Seven years ago, 65 percent of staff at Windsor Regional Hospital in Ontario, Canada, said they would not recommend the hospital as a place for friends and family to work. But the hospital has turned that outlook around, with 86 percent now saying they would recommend it. FierceHealthcare recently caught up with David Musyj, president and CEO of Windsor Regional, to find out why staff responded so negatively and what it took to get workplace satisfaction responses to soar.
FierceHealthcare: What problems were so bad at the hospital that the staff wouldn't even want their own family members to be there?
David Musyj: Bottom line is people were actually embarrassed to admit they worked in healthcare and did not openly admit they worked at Windsor Regional Hospital. Healthcare in general and the hospital, in particular, did not have a good reputation for facilities, food and overall environment. First impressions are very important. Patients had a negative first reaction, which then reflected negatively on staff compassion and care. Our staff did not stand a chance to overcome that initial impression.
To help the staff, we had to invest in the facilities, food and overall environment. This allowed the staff to concentrate on the compassion and caring components.
A saying was around our hospital when I started working there: The quickest way to get an idea from being implemented is to tell senior administration.
FH: What changes did your employees want?
DM: Staff wanted to be listened to. In addition, they wanted their ideas implemented. Once we started to listen and started to implement their ideas, it caught on like wild fire.
FH: What surprised you and your leadership team?
DM: How some ideas were so simple, made so much sense and cost very little to implement but had massive returns for the patients and staff.
FH: What suggestions did your team implement right away as a result?
DM: One thing that was talked about for years was having an on-site fitness facility for staff. Staff continually asked, but we ignored them, saying it was too costly. Not until we really listened did it start making sense.
Staff could go to the facility before or after work or even on breaks. Going to the gym when you have to get into your car and stop on the way to and from work makes it easy to avoid. We need our staff to be healthy to take care of our patients.
We always thought we could not afford our fitness facility. But we found a small room, got some donations of equipment and bought a few items to start. We charge the staff a small monthly fee. The fitness centers are now self-funding after five years. They are a huge recruitment and retention concept. The fitness centers have even resulted in staff quitting smoking and walking on a treadmill instead.
FH: What other staff suggestions will you implement over time?
DM: The simple ones are the easy ones to remember. Handwashing is a huge issue in healthcare. Statistics clearly show the direct relationship of low levels of handwashing to high levels of hospital acquired infections (HAI).
We have handwashing stations all over the hospital.
One staff member asked where do patients/families/staff spend time with very little to do? The elevators. As a result, we put handwashing stations in the elevators. Bingo-simple--low-cost--major benefit to patients and staff by reducing spread of HAIs.
FH: What was the most important factor to successfully shifting the hospital workforce culture?
DM: Again, listening--active listening. Then implementing, and implementing fast. If someone would not be harmed by the implementation--which is 99.9 percent of the ideas--then do it fast. Do not be afraid of it not working. Take the approach that doing nothing is a decision. Also, not doing something until it is perfect results in frustration and staff giving up and giving up on creativity.
Once staff sees their ideas in action and implanted quickly, the creativity quadruples. This then spreads into being creative to enhance patient care and the patient experience. Three years running, WRH has been recognized with the most leading practices by the Ontario Hospital Association--a record that Joe DiMaggio would be proud of.
FH: Did you and your leadership team hit any major obstacles when trying to improve staff and patient satisfaction?
DM: The concept of fear. We work in a healthcare setting. We generally think we have to test things to utter frustration until we implement. We had to break that way of thinking. We can do many things that do not result in any possible negative impact to patients/families. In fact, it is the opposite; they have major positive impacts.
FH: What advice would you give to other hospital administrators facing a similar staff satisfaction issue?
DM: You have to recognize the direct relationship between patient and staff satisfaction. When you increase one, you increase the other.
Make the team members' tasks easier. Make their environment friendly and welcoming to patients. Otherwise, your staff will have to spend time defending and explaining to patients and families why the facility needs paint, why it's dirty or why food choices are limited, etc. Can you imagine having to defend this to 30 to 50 people a day, every day? How long before staff answer "not my job," "call management, they do not make changes," "call the CEO; he never listens to us."
After you do this, listen. Actively listen, implement fast and celebrate the idea.
Before you know it, you have implemented many initiatives that increase staff and patient satisfaction. The best letters I get are the ones where a patient has noticed all the little things we have done to increase their satisfaction.
Editor's note: This interview has been edited and condensed for clarity.