A Wakeup Call for Leaders

Vicki Hess, RN, MS, Top 5 Healthcare Speaker Principal, Employee Engagement Solutions, LLC www.HealthcareEmployeeEngagement.com

© Vicki Hess

1. The organization at a strategic level.

2. Leaders at a tactical level.

3. Individuals at a personal level.

This model shows that to improve and sustain

engagement it takes:

You can read more about that here.

A core tenant of engagement is the It Takes 3™ model that

I share in my book, 6 Shortcuts to Employee Engagement.

Before I get too far ahead of myself, let’s make

sure we are all on the same page regarding

employee engagement. My definition for

engagement is when employees are satisfied,

energized & productive. I call this “Professional

Paradise”. You can read more about that here. 

When it comes to employee engagement, it’s time

for a wakeup call.

We know that healthcare leaders aren’t hitting the

snooze button. Everyone is working HARD!

In 2017, the average turnover in healthcare jobs was 20.6%, up from 15.6% in 2010.

When it comes to employee engagement, alarm bells are ringing.

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click on statistic for source

27% of nurses plan to retire in less than a year.  

There will be 204,000 job openings per year for registered nurses from 2016-2026.

50% of nurses say they don't trust their leaders, don't think their leaders care about them as an individual, and don't believe their leaders support their career goals. The percentage of healthcare employees who are merely “contributing” (versus actively engaged) has gone from 22% in 2011 to nearly 30% this past year. 1

Employee Engagement in Healthcare by Quantum Workplace, 2016 1

800+ people who self-identified as

“healthcare leaders" completed the survey.

The Respondents The Survey

The questions included self-evaluation of

actions and behaviors leaders take for

themselves and others which impact employee

engagement.

The survey also asked about level of importance

for several executive leadership actions.

This is a mixed method survey with both

quantitative and qualitative questions.

Participation in the survey implies consent to use

the data. This is consumer research.

The survey was hosted on Survey Monkey®.

The survey was open for 3 weeks.

Just The Facts

These leaders work in acute care (71%),

long term care and ambulatory care settings.

58% have been leading 10+ years.

89% state that they plan to be working at

their organization one year from now.

70% have a title of Director or Manager.

Earlier this year, I was in a yoga class and I had an idea

that I needed to have a fresh perspective from healthcare

leaders related to engagement. I was curious. At that

moment, the phrase “Voices of Healthcare Engagement”

popped into my head. If you are like me, sometimes you

run with these out-of-the-blue ideas and sometimes you

let them go. In this case, I kept getting the message from

different perspectives and decided I better get to work.

The idea was to check-in with fresh research to provide

you with additional information to spur on the wakeup call.

It’s good to know your strengths and statistics aren’t

mine. I knew I needed help to make sure I wouldn’t

experience the “garbage in, garbage out” phenomenon.

So, I called my super smart, statistical expert colleague

Andrew Gage (Gage Consulting & Analytics) to help me

set-up the survey and analyze the results.

Questions were written and reviewed and then the fun

began. I asked for survey responses and leaders answered.

My initial goal was to hear the voices of 500 healthcare

leaders. I was pleasantly surprised by the 816 responses I

received. Throughout this summary, the quotes you see are

from the qualitative section of the survey. The leaders share

their frustration and joy in these open-ended responses.

As you read this summary of results, you’ll see that I’m not

here as an academic voice, I’m here as a “woman on the

street” voice. The questions we asked get to the heart of

engagement and I’m happy to share an informal review

of what I learned and what to do next.

 Voices of Healthcare Engagement

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“In the last year I have had an

increase in 'burnout' due to

the increase in new initiatives

coming all at once. Everything

is a priority to everyone from

different levels. Not able to

make my own work a priority

and having to work on it at

night and weekends.”

Finding joy in the growth and progress of

direct reports.

Personally connecting to the

mission/vision of the organization.

Welcoming and initiating change.

Top 3 - Self-evaluated as “Most Proficient”

Managing my own emotions.

Creating boundaries for myself and others.

Taking time for reflection and

self-awareness.

Top 3 - Self-evaluated as “Most Challenging”

The model we used for the signature elements of self-

engagement is from Nurse Manager Engagement: Strategies

for Excellence and Commitment by Barbara L. Mackoff (2011,

Jones & Bartlett Publishing, Sudbury, MA). This model provides

a tactical, behavior-based approach to self-engagement that

works well for our purposes.

We asked leaders to evaluate a series of behaviors that

positively impact self-engagement on a scale from

(1) Most Challenging to (7) Most Proficient. 

Here are the highlights of the responses. 

Engagement of Self 

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Recognizing staff for excellent work

performance.

Asking for staff members’ opinions on

changes in the department.

Providing staff members with opportunities

to grow and develop.

Holding regular one-on-one meetings to

connect to staff members

Connecting what staff members do on a

daily basis with their internal motivators.

Providing feedback to staff members who

aren’t doing a good job.

Top 3 - Self-evaluated as “Most Challenging” Top 3 - Self-evaluated as “Most Proficient”

For this section, we used signature elements from my book,

6 Shortcuts to Employee Engagement: Lead & Succeed in

a Do-More-With-Less World (2013, CreateSpace). This

model provides a tactical, behavior-based approach to

team member engagement.

Once again, we asked leaders to evaluate a series of

employee engagement behaviors on a scale from

(1) Most Challenging to (7) Most Proficient. 

Here are the highlights of the responses. 

Engagement of Others 

“I have finally figured out that employee relationships

aren't really that complicated. If you take the attitude of

being in service to others and approach people with

direct and constructive communication, things flow

easily. Drama diminishes and there is more time to focus

on performing job related tasks and even enjoying each

other and the work.”

