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Employee Satisfaction: What do we do with the data? Mary Tellis-Nayak, RN, MSN, MPH VP Quality...

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Employee Satisfaction: What do we do with the data? Mary Tellis-Nayak, RN, MSN, MPH VP Quality Initiatives My InnerView [email protected]
Transcript

Employee Satisfaction:What do we do with the

data?

Employee Satisfaction:What do we do with the

data?

Mary Tellis-Nayak, RN, MSN, MPHVP Quality Initiatives

My [email protected]

Mary Tellis-Nayak, RN, MSN, MPHVP Quality Initiatives

My [email protected]

ObjectivesObjectives

The participant will be able to:— Identify three issues which staff say

cause them to recommend a nursing home as a good place to work

— Describe the relationship between the quality of the workplace and 3 other measures

— Discuss what must be done with employee satisfaction results

— List 2 things a leader can do with the results of staff satisfaction surveys

The participant will be able to:— Identify three issues which staff say

cause them to recommend a nursing home as a good place to work

— Describe the relationship between the quality of the workplace and 3 other measures

— Discuss what must be done with employee satisfaction results

— List 2 things a leader can do with the results of staff satisfaction surveys

Our MissionOur Mission

To provide long-term care leaders evidence-based management tools to better achieve their organization’s goals

To provide long-term care leaders evidence-based management tools to better achieve their organization’s goals

My InnerView NationwideMy InnerView Nationwide

» 5,600+ providers in all 50 states and District of Columbia use our tools

» Largest satisfaction benchmark database in long-term care

» Recommended by:

— 3 national associations— 32 state associations

» 5,600+ providers in all 50 states and District of Columbia use our tools

» Largest satisfaction benchmark database in long-term care

» Recommended by:

— 3 national associations— 32 state associations

Providers will commit to focus on

at least 3 of 8 measurable goals

Providers will commit to focus on

at least 3 of 8 measurable goals

CLINICAL GOALS:

1. Reducing high risk pressure ulcers

2. Reducing use of daily physical restraints

3. Improving pain management for longer term nursing home residents

4. Improving pain management for short stay, post-acute nursing home residents

CLINICAL GOALS:

1. Reducing high risk pressure ulcers

2. Reducing use of daily physical restraints

3. Improving pain management for longer term nursing home residents

4. Improving pain management for short stay, post-acute nursing home residents

OPERATIONAL/PROCESS GOALS:

1. Establishing individual targets for improving quality

2. Assessing resident and family satisfaction with the quality of care

3. Increasing staff retention

4. Improving consistent assignment of nursing home staff, so that residents regularly receive care from the same caregivers

OPERATIONAL/PROCESS GOALS:

1. Establishing individual targets for improving quality

2. Assessing resident and family satisfaction with the quality of care

3. Increasing staff retention

4. Improving consistent assignment of nursing home staff, so that residents regularly receive care from the same caregivers

Lookingat

NationalResults

Lookingat

NationalResults

National Employee SatisfactionSurvey Results

2006

Nearly 107,000 responses

National Employee SatisfactionSurvey Results

2006

Nearly 107,000 responses

» First nationwide report

» 1,933nursing homes in 49 statesand D.C. participated in 2006

» First nationwide report

» 1,933nursing homes in 49 statesand D.C. participated in 2006

NOTE: Alaska not included

Employee’s ageEmployee’s age

FIGURE 2a

Employee’s job categoryEmployee’s job categoryFIGURE 2b

Length of employmentLength of employmentFIGURE 2d

SATISFIED NURSING HOMEWORKERS BY CATEGORYSATISFIED NURSING HOMEWORKERS BY CATEGORYBased on the percent of total weighted respondents who rated their overall satisfaction as “excellent” or “good” in each job category

FIGURE 1

An Exercise:

What Matters Most?

An Exercise:

What Matters Most?

Survey items:Survey items:

1 Quality of orientation

2 Quality of in-service education

3 Quality of resident-related training

4 Quality of family-related training

5 Comparison of pay

6 Care (concern) of supervisor

7 Appreciation of supervisor

8 Communication by supervisor

9 Attentiveness of management

10 Care (concern) of management

11 Safety of workplace

12 Adequacy of equipment/supplies

13 Sense of accomplishment

14 Quality of teamwork

15 Fairness of evaluations

16 Respectfulness of staff

17 Assistance with job stress

18 Staff-to-staff communication

Ranked correlations (p < 05) between employee workplace recommendation and employee satisfaction itemsRanked correlations (p < 05) between employee workplace recommendation and employee satisfaction items

