Viennese Hospital Association, Austria Training and development
The Viennese Hospital Association (Wiener Krankenanstaltenverbund (KAV)) is the biggest employer of health staff (medical doctors, nurses, physiotherapists etc) in Vienna, and also one of the largest health institutions in Europe. Of its 32,000 employees, around 13,500 are nurses, female and male, who work with other professionals in KAV hospitals and in geriatric institutions, treating around 400,000 patients annually.
Since 1 January 2002, the KAV has operated as an independent enterprise with an annual expenditure of €2.2 billion euro. The company’s motto is: ‘We are here to give people medical, nursing and psychosocial care, we consider sick people as partners and treat them with respect’. It is management policy in every hospital to promote employees internally and to provide education and training for every employee.
The KAV fosters an organisational culture that values and rewards experience and training in the workplace. The organisation discusses important employee initiatives with the trade union for municipal workers and in its social dialogue with each hospital’s works council.
The original initiative
The original initiative focused on nursing skills and sought to develop a horizontal career model based on five competency levels. Three pilot studies tested the model, its assessment tools and promotion plans, and evaluated them for their practical application and their impact on job satisfaction and motivation.
The results were as follows:
- Skill levels do not automatically improve over time, but continual challenges and vocational education do advance skills and help nurses to reach senior level. The horizontal career model enabled nurses to develop their skills.
- Identifying nurses as senior nurses and acknowledging their excellent work meant that they were more appreciated by other professionals and by management. Their competence was officially acknowledged.
- The support of a senior nurse could enhance the competence level of an entire team.
- Job satisfaction and motivation increased in two of the pilot teams but not in the third, which was being reorganised.
- Head nurses were very pleased with the initiative because it allowed them to concentrate on managing staff and on their work with patients and other professions.
- Nurses spent less time off the job because senior nurses trained and coached on the job.
- The skills-assessment methods and measures, for both implicit and explicit content, proved practicable and transferable.
Good practice today
The project team developed a plan, based on the experience of the pilot initiative, to implement the horizontal career model, and presented it to the General Department for Nurses. Although the department was interested, it does envisage some problems in a broader application, including difficulties in the establishment of permanent senior nurse positions. The project team suggested changing the current position of assistant nurse manager to that of senior nurse, leading to a higher salary and, therefore, recognising the senior nurses’ experience and performance. At present, individual departments can do this but it is not part of the company’s official personnel policy.
Although the KAV has not formally adopted the horizontal career model, two of the three pilot wards continue to use it. Due to a complete reorganisation of the third pilot ward, the experimental model was no longer used there.
In 2004, the KAV was presented with the Reifeprüfung award of the Federal Ministry of Social Affairs for its horizontal career model. This award recognises efforts by enterprises or departments that promote older workers or that try to retain them in the workforce. The initiative raised a lot of interest in other Austrian hospital organisations, and the model’s project team was invited to present it at nurses’ congresses and meetings throughout the country. Several articles on the model have been published in technical journals.
Recently, the entire KAV organisation was restructured and the former director of the General Directory for Nurses has now been appointed head of the company’s strategic quality management division. There is a good chance, therefore, that the discussion about implementing the model will be continued.
The senior nurses and project team of the pilot programme are still trying to get the competence model formally included in the KAV’s personnel development plans and human resource policies, and are looking for recognition of the senior nurse status. Further evaluation of the model’s economic effects (for example, lower staff turnover) would be of interest to the KAV and might support arguments in favour of implementing the model as good practice.
Contact person in the Viennese Hospital Association:
Frau Direktor Anna Danzinger
Schule für allgemeine Gesundheits- und Krankenpflege
Lazarettgasse 14, Schulgebäude 1
Tel: (43 1) 40400 7430
Fax: (43 1) 40400 7444