Want to keep workers engaged? Ask for their ideas

When a Kansas hospital faced a fiscal crisis, it turned to its staff for ideas on how to weather it. Enlisting employee ideas on running your practice is a sound idea, experts say, and not just for emergencies. Soliciting input helps keep your practice strong and your employees loyal.

"Staff are closer to the people than the doctor, and they have a lot of thoughts about how to serve people better," said Richard Reece, MD, a retired pathologist and author of Innovation-Driven Health Care: 34 Key Concepts for Transformation. "And when you listen, you pay respect to your staff for their knowledge."

The 103-bed Newton (Kan.) Medical Center launched their "Show Me the Money" campaign in November 2008, asking employees for ideas to avoid layoffs. Senior leadership took pay cuts, and the staff were asked in mass e-mails and employee newsletters: "How do we reduce costs without a negative impact on patient care?"

Managers received 121 ideas, and a committee chose 63 for immediate implementation, saving about $1.7 million. Actions included:

• Identifying supplies that could be bought at a lower price.
• Reducing the amount staffers were reimbursed per mile for driving.
• Eliminating plastic bags with the hospital logo.
• E-mailing, rather than printing and posting, the volunteer newsletter.
• Cutting the employee discount in the cafeteria from 40% to 25%.

The staff even recommended selling hot chocolate, which had been provided free to nighttime visitors, for 35 cents a cup.

"We have had a lot of thanks and acknowledgement from the staff. They got a sense of community and the sense of pulling together for something we all value: the survival of the hospital," said Vallerie Gleason, RN, Newton's vice president of physician services. "If you ask for help, people will generally help, particularly in our line of work."

Experts say the concept of asking staffers for their thoughts works well in all health settings -- and it doesn't have to be an extensive program. Practices can create a culture of ideas when physicians and other senior leaders routinely ask staffers if they have ideas to save money, improve patient care or increase revenue.

"Just asking the question is powerful," said Bob Murphy, RN, senior leader at Studer Group, a consulting firm based in Florida and Texas.

One way to get new ideas is to hold regular staff brainstorming meetings. "Sharing the ideas that are generated might start others to come up with something better and build momentum," Murphy said.

Experts say these efforts are worth the time, because staffers' suggestions could improve efficiency and save money. Employees also might have ideas that reduce a practice's liability or other risks. In addition, implementation does not necessarily create more work for the physician, because the staffer can be charged with developing an idea further.

"If you are not open to ideas, feedback, suggestions and risk assessment early on, you're going to lose much more money and time," said John-Henry Pfifferling, PhD, director and co-founder of the Center for Professional Well-Being in Durham, N.C. "You've got to build time in."

Being able to contribute ideas also can help employees feel more valued, reducing burnout and turnover. This does not mean that all of the ideas have to be used immediately -- or ever. Some are bound to be impractical or just not very good. The key to keeping ideas coming, experts say, is to always allow them to be heard and to acknowledge the staffers who contribute them.

For example, the ideas generated by Newton's staffers that have not been used remain on the list of future possibilities.

"Staffers want to be involved to ensure the vitality and viability of the practice," Pfifferling said. "And they want to be listened to and heard."

Expensive rewards, such as a percentage of the money saved, aren't necessary. "For most people, it's not about the reward. It's about the recognition," Murphy said.

Newton held a staffwide meeting at which various departments displayed examples of how money was saved. The originators of the ideas were acknowledged and thanked. In the spirit of saving money, no hospital funds were spent on the event.