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Engagement vs. Satisfaction Among Hospital Teams

Engagement vs. Satisfaction Among Hospital Teams

by Rick Blizzard

In consulting with large healthcare clients, I'm frequently asked about the differences between employee engagement and employee satisfaction measures, and whether high levels of both are needed for a healthy workplace.

In the case of engagement, the answer is easy. The importance of employee engagement to positive business outcomes has been repeatedly demonstrated in Gallup research. Engaged employees are psychologically committed to their work, go above and beyond their basic job expectations, and want to play a key role in fulfilling the mission of their organizations. A radiology technologist who sees a patient shivering as she climbs onto the X-ray table and places a blanket on the table to keep the patient warm is just one example of the caring attitude and willingness to take extra steps that are characteristic of engaged healthcare employees.

According to Gallup's employee engagement polls of the working population, which measure engagement using the Q12 survey instrument, only 28% of U.S. employees are engaged in their jobs, while 17% are actively disengaged -- meaning they are uninvolved and unenthusiastic about their jobs and love to tell others how bad things are.

The concept of engagement is catching the attention of the management world. A recent cover story in HR Magazine titled, "Getting Engaged," notes that the engagement challenge "has little to do with employee satisfaction; some employees are highly satisfied to be under little pressure to produce. The engagement challenge has a lot to do with how an employee feels about the work experience, about how he or she is treated. It has a lot to do with emotions." But Gallup research indicates there is more to the engagement story, and that employee satisfaction is an important subplot.

Is Employee Satisfaction Irrelevant?

Gallup research shows that both employee engagement and employee satisfaction relate to meaningful outcomes. However, satisfaction is a broad, attitudinal outcome, like organizational loyalty or pride. It is hard to act on, and some facets of satisfaction are irrelevant to performance. On the other hand, engagement predicts satisfaction, as well as many other concrete business outcomes. It is easy to measure, and relatively easy to improve.

For example, the engaged radiology technologist who puts a blanket down for his shivering patient will probably have a low repeat radiology rate -- that is, he's less likely to have to redo the exam because the patient was uncomfortable and wiggled around. But if this technician were only satisfied with his job (in terms of salary, a reserved parking spot at the hospital, and so on), without being engaged and therefore highly attentive in his work, he might not achieve the same positive outcome. 

But that's not to say satisfaction isn't important -- in addition to being engaged, truly happy employees will also be satisfied with their salaries, their benefits, their schedules, and other items that don't relate directly to engagement. Together with the 12 questions that measure engagement, Gallup includes a question about satisfaction on each employee survey that it conducts. And within healthcare, Gallup finds that only about one in six employees are extremely satisfied with their organizations as a place to work.

Low Engagement, High Satisfaction

Why would an employee display low engagement but high satisfaction? One option is that the employee is miscast in his or her role. Employees may love their organizations for placing them in high-paying positions, but the organizations may still fail to hold them accountable for being productive. 

A second scenario is more positive. An employee may take pride in the organization for which he or she works (perhaps a major university teaching hospital), and enjoy the work that he or she is doing, but still have a poor relationship with his or her supervisor and workgroup. Despite low levels of engagement, the employee may be hesitant to leave the hospital for other opportunities, particularly in a tight job market. 

High Engagement, Low Satisfaction 

What if employees are engaged with their workgroups and supervisors, but not satisfied with their organizations? Again, there are both positive and negative scenarios. First, an employee who is highly engaged with his or her workgroup may be more willing to be patient with the organization as it undergoes change.

On the other hand, high engagement and low satisfaction may be a serious warning sign. A team consisting of engaged workers who are unhappy with their organization, could develop an "us-vs.-them" mentality. Employees may love what they do, they may love their coworkers and direct supervisors, and they may be good at their jobs. However, if they feel disconnected from the organization, they may be less likely to work for the good of the overall organization. Cynicism may be the result -- a consequence that's all the more detrimental coming from otherwise engaged employees.

Bottom Line

Employee engagement is the key to successful use of an organization's human capital. However, employee satisfaction has not become an irrelevant measure. Used appropriately within the larger framework of engagement, employee satisfaction measures can provide useful insight for the organization.

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