The Executive Suite: Employee Engagement: What it is, why it matters

When I speak with physician leaders and practice managers about employee engagement, they sometimes react with confusion. (Or worse, an eye roll.) I can understand why—the term “engagement” may sound like a buzzword, just a pretentious way of saying “morale.” But it actually means something distinct, and it can pay off in patient service and practice profitability.

A (very!) brief history of management theory

There was a time—say, a bit more than 100 years ago—when American employers didn’t worry in the least about how their employees felt about their work. During the post-Civil War industrial boom, the formal study of management and productivity was just emerging. The emphasis of this new “science” was on workers as inputs into industrial processes. One employee was regarded as more or less identical to another.

Over time, though, management leaders understood the people side of business differently. Henry Ford famously realized that a stable workforce would improve productivity and profitability, and so began paying his workers more to retain them. In the 1970s and 1980s, innovators in Japan, especially Toyota, made huge gains in quality and profitability by recognizing that the lowest-level employees are in the best position to catch and fix errors—and that they’re eager to do so if encouraged.

Today’s business leaders have learned that people are generally motivated to do good work. When workflows and management practices enable employees to contribute more meaningfully, the entire organization benefits. This is the foundation of employee engagement and few industries stand to benefit more from it than ours does.

Employee engagement comes naturally in healthcare

A simple definition of engagement is the degree to which employees are enthusiastic about their work and feel able, committed, and excited to contribute their employer’s mission and reputation.

Many people working in healthcare chose their careers not just to earn money, but to help others. In every role in medicine, you find employees who are proud to work in a field that helps others. This sense of mission gives medical practices a head start in engaging their employees. When medical practices tap into this shared spirit, they can see dramatic benefits in patient service, productivity, and even safety. Costs go down, too, because engaged employees are less likely to leave their jobs.

Gallup, the famous polling organization, has been studying employee engagement for 20 years. Many of their findings stand out as relevant and helpful guidance for physician practices.

For example, they found that healthcare employee safety improves when engagement improves—and that when employee accidents are reduced, patient safety improves, too, validating several benefits of employee engagement with a single piece of research. They’ve also connected nurse engagement with reduced turnover, better patient outcomes, and lower malpractice claim costs.

One of the Gallup’s most useful findings is also one of the most general. Gallup estimates that 70% of variance in employee engagement is due to managers. Of course, this is a double-edged sword: Whether employees are highly engaged or frustratingly disengaged, leadership is likely to be the cause.

Simple steps can promote engagement

It’s a bit daunting to realize that management plays such a huge role in engagement, and that employee engagement, in turn, influences everything from patient safety to profitability. But the good news is that there are easy steps any manager or physician leader can take to improve engagement.

Making sure employees feel recognized for the work they do is crucial. This means more than just general praise. Employees at the lowest level in healthcare feel—often correctly—that the value of their work isn’t appreciated by physicians and administrators. This is understandably discouraging, and it also conveys to employees that their work doesn’t make a real difference.

Acknowledging tasks employees do well in a specific way is an antidote. It may require learning more about what employees actually do—but that step sends a positive message, too.

Shared victories are another powerful way to foster teamwork and engagement. Remember to celebrate administrative victories as well as clinical ones. Whether it’s the successful implementation of a new EMR, better front desk collections, improved patient survey results or increased profitability, all of these outcomes require your staff to work together. By strengthening your practice business, administrative progress also supports your larger mission of patient care.

Ensuring that employees have a sense of ownership in their jobs is important, too. Developing a sense of expertise and significance in their jobs helps employees become more committed and motivated. Employees who are recognized when they take the initiative to improve patient service are more likely to do so.

Physician owners and administrators often ask me if upgrading technology will mean they can “get by” with fewer employees. My answer is usually, “Maybe. But what if the upgrade allows your employees to do more instead?” When better technology yields efficiency, your employees can turn more of their attention to things only humans can do, like reassuring nervous patients or spotting workflow issues that degrade service. Employee engagement combined with smarter workflows can have a more dramatic effect on practice performance than either one alone.