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Workshop 10

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From the conference Competence 50+ 2007 in Gothenburg, Sweden.

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Workshop 10

  1. 1. AGE POLICY AND STATEGIES FOR MAINTAIN AT WORK IN HOSPITALS
  2. 2. CONTEXT
  3. 3. <ul><ul><li>Located in Marseille since 1925 </li></ul></ul><ul><ul><li>1945 : special status (anticancer Center) shared between 20 similar hospitals in France </li></ul></ul><ul><ul><ul><li>Private but… </li></ul></ul></ul><ul><ul><ul><li>Non profit goal </li></ul></ul></ul><ul><ul><ul><li>Public service mission </li></ul></ul></ul><ul><ul><ul><li>Universitary hospital </li></ul></ul></ul><ul><ul><ul><li>Includes a great research center </li></ul></ul></ul>Institute Paoli Calmettes (IPC) IPC
  4. 4. <ul><ul><ul><li>Dedicated to oncology </li></ul></ul></ul><ul><ul><ul><li>On all aspects (cure, tracking, prevention, research, training, medical teaching) </li></ul></ul></ul>Varied fields…
  5. 5. <ul><ul><li>capacity : 292 beds and places (surgery, hematology, medical oncology) </li></ul></ul><ul><ul><li>Complete technical unit (imagery, laboratories, operating theaters, radiothérapy, nuclear médecine, réa, endoscopy, marrow treatments…) </li></ul></ul><ul><ul><li>Average Stay duration : 6,5 days </li></ul></ul><ul><ul><li>100 000 days treatment (32 000 ambulatory) </li></ul></ul><ul><ul><li>42 000 medical consultations </li></ul></ul><ul><ul><li>6000 new patients each year </li></ul></ul><ul><ul><li>Fundamental and transfer research </li></ul></ul>Main activity relevant datas
  6. 6. <ul><ul><li>BUDGET : </li></ul></ul><ul><ul><ul><li>110 M€ operationnal budget in 2007 + 15 M€ equipments </li></ul></ul></ul><ul><ul><li>social perimeter : </li></ul></ul><ul><ul><ul><li>1100 direct staff, 1200 persons working on campus </li></ul></ul></ul><ul><ul><ul><li>More than 150 different jobs </li></ul></ul></ul><ul><ul><ul><li>Many subcontractors (bio-cleaning, meals, laboratories, waste treatment…) </li></ul></ul></ul><ul><ul><ul><li>High level of training and skills </li></ul></ul></ul><ul><ul><ul><li>Vocationnal training: more than 2000 sessions each year </li></ul></ul></ul><ul><ul><ul><li>70% are women in this sector </li></ul></ul></ul>Volumes
  7. 7. <ul><ul><li>220 nurses </li></ul></ul><ul><ul><li>160 doctors </li></ul></ul><ul><ul><li>90 nurse’s aides </li></ul></ul><ul><ul><li>60 secretaries </li></ul></ul><ul><ul><li>60 laboratories technicians </li></ul></ul><ul><ul><li>70 non medical managers </li></ul></ul><ul><ul><li>… </li></ul></ul><ul><ul><li>1 priest, 1 aesthetician, 1 hairdresser, 1 librarian… </li></ul></ul><ul><ul><li>60% of the hospital added value is due to workers ! </li></ul></ul>Hospital diversity
  8. 8. PROJECT
  9. 9. <ul><li>Reducing discriminations in hospitals, specialy due to age all over the career </li></ul><ul><li>Strategies and tools to maintain people and performance at work in Sanitary sector </li></ul>Project EQUAL 1 (2002-2005) Etic
  10. 10. <ul><li>New training methods description of new jobs or new missions in sanitary units. New professional profiles </li></ul><ul><li>Evolutions in the systems of recognition </li></ul><ul><li>improving transfers of knowledge </li></ul><ul><li>Management tools related with skill validation procedures (definition of professionnal path, skill descriptions…) </li></ul><ul><li>young workers's integration and tutoral methods </li></ul><ul><li>solutions to avoid discrimination of old workers </li></ul>Objectives of the project Etic
  11. 11. IS AN AGE POLICY NECESSARY IN HEALTH SECTOR ?
