City Hospital is located in the heart of a large midwestern city. It is one of major hospitals in the area and has recenfly built a small addition for treafing well—known patients, such as professional football players, top company execufives, and singing stars. Visiting or local celebrities always choose City Hospital if they need treatment. City Hospital has about 1,200 hospital beds and employs 4,500 individuals, including about 40 patient escorts. The job of patient escort is a rather simple one, requiring only minimal training and no special physical talents.
When patients need to be moved from one location to another, patient escorts are summoned to assist in the move. If the move is only a short distance, however, a nurse or orderlycan move the patient. Of particular importance is the fact that patient escorts almost always take patients who are being discharged from their hospital room to the front door of the hospital. A wheelchair is always used, even if the patient is able to walk unassisted. Thus, the typical procedure is for the nurse to call for a patient escort.
The escort then gets a Wheelchair and goes to the patient’s room, assists the patient into the wheelchair, picks up the pauent’s belongings, wheels the patient down to the hospital’s front door or to his or her car in the parking lot, and retnrns to the work station. The job of patient escort is critical to the hospital since the escort is always the last hospital representative the patient sees, and hence has a considerable influence on the patient’s final perception of the hospital. Of approximately 40 escorts, about three—fourths are men and one—fourth are women.
Most are high school graduates in their early twenties. Some, particularly those on the early morning shift, are attending college at night and working for the hospital to earn money to pay college expenses. Pour of the escorts are older women who had previously served as hospital volunteers and then decided to become full—time employees instead. Turnover among patient escorts is quite high and has averaged 25 percent in recent years. In addition, upward mobih’ty in the hospital is quite good, and as a result, another 25 percent of the escorts transfer to other jobs in the hospital each year.
Thus, about half of the patient escorts need to be replaced The hospital a standard procedure When hiring patient escorts. When a vacancy occurs, the human resource department reviews the file of applications of individuals who have appfied for the patient escort job. Usually the file contains at least 20 applications because the pay for the job is good, the work is undemanding, and few ski]ls are required. The top two or three applicants are asked to come to the hospital for interviews. Typicafly, the apph’can’ts are interviewed by the human resource department and then by the patient escort superviser.
The majority of those interviewed know some other employees of the hospital, so the only reference check is a call to these employees. Before being hired, apphcants are required to take physical exams given by hospital doctors. Every new escor’t attends an orientation program the day on the job. This is conducted by a member of the hospital’s human resource department. The program consists of a complete tour of the hospital; a review of all the hospital’s HR policies, including a description of its promotion, compensation, and disciplinary policies; and a presentation of the hospital’s mission and phflosophy.
During this orientation session, employees are told that the hospital’s image in the community is of major importance and that all employees should strive to maintain and enhance this image through their conduct. After orientation, all patient escorts receive on-the-job training by their immediate superviser. During the last two years, the hospital has experienced a number of problems with patient escorts, which have had an adverse effect on the hospital’s image. Several patients have complained to the hospital administration that they were treated rudely, or in some cases roughly, by one or more patient escorts.
Some complained that they were ordered around or scolded by an escort during the discharge process. Others stated that their escorts were careless when wheehng them out of the hospital to their cars. One person reported that an escort carelessly tipped him over. AH escorts are required to wear identification tags, but patients usually cannot remember the escort’s name when lodging a complaint to the hospital. Additionafly, the hospital has difficulty determining which escort served which patient because escorts often trade patients. even when the hospital can identify the offending escort, the employee can easily deny any wrongdoing.
He or she counters that patients are generally irritable as a result of their illness and, hence, are proue to complain at even the slightest provocation. At the hospital admhfistrator’s request, the human resource manager asked the chief supervisor patient escorts, the head of the staffing section within the human resource depaflment, and the assistant human resource director to meet with her to review the entire procedure used to select patient escorts. It was hoped that a new procedure could be devised that would efiminate the hiring of rude, insulting, or careless patient escorts.
During the meeting, a number of suggestions were made as to how the selection procedure might be improved. Criticisms of the present system were also voiced. The chief superviser of patient escorts argued that the problem with the hospital’s present system is that the application form is void of any useful information. He stated that the questions that really give insights into the employee’s personality are no longer on the application form. He suggested that applicants be asked about their hobbies, outside activiues, and their personal likes and dislikes on the application form.
He also suggested that each applicant be asked to submit three letters of recommendation from people who know the applicant well. He wanted these letters t0 focus on the prospective employee’s personality, particularly the applicant’s to remain friendly and polite at all times. The assistant human resource director contended that the hospital’s interviewing proce— dure should be modified. He observed that, during the typical interview, little attempt is made to determine how the apphcant reacts under stress.
He suggested that if applicants were asked four or stress-producing questions, the hospital might be in a better position to judge their ability to work with irritable patients. The head of the staffing section noted that patient escorts require little mental or physical talent and agreed that the crucial attributeescorts need is the ability to always be courteous and polite. He wondered whether an attitude test could be developed that would measure the apphcant’s predisposition toward being friendly, helpful, sensitive, and so on.
He suggested that a job analysis could be donc on the patient escort position to determine those attitudes that are critical to being a successful patient escort. When the job analysis was complote, questions could be developed that would measure these critical attributes. The test questions could be given to the hospital’s present patient escorts to determine whether the test accurately distinguishes the best escorts from the worst.
The head of the staffing section reahzed that many of the questions might need to be eliminated or changed, and if the test appeared to show promise, it would probably need to be revaudated in order to meet govemment requirements. He felt, however, that a Wefl—designed test might be worth the effort and should at least be considered.
The meeting ended with all four participants agreeing that the suggestion of trying to develop an attitude test was probably the most promising. The assistant human resource director and chief superviser of patient escorts stated that they would conduct a thorough job analysis covering the patient escort position and develop a list of attitudes that are critical to its success.
A second meeting would then be scheduled to prepare the actual test questions.
- Critique each of the alternative approaches suggested for solving the problem of selecting patient escorts at City Hospital.
- Recommend a procedure for recruiting and hiring patient escorts.
- Besides improving its selection procedures, What other actions could the hospital potentially take to improve the behavior of the patient escorts?