Employee Engagement

What’s the Real Story Behind Your Employee Engagement Scores?

By Susan Alcorn and Aaron Campbell

Health system leaders know employee engagement matters. They know engagement and satisfaction are directly correlated with financial viability, as well as with their systems’ ability to provide quality care, delight patients and families, and recruit and retain the best and brightest team members. And they know that the best way to build engagement is to create positive and nurturing work environments, in which employees can thrive and grow.

To that end, many systems invest in a variety of field-tested tools to measure employee engagement and satisfaction. Employees are surveyed about the working environment; relationships with managers, peers, and leaders; and satisfaction with compensation and recognition. The surveys also probe to see if employees understand and are committed to the organization’s goals, mission, and vision.

But are those surveys delivering the information necessary to truly understand and build engagement? To get at the heart of engagement, a different approach may be needed.

Getting to the Heart of Engagement

Often, traditional employee engagement questions frame issues as operational when they really are issues of the heart, such as morale, confidence, or lack of trust in leadership. The result is that leaders may not connect the dots and then fail to get the answers they need. For example, if employees are asked about their understanding of the organization’s mission and vision but not about whether it’s being lived out in patient care, leaders will only see half the story.

It is entirely possible to have a highly engaged employee who has a negative perception of leadership and/or the care the organization provides. This employee won’t be fully motivated by a pay increase or a boost in benefits for more than a nanosecond. Instead, the employee must be invited and empowered to help identify and solve patient experience and quality issues. Doing so will engage mission-driven staff and providers, and foster trust and communication between employees and leaders. It will also deliver invaluable insights for improving the experience for both patients and employees.

To get at the heart of engagement, leaders must frame the work differently—focusing on the “why” rather than the “what.” Here are some questions that speak to what motivates many employees’ and caregivers’ and provide insight well beyond the typical engagement survey:

  • Overall, how would you rate the experience our organization currently provides to patients?
  • How likely are you to recommend our organization to friends and family members who need care?
  • How would you define a great patient experience? In other words, describe the type of experience you would want for yourself or someone you love.
  • What challenges or barriers must our organization overcome to provide every patient with an exceptional experience?
  • What tools, resources, or training would help you provide a better experience to patients and their family members?
  • From your perspective, how committed would you say our organization’s leadership is to providing an exceptional patient experience?
  • How and to what degree is patient experience being emphasized as a priority in your unit, department, or office?

Next Steps

Listening is only the first step. Too often, leaders are tempted to review employee engagement survey numbers and shelve them. But engagement is a two-way street. Leaders must also show people throughout the organization that they’ve been heard, that their feedback matters, and that the information learned is being used to make the organization better. The following principles can help guide this work:

  • Focus on the Heart. Use the language and issues raised by employees to connect future initiatives with concepts and projects that genuinely motivate and inspire employees.
  • Care Out Loud. Share the story. Tell employees about the conversations. Explain the rationale behind them and how the learnings will be used.
  • Focus on Being More, Not Doing More. Frame new initiatives as opportunities to be better for colleagues and patients, rather than adding another checklist to the pile.
  • Probe for the Truth. Conduct focus groups to better understand areas of challenge or to double down on areas of strength.
  • Make Employees Part of the Solution. Strengthen culture through employee-fueled grassroots improvement or pride campaigns, leverage employee voice and experience when designing new processes or programs, elevate managers and supervisors as messengers and equip them to communicate directly and personally with those they lead, use huddles to gather ideas.
  • Assess and Close the Recognition Gap. Years of research across many industries has shown that leaders perceive that they are giving far more positive feedback than employees perceive receiving it. Increasing recognition is the easiest and most effective way to reinforce positive behaviors and attitudes.

It is well understood that happy employees mean happy patients. But getting to true engagement and satisfaction requires pausing and asking some tough and pointed questions—and then empowering employees to help find solutions.

Susan Alcorn

Susan M. Alcorn is currently a counselor at Nashville-based communications firm, Jarrard Phillips Cate & Hancock, and President of Alcorn Strategic Communications, Washington, DC. Until recently, Susan was chief communications officer for Rochester Regional Health, Rochester, NY. Prior to joining Rochester, Susan was CCO at Geisinger Health System, Danville, PA, where she helped position Geisinger as a nationally recognized model for how healthcare should be delivered and financed.


Aaron Campbell

Aaron Campbell has 15 years of experience in healthcare policy and is currently a senior managing advisor at Jarrard Phillips Cate & Hancock. He specializes in working with providers to improve the human experience in healthcare through engagement, best practice implementation and culture development.

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