For eight hours everyday, Kehar Singh stands behind a small cart in Sarojini Market in south Delhi, selling sweet potatoes roasted on coal. He lives near the fruit and vegetable market of Azadpur in north Delhi, and travels for more than an hour to get to work in the south of the city. He said he has never seen dhuaa or smoke of the kind that has engulfed Delhi this week.
“My eyes hurt a lot,” he said. “This is the first time I have seen such a lot of smoke.”
But Singh does not know the severity of the pollution. With the levels of PM2.5 – microscopic particulate matter that invades the lungs – touching 999 in parts of Delhi, way above the safe levels of 100, the Indian Medical Association has described the situation in Delhi as “a public health emergency”. The state government has asked schools to remain shut. The central government has issued an advisory asking people with breathing trouble to stay indoors and to avoid places with dust and smoke.
For street hawkers like Singh, who survive on daily earnings, this is not an option. Singh has not even heard about the advisory.
“I start by day at four in the morning,” said Singh. “I have no time to hear any news.”
‘Stay away from Delhi’
Singh migrated to Delhi from his village in Uttar Pradesh’s Badaun district when he was about 25 years old. “We had no land,” said Singh. “I was forced to come to Delhi to work.” Many people from his village worked in Sarojini market, a bustling centre for the sale of clothes and accessories. He started working with them.
Two decades later, Singh has his own food cart, from where he sells sweet corn in the summer and sweet potatoes in the winter. But he still does not feel comfortable in the city.
“There is too much tension here,” he said. “We have to be worried about the police all the time.” He was referring to the police targeting street hawkers like him.
Another problem is that he keeps falling sick. He either has a cold or cough, or suffers from gastric problems. “I eat from hotels all the time,” said Singh. “Khana pani accha nahi hai. The food and water here is not good.”
That explains why he does not want his sons to come to Delhi for work. They are still in school, but have already started working for other farmers in their holidays. Singh wants them to stay away from Delhi. “People fall sick here and the work is not guaranteed,” he said.
The only time when Singh feels healthy is when he visits his village at Diwali time every year. “As soon as I reach there, I start feeling better.”
Transforming patient care by managing talent better
Active leadership roles by physicians, innovative human resource strategies and a strong organizational culture can bridge the talent gap in healthcare.
Attracting and retaining talent is a challenge for many industries – however for the healthcare industry, the problem is compounded by acute shortage of skilled professionals. India has a ratio of 0.7 doctors and 1.5 nurses per 1,000 people as against the WHO ideal average of 2.5 each of doctors and nurses per 1,000 people. This reflects the immense human resource challenge in the Indian healthcare industry.
So, what can hospitals do to retain and groom the existing talent? How can a clear leadership vision motivate healthcare professionals to perform better? These were among the questions addressed at the Hospital Leadership Summit hosted by Abbott. The panel focused on three key aspects: leadership, talent retention and organisational culture.
Role of leadership
Dr. Robert Pearl, Executive Director and CEO of The Permanente Medical Group and Faculty at Stanford Business School, spoke at length about the role of strong leadership in human resource and talent management. He began by defining the role of a leader. In this video, Dr. Pearl describes a leader as someone who motivates others by setting a strong vision.
According to Dr. Pearl, for a leader to craft such a vision and motivate others to work towards it, he or she would require certain qualities. These include empathy, good communication and ability to make quick decisions, stay calm under stress, multitask, and take responsibility - qualities that physicians typically possess by virtue of their profession. He thus urged doctors and physicians to play a greater role in leading their institutions.
His view is supported by research - a report in a Harvard Business Review says that physician-run hospitals scored 25% higher in quality rankings across geographies over hospitals run by professionals from non-medical backgrounds.
Dr. Pearl says, a leader who is also a physician is in a better position to set benchmarks for other professionals. Setting benchmarks would also mean setting an example for organizational behavior, culture and thought process. Many studies have examined the influence of a leader on his organization’s culture. This is expressed well by Dr Larry Senn’s concept ‘Shadow of the leader’ which emphasizes that the kind of ‘shadow’ a leader casts across the organization impacts how the employees think, behave and work. Thus, it is all the more important for physicians to get involved in hospital leadership.
