The Importance of Employee Engagement

Posted Oct 8, 2015

by Patricia N. Reams, MD, MPH, CCHP-PPatricia Reams

Recently, a friend who works in health care thanked her supervisor for allowing her to grow in her job with educational opportunities, mentoring and a minimum of micromanagement. We marveled that she felt the need to express her appreciation because she had routinely experienced the opposite throughout a long career. That led us to discuss what makes people love or hate their jobs, what makes them feel valued and respected. This is especially important in health care because a healthy work environment is most effective in caring for patients.

In the literature I have seen much about employees who quit their jobs. This can be detrimental to an organization’s cost-effectiveness due to the need to hire and train new employees. My observation as an employee, employer and surveyor is that many, perhaps most, people who are unhappy tend to stay where they are but become disengaged.

Disengagement can take many forms: taking extra time to answer calls, “filing” sick slips in the trash, refusal to stay up to date on knowledge needed to do the job, routinely coming late to work and refusal to communicate with coworkers. Occasionally there is an incident of sabotage, as in the manager who stopped filing records after his supervisor refused to give him a new file cabinet. In most cases their resistance is not blatant enough for personnel action. The effect is an erosion of morale that can destroy an organization’s culture and undermine its reason for existence—in this case, the delivery of excellent health care.

When employees are disengaged it is most important to look for reasons. Many employees will talk about feeling undervalued. They say that they have approached supervisors with requests but have been ignored, or have not received a reasonable explanation for why the request cannot be granted. Some say that they are not given the educational opportunities that they feel they need. Some perceive that they are not paid equally for equal work. Some feel overburdened or are given more work than their coworkers. Some are unable to achieve a work–life balance. Some say that they have not been acknowledged for great work.

Sense of Purpose
Correctional health care organizations exist within the framework of much larger organizations and many personnel policies can make it seem impossible to properly supervise employees. However, the most satisfying job I ever had was in Virginia’s Department of Youth and Family Services, where I was included as a member of a team that had a purpose. I was given a position to play to achieve that purpose, but was allowed to create many of my own expectations in addition to those that came from management. My supervisors always listened to my requests, although they did not always fulfill them. I was supported in innovations as diverse as getting a new law passed to getting new curtains in the clinic. I felt that I was treated fairly, and I hope I treated those who worked for me with the same respect. Often supervisors think that they need to be able to fire employees in order to effectively manage them. I submit that timely coaching within a well-communicated sense of purpose can be just as effective.

The National Commission standards encourage a healthy workplace with requirements for education, collaboration and adequate work space and equipment. The standards are just the beginning. It takes creativity, vision and good communication skills to be a great leader. People respond by passing the value they perceive onto others. That encompasses the culture we wish to pursue in health care.

Patricia N. Reams, MD, MPH, CCHP-P, is 2014-2015 chair of the NCCHC board of directors and serves on the board as the liaison of the American Academy of Pediatrics. She also is a pediatrician at Cumberland Hospital, New Kent, VA.