staff retention in socio- sanitary structures

Transcription

STAFF RETENTION IN SOCIOSANITARY STRUCTURES
The findings presented in the study have been brought together by an transnational
partnership with the support of the European Social Fund for the Equal program and
carried out in three countries: Italy, France and the Netherlands.
The transnational partnership studied three lines of research:
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the evolution of needs in the socio-sanitary sector
the modes of retaining socio-sanitary sector workers in the labour market
the new modes of distance learning
This section of the study, carried out by the French team, concentrates on staff
retention in socio-sanitary structures.
The primary aim of this document is to bring together and formalise the partners’ data
for the benefit of the transnational partnership.
Equally, this study is to be circulated though the national networks of the three
countries involved.
The findings or analyses contained in this study do not purport to be a representative
sample of the entire situation of the sector but rather to provide an informative
example of the situation in the field which is potentially similar or reproducible.
The study aims to put forward examples of the thoughts, attitudes and good practice
on the subject.
Transnational Project FSE Equal ETIC
Contribution : France
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Presentation of the structures studied:
The inter-hospital partnership involved in this study interestingly brings together three
very different structures in the socio-sanitary field :
Institute Paoli-Calmettes:
The Institute Paoli-Calmettes (IPC) in Marseilles, is an Anticancer Centre. A private
institution but part of the public health system, the Institute Paoli-Calmettes has a
university role specialising in the study of problems relating to the treatment of
cancer. Both a hospital and a centre for research and training, the IPC employs a
staff of approximately one thousand two hundred in an area of nearly 150 metres.
Jeroen Bosch Hospital:
The hospital group “Jeroen Bosch Hospital” is a private foundation status hospital
with a public health role.
The Dutch working code governs the management of a personnel of 5000.
Azienda Sanitaria Locale, Brindisi:
The ASL Brindisi (AUSL BR/1) unites the social and health services in the Brindisi
region (Southern Italy – Pouilles). The study focused on the health sector through
analysis of two hospital structures: the local hospital of San Pietro Vernotico and the
regional hospital of Perrino (Brindisi). The combined staff of these two structures
reaches a total of almost 1500.
For the purposes of this report the above structures were visited and data collected
on each.
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Introduction
On a European scale the challenges of the job market are changing.
The shortage of a qualified workforce is becoming a major concern for businesses
who are facing the prospect of a massive series of departures once the post-war
baby-boom generations reach retirement age in 2006. Due to the regular decline in
the birth rate across Western Europe, the generations entering the workforce will not
be able to offset the impact of this phenomenon.
Certain sectors are particularly affected by these demographic changes. The
combination of a higher volume of retirees with an increase in needs, and therefore of
labour, means that such sectors will be particularly vulnerable to recruitment
difficulties. In France, the hotel & catering industry and health sector are already
concerned by these difficulties posed by these issues, which will only become more
severe in the years to come.
At the same time, the widespread increase in the pensionable age should ease the
volume of departures.
The age at which one receives the maximum pension is gradually being increased by
those European countries who are facing a budget deficit in their pension funds.
In France, where the average retirement age is one of the lowest in Europe due to its
generous pre-retirement schemes for the under-60s, the last three years have
prompted a radical change in policy.
Thus, schemes for phased-in retirement have either become stricter or disappeared.
For example, at the end of 2002 France abolished phased-in retirement in the public
sector. According to the ARPE, the scheme for total early-retirement had been
almost completely stopped in the private sector by 2001. 2003 marks then end of
progressive early retirement (part-time) in the private sector.
As in other structures, hospital demographics are now experiencing a period of
ageing and the situation is similar across Europe.
The prosperous post-war years saw huge development in hospital structures: in
building, equipment and personnel. Since then, buildings have been renovated and
equipment replaced, yet the personnel has remained largely unchanged and has
aged.
Consequently, hospitals are today faced with the problem of functioning with a
personnel who are older than ever, in an environment where age and work have
increasingly become factors of exclusion.
During the 90s a very dynamic development of techniques resulted in the entire age
groups, namely the over-55s and even over-50s, leaving the labour market.
The repercussions of this policy are evident today: the younger generations entering
the workforce view any extension of the working life as unbearable. Working time
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reductions, introduced in France, have done nothing to negate the belief that future
generations will be the big losers in the working time issue.
The extension of careers by several terms or years will once again become a reality,
despite the resistance of employees to accept such a fact.
However, human resources is the key issue in a social and health sector where
human investment represents near to 80% of the value added.
It can therefore be understood that there is a double reality driving this issue:
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businesses in the health sector are going to fight to retain their potential of
qualified staff
these businesses are going to face a general ageing of their personnel staff
and will have to break new ground in order to retain their older workers
This study is based on these two premises:
The first part endeavours to describe the factors which are working towards
sustainable retention and the life-long development of employees and their
professional skills.
The second part will focus on a more specific analysis of the retention in work of
older employees.
Both parts report the tools, methods and concepts, some of which are traditional
others more innovative, which will enable the goal of sustainable staff retention in the
socio-sanitary sector to be reached.
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1. The strategies and tools for life-long staff retention
The health sector is faced with an increasingly tight labour market, particularly in the
qualified professions, the so-called “core profession” (nurses, doctors, technicians,
paramedics, etc)
This shortage translates into problems of recruitment and of the nomadic behaviour
of recruited staff. Employees are led to compare and seize the advantages of one
structure over another in a highly competitive market. This situation is particularly
fierce in the nursing profession where there is a shortage throughout Europe, with the
exception of a few countries such as Spain.
Hospitals must therefore continually invest more to encourage staff loyalty among
staff in the more competitive sectors.
In other sectors, where staff generally remain in their positions for a significant
number of years, hospitals must react against life-long factors of exclusion which are
a product of time.
It is noticeable that, not only do the three structures involved in this study
demonstrate similarities in their strategies for retaining staff, but they have their own
particular strategies.
In HR management, commercial practices are either rejected or adapted for the
hospital environment or schemes created specifically.
There is a significant disparity is the existence and application of these tools between
the three structures.
1-1 A variable staff retention strategy
Interest in a staff retention strategy
Firstly, the authors of this study examined whether the aim of long-term retention was
included in the objectives of the organisation and, if so, whether the approach was
general or targeted to specific sectors or professions
It should be noted that the policies for staff retention are closely linked to the
state of the labour market where local factors can be significant.
For example, the hospitals studied in southern Italy do not have any recruitment
difficulties. On the contrary, the demand for work outstrips supply and the on-going
restructurings (hospital mergers, reorganisation and rationalisation of activities) result
in the number of positions being cut, thus reinforcing the current situation.
Consequently, the staff retention policy in place is less voluntarist.
In northern Italy, however, the shortage of professionals is comparable to that seen in
France.
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Hospitals in France are facing a shortage in certain core positions such as nurses,
doctors, diagnostic radiographers, nursing auxiliaries and physiotherapists. As in
Italy, this shortage varies according to sectoral and geographical factors.
On a sectoral level, cancer, the core occupation of the IPC is not the most
immediately attractive sector for nurses: likewise psychiatric and geriatric nursing.
For technicians, radiotherapy is generally less attractive than radiology or, more
recently, nuclear medicine.
On a geographical level, the south of France is an area renowned for its climate and
quality of life, factors which facilitate recruitment to the area. Conversely, Paris has
been subject to a drain of its professionals and is now facing serious recruitment
difficulties.
In Holland, shortages in the healthcare professions vary according to the attraction of
these professions compared with other professions which are seen as worthier but
which carry greater risk in times of crisis (the banking, commercial and business
professions). The shortage of doctors is beginning to be felt in the large cities which,
in times of difficulty, have recourse to foreign professionals.
On the other hand, the common concern is that of the longevity of the staff.
The notion of a job for life is still alive in Italian hospitals, both for doctors and for the
non-medical staff.
This is similarly the case in France and in Holland. At the JBZ, staff remain in their
job for a significant length of time and this is combined with a low level of departures.
The challenge is therefore to find the levers and motivation which will encourage a
professional to remain long-term in the same structure.
Competition also has an impact on the issue of staff retention. Thus, Italian hospitals
have been prompted to demonstrate a greater and increased production within a
change in financial management which, with a background of service and
establishment objectives, places greater emphasis on the link between finance and
production.
Against this background, the retention of high-performing staff should be a lever for
development in this healthcare structures.
Competition with the private sector, government regulated or not, is particularly
strong.
The IPC is acutely aware of this logic : reforms in hospital financing which are
expected to take effect in 2004, will define the major part of the hospital budget in
accordance with its activity. Therefore, the performance of each structure, and in turn
its staff, will become strategic.
Mechanisms of termination of employment contracts
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Any examination of staff retention also calls into question the flexibility or rigidity of
the rules governing redundancy and the practice of such in the health sector.
Redundancy is almost unheard of in Italian hospitals which must compromise with
employees in long service and unfailing loyalty.
Like the majority of Dutch hospitals, the JBZ has little recourse to the forced
termination of employment, outside of cases of disability.
Of the three locations analysed the Institute Paoli-Calmettes has the highest
turnover. However, this is due to voluntary departures such as resignations,
retirement, early retirement, disability, sabbaticals etc. rather than enforced
departures.
In reality, termination of employment contracts in the socio-sanitary sector are more
often initiated by the employee (for personal or professional reasons) than by the
employers who have a tradition of staff retention.
Contrary to the profit-making sectors, the character of the public service and its
corollaries, the public financing limits the research of the financial performance but
also of the performance, pure and simple!
The restructuring practices of the profit-making sector impact on employment which
is considered variable according to economic performance. Such practices are
almost unheard of in the hospital sector.
The tools for termination of employment either on an individual or collective basis
(outplacements, economic redundancy) are rarely implemented.