  12. 12. Why ? Hospital Demography <ul><li>The number of young people is decreasing. Health sector is not so attractive for women </li></ul><ul><li>France hasn’t enough doctors, nurses, aid-nurses to replace the people in retirement </li></ul><ul><li>The number of old people is increasing (ageing) </li></ul><ul><li>Older people (need to) work longer > the legal age of retirement in France is now 60 but this age is being delayed each year till probably 65 yo in the next decade </li></ul><ul><li>WE MUST ATTRACT AND KEEP ! </li></ul>
  13. 13. Ages pyramid IPC
  14. 14. Ages pyramid : aid nurses
  15. 15. in our dutch hospital partner <ul><li>age structure JBZ (IPC Hospital partner) </li></ul><ul><li>Age 1996 1997 1998 1999 2000 2001 2002 </li></ul><ul><li><20 1 1,1 0,8 1,4 1,3 1,9 1,6 </li></ul><ul><li>20 t/m 29 30,9 29,7 29 26,7 25,6 24 21,9 </li></ul><ul><li>30 t/m 39 34,2 34,6 34,1 34,2 32,5 32,1 31,4 </li></ul><ul><li>40 t/m 49 24,2 24,4 25,2 25,7 26,9 27,3 28,9 </li></ul><ul><li>> 50 9,7 10,2 10,9 12 13,7 14,7 16,2 </li></ul><ul><li>Total in per cent of the number at 31 december of the year. </li></ul>
  16. 16. <ul><li>Different reasons are moving toward the necessity of working on better employability in this sanitary sector : </li></ul><ul><li>growth of work technicity in the sanitary field </li></ul><ul><ul><li>new needs from patients </li></ul></ul><ul><ul><li>new technical, social or sanitary fields </li></ul></ul><ul><li>more work because of </li></ul><ul><ul><li>great increase of older patients with more complex clinical frame </li></ul></ul><ul><ul><li>highest technicity on treatments </li></ul></ul><ul><li>more penibility in sanitary jobs </li></ul><ul><ul><li>new hard responsabilities (in management, in the relationship with patients) </li></ul></ul><ul><ul><li>results count now more than means </li></ul></ul><ul><ul><li>the ambulatory systems (day hospital, home care…) has for result to concentrate hard treatments and depending patients in hospital </li></ul></ul><ul><ul><li>the financial difficulties of the systems increase the productivity and quality approaches </li></ul></ul>Why ?…new needs Etic
  17. 17. <ul><li>The R.O.I (return on invest) is now very long on some jobs : </li></ul><ul><li>>> the training path of nurses, doctors…needs more and more efforts (time, money, flexible organization…) </li></ul><ul><li>>> it ’s a great spead of energy to loose such efforts with too much staff departures </li></ul>And also… Etic
  18. 18. <ul><li>The productivity and performance must be maintained at least, or increased </li></ul><ul><li>The future is to maintain all the staff and specially the older </li></ul><ul><li>Good new… </li></ul>More work + less people Etic
  19. 19. They stay… <ul><li>A large part of our staff is staying longer in our hospital : </li></ul><ul><ul><li>50 % of the IPC’s staff say that they want to stay till retirement ! </li></ul></ul><ul><ul><li>And more in the second part of career </li></ul></ul>
  20. 21. But in which condition ? <ul><ul><li>Problems : </li></ul></ul><ul><ul><li>77% want to be maintained in the same unit </li></ul></ul><ul><ul><li>78 % want to stay in the same job </li></ul></ul>
  21. 22. Marketing Méditerranée Etude IPC PERSO 3 - Octobre 2006 Rapport de données brutes Marketing Méditerranée 06 158 Tous droits de reproduction réservés
  22. 23. Marketing Méditerranée Etude IPC PERSO 3 - Octobre 2006 Rapport de données brutes Marketing Méditerranée 06 158 Tous droits de reproduction réservés
  23. 24. Do you think mobility is useful… 
  24. 25. Objectivate differencies <ul><li>Our internal surveys show specific characters on two categories of workers : </li></ul><ul><ul><li>Less than 45 </li></ul></ul><ul><ul><li>More than 45 </li></ul></ul><ul><ul><li>Two examples </li></ul></ul>
  25. 26. results in illness absenteism (2004) ETIC X 2 (approx)
  26. 27. results in accidentology at work ETIC X 3
  27. 28.   PART TIME, CHOICE OR NECESSITY
  28. 29. <ul><li> build an age conscious policy </li></ul><ul><li> manage all ages with common basis tools </li></ul><ul><li> but consider specially (positive discrimination) two targets, stategic : </li></ul><ul><li>- young workers </li></ul><ul><li>- elder workers </li></ul>Transfers : 3 ideas  
  29. 30. BUILDING AGE CONSCIOUS POLICY
