Nanaimo Regional General Hospital is rife with bullying, coercion, harassment, intimidation, lack of trust, nepotism and favouritism, according to a damning survey of staff and executives.
“’Would you recommend NRGH as a good place to work to a favourite niece or nephew just finishing training/university?’” Almost universal response of ‘NO!’” said the Nov. 6 presentation by Denver consultancy Vector Group Inc., which was obtained exclusively by theBreaker.
“Numerous people in several parts of the hospital volunteered that they’ve instructed their friends/families to take them elsewhere (the mainland) for care if they get sick.”
The presentation said that, in Vector’s opinion, the hospital’s culture is “past the tipping point.”
“From all indications Nanaimo Regional General Hospital is failing significantly in regard to managing people.”
Vector CEO Bob Carleton and COO Gary Craig delivered the initial findings of their three-week assessment on Nov. 6. Two days later, on Nov. 8, employees were briefed. A source told theBreaker that Carleton and Craig said NRGH is one of the three-worst organizations they have ever dealt with.
“The simple act of continuing with daily operations exacerbates the toxicity of the culture,” said Carleton and Craig’s report. “This situation is not sustainable and will, in due course, lead to some form of self-destruction. However—it is very fixable in relatively short time frames with sustained and focused effort.”
The litany of criticism continued.
Basic trust between people doesn’t exist at all levels. Instead, there is suspicion, fear and often loathing that predominates thinking about administration.
“NRGH maintains an atmosphere of fear and uncertainty. Advancement is about who you know, not about performance. People feel the reality is clear; NRGH is headed downhill and nothing will ever change.”
The study found the hospital has a toxic culture that disrespects and devalues people, and is focused more on budget than employees’ well-being and patient care.
“Maintaining an atmosphere of fear, bullying, intimidation, retaliation and censure that prevents people from raising questions, issues or concerns. Placing high value on cronyism and nepotism in recruiting, hiring and promoting.”
A 10-point “culture summary” said managers spend more than 80% of their time on paperwork, people are the least-valued commodity in the system, pride and willingness to help each other is rare and, when present, is viewed suspiciously.
“Accountability does not exist, other than the fact you may be blamed for anything at anytime. [She or he] who blames first wins. Keep your head down, say nothing, raise no issues or uncomfortable questions and you will not be noticed—which is the best you can hope for.”
The presentation suggested an eight-point way forward, including moving rapidly in rolling out the controversial iHealth records digitization with effective computer-based training, fixing the holidays and vacations scheduling problem, and communicating quickly with staff on study findings.
“Authority figures must take responsibility for improving the situation and announce a clear action plan with timeframes for moving ahead. Include some form of ‘Yellow Card’ program to facilitate constructive discussion between management and staff during times of conflict or failure to live up to the values.”
In September, the Ministry of Health ordered Ernst and Young conduct an independent review of Island Health’s 18-month old iHealth paperless records system. Doctors complained the $174 million system is an error-prone, time-consuming boondoggle.
Island Health hired Vector for $150,000 on an 18-month contract after 19 companies responded to a request for proposals early this year, said NRGH clinical operations director Damian Lange.
“The report itself has been difficult for many to digest and take in,” Lange told theBreaker in a Nov. 9 interview. “It’s taken us many years to get where we are locally and it’s going to take us some time to get out of here.”
Asked if there would be any immediate personnel changes, he said: “This isn’t necessarily about one, two, three or four people, this is a systemic reflection, this has been many years in the making, culminating in the harsh reality of this report.”
Health Minister Adrian Dix said “we’re very interested and very concerned.”
“I mean, when a report describes the culture of a hospital as toxic, we have to take action,” Dix told reporters in Victoria. “My expectation, active expectation, will be that actions are taken to improve that, because ultimately, it’s the people who work for us, who are very important to us, and patient care, which is very important to us.”
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