Employee Satisfaction:What do we do with the
data?
Employee Satisfaction:What do we do with the
data?
Mary Tellis-Nayak, RN, MSN, MPHVP Quality Initiatives
Mary Tellis-Nayak, RN, MSN, MPHVP Quality Initiatives
ObjectivesObjectives
The participant will be able to:— Identify three issues which staff say
cause them to recommend a nursing home as a good place to work
— Describe the relationship between the quality of the workplace and 3 other measures
— Discuss what must be done with employee satisfaction results
— List 2 things a leader can do with the results of staff satisfaction surveys
The participant will be able to:— Identify three issues which staff say
cause them to recommend a nursing home as a good place to work
— Describe the relationship between the quality of the workplace and 3 other measures
— Discuss what must be done with employee satisfaction results
— List 2 things a leader can do with the results of staff satisfaction surveys
Our MissionOur Mission
To provide long-term care leaders evidence-based management tools to better achieve their organization’s goals
To provide long-term care leaders evidence-based management tools to better achieve their organization’s goals
My InnerView NationwideMy InnerView Nationwide
» 5,600+ providers in all 50 states and District of Columbia use our tools
» Largest satisfaction benchmark database in long-term care
» Recommended by:
— 3 national associations— 32 state associations
» 5,600+ providers in all 50 states and District of Columbia use our tools
» Largest satisfaction benchmark database in long-term care
» Recommended by:
— 3 national associations— 32 state associations
Providers will commit to focus on
at least 3 of 8 measurable goals
Providers will commit to focus on
at least 3 of 8 measurable goals
CLINICAL GOALS:
1. Reducing high risk pressure ulcers
2. Reducing use of daily physical restraints
3. Improving pain management for longer term nursing home residents
4. Improving pain management for short stay, post-acute nursing home residents
CLINICAL GOALS:
1. Reducing high risk pressure ulcers
2. Reducing use of daily physical restraints
3. Improving pain management for longer term nursing home residents
4. Improving pain management for short stay, post-acute nursing home residents
OPERATIONAL/PROCESS GOALS:
1. Establishing individual targets for improving quality
2. Assessing resident and family satisfaction with the quality of care
3. Increasing staff retention
4. Improving consistent assignment of nursing home staff, so that residents regularly receive care from the same caregivers
OPERATIONAL/PROCESS GOALS:
1. Establishing individual targets for improving quality
2. Assessing resident and family satisfaction with the quality of care
3. Increasing staff retention
4. Improving consistent assignment of nursing home staff, so that residents regularly receive care from the same caregivers
National Employee SatisfactionSurvey Results
2006
Nearly 107,000 responses
National Employee SatisfactionSurvey Results
2006
Nearly 107,000 responses
» First nationwide report
» 1,933nursing homes in 49 statesand D.C. participated in 2006
» First nationwide report
» 1,933nursing homes in 49 statesand D.C. participated in 2006
NOTE: Alaska not included
SATISFIED NURSING HOMEWORKERS BY CATEGORYSATISFIED NURSING HOMEWORKERS BY CATEGORYBased on the percent of total weighted respondents who rated their overall satisfaction as “excellent” or “good” in each job category
FIGURE 1
Survey items:Survey items:
1 Quality of orientation
2 Quality of in-service education
3 Quality of resident-related training
4 Quality of family-related training
5 Comparison of pay
6 Care (concern) of supervisor
7 Appreciation of supervisor
8 Communication by supervisor
9 Attentiveness of management
10 Care (concern) of management
11 Safety of workplace
12 Adequacy of equipment/supplies
13 Sense of accomplishment
14 Quality of teamwork
15 Fairness of evaluations
16 Respectfulness of staff
17 Assistance with job stress
18 Staff-to-staff communication
Ranked correlations (p < 05) between employee workplace recommendation and employee satisfaction itemsRanked correlations (p < 05) between employee workplace recommendation and employee satisfaction items
FACTORS THAT DRIVE WORKFORCE RECOMMENDATIONFACTORS THAT DRIVE WORKFORCE RECOMMENDATION
Ranked correlations (p < 05) between employee workplace recommendation and employee satisfaction itemsRanked correlations (p < 05) between employee workplace recommendation and employee satisfaction items
FACTORS THAT DRIVE WORKFORCE RECOMMENDATION (continued)
FACTORS THAT DRIVE WORKFORCE RECOMMENDATION (continued)
TABLE 5
Ranked by average scores and correlations with workplace recommendationRanked by average scores and correlations with workplace recommendation
PRIORITY ITEMS FOR NURSING STAFFPRIORITY ITEMS FOR NURSING STAFF
TABLE 6
What doesresearch tell us
about satisfactionsurvey data?
