Personnel Policies & Programs - Patient Care Services

Force 4
Personnel Policies & Programs
Salaries and benefits are characterized as
competitive. Rotating shifts are minimized, and
creative and flexible staffing models are used.
Personnel policies are created with staff
involvement, and significant administrative and
clinical promotional opportunities exist.

EXECUTIVE SUMMARY FORCE 4: PERSONNEL POLICIES AND PROGRAMS
Salaries and benefits are characterized as competitive. Rotating shifts are minimized, and
creative and flexible staffing models are used. Personnel policies are created with staff
involvement, and significant administrative and clinical promotional opportunities exist.
Massachusetts General Hospital has a long history of supporting and recognizing employees
as evidenced in its policies and practices that support employee education, training, and professional
development; in rewards that recognize exceptional employee performance, special
accomplishments, and length of service; and in competitive wage and salary programs. For the
second consecutive year, MGH has been recognized by the American Association for Retired
Persons (AARP) as a “Best Employer” and Working Mother Magazine as one of the top 100
companies for working women.
MGH and PCS leaders appreciate the challenges and significant impact of shortages in
nursing and other clinical role groups, and believe that being positioned as the “Employer of
Choice” in the Boston health care community is essential. This inevitably involves multiple
strategies aimed at both recruitment of new staff and retention of current employees which are
detailed throughout this Force. For Patient Care Services (PCS) employees this includes competitive
wage programs, supportive work environments, recognition and rewards programs, and a dedicated
PCS Human Resource team. The Department of Nursing, Human Resources and Compensation
and the Budget Office work collaboratively on many areas but particularly around issues related to
wage and salary and employee compensation, evaluating salary ranges for all PCS clinical and
support roles.
The Hospital’s marketing campaign and general recruitment efforts have a high level of
direct care staff involvement. With the support of Human Resources, Nursing Directors have the
authority and accountability for staff selection and retention. This unit level accountability for hiring
into approved positions has been extremely effective. Typically, the Department of Nursing begins
the fiscal year with a Staff Nurse vacancy rate of about 5%, primarily a result of newly-approved
positions. As the year progresses that vacancy rate generally falls to about 1%. Retention rates are
impressive as well with the overall rate of direct care Staff Nurse turnover at 4.6% for FY06.
The organization’s success reflects its culture of valuing and appreciating employees;
organizational policies that consider a balance of patient and staff needs; a well defined competency
program for all direct care staff; and a strong commitment to, and utilization of, a patient
classification system to assure adequate staffing levels based on patient, staff and unit variables.

MGH has a number of policies that address employee rights and promote a safe and healthy
work environment. These include Human Resource policies on violence in the workplace,
harassment, sexual harassment and substance abuse; Administrative policies on firearms and
weapons; and Privacy and Security policies defining violations of privacy and security and
procedures for reporting. Massachusetts General Hospital (MGH) is also committed to creating an
environment of mutual respect and understanding. It is defined in the Hospital’s Diversity Plan and
personnel policies. This information is disseminated in orientation, via E-mail and is readily
available on-line.
Staff Nurses strive to provide excellent care to patients and maintain control over their
practice. An essential enabling element is adequate, flexible staffing with an effective RN mix. The
QuadraMed WinPFS Productivity and Benchmarking system has been used at MGH for over 20
years and is considered a credible tool for predicting and justifying direct care resources to both
nursing staff and those outside nursing; such as, administrators and financial officers. A targeted
workload is established for each patient care with inherent flexibility. Examples provided in this
Force demonstrate staffing decisions and patient care assignments are based on patient needs –
current volume, anticipated turnover, projected admissions, patient acuity and nursing care
requirements – and staff requirements – skill level, experience, work schedules, availability,
minimum staffing requirements and reasonableness. Additional staffing resources are described as
well.
For Staff Nurses, the primary issue in work-life balance is the ability to maintain some level
of control over their work schedules. Although there is no “standard” staffing pattern across the
units, there are guidelines appropriate for the patient population on each unit. Within those
parameters, Staff Nurses have maximum flexibility in creating schedules that promote work-life
balance. The Professional Exempt status of the nursing staff provides a level of flexibility that allows
for consideration of staff needs and preferences while still providing for appropriate resources to
meet patients’ needs for nursing care.
Performance evaluation is an integral part of the life of the organization. In addition to the
ongoing dialogue that occurs on a day-to-day basis between employee and manager and among
peers and colleagues, formal, written performance appraisal is required for every employee annually.
Nursing’s performance appraisal process is strongly influenced by the vision, values and strategic
direction of the department; the focus on patient- and family-centered care; the commitment to
clinical excellence and the narrative culture that define nursing at MGH. Annual performance

appraisals are a time to reflect on the previous year and establish goals that support the strategic plan
of both the organization and department. In addition, 360 o evaluation has been implemented for
both the Nursing Directors and the Clinical Nurse Specialists as a means of assessing current
knowledge and skills to create a meaningful leadership development program.
As articulated in the hospital’s mission statement, MGH is committed to educating leaders in
the health care profession. Supporting career development for employees enables the organization
to attract and retain a highly skilled and diverse workforce, as it strives to meet its goal of providing
the highest quality of care to patients. The Clinical Recognition Program reflects the narrative
culture embedded in practice at MGH. The first-of-its-kind interdisciplinary advancement model,
the Clinical Recognition Program celebrates acquisition of clinical expertise over time. It was
designed to recognize and reward clinicians who choose to grow their practice at the bedside.

TABLE OF CONTENTS
Volume 3
Force 4: Personnel Polices & Programs
Sources of Evidence
4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
4.9
4.10
4.11
4.12
4.13
4.14
4.15
4.16
4.17
4.18
Pages 1-21
Pages 22-38
Pages 39-66
Pages 67-76
Pages 77-119
Pages 120-129
Pages 130-139
Pages 140-143
Pages 144-147
Pages 148-155
Pages 156-165
Pages 166-174
Pages 175-182
Pages 183-202
Pages 203-210
Pages 211-216
Pages 217-227
Pages 228-240