How to unlock the hidden potential in hospital volunteers
Volunteers are an essential part of the health care system. Statistics Canada noted that seven percent of Canadian volunteers work in health settings, and one researcher calculated an average of 700 volunteers per Toronto hospital.
Volunteers do so much. But we could be using them so much more effectively.
In Canada, workforce planning and management focuses on those in paid roles, with little attention on volunteers. This is despite the fact that volunteers often take on large responsibilities, such as providing emotional support to patients and families, facilitating recreational activities and helping with administrative tasks.
In many cases, volunteers enable the clinical team to do more to meet patient needs. At Bridgepoint, a rehabilitation and complex care hospital in Toronto, highly trained volunteers help patients at mealtimes, encouraging safe and adequate eating while freeing nurses to focus on patients who need more advanced care.
In England, volunteers support older adults returning home after a hospital stay, helping with shopping, housework or filling prescriptions. These types of activities clearly benefit patients. However, in the majority of health care organizations, volunteers are underused and their contributions are unaccounted for or under-recognized.
It is well known that the health care workforce is stretched to the limit and health workers are struggling to meet patient needs with limited budgets. In this environment, hospital management must face head on how to use volunteers most effectively.
If policy makers and hospital management included volunteers in their definition of health human resources (HHR), we could shift from thinking about hospital volunteers as a nice to have to seeing them as an essential member of the care team. To enable them to contribute as much as possible to the health care system, their involvement must be planned and purposeful. We are not proposing that volunteers be viewed as a replacement workforce for busy health care providers; we are advocating for the recognition of an existing team member.
Administrative processes that govern volunteers must be altered to consistently mirror those used for paid providers. Thinking about hospital volunteers as HHR will ensure that we recruit, train and manage them in the same way as other HHR. That includes implementing standardized recruitment practices, aligning volunteers’ skills with tasks, and offering standardized, comprehensive training. There should also be proper supervision and ample opportunity for volunteers to provide and receive feedback, as we expect for other health care team members.
Strategically integrating volunteers into health care teams with an HHR-oriented management approach will make the most of their time and effort, while improving patient outcomes and experience. Seeing volunteers as HHR may help organizations develop outcomes-based descriptions for volunteer positions that clearly identify the role of the volunteer and the relationship between the volunteer and the clinical team.
This role clarity will help hospitals recruit volunteers with the necessary knowledge, skills and attitudes to excel in these roles, which in turn may improve the efficiency and satisfaction of volunteers. Volunteers who understand how their role improves the experiences of patients and families may be easier to recruit and more committed to their organizations. Matching volunteers to work they are skilled at and enjoy will lead to better retention, which is an important concern for volunteer managers.
In our research, we found that confidentiality and safety issues are often cited as key obstacles to more meaningful involvement of volunteers in the hospital setting. Explicitly including volunteers as members of the health care team may reduce fears regarding safety, confidentiality and liability because the volunteers will have clearly prescribed and communicated roles on the unit, and consistent supervision by designated team members.
Thinking about volunteers as HHR will help organizations measure performance, evaluate the impact of volunteers and ensure alignment with the mission and values of the organization. A group of experienced volunteer administrators have developed a Balanced Scorecard to help hospitals do just that. This is a departure from traditional approaches to measuring volunteer impact, which have often assessed numbers of volunteers and calculated the wage equivalent. A Balanced Scorecard approach will help hospitals assess and measure what volunteers contribute in the same manner as other HHR.
There are those who would argue against viewing volunteers as HHR, however. Some people fear that it will discount the altruistic motivations of volunteers, and suggest that their value should not be calculated at all. We believe that it is important for hospitals to understand and be able to communicate the contributions that volunteers make.
There’s also the understandable fear that HHR principles may medicalize the nature of volunteer work, potentially reducing the human connection of volunteer-patient interactions. However, we believe that focusing on the contributions of volunteers to improving patient experience and outcomes will increase the connection between the volunteer and patients – further humanizing the interactions.
Therefore, we propose that a middle ground is possible, where more careful attention paid to managing volunteers can be balanced with the needs of volunteers, patients and care providers.
Volunteers want to play a role in improving health care, and health care settings have a responsibility to ensure that they are engaged in meaningful work that explicitly benefits patients and families.
Michelle Nelson is a research scientist at the Lunenfeld-Tanenbaum Research Institute. She researches the design and delivery of rehabilitation services, with a keen interest in the role of volunteers. Her research is generously funded by Manulife.
Juliana Yi is a PhD candidate in Health Services Research at the University of Toronto and research coordinator at Lunenfeld-Tanenbaum Research Institute. Joanne Fine Schwebel is the director of the Volunteer and Interpreter Services programs at Mount Sinai Hospital and is co-author of the recently published book “Measuring the Impact of Volunteers: A Balanced and Strategic Approach.”