In conclusion, it can be said that the while the problem of staff retention is evident
everywhere it leads to two very different questions:
1) what must be done to retain an employee and to keep precious skills? This
first question is especially applicable to those workers who have the possibility
to leave the hospital, in positions where the offers of employment exceed the
demand.
2) what must be done to maintain the level of performance of a staff member who
is likely to remain 30 or 40 years in the same structure? This is the most
frequently faced problem in the socio-sanitary sector due to the tradition of a
“job for life”
While these complementary and simultaneous questions are evident in each hospital
the emphasis placed on each differs between structures; the IPC, for example, finds
itself clearly faced with the first question in the case of its nursing or medical staff (a
strategy of retention to counter the shortages) and with the second question for the
other occupations (retention strategy to face the problems of “usury”).
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This double question leads the hospitals to develop human resource policies and
tools which are adaptable to the double objective of the attraction and retention on
the one hand, and the maintenance of performance on the other.
1-2 The tools of staff retention
The tools in play in the three organisations with the aim of retaining staff can be
grouped into six categories:
•
•
•
•
•
•
•
Systems of integration and tutoring
Progressive management of workers and skills
Continuous development
Skills management
Recognition and satisfaction
The sharing of information and knowledge
The addressing the work-family life balance
1-2-1 Systems of Integration and Tutoring
The tools used in the integration phase are centred on the short-term retention, of
young hires.
For the national division of Project Equal, the IPC has invested a great deal in the
creation of a course of progressive integration for young nurses, beginning in 2002.
In 2001, the nursing profession had an extremely high rate of departures following
recruitment : almost one in two nurses recruited remained less than one year in the
hospital. Investigation revealed that the difficulty of the job coupled with the brutal
transition from school to the workplace was one of the factors of this drain.
Nurses are now taken care of much earlier through a process which aims to ease
their introduction to the reality of life in the cancer division.
Nursing colleges have furthered this approach by integrating into their course
alternating periods of study and work experience in hospitals. However, this does not
yet go far enough to cope with the complexity of the job requirements.
The IPC’s considerable effort has enabled the following to be established:
-
integration tutors responsible for overseeing the first steps of the new recruits
a period of dual training, in various sectors of the IPC
integration period with reduced responsibilities
specific plan of evaluation during this professional phase
Results have surpassed all expectations and fully justify the high cost of the plan:
91% of the nurses recruited since its implementation have remained at the IPC.
The policy of integration requires not only the means but also a total control of the
recruitment process in order to be effective.
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In Italy, recruitment is not carried out by the individual hospital but by the ASL
(Azienda Sanitaria Locale). Candidates are therefore imposed on the hospital.
In addition, the ASL chooses whether or not to offer a position and, during periods of
restructuring, can also decide to freeze a position. Professionals are thus placed in a
precarious position and replacements are ensured before definite posts come free.
These conditions do not facilitate integration. Indeed, after six months the lack of a
position will force a substitute nurse to accept another position thus completely
negating any integration effort.
1-2-2 Changing occupations and progressive personnel management
Structural changes in employment are, unfortunately, more often endured than
planned. The shortage of nurses across the three hospitals gives rise to creative
reactions to avoid increased workloads leading to departures:
-
in France, the recruitment of foreign nurses
increase in student nurse places (France)
development of support staff for nurses (Socio-sanitary operators in Italy) and
doctors (teams of nurse practitioners in Holland)
These reactions, however, occur most frequently on a national level as a result of
circumstantial pressure.
Therefore it is necessary to encourage the local level development of a forwardthinking analysis of the changing occupations.
The Italian national project is a good illustration of this how the analysis of changing
socio-sanitary needs can lead to a consideration of new socio-sanitary occupations
adapted to accommodate these changes.
Likewise, the National Federation of Anticancer Centres has set up an observatory of
employment and skills. Their mandate is to anticipate, address and, indeed, incite
changes in the sectoral occupations.
The observatory analyses skills areas as diverse as :
-
clinical dosimetry
skills sharing between doctors and paramedics
clinical or biological research
On a hospital level, analysis of the three hospitals shows that new occupations and
skills areas are emerging in the following areas:
-
the organisation and sharing of knowledge (knowledge management, elearning)
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transversality at the heart of the hospital organisation, marked by vertical and
hierarchical relations: quality, network creation, local relations, treatment
coordination
patient information (diagnosis given by nurses, creation of patient committees,
etc)
introduction of new technologies (clinical dosimetry, biological research,
internet etc.)
Through the systematic exploration and needs analysis of emerging occupations,
employees are immediately able to start developing their skills and take advantage of
the new perspectives of professional change.
1-2-3 strategies and systems of continuous development
Continuous development remains one of the key elements in staff retention. Study
reveals that while all hospitals have recourse to continuous development, access to it
is very unequal.
Staff in Italian hospitals do little training outside the job. Indeed, ASL funding for
training is limited. Doctors have easier access to training and often pass on what they
have learnt to their colleagues.
However, 2002 saw the implementation of a more voluntarist policy with the creation
of the L’Education Continue Medicale for the continuing medical education of doctors
and paramedics. The scheme requires that a mandatory number of continuous
development points are accumulated over a period of five years.
Yet, the system has quickly been abused : the deliberate over-valuation of some
courses, in terms of points awarded, has led to the number of courses being limited.
Training budgets are too limited and it is often the case that the employee has to foot
the bill for travel, lodging, indeed the entire course.
A single training plan, valid for all the hospitals, is carried out by the ASL training
department. This system is overly centralised and discourages individual needs.
Finally, the absence of any real training program on a hospital level and, more
importantly, the lack of financial investment are considerable obstacles for any
progress to be made in this area.
This situation is all the more damaging because reforms currently being considered
plan to link access to longer service to mandatory training. This move towards the
recognition of skills acquisition will only achieve its objective through adequate
financial investment and a flexible approach in its management.
The study shows that continuous development can reach its potential when:
-
it is linked to evaluation practices, collective or individual
needs are outlined in advance
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-
the presentation and content of the training course match the needs of the
employees (custom made)
1-2-4 Skills management
Attention to the development of the employee’s skills focuses on a series of
complementary tools but which are often set up in a disjointed and incoherent
manner.
Moreover, skills management can only be achieved well if the following tools are in
place:
-
a clear vision of the organ grams, the job content and of the expected skills
a formalised and regular evaluation
accompanying tools (training, mobility, new objectives, coaching etc)
life-long skills development
Clarity is not always present even though this could sometimes have a structuring
effect.
For example, general decrees governing skills exist in Italy and in France for
government regulated professions but job descriptions are rarely used.
On the other hand, Italy has recently repealed old decrees governing nursing skills
without replacing them with any new outlines. The current transitional period leaves
room for a degree of freedom and fresh interpretation of which the nursing profession
is taking advantage to assume new roles delegated by doctors.
While areas of responsibility remain they have since become more general and hazy.
In France, Anticancer Centres have introduced job descriptions and profiles for all
medical and non-medical ancillary staff.
Mobility is an important factor in staff retention. Well managed it can combat boredom
and encourage the permanent development of training and the ability to adapt to
change.
It should be encouraged and developed. Unfortunately, it is all too often the case
that some professional categories have insufficient access and other, no access at all
(head physicians in Italy cannot change hospital).
The policy of mobility must be clearly integrated in HR management policy. Indeed,
when mobility is rarely encouraged it is endured as a constraint, even as a
punishment (Italy). The end result can be problematic, leaving the less appealing
sectors with little or not possibility of recruiting staff.
Mandatory mobility, a measure accepted by the ASL, can get round this problem but
in doing so creates another: staff who are forced to move bitterly resent the
unwanted change.
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In other respects, mobility can develop hospital occupations and avoid the
disadvantages brought on by over-specialisation in one job.
The route of specialisation (indeed hyper specialisation) is often plebiscited in
hospital occupations. A doctor who, following many years of study, becomes the
uncontested specialist in a particular discipline is considered the model of a
successful career.
The results of an opinion poll carried out among the staff at the Institute PaoliCalmettes found that 87% of those interviewed (all hospital occupations) believed
that “to specialise in one professional division…is a good thin”.
Hospitals must therefore understand that the expectation of specialisation is one
factor of retention.
Hospitals could, for example, design tools for the development and recognition of
expertise or their own fields of reference to encourage staff retention.
Thus, within the frame of its “transfers” project, the IPC has created “referent”
missions for nurses and nursing auxiliaries enabling them to work in a job which has
a recognised expertise. This expertise is, however, for a fixed-term and other workers
must be able to have access to the same conditions. Its aim is the sharing of
knowledge and a critical consideration of practices.
Within this general idea of life-long job development, appraisal meetings also have a
place. These are one way of demonstrating the interest that a company has in its
staff.
The study shows that, despite being generally accepted as useful, the tool is used
unequally. It is not yet used in the Italian hospitals involved in this study. It is being
developed in the Dutch hospitals and is in general practice in the Institute PaoliCalmettes (MDs and PhDs).
In France, the CLCC, for its part, has been involved in developing the validation of
professional experience (VA.P. validation des acquis professionels) for non-medical
staff since 2002. This step aims to energize and recognise the progressive
acquisition of skills by staff throughout their career.
This scheme, coupled with the an annual appraisal has largely contributed to the
installation of a process of skills management in the Centres.
1-2-5 Systems of recognition and motivation
Staff retention is also as a result of tools to value and recognise the efforts and
performance of staff.
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In this context, salaries (and its various add-ons) remain an important element in
motivation. However, research into other forms of recognition and satisfaction are in
progress.
In the majority of sectors, salaries are increasingly made up of variable remuneration
packages linked to individual or collective performance, such as annual results etc.