FACTORS THAT DRIVE WORKFORCE RECOMMENDATIONFACTORS THAT DRIVE WORKFORCE RECOMMENDATION

Ranked correlations (p < 05) between employee workplace recommendation and employee satisfaction itemsRanked correlations (p < 05) between employee workplace recommendation and employee satisfaction items

FACTORS THAT DRIVE WORKFORCE RECOMMENDATION (continued)

FACTORS THAT DRIVE WORKFORCE RECOMMENDATION (continued)

TABLE 5

Ranked by average scores and correlations with workplace recommendationRanked by average scores and correlations with workplace recommendation

PRIORITY ITEMS FOR NURSING STAFFPRIORITY ITEMS FOR NURSING STAFF

TABLE 6

Recommendation for careRecommendation for care

FIGURE 3

Recommendation for jobRecommendation for job

FIGURE 3

Does not total 100% due to rounding

Overall satisfactionOverall satisfaction

FIGURE 3

TRAININGTRAINING

May not total 100% due to rounding

TABLE 1

WORK ENVIRONMENTWORK ENVIRONMENT

May not total 100% due to rounding

TABLE 2

SUPERVISIONSUPERVISION

May not total 100% due to rounding

TABLE 3

MANAGEMENTMANAGEMENT

May not total 100% due to rounding

TABLE 4

What doesresearch tell us

about satisfactionsurvey data?

What doesresearch tell us

about satisfactionsurvey data?

What about employee data?What about employee data?

What do we know today?

higherfamily

satisfaction

higherfamily

satisfaction

lowernursing

assistantturnover

lowernursing

assistantturnover

higheremployee

satisfaction

higheremployee

satisfaction

higherfamily

satisfaction

higherfamily

satisfaction

Key Performance DriversKey Performance Drivers

highersatisfaction

amongfamilies

and employees

highersatisfaction

amongfamilies

and employees

higheroccupancy

rates

higheroccupancy

rates

Key Performance DriversKey Performance Drivers

highersatisfaction

amongfamilies

and employees

highersatisfaction

amongfamilies

and employees

betterclinical

outcomesrelated to falls,

pressure ulcersand catheters

betterclinical

outcomesrelated to falls,

pressure ulcersand catheters

Key Performance DriversKey Performance Drivers

SUMMARY OF RELATIONSHIPS

StaffSatisfaction

StaffSatisfaction

Resident/FamilySatisfaction

Resident/FamilySatisfaction

HR Decrease nurse absenteeism

Decrease nurse turnoverDecrease CNA turnover

HR Decrease nurse absenteeism

Decrease nurse turnoverDecrease CNA turnover

Improve care outcomes

Improve relationships

Improve care outcomes

Improve relationships

FinancialIncrease occupancy

FinancialIncrease occupancy

50

60

70

80

Lowest Low High Highest

Facilities with higher family satisfaction have better work environments

Facilities with higher family satisfaction have better work environments

< 54% 54% to 58% 58% to 64% > 64%

Mean = 68.0

EM

PL

OY

EE

EN

VIR

ON

ME

NT

SC

OR

E (

%)

FAMILY SATISFACTION

48

52

56

60

64

Lowest Low High Highest

Facilities with higher family satisfaction have better employee training

Facilities with higher family satisfaction have better employee training

Mean = 57.1

EM

PL

OY

EE

TR

AIN

ING

SC

OR

E (

%)

FAMILY SATISFACTION

< 54% 54% to 58% 58% to 64% > 64%

60

70

80

90

Lowest Low High Highest

Facilities with higher family satisfaction have better supervision

Facilities with higher family satisfaction have better supervision

Mean = 72.2

EM

PL

OY

EE

SU

PE

RV

ISIO

N S

CO

RE

(%

)

FAMILY SATISFACTION

< 54% 54% to 58% 58% to 64% > 64%

50

60

70

80

Lowest Low High Highest

Facilities with higher family satisfaction have better management

Facilities with higher family satisfaction have better management

Mean = 66.5

EM

PL

OY

EE

MA

NA

GE

ME

NT

SC

OR

E (

%)

FAMILY SATISFACTION

< 54% 54% to 58% 58% to 64% > 64%

» More residents without falls

» More residents without pressure ulcers

» More residents without acquired catheters

» Less nurse turnover

» More nurse stability

» Less CNA absenteeism

» Less nurse absenteeism

» Higher occupancy

» More residents without falls

» More residents without pressure ulcers

» More residents without acquired catheters

» Less nurse turnover

» More nurse stability

» Less CNA absenteeism

» Less nurse absenteeism

» Higher occupancy

Facilities with higher employee satisfaction have:Facilities with higher employee satisfaction have:

CNAs speak up!

