The Significance of Employee Engagement in Healthcare Essay
The Significance of Employee Engagement in Healthcare Abstract The following research paper describes in detail the relevance of employee engagement to a healthcare provider. Engagement of employees is often an overlooked area of focus as hospitals look for ways to improve processes and reduce operating expenses. Healthcare is somewhat unique in that cost to the customer is not the main economic force driving patients to the various hospitals or healthcare providers. The focus of the following is to examine the importance of employee engagement hospital wide.
There are factors that lead a prospective patient to choose one healthcare provider over another, assuming choices exist. When discussing engagement, emotions can play a very critical role, and the affects of employee engagement on measurable components of a successful healthcare system are extensive. This research will go into detail on how engagement impacts most areas of healthcare, including areas that many professionals in the healthcare industry may not even realize.
Hospital executives are beginning to understand there is an economic relationship that exists between engaged employees and almost every other facet related to the operation of a successful health care system. KEYWORDS. Employee Engagement, Patient Satisfaction, Healthcare Providers The Significance of Employee Engagement in Healthcare Employee engagement in theory is fabricated of simple practical concepts made up of common sense ideas. Countless companies each year, including the healthcare industry, spend millions of dollars trying to determine how to better engage employees and the impact it causes.
How can companies spend that much every year just trying to figure this out? For example, in healthcare, a hospital will spend approximately $785,000 in total network and hardware configurations as part of the expense for the development of an Electronic Medical Records system (Renner, 2009). When spending the $785,000, the hospital is receiving in return a tangible product that will perform the exact job functions it was designed to carry out. Employee engagement is a huge financial investment which is relatively intangible and could be characterized as an investment in human emotion.
The basis for emotional economics makes sense in this situation. When employees are better engaged, performance levels rise and employees actually care about what they are doing. The main topics to be explored are the significance of employee engagement and the various parts of healthcare that are impacted by this. Employee engagement is such a large topic, to better understand the topic it is necessary to ask a couple more questions. What other areas of business may be impacted as a result of an organization having a clear understanding of employee engagement?
A couple of areas to be explored further include correlations to patient satisfaction, turnover, performance and patient outcomes. Once an organization has a clear understanding of the areas employee engagement can have an impact, the next question becomes how to measure the level of engagement among the workforce. In addition, once the level of engagement has been converted into a quantitative amount, what is done with the information? This is also an area where many organizations fall short, which will be discussed in depth. Background: What is Employee Engagement?
It is very important to define and understand what employee engagement actually means. Initially, engagement has been found to have many different meanings depending on the goal or desired outcome of the organization. A “satisfied” employee is not necessarily an engaged employee. The Towers Perrin study defined engagement as, “the willingness and ability to contribute to the company’s success to the extent to which employees put discretionary effort into their work, in the form of extra time, brainpower and energy” (2008). Engaged employees are committed in an organization.
Healthcare systems have a wide range of employee engagement, from actively disengaged to the contrary actively engaged. An actively disengaged employee is an employee that may be physically present, but psychologically absent. They are unhappy with their work situation and insist on sharing that unhappiness with their co-workers. Jim Harter and Tom Rath give an excellent analogy describing the disengaged employee in their book Well Being, the Five Essential Elements, they said to think back to when you were in school sitting through a class in which you had very little nterest. Perhaps your eyes were fixed on the clock or you were staring blankly into space. You probably remember the anticipation of waiting for the bell to ring so you could get up from your desk and move on to whatever was next. More than two-thirds of workers around the world experience a similar feeling by the end of a typical workday (2010). Disengaged employee attitudes tend to be contagious. An actively engaged employee is on the other side of the pendulum. They work with passion and feel a profound connection to their company.
They drive innovation and move the company forward. Engaging Impacts Understanding employee engagement is the first step, but the goal is to understand the relationship linking an engaged co-worker and the earlier identified areas impacted. These can include a broad range of topics such as patient satisfaction, employee performance and employee turnover. The following Gallup chart illustrates perception is everything. The correlation between employee engagement and patient satisfaction in healthcare is unique. In general providers do not market themselves on cost.
More times than not, a surgical patient will not know the cost for the procedure before undergoing the operation. With all the possible variables involved, the providers most likely do not know the associated costs either. Even if cost were available, providers do not want to use the Wal-Mart strategy of being the low cost leader. People associate lower cost with lower quality of care. Since cost of care is not a marketable factor, other areas become overstated including the satisfaction of the patients. It is healthcare provider’s obligation to ensure the patient is satisfied or market share will be compromised.
