Employee Engagement and Patient Outcomes Presentation to Social Partnership Forum Michael West The King’s Fund March 2014
The existing body of research on staff engagement has presented the concept in a variety of ways … • Such as empowering employees to decide how best to A set of working conditions deliver their roles • Such as individuals’ involvement in their roles or sense of An attitude or state of mind commitment to their organisation • Such as ‘going the extra mile’ in one’s role or advocating A set of desirable behaviours the organisation to third parties • Particular outcomes Such as higher levels of staff happiness or job satisfaction for staff or the or greater agility for the organisation organisation For example, the Institute of Employment Studies defines employee engagement as a blend of 2 commitment to the organisation, job involvement and feelings of empowerment.
The Link Between People Management and Performance in NHS • Staff views of their leaders are strongly related to patients’ perceptions of the quality of care • Staff satisfaction/commitment predict patient satisfaction • Supportiveness of immediate managers • High work pressure - patients report too few nurses, insufficient support, privacy and respect. • Poor staff health and well-being, high injury rates- patients less satisfied, poorer care and financial performance • Good HRM practices - low mortality http://www.dh.gov.uk/health/2011/08/nhs-staff-management/
Inclusiveness, Engagement and Proactivity in NHS Employee Reactions Leadership Health and Well-being Supervisors’ Support Overall Engagement Stress Team Working Job Design • Advocacy Organisational Work Pressure Performance • Intrinsic Engagement Having a challenging Quality of Services role Financial Performance • Involvement/Proactivity Absenteeism Feeling valued by Patient Mortality Rate colleagues Patient Satisfaction http://www.kingsfund.org.uk/publications/leadership_review_12.html
There is overwhelming evidence linking high staff engagement with beneficial behaviours, better outcomes and improved performance • Involvement in one’s role • Commitment to one’s organisation High staff • Positive feelings towards one’s organisation engagement Desirable Outputs for the Overall Outputs for staff behaviours organisation performance • Levels of innovation • Higher job satisfaction • Fewer defects in • Greater customer amongst staff (Gallup manufacturing satisfaction or patient • Lower staff sickness 2007) experience (IES, • Less inventory absence (Gallup 2006) Salanova, West) • Willingness to advocate shrinkage • Lower staff turnover • Increased operating the organisation to • Fewer accidents at others (Gallup 2006) (Gallup 2006) income (Towers Perrin work (Gallup 2006) 2006) • Lower infection rates in • Increased productivity hospitals (West 2012) (Gallup 2006) • Increased profitability (Gallup 2006) The causal link from engagement to performance has not been proven. But longitudinal studies 5 suggest that engagement contributes to performance more than performance to engagement.
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Engagement depends on values, behaviours and routines throughout the organisation ... Leadership • Trust, integrity and • Leaders who support staff concern for staff well- in delivering their roles being • Leaders who give staff voice and involve them • Fairness and justice in decisions Management at different levels • Managers who • Managers who welcome staff views and engage their teams • Managers who show appreciation of effort and contribution in decisions Teams and team working • Well structured teams • Effective communication and co- • Rites and rituals which celebrate • Clear accountabilities and few layers of ordination success and reinforce good practice • A supportive work community hierarchy Individuals’ work • Sense that work is • Challenge and • Authority, autonomy • Manageable • Clear objectives and meaningful and stimulation and influence over workload and access well-structured • Opportunities to valued appraisals work and environment to necessary learn and grow resources 7
Positivity builds inclusiveness, engagement and compassion • Barbara Fredrickson www.positiveemotions.org • Positivity balance • Leader positive affect, climate and performance • Turning negatives into positives • Dealing with quarrelsome, disruptive behavior and poor performance
The main pieces of research have emphasised different factors or ‘pre - conditions’ that are likely to lead to high levels of engagement Kahn Maslach et al Towers Perrin Macleod and Clarke West and Dawson (1990) (2001) (2005) (2009) (2012) • • • • • Meaningfulness of Sustainable workload Strong leadership Leadership which Culture of trust work for individuals provides line of sight between leaders and • • Feelings of choice and Accountability from individuals’ work staff • Safety for individuals control over work and to vision and aims or • • to bring their ‘selves’ environment Control over one’s organisation Involvement in to their work environment decision-making • • Rewards and Managers who offer • • • Having the physical recognition Opportunities for clarity and Relatively flat and emotional development appreciation of effort hierarchies • resources needed to Community and social • • bring ‘self’ into work support Employees who feel Clear roles and able to voice their challenging work • Perceived fairness ideas and be listened • and values to Working in well- structured teams • A belief that the • organisation lives by Feeling valued, its values respected and supported • Rites and rituals to celebrate success • Learning opportunities 9
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