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Volume 60
Number 8
October 2009


Skyrocketing Survey
The Pediatric ED sets an example for boosting employee engagement.

blank David Nichols
Nurse Ani Bernardez examines a patient in the Pediatric Emergency Department.

They instituted a professional-practice model and put a purple-alert policy in place to relieve congestion. They started an orientation program for new nursing graduates to reduce the vacancy rate and implemented a computer charting system to help with work flow. Still, the Pediatric Emergency Department was stuck.

"Looking back on all the changes we’d made, I was disappointed when I got the [Gallup] scores in 2007," says Julie Welch, nurse manager of the Pediatric ED. "Employee engagement was pretty low."

To be exact, their grand mean score was 3.32, lower than the overall Johns Hopkins Hospital and Health System score. After getting this year’s results, however, they celebrated with dinner and sparkling cider. Their score had shot up to 4.23.

In Gallup parlance, employees who are "engaged" in their work are loyal and psychologically committed to their organization. In terms of scores, even "a 0.2 score increase is meaningful," says Pamela Paulk, vice president of human resources for The Johns Hopkins Hospital and Health System. "So 0.9 is huge!" (In comparison, the hospital’s score increased 0.04 from 2007 to 2009.)

How did the department pull it off? At first, Welch went to a colleague for help and mimicked her ideas. Then she reached out to Organization Development and Training for a consultation. The most meaningful results were discovered after she created a key team of 14 high-performing employees who meet monthly for two hours to work on staff engagement.

Welch educated the team on the Gallup methodology. Through more than 30 years of research involving more than 15 million employees, Gallup has developed and identified 12 questions to measure employees’ satisfaction while linking to crucial business outcomes, according to the company’s Web site. Their research shows that engaged employees are more productive, more customer- and safety-focused, and less likely to leave the organization.

"We talked about every question," says Welch, "and then asked ourselves how we could improve our scores."

One of the questions that came under scrutiny concerned having a best friend at work. Welch explained to her staff that the statement didn’t mean "your one, true best friend. It means you have somebody at work you can count on to support and help you when things get rough. I think that made a huge difference, talking about how to interpret the questions."

The department also put some concrete programs into place to boost morale. They created a buddy system for new nursing grads. They started celebrating birthdays and selecting an outstanding employee of the quarter.

The staff made a point of ignoring behaviors of the actively disengaged employees who practiced a lot of negative talk; eventually, those employees left the department. Now Welch and her team are trying to move the middle group of workers to fully engaged staff.

They have another goal in mind. "We not only need to continue to improve our employee satisfaction scores," says Welch, "but work on patient satisfaction too."

– Mary Ellen Miller



Johns Hopkins Medicine

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