There are many variables to patient satisfaction, but research has shown a direct correlation between high patient satisfaction levels and a highly engaged staff. Press Ganey has done extensive research in an area they refer to as the Employee Partnership Model TM. In 2009, Press Ganey analyzed the experiences of 169,002 employees and 305,757 patients from 185 U. S. hospitals to underscore the predictive value of the partnership model. The regression analysis shows the relationship between these two variables is strong and indicates that as one variable increases (i. . , patient satisfaction) there is a positive increase in the other variable (i. e. , employee engagement). Correlation studies do not prove that improvements in one variable cause improvements in the other, however there is a definite correlation between them. Below is Press Ganey’s regression analysis. Employee turnover is another area directly impacted by employee engagement. Turnover occurs when an employee permanently leaves a healthcare facility. Turnover can cost an organization anywhere from 1. 5 to 2. 5 times the annual salary paid (Cascio, 2010).
Unfortunately, healthcare organizations cannot budget for this cost since turnover is not always predictable. According to Gallup, research was conducted “which included a meta-analysis of 44 organizations and 10,609 business units, Gallup Polls of the U. S. working population, exit interviews conducted on behalf of several companies, and Gallup’s selection research database, most people quit for a few explainable reasons. What’s more, a set of engagement elements explains 96% of the attitudes that drive voluntary turnover rates for work units. But the reasons people leave might not be what most bosses think” (2008).
These findings are a clear indication that an engaged staff can lead to significant savings. Patient outcomes also have a strong relationship with employee engagement. The American Heart Association discussed how both Duke University and North Carolina University School of Medicine conducted a study. Researchers examined whether patient satisfaction is associated with adherence to practice guidelines and outcomes for acute myocardial infarction. Patient satisfaction was positively correlated with 13 of 14 acute myocardial infarction performance measures.
After controlling for a hospital’s overall guideline adherence score, higher patient satisfaction scores were associated with lower risk-adjusted inpatient mortality (P=0. 025) (2010). These results are enlightening, how engaged employee’s can make a difference just be being enthusiastic about their work. Patient satisfaction, employee performance and employee turnover are just a few areas that are directly impacted by employee engagement. There are many other areas were studies show a strong relationship to engagement.
For example, work performance would be another good example. The financial impact correlated with an engaged staff is huge for healthcare organizations. Studies continuously reaffirm that an engaged staff can result in financial well being. Where Does the Data Come From In recent years, tracking employee engagement has become a huge business. Given the previous data, patient satisfaction, turnover and patient outcomes, it is natural that companies are interested in gauging the engagement levels as a key indicator of where the organization stands in the market.
There are several organizations that offer services in this field including PeopleMetrics and Watson Wyatt; however Gallup and Press Ganey are the leaders in the industry. Both Gallup and Press Ganey have determined the best methods for measuring engagement as well as organizing the data so other institutions are able to interrupt the data. Data is not only reported as one number for the entire organization but it is also broken down into many different categories including the manager level, department level and even by job type.
Press Ganey recently released The Pulse which related to engagement scores. It appears the closer the employee is to patient care, the lower the engagement scores were. This is not an inclination most healthcare administrations were excited to see, but it is very revealing and even an eye opener for the organizations. Gallup has concluded that employee engagement can be captured within 12 questions. There claim is that after years of study and research all areas of engagement can be summed up with the context of the following twelve questions shown below.
Making Employee Engagement Actionable At this point the impact of employee engagement and the data collection methods have been discussed, however there is still one step left of equal or greater importance. This step makes bringing the data collected to life as well as making it actionable. If a healthcare organization wants to lower morale and the engagement process, the organization would ask for the co-workers opinions and then disregard the answers. In many organizations this is the norm rather than the exception; employees complete the survey and wait for a response.
Generally employees get no feedback which leads to an assumption that their opinions have been dismissed. Melissa Lampe and Joanne Earl (2006) wrote in an article for the Gallup Management Journal, “A well-crafted survey can help increase engagement, but only if its part of a comprehensive approach to managing engagement. Once survey results are available, their release should be closely followed by two things: inclusive impact planning and effective changes. ” These results should be available for employees to view or at least discuss the results with them.
Gallup also suggest conducting the following six steps as being vital to making significant improvements in the employee engagement process: 1. Introduce the impact planning session and state its purpose. This will help employees understand what engagement is, why the survey was conducted and what it measures, what the survey items mean to them and to their workgroup, and why impact planning is a vital step in improving employee engagement. 2. Distribute and explain the survey results. 3. Discuss what those results mean for the workgroup, item by item. 4. Select two or three key items to work on over the next 12 months. . Brainstorm follow-up actions and complete a plan for improvement. 6. Follow up regularly on the plan, and on how people are feeling about the team’s progress toward meeting its goals. Ethics Relating to Engagement McDonald stated, “There are clear financial, legal and ethical reasons for addressing employee wellbeing, happy people help organizations achieve success (2012). Employee wellbeing is taking care of our employee health, both mental and physical. Improving employee well-being creates a healthier, more engaged workforce. Ethics is a word that is used in healthcare frequently.
