How the UKE is revolutionizing employee retention

Can you briefly describe the UKE?

Michael van Loo: The UKE comprises more than 78 interdisciplinary clinics, outpatient clinics and institutes in 13 centers. In total, we employ around 18,000 staff from various professional groups, of whom more than 15,000 are currently in active service. We are currently training around 1,000 junior staff and employ more than 5,000 nurses and therapists as well as 4,500 doctors and scientists.

What is behind the “UKE INside” label?

Michael van Loo: Around 15 years ago, we at the UKE set ourselves the goal of being the best employer in the healthcare sector in the long term and always thinking one step ahead. Although the shortage of specialists was not as acute back then as it is today, we wanted to take measures at an early stage so that we would not be affected later. We therefore decided to focus more on employees as well as patients. With the support of our Management Board, we developed a comprehensive HR policy strategy that goes beyond a purely business-oriented approach and meets the needs of our employees - at the time called an employee-oriented HR policy. As the title was somewhat unwieldy and the strategy was initially only directed inwards, we labeled it “UKE INside”. Although we did not actively communicate the positive development to the outside world, our good reputation as an employer spread via social media and we were recognized as one of the best employers within just three years.

Our system is based on a decentralized organization. Instead of creating central staff units, we involve all employees. Our HR policy is divided into three areas of action: Leadership and qualification, health and health management and work-life balance. Each area is overseen by a working group consisting of the Head of HR, a member of the Management Board and other interested parties. These groups meet several times a year to evaluate and further develop our position in these areas.

Was für Maßnahmen haben Sie konkret ergriffen?

Michael van Loo: First of all, we collected what already exists and is bundled and marketed under UKE INside. This includes various advisory services, check-ups, our company kindergarten and much more. Since then, new ideas resulting from the needs of our employees have been evaluated and implemented as part of targeted project work. For example, childcare has been expanded to include a program that covers almost the entire vacation period. Such offers are evaluated internally and adapted or discontinued as necessary. Successful measures are included on our intranet, where we provide a total of around 300 offers, ranging from “A” such as acupuncture to “Z” such as supplementary benefits.

Our system is based on a top-down, bottom-up principle. Management supports the measures and employees are involved. Every year, around 250 employees are actively involved in this process. Many measures do not cost a lot of money, but bring great benefits. Since 2019, we have been using the opportunities offered by the former Nursing Staff Strengthening Act to obtain additional funding for projects to improve working conditions. Techniker Krankenkasse and DAK provide us with financial support for various projects such as “Working 5.0”, which was only made possible by this funding. 

Why do you think none of your competitors jumped on the bandwagon 15 years ago?

Michael van Loo: Even if there are still sceptics, many of our competitors now admire what we have achieved. First and foremost, this requires a commitment from management that recognizes employees as the most important success factor and must offer a culture of cooperation and “give and take” in a balanced relationship. It should not be expected that every investment will pay off 1:1 and as directly as possible. There is often a lack of insight into the fact that increased motivation, identification or a lower fluctuation rate are not directly reflected in the result, but contribute indirectly and sustainably to economic success. Increasing numbers of applicants, as well as numerous prizes such as the German Personnel Management Award and the German Health and Demography Award, encourage us on this path. 

You reported on “Working 5.0 at the UKE” at the HR congress. In your opinion, what are the pillars of Working 5.0?

Ulrike Mühle: In 2017, the topic of making working hours more flexible came up, which was explored in greater depth in various workshop formats and working groups. We wanted to move away from the rigid three-shift system towards employee-oriented working hours. As the need was greatest in nursing, we started the conceptual work after two years. Our aim was to retain employees and thus better adapt working hours to work processes. We therefore drew up daily structure plans and used them to analyse work peaks in order to harmonize interprofessional processes with the new working hours. This enabled us, for example, to facilitate more frequent joint ward rounds by doctors and nursing staff and thus strengthen interprofessional collaboration.

In this context, we also looked at various working time models from abroad. On this basis, we have developed our own concept, which includes long and short shifts in order to meet the individual needs of our employees. Although we still work a three-shift system, we offer additional working hours on the wards. We have also developed a concept for mobile working to give nursing staff more freedom. In addition, we have tested a model for flexible working hours (flexitime model) so that they can react to personal events at short notice by starting earlier or later, despite their fixed duty roster. We then tested the overall concept as part of a pilot phase in three different areas. As it proved successful in practice, we have been rolling it out across the entire UKE since 2022. 

What effects and results do you see from “Finding employees”? How does the UKE attract new specialists?

Ulrike Mühle: Our project is comprehensively evaluated by the Hamburg Center for Health Economics, which conducts an annual employee survey. The UKE also provides additional data on applications, resignations and staff turnover, among other things. Only after the evaluation can we make valid statements about whether we have actually gained staff through the project. However, we have already received positive feedback from employees and applications as a result of the project. Although we do not yet have exact figures, we are certain that we are reaching exactly our target groups with this concept. The data from an internal dashboard, which visualizes the use of the new working hours, confirms this assumption. 

Michael van Loo: We are often asked whether the project pays off. But we have to move away from this way of thinking, as not everything can be measured. The fact is that we recruited over 200 new nursing staff last year - a record for us. Although we didn't explicitly ask every new employee whether they joined us because of “Working 5.0”, the success speaks for itself. 

The topic of employee retention also plays an important role here...

Michael van Loo: Employee retention has always been a priority for us - when we started out, this was our core issue. After all, our employees know best what they need. The close bond and the corporate culture we live by now also radiate outwards, which automatically increases our appeal and leads to the recruitment of new employees.

Ulrike Mühle: On the subject of working hours: Studies show that helping to shape the duty roster and their own working hours is of the utmost importance to employees. As the duty roster determines the lives of care staff, additional options for shaping it significantly improve job satisfaction. 

What experience do you have in integrating foreign nursing staff?

Michael van Loo: I often hear from colleagues in management positions that the integration of the new generation, dealing with the so-called feminization in medicine or the integration of foreign specialists in the hospital landscape seems almost impossible. I take a more relaxed view. As an employer, it is important to create a sustainable, good corporate culture that minimizes the “real” hurdles to integration, namely those in many people's minds, so that every employee feels welcome, regardless of age, gender or origin. There are bureaucratic hurdles when it comes to integrating foreign specialists, even if it is honest to say that they have at least the same, if not better, professional qualifications.