Healthcare's Employee Engagement Gap: How Top Systems Get & Stay Ahead

For healthcare organizations, research suggests a new trend is emerging: a widening gap between the top-performing systems and the rest. This divide isn't just about financial performance or patient outcomes — it's fundamentally about employee engagement and experience.

On the heels of our 2024 State of Healthcare Employee Experience report, fresh mid-year data across 3.86 million healthcare workers sheds light on this growing disparity. While the gap between the most and least engaged healthcare systems was merely .23 points different four years ago, the gap grew to .74 by early 2024 and has continued to grow to .83 over the last six months. But numbers only tell part of the story. To truly understand what's driving this gap and how organizations can bridge it, we need to look at real-world examples.

In this article, I'll explore how leading healthcare organizations are tackling key challenges in employee engagement. In doing so, I’ll touch on specific strategies and initiatives that are making a difference, from innovative change management approaches to holistic well-being programs. By looking at these organizational examples, we can gain valuable insights and leading practices into what distinguishes the most engaged healthcare systems from the rest.

Let's start by diving into one of the most critical factors: change management.

Change Management: The New North Star

Data suggests the key differentiator between the most engaged healthcare systems and others lies in effective change management. When it comes to managing change effectively — and in turn, boosting engagement — the best healthcare systems are excelling in three key areas:

1. Laser-Focused Prioritization

In an industry besieged by constant change, top organizations are cutting through the noise. They're not just communicating what they're doing — they're explicitly stating what they're not doing and what is staying the same. This clarity helps employees navigate the sea of changes without feeling overwhelmed that everything is changing or distracted by focusing on areas that are not a priority. Instead, this clarity helps anchor employees on what will remain constant and focuses them on the organization’s clear goals and the path forward.

One health system we work with has adopted a "stoplight" approach:

• Green: Current priorities
• Yellow: Ideas for future consideration
• Red: Not a focus at this time

This visual method, cascading from C-suite to front-line employees, aligns the entire organization. It's not just about having a strategy — it's about having a strategy everyone can understand and act upon. As changes occur, helping employees focus with visual cues provides clarity on what actually is changing and what will be a priority while also communicating that other ideas and feedback were heard but will not be a focus at this time. This clear communication can help focus employees on what matters most. 

2. Employee-Driven Change

The adage "people support what they help create" is more important now than ever before as our research finds highly engaged employees are 2.3x more likely to say leaders seek out their ideas during times of change and decision-making. Organizations are recognizing that involving employees in change processes isn't just good for morale — it's good for implementation.

One way to gather input efficiently at scale is to seek input using a listening channel designed for ideation and co-creation. For example, a health system facing leadership changes used crowdsourcing to gather input from nurses on desired traits for a new Chief Nursing Officer. This move didn't just give nurses a voice in selecting their next leader; it provided invaluable insights for the incoming CNO and set the stage for a smoother transition.

3. Top-Down Communication in Times of Change

There's a common misconception that employees prefer hearing from their immediate leaders. However, our research shows that during times of significant change, healthcare workers crave communication directly from senior leadership. While immediate manager communication can help reinforce messages from the top or clarify where their team fits into broader goals, employees want and need to hear messages about the organization’s future directly from the top.

Perceptyx's Lauren Beechly and Emily Killham discuss the power of change management

When it comes to senior leader communication, the best-performing organizations ensure senior leaders are visible. This can include executive rounding not only in roles providing direct patient care but also hearing first hand experiences from those in roles supporting patient care. Executives are seeing, listening, and following up as they hear concerns and suggestions directly from employees themselves. Not only does this help employees feel seen, heard, and valued, but it also provides direct access for executives to see opportunities and hear ideas directly from those closest to the work.

Besides executive rounding, senior leaders are also using brief, focused, inspiring videos to communicate clear messages to the entire organization during times of change. One large health system merger kicked off with a message from the CEO focused on the "why" behind the change. This approach builds confidence and buy-in across all levels of the organization, creating a shared sense of purpose and understanding for the change taking place.

Lauren Beechly discusses executive rounding and other leadership best practices

Tackling the Talent Crunch

The healthcare industry's talent shortage isn't news, but innovative approaches to addressing it are. Leading organizations are rethinking roles, leveraging technology, and reimagining the candidate experience.

Role redesign is at the forefront. We're seeing a focus on redesigning roles, looking at mission-critical actions and what other tasks can be redesigned, performed by other roles or emerging technologies, or stopped completely. This includes implementing technologies like dictation software to streamline documentation and new uses of AI, allowing healthcare professionals more time to focus on direct patient interactions.

