The Relationship betweenEmployee Satisfaction and HospitalPatient Experiences

The Relationship between Employee Satisfaction and Hospital Patient Experiences The following white paper from The FORUM: Business Results Through People examines the vital link in the hospital industry between employee satisfaction and the satisfaction and quality of patient care, based on extensive research conducted at a major New York City hospital. Although this study was initially completed in 2009, health care continues to grow and now represents more than 17 percent of the U.S. economy and will grow as the population ages and c o v e r a g e increases under Federal regulation.

Health care is an enormously people-intense industry,

and

the importance of employees can hardly be underestimated. The changes taking place in health care require employees to be very engaged and to perform at the highest level in order to comply with increased regulation and ensure patient safety and satisfaction.

new treatments and better outcomes for patients. In an industry

where success is being driven more and more by patient satisfaction scorecards, reliable access to and retention of top talent is essential to meet the demand for quality patient care.

According to an April 2008 study by Futurestep, “nowhere

is the (talent staffing) problem more severe than in the health care environment, where talent shortages put lives at risk.” As

the U.S. population ages, the healthcare industry continues to

grow in size and importance, now representing 17 percent of GDP. For seniors, 40 percent of their total economic consump-

tion is directed to healthcare spending. Within the next 10 years, overall healthcare spending as a percentage of GDP is likely to rise to 20 percent ($2.9 trillion).

Despite temporary hiring freezes in certain healthcare

markets, industry growth is expected to continue, and healthcare organizations will continue to find it difficult to recruit

and retain high-quality professionals. The reasons are twofold

— first, a growing proportion of the workforce is retiring or resigning, and secondly, there are an insufficient number of new graduates in the medical and healthcare administration fields.

The situation is especially acute in the nursing profession,

where shortages exist globally. According to the American

businesses, the benefits of having engaged, empowered, loyal

rate at acute-care hospitals is 21.3 percent, with higher turnover

employees can lead to increased retention, lower costs, enhanced reputation and a profitable business picture.

As the healthcare business becomes more competitive, every

advantage is important, but all too often, hospital administrators

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are increasingly feeling the pressure to manage costs and provide

Critical condition: the talent crisis facing health care

In the healthcare industry, as in other service-related

do not always consider employee performance and satisfaction as a competitive edge.

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In this competitive environment, healthcare administrators

Organization of Nurse Executives, the average nurse turnover rates in critical care units. Much of the turnover is attributed to

job stress and burnout linked to reduced staffing. And, says a

Spherion report on healthcare staffing, “hospitals are diverting

patients, losing revenues and compromising patient care due to

inadequate staffing levels. The overall state of affairs has reached a critical point.”

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Additionally, healthcare organizations are looking beyond

financial performance measures, giving more focus on how to deliver higher quality care. While some improvements in care

quality can be reached through investments in technology and

infrastructure, the most dramatic improvements are achieved through people.

FORUM study unveils key findings

So, the key question is how do service-based organizations,

such as hospitals, determine their level of employee engagement,

programs may be distracting to meeting the demands for patient care.

• The expanded use of computers for diagnostic testing

and vital signs monitoring has eroded the patient’s feeling of being personally cared for. As the popularity of elec-

tronic health and prescription records expands, healthcare employees need to exercise “the personal touch” in caring for patients.

and what impact does it have on patients? To answer this ques-

• A key conclusion of the study is that, in addition to what

of Wisconsin and Frank Mulhern of Northwestern University

how the employees feel about what they do. Patient experi-

tion, researchers Jimmy Peltier and Andy Dahl of the University

conducted an exploratory study to investigate the relationship

between employee satisfaction and patient satisfaction at a major New York City hospital.

healthcare workers do, emphasis needs to be placed on ences will not be good if employees are not happy.

Getting started: how the study was conducted

The approach involved a review of current literature on

Key overall findings from the study include:

healthcare performance, primary data collection through an

• Hospital departments that have higher levels of employee

empirical analysis of employee and patient satisfaction data.

satisfaction provide better experiences for patients.

• Patients that have higher levels of satisfaction are most likely to recommend the hospital to others when they are

treated in the high employee satisfaction departments,

online forum and interviews with key hospital staff, and an

The literature review focused on employee engagement,

employee satisfaction, and patient satisfaction in healthcare settings, and provided a foundation for the key people-related issues facing health care.

