Alexandra Hospital: Going places

When we think about organisations facing constant changes, industries like construction, technology and, in recent times, finance, are the first to come’ to mind. Although best medical practices and pharmaceuticals are always evolving, the employee policies of most hospitals are usually set in stone.

While this may work for others, it is not the way HR at Alexandra Hospital runs the show. MK Fatimah, Deputy Director, HR, Alexandra Hospital, says HR’s approach to change is not only aligned with its drive for continuous improvement; it is also an important by-product of the hospital’s developmental history.

Established initially as a British military institution, the hospital thrived in the 70s before seeing a decline over the next decade. By the 1990s, Alexandra was considered a “one-star” hospital. Neither staff nor patients received full attention, feedback or space. The public image suffered as a result.

“It was seen as a hospital for the old and poor, a cheap option,” Fatimah said, noting that only 39% of patients would recommend the hospital to others.

In 2000, management was transferred from the Ministry of Health to the National Healthcare Group. Fatimah says this change meant the hospital could provide greater, more flexible, and more responsive services. It paved the way for a complete restructure of the organisation. “A continuous drive towards improvement has been part of us since we started,” she says.

As of April 2008,  a new healthcare cluster, Alexandra Health, was formed with both Alexandra Hospital and Jurong Medical Centre.

Recognising that change had to start from within the organisation, HR established goals which remain relevant to employees today. These long-term principles demand proactive thinking and expect every individual to add value to their team. Customer service standards are high, with the mindset of always putting patients’ interests first.

Fatimah says the training and development team adopted a motto: for staff to “out-innovate, out-run and out-perform all corners”.

Fatimah works very closely with management to ensure that employment practices remain consistently aligned with organisational goals. She attributes this approach to a basic tenet of the healthcare profession – being a team player. Medical care requires a multidisciplinary effort: doctors, nurses, lab technicians and pharmacists must work together to treat patients.

Therefore, hiring is stringent, with interviews carried out by both HR and the hospital leaders. “Management is very involved,” says Fatimah. “At orientation for new staff, everyone in senior management is there to explain what the organisation stands for.” By showing staff that senior managers are available to them, HR develops an image and brand that Alexandra Hospital is an organisation where people go out of their way to make things happen.

Benchmarks for success

“Employee expectations” can be a generalised phrase; seemingly borrowed from any company’s HR manual. But these guidelines now take on real meaning at Alexandra Hospital, relating directly to patient welfare. Defining what a patient wants – dignity, confidentiality, accessible and quality services, and cost-effective treatments – allows employees to place their contributions in perspective, Fatimah says.

However, this isn’t to say Alexandra Hospital isolates its standards from other organisations. In fact, HR uses the best practices of several successful multinationals as points of reference for its own drive towards improvement.

Organisations such as the Ritz-Carlton Millenia and Raffles Hotel are benchmarked for their high quality service. Toyota is used as an example of operations excellence because it creates value for customers at the lowest possible cost. Not forgetting its key service, the hospital also tries to emulate the Minnesota-based Mayo Clinic’s exemplary clinical practices.

With this amalgamation of practices from different organisations, does the employee culture at Alexandra Hospital risk losing its own identity? Not if HR takes ownership over its training and recruiting methods, Fatimah says. While HR emulates practices of various companies, it has created a very personal motto which resonates for its own employees.

“We tell them to provide a level of care which is good enough for their own mothers without the need to make special arrangements,” Fatimah says. It may not sound refined, but empathy – often sideswiped by practicalities in the medical sector – makes a lasting impression. Understanding the anxieties of making hospital arrangements for loved ones, employees can identify with patients and provide top-notch service as a result.

HR’s motivation is rooted in principles of mutual expectations and standards. “We expect staff to provide high quality care and training so they can help the orgaisation deliver care and service to our patients,” says Fatimah. To boost performance, HR has to give the same level of support to staff.

However, HR also recognises there is still room for improvement. Fatimah says staff are currently working on providing faster turnaround times for emergency room patients. The target is to have patients enter and leave within only one hour, having seen a doctor and purchased their medications. So far, 70% of patients enjoy this faster service but this is not enough for an HR department dedicated to equality in the patient experience. Fatimah wants every single patient to be served with speed, efficiency and concern for their immediate needs.

Health ambassadors

As change dominates the hospital’s business vision, how does Fatimah characterise the employee identity and culture? First and foremost, she says staff see themselves as “health ambassadors”. HR helped to establish this identity early on by advising  staff to actively take care of their own health. Employees aged over 40 are put through health assessments and given talks on the advantages of exercise and a nutritious diet, for example.

The message HR wants to put across is that health should not simply be part of their careers – it should be integral to their lifestyles outside the hospital as well. There is also a strategic advantage here, Fatimah says. If staff practice a healthy lifestyle, they are more likely to preach it. HR hopes that staff on all levels can pass on healthy living messages to patients in everyday language, delivering a very personal and beneficial service to patients.

Strengthening bonds through informal interaction is a trademark of employee communication at Alexandra Hospital. In fact, Fatimah believes it is one of the best ways to maintain the organisation’s newfound culture. Recruitment initiatives are much more fruitful when employees recommend friends from outside Alexandra Hospital who might embody the same values. “Staff recognise our standards and this is a great way to get people on board,” she says.

This personalised hiring effort is part of a recruitment drive as the hospital faces another major change – relocation. Fatimah admits that ramping up manpower is an ongoing challenge. There are 440 beds in Alexandra Hospital, about a hundred less than in the new Yishun location. Staff numbers will have to increase from 1800 to 2500 to serve the planned increase in patient numbers.

Overseas recruitment is therefore in full-swing. HR can also screen potential applicants at job fairs and through partnerships with government bodies like the Workforce Development Agency and the Career Development Centres in each of the relevant regions of Singapore.

Fatimah says the change in location is a double-edged sword for recruitment efforts. While potential job candidates living in the Northwest of the island are naturally drawn to a workplace close to home, those living close to the hospital’s current location are reluctant to make a long commute. “It’s hard work for the moment,” she says.

However, HR is working on some initiatives that might help bring over some of the current fence-sitters. Flexible working schemes are seen as an important retention tool. The hospital recognises that its workforce consists of people at different stages of their lives, and aims to accommodate their individual needs. For example, medical staff who express a preference to work certain shifts are granted their chosen time slots provided there is available room.

Some staff work three-day or four-day weeks in order to maintain work-life balance. Fatimah says this is particularly popular with new mothers.

Fatimah says the flexibility to change work schedules as needed has been an important part of the hospital reorganisation. Recently, a doctor at the hospital had twin babies and requested to work part-time for a year. Now she’s back on a full-time schedule.

Catering to changes is never an easy task for HR, but Fatimah maintains that is integral to their goals in the organisation. “We don’t want to lose staff,” she says. “So we find out their needs.”

Training and career progression options form a structure which supports these employee goals. Every role has a career track and development opportunities are available beyond core training. The organisation also prides itself in its job rotations scheme which allows staff to go on overseas attachments. Conferences are held locally and overseas as well.