HR@Work. Practices from Vaatsalya profiled by IPIHD

Applying cost-saving principles from manufacturing, healthcare delivery innovators across the globe are able to cut costs and improve access for patients. They streamline services to eliminate waste and provide high-quality care for a fraction of the normal market rate. However, amidst state-of-the-art technology and streamlined procedures, there is an elephant in the room. And the elephant is giving her notice.

Many countries are facing critical shortages in healthcare workers and difficulty in retaining skilled workers. This is particularly challenging for low-income countries and rural areas. Lack of trained and talented workers limit access to high quality care and exacerbate healthcare disparities. Yes, medications, diagnostics and innovations in medical technology are important; but without the doctors and nurses to deliver the care, nothing gets done.

In the developed world where healthcare costs continue to rise, doctors and nurses are recruited and retained through relatively high wages and opportunities for career growth. But in emerging economies, where low-cost access to healthcare can also mean lower wages, retaining talented healthcare workers is not only a challenge: it’s a barrier to continued growth.

How, then, can health care innovators, operating on tight budgets to provide the lowest cost services possible, attract and retain top talent?

Vaatsalya celebrates International Nurses Day at Gulbarga location

Vaatsalya, a hospital network providing affordable care to small towns in India, has set out to find the answers. Vaatsalya, an IPIHD Network Innovator, is a for-profit low-cost hospital chain focused on primary and secondary healthcare services in Tier II and Tier III cities, where access to quality care is traditionally limited. As they seek to expand to 20 hospitals in southern India, they are working to reduce employee turnover and improve their recruitment process.

I recently had the opportunity to visit Vaatsalya’s headquarters and meet with their new human resources director to talk about these challenges. While up against the odds finding qualified nurses in a steadily shrinking talent pool and placing highly skilled doctors in rural villages, he, together with his team, has developed an impressive system of processes and cultural shifts designed to make this happen.

Top Drivers of Employee Turnover

Across most organizations like Vaatsalya, providing much-needed care in rural areas, the top drivers of employee turnover are the same: Compensation, work environment, and location. Some of the barriers to employee retention faced by successful organizations such as Vaatsalya include:

Relationship with Manager: Employees that feel empowered and respected by their managers have a significantly higher likelihood of staying. Those who don’t, leave.
Respect in the Workplace: Healthcare workers seek positive feedback in addition to constructive criticism to improve performance. However, in many healthcare settings across India, positive feedback is not included as a central component to employee growth.
Satisfaction with Compensation: Given that doctors and nurses usually opt for educational loans, compensation is one of the drivers in employee retention.
Interest in Living in a Rural Area: Given the incredible growth and opportunities in urban settings compared with rural parts of India, many nurses and doctors are not interested in moving their families to rural communities.
Opportunity for Learning: In an era of knowledge not many organizations have the bandwidth to continuously train and up-skill their employees. In a market already reeling under scarce talent, the competition for talent continues to intensify.

Establishing Key Values

Indeed, these challenges are daunting. How can lean operations simultaneously cut costs and attract and retain employees in rural areas?

To combat the main drivers of employee turnover, the Vaatsalya HR team developed a new HR system designed around existing key organizational values at Vaatsalya to increase employee satisfaction, and, in turn, patient satisfaction.

Vaatsalya celebrates International Nurses Day at Shimoga location
Key Value #1: Ensure that all employees feel valued and understand how their work contributes to excellent patient care.

Provide each hospital manager with a set of stories and discussion questions to engage team members at the start of each day in a full team meeting.
Implement a system for employee awards and recognition, allowing both patients and colleagues to recognize excellence.

Key Value #2: Motivate employees through attainable future growth opportunities within the organization.

Develop and share a transparent career path within each hospital for high performing employees.
Ensure each employee has a monthly development conversation with their manager, regardless of their position.
Provide continuing education opportunities to all employees throughout the year.
Develop employee engagement programs emphasizing fun, learning, growth and culture building.
Develop Talent Matrix by deploying performance versus potential ratings and build leadership development programs for “High Potential” and “Critical Employees.”

Key Value #3: Provide a highly transparent organizational structure.

Develop salary bands for each position to ensure pay consistency across regions using internal and external equity benchmarks. Publish annual compensation reports so that all employees understand how career growth translates to increased pay.
Create detailed job descriptions with competencies for all positions and internally circulate for expectation setting and people engagement.

As the HR team said, “Inspiring healthcare workers to be their best is what Vaatsalya is all about.” In acknowledging the elephant, she’s invited to stay.

After all, engaged nurses and doctors means more lives saved. And what could be more important than that?

From IPIHD Blog