A “damaging and damning” report on workplace culture at Nanaimo’s hospital says the situation isn’t sustainable and will lead to self destruction – but it can be fixed.
Results of a workplace culture assessment by Vector Group, hired by Island Health, was shared with hospital leaders, doctors, clinical and support staff on Wednesday.
Of the hospital’s more than 2,200 employees, 473 took part in the assessment, which says from all indications the hospital is “failing significantly” in managing people. The majority of participants perceive, for example, that decisions are based solely on budget with little to no regard for employees’ well-being or quality patient care, accountability for abusive behavior is non-existent and the hospital has maintained an atmosphere of fear, bullying, intimidation, retaliation and censure that prevents people from raising questions, issues or concerns.
Vector Group said the organizational culture is past the tipping point and the simple act of continuing daily operations at Nanaimo Regional General Hospital exacerbates the toxic culture. But it also said it’s very fixable in relatively short time frames with “sustained and focused effort.”
Damian Lange, director of clinical operations at NRGH, calls the report frank and very damaging and damning. Some of the results had been heard over the last number of years but to have it as frank as it was and sent to all staff in its unedited form was difficult for some leaders locally to take, he said.
“At the same time we had made the local decision that we need to stare this head on and we need to share this in its exact form with the staff who contributed and start the process of acknowledging what truly is and how we can move forward together,” he said.
Island Health will work with the consultants for the next year and a half. A press release says leadership and a workplace culture committee and steering committee will put a strategy together in the coming weeks for moving foward.
“Now that we’ve disseminated this report to all staff and physicians and it’s been sent across the organization and beyond we absolutely have to be timely,” said Lange, who believes there has to be forgiveness and a focus on re-establishing fundamental relationships because the way forward is together.
“We need to start fresh and have the culture work as our No. 1 priority, be out there with our teams and all clinical staff to really understand what’s in their way of providing quality care, what’s in their way of feeling comfortable and proud of their workplace” said Lange, who told the News Bulletin conversations are already starting around forums and how to hold each other accountable to constructive, respectful conversations.
Christine Sorensen, acting BCNU president, said the report outlines a concerning picture but it comes as no surprise to BCNU, whose members have been demanding change, and it’s reassured to see the issues highlighted in the report and that the problems are considered fixable.
“There will be a long process of healing and recovery that will be needed but certainly we congratulate Island Health for being willing to look at the situation, for doing the review and for being so open to put out all of the complexities and problems and we hope they are just as willing to work with all the parties involved to make this a better workplace,” she said.
Dr. Dave Coupland, vice-president of the Nanaimo Medical Staff Association, called it somewhat disheartening and discouraging to see the hospital in this light but he also said it’s in times of crisis that change can be made and there’s a real opportunity to turn the hospital around.
“[The report] shows the concerns and issues that were raised by the front line staff … were real and valid and it legitimized them,” he said.“I look at it as an opportunity that we can build from here.”
As for how the culture came to be, Coupland said it was insidious and has been growing for a long time, but he sees IHealth as being the straw that broke the camel’s back, taking it from a difficult environment to a toxic one in crisis.
Fundamental change to the approach to leadership is needed and it’s got to start at the top, he said, pointing out that Island will have a new board and will have a new chief executive officer, which in an opportunity for that change. He too believes in the need for a new relationship that values health care workers and their opinions, allowing them to participate in an advisory role in management, not just in patient care, and to find solutions.
“It’s a long-term problem, we didn’t get here easily and it’s not going to be a quick fix,” said Coupland, who did say community needs to be assured patient care is still excellent, but not optimal.
“Until things change, we probably can’t optimize it and we really need to change things because I’ll tell you, there is potential for patient care to deteriorate given the circumstances and the cracks are definitely showing,” he said.