With an objective of long-term retention, other methods of remuneration are being
developed such as benefits contributions, bonuses for long-service, progressive
pension fund contributions, save-as-you-earn schemes
In general, the variable parts of salaries are rarely implemented in hospitals as the
following example in Italy demonstrates:
head physicians in Italy (the “primario”) have a remuneration package where part of
their salary is linked to their strategic dimension. In addition, they receive a bonus
linked to their speciality.
However, variable salaries remain marginal. Other than in the case of doctors,
salaries in Italy only change with length of service or, more rarely, promotion.
Local variations are almost nonexistent as salaries in Italy are fixed at the same level
for all ASL.
In the health sector, salaries are far from being the key element effecting retention, at
least in comparison with other more money-driven sectors of the economy such as
electronic or computer engineering, pharmaceuticals, commerce etc.
In addition, it must be remembered that a hospital does not only employ those who
are directly involved in healthcare and, elsewhere it finds itself in direct competition in
sectors where there is a tight labour market such as catering and IT. In these sectors
which are peripheral to the hospital’s core occupation, salary holds greater
importance.
Hospitals must develop other factors of recognition.
Recognition must come from a remodelling of the forms of hierarchical organisation
and staff responsabilisation. Autonomy is an important factor for managers and,
increasingly so, for non-managerial staff who equally aspire to management relations
founded on professionalism, responsabilisation and trust. To this end, there is
increased research into tools for a more concerted and participatory decision-making
process.
In Italy, there exists a very centralised management structure where the local health
and administrative hospital directors are hugely dependent on the decisions made
by the General Management of the ASL.
Notably, the main decisions concerning personnel, recruitment, future mobility,
training, and career etc, which should be made as to the field as possible, are, in
reality made by the ASL.
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Unfortunately, the only autonomy left to administrative directors is with regards to
hours and improving working conditions.
Research for satisfaction, retention and performance.
Less directly expensive than salaries but more difficult to put in place as they are
often individualised and multiform, policies for satisfaction require an HR
Management which is attentive, reactive and flexible.
This approach is focused on pleasure, whether deriving from the job itself, from the
environment or from the atmosphere of the structure.
The “start-ups”, which enjoyed a period of euphoria from 1999-2001, understood and
quickly refused this principle by creating working conditions and an environment that
was able to attract and retain the best staff.
Hospitals can also work based on factors of consideration and satisfaction. However,
they first need to introduce such factors by looking closely at local hopes and needs.
Methods of analysing the satisfaction of the “internal client”, the employee, are being
developed.
Assessing satisfaction is through detailed qualitative inquiries conducted by the
structures. The transnational work of Project Equal has been particularly useful in
that it has enabled this type of assessment to be tested in the hospital environment in
at least two of the structures studied.
(see annexe: the PC internal questionnaire and the results of a opinion poll carried
out by JBZ)
1-2-6 finding the work-family balance
Time management has become an important issue because it strongly effects the
professional-personal life balance that everyone wants.
In socio-sanitary structures which are often open 24/7 and where flexibility and
availability in a staff member are particularly valued, the management of work
schedules is a growing concern.
Firstly, the reduction of the working week has been introduced in various health
systems:
In French, the working week is 35hr for day shift workers and 31.5hrs for night shift
workers. Staff in Italian hospitals have a 36hr working week.
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Against the favourable background of a reduced working, greater emphasis must
now be placed on time management.
Flexibility and variety in the organisation of work is a strong advantage compared
with a uniform and rigid application with little consideration for individual
circumstances.
Part-time working is gaining ground: in JBZ, the majority of staff work part-time and it
is a situation which is perfectly accepted, even encouraged.
Positions can be created to cope with the demand for part-time positions (in Italy,
there is morning part-time shift, and in Holland, a four-day week)
At the Institute Paoli-Calmettes, part-time staff represent 20% of the workforce.
In Italy, it is also relatively widespread particularly amongst women and those who
are new to the labour market.
Hospital involvement in facilitating a personal life is a route which should be explored
if hospitals want to retain their staff:
•
•
•
•
childcare schemes
transport assistance
information services
logistic services offered to staff (concierge, financial reductions for home
internet)
There is a trend towards Information Systems in HR aimed at developing the
“employee relation management (ERM)” by developing information given to the staff,
particularly through IT means (intranet, mail, etc)
The interconnection of information networks and the speedy sharing of that
information are contributing factors in the bid to retain staff because they reinforce a
feeling of belonging within the company.
The IPC is, for example, firmly rooted in this concept and is advancing in the
following two ways:
-
the creation of a comprehensive intranet which integrates the informative and
interactive potential
decentralised management schemes either for the managers (time
management) or for the entire staff (electronic platform for documentation and
training)
1-2-7 Methods for the sharing of knowledge
Is knowledge documented?
What is the role of IT in the sharing of knowledge?
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The transmission of knowledge is an important factor today for a number of reasons:
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the volume of knowledge required to work in a socio-sanitary structure is
constantly increasing
the performance of these organisations is largely dependent on its ability to
manage and share a considerable volume of information on a daily basis
the younger generations, following their initial studies, have a great need for
knowledge and, more so than in the past, to be supported in the early stages
of their careers
the policy of postponing the retirement age offers opportunities for older
workers to spend more time sharing knowledge. This could also play a critical
role in keeping older workers motivated, often a difficult task towards the end
of a career (see second part)
The sharing of knowledge is still, traditionally and in the main, done by peers.
The three hospitals in the study all recognised that it is wise to concentrate on the
new systems of electronic distance learning or e-learning. A new electronic
association is slowly developing which will support the human tutoring experience.
These systems are particularly suitable for IT, technical and linguistic training as well
as pre- and post-training testing. In addition, they are also means of sharing and
offering information in a way which is compatible with the individual demands of the
hospital (24hr availability, regularly updated, accessibility etc)
For its national Equal project, the Jeroen Bosch Hospital has developed a university
platform distance-learning system with a content relating to :
-
parenteral nutrition (target audience: nurses)
new information systems (target audience : all JBZ staff)
The sharing of knowledge and practices does not only happen through computer or
electronic channels. Mechanisms of tutoring: older member > novice or expert >
non-specialist need to be developed. These will lead to the creation of mechanisms
of attachment to the company resulting in adhesion and staff retention.
The Equal project conducted by the IPC has also led to the characterisation and
development of this tutoring processes:
-
through analysis of the sharing of knowledge carried out by the Centre for
research on qualifications (Centre de Recherche sur Les QualificationsCEREQ)
through tutoring experiments in the laboratory sector where oral
communication and experience are difficult to replace by written means and
even more so by IT processes.
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2 – Specific aspects linked to the retention of older workers (over
50s)
To date, the average retirement age of the three countries involved in this study is
low:
•
•
•
58 years in France
59 years in Italy
Less than 59 years in Holland
France is particularly badly placed in this area; of all the countries in the OECD, it has
the sad record of the lowest employment rate in the 55-64 age group. Only 38% of
men in this age bracket still work.
In the health sector, employees have been taking advantage of the opportunities
provided by certain schemes for a number of years: withdrawal at 55 for those in
strenuous positions; schemes of phased-in retirement or early retirement in France.
However, these statistics are evolving in accordance with the general impact of the
ageing demographic within European societies.
For example, in the three countries involved in the study, the age at which a retiree is
entitled to a maximum pension has been increased over the last two years.
The Italian retirement system is currently being reformed with a view to increasing the
working period required to claim a full pension to 40 years.
This phenomenon is not necessarily found in all the countries. For example, the
average age for workers in Britain, Sweden, the USA and Japan to withdraw from
employment is already over 60 (over 65 in Japan).
This second section will therefore concentrate more specifically on the French
system and will be more forward-thinking. The Italian and Dutch hospitals of the
transnational partnership are not yet affected by a major staff ageing problem, unlike
the IPC, which is more concerned with this problem in the years to come.
On this subject, demographic assessments, along with age and service pyramids,
enable a shrewd understanding of the extent of the ageing phenomenon in the
hospitals concerned.
The report brings to light a number of questions concerning:
-
the representations and the consequences of the ageing demographic
the actions providing the older worker his full place in the hospital
Page 17
2-1 Improving the perception of the challenges
representations of the retention of older workers
and
the
Defining seniors at work: is 50 the right age to start tackling problems of age in
the workplace?
Why should 50 be the relevant age to qualify the effects of ageing in the labour
market?
Social representations within the hospital are very significant and go a long way to
explaining the discriminatory factors which can affect older workers. Moreover, these
representations, which are fuelled by the external environment, tend to consider that
the relationship between costs and benefits deteriorates from this age.
Various factors, which are unfortunately objective, fuel and reinforce these intuitive
perceptions.
The frequency of health incidents in the over 50s is also statistically higher,
particularly in the jobs where the physical or psychological stress is accumulative
(nurses, nursing auxiliaries and, in general, in jobs which involve a high degree of
patient contact).
More precisely, for the IPC, statistical analysis shows that:
-
there is a higher rate of work absenteeism in the over 50s
the number of part-time positions for whatever reason (disability, earlyretirement, flexi-time …) is very high in the over 50s
“salary bonuses” are less developed in the over 50s
In addition, figures show that, in the hospital sectors where managerial demands are
less, mobility at this age is less and that investment in training diminishes over the
remaining working years for a worker in his fifties.
The subject is unfortunately consensual in so far as the representations are shared:
-
by the management, encouraged by public powers which provide incentives
for the early withdrawal of the older workers
by the social partners, which could have different interests in supporting these
individual withdrawal plans
by the other employees, the older workers generally have an awareness of
their difficulties
Page 18
It is important that companies equip themselves with the analytical tools to identify
and prevent the factors evident in the seniorisation in work.
These factors exist and should not be ignored:
Human biology changes with age; the everyday consequences of the ageing body do
not spare the professional sphere. Certain occupations are evidently more
susceptible to this than others: it is easier to be effective in medicine at 50 than, at
the same age, to want to become a champion tennis player.
