The effects of the relationship of management and union at Washington Hospital Center and how improvements in this relationship can impact employee benefits and healthcare care delivery
According to the investigations conducted by Molander, (2000) in “Human Resources at work”, most of the workers at Washington Hospital Center have been abandoned and their needs were greatly neglected. The law dealing with the minimum wage, for example, was unknown in the institution. Benefits associated with a collective bargain, protection of job and related benefits were all inexistent. The administration at the institution advocated for the illegality of the workers joining a union. The administration turned a blind eye on the perceived benefits that the clients in the hospital would most likely access in case that the rights of the employees were uplifted through the freedom of expression given through the promotion of the unions. Most of the commonly raised concerns revolved around the quality of the care that the patients were given as a result of the persistent complaints by the institution nurses due to the exposure to poor conditions of work (Molander, 2000).
Morris & Feldman, (1997) in their work “Managing emotions in the workplace” conducted a study that proved a positive relationship between the poor conditions of work as evidenced in Washington Hospital Center and the level of employee burnout The results of his findings indicated that in such a setting, which offers services of great importance to the customers, then the customers remain to suffer as a result of the developing burnout among the workers. The burnout has important ramifications to the level of health care service delivery (Morris & Feldman, 1997). This is due to the contribution of the poor conditions of work that brings a feeling of being overworked among the nurses. This consequently promotes a situation whereby the nurses are not in their best with regard to the provision of the highest standards services of health care to the patients.
Organ, (1995) in “A meta-analytic review of attitudinal and dispositional predictors of organizational citizenship behavior” has established that the employees are entitled to other benefits of collective bargaining in Washington Hospital Center. This implies the rights that the employees should have facilitating their representation in the issues of negotiation of the terms as well as the conditions that govern the nature of their employment. In case this issue of collective bargain has not been looked in to, then the employees are denied the necessary input in as far as the working conditions are concerned (Organ, 1995). The contribution of collective bargain among the employees is a single united voice and a level ground for meeting with the management for the purpose of negotiating “in good faith” all the issues pertaining to their working conditions. This, therefore, brings about a genuine effort of arriving at positive agreement. On negotiation of a contract, some procedures of enforcement therefore becomes applicable that facilitates that the employees are in a position of honoring the accord.
Silva, (1995) in “overdrive, managing in crisis filled times” reported one of the union workers saying that “being a union member means I have a voice, that people care if I keep my job and get treated fairly”. The worker has also appreciated they importance that the management has attached to the issue of training all the members who are covered by the union in issues of representing the fellow coworkers. It is however worth noting that the majority of the most important issues in the institution has been unresolved which include the issues of wages, the improvement of the entitlement to sick leave, guaranteed working hours, the establishment of a pension plan, the shift as well as the weekend premiums, better sharing of costs of the benefits as well as the disability benefits on a long term basis (Silva, 1995).
Silva (1995) also addresses the issue of employee turnover at Washington Hospital Center should be checked in relation to the provision of a supported union at the health facility. Employee turnover cost can become a very significant cost that can lead to attrition on the bottom line of Washington Hospital Center. Washington Hospital Center has a possibility of confronting with high cost of employee turnover although they have low employee turnover rate due to an underestimated indirect cost from the consequences of employee turnover. Knowing the cost of losing and replacing an employee is able to help Washington Hospital Center to determine how much they can afford to retain their good performers. To begin with the first motivation, it is about high employee turnover cost that can result from the prohibitions to joining the union at Washington Hospital Center.
Abassi & Hollman (2000) in Public Personnel Management, 2 (3) pp. 333-342 state that employees are the main contributor to the success of organizations. It can be apparently seen that Washington Hospital Center has to invest a large amount of money on their employees in terms of hiring, training, developing, and retaining. As it is mentioned by Abassi & Hollman (2000) “the more you pay this person, obviously, the more you value their contribution to the growth and success of your business”. The value of employees is considered as one of the most important intangible resources in Washington Hospital Center, especially their skills. Broadly speaking, skills are hard to replicate not only technical skills but also soft skills. Therefore, when an employee decides to leave Washington Hospital Center for whatever reasons, it denotes an enormous cost from the view of Washington Hospital Center that is called employee turnover cost (Abassi & Hollman, 2000)
According to Gilman (1998) in Costs of UK labour turnover increase, he presents that the estimated employee turnover cost per person for an associated professional and technical occupational group in professional service industry such as Washington Hospital Center from the IPD survey at that time was £5,358. Moreover, the highest turnover cost was found among professional occupational group in professional service industry, which was £7,317. Furthermore, Gilman (1998) supports the information about the costs of employee turnover divided by occupational group as illustrated in figure 2.
