Running head: EXPERIENTIAL

Experiential Exercise Chapter 13 Rochelle Betton-Ford Human Resource Management (LDR 625-OA) March 1, 2014

EXPERIENTIAL EXERCISE Experiential Exercise Chapter 13 1. The surrounding community of Hospital A has just experienced a debilitating ice storm, with loss of power expected for the next five to seven days. Employees at Hospital A are showing up for work, but they are not alone: Some single parents have brought their

children and some have carried along their pets. Still others have come in or have stayed after their shift to have a warm place to be. How could Hospital A accommodate these groups? If the hospital does not accommodate them how will it handle or make up for the resulting staff shortage? What steps can Hospital A take in the future to plan for this type of expectation? Look for win-win solutions to this challenge. Communication is instrumental to the success of the implementation of the hospitals preparedness disaster plan. The hospital has had several practice drills over the years in preparation for such an event. Now, the disaster is a reality, and hopefully all of the training has paid off. The engineering and maintenance department have assess the hospitals electrical, heating and cooling equipment as well as physical foundation for any problems or damages caused by the ice storm. The back-up generators are in excellent working condition and are in place if it becomes necessary to operate them in case of a power failure at Hospital A. In the meanwhile the administrator (risk management team) has begun to determine the hospitals capability and possible areas of concerns that may affect the hospital in caring for this additional group (Richter, 2009) and maintain the usual standard of care for its patients, this action is referred to as surge capability (Fried and Fottler, 2008, p. 351). A count of the number of additional individuals will be taken to make certain that the hospital can adequately respond to this group, or if they will have to request for emergency supplies from a buddy system a mutual aid agreement with

EXPERIENTIAL EXERCISE other health care facilities that are in close proximity to the hospital (Richter, 2009), established through the preparedness disaster plan or an emergency relief agency. The emergency department, nursing staff, physicians, laboratory staff and, dietary, laundry, security staff all know what role they have in making certain that their individual and team efforts are in carry out in an efficient manner, they have all been trained on the

contents and procedures of the plan (Fried and Fottler, 2008). The conference rooms and several of the waiting rooms will accommodate employees that have chosen to stay after their shift ends, and employees with children and pets that have come in looking for a warm place to be, as well as those persons visiting patients, and people that have turn to the hospital for relief. Vacant rooms will provide a makeshift shelter for pets that have been brought in with staff. Meals and hygiene provisions will be divided among groups, making certain adequate supply is monitor and managed, supplies will last for seven days. Nurses and physicians and support healthcare providers are assessing the hospital current patients, medications and treatments required for the next seven days. Hospital A will continue to participate in drills, exercises and discussions regarding preparedness disaster plans on a quarterly basis (Fried and Fottler, 2008). In the event of staff shortage Hospital A has implemented an emergency roster, that includes the name, cell phone number and email to communicate a crisis to staff, these employees will be on alert and committed to come in to work at any given time. Each department has available staff that will respond by reporting to the hospital in a crisis situation. Employees will rotate days and times when they may be available during a crisis, therefore the hospital is covered at all times. Employees as well as administrators from other departments will also extend hours and days, which will provide relief to co-workers. In doing so will prevent

EXPERIENTIAL EXERCISE whenever possible exhaustion and create fairness. The American College of Healthcare Executives (2012) recommends steps in preventing staff shortage, listed below are a few recommendations: Attracting and retaining qualified staff, strengthening the patient/clinician/executive relationship Treating staff with respect, Promoting continuous quality improvement Flexible scheduling Professional development Marinating workloads and expectations Make sure staff is being employed in an effective manner Closing units or diverting patients if shortages become severe.

2. Many of the maintenance staff (who are mostly male) at Hospital B are experiencing back injuries that have caused a shortage of technicians on any given shift. Hospital B recently began staff cutbacks, scheduling no male aids that are trained to assist with patient transfers. What correlations are there between the back injuries and staff cutbacks? What steps can Hospital B take to resolve both issues? This is where management should perform walk around, for each department. Asses the number of staff performing certain duties, and then compare the number of maintenance staff that are experiencing back injuries. Might the reason for the shortage of technicians on the shifts be related to the back injuries of the maintenance staff? Possibly. Hospital B must assess the cause of back injuries of maintenance staff. It is important to measure the effectiveness of workplace safety and preparedness program Are there any problems or

EXPERIENTIAL EXERCISE concerns with the safety and preparedness requirements? Is the hospital meeting the Occupational Safety Health Administration (OSHA) guidelines and regulations establish for staff? According to the United States Department of Labor Occupational Safety and Health Administrations (2012) musculoskeletal disorders (MDSs) are a major source of injury to healthcare workers. In nursing aides, orderlies, and attendants had the highest rates of MSDs.

There were 27,000 cases, which equates to an incidence rate (IR) of 249 per 10,000 workers that is seven times the average for all industries. These injuries are due in large part to overexertion related to repeated manual patient handling activities. With the staff cutbacks, the remaining employees must continue performing the same amount of work without the assistance of the maintance staff and no male aids. Hospital B must immediately implement recommended guidelines of OSHA for its staff, in order to prevent these same injuries from reoccurring. Steps to protect employees and to measure workplace safety and preparedness are documented concerns and how to address them and measure the successes as well (Fried and Fottler, 2008). Below are ways to prevent or decrease the number of back injuries and other workplace injuries (United States Department of Labor, 2009): Training staff in the correct handling of patients Ergonomics Physical conditioning and stretching programs Providing mechanical lifts/hoist for patients Strength testing workers Repetitive strain reduction training Workplace analysis Accident and record analysis

EXPERIENTIAL EXERCISE Methods of transfer and lifting Procedure for reporting early signs of unsafe working conditions Employing lift team Prohibiting single person from lifting.