• A 2004 study

• 156 nursing facilities in the Southeast

• 3,579 CNAs, 6,502 families surveyed

• November 2004

Quality of leadershipand quality of the workplace:

The interface

Quality of leadershipand quality of the workplace:

The interface

Indicators ofquality of workplace

Indicators ofquality of workplace

1. Pay compared to other nursing homes

2. Safety of workplace

3. Adequate equipment and supplies to do your job well

4. Work allows you to make a difference in people's lives

5. Co-workers work as a team

6. Fair performance evaluations

7. Staff are respectful of residents

8. Helps you get to deal with job stress

9. Communication between shifts

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Quality of leaders produce a quality workplace Rating by 6,305 CNAs in 156 Nursing Facilities:

4 percentile ranked groups, 2004

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A quality workplace creates QoL for resident

As Staff are

Treated

So will the elders be treated.

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A quality workplace makes business sense

We did the best we could,

with what we knew, And when we knew better,

we did better

Maya Angelou

Now you know better

so …

Now you know better

so …

… what do you do?… what do you do?

If you do not plan to use the results of your employee

satisfaction survey to improve the work

environment, it is far better that

you not conductthe survey at all.

If you do not plan to use the results of your employee

satisfaction survey to improve the work

environment, it is far better that

you not conductthe survey at all.

Using Satisfaction DataUsing Satisfaction Data

» One member of the leadership team must be responsible and held accountable for managing this initiative— Human Resources— Department Manager(s)— Administrator/Assistant Administrator— Staff Development

» One member of the leadership team must be responsible and held accountable for managing this initiative— Human Resources— Department Manager(s)— Administrator/Assistant Administrator— Staff Development

Using Satisfaction DataUsing Satisfaction Data

» Use current structures or create new ones— QA&A committee— Staff meetings— Neighborhood/unit meetings— Interdepartmental teams— Focus groups

» Use current structures or create new ones— QA&A committee— Staff meetings— Neighborhood/unit meetings— Interdepartmental teams— Focus groups

Communicating resultsCommunicating results» Determine what you want to communicate initially

and to whom — Depends on your current facility structure (e.g.

neighborhoods vs. units; universal workers vs. departments)

» Consider the current culture of your community when considering how to proceed

— Use a bulletin board to post results

— Pull together an employee group to obtain feedback

— Publish results in a newsletter format

— Have unit/team meetings to present the results

— Have an all staff meeting on each shift

— Initially present the results to department heads

» Determine what you want to communicate initially and to whom — Depends on your current facility structure (e.g.

neighborhoods vs. units; universal workers vs. departments)

» Consider the current culture of your community when considering how to proceed

— Use a bulletin board to post results

— Pull together an employee group to obtain feedback

— Publish results in a newsletter format

— Have unit/team meetings to present the results

— Have an all staff meeting on each shift

— Initially present the results to department heads

Where do we start?Where do we start?

» Choose the issues— Start with “low hanging fruit”

— Choose an area where you know you can show staff that you are listening to them

— Choose an area which is important to the staff even if you may not have scored too badly

— Choose an area where you know you can achieve results quickly

— Choose an area which is no surprise because you’ve “heard it before”

» Choose the issues— Start with “low hanging fruit”

— Choose an area where you know you can show staff that you are listening to them

— Choose an area which is important to the staff even if you may not have scored too badly

— Choose an area where you know you can achieve results quickly

— Choose an area which is no surprise because you’ve “heard it before”

My InnerView’s reportshelp you to choose

the topic(s) which aremost important

to your staff.

My InnerView’s reportshelp you to choose

the topic(s) which aremost important

to your staff.

1. How residents, families and staff rate your care and services

• Your average score on each item:

1 – 4: “Poor” ”Fair” ”Good” ”Excellent”

• Rank order all items by their average score:

1 – 100: lowest to highest ranking score

2. How much each item influences residents, families and staff to recommend the facility to others.

• Correlate each item with “Recommendation”

0 - 1: no correlation to strongest correlation

• Rank order all items by their correlational strength:

1 – 100: lowest to highest ranking correlation

Quadrant analysis: Two key concepts

The Quality Quadrant and Action Priorities

1 ---------- Lowest to highest ranking correlation -------- 100

Recom-mendation

Item score

Su

cces

ses

You have little control over customer expectations

Yo

u c

an m

eet

cust

om

er e

xpec

tati

on

s

C.