Figure 2 – The costs of labour turnover divided by occupational group
Wegge, (2007) in Journal of Occupational and Organizational Psychology” has found the danger of leaving of employees without a supported union can be a huge impact in the financial aspect of Washington Hospital Center, regardless of industry. As reported by Parise, S., Cross, R. & Davenport, T.H. (2006) in “Strategies for preventing a knowledge-loss crisis, lack of job satisfaction was the primary reason for employees’ decision to leave. Most of their resignations resulted from the lack of a supported workers union in the institution leading to neglect in their needs. On the other side, if management in Washington Hospital Center does not clarify goals and decisions to employees then their work are not recognised or valued when it completed, this will damage the morale and esteem of those employees (Parise, Cross & Davenport, 2006) As a result, those employees are pushed to be dissatisfied with their old job then they will seek for a new job.
Webb & Cleary, (1994) in “Organizational change and the management of expertise” expresses the lack of advancement opportunities which is also supported by the workers unions refers as “push factor” because it pushes employees in the direction of leaving Washington Hospital Center. On the other hand, if those employees receive the opportunities of external promotion from outside Washington Hospital Center, this factor will become “pull factor” that stimulates the employees to take action (Webb & Cleary, 1994). Good performers may expect to be promoted faster than normal. If the opportunities either rising pay or promotions within the Washington Hospital Center have been limited, the Washington Hospital Center may need to evaluate trade offs between creating such opportunities and losing good performers in some circumstances. The follow up of the clients is then disrupted because the old clients are likely to meet new health care providers who are unaware of their medical history.
According to Naidu & Narayana, C(1991) in “How Marketing Oriented Are Hospitals in a Declining Market?” Journal of Health Care Marketing the level of pay was ranked as the forth reason for employee turnover which in turn affects the quality of health care delivery at Washington Hospital Center. Most of the respondents’ interviewed by Naidu & Narayana, (1991) indicated pay and conditions as the third reason in their decision to leave the Washington Hospital Center as revealed by Naidu & Narayana, (1991). Good performers are de-motivated if they work smarter and harder but they get equal outcomes as average or poor performers. In the worse way, if management in Washington Hospital Center shows bias and gives some employees better chances such as promoting someone who lacks training and/or necessary experience to be supervisor, it will rapidly push top performers in the direction of seeking better paying jobs. It can be seen from many exit interviews that the regular reason for leaving is to get a better opportunity, which typically means a better pay and conditions. On the other hand, it will be a major pull factor if competitors of Washington Hospital Center give an offer of a better opportunity to the top performers (Naidu & Narayana, 1991)
Work life balance at Washington Hospital Center is another area that is affected by supporting the workers unions. Acoording to Myers, (2009) in “Business continuity strategies”, success has a different meaning for different people: some people think that it means enjoying their job whereas some people consider it as climbing the career ladder as high as possible (Myers, 2009). According to a study from the Washington Hospital Center, most of respondents were dissatisfied with their current working hours. In particular, younger respondents desired flexible work throughout their lives (Myers, 2009).