-
The view of companies towards the effectiveness of the older workers still
remains quite negative: less adaptability to change, less motivation for training
(especially in new technologies) and, above all, higher salaries, are the main
elements which are immediately cited by younger managers or employees.
-
The attitudes of the older workers themselves can reinforce these
impressions : preference to stay in the same job, lack of interest in training,
wanting “easier” positions
In the transnational partnership, the age of 50 also has a symbolic value which is
recognised by the partners of the project.
Setting an age provides a precise point from which policies can be structured and
actors energise, without falling foul to short-sightedness.
From this point of view, the age of 50 provides a level which is neither too late, nor
too early, and from where the latter years of the professional life can be best
considered and guided.
The challenge of managing older workers: rebuilding representations while
avoiding all positive and negative discrimination
Once the administrative parameters have been set, it is important to understand and
analyse the professional expectations and difficulties of the older workers as well as
the general behaviour of companies towards this category of workers.
As this could result from gender issues, age should be factored into a company’s
management schemes and tools and particularly through the following methods:
-
internal analysis of opinion and satisfaction
statistical charts (training, salary, hours)
analyses of absenteeism and working conditions
The specific actions concerning the over 50s should be adapted to the individual
situation of the workers and should not result in excessively positive discrimination for
older workers.
Page 19
Employment factors are not necessarily discriminatory for the older employees in
work, indeed they are often cumulative:
-
higher salaries, stemming from individual and collective history
key posts in the organisation
higher tolerance
stronger support networks (unions, etc)
greater protection (against redundancy particularly)
greater awareness of their social rights
It would therefore be out of place to create a new ghetto through a new “statute for
older workers” which would reject all other age groups. Moreover, the acceptance of
a company age policy can only be put in place with the cooperative consensus,
where the feeling of inter-generational equity prevails.
It is advisable not to stigmatise older workers by focusing exclusively on policies and
initiatives aimed at them.
The solution lies elsewhere.
The policy for the retention of the over 50s in employment must concentrate on
extending measures which have been in place throughout the working life. One
shouldn’t “lower the guard after 50” and continue to apply the same rules, in a
continuum of the HR policy.
In reality, failure to adapt does not arise at 50, 55 or 58 years but is evident
throughout the working life.
The corrective approaches are, in part, the acknowledgement of failure and the
admission of the ineffectiveness of a tardy HR management policy.
The work of the over 50s should continue to be developed. However, for the
employees concerned, this new perspective of a longer working life, following years
of a policy of early retirement, is difficult to implement and the results will not be felt
immediately.
In particular, the most difficult task is, undoubtedly, to change the social
representations.
This occurs through specific information and communication.
The awareness of the relation between age and work is not consistent amongst the
employees.
Situating and expressing the problem at all levels of the hierarchy is one suitable way
in which to change the social representation and to unlock solutions. The example
should, understandably, come from the top and Management and the social partners
must state their position on this subject.
JBZ management has, for example, clearly displayed its interest in addressing this
question by implementing a policy called “age-conscious personnel management”
Page 20
Various concrete initiatives can support this voluntarist approach to communication:
-
training designed to make the managers more sensitive to the problem of age
the involvement of the older workers themselves in the discussions and
analyses relative to the place of the older worker within
support including more initiatives from older workers in order to develop
exemplary factors (training, career wishes, changing a position or service,
tutoring etc)
entrusting projects to older workers
attention focused on the mixing of ages in projects or working groups
Recruitment in the over 50s labour market is also a symbolic management decision
which challenges the usual perception of the effectiveness of the older works.
Age is not used as a limit or an exclusion factor in job offers. However, salary
expectations when linked to age (once again linked to length of service) constitute a
discriminatory factor in recruitment.
Moreover, there are not sufficient incentives for the hiring of older workers in France.
There is no significant aid favouring the recruitment or retention of older workers but,
on the contrary, certain cases of enforced withdrawal such as redundancies incur
penalties. This process of penalization “sanctuarises” difficult individual cases and
thus contributes to the degrading of the image of older workers.
It is considered that aspects of communication and image are important at work, but
they are not the only management lever that should be acted upon.
Work on the motivation and use of the oldest workers involves the implementation of
the polices and tools which will reinforce them.
2-2 actions to develop and protect the over 50s workers
The issue of age at work should be the object of specific support measures.
Approaches which aim to be preventative should be favoured as long as they enable:
…
-
the lack of interest in training to be curbed
the development of training and particularly of certain strategic training
(namely in new technologies)
the recognition of the new “senior” functions
the relaunch of the over-50 career (orientation, work appraisal…. adapted
development and financial incentives
“preventative” placements and the battle against stress
2-2-1 the reduction of absenteeism among the over 50s
Page 21
Absenteeism among older workers towards the end of their working life is,
unfortunately, one of the mechanisms used to regulate the withdrawal of older works,
much like the schemes for early retirement.
However, while certain schemes can sometimes be encouraged by employers,
absenteeism is understandably largely prejudicial. Allowing it to develop gives credit
to the idea that from a certain age onwards no other solution is available than
the withdrawal from the labour market.
The battle against the absenteeism must be brought forward, by connecting the
social partners, occupational medicine, the managers, and social funding.
Maintaining health and well-being at work should be particularly emphasised
amongst the older workers and viewed differently from the younger generations.
The idea of a complete health check up for the older workers, organised by the
hospital could be offered to avoid or limit situations of incapacity.
This assessment should be able to be extended to include all aspects of working life
and address professional and social aspects.
Overall, a complete older worker assessment could be offered to employees reaching
the age of 50 covering:
-
the career and professional perspectives
health
social and family aspects
Action on working conditions is also a way of limiting absenteeism.
On this theme, the IPC has implemented a policy of involvement to be followed by
the managers in order to ensure a quick response to the problem and to contribute
rapidly to the solving of these problems.
2-2-2 capitalising on the experience of older workers
The organisation of explicit and formalised tutoring positions which mobilises an older
worker in the development of the skills of his successor can have positive results.
The Institute has, for example, been able to trial a period of sustained tutoring
between the experienced laboratory technicians, during the final year of their
professional career and the novice technicians.
In the context of a highly specialised occupation, in which skill is acquired slowly, the
operation has accelerated the integration of the new hire.
Advantages are also found in terms of motivation.
Page 22
However, the senior-novice tutoring does not only have advantages; the cost is a
major stumbling block. Tutoring involves freeing up a significant amount of time to
create periods of apprenticeship. To double the whole or part of a position for a
period, which could last from 6 months to one year, represents a significant
investment the return of which must be analysed (less money spent on external
training, increased quality, better productivity…).
For this reason, tutoring should not be across the board but should be reserved for
those occupations where the apprenticeship is long, complex and is developed more
from hands-on training than from a classical training.
In professional relations, experience at IPC has shown than tutoring could also have
negative effects in isolating, for example, the tutor/student from the other employees.
Tutoring could be viewed by other employees, who find themselves in less favourable
conditions, with a degree of “jealousy” or annoyance.
However, the steps taken by the IPC in senior-novice tutoring remain positive
experiences which should be offered generally in the sectors where it could prove
useful.
2-2-3 maintaining training in the over 50s
The data analysed regarding training policy continues to provide evidence of several
phenomena:
•
from 50 onwards, the amount of on-going training undertaken by an employee
gradually declines to practically zero 2 or 3 years prior to retirement
•
the content of the training undertaken tends to degenerate
•
managers also appear to become less demanding of training for older workers
It is therefore advisable to create or recreate training programmes for older
employees which encourage them to:
-
evaluate their gaps and make their managers aware of such gaps
to develop themselves
to train or tutor younger employees
to seize and look positively at opportunities for change
to accept horizontal career moves rather than vertical moves: example of
“atypical” changes or paths can be found at JBZ (see the enclosed document)
or at the IPC. Analysis of the new health needs also provide new opportunities
for experienced personnel in a structure. Analyses of this can be found in the
work carried out by the USL Brindisi.
Page 23
Undoubtedly, a more systematic evaluation of the effectiveness of the training of
older workers is needed.
2-2-4 salary changes for the over 50s
The salary for older workers is not the main lever which should govern reactions yet
salary policy offers management possibilities including in the over 50s.
Changes in salary for older workers are often limited, by the upper limit of the
service-related part of the salary.
An employee could accept the idea of a « levelled » salary which always remains
higher than that of younger workers or those who have not been in service for as
long.
At this stage of the career, the variable salary (goal bonuses, mission expenses)
could, on the other hand, be well applied, in developing the factors of the
accumulation of experience such as:
-
expert skills
the role of the tutor or the sharing of knowledge
the roles of the project organisers or leaders
At the very least, bonuses could encourage the retention or development of
professional performance in the over 50s with various conceivable schemes:
the development of variable salary schemes with a more marked reversibility
for older workers (for example, the possibility of either losing a skills bonus if
professional performance declines or retracting a responsibility-based bonus
when changing to a less responsible position…)
However, this approach is difficult to get accepted in a sector where salary
increases are acquired and retained over time or with age and are never
questioned.
-
-
The increase in premiums for older workers, or of the abundance of timebanking, according to performance criteria rather than time.
-
A variable part providing financial encouragement for mobility and training
The IPC employs this policy by linking the variable part of the salary to the
maintaining of a good level of training and a high level of professional effectiveness
2-2-5 Supporting the transition by adjusting the working time
between full time and retirement
Page 24
For older workers time becomes one of the major social issues; having settled their
material life and their salary, they are now looking for more spare time rather a
development in salary.
At this point it is useful to refer to the Dutch hospital which favours relaxing working
hours for the older workers. For example, from 55 onwards, employees can
comfortably work their hours in 4 days and retain the same salary.
