LeadingAge Magazine · July/August 2015 • Volume 05 • Number 04

Understanding and Boosting Staff Engagement

July 12, 2015 | by Debra Wood, R.N.

In a human-service field, workers who go the extra mile to give true person-centered care—in other words, going beyond job satisfaction to achieving real engagement—make an immense difference. Here is how some providers are building engagement in their employees.

Close your eyes. Envision your most motivated employee: perhaps the aide who goes above and beyond for residents, the dietary staff member who tracks down a favorite food for Mr. Jones, or the housekeeper who takes time to listen to Mrs. Smith talk about her grandson’s wedding. Wouldn’t it be wonderful if all employees behaved in this manner? A fully engaged workforce will go that extra mile and outcomes will improve.

“An engaged person helps the business grow,” says Michael Matteo, senior director of operations at The Village at Unity in Rochester, NY.

According to a survey conducted in 2013 by PricewaterhouseCoopers, Unity Health System, now Rochester Regional Health, scored in the top 20 percent of the nation in employee engagement, and senior housing employees’ scores led all of Unity.

“Senior housing is a calling, more than a job,” Matteo says. “When employees sense there is a greater something outside of a paycheck or job security, a reason for being, that starts the process of engagement.”

Developing an engaged staff may sound easy, but it takes work. A 2015 Gallup survey found only 31.5 percent of U.S. employees were engaged on their jobs in 2014 (the highest level since 2000), meaning they were involved in, enthusiastic about and committed to their work and workplace,

Matteo explains the difference between engagement and satisfaction as a matter of who benefits. With a satisfied staff member, the benefit is to them, whereas for an engaged person, the benefit is not only to them but to the organization as well.

Satisfaction is more about how the employee feels about wages and benefits, and engagement is more about the effort, adds Kelley Mitchell, vice president of Human Resources at Cross Keys Village - The Brethren Home Community in New Oxford, PA.

“A person can be satisfied by their work, but that doesn’t mean they care about it,” adds Krista Borbely, director of Human Resources at Clark-Lindsey, a continuing care retirement community in Urbana, IL. “A person is engaged when they care about the outcome, not just performing the task. Engagement is the desire deep in your gut to do a good job and not just because it is your responsibility.”

ADP Research Institute describes satisfaction as the employees’ “happiness—about their job and conditions, such as compensation, benefits, work environment and career development opportunities. Engagement, on the other hand, refers to employees’ commitment and connection to work as measured by the amount of discretionary effort they are willing to expend on behalf of their employer.”

Kevin Kruse, author of the books Employee Engagement 2.0 and Employee Engagement for Everyone, defines employee engagement as “the emotional commitment the employee has to the organization and its goals.” They care and use discretionary effort.

The Society for Human Resource Management’s 2014 “Employee Job Satisfaction and Engagement: The Road to Economic Recovery” report indicated the top five aspects of job satisfaction were compensation, job security, opportunities to use one’s skills, relationship with immediate supervisor and benefits. The top five employee engagement conditions were relationships with co-workers, opportunities to use skills, relationship with supervisor, the work itself and being able to contribute to the organization’s goals. The report recommended that employers strengthen relationships at all levels of the organization.

Clark-Lindsey makes a conscious effort to hire people who are able to describe how they do their work in a way that demonstrates a willingness to truly care, Borbely says. Then resources within the community help them develop engagement. For instance, Clark-Lindsey offered an educational program called Imagine Academy 2.0, which included a discussion of the domains of well-being and a sensory virtual dementia tour, and then created a video of the program.

“We talk about why we do our work in terms that resonate with people,” Borbely says, which may include “helping residents feel secure,” or that “people care about them.”

Work groups, including front-line staff, residents and leadership, have formed to solve resident concerns, such as making food available at any time of the day or increased access to the courtyard.

Clark-Lindsey invites staff to bring spouses and family members to some events, fostering a home-like environment and blending “families.”

“It increases buy-in and engagement when your place of employment is the place of your family,” says Laura Beyer, community relations coordinator at Clark-Lindsey.

Engagement develops when people deeply know each other and the organization creates opportunities for residents and staff to truly know each other, such as a fishing trip, antique car rides or concerts, Borbely adds.

“When you feel you will be missed if you aren’t there, there is a sense of commitment and comfort,” Borbely says.

Inclusion and transparency about policies and processes contributed to The Village at Unity’s high engagement scores, Matteo explains. When the campus began to grow, the organization decided to connect its two neighboring communities. It held a series of brainstorming sessions to gather staff members’ opinions. Engagement built as employees saw their ideas, such as creating an art studio, a meditation room, walking trails and new restaurant, come to fruition.

LeadingAge Thrive provides resources to help members achieve peak effectiveness at serving seniors and their communities. The seven major topic areas in Thrive include questions designed to stimulate discussion among your leadership team and board of directors. Thrive also includes resources such as white papers, articles, tools, presentations and business intelligence.

Under the “Workforce and Leadership Development” section of Thrive, see the resources connected to these questions:

  • Do we have a comprehensive orientation program for new employees across all staff levels and settings?
  • Do we conduct employee satisfaction and engagement surveys, provide employee feedback, and use the data to make organizational decisions?
  • Do we use evidence-based management best practices (e.g., supervisory training, open communication, empowerment of frontline staff, self-managed work teams, peer mentoring and support) to set organizational priorities, solve problems, improve the working conditions and the quality of the job and minimize turnover and instability in the workplace?
  • Do we offer competitive compensation and benefits for staff at all levels and across all settings?
  • Do we provide mentoring and peer support initiatives to enhance frontline supervisors’ and workers’ self-image and encourage them to grow in their job?
  • Do we have a comprehensive cultural competence strategy to support healthy staff-to-staff and staff-to-resident/client relationships and quality service delivery?
  • Do we have in place a comprehensive employee orientation program?
  • Do we provide clinical placements and internship opportunities for those who are or may be interested in pursuing a career in aging services?

