Clint Maun, CSP

The absence rate for American businesses has been unchanged for the last 40 years... approximately 3% of the workforce is absent on any given day. However, healthcare has an absence rate that is slightly over double that percentage, somewhere around 7%. This is largely due to factors affected by the types of individuals health care is involved with in employment relations:

1. People who are younger have higher absence rates.
2. People making unsettling transitions to a new location have higher absence rates.
3. Single parents have higher absence rates.
4. People with small children have higher absence rates.
5. Women have higher absence rates (this is not because of gender bias, but because it is stereotypically believed that women should stay home and be involved with sick children rather than men. We don’t believe this should occur, but it does.)
6. People new to a particular job field or area of endeavor have a higher absence rate.

This above profile represents many individuals involved in healthcare. Thus, it’s natural to assume that we are involved with co-worker relations where healthcare absence rates are higher than the national business average. When absence rates are excessive, it becomes a prohibited problem to the delivery of service.

When absence rates are measured monthly, quarterly or yearly, it doesn’t provide a flavor for what’s really happening in an organization. We suggest you deal with absences by:

1. Reviewing rates by unit, shift and department on a very specific basis. Consider looking at it daily.
2. Deal with each absence or tardiness situation each time it occurs giving some type of impact to the individual who was absent or tardy.
3. Develop a program that incorporates reasons people should want to come to work versus being involved with other excuses or issues that have caused them to not make it into work.

When a facility becomes specific about it’s absence and tardiness rate by unit, shift and department, it sends a message to supervisors and coworkers that we need to be accountable on our own unit, shift or area for having an appropriate number of individuals at work. When a unit has four people who are scheduled to work and one calls in sick, that’s a 25% absence rate for that particular day on that unit. If that rate continues every day during a consistent period of time, it grossly exceeds the numbers mentioned above. When the facility begins to record absence standards or attendance targets by unit, shift & department, it sets in motion the concept of specific accountability.

We believe each absence or tardy should be consistently and immediately dealt with. We’re not suggesting you become punitive with each absence or tardy. But waiting until someone gets a certain magic number of absences or tardiness before they are dealt with is a sure sign for failure. By the time people reach a certain number in a disciplinary action process of absence or tardiness, they’ve already been taught old habits and are well on their way to making the decision to leave before being fired due to an absence management point system.

It is important the supervisor for each person missing work indicate to them when they return that “they were missed yesterday”, “sorry to hear about what caused them to be absent”, or “sorry to hear they were late”, and ask what happened? Begin by being positive. Example: “Mary, I understand how problematic it was yesterday when your child was ill and we’re glad to have you back to work today. We didn’t run as smooth with you gone.” That statement then progressively changes over time if she continues to repeat the problem with absences to, “Mary, this is the third occasion of absence in this period of time, which presents a problem related to our absence policy. We need your work and it’s important for you to show up when you’re assigned. Yesterday we had to do a schedule change and/or approve overtime to make it through the day because you weren’t here. Some of the people working with you were very frustrated because they weren’t able to provide the service delivery expected on the unit. I indicated to them it was OK to talk with you concerning this problem.”

Change the conversation tone each time absences occur to incorporate a more progressive involvement concerning the consequences of continuing to be late or absent. This places the responsibility on the specific unit, team and supervisor to handle absence or tardiness each time it occurs. Send a message that chronic repetition of problem behavior by an employee must be addressed each time it occurs. Peer pressure has influence.

In addition to these suggestions, consider the adoption of a self or team scheduling process. We’re referring to the ability of members of a team on a unit, shift or department to be involved in the initial recommendations for how a schedule be set up for a specific period of time. Many organizations need to move away from 30 day schedules when they can’t even get a schedule posted that lasts for an entire weekend. Many facilities need to move away from a centralized scheduling process where one person is trying desperately to keep the organizations’ budget happy, the regulators happy, the families happy and the employees happy. It’s not possible for one individual to be the developer of happiness for the entire organization by getting everyone to work when they want along with getting all their time off when they want.

We believe the organization should be involved in time on and the individual should be involved in time off. When the individual is involved with their peers in decisions about when they’ll sign up for work for a two-week period, then they are involved in the scheduling process. We find when people sign up - they show up. People involved in the scheduling process as teams tend to possess more ownership in the schedule and are more involved in the success of that schedule. We also suggest individuals be involved in finding their own replacement if they can’t make it to work. Why would we want to have them call into the facility to let us know they’re not going to be here or will be late? They should be involved with their peers to help stabilize the staffing for the organization. Learn more about Team-Based Scheduling.

If they are able to call their own replacement and that person comes in willingly, without any extra cost to the facility, there should not be a negative absence management process. We should instead congratulate them for finding a replacement for the schedule since they handled it in an adult fashion. Centralized scheduling systems create a parent/child philosophy, which has been out of fashion with coworkers since the late 1990’s. Many coworkers want flexible options in their life for employment along with the other things going on.

It is important to realize the most important thing to today’s co-worker is input in their schedule. We find when they have schedule involvement with their peers in an adult fashion the facility can concentrate on providing service rather than patching together a schedule. When it becomes a chronic plan of, “I’ll take care of me and not worry about the organization” the facility feels like they’re un-empowered and trapped because they desperately need the person, so they put up with their absence or tardiness problem. This leads to setting up silly systems such as paying for people to call in sick this week and then giving them overtime the next. All that does is allow workers to receive their full complement of pay for a two-week period without any consequences to the absence or tardiness problem they’re creating.

Once again, we believe it’s important to set in motion a specific unit, department or shift based process for handling absences. We also believe each and every occurrence of absence or tardiness should have some kind of action associated with it. When the team is involved in the ownership of the schedule and replacement issues, there is a chance for team based absence management to occur.