“I need to be rounding more with employees and talking

with them about would motivate them and/or make

them more engaged. I really am overwhelmed with things

to do and find it very difficult to find time to engage one

on one with individual employees.”

“Spending more time in all my departments. I am pulled to many meetings which

are also important. So balancing all the needs is very time consuming.”

“Many days I spend time in my office doing audits, time cards, and other tasks

that take me away from the staff. I would like to spend more time rounding and

coaching staff. Many tasks I do could be done by an administrative assistant.”

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Suggestions for Executive Leaders to Improve Engagement

Using the It Takes 3 model as our guide, we also

asked leaders to rate the level of importance

related to EXECUTIVE LEADERS for 5 actions

with a focus on improving or sustaining

employee engagement. (ie, Vice-President,

CEO, CFO, CHRO, etc.) The scale was

(1) least important to (5) most important.

“Communicate, Communicate, Communicate.

It is never enough.”

MOST IMPORTANT

Clearly communicate why changes are made.

Make employee engagement part of the

strategic goals.

Come to our department for informal

connections with staff (rounding).

LEAST IMPORTANT

Hold Town Hall meetings.

Come to our department for formal

connections with staff (organized meetings).

“Higher ups need to come to the unit more often,

especially on night shift. Some of the employees do not

even know who they are, and therefore do not feel

supported and engaged.”

“Staff perception is that the c-suite is not interested in the work they do in healthcare...that everything is related to the bottom line. We need to find a way to change that perception and to get the staff on the floor talking to the administrators of the organization." "The barriers are known to senior leaders...it often seems there is only acknowledgement of the barriers without follow through on process improvement."

“Happy employees equal happy patients. Inviting

engagement looks different to each generation. We

need to make sure that we are meeting each employee

where they are..”

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Executive leaders spend informal time with staff on

all shifts. Listening, observing and seeking to

understand the life of the front line staff and leaders.

Most healthcare organizations offer an abundance

of growth & development opportunities and leaders

feel this is a strength. Unfortunately, in employee

engagement surveys, the employees say that there

aren’t enough growth and development

opportunities. Close this perception gap by actively

communicating what’s available and who is taking

advantage of it.

Build time for reflection into meetings and daily

schedules. How can we really expect leaders to do

their best work when “doing” is rewarded over

“thinking”? Encourage leaders to create boundaries

for themselves and others.

Easy Fixes

You might be wondering, what should we do now? Here are 3 easy fixes and 3 more challenging action

items. Get together with your leadership peers. Review the data shared here and figure out what you

need to do to create a culture of engaged employees with the new knowledge you have gained.

The Wakeup Call

More Challenging Fixes

Analyze and adjust span of control for front-line leaders to

a reasonable number. “Reasonable” means that there is

ample time for leaders to consciously connect with all team

members on all shifts in all locations on a regular basis.

Change the way you talk about engagement. Tap into

personal motivators of staff to help them recognize how

being engaged helps them personally. Go from a

traditional “parent” mindset (we take care of our

employees) to a “partner” focus with an emphasis on

empowerment and shared responsibility for engagement.

Fix what you need to and then get out of the way and let

the team do what you hired them to do.

Teach leaders how to communicate assertively when it

comes to job performance and accountability. Imagine the

absence of passive, passive-aggressive and aggressive

communication styles. No more game-playing. Recognize &

reward open, direct, professional dialogue.

Wrapping it Up for Now

Upon review of the results, in the future when we look

back to 2018, we might quote Charles Dickens and say, “It

was the best of times, it was the worst of times”. 

Healthcare leaders are both optimistic and overwhelmed.

They are energized and exhausted. They are caring and

concerned. They want to take action to improve

engagement but many don’t know where to start or how

to keep the momentum going.

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The alarm bells are ringing...

are you ready for the wakeup call?

ABOUT VICKI HESSCERTIFIED SPEAKING PROFESSIONAL

Vicki Hess, RN, MS is your go-to resource for

transforming employee engagement at the

individual, departmental or organizational level.

As the author of 4 books, Vicki inspires clients to

take action. Organizations that implement

Vicki’s ideas experience increased productivity,

safety, quality, retention, client satisfaction,

creativity and more. To read what her clients

have to say about working with her, please visit:

vickihess.com/about-vicki-hess/what-clients-say

A highly-regarded speaker, author, facilitator

and consultant, Vicki shares her expertise in

employee engagement as well as workforce and

leadership development with healthcare

organizations across the country. She has more

than 30 years of hands-on business and

healthcare experience that she draws upon to

provide inspirational and evidence-based

strategies for workplace engagement. Using

time-tested methods including workshops,

retreats and keynote presentations, Vicki is a

much sought-after speaker whose knowledge of

the industry makes her uniquely qualified to

address the ever-changing priorities of today’s

healthcare organizations.

Ms. Hess holds a BSN from the University of

Florida and a Master’s Degree in Human

Resource Development from Towson

University. She was an adjunct professor at

Johns Hopkins University Graduate School of

Business for five years.

Vicki is one of 250 women in the world to haveearned the Certified Speaking Professional(CSP) designation, the speaking profession’sinternational standard for platform skill. Shehas been voted a TOP 5 Healthcare Speakerby Speaking.com for four years in a row.

Vicki is a contributing author for AONE NurseLeader, American Nurse Today, Hospital &Health Network, Becker’s Hospital Review,NurseTogether.com and other industrypublications and blogs. To learn more about Vicki and to see some of her presentation videos,visit: HealthcareEmployeeEngagement.com

© Vicki Hess vickihess.com For speaking inquiries, please contact Marcia Snow, 888-797-6700 or

marcia@vickihess.com