The value of staff engagement has become widely recognized in healthcare organizations. Staff engagement has been strongly correlated with better healthcare including improved patient safety, clinical outcomes and improved financial outcomes. Accreditation Canada has recognized the need to measure staff engagement, and some provinces now require this measurement as part of their performance reporting. Is staff engagement the new flavour of the month? Does it really matter? And if it matters, what is the role of leadership, most specifically that of nurse leaders, in enhancing staff engagement? 

It is difficult to read anything in management literature without seeing the term staff engagement. There is a growing list of organizations that are offering services to measure and enhance staff engagement. Is this a new concept or just a new name and approach to the more familiar term of staff morale? I would argue that the concept is not new and is similar to staff morale, but what is different, valuable and will keep staff engagement initiatives an organizational priority, is the evidence-based approach to measurement and engagement improvement initiatives. 

For those of us who have managed in healthcare for many years, the issue of staff morale has been a difficult one to address. Historically, staff satisfaction surveys did not provide the level of information required to understand the sources of poor morale and to plan effective improvements. It, often, did not correlate well to a manager’s observations. Satisfied staff did not always equate too well with improved patient or organizational outcomes. Satisfaction did not always mean commitment to the goals of the organizations. However, engaged staff have been shown to be positive and passionate about their work and their contribution to the organization. Using evidence-informed survey methodologies provides important information to organizations about what contributes to staff engagement and, importantly, tells us what is contributing to the active disengagement of staff. The approach also helps us to measure the impact of our interventions to continuously improve levels of engagement. 

Staff engagement does matter. There is evidence that workplaces with higher levels of staff engagement are healthy workplaces. Staff feel engaged not only when they believe they are able to support and to positively contribute towards the goals of the organization but also when they feel that their contributions to the organization are being recognized. People who work in healthcare do so because they want to make a difference in the lives of the people in their communities. Unfortunately, circumstances in some organizations have not always enabled or encouraged employees to feel empowered and engaged in making that impact. Research has shown that effective organizations have staff that are passionate, productive and invested in continually improving the services provided to patients. 

Effective organizations need effective leadership and leaders who are committed to the improvements necessary to enhance staff engagement. Leaders need to be visible and need to consistently communicate the vision and goals of the organization. Staff cannot contribute to the achievement of the goals if they do not understand them and how they can contribute. Leaders need to be responsible for demonstrating their own commitment to the organization and for helping staff to clearly understand how they contribute to overall success. Committing to measuring and improving staff engagement is not for those faint of heart, the results are often a reflection of the improvement work that is required of senior leaders. 

Staff engagement results at my own organization are an excellent example of the key role that leadership plays in employee engagement. Consistently, over the past two years, the top two employee engagement drivers that needed improvement were managing performance and recognition. Each of us wants feedback on how we are doing in our roles and we want to be recognized for the work we do and the time we commit to our work. When this happens consistently, we feel good about ourselves and the contributions that we make. Managers and leaders with large spans of control often struggle to make consistent performance feedback and recognition a priority, but the staff engagement results have reinforced that they need to be. Our improvement plan includes changes in our performance management and recognition systems that make it easier and less time-consuming for managers to provide staff feedback in a meaningful and consistent manner. 

These changes are also a tangible way to support managers, which is the second part of the improvement plan. The results showed that there was a strong correlation between engagement levels of staff and their manager’s effectiveness. The survey data also told us that a manager who feels supported is often an effective manager. This was a strong message for senior leaders; while we have understood the challenges of the first-line managers, we were not always doing enough to support them in their roles. We now have data from them to help us understand as leaders what we need to do to support managers and therefore have a positive impact on staff engagement. Leaders are key to improving engagement, resulting in better patient and organizational outcomes; we have had the courage to ask, and the ultimate improvement in engagement scores depends on our leadership and support of all leaders in our organizations. 

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Lisa McIntosh wrote:

Posted 2016/05/15 at 09:01 PM EDT