  30. 31. Age- conscious personnel management <ul><li>Is focused on differences between employees and how to deal with these differences </li></ul><ul><li>Differences in various fields </li></ul><ul><ul><li>careerphase </li></ul></ul><ul><ul><li>ambition </li></ul></ul><ul><ul><li>physical condition </li></ul></ul><ul><ul><li>relation work- private </li></ul></ul><ul><li>Not identical for everyone </li></ul><ul><li>So it’s ‘ custom made’ </li></ul>
  31. 32. Following statistics : “age conscious management” <ul><li>Monitoring datas of ageing in work : </li></ul><ul><li>Specify the tools over age and specially : </li></ul><ul><ul><li>Absenteism at job </li></ul></ul><ul><ul><li>Satisfaction survey </li></ul></ul><ul><ul><li>Health job accidents </li></ul></ul><ul><ul><li>Wishes specially time representation and welfare </li></ul></ul><ul><ul><li>at work </li></ul></ul>
  32. 33. <ul><li>Experiment the solutions wich have an positive impact on maintaining staff at work and developping their employability, whatever the age </li></ul><ul><ul><ul><li>avoid discrimination as far as it’s possible </li></ul></ul></ul><ul><ul><ul><li>Managent tools for lee than 50 can be good also for 50+ ! </li></ul></ul></ul><ul><li>Develop specific strategies at some key moments of the career (age related tools) </li></ul><ul><ul><li>Young workers </li></ul></ul><ul><ul><li>Workers in their second part of career </li></ul></ul>On this basis, two complementary approaches Etic
  33. 34. ALL AGE LONG MANAGEMENT
  34. 35. <ul><li>All over the carreer, the objectives are : </li></ul><ul><li>to maintain motivation and satisfaction at work </li></ul><ul><li>to recognize the increase of technicity </li></ul><ul><li>to prevent work damages </li></ul><ul><li>to improve the communication to employees </li></ul><ul><li>T o develop participation at work </li></ul><ul><li>>> the dutch hospital partner satisfaction survey (2004) shows that the group of employees with more satisfaction at job are those who have possibility to participate to regular work meetings and benefit of an individual face to face individuel session every year </li></ul>For all ages Etic
  35. 36. <ul><ul><li>Evaluation </li></ul></ul><ul><ul><li>New training methods (e-learning) </li></ul></ul><ul><ul><li>Satisfaction surveys </li></ul></ul><ul><ul><li>Instant shared internal communication (intranet…) </li></ul></ul>IPC built different tools Etic
  36. 37. <ul><li>>> operationnal since 1998 (non medical staff) and 2001 (medical staff) </li></ul><ul><li>for : </li></ul><ul><li>individual attempts (results objectives, personnal wishes…) </li></ul><ul><li>collective treatments (training, work improvments, careers, job changes…) </li></ul>About annual evaluation Etic
  37. 38. Identify but also reply to the attempts ! Etic
  38. 40. Special objectives <ul><li>Incitations to mobility </li></ul><ul><ul><li>Collect wishes </li></ul></ul><ul><ul><li>Postpone assessment sessions (to measure possible evolutions) </li></ul></ul><ul><li>Develop the contents of jobs </li></ul><ul><ul><li>New tasks, new skills, new training needs </li></ul></ul><ul><li>By recognizing individual performance (variable part of salary) </li></ul><ul><li>- wage bonus on acquisiting new skills </li></ul><ul><li>- wage bonus on successful mobilities </li></ul>
  39. 41. <ul><ul><li>Provisional and dynamic administration of Jobs and Skills </li></ul></ul><ul><ul><ul><li>Define jobs characteristics and associated skills </li></ul></ul></ul><ul><ul><ul><li>Anticipate and create new jobs </li></ul></ul></ul><ul><ul><ul><li>change organisations to multiply individual opportunities </li></ul></ul></ul><ul><ul><ul><li>Be attentive to changes and innovations in the workplace </li></ul></ul></ul><ul><ul><li>Secure the professional pathway </li></ul></ul><ul><ul><ul><li>Define the pathway (and the means to succeed </li></ul></ul></ul><ul><ul><ul><li>Maintain the professionnal challenge step by step </li></ul></ul></ul><ul><ul><ul><li>Regular assesment, on basis of experience </li></ul></ul></ul>For careers…necessary tools Etic
  40. 42. <ul><ul><li>More and more knowledge, sooner and sooner (prerequisit before working !) </li></ul></ul><ul><ul><ul><li>Quality </li></ul></ul></ul><ul><ul><ul><li>security </li></ul></ul></ul><ul><ul><li>Less time to train : training in hospitals must go toward </li></ul></ul><ul><ul><ul><li>Shorter sessions </li></ul></ul></ul><ul><ul><ul><li>Multiple sessions </li></ul></ul></ul><ul><ul><ul><li>Everytime training (night and day, home ?) </li></ul></ul></ul>New training methods related to new staff needs
