The Business Case for Investing in Employee Engagement Survey Solutions Employee Engagement The Business Case for Investing in Employee Engagement Intuitively, we know that organizations with higher levels of staff engagement should have better outcomes—staff who are engaged are more willing to go above and beyond to help the organization succeed. Across the next few minutes, I’m going to share data proving how important staff engagement is.

How Advisory Board Defines Employee Engagement The Advisory Board’s Engagement Index This organization inspires me to perform my best I am willing to put in a great deal of effort in order to help this organization succeed I would recommend this organization to my friends as a great place to work I am likely to be working for this organization three years from now To be considered engaged, a respondent must answer ‘Strongly Agree’ to at least two items, and no less than ‘Agree’ to any item. Disengaged Ambivalent Content Engaged Source: Advisory Board Survey Solutions. I’m going to be sharing data based on the Advisory Board’s Employee Engagement Survey, so let me give you a quick overview of how Advisory Board defines employee engagement. Each survey participant rates the four statements in the Engagement Index on the left using a six-point Likert scale (ranging from Strongly Agree to Strongly Disagree). Respondents’ answers put them into one of 4 categories: Disengaged, Ambivalent, Content, or Engaged. “Engaged” staff “Strongly Agree” with at least two statements and at least “Agree” with all four. This isn’t a theoretical definition of engagement. Hard data backs up our assumption that improving performance on this metric will impact organizational performance.

Proving the Crucial Piece of the Puzzle Engagement Driving Success on Key Organizational Priorities Patient-Focused Staff-Focused Patient Satisfaction Retention Culture of Safety Performance Engagement Source: Advisory Board Survey Solutions’ interviews and analysis. Advisory Board analysis shows improving engagement leads to improvements not only in patient-focused outcomes like patient satisfaction, but also staff-focused outcomes like retention and performance. Let me show you data connecting engagement to each of these outcomes.

Employee Engagement Category Performance So It Is True… Engaged Employees Are Our Top Performers Percentage of High-Performing Employees by Employee Engagement Category n = 9117 “Engaged” employees 1.5x more likely than “content” employees to receive the top review score. Employee Engagement Category Source: Advisory Board Survey Solutions’ National Employee Engagement Database, 2015. First, staff performance. Engaged employees are more likely to receive the top performance rating score. Looking at the chart, you can see that some of the greatest gains in employee performance come from moving staff from “content” to “engaged”, as engaged employees are 1.5 times more likely to receive the top review score than their content colleagues.

Ample Room for Improvement Focus on Engaging Your Content Staff Engagement Distribution % of respondents by engagement category, 2015 Sizing the Potential Return Of the non-engaged staff, the vast majority are content Migrating content staff to engaged leads to most significant performance improvements Source: Advisory Board Survey Solutions’ National Employee Engagement Database, 2015. Additionally, the vast majority of staff fall into the content category – about 40% - providing a significant opportunity to improve employee performance.

Turnover Doubling With Disengagement Retention Turnover Doubling With Disengagement Turnover Rate by Employee Engagement Category % No Longer with Organization, One Year Later n = 14,4231 Employee Engagement Category Sample from 2 organizations’ 2014 survey; results derived from comparison of 2014 survey responses to actual % of employees that had left organization by time of 2015 survey. Source: Advisory Board Survey Solutions’ National Employee Engagement Database, 2015. Let’s look at the second staff-focused outcome: Retention. This data shows the actual turnover rate—staff who had left the organization by the time of the next year’s survey. Disengaged staff are clearly more likely to leave. (And this is just turnover one year later. We would expect to see an even more dramatic difference if the turnover rate was tracked for the following three years.) It’s a real question whether this turnover is bad: On the one hand, turnover is generally expensive, but on the other hand, these are the people we may want moving out of the organization.

Strong Correlation Between Engagement and Safety Culture of Safety Strong Correlation Between Engagement and Safety Percent “A” Grades on Patient Safety by Employee Engagement Category “Engaged” employees nearly 4x more likely to grade patient safety as an “A” than “disengaged” employees Employee Engagement Category The overall correlation between culture of safety grade and engagement index is 0.41. Source: Advisory Board Survey Solutions’ National Employee Engagement Database, 2015. Let’s look at the next outcome: Culture of Safety. Here, “engaged” employees are nearly four times more likely than “disengaged” employees to grade patient safety as an “A.” This data is based on employee perceptions of safety (rather than safety outcomes). However, it is drawn from the government’s standard survey for measuring culture of safety. There are multiple AHRQ Culture of Safety Surveys. The one used most often (and used in this analysis) is the hospital survey, in which staff provide a grade based on the prompt: “Please give your work area/unit in this hospital an overall grade on patient safety.” The response options are: A (Excellent), B (Very Good), C (Acceptable), D (Poor), E (Failing).