Lee, (2000) in “An empirical study of organizational justice as a mediator of the relationship among leader-member exchange and job satisfaction, organizational commitment and turnover intentions in the lodging”showed that work life balance was the fifth reason for leaving of employees, which was about 10% of respondents. Lee, (2000) pointed out that flexibility of hours worked is commented as work life balance. Also, he noted that not only Generation Y employees who seek work life balance but also Generation X and Baby Boomers About 80% of employees in Washington Hospital Center believe that work life balance plays a vital role in deciding whether to leave or stay with Washington Hospital Center All these issues are comprehensively deliberated if the employees are given a voice through their unions (Lee, 2000)
Hofstede, (2001) in “Cultures’ Consequences, Comparing Values, Behaviours, Institutions, and Organizations across Nations” has advocated for one way of getting the reasons of resignation from an exit interview about the contribution of the workers unions in the workplace. It may be the attraction of a new job or the chance outside Washington Hospital Center, which ‘pulls’ the departing employees from time to time. Conversely, the employees may be ‘pushed’ due to dissatisfaction in their present jobs to seek alternative employment. However, the real reason for leaving of employees may difficult to discover. As Hofstede, (2001) said, “some employees in Washington Hospital Center may be reluctant to state the reason case this affects any future references or causes problems for colleagues who remain with Washington Hospital Center”. Therefore, employees generally state that their reasons of leaving are from “pull factors” such as higher pay offering despite it is not the real reason. This will gain the real problems because those employees need the problems to be fixed unlike those that have already decided to leave (Hofstede, 2001).
According to Fried, (2007) in his work “The validity of the Job Characteristics Model” One of the most important accomplishments required of the management at Washington Hospital Center is to reduce the rate of employee turnover that is brought about by suppressing of the workers unions in the institution. When an employee voluntarily makes a decision to leave an Washington Hospital Center for whatever reason, the institution is certainly going to lose more or less its money. Fried, (2007) estimated that a small increasing turnover rate as 1 or 2% could have a negative effect on the rate of performance. Therefore, in order to make an effective management, it is vital for Washington Hospital Center to observe the extent of turnover and its costs and try to establish the possible relationship of the issues to workers union. Although it is noticeable that employee turnover is costly, it is quite difficult to quantify the actual cost of turnover. As an illustration, one of previous studies relating to employee turnover cost presented the turnover cost ranges as percentage of annual base salary categorized by job types as shown in table 2.
Table 2 – Turnover cost ranges as percentage of annual base salary
Source: (Fried, 2007).
According to the above table, employee turnover cost can range from 30 to 200 percent of the annual base salary. The cost would be increased if employees move on to work for competitors. As a matter of fact, personnel are more likely to be re-employed within the same industry by a competitor. Hence, competitors would gain from the potential employees who have just left. It is, therefore, an important role of the management of Washington Hospital Center to take active measures to avoid the proliferation of workers turnover through comprehensive deliberations of the issues affecting the workers held through forums with the representatives of the workers. This is the only way that the problems affecting the workers can be identified and amicable solutions arrived at to make sure that the extent of the quality of health care delivery in enhanced.
Fisher, (2000) work on Mood and emotions while working: missing pieces of job satisfaction? in Journal of Organizational Behavior has played a contributory role in issues of workers unions. Fisher, (2000) also identified the different approaches to managing a multi-cultural team within Washington Hospital Center and ways to identify which approach Washington Hospital Center needs to be adopted in order to reach its successful goal of operation within an organization. (Fisher, 2000)
According to the arguments by Gilman, (1998) in “Costs of UK labour turnover increase”, it is important to note further that high employee turn over can dent the good image of Washington Hospital Center that may eventually negatively influence the services related to Washington Hospital Center hence the need for job satisfaction among employees. This is so to say that high employee retention is key in the achievement and the realization of the Washington Hospital Center future or long term growth. Yet another point to note is that retention of best employees in Washington Hospital Center is one way of ensuring and luring the probable investors as they would reflect the employee retention rate and their investment rate more especially if Washington Hospital Center is doing well in service delivery. It can, therefore, be concluded without any doubts that poorly managed employee turn over can destabilize Washington Hospital Center which eventually could lead to damage of the health care delivery. The answer therefore to good services at Washington Hospital Center given all other factors kept constant is employee job satisfaction through the promotion of a sound and supported workers union (Gilman, 1998)
Abdul-Gader & Bhuian, (1997) in “Market Orientation in the Hospital Industry” have given a lot of contribution in this issue. According to their publication, it is only in the recent years that employees have recognized and appreciated the link between distributive justice and the effectiveness of running companies and organizations. Abdul-Gader & Bhuian, (1997) found a direct relationship between distributive justice and job satisfaction through the rewards and the payments offered to the employees in the form of wages and salaries. According to Abdul-Gader & Bhuian, (1997), training of the managers is one way of ensuring that the employees receive fair and just treatment According to a research that was conducted to determine if distributive justice could act as a predictor of employee job satisfaction, it was pointed out that distributive justice is one of the major indicators of the level of commitment of the employees to the organization. In the same study conducted by Abdul-Gader & Bhuian, (1997), he pointed out the need for the managers to timely and effectively communicates relevant information to the employees as one major step in ensuring employee’s commitment to organizations. It is indicated that by applying the rule of fairness, employees will be rewarded according to their achievements and contributions to the organization void of bias and discrimination.
