Smile Please !

The morale of healthcare employees can directly affect the quality of service and customer care being provided. However, have Indian hospitals started to view morale boosting measures as seriously as they need to? Finds out Sonal Shukla

In an interesting study done by largest research organisation in the world specialising in mental illness, the US based National Institute of Mental Health, at least one in four employees in healthcare endure an episode of significant psychological illness during their prime working years and in any given year, more than one in 10 will experience clinical depression. Moreover, for some occupational categories the risks are even greater. Physicians, nurses, chiropractors, health technologists and dentists have higher-than-average suicide rates. Health technologists, licensed practical nurses, clinical laboratory technicians, nurses aides, registered nurses and dental assistants had among the highest rates of hospitalisation for mental disorders in one study of 130 job classifications. While there are no official estimates for Indian healthcare employees, but indeed they would indeed share the same story.

As levels of competition have grown manifold, there is a pressing need to give a lot of emphasis on the quality of service which has translated into greater stress for all healthcare staff. The uniqueness of this industry is that employees are forced to face the stark realities of life and death, 24x7, under tremendous physical exertion, irrespective of time, date or day or of any turbulence in their own personal lives. Any lack of effective and timely efforts in keeping employee spirits and morale high therefore leads to a steady dip in their performance. Says Dr BK Rao, Chairman, Sir Ganga Ram hospital, New Delhi, "HR managers, particularly those responsible for healthcare facilities, face a major daily challenge in boosting the morale of all staff. Research on motivation has shown us that if you want to improve the experience of patients and the reputation of your service, pushing already motivated people to become even more so is crucial."

However, an averagely intelligent HR audit can immediately diagnose this drop in productivity, according to Shrabani Basu, Management Consultant and Corporate Trainer, This is because, it is only to a certain extent, possible to truly 'cure and care' for a patient in all its entirety, only by technical brilliance. A huge chunk of the patients' well being largely depends upon the mental and emotional makeup and well being of the employees of a hospital, that are directly reflected in their concerted emotional and behavioural efforts towards patients. "We all know, in hospitals, it is very important that a patient has to be taken to a high level of 'feel good' domain, which actually affects his responses to drugs and clinical processes towards recovery. To attain this very difficult task of making a patient feel very assured of being well taken care of clinically, is actually largely dependant on his emotional well being along with clinical excellence," she adds.

Pressing Need

The healthcare staff constantly faces tremendous physical and emotional pressure and the nature of the industry makes it even more extracting. Doctors and healthcare staff are not only under pressure from a professional point of view but also psycho-socially as patients and their family members share with them their concerns and grief. While this kind of interaction does give a special dimension to the relationship, but the fact remains that it takes a heavy toll on doctors and healthcare workers. Malcontent employees can even create a sense of gloom and doom in the workplace. In many cases their negative attitude can get transferred to other staff members and bring about low productivity. "The morale of all healthcare workers is especially important since they are dealing with human lives. It also has a direct impact on patients who are already in a troubled state of mind and tend to be more susceptible and affected by the attitude of the healthcare worker dealing with them. Hence, morale boosting becomes extremely essential for a healthcare worker," states Suyash Borar, COO, BM Birla Heart and Research Centre (BMBHRC), Kolkata. Incidentally, healthcare workers, irrespective of their professional stream, are trained and mentored from inception to keep a safe distance from letting the impact of this relationship affect their professional judgment and thereby their overall productivity. However according to experts demarcation between the beneficial involvement with the patient and/ or family for treatment and rehabilitation purposes and cross over to the limit which affects the healthcare staff itself is quite thin; and it is here that they have guard themselves against such possibility." Generally, the care provider scheduling, is done in such a manner that person's duty schedule should avoid building any disturbing relationship between him/ her and the patient. However it is easier said than attained. After all, the staff are also human, it is the humane angle which is playing a predominant role at this juncture." opines Dr Praneet Kumar, Chief Operating Officer, Fortis Escorts Hospital, Jaipur and Director - Quality Assurance, Fortis Healthcare Limited. Therefore in addition to scheduling, seniors in each stream who are sensitive and mature enough to sense any such situation very early, usually intervene. The intervention could be just a simple counseling session(s) for the affected staff to removing the employee from the care giver team or even forced leave of absence at times. All the above actions help prevent or at least minimise any chances of productivity decrease of the individual staff. "What is more important here is the quality of decision making that needs to be protected and therefore it becomes important to institute mechanisms that do not allow the staff to drift into developing emotional relationships that can be counterproductive," adds Dr Kumar.

Morale boosting methods also can go a long way in helping retain the staff. "Issues like attitude of managers towards their subordinates, working conditions, pay, safety, feeling of unfair treatment, lack of recognition, fear of superiors, if all these issues can be dealt intelligently we will definitely be able to retain our employees," feels Anthony Handa, Manager— Personnel, Ruby Hall Clinic. While it is a reality that healthcare staff is currently suffering from a sort of 'compassion fatigue,' not many groups are focusing towards morale boosting. But nevertheless, there are Groups who have taken a small yet positive step forward in this direction. Jaipur based Fortis Escorts Hospital is a case in point. It has created social forums that outline and formulate indoor and outdoor sports activities that are regularly utilised by all, without any differentiation between staff categories. While, this helps in de-stressing the staff, it also helps team building and bonding. The hospital initiated ten day sports meet from this year which the staff managed to attend even after performing their primary duties. Similarly, the entire staff of the hospital was gifted a souvenir— a silver coin with the name of hospital and date of first anniversary as a token of remembrance. "These are few of the activities that we have undertaken that affects the entire staff. Actually, morale boosting activities or for that matter any such intervention for development of soft skills has to remain responsive to changing dynamics and we at Fortis Group invest a lot of time and resources to enable it," shares Dr Kumar. Like Fortis Escorts, there are others like Kolkata-based BM Birla Heart Research Centre, Jaslok Hospital and Research Centre, Mumbai; P D Hinduja Hospital, Mumbai; KG Hospital and Post Graduate Medical Institute, Coimbatore, Max Healthcare in Delhi, Bangalore based Global Hospitals who feel that morale boosting in healthcare is the need of the day and have taken steps to implement some noteworthy measures in this area.