Risk management issue: Curbing Excessive Absenteeism
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Hello my name is Tosin Ola and this presentation will highlight the risk management issue of excessive absenteeism, focus on the methods to curtail absenteeism, steps already in place, the points system, and healthy living programs. Absenteeism is the term generally used to refer to unscheduled employee absences from the workplace (U.S. Legal, 2008., p. 1). According to the U.S. Department of Labor, companies lose approximately 2.8 million workdays a year because of employee injuries and illnesses (Gale, 2003, p. 40). Of all the expenses related to absence, unscheduled time off has the biggest impact on productivity, profitability and morale (Gale, p. 40). The inability to plan for such absences forces hospitals to hire last-minute temporary staff (travelers and per diem nurses) at higher rates, pay more overtime to permanent staff, or add a staffing margin to replace anticipated lost labor by utilizing in-house per diem employees (L. Meyer, personal communication, December 8, 2009). All these tactics negatively affect the bottom line of the hospital in every fiscal period.
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Risk management issue: Curbing Excessive Absenteeism
- 1. By: Tosin Ola, RN, BSN
- 2. Rolling 180 day cycle Incentive attendance Earned holiday for perfect attendance Reimbursed banked sick time payout Probationary period Doctor’s note Lenient policy Flexible scheduling options Self scheduling
- 3. Scheduled paid time off 2 personal days and 10 Disciplinary action vacation days 1st warning: Written Must be pre-approved by warning by manager manager 2nd warning: Written warning by HR Unscheduled paid time Disciplinary review board off which may lead to 8 sick days termination 3 occurrences in a rolling 180 day cycle Call-in no later than 2 hours before shift start
- 4. Educational classes Diet and nutrition Stop smoking Importance of exercise Exercise In-house gym Low membership rate with 24 Hour Fitness gym Weekly Farmers Market Employee health clinic Community events 5 K run Cycle-thon
- 5. All employees start at 24 points Staff can gain points with Staff loses points based the following on the following rules: Picking up a last minute If you call in more than 2 shift hours before the start of Picking up a weekend shift your shift Working full time with no If you call in less than 2 call ins in 1 month hours before the start of Receiving a Superstar your shift award or written If you are tardy compliment from a patient If you leave before the end of your shift If you are a no call/no show
- 6. Track and enforce policy Encourage personal responsibility and accountability Managers should know the understand the scheduling needs of staff The Points system has shown decreasing absenteeism rates
- 7. Davey, M., Cummings, G., Newburn-Cook, C., & Lo, E. (2009). Predictors of nurse absenteeism in hospitals: a systematic review. Journal Of Nursing Management, 17(3), 312-330. Retrieved from MEDLINE with Full Text database. Gale, S. F. (2003). Sickened by the cost of absenteeism, companies look for solutions. Workforce, 3, 40-43. Getty Images (2009). Keywords “Absent”, “Patient care,” and “Nurse”. Retrieved December 11, 2009 from http://gettyimages.com/ Hackett, R., Bycio, P., & Guion, R. (1989). ABSENTEEISM AMONG HOSPITAL NURSES: AN IDIOGRAPHIC-LONGITUDINAL ANALYSIS. Academy of Management Journal, 32(2), 424-453. Retrieved from Business Source Complete database. Taunton, R., Hope, K., Woods, C., & Bott, M. (1995). Predictors of Absenteeism Among Hospital Staff Nurses. Nursing Economic$, 13(4), 217-229. Retrieved from Academic Search Complete database. U.S. Legal (2008) Absenteeism. Retrieved December 10, 2009, from http://definitions.uslegal.com/a/absenteeism/
Editor's Notes
- Hello my name is Tosin Ola and this presentation will highlight the risk management issue of excessive absenteeism, focus on the methods to curtail absenteeism, steps already in place, the points system, and healthy living programs. Absenteeism is the term generally used to refer to unscheduled employee absences from the workplace (U.S. Legal, 2008., p. 1). According to the U.S. Department of Labor, companies lose approximately 2.8 million workdays a year because of employee injuries and illnesses (Gale, 2003, p. 40). Of all the expenses related to absence, unscheduled time off has the biggest impact on productivity, profitability and morale (Gale, p. 40). The inability to plan for such absences forces hospitals to hire last-minute temporary staff (travelers and per diem nurses) at higher rates, pay more overtime to permanent staff, or add a staffing margin to replace anticipated lost labor by utilizing in-house per diem employees (L. Meyer, personal communication, December 8, 2009). All these tactics negatively affect the bottom line of the hospital in every fiscal period.
