Bryan Health and Emory Healthcare Lean into Workforce Engagement Surveying

Added on Oct 8, 2020

Keeping Teams Engaged in Challenging Times: Bryan Health and Emory Healthcare Lean into Surveying
By Audrey Doyle

Ensuring an optimal employee experience is an ongoing journey that requires health care leaders to stay connected with their workforce, especially during times of disruption and instability.

Bryan Health, located in Lincoln, Nebraska, and Emory Healthcare, based in Atlanta, are among the growing number of organizations that understand this well. Their senior leadership teams made workforce engagement a strategic priority several years ago and believe that surveying employees to capture meaningful insights around specific aspects of the employee experience should never be put on hold. So, when COVID-19 struck earlier this year, both organizations continued to prioritize continuous listening.

By not postponing their surveys until a more stable time, these leaders have shown employees they care about their needs as well as their psychological and emotional well-being, which builds employee trust and advances their ability to deliver safe, high-quality care. In addition, the leaders have gained insight into what’s driving employees’ perceptions about their jobs, leadership, and organizational culture as they navigate the challenges of delivering care during a crisis. They will use this insight to direct improvement efforts long after the pandemic ends.

Annual Survey Offers Engagement Baseline

A comprehensive annual survey is a key part of Bryan Health’s employee engagement strategy. Every April, the system administers Press Ganey’s Employee Engagement survey to its more than 5,000 staff members across its acute care hospital, critical access hospitals, outpatient clinics, College of Health Sciences, physician network, and cardiac/vascular physician practice. The annual survey also includes several questions from Press Ganey’s Safety Culture survey to measure the relevant issues and workplace activities that define the organization’s focus on safety.

Although it would have been “easy” to suspend the April 2020 engagement survey because of COVID, Bryan’s leadership felt that doing so would send the wrong message and would be akin to telling employees that their safety and well-being were not a priority, according to talent management and organizational development director, Brooke Cose. “Our senior leadership knew that if we went ahead with the survey despite COVID, we might not meet organizational goals around employee engagement. But they also said there’s no time like the present: If co-workers feel right now that they’re stressed, not safe, or not being kept informed, we need to know so that we can take action,” said Cose.

Cose speaks from experience, as a similar situation occurred in 2018 when Bryan had just begun implementing a new electronic health record (EHR) system. Even though the leadership team knew employees were trying to manage the challenges of implementing a new EHR, they didn’t postpone the survey, Cose explained. Although employees’ frustrations with the EHR were reflected in the system’s mean engagement score that year, the survey revealed improvement opportunities in staff communication that the team wouldn’t have known about otherwise. The leaders addressed the opportunities through tactics such as leadership development training and purposeful employee rounding, and the following year, Bryan’s mean engagement score was in the 91st percentile.

Earlier this year, the value of those insights was realized again when the team was developing Bryan’s COVID-19 response plan. Heeding what they’d discovered about employees’ desire to hear more from their leaders during high-stress periods, the team included in the plan several tactics for keeping the workforce well-informed. For instance, starting in early March, executive leaders began giving almost-daily briefings on social media detailing issues surrounding the crisis, Bryan’s state of preparedness, and how the organization was supporting the community. Also, the CEO began delivering live video messages to employees regularly to let them know what was being done to keep them safe.

According to Cose, the team’s efforts have paid off. Results of the April survey place Bryan in the 94th percentile for engagement. In addition, “all of our scores either stayed the same as they were in 2019 or went up, and we scored significantly above the national average on three key drivers in particular: ‘I feel like I belong in this organization,’ ‘This organization provides high-quality care and service,’ and ‘This organization makes every effort to deliver safe, error-free care to patients,’” Cose said. “This validates that our efforts to continually communicate accurate and clear information to employees, combined with asking them for feedback in the middle of the pandemic, has made them continue to feel safe, valued, informed, and connected to the organization, even if they’re now working remotely or were redeployed.”

At press time, Bryan was working on ways to sustain the positive momentum. In addition to requiring lower-performing leaders to develop action plans for improvement, the organization continues to focus on improving leader communication and ongoing leadership development. Leaders are also considering ways to ensure that employees continue to feel connected and valued. “Some of our biggest onboarding connection points, like new-employee orientation, are now online, so we’re continuing to evaluate how we can create a connection and a feeling of belonging,” Cose said.

Maintaining a Flow of Data with Pulse Surveys

Like Bryan Health, Emory Healthcare uses feedback from the full Employee Engagement survey to monitor and measure engagement levels and direct improvement efforts. Because of its size—the system, which is part of Emory University, comprises 10 hospitals, the Emory Clinic, more than 150 outpatient locations, and a workforce of more than 32,000 people—Emory administers the full survey every 18 months and structured pulse engagement surveys every three months.

A few years ago, Emory leaders made a commitment to not deviate from this survey schedule, so they never considered skipping this year’s pulse surveys, which occurred in February, May, and August, according to Redge Hanna, corporate director of service performance at Emory and an adjunct instructor at the Emory Rollins School of Public Health. They’ll administer another pulse in November and a full engagement survey next spring. “We feel it’s crucial that we stay the course with employee perception measurement,” Hanna said. “It’s the only way we can truly see a difference in the influence of the times and the influence of our improvement efforts.”

Emory’s highly targeted pulse surveys always include 18 core items: the six Engagement Index and six Leader Index items from the full engagement survey, as well as six organizational unit/system items for work unit assessment. The feedback Emory receives from the full survey drives the additional items included in the pulse surveys, and the feedback it receives from each pulse survey drives the additional items included in the pulses that follow. “The intent is to utilize the data collected on an ongoing basis to see what is and isn’t working,” Hanna said.

For example, feedback from the full survey indicated room for improvement in some of the Leader Index items, so Emory improved its structured leadership development programs. Also, upon completion, leaders are shadowed by a coach who assesses whether they’re correctly applying the principles they learned in the program. Leader Index data are also tracked quarterly through the pulse surveys for evidence of sustained improvements.

Staff feedback from the May 2020 pulse survey showed an increase over February in all the Engagement Index items, and in all but one of the Leader Index items: “I am involved in decisions that affect my work.” Based on feedback gathered during employee rounds and other avenues, leaders learned employees were finding it difficult to reach managers who were working remotely or weren’t as readily available due to COVID as they were previously, so the following item was added to the August 2020 pulse.
  • “I am able to maintain personal connections with the people I work with.”
By this point, the high contagiousness of COVID-19 was understood and leaders wanted to know whether employees were feeling adequately protected, so the following two items were also added to the August pulse.
  • “I feel free to raise workplace safety concerns.”
  • “Emory has addressed my concerns for personal protection and safety.”
In addition, the August pulse included the following items so that leaders could learn how social issues as well as how working in a COVID unit and working remotely were affecting employee engagement.
  • “This organization values employees from different and diverse backgrounds (race, ethnicity, sexual orientation, culture, etc.).”
  • “I have confidence in senior management’s leadership.”
  • “I feel like I belong in this organization.”
  • “I am able to maintain personal connections to the people I work with.”
According to Hanna, at press time Emory was analyzing the results from the August survey to determine where to focus new improvement efforts and what items to include in the November pulse.

Continuous Listening Provides Strategic Direction

Regardless of whether it was through a full engagement survey or quarterly pulses, measuring engagement during the pandemic has helped Bryan and Emory ensure that their workforces are prepared to handle the new challenges they face post-COVID.

“One of our core values is ‘Know the way, show the way.’ As leaders, we must listen to our employees all the time, but especially during stressful times. It’s so important to keep asking, keep getting input, and keep making sure our employees feel heard along the way,” said Cose.

“We look at the pulse survey feedback as gifts we receive quarterly,” concluded Hanna. “If they do nothing more than start a conversation around how we should dig deeper to determine where change needs to happen, that’s great. Consistency in surveying is what ensures that we ask for feedback that’s relevant and what will help us drive meaningful change moving forward.”