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Spanning the Ages:
Meeting the Needs of Different Generations

Clint Maun, CSP

This is a reprint from an interview that first appeared in Michigan Health and Hospitals, Jan/Feb, 2003

Never before has the healthcare profession been challenged like it is today. With competitive pressures of increased customer awareness, regulatory compliance and staffing concerns, there are also challenges related to various generational/diversity issues.

Consider these facts:

  • The majority of healthcare patients are senior citizens.
  • Many of the executive and senior management team running healthcare organizations are late Generation X'ers, forty to fifty-five years of age.
  • Most mid-management and supervisory teams are thirty to forty-five years of age.
  • However, there’s a young group of people on the floor having just received their professional licenses, certifications and educations that are caring for senior patients.
  • And emerging into the workforce soon will be the future employee group, which is currently in high school.

This scenario plays out for five or six generations every day and poses many diverse and potentially complex challenges for today’s healthcare organizations.

Patients involved in healthcare settings generally expect traditional values and services. They are interested in accountability and "value for a price". They have a preconceived view of doctor-patient relationships, which places traditional respect values into the equation. In addition, the majority of patients receiving healthcare services are becoming increasingly knowledgeable about expected outcomes. The internet has educated even the very senior patient toward understanding these outcomes and various levels of service delivery.

While this is occurring for the patients, healthcare organizations are being "stretched to the max" with staffing challenges. Facilities are striving to recruit, select and retain quality employees and they face difficult hurdles. Since they don’t want to "give away the farm" by using traveling or registry staffing to maintain employee levels, we work with them to determine what’s necessary to not only keep individuals with seniority but also attract and retain the new worker "under 25 years of age".

The successful organizations today are blending all age groups. They continue to recognize and reward senior employees with benefits, pension plans and pay increases, while dealing with issues affecting the new generation of workers such as enjoyment at work, "fun", time off, and meaningful involvement in performance improvement teams. Successful healthcare organizations recognize that employment for life is not a goal for the new workforce. Don’t develop programs to keep a workforce in place from the time they are old enough to work until retirement. This simply is not of primary interest to the new generation of workers.

To encourage success, organizations can use daily "huddles" in departments/unit, which involves all levels of coworkers, patients and physicians, together accomplishing outcomes and fixing problems as they occur. This group will work on unit/department focused team-based outcomes so everyone has input in setting goals and keeping score. Involve your new coworkers in performance improvement teams that meet their needs - such as clinical outcomes all the way to work environment improvement efforts.

The successful organizations realize that they have to keep the "service excellence bar" high. They are focused on the patient population and their specific needs while at the same time accomplishing results for outcome-based reimbursement success. And, they must try to develop meaningful discussion groups consisting of old/seasoned and young workers in the day-to-day self-governance of patient improvement/service delivery.

Organizations we work with that have successfully guided these age diversity issues did so by senior team involvement and not by referring age diversity issues to the Human Resources Department. The senior team, including the CEO, COO and Director of Patient Services must be actively involved in team-based efforts to recruit and retain coworkers and customer service improvements attached to daily outcomes.

When hiring 25 years and younger employees we recommend using team-based interviews. When hired, the new workers must then receive a passionate and customized orientation that provides them time to learn and requires that they re-demonstrate their learning through an orientation checklist. They should be involved with an assigned mentor throughout their orientation. Mentors should be recognized with some type of reward based upon the retention of the new coworkers after specific milestones, such as 3 months, 6 months, a year and so forth. When rewarding teams, also consider tying reward/recognition at the unit/department level to the retention of coworkers and patient service excellence. This puts responsibility on all levels to accomplish "happiness" for everyone.

While it’s important to realize new younger employees are interested in issues related to "now", they can also be given opportunities for choice in the implementation of scheduling, benefits and work delivery systems. Benefit packages once used to retain workers from yesterday do not appeal to today’s new workers who are interested in controlling their own money. They would rather allocate their pay as they want, putting it into pension plans, retirements, savings, stocks, etc. on their own.

Progressive organizations involve team-based scheduling on the units so everybody can be involved in the discussion of vacations, holidays, time-offs, and staffing. Old parent-child models should be broken. These models aren’t productive for mature individuals anymore, let alone the new workforce. Parent-child models also don’t work for patient satisfaction because it puts patients at risk of waiting for care to be delivered and doesn’t provide them active participation in the process. Today’s patients with the new knowledge they’ve obtained, no matter what their age, expect straightforward discussions and timely decisions in their healthcare.

The younger workers today are interested in team-based involvement, but from their perspectives. You can involve middle-aged coworkers in teams on any topic since most have never had the opportunity for involvement in improvement teams in the past. New workers however have been involved in teams since grade school and expect to be on teams where they are listened to and have the opportunity to impact successful outcomes. Thus, you’re not going to get a young worker to be involved in a "fluffy" team. They would rather put in their time, clock out and go home.

In summary, we find many senior teams need to be champions for what it takes to blend everyone’s needs into an outcome-based plan, put it in writing and develop it as an ongoing effort for the organization. Once you develop this "super team" concept for packaging service excellence and staff retention you can then form sub-teams to attack other issues mentioned such as orientation, interviewing, scheduling, benefits, wage/reward recognition and enjoyment at work  If we are to understand and take advantage of our opportunities we must understand the diversity that presents itself every day.

Are you experiencing high turnover in your facility?

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