Toxic employees. We’ve all worked with them – but can one bad apple really spoil the whole bunch? Having toxic behavior at any company yields bad results. But having it on the hospital floor can have serious consequences. According to a study by Mitchell Kusy, forty-nine percent of nurses that reported toxic behavior by team members said that it has resulted in them wrongly administering medication. And 25% of practitioners in the healthcare industry believe disruptive behavior is directly tied to patient mortality.
So what does this look like for an RN that’s worked on the floor? A former colleague of mine was sharing about a nurse that was difficult to get along with. She constantly picked up extra shifts, worked long hours and never quite seemed happy about her job. Her peers would help her out where they could, but she never wanted to pitch in when the rest of the team needed help with a patient. Her patients seemed relieved when her shift was over and they got a new nurse. When a team that is there to care for people is divided because they are avoiding someone on staff, mistakes are made, patient satisfaction goes down and the care we promise as nurses inadvertently suffers.
1. What is a toxic staff member?
A toxic worker is one who engages in bad behavior while on the job, often to the detriment of the team. And in healthcare specifically, one result is usually poor patient care. Examples of toxic behavior include having a bad attitude, whining, sabotaging others’ work, yelling, and more. Their conduct isn’t done maliciously, but it can still be harmful to their colleagues’ reputations.
2. Can anyone be toxic?
Yes. Everyone from the janitor to the CEO has the potential to be toxic. Whether they feel unappreciated – "I’ll show them for not giving me that promotion!" – or don’t work well with others, no one is immune. In fact, according to that same Kusy study, 80% of doctors have displayed toxic behavior towards staff, and 33% say disruptive physician behaviors occur weekly. No growth opportunities and being overworked are the two biggest ways to create toxics.
3. How do toxics affect my hospital?
So what else does the Kusy study tell us about having toxic staff members in your hospital? Well, for starters, toxic staff wreak havoc on retention, performance, and clinical care outcomes. Among the victims of toxics, 12% end up quitting, (and replacing them can cost over $57k per role!), 38% felt their work quality decreased, and 78% said their organizational commitment declined. For every 10% of unsatisfied nurses, patient recommendations drop 2%.
So what can you do about this in your care center? Cornerstone recently came out with a brief on toxic employees in healthcare that offers some suggestions on how to address this on your team. If you would like to dive further into what you can do to address this in your care center, you can download the rest of the brief here.
Want to keep learning? Explore our products, customer stories, and the latest industry insights.
How Healthcare Organizations Can Build Stronger Leadership From Within
In healthcare there has always been an attitude that the need for a nurse or a doctor is steadfast, no matter what happens to our economic climate. While that may be true, it doesn't mean healthcare workers will always remain in one place. As new nursing graduates enter the workforce, they bring with them the Millennial mobile mentality. These new hires want to move and this can create a lack of leadership needed at healthcare organizations. Strong leadership and talent retention are tantamount in providing the best healthcare services, yet according to Cornerstone's director of industry solutions Gayle Loving, more than 25 percent of new nurse graduates will leave their first job within two years. Identifying talent that wants to stay and grow within an organization is key to succession planning in healthcare. Learning how to identify these folks and understanding their importance was the topic of a recent webinar hosted by Corporate Executive Board (CEB) and Cornerstone OnDemand. While there are always jobs in the medical profession, "buying" leadership isn't as easy in the healthcare industry, says CEB's Jarrett Shalhoop. "Investment in our current workforce is key," he adds. Shalhoop has used his background in psychometrics to identify a key distinction for advancement and retention of leadership at healthcare organizations: high-potential employees are not the same as high-performance workers. While most organizations see high performers as their top talent, it's the high potentials that will become the next leaders at an organization — something the healthcare industry critically needs. Shalhoop says that the leadership trait of confidence (displayed by employees who can grow within the organization as mentors and managers) in the healthcare sector is lower than the international average. These three characteristics of high-potential employees can be indicative of leadership success, Shalhoop says: Ability: Reasoning, interpersonal skills, emotional regulation and technical skills. Aspiration: Interest in responsibilities and challenges associated with senior roles. Engagement: Commitment to organization, effort and intent to stay. Simply identifying people who demonstrate these qualities isn't enough. The most successful healthcare organizations not only identify high-potential employees, Loving says, they also invite them into the leadership conversation. They shouldn't assume that everyone wants to be a leader. "Many times organizations assess folks and look at their career preferences, but they don’t really ask the employee to opt-in," Loving says. Listen to the full webinar here Photo: Can stock
Why Talent Management Makes Sense for Healthcare Organizations
The healthcare industry is certainly no stranger to changing compliance and competency requirements, but the latest shifts are changing the game as we know it for healthcare organizations concerned with providing top patient care. New regulations under the Patient Protection and Affordable Care Act give patients more opportunity to decide the fate of a healthcare organization’s financial wellbeing. Now, high scores in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient surveys result in higher government reimbursements to healthcare organizations, giving patients a significant ability to affect a provider’s profitability. Given that most healthcare firms are experiencing talent shortages in areas such as nursing and IT, it’s essential for these organizations to provide ongoing training and development to their staff to ensure they are able to drive retention and provide a positive, compliant experience for their patients. Why Talent Management? Key to helping healthcare organizations keep pace and still provide a top-notch patient experience is an agile, focused and aligned employee experience that meets generational expectations. With an agile talent management infrastructure in place, healthcare organizations can respond more quickly and cost-effectively to shifts in compliance and validation standards, talent loss or shortage, and overall, gain better insights around how to best develop staff to drive quality patient care and employee retention. Creating an Aligned Employee Experience Several of our healthcare clients, such as Mount Sinai Hospital, New York Presbyterian Hospital, Sanford