Thrive is a LeadingAge member benefit, and access is limited to members. Use the MyLeadingAge login page to log in or create an account.

Visit the Thrive main page.

“Engagement is all about ownership,” Matteo reports. “They are now part of the process about how we do things.”

Additionally, The Village at Unity encourages staff to get to know residents to the point they almost become family. Sometimes a housekeeper will stop and engage in conversation with a resident.

“It’s not just cleaning the room,” Matteo says. “Sometimes that is the only human contact the resident has. Sharing the pictures and stories and listening when residents share a memory is critically important. It is not a waste of time.”

Cross Keys Village recently embarked on an initiative to foster staff engagement. After a staff engagement survey conducted by the consultant Holleran of Lancaster, PA, showed opportunities for improvement, Cross Keys conducted focus groups with employees to learn more about how they felt and found direct-care staff disappointed in how often they saw the leadership team, which the team is addressing.

“It’s not just being out there but making it count,” Mitchell says. She encourages leaders to ask, “Is there anything I can do for you today?” and select four or five team members each month to connect with and solve any issues that the employee brought to the leader’s attention.

Mitchell now aims to increase the ratio of employees truly connected to the organization while reducing those who just come to work and do their jobs and those who work against the company. It will begin with leadership workshops about trust and relationships with others, about the team and about the organization as a whole and how to unlock potential in the staff members.

“To get commitment you have to give commitment,” Mitchell advises. “You have to show your team that you are committed, and they entrust you.”

An engaged staff goes hand-in-hand with person-centered care.

Clark-Lindsey offers employees time to interact with residents and get to know them, reports Rikki Brady, vice president of health services at Clark-Lindsey. Each staff member can spend up to two hours paid per month on an activity not related to his or her job. For instance, one woman teaches the residents to play billiards when she is off duty, which encourages engagement. The staff can spend as much time they wish getting to know the residents when they’re “off the clock.”

One of the things leadership at Clark-Lindsey is working on is empowering staff members to do things residents request without asking permission—everything from rearranging the room to bringing a woman a banana from the kitchen.

The Village at Unity provided all staff with training on the care of residents with dementia, which raised staff awareness that the frail person in front of them was once a vibrant, young person.

“When the connection was made, we started to see the residents differently, as people first,” Matteo says.

Organizations that foster engagement often promote from within and offer employees opportunities to grow within the company. Clark-Lindsey and Cross Keys Village offer tuition reimbursement and scheduling around class schedules.

The leadership team at The Village at Unity almost all came up through the ranks, from wait staff and cooks on up, Matteo reports. The company uses a nine-box grid to help employees figure out where they stand in their career, if they are in a leadership pipeline or good where they are.

“These are transparent conversations we have with our staff people,” Matteo says. “Our culture is unique, and it’s much more successful to promote from within than to bring someone in from the outside.”

The organization also outlines leadership expectations and gives employees tools to make good decisions. Matteo says doing so makes good business sense. The Village at Unity expects front line staff to make decisions.

Bon Secours Health System (BSHSI) was recently named one of the 2015 “Best Companies for Multi-Cultural Women” by Working Mother magazine. Emerging as a best practice workplace for diversity and inclusion has been a fundamental aspect of BSHSI’s strategy to engage and leverage the unique skills and talents of its workforce. As a Catholic provider with over 24,000 employees on the East Coast, the vision and significance of this work is tied not just to the health system but its greater Catholic identity to create an inclusive community of service that encourages diversity and affirms all persons and their unique gifts.

In the Tampa Bay area, multicultural women represent a predominant percentage of the local system’s workforce. Nearly one in six management-level positions are held by women representing ethnic minorities. In order to further develop talented and mission-oriented staff, the health system provides generous tuition assistance, leadership formation programs, and an employee wellness initiative that is successfully helping working moms through onsite fitness classes and financial wellness incentives.

In the midst of the Baltimore riots in April, BSHSI held its 5th Annual Diversity & Inclusion Summit, convening 100 leaders from across the health system to lay out the direction of the organization’s commitment to diversity & inclusion over the next five years. Among the priorities emerging from it was the development of employee resource groups, which tie system-wide groups of employees who have shared characteristics/life experiences to the organization’s strategic initiatives. Currently, emerging leaders and members of the military are among the initial groups. In order to guide the strategic advancement of the diversity and inclusion work and orchestrate its system-wide programming, BSHSI recruited Gloria Goins, an experienced diversity leader from outside of health care, to serve as the chief diversity officer in 2014.

“Strengthening our workplace culture will enable us to recruit, hire and cultivate the best people to continue our mission,” Goins says.

- Written by Stephanie Slankard, assistant to the CEO at Bon Secours St. Petersburg.

All employers should focus on employee engagement. As Matteo says, it is good for business. Kruse has reported it leads to higher service, quality, productivity and customer satisfaction.

A 2013 Harvard Business Review article on employee engagement found senior executives consider it a top business priority.

“A growing body of research has demonstrated that having a highly engaged workforce not only maximizes a company’s investment in human capital and improves productivity, but it can also significantly reduce costs, such as turnover, that directly impact the bottom line,” the Harvard report says.