But it's not just about efficiency — it's also about creating a compelling employee value proposition to attract new and retain existing talent. For example, some organizations are using innovative technology as part of their employee value proposition, encouraging new talent to join because their health system provides the newest technology which will make their job easier, faster, safer, and more rewarding than a similar role with other health systems. In another instance, one healthcare system teamed up with Netflix to create engaging content showcasing their workplace culture. Other organizations are streamlining application processes, including "quick apply" options on social media platforms to meet applicants where they are rather than directing them to company websites to apply. By refining messages on why their organization is a great place to work and simplifying application processes, organizations are finding ways to attract new applicants to their talent pipelines and help alleviate staffing pressures.

The Well-Being Renaissance

Perhaps the most encouraging trend emerging from current research on healthcare workers’ employee experiences is the improvement in employee well-being. After years of heightened stress and burnout, the tide is turning. Our data shows stress levels declining, burnout decreasing slightly, and overall health and work-life integration improving.

This shift isn't by accident. Leading organizations are taking a holistic approach to well-being, addressing not just workplace stress but broader life concerns like housing insecurities and childcare challenges. They're recognizing that employees don't leave their personal lives at the door when they come to work and taking steps to address life stressors that can also impact perceptions and performance at work.

One organization we partner with surveyed employees about their levels of worry related to housing, public transportation, and childcare. The results were eye-opening for executives: high levels of worry in these areas correlated with negative perceptions across the entire employee experience, from engagement to safety perceptions. These data led to meaningful conversations about how to address stress not only within the organization but also beyond the workplace.

Meanwhile, leading organizations continue to take a holistic approach to improving well-being within their health system, providing not only resources to support individuals but also creating cultures of wellness and improving practice efficiencies. When it comes to a culture of wellness, efforts and systems that help employees feel valued is critical. While this can include recognition and appreciation to show contributions are valued, it also includes providing growth opportunities and investing in employees’ development and future.

Leading organizations are investing in employee development, clearly communicating career paths and demonstrating long-term commitment to staff. This approach not only aids retention and develops needed skills, but also contributes to overall well-being by showing employees they have a valued future within the organization.

The Middle Manager Squeeze

While research shows positive improvements for well-being overall, one group continues to feel particular pressure: middle managers. Caught between executive demands and frontline needs, these indispensable leaders are being asked to do way more with far less.

Emily Killham, Perceptyx's Senior Director and Head of the Center for Workforce Transformation, discusses the "manager squeeze"

Forward-thinking organizations are addressing this through multi-faceted support:

• Back-to-basics leadership training and AI-assisted learning to provide personalized development at scale
• 360-degree feedback assessments to help target development efforts
• Mentorship programs to provide support and role models
• Focused communication strategies and AI-powered employee engagement action planning to streamline managers' workloads

These efforts to support middle managers represent a microcosm of the larger trends we're seeing in healthcare employee experience. Organizations are recognizing that targeted interventions, leveraging both human insight and technological innovation, can have a ripple effect throughout the entire system. As these investments take root, we can expect to see further improvements in the overall landscape.

The Road Ahead: Stability on the Horizon

After years of volatility, the healthcare employee experience is showing some signs of stabilization. While the gap between the most engaged healthcare organizations and the rest continues to grow, we are seeing less fluctuation in many other areas in the employee experience, and where we are seeing improvements, it's in well-being and in the ability to get work done efficiently.

While challenges remain, organizations that focus on effective change management, clear communication, and holistic well-being strategies are positioned to create engaging work environments that benefit both employees and patients.

The gap between top-performing healthcare systems and the rest may be widening, but the path to bridging it is also becoming clearer. By embracing these leading strategies and continuously measuring their impact via employee listening, healthcare systems can work to close the engagement gap and create a more committed, motivated workforce. In doing so, they're not just improving employee experience — they're laying the foundation for better patient care and organizational success.

Partner with Perceptyx to Elevate Healthcare Employee Engagement

To gain a more comprehensive understanding of all these EX trends, we invite you to download the full State of Healthcare Employee Experience 2024 report filled with data-driven insights, actionable strategies for improvement, and predictions for 2025. And to learn about how Perceptyx can provide employee engagement solutions and other aspects of a robust listening strategy for your healthcare organization, schedule a meeting with a member of our team.