How Healthcare Employees Benefit From Q12 and Strengths

On a recent Called to Coach, we spoke with Gallup-Certified Strengths coach Penny Gray.

Penny Gray is a registered Organisational Psychologist and holds the position of Group Learning & Development Consultant at St Vincent's Health Australia (SVHA), a large National health and aged care provider. Penny uses strengths-based strategies to help leaders and teams throughout her organization improve performance and engagement.

Can you share with us what you've done prior to St. Vincent's?

• Internal roles and external consultants
• Part time and full time experience
• University work -- lecturer and placement supervisor

What are the largest issues that healthcare organizations are facing?

• In her work, she has observed issues with change, providing support for patient outcomes, and supporting employees who are the care providers. Physical health and safety.
• Strengths is a great platform to discuss patient wellbeing and employee wellbeing/exploring issues around self-care
• Improvement of higher levels of engagement of employees (Gallup)

How did you come to know Gallup and your first encounters with the organization?

• 2016 and 2017 Q12 Engagement survey
• Been at St. Vincents for 4 years and was involved in strengths previously
• Explore engagement within the organization and combined with her previous interest in strengths
• Found the accelerated course in strengths coaching and realized the Q12 engagement survey and her previous experience with strengths combined well

You've used engagement tools in the past. Can you talk about Q12 and what you see as the benefits? How does it differ from instruments you have used in the past?

• It looks at individual needs and development
• It also helps with team placement and identity within a team
• It helps to drive conversations with managers around how they are developing as leaders and how they can support their teams

Can you give me an example of how you use Q12 for conversations?

• In September 2017, Q12 was administered across the organization. This was similar timing with my strengths certification so I was able to look at how I could support managers to interpret their survey results.
• I meet with managers individually but I also attend team meetings and planning sessions to talk about engagement and strengths. I introduce The principles of strengths, how to interpret the results of Q12, and look at how they can lead conversations afterwards with their team.

Q12 is Gallup's employee engagement metric. It's Q12 because there are 12 items that are the 12 foundational needs of employees identified by Gallup. They are listed in hierarchical order with some needs being more important than other needs. It starts with foundational needs (i.e., I know what is expected of me at work) and progresses into team structure, individual, and individual development is at the top. People generally tend to look at the red areas (the deficiencies) and identify those areas as the starting point. How do you approach? Where do you start with the Q12 results?

• I start with an introduction of my approach -- understand the principles and hierarchy of the Q12 / needs to help interpretation efforts.
• I connect it with St. Vincent's mission and values. I talk about the strengths-based approach to development -- we focus on the areas of strengths and what has led to those areas in Q12 to be areas of strengths. St. Vincent's has a strategy around looking for greatness which helps align us with excellence and strengths-based approaches. Mission alignment is key.
• I then talk about engagement and how it is a high level of enthusiasm and commitment to the organization. Highly productive, passionate, committed -- the high-level psychological commitment.
• On the other hand, the disengaged term refers to people who may be productive and meeting expectations but they're often thinking about where else they could be and they're not as committed to the organization. The disengaged tend to have an influence on others around them and it's not usually positive.
• I talk about why engagement matters with its connection to turnover and absenteeism reductions … and increased productivity/safety. Safety statistic is very important to a health care environment.
• I focus on the hierarchy of needs of Q12. I refer to Maslow's hierarchy of needs. Addressing the needs of the individual, then the team, then the development. If you want to address some of the issues at the top of the hierarchy, you need to have the issues and concerns at the bottom of the hierarchy met first. If we are looking to raise engagement in our team, any of the Q12 can help us increase.
• Considerations when you interpret the results of Q12: focus on the areas of strengths to help identify priorities/focus on the first half of the hierarchy. While there may opportunities for development in the higher parts of the hierarchy, it's important for managers to check-in on the base needs.
• In healthcare, one of the most important base needs is related to whether people have access to the equipment and resources they need to be successful. It is often an area that is not met because of lack of resources.
• The next four areas in Q12 are associated with questions around "what do I give?" I remind managers about the response options and the range of scores. I ask for examples of when those needs have been met in the organization and ways in which those needs could be met. This allows me to bring it back to the conversation of what does it mean when we're at our best individually. This connects with StrengthsFinder as we explore talents and contributions. Question 3 is one of the most important indicators of engagement, so if you're looking to build engagement in your teams then this is one that you can address. It's important to address because it's one of the first individual needs. To be able to address the next questions in the hierarchy, you really need to address this one first.
• 3rd area of Q12: Do I belong?
• 4th area of Q12: How can we grow?

How familiar are people with strengths?

• I often observe whether or not people are more curious about my mention of strengths and I provide more information to individuals and groups who express more interest when I bring up strengths.
• At one of our multiple sites, a mental health department uses a strengths-based approach to clinical practice. They are familiar in that area, so I'm always keen to hear about people linking strengths to their practices.
• Some people express that they have heard about strengths but haven't really explored it in depth.
• At the senior levels of the organization, some people have taken StrengthsFinder mainly because of the introduction of Q12 in 2016.
• There are pockets of some awareness of StrengthsFinder and some have not unpacked it.

What did the strengths-based practice look like at that department you mentioned earlier?

• They do not focus on the disorders and the pathology only. They look at the patient's strengths to help them strategize recovery options to help bring their own inner resources to their recovery plan.
• "It is a person-centered care to providing clinical services. It's about providing person-centered care and looking at the individual's own resources, interests, and incorporating that into their recovery plan."