The Institute, in its national project, has also brought forward various forms of
individualising and managing time for older workers:
•
•
•
•
use of a time bank to form one or two sabbatical years
adjustment over a period of several years to a part-time basis
annual contracts on a large scale
conversion of bonuses or a part of the salary into time
The objective here is not to reconstitute the forms of early retirement which have
clearly been abandoned today, but to implement a more individualised approach to
the resources of hours and the money available to older workers.
These particular changes and adjustments must be formalised and outlined in the
contract between the employee and employer in order to form the chart of good
practice for older workers and avoid absenteeism among older workers who are
coming to the end of their careers.
2-2-6 organising an offer of employment adapted to reconversions
for older workers
Undeniably cases of illness, permanent disability or of resettlements are more
common among older workers. As well as being more numerous, cases of incapacity
are also more difficult to treat because they deal with:
-
workers where the cost of redundancy is too high
older workers, often well-known and appreciated in the institution and for
whom a “moral and social debt” has been incurred during a long service
In general, these cases catch the HR Managers off-guard, as, in an emergency, there
are never any protected or reserved positions available which are suitable for these
employees on a temporary or permanent basis.
Absence is therefore preferable and acts a convenient valve for personnel
management. In general, this increases the subsequent difficulties of re-entering the
Page 25
labour market and triggers a downward trend (on the skills of the worker, on
motivation, on the desire of resettlement....)
In these conditions, planning and preventative attitudes must play a significant role.
The IPC is conscious of these pitfalls, and today intends to encourage
preventative resettlement of workers in positions of great stress. Nursing-auxiliaries
with a recognised occupational stress are particularly concerned by this scheme.
An initial trial of this scheme has been implemented with older workers being
resettled in positions of catering assistants.
Page 26
CONCLUSION
Strategies which encourage the early retirement before the age of 60 are gradually
being replaced by policies which manage the skills and the motivation at all ages.
These policies should be considered as necessary adaptation to the differentiation
which settles in through the course of the working life.
It seems that the situations of the young hires are marked by a greater homogeneity
in the expectations and the HR management responses of companies.
On the other hand, the older a worker, the greater the gaps which arise; in terms of
health, ambition, career opportunities, and work-family balance, the situation of the
employee becomes more individualised as his career progresses.
This situation leads management policies to move away from collective approaches
towards more individual solutions.
However, the initial cost incurred by this mode of management is higher because it
involves:
-
increased and longer training (with reconversion as the objective)
increased salary costs
investment in the improvement of working conditions
compromises on hours
However, these costs should be weighed up against the significant costs incurred by
policies which are based on turnover, costs such as:
-
recruitment
redundancy or early retirement
loss of motivation
severe loss of skills
A company which involves itself in this type of action is naturally led to question the
choice between a policy of regular replacement of its staff and a policy of the longterm retention of its employees.
An analysis of the costs against the benefits remains relatively difficult to establish
but risks becoming a minor consideration compared with the reality of the facts.
Indeed, in the demographic context of the years to come, can a hospital really
achieve its performance objectives and bypass an in-depth study on age
management?
Page 27
Recent bibliographical references
Report by for the Conseil Economique et Social (Economic and Social Council) 2004 – author: Michel Pinaud « le recrutement, la formation et la professionnalisation
des salariés du secteur sanitaire et social »
Study by Bernard Brunhes Consultants – 2001 – les salariés seniors : quel avenir
dans l’entreprise
Report by Pr Matillon – Modalités et conditions d’évaluation des compétences
professionnelles des métiers de la santé – 2003
Presentation from the seminar on age management « vieillissement, nouvelles
technologies et organisation : accompagner le changement dans l’entreprise » Conseil Economique et Social (Economic and Social Council), Paris 17th November
2003.
Annexes
1) IPC internal opinion questionnaire
2) JBZ age concious management
3) JBZ presentation and human ressources policy
Page 28
ANNEX 1 : IPC’s EMPLOYEE SATISFACTION QUESTIONNARY
MODALITES PRATIQUES
Dépôt du questionnaire : Votre questionnaire rempli sera déposé dans une
boîte aux lettres fermée, au standard de l’Institut. Cette boîte sera relevée
exclusivement par la société Marketing Méditerranée qui exploitera le
questionnaire.
Engagement de confidentialité : Ce questionnaire est la propriété de
Marketing Méditerranée et sera détruit après l’analyse statistique.
L’Institut ne sera destinataire que des données consolidées. Merci de
votre collaboration.
Fiche signalétique
(Réponse : un seul numéro)
Q.1. Sexe :
1. Homme
2. Femme
Q.2. Âge :
1. Moins de 30 ans
3. De 41 à 50 ans
2. De 30 à 40 ans
4. Plus de 50 ans
Q.3. Vous êtes :
1. Médecin
2. Cadre non médical
3. IDE
4. AS
5. Secrétaire d’unité de soins ou médico-technique
6. Technicien de laboratoire
7. Manipulateur
8. Autre personnel soignant
9. Autre personnel médico-technique
10. Personnel administratif
11. Personnel technique ou logistique
Q.4. Quelle est votre ancienneté à l’IPC ?
1. De 0 à 5 ans
2. De 6 à 10 ans
3. De 11 à 20 ans
4. Plus de 20 ans
Q.5. Vous travaillez :
1. De jour
2. De nuit
Page 29
Votre poste de travail
Q.6. Votre rôle (poste) actuel est défini :
1. Très clairement
2. Assez clairement
3. Peu clairement
4. Pas du tout clairement
Q.7. Connaissez vous les objectifs assignés à votre équipe/service ?
1. Oui, totalement
2. En partie
3. Non
Q.8. Pouvez-vous prendre des initiatives dans votre travail ?
1. Beaucoup
2. Suffisamment
3. Peu
4. Pas du tout
Votre rémunération
Q.9. Quels sont les principaux critères qui doivent déterminer votre
salaire ?
(Plusieurs réponses possibles par ordre croissant d’importance)
1. Initiatives et résultats individuels
2. Compétences
le
+ important
3. Résultats collectifs
5. Diplômes
7. Pénibilité
important
4. Ancienneté
6. Contenu du travail et responsabilités
8. Comportement et savoir être
le -
Q.10. L’institut doit-il continuer à développer les parts de salaire collectif
comme l’intéressement ou l’épargne collective (abondement et plan
d’épargne entreprise) ?
1. Oui
2. Non
Q.11. Par rapport à un emploi équivalent dans une autre structure
hospitalière équivalente, votre rémunération vous paraît-elle :
1. Supérieure à ce que vous pourriez obtenir
2. Egale à ce que vous pourriez obtenir
3. Inférieure à ce que vous pourriez obtenir
4. Ne sait pas
Q.12. Connaissez vous les règles de rémunérations de l’IPC ?
1. Tout à fait
2. Suffisamment
3. Peu
4. Pas du tout
Page 30
Vos conditions de travail
Q.13. Les locaux dans lesquels vous travaillez sont-ils adaptés à votre
travail ?
1. Oui
2. Non
Q.13.bis. Si non, pourquoi ?
…………………………………………………………………………………………
…………………………………………………………………………………………
…………………………………………………………………………………………
……………………………………………………..
Q.14. Dans votre travail, vous disposez de l’équipement et du matériel
nécessaires :
1. En totalité
2. En grande partie
3. Pas suffisamment
4. Pas du tout
Q.15. Pensez-vous que l’Institut prend les mesures adaptées pour limiter
les risques
d’accident et de maladie dans l’exercice de votre activité
professionnelle?
1. Oui
2. Non
Q.15. bis. Si non, pourquoi ?
…………………………………………………………………………………………
…………………………………………………………………………………………
………………………………..
Q.16. Vos horaires de travail vous conviennent-ils ?
1. Oui
2. Non
Q.17. Est-il facile de prendre vos congés aux périodes que vous
souhaitez ?
1. Très facile
2. Facile
3. Difficile
4. Très difficile
Q.18. Est-il facile de prendre vos RTT aux dates que vous souhaitez ?
1. Très facile
2. Facile
3. Difficile
4. Très difficile
Q.19. Diriez-vous que vos conditions de travail se sont améliorées
depuis deux ans :
1. Beaucoup
2. Suffisamment
3. Peu
4. Pas du tout
Page 31
L’efficacité et l’intérêt du travail
Q.20. Vous avez le sentiment que l’efficacité de votre travail s’est
améliorée depuis deux ans :
1. Beaucoup
2. Suffisamment
3. Peu
4. Pas du tout
Q.21. A propos de votre travail, diriez-vous qu’il vous plait :
1. Beaucoup
2. Suffisamment
3. Peu
4. Pas du tout
Q.22. A quoi attachez-vous le plus d’importance dans votre travail
(classer cinq propositions par ordre d’importance) ?
1. Horaires
2. Ambiance du travail
3. Patient et sa prise en charge
4. Rémunération
5. Hygiène et sécurité
6. Formations
7. Evolution professionnelle
8.
Reconnaissance
de
votre
hiérarchie
9. Autonomie et initiative
10.
Autres
à
préciser ………………………
le plus important
le moins important
Q.23. L’ambiance dans votre travail est :
1. Très bonne
2. Assez bonne
3. Assez mauvaise
4. Mauvaise
Q.26. Votre travail vous permet-il d’acquérir de nouvelles compétences ?
1. Oui
2. Non
Q.27. Dans votre secteur, quels sont les dysfonctionnements sur
lesquels il convient d’agir en priorité ? (Plusieurs réponses possibles)
1. Manque de personnel
2. Problèmes de communication
3. Problèmes d’organisation
4. Plannings
5. Matériel et équipement
6. Locaux
7. Hygiène et sécurité
8.
Autres…………………………………..
