Nurturing Hospital Engagement: Licensed Technical Staff

by Rick Blizzard, D.B.A.
Health and Healthcare Editor

Engagement scores lowest in this group

Second in a series on engagement levels among hospital employees

Among the three main categories of healthcare employees that make up a hospital's core patient-care team -- registered nurses, professional staff, and licensed technical staff -- licensed technical staff is the lowest-scoring group in Gallup's hospital employee engagement database. The licensed technical staff category, which includes licensed professional nurses, radiology technologists, and respiratory therapists, scores .15 below hospital employees overall in engagement, as measured by the average of the 12 questions in Gallup's Q12 survey.

Registered nurses are on the front lines in providing inpatient care, but licensed technical staff members serve in key supporting roles. Thus, disengagement among licensed technical staff may impede RNs and even reduce nurses' engagement levels.

What Drives Disengagement Among Licensed Technical Staff?

Licensed technical staff members score above the overall hospital database on only one Q12 item: "I have a best friend at work." This may seem like a positive indicator of trust and teamwork. But given the low scores on all the other items, the relatively higher score on the "best friend" question may actually be a negative. Licensed technical staff may be banding together with an "us versus them" mentality toward the rest of their coworkers (including RNs), actually inhibiting trust and cooperation.

At the other end of the spectrum, there are three Q12 items on which licensed technical staff members score .20 or more below the database average:

  • I have the materials and equipment I need to do my work right.
  • In the last seven days, I have received recognition or praise for doing good work.
  • At work, my opinions seem to count.

How to Improve Engagement

The three lowest-scoring items among licensed technical staff members are the same as those among registered nurses, indicating there are key systemic issues affecting those in both job categories. Employees in the professional staff category, however, give scores above the database average for both the "recognition" and "opinions count" questions, indicating that disengagement on these items is not endemic to all hospital employees. The high scores for professional staff also negate the argument that disengagement on these items can be explained solely by staffing shortages. Many professional staff categories face the same staffing issues as RNs and licensed technical staff.

Low scores on the "materials and equipment" item often signify broken processes (see "Nurturing Hospital Employee Engagement: Registered Nurses" in Related Items). The low scores on this item among RNs and licensed technical staff may suggest that in many cases patient-care processes involving these two groups need repairing. Ensuring that processes run smoothly will help RNs and licensed technical staff members to feel they are part of a well-managed team, rather than two separate silos operating independently.

For example, doctor or nurse tells an inpatient that she will have an X-ray in the morning, but doesn't give a specific scheduled time. The patient must repeatedly ask the nurse when the procedure is to be done because an inpatient radiology scheduling system was not used. Then in mid-morning, radiology is hit with a big emergency department patient influx and many unscheduled outpatients. This bumps the inpatient's X-ray to the afternoon, but radiology fails to communicate this to the floor nurses. Thus, the floor nurses cannot communicate the delay and its reasons to the patient, and both end up frustrated.

Also, neither RNs nor licensed technical staff feel they get sufficient recognition for doing a good job, and they don't feel their opinions count. These findings may reflect doubts among RNs and licensed technical staff that their hospitals are fully committed to delivering quality patient care. Why? Because these two groups tend to feel a great deal of ownership for that care, they must feel empowered to implement and lead their own quality improvement efforts.

Bottom Line

Looking at these scores, it's easy to lump licensed technical staff and RNs together as one disengaged workgroup. But there are significant differences between the engagement profiles of RNs and licensed technical staff. Next week's article will examine these differences in more detail and discuss strategies for helping these two groups operate successfully together.

The Q12 items are protected by copyright of The Gallup Organization, Princeton, NJ, 1992-1999. All rights reserved.

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