Engagement Tiers: The Key to a High-Performing Workforce

Added on Mar 1, 2016

Engagement Tiers: The Key to a High-Performing Workforce
By Diana Mahoney
From Industry Edge February 2016

Health care organizations that make the continuous improvement of employee engagement a top priority are best-positioned for success, according to a new report by Barbara Reilly, PhD, senior vice president of employee, nurse and physician engagement at Press Ganey, and colleagues.

The report, “Building a High-Performing Workforce,” outlines a strategy for building a highly engaged workforce by identifying tiers of engagement at the work-unit level and then designing and implementing targeted improvement strategies accordingly.

Designating work units as Tier 1, Tier 2 or Tier 3 based on performance on a set of questions that are key drivers of workforce engagement allows organizations to customize engagement approaches to the needs of individual groups. Tier 1 units demonstrate the highest performance on key drivers of engagement whereas Tier 3 units perform significantly poorer on the same drivers.

Certain defining characteristics are associated with each engagement tier. For example, employees in Tier 1 work units are the most loyal and intend to stay with the organization, whereas those in Tier 3 may be more vulnerable to burnout, attrition and medical errors.

Importantly, the different tiers of engagement require different follow-up strategies. “Because a struggling work unit needs more support than a high-performing unit, adopting a cookie-cutter approach across the organization will either be insufficient to engage low performers or it will be addressing a problem that doesn’t exist in high-functioning units,” the authors write.

The first step toward building and sustaining a high-performing workforce is to measure engagement with a scientifically valid instrument. However, measurement alone is not sufficient to drive real progress.

Three actions distinguish high-performing organizations that are committed to improving and sustaining engagement over time from organizations that simply measure employee engagement. High-performing organizations:

  • Measure engagement at the work-unit level and manage the follow-up activities based on each work group’s engagement
  • Assess the readiness of each work group before initiating action planning
  • Identify the key drivers of engagement unique to their organization

Grady Health System in Atlanta has been using the tiering strategy to action planning as a way to engage employees at the work-unit level and has experienced dramatic movement across tiers. In just one year the system achieved a fivefold increase in the percentage of work units in Tier 1 (from 4% to 21%), and it halved both the number of work units in Tier 3 (from 65% to 33%) and its voluntary turnover (from 25% to 12%).

A successful engagement strategy also requires understanding each work unit’s readiness for feedback and action planning, which can be evaluated by calculating an action-planning readiness (APR) score. This metric, derived from various survey items, “provides insight into manager-employee relationships by measuring trust, respect, communication skills and openness to discussing issues and solutions,” the authors explain. “High APR scores indicate that the work unit is ready to begin action planning, while low scores suggest that manager-employee relationship issues exist that likely are barriers to effective action planning.”

The most important action is to focus on the right issues at the right level and use the data to drive action planning and change. Taking the time to understand engagement at the work-unit level, assess readiness for action planning and incorporate the global perspective are all winning strategies for keeping and growing the most engaged workforce possible. Download the full report to read more about strategies to building a high-performing workforce.