Employee Engagement and Patient Satisfaction Go Hand in Hand
Every patient deserves to be treated with respect and to receive the highest quality care. As healthcare spending shifts focus from volume-based to value-based purchasing, the importance of providing the best patient experience is becoming more apparent than ever. Patients' overall perceptions of a hospital visit are largely a function of their interactions with the people who work there. For the former to be satisfied, the latter must be fully engaged.
Engagement is the employee on his lunch break who nonetheless readily agrees to walk a lost patient to the lab. It is the physician who removes the trash in a patient's room, and the social worker who takes time during her vacation to check in on a patient. Engaged employees are ready and willing to go beyond the call of duty to do what is right for both the individual patient and the overall organization.
In short, engagement is the emotional and intellectual bond employees have with an organization. The concept encompasses the effort they are willing to make to ensure that all stakeholders—leaders, managers, coworkers, investors—achieve positive results.
Avatar HR Solutions compiled data on 2,400 healthcare organizations using its Employee Engagement Index, which consists of items proven to impact employee engagement, such as loyalty, likelihood of exhibiting discretionary effort, and commitment to the organization. Based on 1.1 million employee responses, we found that the average hospital is only able to engage 31 percent of employees.
This means that almost 70 percent of employees are partially engaged or disengaged. What do these categories look like on the job?
- Partially engaged employees tend to view their work in transactional terms: they come to work for a paycheck and are focused on simply getting through the day. They rarely volunteer for anything and will assist patients only to the degree that is defined in their job description. They don't ask patients any questions beyond those required, because this might lead to extra work.
- Disengaged employees are interested in getting from, not giving to, the job; their behavior can actually do more harm than good. They often have a negative attitude about their employer and job duties that they are happy to share, tend to concentrate on problems and complaints, will avoid doing anything other than the bare minimum, and sometimes speak negatively about supervisors, other employees, and physicians, not caring if patients overhear.
- Actively engaged employees exceed expectations: they are self-motivated and driven to perform at a high level. They are willing to exert discretionary effort to improve the overall outcomes of the organization and serve as positive role models for the team, engaging and inspiring others. Further, they will do everything in their power to ensure patients have the best experience possible.
The Effects of Low Engagement
Employees who are not engaged in their work help degrade the patient experience. They are unlikely to meet a patient's basic and reasonable expectations for respect, assistance, and information. As a result, patient satisfaction across the board will decrease.
But the effects of partially engaged or unengaged employees in a healthcare organization go beyond patient satisfaction, to encompass issues of cleanliness, appropriateness and timeliness of procedures and protocols, errors in documentation, incomplete tasks, and reduced productivity and efficiency. Disengagement is, not surprisingly, correlated with higher absenteeism.
To ensure that patients are safe, receive high quality care, and are ultimately satisfied with their overall experience, it is necessary for hospitals to identify ways to increase engagement.
How to Increase Engagement
Avatar's research shows there are 10 key drivers of employee engagement and 4 key drivers of physician engagement.
The 10 key drivers of employee engage- ment include:
- Job content
- Career development
- Management's leadership abilities
- Availability of resources to perform the job effectively
- Strategy and mission
- Organizational culture and shared/core values
- Open and effective communication
- Senior management's relationship with employees
- Co-worker satisfaction and cooperation
The 4 drivers of physician engagement include:
- Quality care for patients
While these drivers vary according to individual and role, there are underlying themes that affect the engagement levels of all employees and staff, clinical and nonclinical alike. For example, both physicians and maintenance workers want the opportunity to provide input on their job content and organizational decisions. The most effective action plans to boost engagement among all groups are based on ways to leverage the particular drivers that influence each one.
An Engagement Initiative
In 2010, NorthShore University HealthSystem, consisting of four Illinois hospitals, set out to improve the patient experience and become the healthcare employer of choice in their communities. The system worked with Avatar HR Solutions to assess engagement levels across the four hospitals. When they compiled and analyzed the data, they identified two major factors that seemed to offer the greatest opportunity to better engage physicians and employees: recognition and involvement in decision-making processes.
Accordingly, NorthShore developed system-wide action plans specifically addressing these two drivers, as well as providing tools for some of the other drivers. Over the course of the following year, it implemented the plans, including but not limited to these specific actions:
- Scheduling consistent staff meetings to promote improved communication and opportunities for employee feedback
- Recognizing team members for their efforts at the staff meetings
- Introducing Workplace Solutions, a resource for everyday work life and practical concerns available to employees 24/7
- Giving employees additional opportunities to participate in projects/tasks outside of their daily routines
- Implementing shared decision-making models for employee participation
In 2011, NorthShore conducted a pulse survey to evaluate progress made; the findings allowed the system to strengthen their improvement efforts by:
- Further developing communication strategies to explain changes that were made as a result of the survey
- Identifying and working closely with managers and supervisors who needed additional help with the action planning process
- Rewarding and recognizing managers and supervisors who were effectively implementing action plans and encouraging them to serve as mentors to colleagues who were struggling
When NorthShore next conducted a full-fledged assessment in 2012, it saw a 10 percent increase in engagement levels across the board. Both employees and physicians were more likely to agree with statements that they were recognized for their work and that they had become more involved in the decision-making process.
"We are very excited about the overall improvements we've seen in our engagement scores from year to year," Maya Bordeaux, vice president of human resources at NorthShore, said. Improvement is always an ongoing journey, but NorthShore is set on its course.
"The system understands the importance of having an engaged workforce and is committed to continuously enhancing the employee experience as well as the patient experience."
The Best It Can Be
As NorthShore realized, engagement is essential to making an organization the best it can be. Even if they don't say it in so many words, patients notice the difference when physicians and employees are engaged in their work.
Full engagement translates to patient expectations being fully met, which in turn boosts patient satisfaction. By identifying key drivers and using selected best practices in ongoing engagement efforts, hospitals and health systems can reap the benefits of having everyone give their all to the common good.