Weiss, (1999) in “An examination of the joint effects of affective experiences and job beliefs on job satisfaction and variations in affective experiences over time” has also documented the importance of the unions. They help the management at Washington Hospital Center to solve their problems measurably and manage their ability to build value, manage risks and eventually improve on their performance. Their services range from legal advice to financial support, business process and outsourcing as well as management consultancy. These are industry-focused services that enable the Washington Hospital Center to gain public trust and enhance value for their clients and their stakeholders. By working with the workers unions Washington Hospital Center gets to network and share ideas with professionals through their conceptualization, and practice aimed at bringing solutions to the problems as well as gaining fresh approaches to these involvements. Putting people at the heart of change in through deliberations in the unions ensures great success as it helps the management of Washington Hospital Center to actualize their needs and what they really want. Many people are uncomfortable with change especially those that deal with their career but with the arrival of consultants, the burden have eventually been lightened. Lasting success is achieved through considerable skill offered by the unions as well as working with and integration with people in delivering services (Weiss, 1999).
The work of Abraham, (2009) in “The impact of emotional dissonance on organizational commitment and intention to turnover” has also contributed to immense information of the issues relating to workers unions. The current scenario at Washington Hospital Center requires the promotion of an emotional environment and status that may concern the organization’s ability and the consequences that such decisions may have on the work performance of employees and the overall goal of the Washington Hospital Center. The environment in the workplace determines the success of good working relationships. The idea of the fear of attending to the workplace is not appreciable among the majority of the workers. The human resource development at Washington Hospital Center is dependent on the extent of the friendliness of the environment of work (Abraham, (2009). The temptation of the participation in the conversations that may result to a toxic workplace is avoided. The rumors related to the changes in the workplace are dismissed that may bring about some fears because most of the people fear changes which in most of the cases results to a decrease in the morale of the workers. The thorniest issues are addressed in a direct manner. In the case that the performance of the employees is appreciable, it is usually good to show a sign of appreciation. This is a gesture that is good and it has some important implications in the process of initiating innovations at Washington Hospital Center
White, (2002) in “Writing your MBA dissertation” has documented that effective management and solution of rising needs of the workers within the Washington Hospital Center in addition to trying to achieve attitudes coherence has great positive implications to the stakeholders of Washington Hospital Center and the achievement of the set goals and objectives. The management in Washington Hospital Center should concentrate on the urgency, timeliness as well as adequacy pertaining to the underlying workers needs and its identification assessment as well as resolution. Human resource development and management at is considered one of the most advancing and growing departments of any given organization whether it is profit making or not (White, 2002). Business proposal experts argue that the success of any organization is entirely dependent on the techniques and methods put in place for the management of employees in particular organization.
Zaremba, &Tucker & Ogilvie, (1992) in “Journal of Health Care Marketing” found the current global business scenario is associated with a mutiny of workers needs as a result of the factors allied to business like the re-engineering processes of business, globalization among others, which forms an important component of the current business trends. There is, therefore, a need for a higher degree of attention since business integration complicates and diversifies business operations. This, in turn, result to differences in views and opinions as a result of cultural backgrounds and therefore the selected tool for the management of the needs of the employees in the current business situation should be chosen with great care. This, therefore, calls for a clear understanding of the importance of access to the best possible approaches that are applicable in the process of employee management. There has been a need for extensive research in this field which, when conducted well shall lead to the adoption of the necessary measures of dealing with such situations of in any organization. The current trend in business is an effort towards gaining a competitive advantage that can only be achieved in the situation that the operations in the firm are carried out in a harmonious manner (Michael, 1999).
Abassi, S.M. & Hollman, K.W. (2000) “Turnover: the real bottom line”. Public Personnel Management, 2 (3) pp. 333-342.
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