How Top Health Systems Improve Healthcare Employee Engagement

Key Takeaways: While engagement levels for the 50th percentile of healthcare systems have stabilized at record lows, top-tier organizations in the 75th and 90th percentiles have successfully rebounded to or exceeded pre-pandemic levels. This widening performance gap reveals a critical opportunity: to close the distance, healthcare systems must address record-low levels of employee pride, motivation, commitment, and advocacy.

Lauren Beechly, Ph.D. & Ellen Lovell, Ph.D.

December 26, 2025

We analyzed our national healthcare database of 3.2 million healthcare workers from 485 health systems to determine why employee engagement in the healthcare industry has declined more in recent years than in other industries. After a rise in the early pandemic period, engagement declined below pre-pandemic levels for most healthcare systems, with the top 75th percentile falling below pre-pandemic levels and the best-in-class systems dipping slightly below pre-pandemic levels.

How big is the engagement gap across health systems?

Employee engagement across most U.S. health systems has plateaued at record lows. The 50th percentile stopped its descent and has held steady. Although the fall has paused, pride, motivation, commitment, and advocacy continue to lag.

Meanwhile, the best systems (those in the top 75th and 90th percentiles) have rebounded, with the 75th percentile returning to pre-pandemic levels and the 90th percentile exceeding pre-pandemic levels and approaching the early pandemic highs.

What this tells us is that the best healthcare systems are rebounding stronger than before, even as the gap between average healthcare systems and the top-percentile systems continues to grow.

Using this data as a starting point, we wanted to discuss what the best systems are doing to elevate their employee experience and employee engagement. What can your healthcare organization do to ensure it benefits from this positive trend?

What actions help top health systems remove engagement barriers?

Top-quartile health systems share a consistent playbook. They:

Set a clear roadmap. Leaders narrow priorities to a few measurable goals and communicate progress regularly.
Link daily work to mission. Managers connect individual tasks to patient outcomes so employees see purpose in every shift.
Define and model behavior standards. Expectations for how colleagues treat one another are explicit and enforced.
Stay visible. Senior leaders round in person and online, answer questions, and build trust through transparency.
Create two-way communication loops. Frontline teams share ideas through surveys and forums, and leaders report back on what will change.

What is employee engagement in healthcare?

Employee engagement shows how strongly doctors, nurses, and support staff feel connected to their work and organization. Engaged teams speak up with ideas, stay longer, and provide safer care. Perceptyx research covering 3.2 million healthcare workers links higher engagement scores to stronger pride, commitment, and lower turnover.

What are effective ways to boost employee engagement in hospitals?

Connect work to mission. Help every role — from environmental services to the C-suite —s ee how their tasks improve patient outcomes.
Invest in manager capability. Equip frontline leaders with coaching skills, regular one-on-one time, and clear expectations they can reinforce daily.
Close the feedback loop. Share survey results openly, explain what will change, and report progress so employees know their voice matters.
Recognize contributions in real time. Celebrate wins at huddles, in team channels, and through peer-to-peer programs that highlight specific behaviors.
Remove barriers to care delivery. Streamline workflows, fix broken processes, and give staff the tools and autonomy they need to do their best work.

Perceptyx helps health systems identify which levers will move engagement fastest, then track progress through continuous listening and predictive analytics.

How do health systems measure employee engagement?

Annual or pulse surveys: Regular questionnaires measure pride, commitment, advocacy, and intent to stay across the organization.
Exit and stay interviews: Structured conversations reveal why people leave and what keeps top performers engaged.
Focus groups and listening sessions: Small-group discussions uncover barriers that quantitative data alone may miss.
Real-time feedback platforms: Digital tools capture sentiment after key moments — shift changes, policy updates, or leadership announcements.

The most effective health systems combine multiple methods to build a complete picture, then share results transparently and act on what they learn.

What are the 4 pillars of employee engagement?

Purpose: Employees understand how their daily work connects to patient outcomes and organizational mission.
Growth: Clear development paths and learning opportunities help staff build skills and advance their careers.
Leadership: Managers provide regular feedback, remove barriers, and model the behaviors they expect from their teams.
Voice: Organizations create channels for employees to share ideas and concerns, then act on what they hear.

How can Perceptyx help your health system learn from top performers?

Higher engagement drives better patient outcomes and lower turnover. Perceptyx partners with health systems to run continuous, multi-channel listening, surface predictive insights, and guide action at every level. See how our healthcare solution works or request a demo.