Selecting Patient Escorts Case

Michaela Romanova
Tvoj Email
HR 405
Professor Email
May 6, 2016

STRATEGIC
MANAGEMENT OF HUMAN
RESOURCES
HR 405

Read the case Selecting Patient Escorts. Please, answer the following questions briefly and
clearly.
Selecting Patient Escorts
City Hospital is located in the heart of a large Midwestern city. It is one of five major hospitals in the area
and has recently built a small addition for treating well-known patients such as professional football
players, top company executives, and singing stars. Visiting or local celebrities always choose
City Hospital if they need treatment.
City Hospital has about 1,200 hospital beds and employs 4,500 individuals, including about 40 patient
escorts. The job of patient escort is a rather simple one, requiring only minimal training and no special
physical talents. When patients need to be moved from one location to another, patient escorts are
summoned to assist in the move. If the move is only a short distance, however, a nurse or orderly can
move the patient. Of particular importance is the fact that patient escorts almost always take patients who
are being discharged from their hospital room to the front door of the hospital. A wheelchair is always
used, even if the patient is able to walk unassisted. Thus, the typical procedure is for the nurse to call for
a patient escort; the escort gets a wheelchair and goes to the patient's room, assists the patient into the
wheelchair, picks up the patient's belongings, wheels the patient down to the hospital's front door or to his
or her car in the parking lot, and returns to the work station.
The job of patient escort is critical to the hospital since the escort is always the last hospital representative
the patient sees, and hence has a considerable influence on the patient's perception of the hospital. Of
the approximately 40 escorts, about three-fourths are men, and one-fourth are women. Most are high
school graduates in their early twenties. Some, particularly those on the early morning shift, are attending
college at night and working for the hospital to earn money to pay college expenses. Four of the escorts
are older women who had previously served as hospital volunteers and then decided to become full-time
employees instead. Turnover among patient escorts is quite high and has averaged 25 percent in recent
years. In addition, upward mobility in the hospital is quite good, and as a result, another 25 percent of the
escorts typically transfer to other jobs in the hospital each year. Thus, about half of the patient escorts
need to be replaced annually.
The hospital follows a standard procedure when hiring patient escorts. When a vacancy occurs, the
Personnel Department reviews the file of applications of individuals who have applied for the patient
escort job. Usually the file contains at least 20 applications because the pay for the job is good, the work
easy, and few skills are required. The top two or three applicants are asked to come to the hospital for
interviews. Typically, the applicants are interviewed first by Personnel and then by the patient escort
supervisor. The majority of those interviewed know some other employees of the hospital, so the only
reference check is a call to these employees. Before being hired, applicants are required to take physical
exams given by hospital doctors.

Every new escort attends an orientation program the first day on the job. This is conducted by a member
of the hospital's Personnel Department. The program consists of a complete tour of the hospital, a review
of all the hospital's personnel policies, including a description of its promotion, compensation, and
disciplinary policies, and a presentation of the hospital's mission and philosophy. During this orientation
session, employees are told that the hospital's image in the community is of major importance and that all
employees should strive to maintain and enhance this image by their conduct. After orientation, all patient
escorts receive on-the-job training by their immediate supervisor.
During the last two-year period the hospital has experienced a number of problems with patient escorts
that have had an adverse effect on the hospital's image. Several patients have complained to the hospital
administration that they have been treated rudely, or in some cases roughly, by one or more patient
escorts. Some complained that they had been ordered around or scolded by an escort during the
discharge process. Others stated that the escort had been careless when wheeling them out of the
hospital to their cars. One person, in fact, reported that an escort had carelessly tipped him over. All
escorts are required to wear identification tags, but patients usually can't remember the escort's name
when complaining to the hospital. Additionally, the hospital usually has difficulty determining which escort
served which patient because escorts often trade patients. Finally, even when the hospital can identify the
offending escort, the employee can easily deny any wrongdoing. He or she often counters that patients
are generally irritable as a result of their illness and hence are prone to complain at even the slightest
provocation.
At the hospital administrator's request, the Personnel Manager asked the Chief Supervisor of Patient
Escorts, the head of the Staffing Section within the Personnel Department, and the Assistant Personnel
Director to meet with her to review the entire procedure used to select patient escorts. It was hoped that a
new procedure could be devised that would eliminate the hiring of rude, insulting, or careless patient
escorts.
During the meeting, a number of suggestions were made as to how the selection procedure might be
improved. Criticisms of the present system were also voiced. The chief supervisor of patient escorts
argued that the problem with the hospital's present system is that the application blank is void of any
really useful information. He stated that the questions that really give insights into the employee's
personality were no longer on the application blank. He suggested that applicants be asked about their
hobbies, outside activities, and their personal likes and dislikes on the application blank. He also
suggested that each applicant is asked to submit three letters of recommendation from people who know
the applicant well. He wanted these letters to focus on the prospective employee's personality, particularly
the applicant's ability to remain friendly and polite at all times.
The Assistant Personnel Director contended that the hospital's interviewing procedure should be
modified. He observed that during the typical interview little attempt is made to determine how the
applicant reacts under stress. He suggested that, if applicants were asked four or five stress-producing
questions, the hospital might be in a better position to judge their ability to work with irritable patients.
The head of the Staffing Section noted that patient escorts require little mental or physical talent and
agreed that the crucial attribute escorts need are the ability always to be courteous and polite. He
wondered whether an "attitude" test could be developed that would measure the applicant's predisposition
toward being friendly, etc. He suggested that a job analysis could be done on the patient escort position to
determine those attitudes that are critical to being a successful patient escort. Once the job analysis was
complete, questions could be developed that would measure these critical attributes. The test questions
could be given to the hospital's present patient escorts to determine whether the test accurately
distinguishes the best from worst escorts. The staffing head realized that many of the questions might
need to be eliminated or changed, and that, if the test appeared to show promise, it would probably need
to be revalidated in order to meet government requirements. He felt, however, that a well-designed test
might be worth the effort and should at least be tried.

