Not all face a 'culture of fear' at Bartlett

Posted: Wednesday, June 30, 2010

An independent evaluation of Bartlett Regional Hospital's employment atmosphere revealed those who feel there is a "culture of fear" are a minority in the hospital.

The Foraker Group discussed an overview of its findings with the hospital board last week, and discussed the report's findings with the board subcommittee looking at the issue earlier this week. The board ordered an independent evaluation after Bartlett employees and physicians voiced concerns about a "culture of fear" at the hospital at an April Assembly meeting, with some employees saying they were afraid to speak up for fear of retribution.

"The culture of fear, though a reality for some, is not pervasive," the report says. "Better communication as well as the credibility of and confidence in the administration are bigger issues to be addressed."

The root of concerns appears to be centered on a conflict of values around performance improvement measurements, the report said. Foraker Group President and CEO Dennis McMillian told the subcommittee Monday that while most employees feel "angst" over productivity measures implemented by hospital administration and approved by the board, some saw it as a move in the right direction. Some worried that focusing on productivity measures could affect patient care, though no one said that was currently a problem, McMillian said. He recommended the hospital proceed more slowly with the changes.

Of the 89 employees (almost 20 percent) randomly selected and interviewed by the team, 12 percent said they personally felt a culture of fear, and nearly 20 percent said that while a culture of fear does not exist for them, they believe it exists for others. That percentage was not divided by department. McMillian said the employees that expressed feeling or knowing about a "culture of fear" tended to be long-term employees who were non-union, and came from various departments and positions.

The report also said that most employees enjoy working at the hospital, and many worried that concerns over a "culture of fear" may impact the public's trust in the level of care provided, which employees said is still high.

The Foraker Group also conducted a week-long electronic survey that 255 people, more than 50 percent of the hospital's workforce, completed.

The report isolated productivity, internal process and trust as the hospital's largest issues, and gave recommendations for improving them.

Board Chairman Nathan Peimann said of the three issues, trust is the hospital's biggest concern among what he called "a large minority."

"I think it may be an insurmountable issue for a small part of that group," he said. "We need to find ways to engender trust ... from the board. And we need to hear from management on how we can change this issue. The only way this will change is by sincere effort by administration, and that can't come from us."

The report also said some employees will never be satisfied, regardless of the administration's efforts, adding that those who are the most upset may be "drowning out the more legitimate concerns of the other employees."

McMillian added that "i t's obvious the people that fear feel fear, and we are not challenging those people's fear. We are saying that some of those people with fear would likely feel fear any place they worked or will work, and some of them are not (people who would feel fear anywhere.)"

McMillian also specified the report deals with perception and not records, employee files, or a forensic investigation that would lend credence to the truth of one view over another.

Concerns do persist. The hospital's working culture was discussed at the Assembly meeting, with neurologist Susan Hunter-Joerns telling the Assembly nurse Kim Corrette's job was threatened the morning after she publicly expressed that she felt a culture of fear at the hospital.

Also at the Assembly meeting, Assembly member Bob Doll said that whatever the ultimate conclusions of the report, he had received information that "current practice continues to be inimical to the interests of employees, at least nursing staff" and that he believes the city is at risk.

Doll said when the hospital board presents the report to the Assembly, the Assembly needs to prepare itself to "ask some penetrating questions about ongoing human relationships at the hospital."

Subcommittee Chairwoman Linda Thomas said one of the key things she picked up on from the report is that the negative culture reported by some employees isn't based strictly upon administration, but also on departments that feel they're criticized by other departments.

"I think we need to carefully look at that," she said.

"I think it was a good and positive process," Thomas said. "There are people that are going to be disappointed on both sides ... opinions are all over the map. Hopefully ... the entire hospital can work to pull together and not let it get to this level of frustration again."

"It's going to take some time to move ahead," McMillian told the board.

The board subcommittee will discuss short- and long-term recommendations for moving forward next Wednesday at 12 p.m.

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