Question

Case 2.1: Organizational Culture Can Help Reduce Burnout in Hospitals

There are more than 5,600 hospitals in the United States that admit a total of approximately 35 million patients each year, so it is no surprise that there is a great amount of pressure on physicians, nurses, staff, and hospital administrators to provide top quality care with the utmost urgency and accuracy. The services these health care professionals provide are invaluable and the decisions they make can have a lasting impact on patients and their families.

What happens when nurses and physicians start to feel exhausted as a result of extended periods of work stress? Does this exhaustion impact the quality of their work? A 2010 research study focused on how job engagement of health care providers can affect the quality of care patients receive. A key finding of the study identified burnout as the primary cause of poor quality of care. Burnout is a condition characterized by exhaustion, feelings of hopelessness, and increased chances of making a mistake. The study found that hospital staff were constantly pushed to their physical, emotional, and mental limits by exposure to chronic sleep deprivation, extreme demands on their time and attention, and long shifts in fast-paced, stressful environments. Add into the equation that any small error, miscommunication, or the overlooking of a piece of information can have deadly consequences. In order to avoid burnout, it is important for administrators and department (nursing, surgery, emergency room, ambulatory services, intensive care unit, pediatrics, and so forth) leaders to create an organizational culture that fosters trust, open communication, support, and stress management education for doctors, nurses, and staff.

Each hospital has a unique culture that can either help or hinder employees’ ability to cope with the stresses of working in such a fast-paced environment. The following section provides a brief overview of how three hospitals in the United States are helping their staffs manage stress in a positive and productive manner.

Three Hospitals with Supportive Organizational Cultures

Baltimore-based Johns Hopkins Hospital is a prime example of an organization that offers a supportive culture for its doctors, nurses, and other health care providers. U.S. News & World Report has ranked the hospital in the top 25 “Best Hospitals” for more than 25 consecutive years. The yearly rankings have consistently shown high levels of patient satisfaction as well as statistical data showing low levels of infection, provider errors, and deaths. Even though Johns Hopkins is known for having some of the most gifted doctors and researchers in the world, it is continuously taking steps to nourish and maintain a supportive organizational culture. For example, a mentorship program encourages confidence, learning, and professional growth through strong communication between junior and senior level nurses, doctors, and administrators. There are many opportunities for employees to participate in team development, earn wellness incentives for a healthy lifestyle, and give back to the community by volunteering to work with students in the Baltimore area. Johns Hopkins also offers great benefits, strong job security, and financial help for registered nurses relocating to work at the hospital.

Another example of a hospital with a supportive organizational culture is the Armstrong County Memorial Hospital (ACMH) in Kittanning, Pennsylvania. With more than 850 employees, ACMH is a tight-knit and supportive community united in its goal to provide patients with the best care possible. While offering its employees standard benefits such as medical, dental, and life insurance, ACMH also provides discounts at many local businesses, hosts annual dinners celebrating employees’ dedication and service to the company, and holds raffles and pep rallies to boost morale and take employees’ minds away from the daily stress they encounter.

A third hospital, Akron General Medical Center (AGMC) in Ohio, helps its staff and employees manage stress by providing free medical services to employees and their families within the hospital system, tuition reimbursement, on-site dry cleaning in the facility, optional pet insurance, discounts at local businesses and entertainment establishments, and financial assistance and flextime schedules to handle adoption-related expenses and activities. Akron General actively recruits a diverse staff to improve the quality of services they deliver to patients. Not only does AGMC provide extensive on-the-job training, but it also offers a variety of Page 53educational and professional development classes that allow employees to learn about everything from sports and physical therapy to dealing with trauma.

Taken together, Johns Hopkins Hospital, Armstrong County Memorial Hospital, and Akron General Medical Center have created supportive cultures and work environments that help their doctors, nurses, administrators, and other staff combat job burnout, pursue a healthy work life balance, alleviate stress, and provide a higher level of quality of care for patients.

Intervention Points for Creating Culture

The five intervention points for creating culture change discussed earlier in the chapter provide a helpful framework to understand how each of the three hospitals mentioned above creates and maintains their unique and supportive cultures. Hospital managers and department leaders communicate the desired behaviors (e.g., delivering high quality health care, being supportive of co-workers’ needs, balancing work-life priorities, practicing stress management techniques, and so forth) through verbal and written communication of expectations as well as by role-modeling the desired behaviors on a daily basis.

Not only is it important for managers and leaders to set clear expectations, but it is crucial that all hospital employees understand the reasoning behind them. When doctors, nurses, and other employees understand that the professional development opportunities available to them will help the hospital better serve their patients and allow for high-quality care, they are more likely to take advantage of them. Behavioral expectations are also communicated through performance reviews and verbal praise or constructive feedback.

Socialization is a key component of culture creation in all three hospitals. During the recruitment phase, ACMH makes it clear that they value diversity in their staff and each hospital provides realistic job previews that allow potential employees to reduce uncertainty and determine whether there is a strong person-organization fit (prior to accepting a position). The effective mentoring program established at Johns Hopkins encourages two-way communication and creates confidence in doctors and nurses early in their career. The socialization process is reinforced with the recognition dinners and parties given to ACMH employees who are celebrating professional and personal milestones. The variety of perks offered by AGMC demonstrate the hospital’s dedication to ensuring all employees can maintain a great work-life balance. Employees whose goals and values no longer align with the hospitals’ are removed either voluntarily (leaving for another organization) or involuntarily (being fired due to performance levels that fail to meet company expectations).

In sum, managers and leaders need to continually intervene at key points to reinforce the positive aspects of their organizational cultures. The three hospitals above have positive and supportive cultures that help their doctors, nurses, administrators, and other employees manage the stress that frequently accompanies their jobs of providing patients with excellent service and care.

Questions

1.Assume you are in charge of socializing the newly hired nurses at a local hospital. What steps would you take to ensure that they understand the hospital’s organizational culture? How would you help them understand how to manage stress on a daily basis so as to prevent burnout later in their careers? Explain.

2.Hospital environments are more stressful in nature than the work environments found in many other organizations. What are some of the unique challenges that hospitals face when attempting to create a supportive organizational culture that helps employees reduce and manage their stress levels?

3.Think about your university or an organization for which you have worked. Using the intervention strategies discussed in the text, provide examples of how the university or organization attempted to create a certain type of organizational culture. Was it successful (or unsuccessful) in creating the desired culture? Explain.