The meeting ended with all four participants agreeing that the suggestion of trying to develop an "attitude
test" was probably the most promising. The Assistant Manager and Chief Supervisor of Patient Escorts
stated that they would conduct a thorough job analysis covering the patient escort position and develop a
list of attitudes that are critical to its success. A second meeting would then be held to prepare the actual
test questions.
(Applications in Human Resource Management, 4th edition, Nkomo, Fottler, & McAfee, South-Western,
2000, pp. 106-08)

Your task is to provide the City Hospital Personnel Department with more details about the
following aspects:
1. What external and internal environment elements do they need to consider? Why?(14
points)
Probably the most important internal element to consider here will be the organizational
culture. The reason for this is that in cases where it is very hard to monitor individual
behavior, having very good corporate culture committed to excellence can reduce the cost
of monitoring (Bolton, P., et all, 2013).
With regards to external environment probably the most important element to consider
would be the legislature. For example, in some states, it might be illegal to ask potential
employees personal question that could be still relevant to the hiring process. Moreover,
various ways of monitoring employees, for example by camera system might be also
illegal.
2. Which environmental elements do you consider as unimportant in this situation? Why?
(10 points)
A good example of an unimportant element in this particular case would be trade unions.
While traditionally unions were very important part of consideration during
environmental elements evaluation, this is no longer the case in the United States. This is
mainly due to the fact that these are nowadays completely unimportant in the United
States, because of very small, and still declining, membership (Schnabel, C., 2013), and
also due to the erosion of union privileges thanks to so-called right to work laws.
3. Explain all the steps they need to do in the process of job analysis. What sources of
information can they use? What information collecting methods would you recommend?
Justify your recommendations. (14 points)
The main steps in the job analysis are determining training needs, compensation,
selection procedures and performance review. There are various sources of information
that can be used for the job analysis including the interviews of current employees and
supervisors, consulting expert panels, creating structured or open-ended questionnaires,

