While employees work, hospital watches children - Mary Hitchcock Memorial Hospital, Hanover, New Hampshire

Healthcare Financial Management, Sept, 1990 by Kevin Read

While employees work, hospital watches children A New England hospital has opened its own child care center as a boon to its current employees and as a way to boost staff recruiting.

Mary Hitchcock Memorial Hospital, a 411-bed facility in Hanover, N. H., made on-site child care available to its employees and those of two other institutions, the Hitchcock Clinic and Dartmouth Medical School, in September 1989. The hospital, clinic, and medical school comprise the Dartmouth-Hitchcock Medical Center.

Dartmouth College has its own child care center, but the hospital's center is available to college employees if their own center is full.

In the fall of 1987, Mary Hitchcock Memorial Hospital faced a period of difficulty in recruiting nurses, especially those from outside its non-metropolitan area, according to Gail Dahlstrom, director of management services. The hospital responded by conducting an employee survey on the need for a child care center and the details that such a program might entail.

The survey led the hospital to hire outside child care consultants and form an internal committee that included representatives from the administration and human resource departments of all three components of the medical center.

The decision to open the center hinged on two factors, Dahlstrom said.

"Primarily, it was the recognition that we had a work force that really was dependent on high-quality child care to do its job well," she explained, citing the hospital's high percentage of female employees with children.

The hospital also "wanted to make a statement that child care was a valuable service to make available . . . that it was something we were concerned about."

Construction costs for the facility totaled slightly more than $1 million. The cost of care for each child enrolled in the center varies according to a sliding scale based on the parent's income. The portion of care not paid by parents is subsidized by the hospital as part of its employee benefits package.

High-quality care

Paul Gardent, senior vice president and chief operating officer at Mary Hitchcock Memorial, said the hospital wanted to establish a child care center with a high-quality staff and healthy ratio of staff members to children. The current ratio is close to one staff member for every four children.

The staff includes a director, a program secretary, two head teachers, seven teachers, and 12 teachers' aides.

"There's a dilemma in putting together a high-quality child care center and making it affordable for both the employee and the institution," Gardent said. The only choice that many parents have, he added, is "a sitter where they sit the kids in front of the TV . . . and there's not much interaction with the kids. We try to be attentive to that problem."

Mary Hitchcock Memorial's child care center offers more than babysitting, said Melba Christy, director of child care.

The center places children from six weeks old to six years old in a creative curriculum that varies according to the developmental readiness of the child, Christy said. "We look at emotional skills, social skills, cognitive skills, and motor skills . . . and then design activities that are going to impact the development of each child in the program."

Licensed for 109 children, the center now serves 84. Its 10,000-square-foot space, which includes specially-designed, child-size facilities is "really spectacular," Christy said. "It's been known locally as the Taj Mahal for children."

Growing concern

Gardent believes that employers are beginning to address the concern of child care for employees. "I think we're seeing a question in the political arena as to what extent of child care should be supported by the individual, what extent by the employer, and what extent by the government. I think this will be a major issue in the '90s," he said.

Christy agreed. Employer-provided child care, she said, "seems to be rather vogue. . . . Many other hospitals, particularly in the Northeast, have gone this route."

Hospitals that choose not to set up their own centers have other options, she said. Some firms assist employers in establishing and managing child care centers. Another choice is for the employer to purchase slots in independent centers, much as affiliated institutions make use of Mary Hitchcock Memorial's child care center.

The child care center is clearly an aid in recruiting new employees--and not only those with children, Dahlstrom said. "Even some people that don't have children have said, 'that really makes a statement on what Dartmouth-Hitchcock Medical Center is all about, the fact that you provide child care within your whole human resources perspective.'"

Kevin Read is features editor of HEALTHCARE FINANCIAL MANAGEMENT