We've all seen the big storm brewing in healthcare. It's growing bigger every day. From financial cutbacks to new models of care to electronic medical records and more, healthcare leaders are facing unprecedented change.
The missing element in all the discussions about healthcare reform and change is employee engagement. How can we possibly continue to ask more of employees when they are nervous, uncertain and disconnected? The message is clear: You aren't going to get through this big storm without sustainable employee engagement.
The solution is three fold. The three must-haves for sustainable engagement are: 1) organization that deliberately and consistently supports engagement at the strategic level; 2) leaders who regularly drive engagement at the tactical level; and 3) employees who embrace engagement at the personal level.
This combination of three must-haves ultimately allows team members to work in an environment where they can find a true and lasting connection to their work, which results in sustained internal motivation to survive and even thrive in do-more-with-less times. Improving employee engagement is a pivotal way to accomplish everyone's goals — the patient's, the organization's and the employee's. Study after study shows the positive connection between engaged employees, patient satisfaction, financial outcomes, etc. And as a leader, focusing on engagement puts you in a position to drive positive transformation and enjoy your job while you're doing it.
In the "It Takes 3" model (Figure 1) you'll notice that the organization, leaders and employees all overlap in the center to create engagement. The organization and leaders are on the bottom because these two are foundational — they support engagement. All three circles are the same size because all three elements are necessary with the same level of importance for sustainable engagement. Remember, 'It takes 3' to be successful. 
Let's look at each must-have:
1. An optimized organization that supports engagement at a strategic level. You may be thinking this is very obvious. I agree. Unfortunately, when I talk with healthcare leaders across the country I ask them about their strategic initiatives regarding engagement and I get "umms" and "ahhs." The leaders are not able to clearly articulate the strategies that focus on engagement. Does your leadership group know? They need to!
In addition, an optimized organization needs a strong and compelling mission/vision that drives behavior. Just the other day, I was with a group of nursing leaders who weren't able to convey their organization's mission without referring to their badge. The mission was about six sentences long — no wonder they couldn’t articulate it. It wasn't compelling — in fact, it was confusing. What?s your mission? Does it compel employees to be engaged?
From a strategic perspective, other important elements of sustainable engagement include fair compensation and benefits and working in a safe environment (physically and psychologically). In addition, open and honest communication from executive and front-line leaders is the foundation for employees to feel a positive connection to work. The board and executive team ultimately set the tone for what’s important day-to-day via multiple methods of communication.
One final element of an optimized organization is the opportunity for growth and development. These are all must-haves at the organizational level for sustainable employee engagement.
2. Motivated managers who support engagement at the tactical level. Leaders in an organization must embrace employee engagement as a key area of focus. I use the term "embrace" deliberately. I hope it invokes the idea of holding it close and a positive feeling. Distractions abound that pull leaders away from a focus on engagement, and this is a problem that is evidenced over time through unwanted turnover, employee complaints and low morale. The leader who embraces employee engagement as a key priority will meet his or her goals faster and more productively.
A leader who understands the importance of employee engagement works to create a positive connection with each member of his or her team. Through one-on-one meetings, daily rounding with staff, huddles and interactive team meetings, these leaders directly support associates.
Effective leaders aren't afraid to call a challenge a challenge and work to shrink the challenges that are within their control. I see leaders trying to put a positive spin on big changes and the employees just don't buy in. Transformational leaders understand the ramifications of these changes and are open and honest about the work it will take to move forward.
Equally as important, leaders who promote engagement share the responsibility and teach their team how to shift the challenges they experience to positive outcomes. They regularly measure and monitor employee engagement; they don't wait for a bi-annual survey to determine levels of engagement. In addition, engaging leaders purposefully focus on the positive actions and outcomes of staff and celebrate their success.
3. Engaged employees that support engagement at a personal level. A lot has been written and discussed about the first two areas: the organization and leaders. We've been tiptoeing around no. 3 — the employee's personal responsibility for his or her own engagement. While at work, each team member decides to be engaged or disengaged. It's not something that someone does to you; it's internal and itss time to acknowledge that truth.
I recently asked several thousand healthcare workers via email and social media who is responsible for their engagement at work. The number one response (71 percent) was "myself" followed by "my manager" and "the organization." I was shocked. I don't see this in conversations with healthcare team members and leaders. I don't see this in articles I read. I see employees pointing the finger at their manager or the executives, asking for external conditions to improve their internal engagement. Look at many of the employee engagement survey questions that are asked. Are they focused equally on the employee's role in creating engagement for themselves? They should be.
Recently, when talking with a very engaging nurse leader about her daily rounding with team members, she was sharing the questions she asks each employee. She asks about how the person's day is going, what resources he or she needs and what obstacles she can help remove. I suggested that she add a question to her rounding, "What are you doing today to feel positively connected to your job?" She loved the idea! Let's not promote the idea that it's someone else's job to make folks happy at work. Let's promote a shared responsibility for engagement.
Take a look at each must have for sustainable employee engagement. How do you fare? What can you to do improve the strategic focus of the organization, the tactical focus of the leaders or the personal focus of the employees to propel your organization through the next big storm in healthcare? Now is the time to check so that you team is ready, willing and able to overcome the challenges on the horizon.
Vicki Hess, RN, MS, CSP, author, consultant and professional speaker, works with healthcare organizations across the country to create sustainable cultures of engagement. Read more in her third book for healthcare leaders, "Six Shortcuts to Employee Engagement: Lead & Succeed in a Do-More-with-Less World," due out August 2013. Vicki can be reached at vicki@vickihess.com or www.VickiHess.com.
More Articles on Employee Engagement:
4 Drivers of Cultural Transformation in Healthcare
First Things First: Treat Employees Right