Healthcare Employee Engagement: What Top Systems Do

The engagement gap between top-performing healthcare systems and the restcontinues to grow, based on data from 4.2 million healthcare workers. This divide is rooted in employee engagement and experience, which in turn drives financial performance and patient outcomes.

OurState of Healthcare Employee Experience 2026 report reveals the scale of this growing disparity. 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.

The strategies below draw from Perceptyx data across 4.2 million healthcare workers and direct work with health systems facing these challenges. Each example includes specific approaches HR leaders can evaluate and adapt for their own organizations. By looking at these organizational examples, we can identify specific practices that distinguish the most engaged healthcare systems from the rest.

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

How Do Top Healthcare Systems Use Change Management to Drive Engagement?

The data shows that effective change management is the primary differentiator between the most engaged healthcare systems and the rest. 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

Top-performing health systems address constant organizational change by narrowing employee focus rather than expanding communication volume. 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. The strategy only works when every level of the organization can understand it and act on it. 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.

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. The crowdsourcing effort gave nurses a voice in selecting their next leader, surfaced the leadership traits nurses valued most, and gave the incoming CNO a clear picture of team expectations before day one.

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

How Are Healthcare Organizations Addressing the Talent Shortage?

The healthcare talent shortage persists, but how organizations respond to it is evolving. With the majority of healthcare workers in frontline, deskless roles, leading organizations are rethinking role design and using technology to remove barriers that make these positions harder to fill and easier to leave.

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.

Efficiency gains matter, but leading systems are also using these changes to build a more compelling employee value proposition that attracts new talent and retains existing staff. 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.

Why Is Employee Well-Being Improving Across Healthcare Systems?

Employee well-being in healthcare is improving. After years of heightened stress and burnout, our data shows stress levels declining, burnout decreasing slightly, and overall health and work-life integration trending upward.

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.

Onepartner organization found that high levels of worry in specific external areas correlated with negative workplace perceptions, including engagement and safety. Key stressors identified included:

• Housing insecurities

• Public transportation challenges

• Childcare availability

These insights allow executives to address stress holistically, both within and 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.

Why Are Middle Managers Under Growing Pressure in Healthcare?

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 leaders are absorbing more responsibility with fewer resources.Because manager engagement directly influences team-level engagement, safety perceptions, and patient outcomes, organizations that fail to support this group risk undermining gains made elsewhere.

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.

Where Is Healthcare Employee Experience Headed?

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 strengthen both employee experience and the patient care and organizational performance that depend on it.

Frequently Asked Questions

What Is Employee Engagement in Healthcare?

Employee engagement in healthcare measures how connected workers feel to their organization. Perceptyx tracks it through four components: pride in the organization, motivation to perform well, intent to stay, and willingness to recommend the employer to others. Health systems with higher engagement scores consistently outperform peers on patient safety and patient satisfaction measures.

Why Does Healthcare Employee Engagement Matter for Patient Outcomes?

Engagement affects care quality in direct, measurable ways. Perceptyx research shows that the most engaged health systems are significantly more likely to rank as top performers on patient experience. Disengaged employees are also more likely to leave, which worsens staffing shortages and adds pressure on those who stay. Both of those effects eventually reach patients.

What Are Effective Employee Engagement Activities for Healthcare Organizations?

Perceptyx data from 4.2 million healthcare workers points to several high-impact approaches:

• Using structured change communication (such as a "stoplight" priority system) to reduce employee overwhelm

• Involving staff in decisions through crowdsourcing and co-creation tools

• Supporting middle managers with targeted coaching and 360-degree feedback assessments

• Addressing well-being factors that extend beyond the workplace, including housing and childcare stressors

Organizations that pair these activities with regular employee listening see stronger, more sustained engagement gains. Learn more in the State of Healthcare Employee Experience 2026report.

Why Is the Engagement Gap Between Health Systems Growing?

Perceptyx benchmark data covering 4.2 million healthcare workers shows the engagement gap between the highest- and lowest-performing health systems continues to widen. Leading systems have maintained or improved engagement by prioritizing structured change management, direct senior leader communication, and consistent well-being investment. Systems that have not focused on these areas have seen engagement fall, with no recovery in the most recent data.