Healthcare Employees Anxious About Quality?

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

The year 2002 was a rough one for the healthcare industry. Staffing shortages continued. High-profile medical errors put quality and safety issues in the media spotlight. Financial pressures led to continued downsizing and budget cuts at many institutions.

Were the prevailing attitudes of healthcare workers affected by these and other environmental stressors? To investigate that question, we examined the 2002 database responses to Gallup's 12 core employee engagement questions across a variety of healthcare organizations, comparing them to the average responses from the 2001 database. Somewhat surprisingly, 11 of the 12 questions showed some improvement with regard to the percentages of employees giving the most positive responses, while the results for the remaining item were essentially unchanged.

Commitment to Quality

The single item for which the results were static is: "My coworkers are committed to quality" (respondents are asked for the level to which they agree or disagree). In consulting with healthcare clients, I've come to recognize a number of influences at play here. Many nurses express concern that ongoing staffing shortages have an adverse effect on quality, but that hospital administrators don't seem to care. Further, staff members often say they are concerned that in the pursuit of "bodies" to fill various positions, qualifications for many roles are lowered or overlooked. Ultimately, this trend may result in the increased turnover among qualified staff, as Gallup has found that the second-most commonly given reason among staff members who leave healthcare organizations is lack of trust in the quality of coworkers' care.

Another emerging factor is employees' tendency to perceive "quality silos." In a stressful environment, such as might be found in a busy hospital, an "us vs. them" mentality may develop. While workgroup staff members may be supportive of each other, cooperation can easily deteriorate between the workgroup and other areas depended on for support. Concentrations of low scores on the "coworkers committed to quality" question in specific departments can be an indicator of the development of quality silos within the organization.

But as noted, 2002 results for this question are the exception -- the average scores for all other indicators of employee engagement saw at least a slight rise over the previous year. Given the tough environment in which healthcare workers often find themselves, that's very good news. The second half of this column will examine the engagement items on which average scores increased the most, and discuss their meaning for healthcare workplaces.

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