Does this conversation move to resilience?

• Q12 question 4 is around recognition.
• Question 5 addresses to what degree the individual has a supervisor who cares about them as a person. That is the question I explain is linked to wellbeing because it is about support seeking and support receiving. People who are engaged tend to report higher quality of life and that is linked back to wellbeing and support. This question brings up conversations around support.
• This leads to the language we can use when drafting and communicating improvement plans. "How, as a leader, can I provide more support to my team to be successful?" We want to be careful that we're not adding to the workload in an already overworked population, but how can we add more support. For some leaders -- that is how they address that concern.
• In regard to employee wellbeing and resilience, Penny would like to bring in strengths more often at work.

How do you do the action planning? Once you've sat down to discuss the insights from the Q12 report, do you help them craft their action plan?

• In most cases, Penny will sit with individual managers with their report. If it's a group session for a lot of managers, she'll provide a sample report to review the components and how to interpret the results. Provide them the various comparison points within the report. Once people have an understanding of the hierarchy, principles, and report, Penny will explain the next steps of creating an action plan. This is based on the engagement champion training that was provided at St. Vincents -- a day of training to develop a role so people can have a conversation around their results and action planning.
• Put the results in the context of the team and current goals of the team. For some people, the language of "performance goals" may resonate but for others it's around "what are the important issues you are looking to address" or "what are your team priorities"? It's about identifying their current goals and how this report is just one aspect of evaluating their team.
• Tools at the end of the report include question/conversation guides that managers can ask when they have conversations with their teams in regards to the reactions to the report/results.
• It is important to acknowledge where things have changed since taking the Q12.
• Giving people a voice -- what would this (insert question) look like if it was improved for you and for the team?

How do you help those managers who do not feel comfortable to have these conversations with their staff?

• Penny will acknowledge the difficulty and the challenge of these types of conversations 1on1 with managers to help broach the subject with the manager. Penny also offers her help and presence during team meetings to discuss the results and help address any questions or help the team to discuss. Sometimes the manager is happy to have her facilitate the conversation and sometimes the manager may prefer to lead the session and have Penny be supportive when needed.
• Penny may sometimes meet with the senior team members within the department vs. the manager vs. the whole team. Sometimes there is a combination of all three options.
• There are sample templates of action planning tools that help managers prepare their plans.

Are they largely patient-facing or behind the scenes?

• Penny has worked with IT, engineering, finance, and also patient-facing teams.

Do you see any unique challenges of patient-facing teams in which you've helped them apply strengths-based language?

• Question 4 about recognition has often come up as an area for development. The common theme that comes up is around how you can tailor and customize recognition you provide to people. On really large teams, it's difficult to get to know the individual strengths and tailor recognition to those preferences. But at least we are having the conversation on different forms of recognition and reasons why people enjoy/respond to different styles.
• "People are acknowledging that giving positive feedback is difficult. This is what Question 4 is all about … it is fascinating that people are saying they find it difficult to give positive feedback. So, how can we equip people with practices, strategies, and skills to be more comfortable to do that." It's recognizing the effort of others and not necessarily the outcome.
• This can be related to patient care, too. People can have more effective conversations with their patients because of conversations with colleagues being more truthful, constructive, and acknowledging of others feelings.

Is there a success story with a team in which you've seen real change in regards to engagement and strengths?

• It is often the small conversations. Her approach has been to offer drop-in optional sessions for staff. It's been most rewarding when she has requests for follow-up support after her initial meetings with them.
• It's very rewarding to see how the individuals are getting something from the report results.
• Recently one manager who had a lot of staff in administrative positions. The manager thought of ways to engage their staff in different opportunities -- which was a strategy they hadn't used in the past.

What are your next steps?

• There are some private hospitals within St. Vincents that could be additional areas in the organization to expose them to engagement and strengths.
• In her external work, she is bringing strengths into her supervision of other psychologists and her own clients who have professional teams.

Jim: I've never made the connection between Question 3 on Q12 as an entry point into strengths. It's a great entry point to start moving the conversation to strengths-based conversations. There is a Gallup engagement champions course that is offered for those interested. Do you see a question in Q12 that gets misunderstood more than others?

• Penny sees the most pushback on Q10 "I have a best friend at work." She acknowledges that this is a controversial question. There was some communication that was sent out before the Q12 administration that this question addresses that you have someone at work you can turn to and confide in when you're looking for support. That may have helped in some ways. She acknowledges that, despite Gallup knowing this is a controversial topic/question, it does have merit. People get hung up on the "best friend" concept, especially in healthcare where professional and personal boundaries between colleagues and also professionals/patients is so important. Especially within the healthcare context, this question is really difficult.
• Jim: "Chaos creates clarity" -- this question might be controversial because it incites good conversations around that term of "best friend."

Wellbeing is coming up more and more -- with a focus on thriving. There is trauma in the medical and healthcare field. Have you seen any work between people who have had trauma and the impact of filtering that through a strengths lens?

• Penny has not but she sees the connection. She draws on research associated with psychological safety and clinical outcomes.
• Jim: When patients are in pain it is difficult for them to thrive, but healthcare is in an important realm of helping patients recover.

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Penny Gray's Top 5 CliftonStrengths are Learner, Individualization, Arranger, Maximizer and Belief.