The Science Journal of the American Association for Respiratory Care

1995 OPEN FORUM Abstracts

STAFF EMPOWERMENT IN A BARGAINING UNIT ENVIRONMENT CONTRIBUTES TO REDUCTION IN MIDDLE MANAGEMENT.

Daniel Pavlik, M.Ed., RRT, Gregory Nichols, MSA, RRT, Pulmonary Services Department, MetroHealth Medical Center, Cleveland, Ohio

Introduction: The challenge to reduce cost without infringing on quality patient care ironically centers on our most expensive resource - direct patient care staff. In our 700 + bed academic medical center the RRTs and CRTTs are in a union. Our goal was to design a program to provide shift leadership using union employees and reduce supervisor staff. Bargaining unit contract language and traditional union values provided a challenge to staff empowerment.

Methods: Our management team agreed to support a program which empowered staff in a leadership role for coordination of a shifts clinical activities. Two clinical supervisor positions were retained. The management team identified qualities needed to be successful as a "Team Leader" (TL), developed an evaluation tool. Two clinical specialists and the manager chose eleven staff they suspected would meet these qualifications. Staff were rated by each team member and an average score was determined. Scores were grouped, and a cut score determined. The director met with the union steward sharing written guidelines identifying the shift responsibilities. The guidelines included on-call management support for all hours a TL was assigned to coordinate a shift. An introductory meeting was held with each potential TL, sharing program goals, evaluation criteria, assignment guidelines, and asked to provide frank and candid concerns if placed in the assignment. The nine staff agreed to pilot the program and were scheduled for orientation. Following orientations, TLs were scheduled on weekends, holidays, and during supervisor vacations.

Results: Team Leaders were excited yet apprehensive about encountering peer pressures, dealing with friends, and confronting difficult staff. Some TLs were not voting union members. Fundamental union culture was being challenged by assigning staff the responsibility of giving work direction and making assignments for union "brothers" and "sisters". Difficulties arising from union resistance was minimal. The program was implemented in 12/94. At the same time, 3.5 FTE supervisor positions were deleted and provided an expense reduction of $179,200. In 2/95, staff and TLs were surveyed to gain input on program acceptance and to determine long term success. Staff experiences with TL program were positive and provided support for deleting the final 0.5 FTE supervisor position ($25,600). Staff identified TL empathy, better understanding of the daily challenges, and more overall support during the shift as program strengths. Mandating overtime, enforcing the discipline policy/procedure, authorizing all changes in the number of staff/shift, investigating critical occurances, and ordering rental equipment remained a management responsibility. Conciusions: Team management decisions expand potentials and provide direction to tough decisions on staff reduction. Not all staff reductions end in reduced patient quality and staff morale. Many individuals possess leadership qualities which are dormant or exercised in non-traditional ways. Identifying these individuals and empowering them in critical roles can provide job satisfaction and improved employee morale while reducing expenses. Staff empowerment, provided with adequate management support can work in a bargaining union environment.

OF-95-038

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