Clients frequently ask, “Should we start improving our hiring efforts at the top or the bottom of the organization?” What they are asking is should they start with leadership or frontline staff? Some think that it only makes sense to start with leadership because leadership sets the direction. Accordingly, having the right leaders in place is critical to building a high-performance culture.
Others think they should start with the people who are interacting with patients every day – as those interactions drive the patient experience. Choosing better leaders may not have an impact right away, but starting with nurses, techs, nursing aides, and medical assistants can change your culture and the patient experience pretty quickly.
But if patient-centered, service-oriented frontline staff aren’t supported by managers, they may not feel valued and stick around. You see – there’s no right answer and we encourage clients to look at every job family from the get go.
Who’s More Important – the CEO, the Physician, the Nurse or the OR Tech?
“Where to start” always raises another important question: Who’s more important? Are the best hospitals the best because they have the best leaders? Doctors? Nurses? Frontline staff? Interestingly, I’ve never see a great organization that had a significant gap. There’s no evidence that if you have the best physicians, you can lower your standards for techs or any other group. What I can tell you is that some organizations don’t understand that EVERYONE is important – including OR techs, transporters, and dietary workers. Every one of these people impact patient outcomes, including the patient experience.
Here’s a great blog post from KevinMD about the value of an Operating Room Technician. Not just a tech: Everyone’s important in the OR
Some would see the OR tech as the least important person on the team but this surgeon points out:
The notion that there is a hierarchical pyramid is an erroneous one. Surgical instruments don’t fall from the sky; they don’t appear in our hands by chance, and the patients don’t get good care, laboratory test results, x-rays, or so many other procedures by the visible team members alone.
You can say the same thing about medical assistants in the clinic. Good MA’s make the office run efficiently, improving the patient experience and the physician experience. Enhanced efficiency means mistakes are avoided, and patient wait times decrease, among other things. Good MA’s go above and beyond to ensure that patients get the best care possible. Similarly, good OR techs keep things running smoothly, allow the surgeon to concentrate on the patient, and keep things on schedule in the hospital’s largest cost, and revenue, center.
With regard to the impact of frontline staff on the patient experience, click here to read our blog about the impact of an environmental services worker, on a sick kid (our most widely read blog post ever!).
Avoid the Cultural Hourglass
Sometimes, it’s important to remind everyone that frontline staff can be as important as everyone else. Traditional healthcare culture focuses on hierarchy. For instance, we’ve written about the “cultural hourglass” where senior leaders value the frontline staff and frontline staff value their role in patient care but their managers – the middle part of the “hourglass” value dependability over service-orientation – creating a serious disconnect and talent gap.
With all of this in mind – where do you start? Everywhere. That might seem overwhelming but if you look at the organization as a whole, and appreciate the interrelatedness of all talent strategies, it only makes sense.
To learn more about the concept of the Cultural Hourglass: