Making Connections: Nurturing the Engagement-Experience Link

Added on Mar 30, 2017

connectioinsCaregiver engagement is a powerful driver of the patient experience, but engagement and patient experience improvement efforts must work in concert to be optimally effective. Ensuring that engagement is properly connected to the patient experience requires understanding the possible areas of misalignment and providing the resources and support needed to address them.

Occasionally, a unit with high employee engagement may not be showing expected results. When this happens, senior leaders should work to identify and address the underlying reasons for the disconnect to get the unit back on track. Following are some possible causes for the disconnect.

  • The unit’s patient experience scores are a lagging indicator and simply have not yet caught up with the high engagement. If this is the case, the chasm will become progressively narrower as time passes.

  • A physician, nurse or other health care employee can feel highly engaged and connected to his or her job and co-workers, but may not be consistently and reliably executing on the organization’s care standards, smoothly navigating handoffs and transitions or delivering care with compassion and empathy.

  • There may be a communication breakdown, such as when caregivers use dense or abstract language that leaves patients feeling confused.

  • Leadership may be misguided or insufficient, pointing highly engaged team members in the wrong direction.

  • Caregivers may be delivering one-size-fits-all care, rather than acknowledging that patients have unique needs.

  • Caregivers are engaged, but not at a level high enough to influence the patient experience. Our data show that patients give high ratings to the teamwork aspect of their care only when caregiver engagement has topped the 75th percentile. In other words, it takes high levels of caregiver engagement for patients to perceive adequate levels of teamwork. This fact is more significant when you consider that teamwork is a critical component of patients' loyalty (Likelihood to Recommend)—second only to confidence in their caregiver.

  • Employee engagement could be artificially inflated, as when a manager instructs his or her direct reports to rate items positively. This scenario is rare, but when it does occur, it typically can be discovered quite easily.

The engagement-patient experience connection may also expand or contract as a function of time. Engagement is built and maintained over time. The enduring relationship between caregivers and the organizations they work for influences how ​caregivers feel about their individual situations and ultimately affects their interactions with patients. Patient encounters, by their nature, are individual. As such, they are susceptible to the effects of short-term changes in caregiver attitudes and behaviors related to circumstances of a given day, hour or even minute, which can introduce variability in the patient experience.

Further, while individual patient encounters are discrete, patient experiences on the whole are a continuously flowing feed. Caregivers can maintain positive feelings about their organization each day through patient encounters, and they may feel that they are being supportive to each patient, even if some encounters have been challenging. However, it has been proven that one negative patient experience can carry over to the next patient. Because of this, a patient may feel the “aftereffects” of previous patients through his or her caregiver.

So, what is a senior leader to do in the face of an engagement-experience disconnect?

  1. Show up. Lean in. Ask questions and spend time with the unit.

  2. Consider a skip-level meeting with the team, and listen. Ask the team for their views and opinions on the situation.

  3. Invite HR business partners and patient experience leaders to the table for a joint analysis. Break down the silos that keep these groups from working together.

Equally important is understanding what senior leaders should NOT do, which is to hope for the best and do nothing. This is not the time for a laissez-faire attitude. The ship definitely can be righted, but not without sufficient intervention.