Striving for greatness: Hilo Medical Center looks to improve following employee survey

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Results of a recent survey of Hilo Medical Center employees will be used to help improve the hospital’s work environment.

Results of a recent survey of Hilo Medical Center employees will be used to help improve the hospital’s work environment.

“I’ll say that right up front to the community: We’re a good hospital — but not great yet,” CEO Dan Brinkman said in an interview.

The hospital has completed town hall meetings to share the results with workers. The employee engagement survey, completed by Press Ganey, was conducted in January with employees learning results in June.

On a scale of 1-5 — with 5 the best — employees ranked Hilo Medical Center a 3.92.

Hospital records provided to the Tribune-Herald show employees ranked Ka‘u Hospital a 4.4 and Hale Ho‘ola Hamakua a 3.96.

When averaged, Brinkman said, Hilo Medical Center facilities in the region scored 3.96 out of 5.

“That’s a pretty good score. However, it’s not where we need it to be,” Brinkman said in a video presentation for those unable to make one of five employee meetings.

“A lot of hospitals are clumped around that four number, and we’re at the back of that pack, and I believe we can do a lot better,” Brinkman told employees.

In the interview, Brinkman said moving from good to great takes time. He likened it to climbing a mountain, saying, “the last 1,000 feet are the hardest.”

Those hardest 1,000 feet leading to greatness are ahead for Hilo Medical Center, he said.

Eighty-four percent of employees said they enjoy working with their coworkers, 93 percent like the work they do, and 87 percent agree patient safety is a high priority for the organization.

But Brinkman said nearly half of hospital departments — 47 percent — will need “assistance and resources” to help transform the hospital into a great workplace.

Just 39 percent agree their unit is adequately staffed, 47 percent think the hospital offers enough career development, and 38 percent say different levels of the organization communicate effectively with each other.

Hospital leadership plans to address those categories in a variety of ways proven effective at other hospitals nationally.

Brinkman said staffing adjustments will be made “or maybe we need to spend a little bit of extra money, if I can find it,” he said. Doing that, though, is “robbing Peter to pay Paul.”

The hospital follows national staffing benchmarks — one nurse for every two patients in the ICU, one for every four patients in the ER, and one for every five or six patients on medical units, Brinkman said.

Leaders plan an all-departments staffing review, are seeking worker input about career options, and want to address “opportunities for improvement” via freer communication.

For example, Brinkman said, every manager now sends hand-written thank-you notes to four employees per month. Hospital communications director Elena Cabatu said she received one and was so touched that she shared it with her grandmother.

Key to hospital evolution, Brinkman said, is that most workers are excited about making improvements.

But Brinkman said response to the item, “This organization conducts business in an ethical manner,” is concerning. Fifty-eight percent agreed. But the remainder were neutral or disagreed.

The hospital’s overall ethics score of 3.59 is just 0.49 below the national average, Brinkman said, but he still wants to learn more in a follow-up survey underway. Are ethical concerns related to staffing, services or accessibility? Brinkman hopes employees will elaborate.

Brinkman said a 2012 survey of employees triggered no changes.

That, he said in the interview, was because of budget shortfalls, leadership changes, layoffs, service decreases and cuts in federal reimbursements.

“Service cuts and rifts” lasted almost two years, he said.

But more stable times mean the hospital is now prepared, long term, to improve the work environment.

Scores went up from the 2012 survey, Brinkman said. But that was expected because there’s less upheaval now.

Goals now include improving the patient experience, employee engagement and physician engagement.

Every employee is essential to patient safety, Brinkman said. A housekeeper properly cleaning a bed can impact safety as much as a surgeon.

“That’s what’s really cool, about hospitals, is there’s a mission for everybody,” Brinkman said.

A program, started before the survey results, called Go Malama, should systematically improve the hospital work environment in a planned, incremental way, he said, with worker input essential.

Employees will often be asked if their ideas get taken seriously and whether managers listen. They’ll be asked for suggestions to make jobs easier, more rewarding and better for patients.

Cabatu said “what’s in the best interest of our patients” will be the Go Malama focus.

“I’m cautiously optimistic because I think our patients will certainly benefit from it,” Brinkman said.

Surveys went to 1,176 employees, and 863 replied, a response-rate of 73 percent — a big increase from 2012’s 43 percent.

The Hawaii Government Employees Association, which represents many workers at the hospital, declined to comment about the results.

Brinkman promised to repeat the survey in 2018 and hopes to repeat annually.

“I’m very hopeful that we’ll be able to not only make things better, but keep them there,” he said.

Email Jeff Hansel at jhansel@hawaiitribune-herald.com.