THE CASE: Selecting Patient Escorts
City Hospital is located in the heart of a large Midwestern city. It is one of five major hospitals in the area and has recently built a small addition for treating well-known patients such as professional football players, top company executives, and singing stars. Visiting or local celebrities always choose City Hospital if they need treatment.
City Hospital has about 1,200 hospital beds and employs 4,500 individuals, including about forty patient escorts. The job of patient escort is a rather simple one, requiring only minimal training and no special physical talents. When patients need to be moved from one location to another, patient escorts are summoned to assist in the move. If the move is only a short distance, however, a nurse or orderly can move the patient. Of particular importance is the fact that patient escorts almost always take patients who are being discharged from their hospital room to the front door of the hospital. A wheelchair is always used, even if the patient is able to walk unassisted. Thus, the typical procedure is for the nurse to call for a patient escort; the escort gets a wheelchair and goes to the patient’s room, assists the patient into the wheelchair, picks up the patient’s belongings, wheels the patient down to the hospital’s front door or to his or her car in the parking lot, and returns to the work station.
The job of patient escort is critical to the hospital since the escort is always the last hospital representative the patient sees, and hence has a considerable influence on the patient’s perception of the hospital. Of the approximately 40 escorts, about three-fourths are men, and one-fourth are women. Most are high school graduates in their early twenties. Some, particularly those on the early morning shift, are attending college at night and working for the hospital to earn money to pay college expenses. Four of the escorts are older women who had previously served as hospital volunteers and then decided to become full-time employees instead. Turnover among patient escorts is quite high and has averaged 25 percent in recent years. In addition, upward mobility in the hospital is quite good, and as a result, another 25 percent of the escorts typically transfer to other jobs in the hospital each year. Thus about half of the patient escorts need to be replaced annually.
The hospital follows a standard procedure when hiring patient escorts. When a vacancy occurs, the Personnel Department reviews the file of applications of individuals who have applied for the patient escort job. Usually the file contains at least 20 applications because the pay for the job is good, the work easy, and few skills are required. The top two or three applicants are asked to come to the hospital for interviews. Typically, the applicants are interviewed first by Personnel and then by the patient escort supervisor. The majority of those interviewed know some other employees of the hospital, so the only reference check is a call to these employees. Before being hired, applicants are required to take physical exams given by hospital doctors.
Every new escort attends an orientation program the first day on the job. This is conducted by a member of the hospital’s Personnel Department. The program consists of a complete tour of the hospital, a review of all the hospital’s personnel policies,including a description of its promotion, compensation, and disciplinary policies, and a presentation of the hospital’s mission and philosophy. During this orientation session, employees are told that the employees should strive to maintain and enhance this image by their conduct. After orientation, all patient escorts receive on-the-job training by their immediate supervisor.
During the last two-year period the hospital has experienced a number of problems with patient escorts that have had an adverse effect on the hospital’s image. Several patients have complained to the hospital administration that they have been treated rudely, or in some cases roughly, by one or more patient escorts. Some complained that they had been ordered around or scolded by an escort during the discharge process. Others stated that the escort had been careless when wheeling them out of the hospital to their cars. One person, in fact, reported that an escort had carelessly tipped him over. All escorts are required to wear identification tags, but patients usually can’t remember the escort’s name when complaining to the hospital. Additionally, the hospital usually has difficulty determining which escort served which patient because escorts often trade patients. Finally, even when the hospital can identify the offending escort, the employee can easily deny any wrongdoing. He or she often counters that patients are generally irritable as a result of their illness and hence are prone to complain at even the slightest provocation.
At the hospital administrator’s request, the Personnel Manager asked the Chief Supervisor of Patient Escorts, the head of the Staffing Section within the Personnel Department, and the Assistant Personnel Director to meet wit her to review the entire procedure used to select patient escorts. It was hoped that a new procedure could be devised that would eliminate the hiring of rude, insulting, or careless patient escorts.
During the meeting a number of suggestions were made as to how the selection procedure might be improved. Criticisms of the present system were also voiced. The chief supervisor of patient escorts argued that the problem with the hospital’s present system is that the application blank is void of any really useful information. He stated that the questions that really give insights into the employee’s personality were no longer on the application blank. He suggested that applicants be asked about their hobbies, outside activities, and their personal likes and dislikes on the application blank. He also suggested that each applicant be asked to submit three letters of recommendation from people who know the applicant well. He wanted these letters to focus on the prospective employee’s personality, particularly the applicant’s ability to remain friendly and polite at all times.
The Assistant Personnel Director contended that the hospital’s interviewing procedure should be modified. He observed that during the typical interview little attempt is made to determine how the applicant reacts under stress. He suggested that, if applicants were asked four or five stress-producing questions, the hospital might be in a better position to judge their ability to work with irritable patients.
The head of the Staffing Section noted that patient escorts require little mental or physical talent and agreed that the crucial attribute escorts need is the ability always to be courteous and polite. He wondered whether an “attitude” test could be developed that would measure the applicant’s predisposition toward being friendly, etc. He suggested that a job analysis could be done on the patient escort position to determine those attitudes that are critical to being a successful patient escort. Once the job analysis was complete, questions could be developed that would measure these critical attributes. The test questions could be given to the hospital’s present patient escorts to determine whether the test accurately distinguishes the best from worst escorts. The staffing head realized that many of the questions might need to be eliminated or changed, and that, if the test appeared to show promise, it would probably need to be revalidated in order to meet government requirements. He felt, however, that a well-designed test might be worth the effort and should at least be tried.
The meeting ended with all four participants agreeing that the suggestion of trying to develop an “attitude test: was probably the most promising. The Assistant Manager and Chief Supervisor of Patient Escorts stated that they would conduct a thorough job analysis covering the patient escort position and develop a list of attitudes that are critical to its success.
- Examine the case for the main issue/ problem that is facing the hospital.
- Detail the stated and underlying causes of the problem identified.
- The case provides you with three suggestions. You are to suggest at least three other alternative solutions. Be creative – think in terms of the entire scope of HR activities, including training, compensation, performance appraisal, recruitment, selection, etc.
- Think in terms of a business. What would their criteria be for evaluating and choosing from among alternatives? Justify your choice using business criteria.
- Provide detail as to all of the activities and steps that would take place from the time of solution approval to implementation completion.