Investing and implementing workplace safety and preparedness programs may be consider too costly to implement, but in the long run Hospital B will realize the program is worth the investment when compare to the cost of employee compensation, medical cost, temporary health, unforeseen staff shortages due to sick days, and the possibility of fines for not implementing OSHA rules and regulations for employees. Employee health can be influenced by the institutions willingness to provide a suitable health and safe workplace (Fried and Fottler, 2008). 3. Hospital C has made the decision to create a facility emergency plan. Management is considering three options to pursue this decision: (1) have the hospitals safety officer write the plan, (2) form a planning committee to develop the plan, or (3) bring in an experienced contractor to create the plan. Discuss the pros and cons of each option. Hospital Cs option (1) to have the hospitals safety officer design a plan may provide the necessary coverage for safety controls, monitoring persons, and personnel, food supply and any terrorists attacks, such as chemical, and physical attacks. The safety officer has been trained for specific crisis. While the security office more than likely is well verse and trained in homeland security, he or she lacks the everyday internal operations of a healthcare organization, no does this person alone have the training to differentiate between certain medical priorities. How well might the officer understand the chain of command and the various roles and experiences of the administrators? I do not believe the safety officer should have the

EXPERIENTIAL EXERCISE responsibility of creating the facilities emergency plan. Option (3) to bring in an experienced contractor to create an emergency plan for the hospital. While the experience of the outside contractor to create the plan may sound promising, the additional cost in bringing in the contractor may be far more than what the hospital had allotted resources for. It also may take a

while for the contractor to learn and understand the culture of Hospital C, may take more time to implement a plan specifically for the hospital. Furthermore, the contractor may have experience, but the hospital must consider that the experience may not align with Hospital Cs position and its objectives. Option (2) seems like the appropriate choice. According to Richter (2009) forming a disaster preparedness plan should be given to a committee. The committee will include representatives from the following representatives: 1. Medical staff ER physicians, or trauma surgeon 2. Nursing staff 3. Administration (includes risk manager) 4. Emergency department 5. Security 6. Communications 7. Public relations 8. Medical records and admissions 9. Engineering and maintenance 10. Laboratory 11. Radiology and Respiratory Selecting representatives from each department provides a full understanding of the environment, also these representatives are familiar with the Hospitals vulnerable areas, and may

EXPERIENTIAL EXERCISE have some idea what needs to be address. This is a team effort; no one person should be responsible for creating an emergency plan. While the cost and time to creating and implementing an emergency plan remains quite expensive, the contractors fee will be absorbed through the cost of implementing the plan and purchasing necessary items for the plan. 4. Hospital D has added a new process to its operations. The hospital has an excellent health and safety record, but its safety officer has just retired. Three weeks after the new process is implemented, employees began complaining of stiff joints, headaches, and tiredness. The timing of such complaints is coinciding with the active flu season. How does Hospital D differentiate between the two possible causes of the symptoms? Is the hospital obligated to pay medical costs associated with any testing? What questions

should management ask, and how would management measure the results of its analysis? Is Hospital D a healthy and safe workplace? Just how healthy is the workplace environment. What new process has been implemented and is there a possibility that it is responsible for some type of virus contamination? New jobs to the operation or have undergone changes in its processes and procedures are consider priorities for a job hazard analysis (Fried and Fottler, 2008). Has there been a job analysis performed recently and if so what were the results. If a job hazardous job analysis has not been performed Hospital D must do so at once. The hospital may be obligated to pay medical costs associated with any testing, especially if the new job process is responsible for the symptoms of the employees. It is not unusual for a couple of employees to have the same symptoms at a time, however it is rare for more than two or three employees to complain of the same symptoms nearly at the same time. While there may not be a correlation to the new process and the officer retiring, it is important for the hospital to investigate why this has

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occurred at this time. Hospital D should take steps to prevent any additional outbreaks or sickness. The analysis will provide information on the employees habits and lifestyle practices prior to the new process and the retirement of the officer. I would also contact the officer to see if the officer has any of the same or similar symptoms, and if so provide treatment for the retired officer as well and for the hospitals employees. The management should be concern with the overall health and safety goals and objectives for the hospital and also ask these pertinent questions (Fried and Fottler, 2008, 354-355): Where is the institution now in controlling hazards and risks? How does the institution compare with others Is the institutional management of health and safety effective and efficient? Are we doing the right things? And if not, what must we do to make it effective Is the institutional management of health and safety reliable, are we consistent? Is the institutional culture supportive of health and safety, in the face of competing demands? The Hospital will measure the result of its analysis by count reports, trending data, observations, and use of practical application reviews such as drills, test, workshops and discussions (Fried and Fottler, 2008, p. 354-355). While it is recommended to review a healthcare institutions safety team, in this case it is necessary to review as soon as possible.

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References American College of Healthcare Executives. (2012). Ethical issues related to staff shortages. Retrieved from https://www.ache.org/policy/shortage.cfm Fried, B.J., and Fottler, M.D. (Eds.). (2008). Human resources in healthcare: Managing for success. Chicago, Illinois: Health Administration Press. Richter, P.V. (2009). Hospital disaster preparedness: Meeting a requirement or preparing for the worst? ASHE. 1-9. Retrieved from www.ashe.org/advocacy/ organizational/TJC/ec/emergency/hospdiasterprepare.html United States Department of Labor. (2000). Guidelines for nursing homes: Ergonomics for the prevention of musculoskeletal disorders. OSHA, 1-44. Retrieved from https://www.osha.gov/SLTC/ergonomics