruiting the right people to training and compensating them appropriately. That influence must help providers and staff to both understand the importance of providing good care and hold people accountable for outcomes.
HR is also the keeper of the culture and must drive that culture toward the right areas. You also need processes that draw the line in the sand— to help employees exit the organization if they cannot fulfill their required duties.
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