2014 Employee Engagement Focus Group Findings and Action Items.

2014 Employee Engagement Focus Group Findings and

Action Items

Overview

• Quick review primary outcomes of Engagement survey

• Understanding the feedback – areas for improvement

• Use of Employee Focus groups to gather greater insight

• Next steps/action planning

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Source: Survey Solutions Employee Engagement database, 2014

Dramatic Improvement Since 2013 Pulse

Employees Responding to Renewed Engagement Focus

Inova Health SystemEngagement Relative to Survey Solutions Benchmark

Engagement Mean4.98

38th Percentile

Median %Engaged

Engagement Scores Vary Across System

Engagement Drivers Allow for Detailed Feedback

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Source: Advisory Board’s Employee Engagement Survey

COMMUNICATION AND INPUT

I am kept informed of the organization's future plans and directionMy ideas and suggestions are valued by my organizationMy manager communicates messages that my coworkers need to hear, even when the information is unpleasantMy manager is open and responsive to staff inputMy manager stands up for the interests of my unit/department

EMPLOYEE SUPPORT

I have a manageable workloadMy manager helps me balance my job and personal lifeMy organization does a good job of selecting and implementing new technologies to support my workMy organization helps me deal with stress and burnoutMy organization supplies me with the equipment I needMy unit/department has enough staff

FEEDBACK AND RECOGNITION

Executives at my organization respect the contributions of my unit/departmentI have helpful discussion with my manager about my careerI know what is required to perform well in my jobI receive regular feedback from my manager on my performanceMy organization recognized employees for excellent work

MANAGER EFFECTIVENESS

I have helpful discussions with my manager about my careerI receive regular feedback from my manager on my performanceMy manager communicates messages that my coworkers need to

hear, even when the information is unpleasantMy manager helps me balance my job and personal lifeMy manager helps me learn new skillsMy manager is open and responsive to staff inputMy manager stands up for the interests of my unit/department

I believe in my organization’s missionI understand how my daily work contributes to the organization’s

missionMy organization gives back to the communityMy organization provides excellent care to patientsMy organization provides excellent customer service to patientsOver the past year I have never been asked to do something that

compromises my valuesThe actions of executives in my organization reflect our mission and

values

PROFESSIONAL GROWTH

I have job securityMy organization pays me fairly for my jobMy organization supports employee safetyMy organization understands and respects differences among employeesThe benefits provided by my organization meet my needs

Abusive behavior is not tolerated at my organizationConflicts are resolved fairly in my unit/departmentI have good personal relationships with coworkers in my unit/departmentI receive the necessary support from employees in my unit/department to help me succeed in my workI receive the necessary support from employees in other units/departments to help me succeed in my workMy coworkers do a good job

MISSION AND VALUES

I a m interested in promotion opportunities in my unit/departmentI have the right amount of independence in my workI receive effective on the job trainingMy current job is a good match for my skillsMy manager helps me explore other jobs within my organizationMy manager helps me learn new skillsMy most recent performance review helped me to improveTraining and development opportunities within my organization have

helped me to improve

BASELINE SATISFIERS

TEAMWORK

Strong Performance on Many Engagement Drivers

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Source: Survey Solutions Employee Engagement database, 2014

Driver Category Performance

% Agree/Strongly Agree Relative to Survey Solutions Benchmark

Key areas for improvement

Top System Improvement Opportunities

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Source: Survey Solutions Employee Engagement database, 2014

Driver Opportunities Aligning with Comments from Pulse

Top Improvement Opportunities

Category %A/SAGap to

BMStat Sig

Top Impact

My organization pays me fairly for my job

Baseline Satisfiers

42.1% -8.2%

My unit/department has enough staff

Employee Support

40.1% -1.5%

The actions of executives in my organization reflect our mission and values

Mission and Values

62.3% -1.4%

In addition to these drivers, managers and directors showing performance reviews and stress and burnout as a consistent opportunity

Focus Groups Target Key Improvement Areas

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Operating Unit Total Participants

Clinical Non-Clinical

IFMC 60 30 30

Inova VP/AVP 15 4 11

IAH 30 24 6

IFOH 22 13 9

IMVH 42 34 8

ISO Mgrs/Dir 62 14 48

ISO Staff 42 0 42

Total 273 119 154

• 273 participants • Outcomes mirror data and write-in comments from survey

Mission and Values: Actions of Executives

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Leader Feedback: Actions of Executives

