Gallup's 2005 employee engagement database shows that healthcare employees in the United States are, on average, more engaged at work than are workers in industries other than healthcare. Compared with employees in other jobs, healthcare employees give particularly high ratings on three of the items in Gallup's Q12 employee engagement survey (see "Can Healthcare Workers Be Engaged but Not Satisfied?" in Related Items):
- At work, I have the opportunity to do what I do best every day.
- I know what is expected of me at work.
- The mission or purpose of my company makes me feel my job is important.
That's the good news for the healthcare field. Now the bad news -- healthcare workers lag behind non-healthcare workers on several employee engagement items.
Areas to Nurse to Health
Healthcare workers in the 50th percentile of the database overall trail non-healthcare workers also in the 50th percentile on 5 of the 12 core items in Gallup's employee engagement database.
In many cases, healthcare organizations have flattened their organizational structures, resulting in broader spans of control for managers. These expanded jurisdictions, particularly in nursing, make it harder for managers to develop rapport with each individual employee. Managers usually work during the day, so off-shift employees (those working the early morning and night shifts) tend to have little contact with their managers. These difficulties help explain the lower scores on the "recognition," "progress," and "someone seems to care" items. In some aspect, low scores on the "materials and equipment" item probably reflect ongoing staffing shortages in the healthcare industry.
Most troubling on this list of low-scoring items is the "opinions count" question. Gallup research has found high scores on this item are vital to improving quality and preventing medical errors.
What about "best practice" healthcare organizations -- those scoring in the 75th percentile of the Gallup database? They, too, fall behind their non-healthcare counterparts on some items. At the 75th percentile, healthcare employees score lower than non-healthcare employees on the "recognition" and "progress" items. There is little difference between healthcare and non-healthcare organizations at the 75th percentile on the "materials and equipment," "opinions count," and "someone seems to care" items.
Positive Momentum
Despite their weak points, employee ratings of healthcare organizations have improved compared with the previous year's database. Among those at the 50th percentile overall, the greatest improvement occurred on two items:
- The mission or purpose of my company makes me feel my job is important. (+.12)
- In the last seven days, I have received recognition or praise for doing good work. (+.11)
Healthcare organizations are beginning to better appreciate the importance of focusing on mission in a field in which many employees are driven by a desire to help people. And although the "recognition" item is still one in which healthcare employees trail the rest of the workforce, the gap is not as substantial as it was.
Best practice healthcare organizations have improved most since last year on the "opinions count" item -- the mean score at the 75th percentile has increased on this item by .11, to a level equal to that of non-healthcare organizations.
Improvement: Healthcare vs. Non-Healthcare
Comparing the 2004 and 2005 Gallup databases, healthcare organizations have improved on many specific employee ratings -- but not as much as non-healthcare organizations. At the 50th percentile, healthcare organizations were outpaced by improvements among non-healthcare organizations on 10 of the 12 items. The items with the biggest gaps between healthcare and non-healthcare enterprises include:
- At work, I have the opportunity to do what I do best every day. (-.07)
- My associates, or fellow employees, are committed to doing quality work. (-.07)
- I have the materials and equipment to do my work right. (-.06)
There's more reason for optimism at the "best practice" level -- the improvement gap between healthcare and non-healthcare organizations is narrower at the database's 75th percentile.
When it comes to targeting workplace improvements, healthcare organizations should look at ways to build on the positive momentum already achieved on the "opinions count" and "recognition" items, while also focusing on the items of greatest concern -- for many, that means the items gauging 1) access to needed materials and equipment, 2) employees' perceptions that their associates are committed to quality, and 3) the feeling that someone is concerned with their progress.