Managing and retaining talent
One of the key responsibilities of leadership is to also manage and retain good talent. According to Dr. Pearl, one way of optimizing talent is by making efficient use of human resources.
Astudy by Tuck’s Centre for Global Leadership of nine Indian hospitals reiterates this. It shows that the strategy of ‘task shifting’ or the transfer of routine tasks to lower-skilled workers left specialists free to handle more complicated procedures. The result – more productive doctors performing five to six surgeries per hour.
Attracting and retaining talent was also a major topic of discussion in the panel discussion on ‘Transforming the talent ecosystem’ at the HLS summit. Some of the panelists believed that exposing professionals to areas that go beyond their core skills, such as strategy and analytics, could play a significant role in retaining talent. This would ensure constant opportunities for learning and growth and also answer the hospitals’ growing need for professionals from management backgrounds.
Dr Nandakumar Jairam, Group Director – Columbia Asia pointed out that hospitals need to look at people with soft skills such as empathy, ability to listen well, etc. So, while hospitals expand their recruitment pool and look to other industries for recruiting people, they should also train their existing staff in these skills.
The NYC Health + Hospitals in the U.S, a winner of the ‘Training Top 125’ 2017, is an example of how effective employee training can help achieve corporate goals. Its training programs span a range of skills - from medical simulations to language interpretation, leadership development and managing public health threats, thus giving its employees the opportunity to learn and grow within and outside their disciplines.
Reaching out to premier medical institutes in various ways also helps attract and retain talented professionals. Sir Gangaram Hospital in New Delhi, has emerged to be an attractive employer due its credibility in the medical research space. Their Department of Research aims to facilitate high quality, patient centric research and promotes laboratory based investigations across various disciplines, also assisting clinicians in pursuing projects.
Organizational culture and progressive HR policies
Rajit Mehta, CEO, Max Healthcare, also talked about the importance of having a conducive organizational culture that keeps the workforce together and motivates them to perform better. Every aspect of the organizational functioning reflects its culture – whether it’s staff behavior or communication – and culture stems from alignment with a strong leadership vision.
Organizational culture is also about incentivizing the workforce through performance rewards and employee-friendly HR policies. For example, at a popular healthcare facility in the US, all the 3,600 employees are actively encouraged to stay fit – they can buy fresh fruits and vegetables while at work, get healthy cooking tips from demonstrations in the office kitchen and enjoy free massages at their office chairs.
A report also talks about how some hospitals in the US inducted their employees into therapeutic activities like knitting, meditation etc., as part of their efforts to help them cope with stress. Some hospitals also have designated areas with amenities for staff members to relax and recoup.
Back home, Sir Gangaram Hospital recently helped its employees during the cash-crunched phase following demonetization by distributing currency notes to all. Such initiatives help establish trust and goodwill among the workforce.
Fostering a good culture is crucial for employee engagement. An engaged employee is one who is committed to the organisation’s goals and values and is motivated to give his or her best to the organisation’s success. Employee engagement has direct impact on hospital system health outcomes. According to a review of engagement and clinical outcomes at the National Health Service (NHS) in England, for every 10% increase in engagement there was a reduction in MRSA, a life-threatening skin infection, by .057 cases per 10,000 bed days. Additionally, a one standard deviation improvement in engagement reduced mortality by 2.4 percentage points.
It is however tough to gauge employee engagement and implement policies to improve it. As per an HRsoft study, more than 90% of managers or CEOs believe an engagement strategy is important for the organisation’s success but only 30% actually have one. The infographic below provides a useful starting point for managers to develop a strategy of their own.
These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott is working with hospitals and healthcare professionals to improve the quality of health services. Additionally, in more than 25 countries Abbott is recognized as a leading employer in country and a great place to work.
To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.
This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.