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www.european-hospital.com NEWS & MANAGEMENT Generation Y in hospitals today Facing a commercialised healthcare system Could the widely predicted short- age of qualified staff in German hospitals soon lead to tough competition for members of Generation Y, ultimately resulting in a change in hospital structures and a revolution in the country’s total healthcare system? Perhaps. EH correspondent Bettina Döbereiner spoke with Professor Christian Schmidt – among the first to scientifically examine the needs and desires expressed by today’s German medical gradu- ates to future employers – and also with consultant surgeon Professor Henne-Bruns, who has lengthy experience of coopera- tion between different genera- tions of co-workers. ‘In the future the hospital market will be strongly affected by com- petition for qualified staff,’ predicts Dr Christian Schmidt, referring to Germany’s demographic change, which he believes will soon lead to a massive shortage of qualified staff. This belief – and his personal expe- riences of dealing with the young doctors of generation Y (born after 1981) prompted Dr Schmidt and colleagues to scientifically examine what they have noticed about that generation. ‘We wanted to obtain, as much as possible, empirically sound evidence about this new generation of doctors, so that we can gear our management culture and Personnel Development Programmes specifi- cally towards this generation.’ Work commenced in 2011 (Der Anaesthetist, 60:517-524) by way of a comprehensive literature research on the internet. The bottom line of the evaluation: Members of Gen Y ‘live while they work’ – unlike the post-war generation (baby boom- ers), for instance, who ‘live to work’, but also unlike the members of Gen X, who ‘work to live’. According to this meta-evaluation, members of Gen Y place much importance on sticking to agreed working hours (ideally nine to five), refuse to work unpaid overtime and would consider working part-time for certain periods to achieve a bet- ter balance between job and family life. This could obviously lead to potential conflict for work in the hospital, a place where unpaid over- time is not a rarity and long shifts of work are the order of the day. Apart from their literature research and evaluation, Dr Schmidt and col- leagues also conducted numerous surveys of their own. The largest and most important to date was published in the specialist mag- azine HNO (HNO 2012, 60:993- 1002). Asked about their choice of future employer, young medical students said that a good working atmosphere was the most important aspect for them. In second and third place came a good training struc- ture and breadth of training and in fourth place was a family-friendly employment policy. Looking at these results, Dr Schmidt said, ‘Attracting members of Generation Y to our hospital means creating lifestyle-adapted career paths for them.’ He has very recently – having only been in Rostock for the last six months – helped to introduce a target agree- ment for consultants, which, among other points, calls for feedback and development dialogue with employ- ees. When it comes to being fam- ily friendly, Schmidt pointed out, Rostock University Hospital is already set up very well. ‘Ultimately,’ he added, ‘I’d like to strategically embed a management style that fits in with the new generation in our organisational culture – but this will take time.’ Unlike Schmidt, Dr Doris Henne-Bruns, at Ulm University Hospital, believes the issue of the generation gap to be irrelevant in her daily clinical routine. She also queries the classification of certain birth years into generations and the common up or devaluation of the different generations against one another. ‘This whole evaluation stat- ing that the “economic miracle” gen- eration worked hard and enjoyed it, and that Generation Y, although committed, only want to work for eight hours a day and otherwise prefer to focus on leisure and pleas- ure – there is a message here saying that the older generation did things correctly and the young ones are a little lazy,’ she criticised, encourag- ing us also to ask what the older generation may actually have done wrongly and what the new genera- tion is doing well. Furthermore, in more than ten years of management experience she has not experienced any gener- ation-based conflicts in her hospital: ‘We employ some very young assis- tants and I can see that they want to work just as hard and although they may have an eye on the clock, just like everyone else, they are fully committed and immediately prepared to step in when there are staff shortages.’ The only generation gap issue the professor has observed is that parental leave is more to be expect- ed nowadays among males. ‘That’s very positive; I’ve always supported it,’ she confirms. Unlike the generation issue, Dr Henne-Bruns believes that there is greater relevance in the commerciali- sation of medicine resulting not only in problems for daily routine but most significantly a change in values. Among excesses are liberal diagnoses and over-diagnosing due to finan- an object; this allows the object to be tracked. In many supply chain applications a single tag can be used over and over again but for authenticity applications, once a tag has been used, it must be destroyed. RFID operates in an unlicensed spectrum space and the specific fre- quencies used in a country depend on national regulation. ‘Although RFID is more secure, it is more expensive than barcodes and therefore is an uphill sell to push RFID in apps that have, so far, worked well with barcodes. Nonetheless, RFID can also do more than barcodes. Take the example of a medication that needs to be kept at a certain temperature – a barcode cannot keep track of environmental data. However, by attaching sensors to the packaging of the medication, an RFID tag can log information about the medication’s environment at certain intervals and it is possible to obtain this data at any time sim- ply by reading the tag. ‘In the above example, a ther- mal sensor would be required, but there are other sensors to deter- mine whether a specific object was dropped, exposed to light, or where it is actually kept. RFID offers a cost effective way of monitoring medica- tion freshness and authenticity – but will RFID ever replace barcode? I think this is unlikely because bar- code symbols are much less expen- sive than RFID tags and barcode scanners are competitively priced. ‘However, there is also a case for using barcode and RFID in tandem, as an additional layer of security, for example in tracking patients, because barcodes can be damaged and RFID readings can be jeopard- ised. The latter can occur if there are multiple RFID tags in close proxim- ity to each other. In this incident, an RFID reader might be scanning more tags than intended or not reading the right one. To remedy this, a supplementary barcode can be used to ensure the correct read- ings are taken.’ Where and why is RFID particu- larly useful in healthcare? ‘RFID really excels when stakes are high, for instance when patient iden- tities are confounded, or something valuable goes to waste because it’s handled incorrectly. This is particu- larly true for medications. Patients die due to the administration of wrong drugs, so medication authori- sation screams for RFID because its usage for this purpose is still miniscule. ‘The second high profile use for RFID is in to ensure the freshness of an item, to demonstrate that the supply chain has not been breached; for example, has the medication or sample been kept at the stipulated temperature? ‘In my view, these two are big and exciting opportunities for RFID. ‘Healthcare, of all indus- tries, stands to gain the most from RFID, ultimately because lives are at stake.’ cial pressure on hospitals, and also millions of euros drained from the healthcare system through indirect payments to shareholders via medical insurance premiums by yield-driven private hospital operators. In this, Dr Henne-Bruns holds high hopes for the younger genera- tion: ‘I hope that future generations will no longer be prepared to toler- ate this system in its commercialised shape and that they will drive a shift in thinking.’ Consultant, visceral and thoracic surgeon Doris Henne-Bruns is part of the German ‘economic miracle’ generation (i.e. born just after WWII war (1945-’55). Having studied medicine at the University of Hamburg she trained as a surgeon at Reinbek Hospital and Hamburg University Hospital, where she was awarded her professorship in 1988, writing her habilitation on Auxiliary Liver Cell Transplantation. Following her Hamburg professorship, in 1992 she moved to Kiel University Hospital where she became professor for oncology and transplantation at the General Surgery and Thoracic Surgery Clinic. From October 2001, Prof. Henne-Bruns has been Medical Director of the general, visceral and transplant surgery clinic at Ulm University Hospital. Her specialty: cancer surgery. Christian Schmidt, Medical Director and Head of the Board at Rostock University Hospital since 2014, belongs to ‘Generation X’ (those born between mid 1960s and ’70s). He studied medicine at the universities of Muenster, Germany, and Durban, South Africa, and specialised as a surgeon at Kiel University Hospital. He also studied Public Health with a focus on Healthcare Management in Bielefeld, Germany and Boston, USA. Working in hospital management since 2005, before his Rostock role he was Managing Director of the City of Cologne Municipal Hospital Group. With colleagues, Schmidt is currently writing a comprehensive practice handbook on Generation Y, with publication planned for late 2015. Will today’s junior doctors ultimately change tomorrow’s structures? H Sprague Ackley, Technical Fellow at Honeywell Scanning & Mobility, and a member of the ID World International Congress Committee CourtesyofHoneywellScanning andMobility CourtesyofHoneywellScanning andMobility CN70 RFID 5

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