Towards sustainable employability in health care

2011 – In the near future, a large shortage of personnel is expected in care due to an increase in demand for care, large outflow of workers from the baby boom generation and stable or even reduced inflow of new employees and a bad image. Working in health care should be attractive again and staff should be able to work until their 67th. In addition, there are opportunities in attracting staff from ethnic minorities. Hedzer Fijlstra wrote a report of an internship at NIGZ (the Dutch Institute for Health Care) on sustainable employability and diversity policy in health care. He describes seven good practices in health care organizations.

More fun
In order to have less problems with recruiting staff in the future, the project Excellent Care by V&VN and NPCF aims at bringing back the fun in the work of nurses and caring staff. Fifty ‘pacemakers’ from the staff are trained to think differently and to innovate. This enables them to identify and address issues and areas for improvement.

Adult employment relationship and self-scheduling
At Idealoog, a project of the eight Úniversity Medical Centres, is focused on realizing adult working relationship between manager and employee. Customized arrangements are made through an annual appraisal cycle and thus a dialogue is started. In addition, the employee is made responsible for continued employability and development, supported by a personal budget to spend via the Vitalityplaza and a digital tool that helps the employee in preparing for the talks with the manager.

Foundation ‘Schakelring’ will introduce self-rostering in the whole organization. The team leaders indicate what expertise when is needed and the staff put themselves in the schedule, encouraged by a goodwill points system to ensure that there will be no gaps. This enables to consider the different preferences of employees and to create a better work-life balance.

Work Power and vitality
The Elkerliek hospital focuses on all aspects that determine work capacity (health, motivation, knowledge, skills, and work-related factors) by focusing on competence management, a learning management system, which allows employees to monitor their own development in combination with a digital learning environment, a customized organizational structure with more responsibility lower down in the organization and coaching leadership.

The Waterland Hospital paid much attention to vitality through a vitality interview, the Workability Monitor and promoting physical exercise. Employees are encouraged to think about possible improvements and are rewarded by so called ‘praise’ meetings.

Diversity
GGZ Breburg and Cordaan engage in making the organization culture-sensitive through training in intercultural awareness and cross-cultural working, a knowledge network and workshops in which employees can exchange experiences.

In addition, both organizations try to recruit people from ethnic minorities and make them enthusiastic for care by bringing them into contact with people from other cultures already working in the care and through internships.

Factors for success and constraints
The study identified success factors and preconditions for each good practice. The main constraint mentioned was to engage employees as much as possible in the decision making to get support and to motivate. Good communication is important as well as an incremental implementation instead of rigorous change. In all good practices the support of the board of directors was an important precondition.
In order to increase the chance for success, changes must be in line with the existing structure, and culture of the organization as much as possible. A focus on the effectiveness and efficiency can have negative consequences in the beginning. Sustainable employability requires an investment now and the output will be visible much later. When an organization wants to pay attention to diversity, aiming to attract people from ethnic minorities, it is crucial to make the organization culture-sensitive first.

Reference
The full report with recommendations: ‘Towards sustainable employability in healthcare’ by Hedzer Fijlstra, VU University Amsterdam 2011 is included in the appendix.