  41. 43. <ul><ul><ul><li>Vocational training must be : </li></ul></ul></ul><ul><ul><ul><ul><li>More targeted </li></ul></ul></ul></ul><ul><ul><ul><ul><li>More massive </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Tracable (for individual or collective agreement) </li></ul></ul></ul></ul><ul><ul><ul><ul><li>More assesment methods </li></ul></ul></ul></ul><ul><ul><li>Reinforce classic training </li></ul></ul><ul><ul><li>To refresh knowledge </li></ul></ul><ul><ul><li>To prepare classic training sessions </li></ul></ul>Improve training’s ressources disponibility ETIC
  42. 44. Place of e-learning in hospital <ul><li>IPC create a portal dedicated to : trace training pathes, manage the inscriptions, deliver interactive contents… </li></ul><ul><li>Free access contents (interactive or pedagogic shared material ) </li></ul><ul><li>Training is possible from inside (dedicated room or everyone work place) or outside (internet) </li></ul>
  43. 45. Interactive contents <ul><li>First, implementation of classic e-learning </li></ul><ul><li>ressources (available in commercial market) </li></ul><ul><ul><li>Foreign language </li></ul></ul><ul><ul><li>Bureautic. </li></ul></ul><ul><ul><li>Hygiena and security </li></ul></ul><ul><li>Evaluation by our experts </li></ul><ul><li>Own development for specific and </li></ul><ul><li>non commercial tools </li></ul>
  44. 46. <ul><li>General Satisfaction survey </li></ul><ul><li>Each two years </li></ul><ul><li>Concern all the staff </li></ul><ul><li>Specific surveys </li></ul><ul><li>Various thems : evaluation (1999) environment (2001 and 2003), transports (2003), information system (2004), tobacco (2005)… </li></ul><ul><li>May only concern a part of staff </li></ul>opinion(s) survey(s) Etic
  45. 47. <ul><li>opinion poll among the workers </li></ul><ul><li>study of the staff mobility </li></ul><ul><li>analysis of the motivation factors </li></ul>to manage the expectations and the motivation through out the work life ETIC
  46. 48. Marketing Méditerranée Etude IPC PERSO 3 - Octobre 2006 Rapport de données brutes Marketing Méditerranée 06 158 Tous droits de reproduction réservés
  47. 49. Marketing Méditerranée Etude IPC PERSO 3 - Octobre 2006 Rapport de données brutes Marketing Méditerranée 06 158 Tous droits de reproduction réservés
  48. 50. Marketing Méditerranée Etude IPC PERSO 3 - Octobre 2006 Rapport de données brutes Marketing Méditerranée 06 158 Tous droits de reproduction réservés
  49. 51. Marketing Méditerranée Etude IPC PERSO 3 - Octobre 2006 Rapport de données brutes Marketing Méditerranée 06 158 Tous droits de reproduction réservés
  50. 52. Marketing Méditerranée Etude IPC PERSO 3 - Octobre 2006 Rapport de données brutes Marketing Méditerranée 06 158 Tous droits de reproduction réservés
  51. 53. Marketing Méditerranée Etude IPC PERSO 3 - Octobre 2006 Rapport de données brutes Marketing Méditerranée 06 158 Tous droits de reproduction réservés
  52. 54. <ul><li>transfer the knowledge (knowledge management) </li></ul><ul><ul><li>access to data and information on projects, processes, skills by internet </li></ul></ul><ul><ul><li>“  e-learning ” platform : storage and dissemination of knowledge through ICT </li></ul></ul><ul><li>Avoid age ghettos : </li></ul><ul><ul><li>the working groups are mixed </li></ul></ul><ul><ul><li>The cooperation between different generations of employees must be tracked and sustained </li></ul></ul>Sharing knowledge ETIC
  53. 55. YOUNG AGE TOOLS
  54. 56. <ul><li>In the beginning of the carreer, </li></ul><ul><li>the objectives are : </li></ul><ul><li>to accelerate the transition between studies and work </li></ul><ul><li>to create the best conditions of working and developping new skills </li></ul><ul><li>to reduce the working risks and dangerous situation due to unexperience </li></ul>A younger age policy Etic
  55. 57. <ul><li>Actions : </li></ul><ul><li>- giving specific informations for new workers </li></ul><ul><li>> training sessions dedicated to recent employees </li></ul><ul><li>> welcome meetings </li></ul><ul><li>> special information guide </li></ul><ul><li>building tutorial programs </li></ul><ul><li>Being attractive with new advantages </li></ul><ul><ul><li>accomodation </li></ul></ul><ul><ul><li>help to install and face logistics questions </li></ul></ul><ul><li>Attractive programs for foreign workers (spanish nurses in France, Eastern or south african countries doctors (Holland) </li></ul>Young worker’s specifics Etic
  56. 58. SPECIFIC APPROACHES IN THE LAST PART OF CAREER
