Concerns about health benefits and staffing levels contributed to a decline in employee satisfaction at Carolinas HealthCare System this year compared to other U.S. hospitals, according to a survey conducted for the Charlotte-based hospital system.
In an Oct. 6 email, Michael Tarwater, CEO of Carolinas HealthCare, informed employees of the “approximately 20 percentile point drop from 2014.”
“In your survey responses, you have expressed concerns with our benefit changes, staffing, and your work environment,” he wrote. “While we are disappointed in our percentile change, we appreciate that you have been open and honest about your experience at CHS.…In coming months, we will analyze the data so we can create and implement a strategy to celebrate areas of excellence and improve on areas of concern.”
Based on employee responses, Carolinas HealthCare ranked in the 76th percentile – as well or better than 76 percent of other U.S. hospitals using the same survey, according to Tarwater’s email, which was obtained by the Observer.
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That was a drop from recent years. In 2012, the system ranked in the 99th percentile. In 2013 and 2014, it was in the 95th percentile.
In a recent interview, Tarwater said he initiated the employee engagement survey after taking over as CEO in 2002, and his goal has always been to be in the top 25 percent of organizations surveyed. Hospital officials said the survey measures whether employees are “contributing at the highest level – inspired, enthusiastic and motivated about their work.”
Tarwater said there’s no single cause for the drop in employee engagement this year. “It is a number of things,” he said, including overall change in the U.S. health care system, in part because of the Affordable Care Act.
“Our organization has chosen to be a leader in transforming the way we do health care,” Tarwater said. “.…There are a lot of unknowns that can have an impact on the way people view where they are in their careers.…I know that this is a challenging time.”
Tarwater cites Forbes, Fortune
In the early years of the employee engagement survey, Tarwater said Carolinas HealthCare “bounced around” in the 70th and 80th percentiles compared with other hospitals. Then from 2012 to 2014, the system stayed in the “top decile,” or the upper 10 percent.
“Would I like to be in the top decile every year? Sure. But that’s an aggressive goal for an organization of our scale and complexity,” Tarwater told the Observer. “Our employees are obviously our most important asset. We do these surveys to help learn what we can do to make their lives at work, and really at home too, better.”
Initially, the survey was performed for Carolinas HealthCare by Charlotte-based Morehead Associates. In 2013, the Morehead group was purchased by Press Ganey Associates, a South Bend, Ind., firm that conducts employee and physician surveys across the country to assist leaders with decision making and retention of talented employees.
Hospital systems surveyed by Press Ganey make improvements based on what they learn from employees and other systems, Tarwater said. “The benchmark moves. That can be pretty tough to keep up with year after year.”
Tarwater said he’s still proud of this year’s score and pleased that more than 80 percent of employees chose to participate in the survey. “This is outstanding performance,” he said. “It’s not like we’ve fallen off the ledge.”
In 2015, Carolinas HealthCare has been named to other national rankings that reflect employee satisfaction. It ranked 89th on the Forbes magazine list of America’s Best Employers, higher than Johns Hopkins University at 90th and UNC-Chapel Hill at 95th. The Charlotte system also ranked 14th in Fortune magazine’s list of the Top 20 places to work in health care.
“I think we’re doing a lot of things right,” Tarwater told the Observer.
Staffing, health benefits cited
Specific employee responses to the survey have not been made public, but staffing problems were among the concerns Tarwater cited in his email to employees.
“Starting last year and coming right on through this year, more people were choosing us (for health care), so we were busy, and there was a lot of work to do and a lot of patients to take care of,” he told the Observer.
In your survey responses, you have expressed concerns with our benefit changes, staffing and your work environment.…While we are disappointed in our percentile change, we appreciate that you have been open and honest about your experience at CHS.
Carolinas HealthCare System CEO Michael Tarwater
Staffing problems at Carolinas HealthCare System NorthEast in Concord came to light last summer when the Observer obtained an electronic newsletter written by the hospital president, Phyllis Wingate. She wrote that the hospital “simply didn’t have the staff to fill the need” as it experienced an unusually long period of high patient volume in the first half of 2015.
Although Wingate told the Observer she meant to thank employees for their hard work, her newsletter appeared to blame an increase in patient complaints on the “attitude and commitment” of employees. In response, an “Open Letter to the CHS Administration,” sent by anonymous employees, blamed “poor leadership” and “under-staffing” at the bedside for poor patient satisfaction.
Tarwater said employees have also expressed concerns about the system’s health insurance plan for 2016. Next year, the 30,000-plus employees in the Charlotte region will have only one option – a high-deductible plan. According to health benefits documents distributed to employees, the deductible for a single employee using in-network providers is $1,850. For families, the deductible is $3,700.
For 2015, about 25 percent of employees chose the high-deductible plan; the rest took traditional plans with higher premiums but lower out-of-pocket costs.
To help employees save money to cover out-of-pocket costs, Carolinas HealthCare will contribute $350 to $1,100 to health savings accounts for individual employees, depending on certain “wellness criteria.” For employees with family plans, the system will contribute $1,100 to $1,850.
Tarwater said it will take time for hospital officials to analyze details of the employee engagement survey. “We’re going to continue to listen to our employees,” he told the Observer. “We want to hear from them directly.”