City Hospital is located in the heart of a large Midwestern city. It is one of five major hospitals in the area and has recently built a small addition for treating well-known patients such as professional football players, top company executives, and singing stars. Visiting or local celebrities always choose City Hospital if they need treatment.

City Hospital has about 1,200 hospital beds and employs 4,500 individuals, including about 40 patient escorts. The job of patient escort is a simple one, requiring only minimal training and no special physical talents. When patients need to be moved from one location to another, patient escorts are summoned to assist in the move. If the move is only a short distance, however, a nurse or orderly can move the patient. Of particular importance is the fact that patient escorts almost always take patients who are being discharged from their hospital room to the front door of the hospital. A wheelchair is always used, even if the patient is able to walk unassisted. Thus, the typical procedure is for the nurse to call for a patient escort, and then the escort gets a wheelchair, goes to the patient’s room, assists the patient into the wheelchair, picks up the patient’s belongings, wheels the patient down to the hospital’s front door or to a car in the parking lot, and returns to the workstation.

The job of patient escort is critical to the hospital, since the escort is always the last hospital representative the patient sees and hence has a considerable influence on the patient’s perception of the hospital. Of the approximately 40 escorts, about three fourths are men, and one fourth are women. Most are high school graduates in their early 20s. Some, particularly those on the early morning shift, are attending college at night and working for the hospital to earn money to pay college expenses. Four of the escorts are older women who previously served as hospital volunteers and then decided to become full-time employees. Turnover among patient escorts is quite high and has averaged 25% in recent years. In addition, upward mobility in the hospital is quite good, and as a result another 25% of the escorts typically transfer to other jobs in the hospital each year. Thus, about half of the patient escorts need to be replaced annually.

The hospital follows a standard procedure when hiring patient escorts. When a vacancy occurs, the HR department reviews the file of applications of individuals who have applied for the patient escort job. Usually the file contains at least 20 applications because the pay for the job is good, the work is easy, and few skills are required. The top two or three applicants are asked to come to the hospital for interviews. Typically, the applicants are interviewed first by HR and then by the patient escort supervisor. The majority of those interviewed know some other employees of the hospital, so the only reference check is a call to these employees. Before being hired, applicants are required to take physical examinations given by hospital doctors.

Every new escort attends an orientation program the first day on the job. This is conducted by a member of the hospital’s HR department. The program consists of a complete tour of the hospital; a review of all the hospital’s HR policies, including a description of its promotion, compensation, and disciplinary policies; and a presentation of the hospital’s mission and philosophy.

During this orientation session, employees are told that the hospital’s image in the community is of major importance and that all employees should strive to maintain and enhance this image by their conduct. After orientation, all patient escorts receive on-the-job training by their immediate supervisor.

During the last 2-year period, the hospital has experienced a number of problems with patient escorts that have had negative consequences for the hospital’s image. Several patients have complained to the hospital administration that they have been treated rudely, or in some cases roughly, by one or more patient escorts. Some complained that they had been ordered around or scolded by an escort during the discharge process. Others stated that the escort had been careless when wheeling them out of the hospital to their cars. One person, in fact, reported that an escort had carelessly tipped him over. All escorts are required to wear identification tags, but patients usually can’t remember the escort’s name when complaining to the hospital.

Additionally, the hospital usually has difficulty determining which escort served which patient because escorts often trade patients. Finally, even when the hospital can identify the offending escort, the employee can easily deny any wrongdoing. Such an employee often counters that patients are generally irritable as a result of their illness and hence are prone to complain at even the slightest provocation.

At the hospital administrator’s request, the HR manager asked the chief supervisor of patient escorts, the head of the staffing section in the HR department, and the assistant personnel director to meet with her to review the entire procedure used to select patient escorts. It was hoped that a new procedure could be devised that would eliminate the hiring of rude, insulting, or careless patient escorts.

During the meeting, a number of suggestions were made about how the selection procedure might be improved. Criticisms of the present system were also voiced. The chief supervisor of patient escorts argued that the problem with the hospital’s present system is that the application blank is void of any truly useful information. He stated that the questions that really give insights into the employee’s personality are no longer on the application blank. He suggested that applicants be asked about their hobbies, outside activities, and their personal likes and dislikes on the application blank. He also suggested that each applicant be asked to submit three letters of recommendation from people who know the applicant well.

He wanted these letters to focus on the prospective employee’s personality, particularly the applicant’s ability to remain friendly and polite at all times.

The assistant HR manager contended that the hospital’s interviewing procedure should be modified. He observed that, during the typical interview, little attempt is made to determine how the applicant reacts under stress. He suggested that if applicants were asked four or five stress-producing questions, the hospital might be in a better position to judge their ability to work with irritable patients.

The head of the staffing section noted that patient escorts require little mental or physical talent and agreed that the crucial attribute escorts need is the ability to be always courteous and polite. She wondered whether an “attitude” test could be developed that would measure the applicant’s predisposition toward being friendly. She suggested that a job analysis could be done on the patient escort position to determine the attitudes that are critical to being a successful patient escort. When the job analysis was complete, questions could be developed that would measure these critical attributes. The test questions could be given to the hospital’s present patient escorts to determine whether the test accurately distinguishes the best from the worst escorts. The head of the staffing section realized that many of the questions might need to be eliminated or changed, and, if the test appeared to show promise, it would probably need to be revalidated to meet government requirements. She felt, however, that a well-designed test might be worth the effort and should at least be considered.

CASE QUESTIONS

Assume you are the HR manager when answering the following questions:

1. Before changing the selection process for hiring patient escorts, you want to talk to current escorts to get their views about the problems reported by patients. The patient escorts will probably not think they are the causes of the problems. What are some other reasons for the problems reported by patients, other than a poor selection process?

2. After speaking with patient escorts, you conclude there is some room for improvement in the selection of people for this job.

a. State three criteria that you would use when designing a better selection process.

b. What validation strategy would you use to design new selection practices for patient escorts? Why?

c. Review the various types of selection “tests” described in this chapter. Which type of test do you think could most improve the process for selecting patient escorts? Explain why.