Page 32
L’entretien d’évaluation
Q.28. L’entretien d’appréciation avec votre supérieur est-il:
1. Approfondi
2. Superficiel
Q.29. Lors de ces entretiens, les objectifs qui vous ont été assignés
étaient-ils clairs ?
1. Oui, totalement
2. En partie
3. Non
Q.30. Ces entretiens ont-ils été l’occasion d’un véritable dialogue ?
1. Oui
2. En partie
3. Non
Q.31. Ce temps vous a-t-il paru :
1. Suffisant
2. Insuffisant
Les relations hiérarchiques
Q.32. Dans votre travail, la répartition des responsabilités et de l’autorité
entre vos différents responsables est :
1. Très claire
2. Assez claire
3. Peu claire
4. Pas du tout claire
Votre cadre…
Q.33 … planifie le travail d’équipe
Très bien
Assez bien
Assez mal
Très mal
Q.34 … utilise au mieux les
compétences de chacun
Q.35 … résout les litiges dans le
service
Q.36 … vous informe sur votre travail
et sur les orientations de l’hôpital
Q.37 … vous aide si vous avez un
problème
Q.38 … vous fait confiance et
reconnaît la valeur de votre travail
Q.39 … vous conseille sur votre
carrière
(Mettre une croix dans les cases correspondant à vos réponses)
Q.40. Vous arrive-t-il de parler avec votre supérieur hiérarchique direct
de la manière
d’améliorer le service ?
1. Très souvent
2. Assez souvent
3. Rarement
4. Jamais
Page 33
Le parcours professionnel
Q.41. Pensez-vous que pour votre carrière la mobilité (changement de
poste) soit :
1. Très utile
2. Assez utile
3. Peu utile
4. Inutile
Q.42. Souhaitez vous changer de service au sein de l’Institut ?
1. Oui
2. Non
Q.43. Souhaitez-vous changer de métier au sein de l’Institut ?
1. Oui
2. Non
Q.44. Etes-vous informé sur les postes vacants au sein de l’IPC ?
1. Tout à fait
2. Suffisamment
3. Peu
4. Pas du tout
Q.45. Combien de temps envisagez-vous de travailler à l’lnstitut ?
1. De 0 à 5 ans
2. De 6 à 10 ans
3. De 11 à 20 ans
4. Toute votre carrière
Q.46. Vos possibilités de promotion à l’IPC vous semblent-elles :
1. Très importantes
2. Assez importantes
3. Peu importantes
4. Pas du tout importantes
Q.47. Etes-vous informé sur les possibilités promotionnelles au sein de
l’IPC ?
1. Totalement
2. En partie
3. Pas du tout
Q.48. Etes-vous informé sur le dispositif de VAP (validation des acquis
professionnels)?
1. Totalement
2. En partie
3. Pas du tout
Page 34
La formation
Q.49. Connaissez-vous les possibilités de formation offertes par
l’Institut ?
1. Oui
2. Non
Q.50. Si oui, vous paraissent-elles suffisantes ?
1. Oui
2. Non
Q.51. Si vous avez suivi des stages de formation dans le cadre de votre
poste actuel, vous ont-ils été utiles dans votre travail ?
1. Oui
2. Non
Q.52. Vos souhaits de formations sont-ils suffisamment pris en compte?
1. Oui, totalement
3. Peu
Les formations…
Q.53… favorisent-elles
votre mobilité
professionnelle ?
Q.54… contribuent-elles
à votre progression
professionnelle ?
Q.55… sont-elles
organisées de manière
satisfaisantes (lieux,
déplacements,
remboursements etc.)?
Q.56… sont-elles
compatibles avec vos
plannings ?
2. Oui, en partie
4. Pas du tout
Très
souvent
Assez
souvent
Rarement
Jamais
(mettre une croix dans les cases correspondant à vos réponses)
Q.57. Qui contribue le plus à votre formation ?
1. Votre cadre
2. Votre agent de maîtrise (infirmier principal, technicien principal, etc.)
3. Un autre responsable hiérarchique
4. Le service formation
5.
Autre
à
préciser:
……………………………
Page 35
Services au personnel
A propos des services sur votre lieu de travail…
Cafétéria
Restaurant
Parking
Aide au logement
Aide au transport
collectif (abonnement
RTM)
Médecine du travail
Assistante sociale du
personnel
Psychologue du
personnel
Intranet
Prestations du comité
d’entreprise
Q.58. Utilisez vous les
services suivants ?
Oui
Non
Q.59. En êtes vous
satisfaits ?
Oui
Non
(mettre une croix dans les cases correspondant à vos réponses)
L’information sociale
Q.60. Quelles sont les sources d’informations sur la gestion du
personnel auxquelles vous vous référez le plus ? Classez les du moins
important au plus important (1 représentant le plus important et 5 le
moins important)
1. Votre supérieur hiérarchique
le + important
2. Vos collègues
3. Les notes de service
4. Les panneaux d’affichage
5. Les représentants syndicaux
6. Le Bureau du Personnel
7. Intranet
8. IPC infos
le – important
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Opinion générale
Q.61. En définitive, êtes-vous satisfait de travailler à l’Institut ?
1. Très satisfait
2. Assez satisfait
3. Peu satisfait
4. Pas du tout satisfait
Q.62. Avez-vous d’autres commentaires sur votre travail que ce
questionnaire n’a pas permis d’aborder ?
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………………………………………………………………
……………………………….
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ANNEX 2 : Age- conscious personnel management
maart 2004 Saint- Veras
slide 1
Age- conscious personnel management- an exploration.
That’s the title of my presentation. And with a reason.
Explorers are being send ahead to assess the far away situation, to
collect data, on the basis of a specific purposeful action is taken.
Exploring in relation with this subject means, trying to get in sight the
expectations, wishes and possibilities from the individual employee
and try to realize them in the organisation.
That’s the kind of personnel management the Jeroen Bosch
Hospital wishes.
Therefore specific, purposeful, custom made
slide 2
Demographic developments influences the labour market.
As known the number of young people is decreasing and go to
school longer.
At the opposite, the number of old people is increasing ( ageing) and
they work longer. Maybe need to work longer. Soon the average
employee is 40 years. He needs to be active for at least 25 years.
After the abolition of the regulation early retirement and because of
the almost impossibility of stream out by the law work disability, are
changes in pension rules, the law unemployment and incapacity
for work rules, at that debet. Because of this the average age of the
employee will rise vigorously.
Slide 3
Just something about the ages structure in the Netherlands. As you
see changes the figure of the populations structure of a pyramid
model in a swimming tyre model. The bump of the swimming is
caused by the after-war birth wave. The prognosis is, that the form
later, around 2040, will be like an onion. Now 14% is older then 65 .
Page 38
20 year from now it will be 19%. From 2010, if the baby boomers
become 65, starts a period of approximately 25 year in which there
will exists a false proportion between the number of 65 and older
and the size of the adult population, that the economy and the health
care must hold turning. The high point is around 2035. 25% is then
65 or older.
SLIDE 4
Single figures of the Jeroen Bosch hospital. In 1996 yet 34% of our
co-workers was 40 year or parent. In 2002 it’s already 45%. Of the
employees above 50 the increase is 6.5%.
SLIDE 5
On this slide you see the ages structure in the operation center.
17% is older than 50 year. More important yet is the difference
regarding the entire JBZ to the group 40 year and parent. Over the
entire JBZ it’s 45%. For the OK is that 55%. This needs extra
attention. Why? Think par example of the issuing of rules
concerning irregular services.
From the age of 55 year there is no more need to work irregular.
Because the large number of older employees on a certain moment,
a relative small number of colleques needs to catch these services.
SLIDE 6
What do we mean by age- conscious personnel management?
Age- conscious personnel management is personnel management
which is directed on differences between employee. These
differences can lie on various areas and isn’t resemble for every
employee. Single differences can be: career phase, ambition,
physical condition and proportion privately-work. An age- conscious
personnel management is directed to these differences and utilize
them. An employee that just ended his study will be more involved
with the future and his career. An employee with 40 years
experience has probable more affinity with stability and use of his
experience as for example coaching younger persons. It is to be
kept important both workers for the organization through spending
attention at the needs and possibilities of workers in different phases
of their career.
Side 7
Page 39
What has in the Jeroen Bosch Hospital already been done?
• We did research fit in a study labour- market- politics and
human resource science.
• An adviser human resource management did participate in a
network around this theme
• The HR- department wrote a note ‘age- conscious personnel
management’
• Very recent a student HR- management made a report about
vitality related to age- conscious personnel management. She
developed an instrument to measure the fysical, mental en
psychological- social capacities of the employee to relate the
outcome to the job- demands with the objective to become a
development design
Slide 8
What did the Jeroen Bosch Hospital with these knowledgeenrichment?
Deliver custom made.
SLIDE 9
I give you a few examples of this measure work:
• A nurse couldn’t manage her work anymore physical and
mental. She was places as a secretary at a ward.
• A unit- manager stepped back and became a nurse again.
From a social point of view we call that a step back. I speak
rather of a step further in the career line witch is bending off.
• An operating- assistant that could no longer adept the tension
of the work “at the table” worked the last period of her career
as a general assistant.
SLIDES 10
So continue then really. Naturally of course. Yet it will be clearly
necessary to formulate more intensively, more specifically,
preventive and per-active policy, considering the developments I
Page 40
sketched before : shortage of young people and ageing and these
consequences for the labour market situation in health care.
Preventively by preventing, as far as possible, that problems arise
and per-active through giving attention to this problem and creating
conditions in which age- conscious personnel management can get
figured.
SLIDE 11
Vision:
It’s of large interest that age- conscious personnel management is
rooted is in the behavior and culture of the organization: a manner of
looking and steering that is characterized through attention for the
(age- conscious) chances and limitations of employees and through
a complete and per-active manner of dealing with that. The
management is responsible for the policy within the cluster. In the
annual plan , spearheads and actions need to be formulated within
the result territory “qualities of work “.