• Fear of reprisal/punishment if one says/does wrong thing (primarily Senior System Leadership, IFMC)

• Lack of autonomy or input, meetings to prepare what to say in executive meetings because they feel they can’t have an honest conversation

• Goal-setting/strategic planning not taking into account opinions of lower level leaders

• Leaders told what priorities are, but unable to achieve them because staffing and technology resources are low and continuing to be cut

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• Not involving clinical leaders in decision making process for budgets, process changes, new technology

• Staff cutbacks not aligned with mission – organization sending message it focuses on bottom line, not the patient or employee

• Managers feel they are being micromanaged. They don’t feel they have the authority to give a bonus or to spend a few dollars to recognize their staff

• Lack of accountability for execs when others see their poor behavior

Leader Feedback: Actions of Executives

Action Steps

• Senior leadership council to build specific action items– Focus on behaviors, communication, team engagement, expectations

• Introducing Performance Management process in 2015 for executive leaders– Will includes specific accountabilities for leadership & managerial

behaviors and cultural stewardship

• Purposeful rounding – Increased leader visibility – Focus on engaging with staff to listen, better understand, build stronger

relationships

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Compensation

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Focus Group Feedback

Feedback on Compensation:

• Not paid enough for the amount of work required of them• Losing staff to competitors – “they can get paid more to

do less”• Unable to hire experienced staff, so getting a lot of new

grads• Pay not aligned with cost of living – no increases in 4+

years• Staff not feeling recognized for extra effort due to staffing

cuts

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Focus Group Feedback

Feedback on Compensation:

• Unable to hire qualified staff due to uncompetitive pay• Experience not rewarded, unable to compensate staff

with longevity• Leaders also dissatisfied with their own pay, cuts in

staffing have increased their workload. Burnout, poor work-life balance may be contributing to the perception of insufficient pay for leaders (see leader verbatim comments under appendix).– Span of control – multiple nurse leaders with 100+ of

direct reports– Managers report constantly “on”. On-duty, on call,

long hours 15

Next Steps

• Build merit-based process for annual wage adjustment & eligibility

• Better communication to both managers and staff– Frequency of market reviews – Updates and changes to compensation levels or programs

• Ensure managers are better equipped to respond to staff questions, by providing managers more transparency of compensation reviews, structure, and decisions

Staffing

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Focus Group Feedback

Feedback on Staffing:

• Staffing reduction but workload has increased • Pressure to meet ever increasing demands –

documentation, reporting while supporting higher patient ratios

• Productivity benchmarks not accurately reflecting what they do in a day of work

• Filling in staffing gaps with large amounts of temp or contract workers

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Focus Group Feedback

Feedback on Staffing:

• Support-staff cut – managers taking on support and administrative tasks

• Grid/ratio does not plan for acuity• Unsafe patient/staff ratio• Staffed so lean that if one thing goes wrong it stretches

everyone too thin• No career ladder to incentivize employees to stay

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AVERAGE DAYS TO FILL VACANCIES

Position Entered in Recruiting

System

Position Approved

Days Position Open to

Offer Accepted

Days to Start After Accepting

Offer

Across system, we averaged 89 days from manager initiating requisition approval process to candidate hire date

10 days 61 days 18 days

Recruiting Need Identified Sourcing and Selection Pre-hire onboarding

Highest number of days for sourcing & selection seen in critical care/ER/OR/NICU/L&D and Leadership roles

Talent Acquisition has multiple micro-processes and requires strong collaboration across all process stakeholders to work well

What’s Next

• Detailed process mapping accomplished; pinpoint areas where process not working well

• A3s across five separate but related workstreams:– Approval– Sourcing– Selection– Candidate offer– Onboarding

• Project teams cross-functional, overlap with specific work streams for most challenging areas (e.g. OR/ED/critical care RNs, nurse leaders)

Summary

• Engagement feedback critical

• Survey and focus group feedback has the attention of senior leadership and is actionable

• Next steps designed to improve problem areas

• Reinforce to every employee the value of their feedback and desire of management to listen, understand, and create positive outcomes

• Next Pulse Survey – targeting late Q3

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