In the empirical analysis, the primary objective was to assess

compared to those treated in the low employee satisfaction

the relationship between employee satisfaction and patient sat-

of marketing / promotion, is a primary driver in patient

the concepts can easily be applied to other service- or people-

departments. Word of mouth, more than any other source healthcare decisions.

• Individual employee recognition, as well as the need and value of increasing recognition of staff members in higher positions, were identified as key contributors to employee satisfaction.

• In addition, recognition at the hospital was not only

viewed as acknowledgement for a job well done, but also

as being able to participate in decision making, and being listened to by management and fellow professionals. This

practice results in “more respect and visibility,” which in turn enhances employee satisfaction.

isfaction. While the research was limited to a healthcare setting, based industries, such as retail and hospitality.

The research phase: feedback and ideas for improvement

The research consisted of two components. First, the team

established a 31-member advisory committee that participated

in an online forum about their perceptions about the quality

of service and the motivation, satisfaction and performance of employees. Secondly, the team conducted quantitative analysis

that matched employee satisfaction survey data with patient

satisfaction survey data to assess the relationship between employee satisfaction and patient experiences.

Key findings from the advisory committee forum include:

• Programs and activities at the hospital that are designed

• Advisory committee members identified the hospital’s

strategically, rather than offered as short-term efforts,

alty, retention and motivation. These include recognition

to contribute to employee satisfaction need to be viewed

the overall impact of the program. In addition, multiple

www.customercarenews.com

of

employee

milestones

and

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or efforts initiated on multiple fronts, which weakens

current “best practices” for increasing employee loyaccomplishments,

promoting a family-like atmosphere among long-term

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employees, and support of financial bonds including salary and benefits.

• Areas identified for improvement include better com-

munication of goals, decisions, and information between

departments, greater empowerment and involvement in

decision making, and continuing to improve work relationships, especially between supervisors and their departments and between physicians and nurses.

• The behavior of physicians has a major impact on the level

of engagement with non-physician staff. Physicians who

are disrespectful, make negative comments or treat patients

as (in the words of one committee member) “non-human

intangible entities” lead to reduced engagement in nonphysician staff. When an employee feels like a valuable

Employee, patient satisfaction data “in sync”

The University of Wisconsin/Northwestern University

research team compared the results of the hospital employee and patient satisfaction surveys to determine whether there was

a link between the way employees feel about their jobs and the

quality of the patient experience. Researchers used a variety of statistical methods to evaluate the relationship.

But most importantly, they found, in a side-by-side

comparison of key questions from both surveys, that the

highest scores on the employee survey tracked positively with

the highest scores on the patient satisfaction/quality of care

survey. Researchers concluded that the patient, either consciously or not, infers that the care received is better merely because of the environment created by having more satisfied employees.

team member and feels respected by others, higher levels

Conclusion: people performance boosts healthcare quality,

• The consensus from the advisory committee was that the

more satisfied patients. A key aspect of this study is that health-

has had a positive impact on the quality of care and patient

of benefits of having satisfied employees, not to mention the

of engagement are likely.

level of employee engagement at the hospital is high and satisfaction.

Based on the literature review and input from the advisory

committee, the graphic below was designed to illustrate the link

between employee engagement levels, employee satisfaction, patient satisfaction and organizational financial performance.

business results

The upshot is clear — more satisfied employees lead to

care administrators can add “quality of patient care” to the list

other key benefits of increased retention, lower overall costs, and repeat visits and positive word-of-mouth recommendations by patients.

Hospitals compete aggressively to attract patients, particu-

larly for high-revenue services such as cardiac care. There are a

variety of dimensions that factor into the competitive landscape, including hospital location, technology, physician reputation and the hospital’s image in its service area. Based on the findings

of the study, one can now include the level of hospital employee satisfaction as a competitive factor. CCN

The FORUM: Business Results Through People, affiliated with Northwestern University, is an organization for thought leadership advocating that the most effective way business

leaders create and sustain organizational values is through

partnership with people. The FORUM invites leaders in the

healthcare industry to comment on this white paper and share

their experiences with employee engagement and how it is affecting patient care at their institution. To add your insights, please contact Managing Director Susan Peterson via email at sue@businessresultsthroughpeople.org. To view the full text

of the research paper, plus additional people-centered leader-

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ship research, go to www.businessresultsthroughpeople.org. The FORUM is located in Naperville, Ill. and can be reached via phone at 630-369-7780.

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