\ A number of supporting instruments and conditions must be
present:
Good management information:
area codes as ages structures, absenteeism information, for
example : age-category and positions, internal mobility, need to be
analysed to commit interventions .A new personnel data system,
implemented in 2003 offers all possibilities. Financial space is to be
funded for necessary specific trainings. Permanent training is an
important instrument to hold employees usable long and broad . In
relation with the creation of an image about the older employee it is
necessary that this category employees becomes stimulated to
follow courses and trainings. Permanent training, also of the older
nascent employee, is important to keep up with the developments of
the profession. Furthermore there are specific trainings, with
increases the employability. This offers more possibilities in the
seeking to other work when the present work no longer can be
practiced.
Means also in the conditions of employment. The cafeteria system
that makes it possible to exchange for example free time for salary
or turned around, is also a tool. Also b. v. by a position adaptation
with a salary cutback regulation by which preservations of pension
are guaranteed. Rewards possibilities by irregular services
differently than the collective labour organisation prescribes. Par
example above the 55 year.
Page 41
Flexible regulations concerning working hours rules, adaptation of
rest and pause times, creating regularity, dose physical work
burden.
Investigate possibilities of task-job adaptation. Particular tasks no
longer. Other tasks right extra or adding new. Position or function
differentiation can lead to level’s in positions in particular target
groups.
In the Jeroen Bosch Hospital has been arranged that every
employee annually must get a performance interview. In the recent
held job satisfaction survey did appear that many employees need
such a conversation. In many cases however it did not take place.
The performance interview offers the possibility for early recognition
of problems around the self developing and more older nascent
employee. Sufficient attention is needed serves for wishes related
to the future, desired training and working conditions. It was very
strange that in our pamphlet has been taken up that it was no more
needed to hold performance interviews with employees from 55
year and older. That rule has scraped directly. A recent pilot in the
JBZ concerning Personnel Development programs, did lead to an
advice concerning a system for support personal development of
employees.
Recruitment and selection as much as possible, if the market
permits it, is tuned and adapted to the ages structure of the division
or target groups.
SLIDE 12
To give good filling-out at age- conscious personnel management
,the employee also has to be ready to discuss openly the personal
situation and needs to feel self responsibility for its development
process and career route. It is not a problem of the organization
alone and by the organization only to be solved. Willing to change is
also necessary considering the circumstances. Concessions need to
be accepted in advantage of the job satisfaction of the employee
himself. Steps back must also can appointed and experienced can
as steps forward on a bending off career.
SLIDE 13 See text slide.
SLIDE 14
A few months a go I read this article in my newspaper.
Page 42
The Dutch professor Johann Groothof finds it absurd letting people
work longer. He finds that there is insufficient eye for the health’s
risk’s. With adaptation of the work at the stage of life, care leave,
education, continuing education, yet the beginning is just made. If
you can limit the number early drop outs ,you don’t need the workers
of 60 and older necessarily. Topsport isn’t also to keep up on the
long term. Yet, he also sees possibilities and advantages. Work is
to be held easier longer through attention for good- fellowship,
atmosphere and solidarity. Longer continue working has certain
also the advantage that you remain integrated in the modern
society. He sees olds also as useful as a mentor for their younger
successors. It looks at the end that professor Groothof and I are
coming really together. I reassured finished after that my
presentation.
By the way……….Groothoff is 58 year.
Cor M. M. van Driel Adjunct directeur Jeroen Bosch hospital
Maart 2004
Page 43
ANNEX 3 : Présentation du contexte du Jeroen Bosch
Ziekenhuis (JBZ)
Le groupe hospitalier « Jeroen Bosch Ziekenhuis » est une structure de statut
privé, de type fondation, assurant une mission de service public.
Le JBZ est assez représentatif des structures hospitalières régionales des Pays
Bas
Hôpital embrassant la plupart des spécialités médicales, le JBZ a une situation
relativement monopolistique pour l’exercice du service hospitalier dans
l’arrondissement de ‘s-Hertogenbosch (360 000 habitants) ; en effet, aucune
autre structure hospitalière privée ou publique n’est présente dans cet
environnement. Pour autant, les patients ont le libre choix de leur hôpital et
peuvent se faire soigner dans les hôpitaux de villes voisines (Tilburg, Nimègue,
Eindhoven, voire Amsterdam…).
En outre, une concurrence quelque peu destructrice existe entre les sites
hospitaliers du JBZ, tant que la fusion n’est pas pleinement réalisée.
Le Groupe Hospitalier JBZ comprend 1120 lits et emploie 4000 agents non
médicaux et 200 médecins. L’activité est principalement orientée sur le court
séjour et la rééducation.
Le budget avoisine les 210 Millions d’euros.
Au titre de l’année 200, les principaux paramètres d’activité du JBZ étaient les
suivants :
27 800 admissions
216 500 journées d’hospitalisation
316 500 consultations
Ces activités se réalisent sur 5 établissements distincts :
-
3 établissements à ‘s-Hertogenbosch
o le Carolus Ziekenhuis
o le Willem-Alexander Ziekenhuis
o le Groot Ziekengasthuis
-
1 établissement à Boxtel
o le liduina Ziekenhuis
-
1 établissement à Zaltbommel
o le Bommels Gasthuis
L’hôpital est engagé dans une profonde restructuration avec une fusion de ses
5 sites et une capacité en lits (800 lits à l’avenir). Cette évolution va de pair
avec la volonté stratégique de hisser un certain nombre d’activités au rang de
Page 44
« topklinish », statut hollandais reconnaissant un niveau élevé de référence et
de qualité médicale aux spécialités concernées, pour des hôpitaux nonuniversitaires. La néonatologie et la neurochirurgie sont les principales cibles de
cette évolution stratégique.
Sans être encore trop fortement concurrencé, le JBZ observe une fuite de
patients vers d’autres hôpitaux régionaux, au fur à mesure que le
consumérisme médical se développe dans la population hollandaise. Ainsi,
même si les généralistes de ville sont chargés d’orienter les patients inscrits
chez eux, le « deuxième avis » (deuxième consultation) se développe
Par ailleurs, sans être de statut universitaire, le JBZ est accrédité pour proposer
des enseignements médicaux pour les jeunes médecins.
POLITIQUE DE GESTION DES RESSOURCES HUMAINES
Le code du travail hollandais est appliqué pour la gestion des personnels du
JBZ
(Récupérer le nombre d’équivalent temps plein + nombre de personnes)
Le JBZ enregistre une durée d’emploi de ses salariés très importante
(ancienneté moyenne à récupérer, si possible par catégorie d’emplois). Le turnover semble faible (voir les chiffres).
Les départs sont principalement limités à des situations de départ volontaire
(démissions) ou à des situations de maladie.
Les départs à l’initiative de l’hôpital (départs négociés, licenciement) sont
rarissimes (2 ou 3 par an concernent des problèmes comportemetaux).
Organigramme des emplois
Dans un département de soins, 7 niveaux d’emplois existent avec une
hiérarchie sur trois à quatre niveaux
niveau 1 : employés de ménage
niveau 2 : agents d’assistance hôtellière (pas de contact avec les patients) :
linge, repas…
niveau 3 : aide de soins (toilettes…)
niveau 4 : infirmière
niveau 5 : infirmière principale
niveau 6 : manager d’unité (unit hoofd)
niveau 7 : cadre de secteur (cluster manager)
Management
Page 45
L’unité principale de gestion est le cluster (secteur ou département) sous la
responsabilité d’un cluster manager
. Ils sont responsables de l’organisation, des budgets et du personnel du
secteur, en lien avec le médecin responsable du secteur qui est plus
particulièrement chargé de la gestion médicale et de la communication externe.
Ils pilotent l’évaluation de leur secteur, réalisée par les managers directs
(d’unité). Chaque agent est évalué chaque année. Trois fois par an, une
discussion collective est organisée dans chaque unité.
Ces managers reconnaissent qu’ils ont une responsabilité de fidélisation de leur
salariés. A leur niveau, cette fidélisation passe principalement par le
développement d’une bonne communication avec les salariés (« responsable
de l’ambiance »), par la formation et, à un degré moindre par l’action sur les
conditions de travail.
A noter que l’évaluation est sans lien avec le salaire qui progresse à
l’ancienneté.
La motivation des cadres passe par en premier lieu par la définition de projets
professionnels, d’objectifs, de responsabilités, en en second lieu, par les
actions de formation ou de participation à des congrès
Attractivité / Recrutement / salaires
Les phénomènes de pénurie de personnel sont encore assez faibles. Ils
concernent essentiellement des postes d’infirmières spécialisées, dans certains
services peu attractifs.
Il est parfois difficile de recruter des masseurs-kinésithérapeutes.
Au total, seuls 30 à 40 postes sont vacants dans l’hôpital.
La concurrence du home care existe, bien qu’il n’y ait pas de différence de
salaire. Mais, l’indépendance des infirmières de ville est un facteur d’attraction.
L’Hôpital y répond en mettant en avant les possibilités de temps partiel.
Des expériences de « job rotation » entre la ville et l’hôpital ont été tentées en
vain, les différences de culture entre ces deux secteurs rendent difficile ce
mode de fonctionnement. Du coup, des infirmières de liaison (ccordonatrices ?)
existent pour faire le lien entre la ville et l’hôpital.
Les services les moins attractifs sont la pneumologie et la neurologie. La
charge de travail en soins, plus importante et le manque relatif de technicité
décourage les infirmières de travailler dans ces secteurs.
Toutefois, plus largement, aux Pays-Bas, on peut faire le constat que les
professions hospitalières attirent peu les jeunes, même si cette attractivité peut
être plus importante lorsque le chômage se développe.
