Bartlett Regional Hospital's Board of Directors plans to order an independent evaluation of the hospital's working environment within the next few weeks.
Board Chairman Dr. Nathan Peimann said after the public commenting period of a special meeting Tuesday, in which employees voiced both praise and concern for the hospital's working environment, the board decided to have an independent evaluation to look into employees' fear of retribution for dissent.
"We take that very seriously, and we will do our best to look into it," he said. "We want to see this (evaluation) rapidly deployed."
Hospital CEO Shawn Morrow said in a Monday interview that the hospital has been working "relentlessly" to figure out where the "culture of fear" felt by some employees stems from and is committed to finding out. Both said they don't yet have an answer.
"Getting at the root of those issues is something we've been exploring for at least three years, and probably before I got here," Morrow said. "That's the million dollar question (what is at the root.) We don't have the answer to that, but we're committed to finding out."
At a joint meeting of the Bartlett Board of Directors and the city Assembly last week, Bartlett employees and medical staff said many nurses and other staff are afraid to disagree with administration for fear of retaliation.
Peimann said the assessment will be independent of the board and the management, though those doing the assessment will report to the board.
Peimann also reiterated that nothing the board has heard up to this point indicates patient safety is at risk. "That's our forefront, the most important endeavor," he said. "We haven't heard that there has been a risk of patient safety."
As indicative of that, Morrow and Community Relations Director Jim Strader pointed to strides in patient care, also presented to the Assembly in a joint meeting last week.
As assessed by an outside group, four main medical categories measured by the government as indicative of quality were below the state average three years ago. Today, Morrow said all are above the state average, and three out of four are above the national average.
Some in public meetings commented that this is due to the professionalism of the nurses on staff. Morrow also commended nursing staff.
Patient satisfaction, particularly with inpatient care and the emergency department, has also improved, he said.
Morrow also said that no one has been demoted, reassigned or fired for disagreeing with administration, something many Bartlett employees said they have seen or felt fear of.
"A high performing organization has disagreements," Morrow said. "We need that diversity of opinion. ... Not everybody's going to get their way every time. Sometimes I don't get my way. That's okay. It's not a dictatorship."
Peimann said the board supports hospital management with changes it has brought forward so far to better communication, including quarterly forums and "the burning box" for anonymous questions and concerns.
Morrow said the hospital will be implementing a new strategy in which "anybody on the assembly line can pull the cord and stop the line" if they see a problem and work in small teams to find a solution to it. He said the process, chosen by a 20-person mixed group of front-line staff and others, involves a six to eight month training cycle.
Peimann said the board is also considering the possibility of changing some of its meeting times and locations so they're more convenient for hospital staff, and plans to do more regular assessments of culture and morale at the hospital.
The hospital's Denison culture survey, which measured different groups of employees' view on various aspects of the hospital in 2007 and in 2009, showed a marked difference between different departments' perceptions. Nursing, ancillary services and behavioral health department all scored the hospital low both years. The board of directors, the senior leadership team and department managers all reported improved perceptions. Support staff and active medical staff showed some improvement, though not as much.
Peimann said the board will discuss the planned evaluation more at its next meeting, to be held at 5:15 p.m. in the hospital board room Tuesday. He also said hospital management will likely be suggesting new ideas as well.
"The problems are a concern for us, but we feel like they're at a level we can address and move forward," he said. "We will bring all our resources to bear.... We want to ensure that folks that do have concerns have the ability to have those resolved in a mutually agreeable way."
Contact reporter Mary Catharine Martin at 523-2276 or firstname.lastname@example.org.