Establishing effective employee relations can be considered from 2 perspectives1:
The basic outcome of positive employee relations is satisfied employees who are equipped to meet patient needs and are loyal, both of which result in improved retention.
Many complex federal laws govern the relationship between the employee and employer. Laws such as the ADA and the FLSA are intended to ensure that employees are treated with fair and consistent policies, procedures, and practices that govern day-to-day occurrences in the workplace. ED leaders should know that these legal mandates exist and know when to contact human resource professionals when questions arise about their interpretations or applicability.1 From the standpoint of internal requirements for organizations, human resource policy development should be consistent with business objectives, as well as the strategic intent of the organization.
For example, policies and procedures may address the promotion of internal candidates for open positions, as well as provide ways of recognizing current employees, thereby motivating them. It is essential for ED leaders to know the human resource policies and to ensure the consistent applications of these policies when applicable, particularly policies that can infringe on an employee's employment status, basic working conditions, and ability to be promoted, demoted, or reassigned from his or her current job responsibilities and duties.1
Policies and procedures that relate to employee discipline are particularly important to the establishment of an effective employer-employee relation's environment. These policies must be thoroughly understood and consistently applied. It is recommended that human resource professionals review disciplinary actions. Although not required, it is generally good practice to have a progressive disciplinary process that affords several steps for employees to go through to potentially avert termination with cause.
A grievance or appellate process that allows outside, or objective third parties, to consider both sides of a disciplinary case up to and including termination may be valuable. This process can either be open to any management action or be more restrictive in scope. It is important for the grievance process to have several steps, which could include a panel of employees hearing the grievance or the chief executive officer or senior level manager, such as the ED leader, independently hearing the grievance. However, the wise ED leader should have at least 1 third party present to verify the events and agreed upon outcomes of the proceedings. Grievance processes are not intended to shift accountability or authority for disciplinary actions, but rather to provide support to management in carrying forth their duties relative to employee discipline. Such processes should not be confused with arbitration, which may be available to the employer and employee, for the purpose of resolving legal disputes such as alleged wrongful termination. Grievance processes and structures that are set up with this approach typically result in an environment that can be endorsed and supported by both management and employees.1 The basic tenet of employee relations and HR is consistency and fairness of action without surprises.
Strategic Employee Relations
An organization, division, or department that creates effective employee relations has an advantage over those organizations that do not take this approach. Elements of a strategic approach include training and development of supervisors and managers, focusing on communication practices and styles, consideration of job scope, description and design, and organizational structure in general. The role of the ED leaders can be thought of as a designer of their organization or department, coach, and steward to employees. In their roles as designers, ED leaders must give careful consideration to
- Job design and its relationship to job satisfaction
- Overall design of the organization or department, ie, how the work gets done and how many layers exist
Leaders, in their role as coaches, are involved with the identification of developmental needs applying appropriate resources for staff and the creation of a real learning environment. Leaders in their role as organizational stewards require seeing themselves as servants, both to employees and to other customers.
ED leaders, who help create meaningful work, provide opportunities for growth and achievement, believe in recognition, delegate responsibility and authority for vital decision making, and keep employees informed, take major steps toward creating effective employee relations.1
Meaningfully and frequently communicating with staff is necessary to establish effective employee relations. Communication requires effective listening and understanding of employees' needs, issues, ideas, and thoughts. Successful ED leaders are almost always good communicators, who describe and define the outside environment and the institutional realities, and then create a vision that allows the staff to align their goals with those of the institution. Communication is often taken for granted in terms of form and content, and yet it has great value in maintaining job satisfaction and effective employee relations.1
Involving employees in decisions that affect their jobs and informing them about the status of their work are key to establishing effective employee relations. For example, giving them feedback on how effectively they are meeting corporate quality goals, departmental expectations, patient satisfaction, or financial goals, as well as how the organization is doing as a whole are essential to building a strong employer-employee relationship. Such feedback should be viewed as opportunities for improved performance, as opposed to punitive in nature. An old cartoon comes to mind depicting a pirate addressing his crew, “The beatings will continue until morale improves.” Negative reinforcement is not a successful performance improvement strategy and may damage employer-employee relations. Attention to developing competencies and treating staff with respect are also necessary to establish trust and a foundation for retention. Organizations that continually attempt to improve the performance and capabilities of their employees tend to establish extremely effective employee relations.1
Creating a balance between individual and corporate needs requires having an organizational vision. An organizational vision statement helps employees understand where the organization is going and how they might contribute. In addition, in periods of rapid change, a vision statement helps employees understand the direction of, and become more certain about, the future. Further, it avoids employees having to make up their own, potentially negative, assumptions about the future.1
ED leaders should frequently obtain employee feedback to determine and understand the needs and expectations of the employees. This feedback should be obtained in a risk-free environment. In response to the feedback (ie, surveys), action plans can be designed to address the gaps between the current and identified future states. Development of responsive action plans demonstrates the value of employee feedback and helps employees to understand and validate future goals. Employee opinion surveys, focus groups, town hall meetings, and other methods effectively and symbolically show the importance that an organization places on communication and feedback.
As with other human resource functions, healthcare organization training and education have both internal and external components and requirements. For example, the Joint Commission requires that training and job evaluations are performed on age-related skills and criteria needed for specific patient populations. In addition, OSHA requires that employees be trained on infection control and potential hazards in the workplace.1 Creating “centers of excellence,” ie, designation as a stroke center or trauma centers, and so on, requires ongoing education for physicians and nurses to demonstrate continued competence. Educational issues that range from fire safety to specific continuing education requirements for licensing are ubiquitous in healthcare organizations.
Training is generally defined as providing job-related skills that can be directly applied in a given work situation. Education is generally thought of more broadly to include development of skills and capacities that employees could potentially use performing their job or in other positions. Effective ED leaders consider the professional development needs of their employees and implement programs to address each component. This requires, in addition to observation and feedback, a formalized approach to identify developmental needs. It is often useful to have the employees identify these needs.
For example, employees and ED leaders can use an instrument or ranking system to identify their perceived (employee) developmental needs. The results can then be pooled to build consensus on training needs and resources.1 ED leaders should seek ways to professionally develop their staff. This staff professional development
- Strengthens the relationship between the ED leaders and the employees
- Improves the performance of the provider and the department
- May ensure the employee's commitment to their position
It is most useful to identify training and education needs related to expected job outcomes and organizationally identified goals. This process ensures that training and education are grounded in relevant activities that can be used immediately or sometime in the near future. Training that is based solely on the needs assessments of employees is less effective as it does not incorporate the institution's goal and may be similar to an academic setting in which a variety of educational programs are offered in the hope that they will be interesting and “perhaps” at some point useful to the organization. Although this kind of “employee perceived needs” approach to training can have a positive effect, it tends to be less efficient, consume more resources, and be off target.1
True learning organizations create an environment that allows
- Mistakes to be made
- Assumptions to be tested
- Openness to the ideas of others
- Dialogue and feedback
- Application of inquiry skills
The learning organization process requires a fundamental shift in the way that most professionals think, feel, and act. It requires a willingness to take risks and make mistakes, and the recognition that one's familiar approach may not be the best. This may be particularly difficult for highly trained professionals or individuals as they ascend the organizational hierarchy.1