Questions are asked daily about making the ethically right decision. •MORAL REASONING : –Analyzing by separating the overall structure of a problem into its major components –Weighing by assessing the strengths and weaknesses of the various alternatives –Justifying by providing a compelling moral reason that appeals to an established moral principle –Choosing an alternative that is justified –Evaluating by reexamining the decision and its justification Six of the values that commonly apply to medical ethics discussions are: •Autonomy – the patient has the right to refuse or choose their treatment. Voluntas aegroti suprema lex. ) •Beneficence – a practitioner should act in the best interest of the patient. (Salus aegroti suprema lex. ) •Non-maleficence – “first, do no harm” (primum non nocere). •Justice – concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality). •Dignity – the patient (and the person treating the patient) have the right to be treated with dignity. •Truthfulness and honesty – the concept of informed consent has increased in importance since the historical events of the Doctors’ Trial of the Nuremberg trials and Tuskegee Syphilis Study.
Values such as these do not give answers as to how to handle a particular situation, but provide a useful framework for understanding conflicts. When moral values are in conflict, the result may be an ethical dilemma or crisis. Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values of the medical community (i. e. , the hospital and its staff) conflict with the values of the individual patient, family, or larger non-medical community. Conflicts can also arise between health care providers, or among family members.
Some argue for example, that the principles of autonomy and beneficence clash when patients refuse blood transfusions, considering them life-saving; and truth-telling was not emphasized to a large extent before the HIV era. Diversity (demographic challenges) job engagement there was always the concerns that workers would be “too engaged”. I do not have much experience in healthcare but I believe that it could be a problem. When doctors get too close to their patients and start making decisions from emotional rather than medical point of view.
Also, the whole work/life balance when workers get too engaged. I remember we used the word “workaholic” a lot. Finally, when you have those managers who take advantage of workers engagement in an unethical way such as working more than the maximum weekly hours. Conclusion Studies show that only 29% of employees are actively engaged in their jobs (Employee Commitment, 2005). Employees who are closest to patient care have lower overall engagement scores (Press Ganey, 2010). In other words, the actual caregivers are the least likely to feel engaged.
However from the preceding information, the correlation between patient satisfaction and engaged employees is strong. If employees are not engaged, it will lead to lower patient satisfaction which leads to declining admissions and ultimately erosion of the market share. The correlation between patient satisfaction and employee engagement leaves little uncertainty as to the existence of a relationship, yet it is unclear if hospitals have come to realize this significance. In addition, it is also clear that engaged employees cause high retention rates, better financial performance and patient loyalty.
It is difficult for healthcare providers to see the benefits since the returns are measured in terms of opportunity cost. When employees become engaged, organizations are not immediately going to see a change in their return on investment, this take time. In this tough economic time when many Americans believe the healthcare system is broken, many healthcare systems are managing to maintain costs while experiencing high levels of care. Healthcare organizations are doing this by investing effort in an emotional economic theory revolving around employee engagement.
From the research conducted, it is evident the data collected on engagement is relatively new. Since our current method of healthcare delivery is not old in historical terns, this is not a surprise. This research has answered the questions brought forward from the beginning, and in more cases than not, the answers were expected. What was not anticipated was the number of questions that were elevated along the way, or the number of areas where employee engagement can play such a significant role References American Heart Association. 23 Dec 2009. 7 Nov 2010 http://circoutcomes. ahajournals. org/content/early/2010/02/23/CIRCOUTCOMES. 109. 900597. abstract. Cascio, Wayne F. Managing Human Resources Productivity, Quality of Work Life, Profits. Eighth Edition. McGraw-Hill Irwin. 2010. “Employee Commitment”. Susan de la Vergne. 2005. http://www. auxiliumtraining. com/Employee Commitment. htm. Retrieved 2010-11-10. McDONNELL, F. (2012, March 06). Happy workforce really pays off. Retrieved from http://www. irishtimes. com/newspaper/finance/2012/0306/1224312850100. html Press Ganey Associates, Inc. 010 Hospital Pulse Report: Employee and Nurse Perspectives on American Health Care. South Bend, Ind. Rath, Tom, Harter, Jim. Well Being the Five Essential Elements. New York: Gallup Press, 2010. Renner, Kevin. (1996, October). Cost-Justifying Electronic Medical Records. Healthcare Financial Management. Scarlett, Ken (2008). What is Engagement? Retrieved on 2010-11-18 The Gallup Management Journal. Lampe, Melissa D, Earl, Joanne. 2006. You’ve Gotten Employee Feedback. Now What? The Gallup Management Journal. Robison, Jennifer. 2008. Turning Around Employee Turnover.