Career Minded
 June 2016
What Makes a Happy HIM Work Culture?

By Kayce Dover, MSHI, RHIA
"Happy families are all alike," Leo Tolstoy famously wrote. And the same may hold true for HIM departments. So what are the factors that make an HIM department happy? HIM Connections recently conducted a survey of HIM managers and team members to learn about HIM happiness: What works well in departments? What doesn't? How can managers improve happiness at work? And how can job-seekers improve their chances of landing in a happy HIM department?
Survey respondents were recruited via e-mail invitation; out of 200 of HIM Connections' contacts polled, 35 responded. Of the 32 respondents who provided job titles, 53 percent were HIM directors/managers (12) and medical coding professionals (5). The remaining 47 percent included specialists and administrators who work with HIM in areas of compliance, privacy, data integrity, operations, and information systems.
This article provides a summary of the survey results, along with insights and strategies to help employers create and job seekers recognize an effective HIM work culture.
Obstacles to a Positive Work Environment
The second part of Tolstoy's quote above is, "Every unhappy family is unhappy in its own way." That may be true, but certain factors tend to universally make people unhappy. In this survey, respondents consistently identified problem areas in HIM departments related to the following four key factors:
  • Micromanagement and lack of trust—not giving employees autonomy to do their jobs; managing by intimidation
  • Ineffective communication and team engagement—lack of clear expectations as to what is required to do a good job and achieve success individually and as a team
  • Failure to value people for their abilities and contribution to the organization—low morale or lack of motivation
  • Resistance to change—not open to new ideas; set in old ways of doing things
What Are the Elements of an Effective Work Culture?
The survey found that, most of all, people want to be part of a culture in which they feel valued, respected, and appreciated. Employees want managers who acknowledge their accomplishments, encourage them to voice concerns, are open to new ideas, set clear expectations, and keep everyone informed. Management cannot afford to drop the ball on these activities, which, especially in larger departments, can easily happen.
Respondents offered the following specific examples of ways HIM departments can engage employees and what works well to create a positive environment:
  • A comprehensive on-boarding process that provides clear expectations along with the information and tools employees need to be successful
  • Celebration of successes, encouraging strategic thinking, and taking time to talk to staff
  • Actively seeking individual staff member input; transparency in communication
  • Hold monthly department meetings, as well as short morning huddles where team members report on what was achieved the previous day and focus on tasks for the current day, and managers provide encouragement
  • Have an open-door policy to discuss issues, invite feedback, and offer educational opportunities
  • Cross-training and communication within the team, as well as involvement in decision-making
  • A monthly newsletter specific to HIM that is also shared with other departments
In addition, employees are empowered in an environment that offers flexibility, responsibility, and opportunities for problem-solving. Given those factors in addition to money, 56 percent of respondents ranked responsibility/problem solving as their top priority, 41 percent chose flexible work schedule/personal time, and only three percent said money made them happiest at work. While fair compensation certainly matters to people, working within a supportive culture is a critical factor for dedicated HIM professionals.
Paving a Successful Career Path
Feeling successful at work, feeling there are opportunities for growth along a clearly-defined career path, was seen in the survey to contribute to overall employee satisfaction. In terms of success factors, promotion and advancement ranked highest (54 percent), followed by money (34 percent). When asked to describe their career progression, 58 percent said they had experienced new responsibilities, promotion, and/or a higher salary in the past five years.
As these results suggest, money is not always the number-one driver. More often, people are motivated by the assurance of a solid career progression. During the hiring process, managers should articulate opportunities for promotion and advancement, as well as commensurate compensation. For example, an individual breaking into the profession might start as a coder, knowing there are possibilities for advancement in other areas, depending on their goals.
Leadership Makes or Breaks a Positive Environment
Leadership sets the tone for a positive and supportive HIM work environment. Managers of happy HIM departments do the following:
  • Set the right expectations. They let people know what is expected of them up front and provide the autonomy and resources they need to perform well.
  • Encourage department communication. They engage employees for ideas and feedback. They establish an open-door policy. They are available, approachable, and willing to listen.
  • Recognize team members. They acknowledge team members for their hard work and accomplishments and regularly reward department "superstars."
  • Think outside the box. They are creative. They know that having toys, stress balls, Silly Putty, and other tactile, fidget-friendly objects available during meetings helps release stress, spark new ideas, and inspire creative thinking. (Research shows this works.) They arrange lunch-and-learns or invite motivational speakers that their team can learn from together.
  • Avoid being a "helicopter manager." They communicate expectations and give the team the flexibility and time to complete the job. Rather than micromanaging, they empower the team to do their work and encourage them along the way.
  • Promote work-life balance. They offer flexible hours and opportunities to work remotely whenever possible, to enable employees to come to work refreshed, ready to do their jobs well.
In our ever-changing healthcare environment, HIM professionals must prepare to embrace new opportunities to advance their careers. A positive culture encourages evaluation of an increasing number of choices, supporting efforts to achieve career goals.
Bringing the Right People Together
Effective hiring practices are essential for bringing in people who will contribute to a positive culture. Managers need to know what drives and motivates potential employees. Who will work best under their leadership style? Are the prospective employee's values and expectations aligned with the department's culture? Conversely, prospective employees should be clear in their own minds about their work values and expectations.
During the interview, employers should clearly define and discuss the various aspects of the culture and set clear expectations about what the department is trying to accomplish. This means asking the right questions. The interview should explore career goals, advancement expectations, learning style, and the candidate's ability to work independently as well as part of a team.
Happiness-Seeking Questions for Prospective Employees
How does a prospective employee suss out whether the job they're considering is part of a happy department? When the moment comes in the interview when the manager asks, "Do you have any questions for me?" here are six questions that can help job-seekers determine how happy the department is, and how happy they are likely to be in it:

1. What do you enjoy most about your job or this organization, and what would you change?

2. How do you keep your team engaged and updated?

3. How do you show employees that they are valued members of the team?

4. Can you describe a typical day for someone in this position?

5. What are the three most important qualities you look for in an employee?

6. What are the future opportunities for advancement for someone in this role?

Both employers and job-seekers need to be patient. Taking the time to hire the right people, and find the right job, is well worth the effort, and will ensure happier employees, managers, and departments in the long run.

Kayce Dover is the president and CEO of recruiting firm HIM Connections.

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