looking at task inventories, work logs or checklists and also by direct observation (Baron
& Kreps 1999).
For determining training needs and selection procedures, a good approach would be to
combine several of the above, including the direct observation, interviewing supervisors
and employees and consulting experts. The why I recommend using so many tools for
these two tasks is that these are the most important part that needs to be improved in
order to solve the case. For analysis of compensation, I believe the best starting point
would be to look at the competitors. The performance review should be based on the
interviews with supervisors as well as other employees and customers to get 360-degree
feedback.
4. What recruiting method(s) would you recommend? Justify. What would you recommend
to reduce the recruiting costs? (14 points)
Since one of the main problems with recruitment, in this case, is the screening process, as
the case mentions that some escorts are rude to the patients, I would recommend internal
recruitment and personal recommendation or using external personnel agency. The reason
behind this choice is that it might be very hard to judge the individuals attitude and
mores based just on a single interview.
With internal recruitment, HR has much more time and opportunity to get better and
more round picture of the candidate. This can be also substituted using external personnel
agency, with a good reputation, as personnel agencies usually keep people that they are
hiring out for a long span of time and thus they should be familiar with their personal
traits, and know whether they are reliable.
In my opinion the best way how to reduce costs of this recruitment method, would be to
use the internal recruitment, and to assign new employees first to tasks where their
behavior can be easily observed (for example assisting nurses with mundane day to day
tasks, and in turn they can be interviewed at the end of the day).
This should greatly reduce the recruitment costs because these potential escorts will still
produce work of value for the hospital while they will be still evaluated for the escort
position.
5. What selection process and method(s) would you recommend? Why? (12 points)
Since the escorts have such large impact on the image of the hospital, the selection
process should be as thorough as possible. I believe that the base of the selection process
should be face-to-face interviews based on the previously described recruitment process,
and also selection process should include cultural fit selection, and also using personality
tests.
The reason why I recommend this is that in this particular case measuring individual
performance of an escort is very hard because even patient themselves dont remember
which escort was servicing them despite that they already wear visible identification. In

cases where individual performance is hard to measure it pays off to make extra effort in
selecting candidates who have higher level of intrinsic motivation, and have traits that
make them perform well without monitoring (Hendrikse, G. 2003).
For example, tests such as Myers-Briggs Type Indicator (MBTI), while still imperfect,
can provide many insights into how a candidate behaves in some situations and what are
his/hers character traits. This can be further supplemented by the use of personal
recommendations. In the case that the internal recruitment, suggested in the previous
question is being used, the selection process can include an interview with the coworkers, which can focus on the candidates personality.
6. What training format would be appropriate for the patient escort position? Why?(12
points)
I think that the good format for training the patient escort would be first having some
short training session before starting to work, and then continuing with on job training.
The reason why I think that this would be an appropriate format for the training of patient
escort is that it would be probably a good idea to first instruct new escorts about the
proper behavior. This is especially because most of the patients are people from an upper
class where standards for polite behavior might differ a bit from the usual standards.
Afterward, the on job training could be done by the more experienced escorts. For
example, a more experienced escort can first take the new escort to accompany her or
him during one escort, and then let the person perform the same task on the next one.
This will make it possible to also correct them right from beginning if they will make
something wrong, and to also see how they perform on the actual job.
7. What compensation and benefits system would you recommend for such a position?
Why?(12 points)
I would recommend fixed individual salary, with benefits being awarded on the basis of
the whole departmental performance. When it comes to positions where the performance
is hard to measure, such as in this case, it is often best to avoid high powered incentives
(Hendrikse, G. 2003).For example, it is useless to pay a writer by the number of pages, as
this will only provide an incentive to write a large number of pages that might not add
anything substantive to the story.
In the same spirit trying to provide individual incentive pay here would likely just cause
crowding out of effort from the performance that is hard to measure, to the measurable
goals. Yet despite that individual performance is hard to measure, we can still measure
the overall performance well (as even the case itself mentions) and thus, bonus schemes
should be based on the overall hospital performance. This is no panacea as this might
lead freeriding, but it would be still better than providing bad incentives.
8. What tools or methods can the Personnel Department use to measure the performance of
the patients escorts effectively?(12 points)

As it was already stated in the case, measuring the performance of the escorts is
incredibly hard as the patients cant remember them despite that they already wear visible
nametags.
One way of overcoming such obstacle could be performance measuring based on peer
review, however, this would be effective only if escorts interact with each other a lot.
Another possible solution to the problem would be to measure the performance on team
level rather than on an individual one.
Escorts could be divided into teams, where each team would service only particular part
of the hospital. Afterward, the management can match the patients complaints to each
team based on the part of the hospital where the patient was treated. It is true that such
measuring would be imperfect, but it might still provide a good alternative to measuring
individual performance in the cases where it is very hard to do so.

References:
Baron, J. N., & Kreps, D. M. (1999). Strategic human resources: Frameworks for general managers. New
York: Wiley.
Bolton, P., Brunnermeier, M. K., & Veldkamp, L. (2013). Leadership, coordination, and corporate
culture. The Review of Economic Studies, 80(2), 512-537.
Schnabel, C. (2013). Union membership and density: Some (not so) stylized facts and
challenges. European Journal of Industrial Relations, 0959680113493373.
Hendrikse, G. (2003). Economics and management of organizations: co-ordination, motivation and
strategy. New York: McGraw-Hill.