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Rules of Engagement
The results of Hopkins’ employee survey are in: Time to take the next step.

blank Katie Bell
Gallup partner Katie Bell explains survey results to Pamela Paulk, right, and others.

Long before the Gallup Organization's first Hopkins Medicine survey in June to measure employees' engagement in their work, perinatal nurse manager Joan Diamond fervently believed that engaged employees—those who are committed to an organization's mission—achieve more for themselves and their employer than those who simply express satisfaction with their jobs.

"I'm passionate about this," says Diamond, who oversees nearly 100 nurses and has spent three years getting her staff engaged. "Our patients deserve it."

Pamela Paulk, vice president for human resources, and Carol Woodward, HR's strategic consultant, couldn't agree more. Unfortunately, results of the 2007 Employee Survey don't reveal a completely engaged workforce. First, only 47 percent of eligible employees completed the survey, and the results of the "engagement index ratio"— meaning how many fully engaged employees there are for every actively disengaged one—was only 2.2-to-1 for hospital employees. School of Medicine employees had a slightly better ratio of 2.62-to-1. The health care industry median is 3-to-1, and best practice organizations enjoy a 4-to-1 engagement index ratio.

"I would have liked to see our score higher," Paulk says, "but I wasn't really surprised" at the shortfall. "We were at the average in satisfaction [results in the previous surveys], and we know that engagement is harder to achieve than satisfaction."

Every two years since 2001, employees had taken a lengthy, 125-question survey to measure workplace satisfaction. Although the results from the past three surveys showed "tremendous improvement," says Paulk, "at Hopkins we're always looking at how to take things to the next level."

To do that, Hopkins hired Gallup, a 70-year-old company with 15 years of data on assessing employee engagement. Gallup surveyor Katie Bell calls the firm's signature Q12 survey, which features a dozen key questions, "a real temperature check" to determine if employees are as engaged in their work as they are satisfied with being there. Gallup's data, which includes findings from some 500 hospitals, indicate that health care organizations with engaged employees have better productivity, better safety, better staff retention, better financial results—and higher patient satisfaction.

"There's that little something extra—almost an emotional, psychological commitment to the organization—that engaged employees have. We want to create an environment where there are a lot more of those folks," says Woodward.

Bell says on two of the survey's 12 key questions—whether employees have the materials and equipment they need to do their jobs and if they know what is expected of them at work—that Hopkins scored better than many of its peers. Both of those categories are considered the foundation of a strong health care organization

Efforts to act on the findings already are in full swing. Managers are expected to convene focus groups to discuss them and then "create an action plan around one or two items to work on over the next year," says Woodward. "Some things we do institutionally, but we truly believe that engagement is a local issue."

Diamond concurs. In response to Hopkins' 2005 satisfaction survey, she and her supervisory colleagues adopted concepts from the book Discover Your Strengths. Among the ideas was giving staff five accolades for every criticism.

She observes that on the engagement survey, the OB department's results were higher than the Hopkins mean on all 12 questions. "We've done a lot of work," she says, "to get there."

—Neil A. Grauer



Johns Hopkins Medicine

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