MISHRM 2014 Annual Conference

1. MISHRM 2014 Annual Conference HR Amplified: Driven to be…

2. Positive Labor & Employment Relations Daniel Bretz Clark Hill PLC

3. Positive Workplace Relations • According to a Gallup study • as the US’s position in the global market shrinks, there will be fewer good jobs over the next 30 years • global competition for good jobs will escalate • a lack of good jobs in the US will lead to fewer tax dollars, economic strife and governmental bankruptcies • a lack of jobs is a more serious threat than rising healthcare costs, terrorism or environmental degradation "The Coming Jobs War by Jim Clifton

4. Maintaining Good Jobs • As the competitive jobs threat from China, Japan, India and Russia escalates, America’s workplaces must adapt • Americans must become more entrepreneurial • Americans must focus more be on sales, rainmaking and developing customers

5. Small Businesses • Small businesses are job creators • The key to job growth is in small businesses • Out of 6 million businesses in the US in 2007, 99% had fewer than 500 employees

6. Becoming Customer Focused • According to Gallup, there are approximately 100 million employees in the US. Of this: • 28% are “actively engaged” • 53% are “not engaged • 19% are actively disengaged

7. The problem ….. and the solution

8. Engagement starts with a Respectful Workplace Engaged employees trust and respect one another and the work Why respect matters: • Make this a “Best Place to Work” • Improve efficient, safe, error-free performance • Reduce stress, frustration and dissatisfaction • Avoid exposure to the legal process

9. How do you want to be viewed by others? Trust and Respect lead to: • Status • Reputation • Influence • Ability to get things done

10. Disengagement –Looking Outside Employees most commonly seek outside help – an attorney, the EEOC/NLRB, a labor union – when: • the workplace has become irrational • they perceive favoritism • they feel disrespected It’s not always about the money or the benefits, it’s about feeling connected and engaged

11. Disengagement – Quality and Errors Findings of Two Studies • Disruptive behavior has a negative impact on the quality of operations and work assignments • Disruptive behavior contributes to employee resignations and labor shortages

12. JCAHO Study • 24% of unanticipated events resulting in injury or death could be attributed to either • Increased staff turnover • Communication gaps • Lack of teamwork • Other ”human factors” i.e. relationships

13. Other Studies With Similar Findings • >95% have witnessed disruptive behavior by MDs • 30% - knew nurses who left hospital as a result of disruptive behavior • >70 % said it occurs at least once a month • 10% said it occurs daily • 14% aware of actual adverse consequences • “serious problem within and across disciplines” Voluntary Hospital Association 2002, 2005 studies (Rosenstein, M.D.)

14. Consequences of Behaviors • Decreased morale • Increased stress • Diminished productivity • Lack of information sharing • Reduced innovation • Processing delays • Patient dissatisfaction • Compromised Culture of Safety • Poor Outcomes

15. Behaviors Reported in Studies • Disrespect • Berating Colleagues • Abusive Language • Condescending Behaviors • Throwing things

16. Disrespectful Comments Cited in Study • “Any idiot could do that kind of work.…” • “I’m sick of the incompetence….” • “Can’t you read…?” • “How stupid are you anyway …” • “I can’t believe those people….” • “You could have killed that patient….”

17. Quotes on Inappropriate Behavior • “The doctors can be disrespectful to the nurses who can be disrespectful to techs who are disrespectful to housekeepers, etc.)” • “There are no consequences for these behaviors so you become demoralized and they just continue.” • “Surgeons are very belittling—they call you names . . .” • “There is a director who screams at his supervisors all the time and no one does anything because they are afraid of him.” • “I would like to see people written up—people don’t take things seriously. Supervisors hate confronting people.”

18. Causes of Disruptive Behavior Historical factors • Generational differences • Military model • Residency training • Tolerance and indifference • Apathy toward training

19. Roots of the Problem Environmental factors • High stakes • Time pressure • Productivity demands • Cost containment • Knowledge gaps in support staff • Changes/rotations in support staff

20. Roots of the Problem Individual Factors • lack of self-awareness • lack of interpersonal, coping or conflict-management skills • cultural differences • intolerance • bias • 47% reported belief that gender influenced behavior • fatigue • personal problems • substance abuse

21. Why Does The Problem Persist? Barriers to Reporting: • Fear of retaliation • “Nothing ever changes” • Lack of confidentiality • Lack of awareness or willingness to change • Lack of administrative support

22. Can I Avoid All Conflict? • No. Conflict can not always be avoided. • Conflict is normal and can be a healthy part of team interactions • Conflict handled appropriately allows team members to: • Share ideas • Voice concerns • Improve team relationships • Managing conflict in a respectful manner is key.