Secondary opportunties

D.

Primary opportunities

B.

Primary strength

A.

Secondary strength

Ch

alle

ng

es

1 --

- L

ow

est

to h

igh

est

ran

kin

g s

core

1

00

Goal

Just ask why!Just ask why!

My work is stressful —

I gave Mrs. J her supplementand she threw up —

No one told me she had beensick all morning —

My work is stressful —

I gave Mrs. J her supplementand she threw up —

No one told me she had beensick all morning —

There is no communication between the morning and evening shifts of CNAs —

There is no communication between the morning and evening shifts of CNAs —

Take Home TipsTake Home Tips

» Just ask until there are no more ‘whys’ to ask

» Focus on systems and processes

» LISTEN

» OBSERVE

» Don’t BLAME

» Involve the team

» Just ask until there are no more ‘whys’ to ask

» Focus on systems and processes

» LISTEN

» OBSERVE

» Don’t BLAME

» Involve the team

Turn InformationInto KnowledgeTurn InformationInto KnowledgeStudy current processStudy current process

Gather more informationGather more information

Evaluate processEvaluate process

Identify contributing factorsIdentify contributing factors

Determine root cause(s)Determine root cause(s)

Develop Drill Down QuestionsDevelop Drill Down Questions

Issue – OrientationDrill down suggested questions:» New CNAs are oriented specifically to their unit» New CNAs are oriented specifically to their shift » New employees are taught the proper use of equipment

which they will be using» New employees are shown the location of the supplies

and equipment they need to do their job» New employees are assigned to a mentor or a

buddy system» New employees are not given a full a workload initially,

but in gradual steps» New employees are introduced individually to the

residents assigned to them

Issue – OrientationDrill down suggested questions:» New CNAs are oriented specifically to their unit» New CNAs are oriented specifically to their shift » New employees are taught the proper use of equipment

which they will be using» New employees are shown the location of the supplies

and equipment they need to do their job» New employees are assigned to a mentor or a

buddy system» New employees are not given a full a workload initially,

but in gradual steps» New employees are introduced individually to the

residents assigned to them

Use the Workplace Scaleas Starting PointUse the Workplace Scaleas Starting Point

»Pay compared to other nursing homes

»Safety of workplace

»Adequate equipment and supplies to do your job well

»Work allows you to make a difference in people's lives

»Co-workers work as a team

»Fair performance evaluations

»Staff are respectful of residents

»Helps you get to deal with job stress

»Communication between shifts

A Valuable ResourceA Valuable Resource

» “Better Jobs Better Care: Issue Paper”— No. 7/April 2007— “Respectful Relationships: The Heart of

Better Jobs Better Care”

» Link to this paper— http://www.bjbc.org/Page.asp?PgID=27

» This paper addresses the key issue of the long-term care workforce — RESPECT

» “Better Jobs Better Care: Issue Paper”— No. 7/April 2007— “Respectful Relationships: The Heart of

Better Jobs Better Care”

» Link to this paper— http://www.bjbc.org/Page.asp?PgID=27

» This paper addresses the key issue of the long-term care workforce — RESPECT

Whether individuals feelrespect in the workplace is largely a function of how they are treated by their supervisors,their clients and family membersor advocates and,many times, their peers,particularly for new workers.

Whether individuals feelrespect in the workplace is largely a function of how they are treated by their supervisors,their clients and family membersor advocates and,many times, their peers,particularly for new workers.

Studies suggestthat the quality

of these relationshipshas a defining impacton workers’ decisions

to stay on the jobor leave to pursue

opportunities elsewhere.

Studies suggestthat the quality

of these relationshipshas a defining impacton workers’ decisions

to stay on the jobor leave to pursue

opportunities elsewhere.

Lessons LearnedPractical SuggestionsLessons LearnedPractical Suggestions

» Take a “relationships inventory”

» Listen to what workers say about respect

» Identify changes necessary to “operationalize” respect

» Think in terms of maximizing human potential

» Understand the needs of new immigrants and non-English speakers

» Commit to making continuous improvement

» Take a “relationships inventory”

» Listen to what workers say about respect

» Identify changes necessary to “operationalize” respect

» Think in terms of maximizing human potential

» Understand the needs of new immigrants and non-English speakers

» Commit to making continuous improvement

Take a “relationships inventory”Take a “relationships inventory”

» Do managers at all levels of your organization have positive and professional relationships with the people they supervise?

