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Remembering Dan Tosteson, former HMS dean and founder of HMI

Letter From The Editor

In this issue we are pleased to bring you the exciting news that Dubai Healthcare City will launch a world-class tertiary care teaching hospital. This story has been developing for several months, as faculty from HMI, health care leaders in Dubai, a team of architects from a top firm, and clinical and administrative experts from throughout the Harvard medical community have worked together to design every component of the University Hospital.

Feature Stories

Kyriaki Fragoudaki, Nurse Supervisor of Clinical Education (center) and other Hygeia Hospital team members worked with HMI Senior Consultant John Helfrick during a training visit last year

Human Resources teams play critical role in quality hospital performance

International accreditation has come to be regarded as a powerful symbol of a health care organization’s commitment to quality patient care. HMI partners like Wockhardt Hospitals Limited and Acibadem Healthcare Group have embarked on successful initiatives aimed at preparing their hospitals for the rigorous site surveys conducted by Joint Commission International (JCI). Today, because of the impact that the JCI stamp of approval has on patients seeking quality care, much of the attention on accreditation has focused on the delivery of patient care. Yet as Joanne Ayoub of Beth Israel Deaconess Medical Center (BIDMC) points out, a hospital’s Human Resources department has an important role to play in helping the organization earn this important distinction.

“The surveyors from the Joint Commission can spend a great deal of time during a site visit evaluating a hospital’s HR infrastructure,” said Ayoub, who is Director of Organizational Development at BIDMC. “It is common for surveyors to bring HR leadership together to ask specific questions related to new employee orientation programming, required training processes, management development, performance management, and personnel file management. Now that the Joint Commission has adopted the tracer methodology, in which they follow a patient through the care process, they might request the personnel files of all of the hospital staff involved in that patient’s care. When that happens, we have to be prepared to provide those files in a timely fashion, and demonstrate that they are indeed complete.” (See this issue's edition of "Audiovisual" to learn more about the Joint Commission's tracer methodology.)

There are over 20 JCI standards that are related to Human Resources, but according to Ayoub, the key standards for focus in a first-time JCI site survey typically fall within the following categories:

File management: Each personnel file should include the employee’s application, references, current job description, performance evaluations, and specific documentation relating to competency certifications.
Orientation and training: The HR department must be able to show that the organization maintains a new employee hiring process that is consistent hospital-wide, and each department within the hospital has a solid on-boarding process in place.
Staffing plans: This function, typically related to clinical and nursing staff, must be in evidence.
Performance evaluation process: The hospital must have a documented process for evaluating employee performance.

In December, Ayoub made a two-day training visit to Athens to help Hygeia Hospital’s Human Resources team assess the hospital’s JCI readiness and identify key actions to undertake going forward. Hygeia, an HMI partner since 2003, is seeking to become the first health care organization in Greece to receive JCI accreditation.

This visit built upon work conducted in July 2007, when Hygeia HR director Maria Vasiliadou spent several days meeting with HR professionals at a number of Harvard Medical School-affiliated hospitals, including BIDMC. The focus of these meetings was to gain knowledge about core competency requirements for JCI and to benchmark best HR practices. Following the visit, Mrs. Vasiliadou and her team began developing a performance management process for key leadership and employees of Hygeia, and worked to update the hospital’s HR policies and procedures to achieve compliance with JCI standards.

During the most recent visit, Ayoub worked with Mrs. Vasiliadou and Hygeia quality assurance manager Maria Driva on plans to define the hospital’s performance evaluation process. Ayoub emphasized the importance of positioning the performance evaluation process proactively—as a way of enhancing and developing core competency, not as a way to weed out poor performers.

“A good performance development process is an opportunity to engage in forward thinking and look at areas of ongoing development. Using this process, the individual contributor can work with his or her manager to examine the goals they have set for themselves, check their progress, and investigate how the manager can help the employee meet those goals,” she said. Ayoub added that the process of implementing such an initiative is a significant undertaking for Human Resources, saying, “This will not be a one-time effort but rather a change in Hygeia culture that will require ongoing nurturing and monitoring.”

Mrs. Vasiliadou said that although the HR department at Hygeia has many challenges at ahead, she is confident. "Every member of the HR team is highly committed to do whatever is necessary for the successful implementation of all necessary improvements," she said, adding, "The recent training visit by Ms. Ayoub proved to be a highly productive and fruitful cooperation."

GUIDE TO THE DESIGN AND IMPLEMENTATION OF A PERFORMANCE EVALUATION PROCESS

Developed from recommendations by Joanne Ayoub
Director of Organizational Development
Beth Israel Deaconess Medical Center

Performance Process

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