Health Care Turnaround

"Sometimes you have to spend money to make improvements; our safety record is proof."

Editor's note: Changing the way employees' hours were scheduled and providing recognition for their efforts have been successful strategies for Virginia Blood Services ( of Richmond, Va., says VBS Vice President of Organizational Development Eleanor Boens. The independent, non-profit organization serves the state's two largest hospitals and many other hospitals in Virginia. It collects more than 88,000 blood donations per year and uses a communications program assisted by The Marlin Company of North Haven, Conn.

Boens, who is responsible for HR, safety, and non-technical training, discussed the VBS employee recognition program in this Oct. 4, 2005, conversation with Occupational Health & Safety's editor.

Please describe the improvement in your organization's performance that won you a major award last year from the Richmond Human Resources Management Association and the Greater Richmond Chamber of Commerce.

Eleanor Boens: The award was not entirely based on improvement. It was based on our leadership values, employee opinion, benefits, and other data requested on the application, such as hiring, retention rates, and turnover. I believe as an organization we have improved in all of these areas over the past several years, which made us a good candidate for this recognition.

Are improved employee morale and lower turnover part of this improvement?

Boens: Employee morale was measured by the All Star Awards committee that selected VBS as a winner. Five percent of our employee population was required to respond for the results to be counted. Our internal employee surveys says, on a scale of 1 to 5, that the mission of the organization makes the employees feel their job is important and ranks consistently at 4.5 in the last two surveys conducted in 2003 and 2004.

Our turnover has dropped from 52 percent in 2000 to 23 percent in 2004. We anticipate the turnover for 2005 to be 20 percent.

What specific steps were taken to achieve these gains?

Boens: The major step we took to reduce turnover was a complete shift in how we schedule employee work hours. The number one reason employees in our blood collection area cited for leaving was the hours. Not the number of hours worked, but the shifts: One day you might work 6 a.m. to 3 p.m., and the following day, it might be 8 to 5. This made day care, doctors appointments etc. very hard to arrange.

We started with surveys, followed by focus groups with employees. During the decision process of making a change in the shifts, we used employee surveys and focus groups to help formulate a plan that both the employees would appreciate and one that would not hurt us from a business perspective.

Our survey in 2003 told us what they liked, but it also showed that we were not giving employees enough recognition. Since that time, we have made an effort to recognize employees. One of the most coveted recognitions is when our collection staff makes the "Zero List" for the month: This means that they did not have any errors. The reward for this is their name on a list.

When the Zero List started, you got absolutely zero for it. Now, we have a box of items people can grab a gift out of. The gifts are in the $1 range. The staff have fun and feel a great sense of accomplishment when they are on the Zero List.

In addition, we have small token awards that managers can request to say thank you for an employee who has gone above and beyond. It could be for taking on a project [or] going above board to assist a donor or another employee. These are mostly $5 and $10 prizes that I rotate. We have used gift cards from Starbucks, Target, Exxon; discount movie tickets; restaurants; etc.

We also installed . . . communication stations in 2003. The employee feedback on the messages from these boards has been positive. The safety, quality, and customer service messages could not have been more in line with our objectives than if we had written them in house. For a small company, producing the quality of messages that are provided to us could not be done in house.

The messages are colorful, eye-catching, and the messages are in line with behaviors that you want to instill in our employees. In addition, I order specialized messages . . . each month. The messages that I order range from recognizing employees for years of service, retirement, etc. Most recently, we ordered a poster to recognize the staff for an excellent FDA inspection.

So to be on that Zero List is something you really want to accomplish?

Boens: Yes, it is. People cheer when they're on the list. It is a wonderful way to acknowledge employees for doing their job right and doing so the first time around.

That's really good.

Boens: And it costs next to nothing!

That is the best kind. In the aggregate, how many errors were you recording before this safety culture came about, and how many now?

Boens: Safety culture training was geared toward worker's compensation injuries.

I thought maybe it had made some difference here, as well.

Boens: It's possible that it has, but it's not something we were tracking with a tie to the safety culture training. However, our technical error rate has dropped by 2 percent over the past year.

Are your supervisors also getting recognition and rewards?

Boens: Pretty much the only people who don't get rewarded are senior management: a group of about five of us. . . . But that's not what we're here for.

How have your organization's bottom line and your worker's compensation premiums been affected?

Boens: In 2003, we implemented [the] safety culture program that our insurance broker suggested. Our experience modification has dropped from 2.26 to 1.14, and our days in the assigned risk pool are history. Our safety officer, Alison Markow, has taken ownership of this program and created an environment where everyone understands the importance of working safely.

You're a non-profit. Is it difficult in your environment to win approval and funding for new programs such as this?

Boens: Robert Carden, president and CEO, and our board of directors have been very supportive of the changes that have been made. On our implementation of the scheduling changes, the cost would be covered if we kept just one employee from leaving. The changes in scheduling did cost extra, but the significant decrease in employees leaving has more than paid for this improvement.

The safety culture program cost $1,150 for implementation (books and videos). Our decrease in experience mod and no longer paying an assigned risk penalty have offset this cost. Yes, we are a non-profit, but we believe in making improvements. Sometimes you have to spend money to make improvements; our safety record is proof.

What changes have you seen in the workers' attitudes? Who are your other stakeholders, and what do they say about the changes in the atmosphere at VBS?

Boens: The best way to measure the changes is the increase in blood donations from our donors. If they like the experience [and] receive good service while donating, they are more likely to return. We have had a 13 percent increase in donations, a 16 percent increase in the number of people who give four or more times per year, and a 33 percent reduction in complaints from donors about service.

Are other Richmond employers now looking for suggestions and guidance from you?

Boens: We have not had any Richmond employers looking for suggestions, but we have had calls and visits from other blood centers. We have conducted phone interviews, conference calls, and have had two centers visit us here in Richmond.

What are the key lessons learned from your organization's turnaround?

Boens: If you have employees who feel a part of the organization and the processes, then they are more committed to the goals that make us successful.

Do you believe there is more for VBS to accomplish in this area?

Boens: We will continue to make improvements and continue to provide our supervisory staff with training and tools to help them be successful in rewarding and recognizing their staff.

Are you concerned that enthusiasm may wane and some of the ground you've gained may be lost?

Boens: No.

This Q&A appeared in the June 2006 issue of Occupational Health & Safety.

This article originally appeared in the June 2006 issue of Occupational Health & Safety.

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