Note: This article was originally published in McKnight's Long-Term Care News on November 26, 2018.
A recent study published in the American Journal of Health Economics looked at how nursing home nurse turnover contributes to quality of care, mortality and deficiency citations. The researchers found that “higher turnover leads to worse quality of care in terms of bedsores and suggestive evidence that other measures of quality are also worse.” They also found that a 10 percentage point increase in turnover leads to a 19.3% increase in deficiency citations, and an increase in the discharge death rate of between 9.4% and 17.4%.
Substantial research provides evidence that that an engaged workforce delivers higher productivity, higher profits and fewer insurance claims. Not surprisingly, long-term care organizations are putting more emphasis on keeping employees engaged. Employees are also more likely to stick around and not jump to the next employment offer because they will have a deeper relationship with their employer, peers, and residents they serve.
So what’s the answer? Unfortunately, there’s no secret sauce, but there are things that leaders can do to positively affect the engagement levels within their organization. The critical component, however, is how leaders ultimately connect and support their people and their communities.
Improving employee engagement
Good relations between employers and employees start with the hiring and onboarding process. No matter how busy your staff is, onboarding and training new workers simply can’t be rushed. It is essential to get employees started on the right foot.
Think of it as making a good first impression. Even if employees like their jobs, they might be more tempted by a new job offer if their first few weeks did not show that their employer or fellow employees were committed to them. An investment in good training and onboarding processes is an excellent first step toward improved employee retention.
Mentorship programs can be very beneficial as you move beyond onboarding. Given the generational differences we are all confronting in today’s workforce, finding ways to help the veterans impart their experience and institutional knowledge on newer team members can be invaluable. The challenges to doing so often revolve around the lack of capacity, so finding creative and effective ways to enhance meaningful interactions between these two groups of people is important.
Another recent area of focus is health and wellness programs for employees. Employers should always be practicing good communications about why a wellness program – such as smoking cessation or controlling diabetes, is being implemented. Honest discussions of how it will help both employee health and the financial health of the organization will make workers feel more engaged. Transparency by the employer helps build trust and makes employee feel valued. This, too, results in better employee engagement.
Communicate – regularly, openly, and honestly. This doesn’t just mean telling your staff things, it means engaging them in dialogue. Employees are now looking for jobs that suit them, rather than how they can suit their job. Find out what is going on with your teams and who they are as people. You’ll probably learn some pretty great things.
Surveys can provide some data points, but they are no replacement to the insight that can come only through building relationships. Genuine engagement and on-the-job happiness require this kind of commitment to good communications between employer and employee.
Employee benefits programs are a given, yet often overlooked, as part of an engagement strategy. It also helps when employees know that you understand their needs when it comes to benefits. Without a strong benefits program that can meet the various needs of a range of employees, a facility will always be at risk of losing workers.
Flexibility is a tool for success. Long-term care facilities have a wide range of people, and the benefits needs of one worker will vary significantly from another, due to different demographics, family situations, etc. Benefits programs that allow employees, regardless of their position, to make well informed decisions that suit the unique needs of their families are extremely helpful in retaining employees.
A successful approach to benefits requires an HR or leadership team that is well-educated, is able to access the resources provided by carriers and brokers, and is engaged as well as “present” among the other employees. There are powerful new tools being developed to help employees access and understand their benefits, such as digital brochures, videos, and mobile apps, which continue to grow in popularity.
Accessing HR and benefits information on their phones or other devices, and being able to review that information at home, away from the stresses and distractions of work, can be very positive for employees.
Leadership needs to lead
Engaged leadership is the final, and most critical, piece of the puzzle. While the onus for building and sustaining engagement levels seems to rest on the shoulders of senior leaders, immediate managers, and HR professionals, it’s important to remember that employees control their own attitudes. A recent Mercer | Sirota study found that 96% of employees surveyed seek to maintain a high level of engagement at work; 79% regularly seek to find ways to stay engaged; and three-quarters take steps to re-engage when they feel their energy is lowering.
Too often employee engagement strategies focus solely on what can be done to enhance the engagement of an employer’s labor force. They neglect focusing on enhancing leadership’s engagement. Employees in many communities in which we have worked have told us that their managers are the ones who are the disengaged ones. Leaders and managers need to get out of their offices, walk the floor, and interact with their people, at all levels within the community.
The result can be not just a healthy work culture, but a very strong team approach to the work of providing healthcare to patients. When employees are engaged – when they feel that they have a stake in their community – communication, productivity, and quality of care are all improved.
While there are certainly things that need to be in place – employee benefits programs, wellness programs, regularly communications, etc., the ultimately success depends on leadership that leads.
The importance of leading by example within the community cannot be overestimated. If you’re unable to demonstrate to others that you are in a “we” environment, rather than an “us vs. them” environment, there’s no chance your employees will, either. When your employees refer to “us” or “we” more frequently than “they,” you know you’re on the right track.