Ce manque d’attractivité des métiers hospitaliers pour les jeunes étudiants tient
au moins à trois facteurs :
- l’image faiblement valorisante ou valorisée du travail en milieu hospitalier
par rapport à d’autres secteurs de l’économie (banque, informatique…)
Page 46
-
les contraintes liées aux conditions de travail de ce secteur (pénibilité,
horaires difficiles…)
le niveau des salaires, en général assez peu compétitifs par rapport à de
nombreux autres secteurs.
Sur ce dernier point, les pouvoirs publics ont réagi depuis cinq ans en
revalorisant récemment les professions hospitalières.
Aucune incitation n’existe de la part des pouvoirs publics pour recruter des
salariés de plus de 50 ans, sauf pour les hôpitaux ou des opérations
spéciales ont été organisées pour permettre le retour des infirmières ayant
cessé de travailler.
A titre d’illustration la rémunération brute moyenne d’une infirmière de base est
de 2500 € par mois. Une infirmière plus expérimentée pourra gagner 2700 € par
mois. Pour une infirmière spécialisée, le salaire pourra atteindre 3000 €.
La politique salariale du JBZ est calée sur des grilles de salaire nationales,
uniformisées en 2000 pour les emplois publics.
Le JBZ n’a pas la possibilité de construire une politique salariale autonome et
attractive pour la quasi totalité des personnels.
Une évolution semble toutefois se faire jour pour les rémunérations médicales.
Les difficultés de prise en charge des patients dans certaines disciplines (liste
d’attente d’ un an par exemple en chirurgie plastique ou en chirurgie
orthopédique) peuvent conduire à la création d’un secteur privé au sein de
l’hôpital, pour ces spécialités.
La mise en place du paiement à la pathologie à compter de l’année 2004 (sur la
base des DRG’s) devrait aussi pousser dans cette direction, en donnant à
l’hôpital la possibilité de produire plus, de récupérer des enveloppes
budgétaires supplémentaires et de mieux rémunérer certains spécialistes
médicaux.
Les politiques de recrutement à l’étranger sont encore embryonnaires et
concernent des expériences dans des hôpitaux de grandes villes
(Amsterdam…) pour des médecins issus d’Afrique du Sud, des Philippines ou
d’Europe du Sud. Ces expériences se sont souvent conclues par des échecs en
raison de la double barrière linguistique et culturelle.
Développement de carrière – formation
La possibilité de faire une longue partie de sa carrière au JBZ est soutenue par
une politique volontariste de formation (statistiques à récupérer).
La Direction Générale estime que la formation est l’instrument principal qui
permet de maintenir les salariés dans leur emploi.
Le deuxième instrument de maintien dans l’emploi qui est avancé est celui de
l’amélioration des conditions de travail.
Page 47
La stratégie consistant à développer le rôle d’enseignement et de formation du
JBZ participe également du souhait d’attirer et de maintenir les professionnels
de santé. Le JBZ aspire en effet à devenir un des 17 meilleurs hôpitaux
régionaux hollandais dans ce domaine en atteignant cet « academic level » qui
confère à l’hôpital une vraie mission de « teaching hospital ».
la Direction Générale considère que dette image nouvelle de l’hôpital peut
constituer un élément de fierté pour les personnels et favoriser leur fidélisation.
Dans le contexte concurrentiel évoqué plus haut et qui devrait se développer
dans les années à venir,et dans l’optique d’un hôpital à la recherche d’un plus
haut niveau de performance, le niveau de formation des personnels et le
développement de leurs compétence devient stratégique.
La Direction Générale reconnaît que l’aptitude au changement, notamment des
salariés les plus anciens est lente à développer.
En outre, le contexte difficile de la fusion brouille dans l’immédiat la politique
des ressources humaines du JBZ. Beaucoup d’employés, dans cette période
transitoire ne sont en effet préoccupés que par une question : « quelle va être
mon devenir professionnel dans la fusion ? »
La perspective de la fusion amène cependant le JBH à investir sur l’évolution
de ses ressources humaines. Un consultant est spécifiquement missionné sur
le long terme sur les thèmes suivants :
- les programmes d’éducation avec un objectif de fidélisation
- les conseils de carrière
- le développement personnel et managérial
Son action immédiate est toutefois axée principalement sur les études
d’organisation liées à la fusion.
L’évolution de carrière pour devenir cadre de soins reste limitée (5 à 6
formations par an sont octroyées, après entretien simple avec le consultant et
un cluster manager). La formation pour être cadre apparaît plus souple qu’en
France puisque des possibilités de formation en alternance sont possibles.
L’alternance travail/formation existe aussi pour se former au métier d’ infirmière,
tout en conservant son emploi. Toutefois les évolutions des niveaux 2 ou 3 au
niveau 4 sont assez peu nombreuses (par contre, les évolutions du niveau 2
vers le niveau 3 sont de plus en plus fréquentes)
L’aménagement du temps de travail
Le temps plein est de 36H, la limite basse d’un temps partiel est de 9h (25%
d’un temps plein)
Le temps partiel apparaît très développé. La culture hollandaise explique en
partie ce phénomène, notamment chez les femmes. A noter qu’il n’y a pas
d’incitation salariale au temps partiel.
Page 48
L’Hôpital a cependant une politique du temps de travail qui peut être
différenciée d’un secteur à l’autre. Pour certains métiers, l’hôpital préfère du
temps plein. Pour d’autres métiers, le temps de travail peut être laissé à la
volonté du salarié qui « propose » un temps de travail. L’ Hôpital essaie alors
de s’adapter au mieux à l’offre de l’IDE qui dispose de 10 heures de travail à
fournir.
Exemples :
- le secteur de dialyse (Mme Broeders) emploie 70 employés pour
l’équivalent de 52 postes temps plein. Ce secteur est toutefois attractif
pour les IDE et le cadre ne favorise pas le temps partiel pour les IDE de
son secteur
- le secteur de neurologie (Mme Zontag) , peu attractif (malades plus
lourds et plus dépendants) est plus favorable à l’embauche de temps
partiel ; résultat : 200 employés se partagent l’équivalent de 114 postes à
temps plein.
- Le secteur pneumologie – cardiologie (Mr jan Delo) : 160 salariés pour
125 postes plein temps
- Le secteur dermatologie/ophtalmologie/ORL/chirurgie plastique (Hôpital
Carolus): 140 employés pour 110 postes temps plein
Autres conditions de travail
Le JBZ fait un effort pour les jeunes mamans : l’hôpital « achète » (terme à
préciser) des places de crèche dans toute la région.
La mobilité
Elle est faible dans les régions rurales, plus élevée dans les grandes villes. La
mobilité entre les sites du JBH est curieusement inexistante mais le projet de
fusion ambitionne de la développer.
L’offre de mobilité interne se réalise au sein de chacun des sites par appel à
candidature. Les mouvements sont donc basés sur le volontariat et motivés
par :
- le souhait de développer ses compétences
- le temps de travail
- la perspective de carrière. Il est à noter que des salaires plus élevés
existent en oncologie, en gynécologie, en pédiatrie (quels métiers ?)
La gestion de la maladie
L’invalidité concerne 1 million de personnes aux pays bas.
L’hôpital prend en charge la maladie pendant 2 ans.
1% du personnel de l’hôpital est en longue maladie
L’Hôpital et l’employé doivent tout faire pour le reclassement, selon un
protocole précis (visite initiale, propositions…)
Page 49
Au total, l’absentéisme maladie représente 6 à 7 %.
Le JBZ propose des programmes spéciaux de réintégration des salariés au
terme de longues périodes d’absence.
La retraite
L’age de la retraite à taux plein (76% de son salaire) est progressivement relevé
pour atteindre 62 ans en 2005.
Il est possible de choisir l’age de départ entre 55 et 65 ans mais le niveau de la
retraite varie en fonction de cet age de départ.
Aménagement des carrières des anciens
Le JBH n’a pas aujourd’hui de politique globale spécifique de prévention des
effets de l’age sur ses salariés. Le nombre de salariés agés, encore faible (voir
la pyramide des ages) ne suscite pas une mobilisation encore importante sur ce
sujet. Toutefois, la fusion, en mettant en relief les effets de génération
sensibilise les responsables à cette problématique
Certains aménagements particuliers sont toutefois privilégiés :
- l’assouplissement du temps de travail : à compter de 55 ans, les salariés
peuvent aisément grouper leur temps de travail sur 4 jours, en
conservant bien sur une rémunération à 100%. Toutefois, cette
concentration du temps de travail est en discussion dans certains
secteurs dans la mesure ou elle intensifie la charge de travail.
- Les salariés sont invités à revenir de jour après 50 ans
- L’épargne de temps (jusqu’à 1 an) est possible
A noter : Mme Carin Broeders (Dialyse) écrit un projet sur la gestion de
l’ancienneté dans son cluster avec des éléments autour de l’aménagement du
temps de travail : à approfondir en 2003.
Formation
Le gouvernement hollandais semble soucieux de développer une politique de
motivation et d’assesment pour développer les compétences tout au long de la
vie professionnelle. Ceci induirait une nouvelle approche du contrat avec les
salariés et l’accès à de plus longues périodes de formation continue.
Elle se réalise sur des modes classiques. L’offre d’e-learning en hollande
n’existe pas pour le secteur hospitalier.
Communication
Il n’y a pas d’enquête d’opinion interne générale. Certains clusters peuvent
éventuellement réaliser des enquêtes ponctuelles sur leur secteur.
Page 50
La communication interne est faible pour un établissement de cette dimension
mais la fusion devrait lui donner une nouvelle dimension.
Page 51

staff retention in socio- sanitary structures

Transcription

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