» Does the disciplinary action make up a large portion of interaction between frontline staff and managers?

» Do direct care staff see managers as mentors they feel comfortable going to for advice and problem solving?

Without a foundation of healthy relationships among frontline workers and between direct care workers and their supervisors, other initiative to create a more respectful work environment are unlikely to be successful.

» Do managers at all levels of your organization have positive and professional relationships with the people they supervise?

» Does the disciplinary action make up a large portion of interaction between frontline staff and managers?

» Do direct care staff see managers as mentors they feel comfortable going to for advice and problem solving?

Without a foundation of healthy relationships among frontline workers and between direct care workers and their supervisors, other initiative to create a more respectful work environment are unlikely to be successful.

Listen to what workers say about respect

Listen to what workers say about respect

» When workers say they feel a lack of respect, it often reflects their sense that no one is listening to them.

» Everyone knows how to listen but knowing how to listen to information that is emotionally charged is difficult.

» Responding without blaming or being judgemental requires training and practice.

» When workers say they feel a lack of respect, it often reflects their sense that no one is listening to them.

» Everyone knows how to listen but knowing how to listen to information that is emotionally charged is difficult.

» Responding without blaming or being judgemental requires training and practice.

Identify changes necessary to “operationalize” respectIdentify changes necessary to “operationalize” respect

» Review existing P&Ps to understand what changes, big or small, will make workers feel more respected, valued and heard.

» Do you have a process in place to provide emotional support to workers who are caring for consumers or encountering family members who are verbally or physically abusive?

» How does your organization support workers who feel they are being discriminated against?

» Review existing P&Ps to understand what changes, big or small, will make workers feel more respected, valued and heard.

» Do you have a process in place to provide emotional support to workers who are caring for consumers or encountering family members who are verbally or physically abusive?

» How does your organization support workers who feel they are being discriminated against?

Think in terms of maximizing human potential.

Think in terms of maximizing human potential.

» When workers have the opportunity to improve themselves, personally or professionally, they feel better about themselves and have a more positive attitude about their workplace.

» Do you have a career track for direct care workers?

» Do you offer educational opportunities through scholarships or on-site distance learning?

» When workers have the opportunity to improve themselves, personally or professionally, they feel better about themselves and have a more positive attitude about their workplace.

» Do you have a career track for direct care workers?

» Do you offer educational opportunities through scholarships or on-site distance learning?

Understand the needs of new immigrants and non-English speakers

Understand the needs of new immigrants and non-English speakers

» Does your workforce include immigrants or those with limited English skills?

» How well do you understand their customs?

» What are you doing to help them operate in their new language and cultural environment?

» Does your workforce include immigrants or those with limited English skills?

» How well do you understand their customs?

» What are you doing to help them operate in their new language and cultural environment?

Commit to making continuous improvement

Commit to making continuous improvement

» There is no “one-time fix” for creating a respectful work environment

» To be successful, the work must be an ongoing process, fully supported by all levels of people within the organization and owned by more than one person

» One innovation to create a more respectful work environment is likely to lead to another as workers feel more empowered to articulate their needs and interests.

» There is no “one-time fix” for creating a respectful work environment

» To be successful, the work must be an ongoing process, fully supported by all levels of people within the organization and owned by more than one person

» One innovation to create a more respectful work environment is likely to lead to another as workers feel more empowered to articulate their needs and interests.

“A resident’s satisfaction with his/her relationship to nursing staff was found to be significantly related to the proportion of CNAs on the resident’s unit who said they intended to stay in the job, and to the proportion of CNAs who had positive relationships with their supervisors.”

- Bishop, October 2006

“A resident’s satisfaction with his/her relationship to nursing staff was found to be significantly related to the proportion of CNAs on the resident’s unit who said they intended to stay in the job, and to the proportion of CNAs who had positive relationships with their supervisors.”

- Bishop, October 2006

Using employeesatisfaction surveys

will help leadersto improve thetenure of staffby addressingthose issues

most important to them.

Using employeesatisfaction surveys

will help leadersto improve thetenure of staffby addressingthose issues

most important to them.

Don’t miss thisvaluable opportunity

to improve quality of lifefor your residents

by improvingquality of life

for your employees

Don’t miss thisvaluable opportunity

to improve quality of lifefor your residents

by improvingquality of life

for your employees

QUESTIONS?

Contact:Mary Tellis-Nayak

QUESTIONS?

Contact:Mary Tellis-Nayak

[email protected]

773-942-7525

[email protected]

773-942-7525


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