23. Worst Case Scenario Stone-faced helpers who no longer talk to one another

24. All Agree “It was only a few who gave the rest of the group a bad reputation”

25. Basis for Legal Action • Physical Abuse • Assault, Battery • Infliction of Emotional Distress • Discrimination • Gender, ethnicity, age, disability, sexual orientation • Reverse discrimination • Harassment • Sexual • Hostile Environment • Other than sexual --based on gender, ethnicity, age, etc. • Retaliation • Whistleblower Protection

26. Legal Definition of Harassment • Physical or verbal conduct which is • unwelcome • because of sex/age/race/nationality/religion/….or sexual in nature • offensive • severe and pervasive • both objectively and subjectively offensive • the employer knew or should have known of harassment and failed to take action

27. Comments Become Evidence Word choices can be critical • Sarcasm, Cynicism • Profanity • Tone, volume, body language • Jokes, Double Entendres • Clichés • “You people…” • “Get me that girl” • “She is a useless woman…” • “We need some new blood in here…” • “He’s too old to cut the mustard….”

28. You Can be Liable • Under state tort, discrimination and harassment law, an individual can be held personally liable for judgment. • Potential Defendants • Company • Individual

29. Criminal Liability • An alleged harasser can also be charged with criminal sexual conduct • The prosecutor can pursue criminal charges for assault and battery

30. Lessons Learned

31. Workplace Policies • Mission and Values • Positive Employee Relations • Respectful Work Environment • Standards of Conduct • Professional Behavior • Harassment/Offensive Behavior Policy

32. Respectful Work Environment Policy POLICY • Each associate shall be treated and is expected to treat others (i.e., associates, customers, visitors) with respect, courtesy and dignity. Associates will promote professionalism and cooperation. Conduct, whether intentional or unintentional, that is disrespectful to others will not be tolerated.

33. Respectful Work Environment continued… Respectful behavior includes: • Speaking kindly and patiently to coworkers, subordinates, superiors, patients, families, nurses, hospital personnel, physicians, and others, while avoiding rude, embarrassing, belittling, berating, threatening, intimidating, insulting, loud and/or profane or abusive language in either private or public places

34. Respectful Work Environment Policy continued… • Responding to requests for information, input and/or help in a timely and supportive manner even if the response is limited to an explanation of why the individual cannot immediately fulfill the request

35. Respectful Work Environment Policy continued… • Handling conflicts, disagreements and/or differences of opinion in an objective and professional manner, and if necessary, resolving the conflict through the appropriate administrative channels • Abstaining from physical contact or conduct that is, or could be perceived as, threatening or intimidating or otherwise unwanted

36. Standards of Conduct As a leader, you have a responsibility to: • Serve as a role model by carrying-out your responsibilities with the highest degree of personal integrity • Clearly communicate to others your expectations for the highest standards of ethical behavior

37. Harassment Policy Conduct, whether welcome or unwelcome, intentional or unintentional, that is offensive or that constitutes harassment by or against associates based on sex, race, religion, national origin, sexual orientation, age, disability, martial status or any other characteristic protected by applicable law is considered misconduct and will not be tolerated.

38. Bullying Policy Workplace bullying is a form of harassment which makes the recipient feel upset, threatened, or vulnerable, undermines their self-confidence and interferes with their ability to perform work. Bullying tactics are defined as actions or behaviors of a persistent nature that are offensive, abusive, intimidating, insulting, humiliating, demonstrate misuse/abuse of power or which causes the target to be excluded or isolated within their work team.

39. Takeaways • No intent required for disrespect, harassment, mistreatment -- “unwelcomeness” irrelevant • Includes conduct by or directed at employees, staff, vendors, visitors, patients • Includes conduct on and off-premises if within scope of employment • Includes “bullying” • Obligation to report

40. Responding • Variety of ways to report • Obligation to investigate • Required to cooperate with investigation • No retaliation • Violation of policy, failure to co-operate, or lying prohibited

41. Great Place to Work Behaviors which all lead to TRUST • Credibility • Communication • Integrity • Respect • Support • Collaboration • Caring

42. Great Place to Work • Fairness • Impartiality • Equity

43. Great Place to Work • Pride • Personal job • Team • Hospital • Camaraderie • Intimacy • Community TRUST in leaders and co-workers

44. Model the Behavior Gain Respect for your good work and your behavior “The greatest success comes when a champion embraces the issue and spreads the word to other colleagues.”

45. Foundations for Respect • Listen to understand • Be self-aware • Be encouraging • Connect with others • Express gratitude

46. Foundations for Respect 6. Share information – teach 7. Walk in their shoes 8. Speak up 9. Grow and develop 10. Be a team player

47. Top TenRules for Managing with Respect

48. 1. We speak with one voice • Each member of the team has to understand the policies and pressures, the needs of management and their role on the team. • Weakness and lack of resolve will be discovered and exploited.

49. 2. One philosophy • Management can do whatever it wants

50. Management only has to do things….. …… the “right way”