How to manage high absenteeism rates in a highly unionized tertiary health care institution?

Our hospital is a large tertiary care institution in a publically funded health care system. We struggle with high absenteeism rates particularly among our unionized employees. Our hospital has an employee assistantship program (EAP) to assist workers to deal with issues outside of work. We also have an attendance management program.

Recent changes to the employment standards act now require that the first two days of personal emergency leave taken in a calendar year are paid by the employer. Also, the hospital now cannot require an employee to provide a medical note from a physician when the employee is taking the leave because of personal illness. There is concern that these changes to the employment standards act will result in increased absenteeism.

Recent financial challenges have reduced the overall morale of our employees. There is concern that both unionized and nonunionized positions may be eliminated. Management is concerned that the continued stress of job insecurity will only increase absenteeism further.

Any advice on how to manage high absenteeism rates in a highly unionized tertiary health care institution would be appreciated.


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Participant comments on Absenteeism

  1. Tough situation as it appears to me that there are financial challenges in the system, thus the amount of funds potentially available for awards for perfect attendance may be limited. However, if you could find some funds, I would propose a 3 tiered system for 100%, >95%, >90% days worked (or perhaps even make distinction on when the day off was taken- i.e. Fri/Mon vs other days, with or without sufficient notice etc). But the real challenge seems to be overall state of the enterprise.

  2. Agree with Igor regarding an incentive. You might be able to approach the union and suggest an attendance award (monetary, gift card, or even an extra day of time off). It’s also important when faced with these types of challenges (that you cannot control, such as these new regulations) to strictly enforce the existing attendance policies to mitigate as much of the issue as you can.

  3. Despite the financial challenges, you may still want to consider a time and attendance bonus, especially ion the union side. Does not need to be a significant amount of money, but enough to make improved attendance enticing. With high absenteeism, my guess is you are incurring significant costs or lost revenue- premium pay/OT for replacing lost shifts, or the inability to perform cases, accept patients, etc. without adequate staffing. If you were to implement the program now, you wouldn’t incur the expense of bonus payout for say 6 months to a year. This gives plenty of time to garner more than enough savings/revenue to offset the bonus expense, and achieve a return.

  4. We have implemented a program to award on a quarterly basis a bonus to employees that have no missed shifts. Each employee who has no missed shifts or tardy to be selected in a random drawing for the award. This has been a big success with the hourly employees. It has really helped in departments such as housekeeping and dietary where you always have a lot of missed shifts to fill.

  5. Be cautious re rewarding perfect attendance. you work in healthcare, so do you really want people coming to work sick?
    The best way to reduce absenteeism is to create an environment in which people are happy and want to come to work. A sense of community, where they are supported to be the best professional they can be. Focus on what matters to your people – find out from them first (which is really really hard to do reliably and well) – then work on the things that negatively impact them and on the areas where you can do more to positively incentivize (which may not be dollars).
    Look at it this way – if the people are calling in sick because they really are sick then there isn’t much you can do. If the people are calling in sick when they aren’t you can begin to get control of that when you understand what is influencing them to do that and fix it. And for those who are diehard abusers you need to effectively risk-manage their removal from employment as quickly as you can – which in a unionized setting takes time and commitment; and also requires that you have well structured and fully aligned policies, supports, protocols, and most importantly leadership expectations.

  6. First one must establish a good working relationship between the hospital administration and the union. Reduce any adversarial posturing. Have open and honest negotiations. Then work with the union and its membership to understand the health impact on the patients from absenteeism. It adds tremendously to overtime costs and increased FTEs. This means less base income for the employees that actually show up to work, and less money available to improve the health of the patients though hospital capital improvement. Work with the union to paper trail and release the worst offenders and the message will be sent.

  7. Thank you everyone for your very helpful comments! They are greatly appreciated.

  8. Tough situation! The big issue here is the union. If this was a problem within the organization there are many things you could do. Therefore I see it as working with the union versus removing them from the equation. For many centers removing the union is not an option. So with regards to working with the union you may need to meet with their leaders in order to address the issue. Negotiating with them may not be ideal but you may be able to find a solution that makes you both happy.

  9. You’ve got some great comments so far! In one organization where I worked where there was a high sense of connection, loyalty and community, we noticed the staff the commitment to “not letting the team down” helped lower absenteeism. Look for ways to increase that connection with the hospital and the individual team.

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