Health and WellSpan Health, are bringing talent initiatives to the forefront of their strategy in order to remain competitive amid rapid industry shifts. Other success stories include: Â· Carilion Clinic is a nonprofit healthcare organization that serves nearly 1 million patients. A client since 2008, Carilion uses Cornerstone’s integrated system to assess performance, and identify and address training gaps for 11,000 employees with role-specific content. In addition to cost savings, increased efficiencies, and improved compliance and talent enablement, Carilion also worked directly with our product team to help develop Observation Checklist, a unique solution within the Cornerstone suite that allows users to assess and record and employee’s skills and competencies while directly observing specific activities in the field. Read more about their story here. Â· Cadence Health, a unified health system that serves Chicago’s western suburbs and the surrounding region, strives to the region’s most innovative health system and provide an exceptional career experience for its employees. The organization implemented the Cornerstone Performance Cloud in 2012 in an effort to address staffing and leadership challenges. Using the system, Cadence is helping its employees develop careers and opportunities that align their professional goals with the goal of the health system, which is to provide exceptional patient experiences. Since implementing the system, Cadence Health administrators are now 99 percent compliant with their 6,700 performance assessments, and over 18,000 FY13 goals (both team and individual) have been created in the system. Read more about their story here. Â· BJC HealthCare is another great example of a firm using talent management to drive business impact and cost savings. As one of the largest nonprofit healthcare organizations in the United States, BJC uses Cornerstone to identify and assign training to more than 26,000 employees, ensuring superior patient care, safety and compliance. Creating a centralized learning resource for BJC’s employees helps the organization save $800,000 annually as well as drive consistent patient experiences during nursing staff changes and migrations across locations. Read more about their story here. We also recently started working with UMass Memorial Health Care, the largest healthcare system in Central and Western Massachusetts and a clinical partner of the University of Massachusetts Medical School. The organization is implementing Cornerstone’s Learning Cloud and Performance Cloud in an effort to streamline its performance and development processes and enable its more than 13,500 employees to focus on providing best-in-class patient care. To read more about how Cornerstone is helping healthcare organizations drive top-notch patient care, visit www.cornerstoneondemand.com/global-business/industries/commercial/healthcare. Want to find out what your healthcare organization needs most when it comes to talent management? Take our 2-minute quiz and discover your talent management prescription.
Is Coaching Right for My Healthcare Team?
Hospitals and care centers are always looking for well-qualified, highly-skilled practitioners. And as an RN, I was always being asked to learn something new. Typically, one of my more senior peers would orient me on the new task. And I can easily say that the times I experienced the most growth in my career was when I received some kind of coaching. Over 70% of coaching recipients saw an increase in work performance, relationships, and communication skills, and 80% reported having more self-confidence.1 So it’s no wonder that coaching in healthcare is so important. So why don’t more hospitals do it? Quality patient care depends on a well-trained, passionate, committed staff, which in turn is fostered by supportive, skilled leadership. Yet healthcare organizations are facing radical changes in everything from policy to technology, a loss of key leaders and clinicians due to the Baby Boomer exodus, and an increasingly dissatisfied—and overworked—labor force. Not to mention increased competition and the need to run ever-leaner while still providing the same level of care, despite an increased patient load. Nurturing engaged, curious employees and creating skilled, committed leaders are key to surviving and thriving amid all these challenges. So what is coaching? Coaching is an umbrella term for the process of developing people’s skills and abilities, boosting their performance, and dealing with issues and challenges before they become major problems.2 But coaching can be broken out into three different categories: Executive coaching: Designed for top tier team members to improve their performance and leadership capabilities. Leadership and capacity building coaching: Aimed at helping managers—from those involved in patient care to administration to operations—become better leaders to prepare them for more high-level responsibilities. Performance coaching: Implemented to help recipients improve performance in their current roles, build strengths, or correct weaknesses. Must-Have Coaching Skill Sets In addition to the above, coaches should be able to offer intangible skills that enable staff to achieve a higher level of success. Whether a coach is "coaching your coaches," or if a manager is coaching a more junior colleague, they should be able to: 3 Listen actively: Employees need to know that when discussing career aspirations and challenges, their coach is as invested in their success as they are. By being an active listener, the coach will be able to fully internalize and understand team members’ goals and offer meaningful solutions for impactful growth. Part of listening actively is not checking e-mails, not looking at a cell phone, or doing anything else that distracts from the one-on-one element. Reinforce positive behaviors: A quality coach should reward their clients when they’ve made the right move or decision, rather than punish them for the wrong one. By rewarding correct choices, the staff member will display better performance-related behaviors as an instinct, rather than as something they have to think about doing before acting. Ask open-ended questions: Asking "yes/no" questions, or ones that similarly offer a limited number of responses, are risky because respondents have to choose best-fit answers that may not paint the whole picture. Instead, a good coach will use open-ended question, such as "How do you feel when..." or "What do you think is..." This enables the staff member to provide detailed, candid answers, rather than be pigeon-holed into responses that may not present the most accurate information. More on Coaching There are many different types of coaches, strategies for teaching and best practices on timing. For a more in-depth look on coaching, you can download our Coaching Playbook for free, here. #### 1 No author. "The Benefits of Coaching." Outstand.org. Date published: March 28, 2013. Date accessed: March 30, 2015. http://www.outstand.org/index.php/2013/03/the-benefits-of-coaching/ 2 No author. "What is Coaching?" MindTools. No date published. Date accessed: March 27, 2015. http://www.mindtools.com/pages/article/newTMM_15.htm 3 No author. "Business Results Through Coaching."Bersin by Deloitte. No date published. Date accessed: March 26, 2015. http://www.bersin.com/News/Details.aspx?id=15040.