Linking culture and quality
By: Craig Dresang, CEO, YoloCares
It is no coincidence when an organization ranks nationally for both quality of care and workplace satisfaction. According to the National Institutes of Health, “There is a direct, proven link between workplace satisfaction and the quality of patient care, where satisfied and supported healthcare workers consistently deliver safer, more compassionate, and more efficient services.”
Earlier this year as YoloCares’ quality scores surged to the top one percent countrywide, it was concurrently named a Best Place to Work by Modern Healthcare. Operating as a midsized, but prominent, healthcare provider in the Sacramento region, YoloCares was singled out for its strong team culture, competitive pay, and comprehensive employee benefits. In addition, the organization’s commitment to diversity, equity and inclusion is noteworthy. Twelve years ago, just five percent of its staff included people of color. Today, people of color represent 64 percent of the agency’s total workforce. Some stand-out statistics from Modern Healthcare’s anonymous survey found that over 95 percent of staff take pride in the organization, feel they are a part of a team with a common purpose, and love what they do.
The agency’s voluntary turnover rate (the number of people who choose to leave) has remained at six percent or lower for the past decade . . . compared to an industry standard of 18-24 percent. Hospice and home health professions carry some of the highest turnover rates in the healthcare industry. However, intentionality around culture has significantly reduced staff turnover rates. Employees not only contribute to nationally recognized clinical care, education and research; they are part of a culture where engagement is strong, and employees are empowered to have an impact on healthcare and people’s lives.
The agency is also bullish on fostering its own talent, rewarding outstanding performance, and offering opportunities for professional development. For example: the organization’s chief development officer has worked at YoloCares for 15 years. She began her career as an entry-level employee, but kept getting promoted – first as a manager, then as a director, and eventually as a chief – because of exceptional performance and commitment to the organization’s mission. The same story has played out for the director of patient access and palliative care who has worked at YoloCares for 25 years. She started out as a medical records clerk and over time — as she brought more and more value to the agency — moved from an entry-level position to manager and then director.
Another positive change related to professional development was rolled out for the nursing staff. Registered nurses are now required to become certified or credentialed through the Hospice & Palliative Nurses Association. While the process to become nationally credentialed can be expensive, YoloCares fully covers the cost for its nurses. In addition, as California’s first agency to be accepted into the National Partnership for Hospice & Healthcare Innovation (NPHI), employees are routinely sent to NPHI workshops, classes, and conferences to build their professional acumen.
Perhaps a key reason why YoloCares has been nationally ranked as a Best Place to Work is because the agency insists on a culture of direct dealing. It is a magic ingredient that does not allow toxicity or division to take hold.
Many years ago, a CEO I worked for taught me the importance of what she called open doors with boundaries. “An open-door policy is an indication that leadership is accessible to frontline staff,” she said. “Employees should feel comfortable walking into your office to seek clarity or perspective on a situation or organizational decision, or to briefly engage in small talk. However, you must maintain some boundaries to ensure that staff ideas, concerns, or complaints are not coming to you before they are brought to the employee’s supervisor or to the appropriate individuals or work teams first.”
Over the years, this concept has morphed into a practice that I call direct dealing. If someone comes to me with a complaint about their supervisor or teammate, I always ask, “Have you talked to that person directly about your concern?” If the answer is no, then I redirect and encourage the employee to first discuss their concern with that person. Not too long ago, an employee came into my office with an idea about restructuring their work. I asked, “Have you shared this idea with your supervisor?” Their answer: “Yes, but my supervisor doesn’t think it’s a good idea.” I replied, “I do not interfere with a manager’s decision, but I am open to discussing your idea with both you and your supervisor if you would like to schedule a meeting for the three of us to discuss.” The agency simply does not allow conversations about individuals to take place unless that individual is in the room and able to participate in the discussion. Plainly put, the focus is on talking with people, but not about them.
Sometimes employees have great ideas that need to be considered by the entire senior management team. To that end, a senior leader recently brought forward an unconventional suggestion from a frontline staffer. The idea was to establish an employee-led group that would focus on fostering communication, collaboration, and a sense of joy across all departments. The group calls itself the Department of Joy, or DOJ for short. Earlier this month, the DOJ hosted an employee game night (after hours) for staff who just want to hang out and have some fun together. The evening included karaoke under the pavilion, a Dungeon & Dragons game room, board games, potluck and popcorn, movies in the Galileo Place family room, and activities in the garden. The event was confirmation that the YoloCares team not only works well together, but they also enjoy playing together too.