  57. 59. <ul><li>1st action about working time organisation i : huge individual management of the working time during the ending years of the career </li></ul><ul><li>by reducing job duration : France (35 hours/week), Italie and holland (36 hours/week). 32hours possible for people>55 yo in holland </li></ul><ul><li>by saving time (in a special count) to anticipate </li></ul><ul><li>retirement. (France, Holland) </li></ul><ul><li>by changing money into time </li></ul><ul><li>part time jobs </li></ul><ul><li>by adapting plannings closer to workers wishes </li></ul><ul><li>> less days on work (4 working days in JBZ for workers > 55 years old) </li></ul><ul><li>> annual or pluriannual regulation flexible plannings </li></ul><ul><li>> part-time plannings </li></ul>End of career Etic
  58. 60. <ul><li>2nd action : developping work healthy conditions </li></ul><ul><li>By reserving some jobs with low penibility to unhealthy workers </li></ul><ul><ul><li>preventive requalifications </li></ul></ul><ul><ul><li>difficult in an intensive short stay hospital very few jobs are « cool » </li></ul></ul><ul><ul><li>Defining priorities </li></ul></ul><ul><li>for example, assistant of nurses (in french : aide-soignants) is a group very damaged by « dorso-lumbagos ». If they can change of job early, they will have more chance to avoid those problems. </li></ul><ul><li>By promoting an huge and active policy of reducing working risks : consolidation of individual evaluation results </li></ul><ul><li>Care : antigrippal, antitobacco actions… </li></ul>End of career Etic
  59. 61. <ul><li>3rd action : anticipate and prepare the second part of career (act before the « fatal » age !) </li></ul><ul><li>Action : realize general assesment at some key moments of the carreer to re-orientate carreer and prepare the second and last part of professionnal life and sustain motivation in this difficult period. </li></ul><ul><li>IPC main action : all employes more than 45 y.o. get an assesment and a personnal development program : the PIC (Projet Individualisé de Carrière / Personal career project) </li></ul><ul><li>Objective : communicate clearly on end of carreer strategy and profile it (with a new contract or new deal wroten with the agreement of the worker) </li></ul>End of career Etic
  60. 62. PIC Bilan patrimonial Bilan professionnel Bilan médical 2 à 3 RV à une quinzaine de jours d ’intervalle Une dizaine de rendez-vous Madame Lainé Liliane Xicluna et Elisabeth Bacholle Docteur Boufercha ou médecin au choix Ce bilan patrimonial est le bilan d ’entrée dans le dispositif et il permet d ’engager la réflexion sur la suite de la carrière Ce bilan médical est optionnel et au choix de la personne visité spontanée
  61. 63. <ul><li>PIC is part or attitude consisting to sustain the lately mobility of the old workers and secure it </li></ul><ul><ul><li>Warranty to back to initial job if failure </li></ul></ul><ul><ul><li>no wage reduction on horizontal (or less than) mobilities </li></ul></ul>End of career Etic
  62. 64. <ul><li>4th action : a positive management for elder employees </li></ul><ul><li>changing the traditional figures </li></ul><ul><li>By maintaining as long as possible the same efforts in the management : </li></ul><ul><li>- training </li></ul><ul><li>- evaluation and objectives </li></ul><ul><li>- individual part of wages </li></ul><ul><li>We regulary control the evaluative action of </li></ul><ul><li>managers, to not create discrimination </li></ul><ul><li>By giving older employees special responsabilities </li></ul><ul><li>tutoring, transmission of knowledge, expert, teacher or training conceptor </li></ul><ul><li>(older workers must have a rule of conception and activive participation in training sessions) </li></ul>End of career Etic
  63. 65. Conditions for employee <ul><li>Flexibility </li></ul><ul><li>Willing to change </li></ul><ul><li>Change of attitude </li></ul><ul><li>Maintain training </li></ul><ul><li>Respect the “new deal” </li></ul>
  64. 66. Results <ul><li>Permanent motivated personnel </li></ul><ul><li>Higher quality of care (98% of satisfaction for patiens) </li></ul><ul><li>Higher quality of work (hospital certified in 2005) </li></ul><ul><li>Lower absenteism because of illness, specially for elder workers </li></ul><ul><li>Less turnover and early resignations </li></ul><ul><li>Saving costs </li></ul>
  65. 67. Satisfaction of elder workers
  66. 68. SILENCE…BUT NOT ON THE AGE !

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