Words are Free…Wisdom from the Real World™

by Sue Knight, Ph.D., SVP, Client Solutions

The CEO of a large organization with hundreds of small healthcare offices was reflecting on his 2011 employee survey results. Employee engagement had improved from the previous year at Health Services*, in spite of the financial challenge of keeping competitive salaries for frontline employees. “Words are free,” Joe* said as he smiled. Since he didn't have dollars to spend on salary increases, Joe's team decided to spend energy on good communications. It paid off.

The story began with Health Services’ first survey in 2010. Joe’s response had been grim when he first looked at those results. Employee satisfaction with pay was not only well below the national healthcare average, but pay was also identified as a key driver of employee engagement in their organization. Joe’s team knew the pay issue was huge, as their organization provides rehabilitation, personal care, and therapeutic and hospice services to patients with disability and income restrictions. While patients were able to take advantage of government reimbursement programs, payments were less and limit the organization’s revenues. Their small profit margins simply left nothing for pay increases. Adding to the dilemma, many of the employees work in communities where competitors offer higher wages, and changes on the national economic front were worsening. Joe and his team knew they would have to look for solutions other than pay raises in the coming year.

Joe’s team found clues to a solution in those same 2010 employee survey results. Another key driver of employee engagement was employees’ belief that the survey would be used to make improvements. On this front, employees were more optimistic and scores were significantly above the national healthcare average. Why? Because Joe’s team had begun building momentum before the administration phase of the 2010 survey. Joe had sent a message to employees that he cared about what they thought and would personally review all results, including reading every response to the open-ended question on the survey. The rest of the leadership team followed up with their own commitments to act on results. In addition, system-wide communication about the survey were developed, and office leaders got creative about making the survey accessible to their 10,000+ employees, most of whom work in widely distributed locations, often from their homes and without Internet access. As a result, almost 50% of the employees responded to the 2010 survey.

After the 2010 survey results were received, the senior leadership team used that pre-survey momentum to energize discussions with employees about the survey results. They found a way to communicate with every office in their system to share the overall organization results and action plans, as well as to discuss the individual office survey results and action plans. I loved being a part of Joe’s communications and watching his approach. His deep passion for both patients and employees was at the core of the system’s follow-up plan, and that passion carried through to the senior team and the office leaders. Joe knew that he wouldn’t be able to raise employees’ pay, but he wanted them to know that he heard their concerns. He let them know how he was trying to change the picture to allow for salary improvements. In addition, he told them he was exploring ways to address healthcare reimbursement policies nationally by partnering with other healthcare organizations, participating in national forums, and lobbying the government about the structure of reimbursement. The rollout of the survey results involved every level of leadership talking about what the survey said, listening further, and acting on ideas to improve the employee experience, all with a focus toward better meeting the organization’s mission of serving patients.

A lot of communicating went on at Health Services after the 2010 survey, and it showed up in the 2011 survey results. Pay was still a key driver of the survey results, and scores on pay did not improve. However, other key drivers of engagement improved significantly, including the belief that Health Services treats employees with respect, creates office-level cultures that encourages the work, and communicates well with employees.

Joe’s words stuck with me. Words are free, and exchanging words in the interest of improving both employee engagement and patient-centered care can help mitigate the effects of low pay. Health Services’ survey results showed that employee engagement improved even when pay declined. I have to believe that leaders and employees talking about their shared passion for patients was a big part of their success.

How have you communicated about declining pay? I’m eager to hear more success stories in using words!

* Names were changed to protect Morehead's outstanding clients, but the story is real. I have deep respect for the challenges our clients face every day. This Wisdom from the Real World story is just one of many of our clients’ stories. I’ll be sharing more of them with you later.