Ample Opportunity to Simultaneously Drive Engagement and Patient Safety Grades Top Correlations Between Engagement Drivers and AHRQ Overall Patient Safety Grade Driver Correlation My organization supports employee safety .49 My organization provides excellent care to patients .46 My organization provides excellent customer service to patients My ideas and suggestions are valued by my organization .45 Conflicts are resolved fairly in my unit/department My manager stands up for the interests of my unit/department .44 My organization helps me deal with stress and burnout .43 My manager is open and responsive to staff input .42 I receive the necessary support from employees in my unit/department to help me succeed in my work My organization supplies me with the equipment I need My organization recognizes employees for excellent work My manager helps me learn new skills I have a manageable workload .41 Executives at my organization respect the contributions of my unit/department I receive effective on the job training The actions of executives in my organization reflect our mission and values My organization does a good job of selecting and implementing new technologies to support my work .40 My manager communicates messages that my coworkers need to hear, even when the information is unpleasant I receive regular feedback from my manager on my performance Source: Advisory Board Survey Solutions’ National Employee Engagement Database, 2015. This slide provides more detail about the relationship between individual engagement drivers and the overall patient safety grade. Engagement drivers at the top of the chart have the strongest correlation with the patient safety grade. Not surprisingly, employee perceptions of safety at the organization, along with their perceptions of the quality of care and service provided, have the strongest impact on the patient safety grade.

Engaged Employees Key to Satisfied Patients Patient Satisfaction Engaged Employees Key to Satisfied Patients .33 .25 Correlation between HCAHPS overall hospital rating and engagement index Correlation between HCAHPS willingness to recommend and engagement index Source: Advisory Board Survey Solutions’ National Employee Engagement Database, 2015. Engagement also impacts patient satisfaction. This slide shows the correlation between engagement and the HCAHPS overall hospital rating (left) and HCAHPS willingness to recommend (right).

Reprioritizing Engagement Drivers by Impact on Patient Satisfaction Rank Ordering Engagement Drivers by Correlation to Overall HCAHPS Score Determined by Correlation Analysis of 42 Engagement Drivers Rank Driver1 1 My organization provides excellent care to patients* 2 My organization provides excellent customer service to patients 3 My organization supports employee safety 4 My organization supplies me with the equipment I need 5 My organization does a good job of selecting and implementing new technologies to support my work 6 My organization gives back to the community 7 My unit/department has enough staff 8 My organization understands and respects differences among employees (gender, race, age, religion, etc.) 9 I receive the necessary support from employees in other units/departments to help me succeed in my work 10 I have a manageable workload * indicates top driver of engagement. Source: Advisory Board Survey Solutions’ National Employee Engagement Database, 2015. This slide provides more detail on the relationship between engagement drivers and patient satisfaction. Engagement drivers at the top of the list have the strongest correlation to the overall HCAHPS score. The drivers most strongly correlated with HCAHPS relate to how employees feel about the quality of care and service provided at the organization. In addition, employee perceptions of safety, equipment, and technology have an outsized impact on patient satisfaction scores.

Putting the Pieces Together Key Priorities are Inexorably Linked Patient-Focused Staff-Focused Patient Satisfaction Retention Culture of Safety Performance Engagement Source: Advisory Board Survey Solutions’ interviews and analysis. The data backs up what we know intuitively: engagement leads to higher patient satisfaction, a stronger culture of safety, better retention, and better performance.

Access These Resources for More Information on Employee Engagement Benchmark Reports Best Practice Reports Data-Driven Insights for Your 2016 Employee Engagement Strategy Get the latest trends in hospital workforce engagement and discover how your organization’s engagement levels compare to other hospitals and health systems The Data-Driven Prescription for Leader Engagement Best practices to get ahead of the national decline in health care leader engagement National Prescription for Nurse Engagement Best practices to build a highly engaged workforce in today's rapidly transforming health care environment 2016 Physician Engagement Benchmarks Download this report for the latest trends and insights, and learn how you can implement these tactics to optimize your 2017 physician engagement strategy Engaging the Physician Workforce Best practices to improve hospital-physician relationships and enhance alignment Source: Advisory Board.