- There are several methods that facilities across the country have used in an effort to stop excessive absenteeism. Listed below is a summary of a few of the methodsRolling 180 day cycle: This style is used by several facilities, where sick calls are annotated on a rolling 6 month period. The HR department looks at the number of absences for any employee during that time, and they are disciplined accordingly (Davey, Cummings, Newburn-Cook, & Lo,2009, p. 320). Incentive attendance: Earned holiday for perfect attendance for 6 months or >480 hours of unused sick pay could be reimbursed up to half the banked amount to the nurses’ check (Hackett, Bycio, & Guion, 1989, p. 431). Other incentives are to give prizes, rewards, plaques, bonuses and gift cards for employees with perfect attendance.No sick pay for first day of absence period for new employees (Davey, et. al, 2009, p. 322). Since most new employees are on a probationary period, several facilities use this time to gauge the nurses’ productivity. Hospitals can terminate employment during the probationary period for any staff that show signs of excessive absenteeism (L. Meyer, 2009).Progressive disciplinary action policy at manager’s discretion (Hackett, et. al, 1989, p. 438). Managers and the HR department can review the records of the employee and discipline absenteeism according to previously disclosed policies. Physician’s certification required for approval of sick pay at manager’s discretion (Taunton,Hope, Woods, &Bott,1995, p. 228).Lenient policy on requested scheduled days off (Davey, et al, 2009, p. 327). Some flexibility is required with the schedule to accommodate the personal needs of the staff. The manager can approve days off provided that there are alternate arrangements made i.e. switch with another employee, using the float pool etc. Some hospitals use self scheduling to allow the nurses to pick days and schedules that work for them. This has been shown to reduce burnout and stress since the nurses can choose work days that fit their lifestyle. However, this system has been shown to increase role stress for the management or whoever is creating the schedule and may cause cliques and team disunity due to favoritism (Taunton, et al, 1995).
- The hospital permits each full-time employee paid time off accrued annually based on the number of hours worked:8 sick days2 personal days10 vacation daysPersonal days do not accrue, however, sick days and vacation days can be carried over to the next fiscal years. New employees are on probation for 90 days and although their time does accrue, it cannot be applied until after the probationary period. Personal and vacation days must be pre-approved by the manager and count as scheduled absences. The hospital also permits 3 unscheduled sick occurrences every 180 days. Each sick call counts as one occurrence, however if the calls are consecutive, this counts as one occurrence. The sick calls use a rolling 180-day cycle, which means the sick calls are counted from a 6 month block of the most current call. The nurse must call in 2 hours before a scheduled shift, otherwise, it will be deemed as a No-Call/No-Show which automatically is grounds for disciplinary action. The first step of disciplinary action is a signed written warning from the manager. The second step is a written warning from the HR department. The third step is the Disciplinary Review Board which consists of the HR manager, nursing supervisor, CNO, union steward and unit manager. The DRB can terminate employment at this point.
- To promote health and wellness, the hospital initiated the Healthy Living program. Educational classes are available at the hospital for staff that instructs the employees on healthy lifestyle choices and support is available for those trying to quit smoking. The hospital also has an on-site gym and staff has access to very low rates of membership with 24 Hour Fitness. Every Friday from 10am-4pm, the hospital organizes a farmer’s market where local farmers bring fresh produce to the hospital for sale to patients and staff. In addition to this, the hospital sponsors several charitable activities like the 5 K Run and annual Cycle-thon to encourage an active lifestyle. Annual TB testing, vaccination shots and screenings are available to all staff at the Health clinic.
- All employees start out at 24 points. If you call-in more than 2 hours before the start of your shift, the following points will be deducted:Weekday~ 3 pointsSaturday & Sunday ~ 5 pointsHoliday ~ 7 pointsSaturday and Sunday of the same weekend or a double shift~ 15 pointsIf you call in less than 2 hours before the start of your shift, the following points will be deducted:Anyday~10 pointsIf you leave before the end of your shift, the following points will be deducted:Please note: if less than 2 hours are worked, it will be considered an absence and will be subject to points coinciding with the day of the week missed.Weekday ~ 2 pointsWeekend ~ 3 pointsIf you are tardy for your shift, the following points will be deducted:Less than 10 minutes ~ 1 pointMore than 10 minutes ~ 2 pointsIf you are a No Call/No Show, the following points will be deducted:Anyday 10 pointsDisciplinary action in relation to point status:Lose 6 points (18 points left) ~ Verbal warningLose 12 points (12 points left)~Written warningLose 18 points (6 points left)~ Final written warningLose 24 points (0 points left) ~ TerminationYou are able to regain any points that are lost by: (24 points max/no banking points)Picking up a last minute shift ~ 2 pointsPicking up a last minute weekend shift ~ 4 pointsWorking 8-20 hrs/week with No Call-Ins during a month ~ 2 pointsWorking 21 + hrs/week with No Call-Ins during a month ~ 4 pointsReceiving a Superstar Award or a compliment from a patient~ 5 points*Points will be given at the discretion of the unit manager and will not excuse excessive call-ins.(Policy from HR department interview)
- It is useless to have an absenteeism policy if it is not tracked and enforced (L. Meyer, 2009). Healthy living programs can improve the health of employees, but each employee needs to show accountability and responsibility to make sure that when they are scheduled they show up to work. Nurses tend to value their jobs, and offenders usually show improvement in their attendance by the time they reach the 2nd level of action (letter from HR department). Hospitals and medical facilities need workers to ensure the flow of patient care, so it is crucial that nurses and staff understand the importance and the impact that their absence will cause. Ever since the hospital enforced the Points system, sick calls have gone down by 35%, and Meyer suspects that this rate will continue to dramatically decrease.