What doesresearch tell us
about satisfactionsurvey data?
higherfamily
satisfaction
higherfamily
satisfaction
lowernursing
assistantturnover
lowernursing
assistantturnover
higheremployee
satisfaction
higheremployee
satisfaction
higherfamily
satisfaction
higherfamily
satisfaction
Key Performance DriversKey Performance Drivers
highersatisfaction
amongfamilies
and employees
highersatisfaction
amongfamilies
and employees
higheroccupancy
rates
higheroccupancy
rates
Key Performance DriversKey Performance Drivers
highersatisfaction
amongfamilies
and employees
highersatisfaction
amongfamilies
and employees
betterclinical
outcomesrelated to falls,
pressure ulcersand catheters
betterclinical
outcomesrelated to falls,
pressure ulcersand catheters
Key Performance DriversKey Performance Drivers
SUMMARY OF RELATIONSHIPS
StaffSatisfaction
StaffSatisfaction
Resident/FamilySatisfaction
Resident/FamilySatisfaction
HR Decrease nurse absenteeism
Decrease nurse turnoverDecrease CNA turnover
HR Decrease nurse absenteeism
Decrease nurse turnoverDecrease CNA turnover
Improve care outcomes
Improve relationships
Improve care outcomes
Improve relationships
FinancialIncrease occupancy
FinancialIncrease occupancy
50
60
70
80
Lowest Low High Highest
Facilities with higher family satisfaction have better work environments
Facilities with higher family satisfaction have better work environments
< 54% 54% to 58% 58% to 64% > 64%
Mean = 68.0
EM
PL
OY
EE
EN
VIR
ON
ME
NT
SC
OR
E (
%)
FAMILY SATISFACTION
48
52
56
60
64
Lowest Low High Highest
Facilities with higher family satisfaction have better employee training
Facilities with higher family satisfaction have better employee training
Mean = 57.1
EM
PL
OY
EE
TR
AIN
ING
SC
OR
E (
%)
FAMILY SATISFACTION
< 54% 54% to 58% 58% to 64% > 64%
60
70
80
90
Lowest Low High Highest
Facilities with higher family satisfaction have better supervision
Facilities with higher family satisfaction have better supervision
Mean = 72.2
EM
PL
OY
EE
SU
PE
RV
ISIO
N S
CO
RE
(%
)
FAMILY SATISFACTION
< 54% 54% to 58% 58% to 64% > 64%
50
60
70
80
Lowest Low High Highest
Facilities with higher family satisfaction have better management
Facilities with higher family satisfaction have better management
Mean = 66.5
EM
PL
OY
EE
MA
NA
GE
ME
NT
SC
OR
E (
%)
FAMILY SATISFACTION
< 54% 54% to 58% 58% to 64% > 64%
» More residents without falls
» More residents without pressure ulcers
» More residents without acquired catheters
» Less nurse turnover
» More nurse stability
» Less CNA absenteeism
» Less nurse absenteeism
» Higher occupancy
» More residents without falls
» More residents without pressure ulcers
» More residents without acquired catheters
» Less nurse turnover
» More nurse stability
» Less CNA absenteeism
» Less nurse absenteeism
» Higher occupancy
Facilities with higher employee satisfaction have:Facilities with higher employee satisfaction have:
CNAs speak up!
• A 2004 study
• 156 nursing facilities in the Southeast
• 3,579 CNAs, 6,502 families surveyed
• November 2004
Quality of leadershipand quality of the workplace:
The interface
Quality of leadershipand quality of the workplace:
The interface
Indicators ofquality of workplace
Indicators ofquality of workplace
1. Pay compared to other nursing homes
2. Safety of workplace
3. Adequate equipment and supplies to do your job well
4. Work allows you to make a difference in people's lives
5. Co-workers work as a team
6. Fair performance evaluations
7. Staff are respectful of residents
8. Helps you get to deal with job stress
9. Communication between shifts
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Quality of leaders produce a quality workplace Rating by 6,305 CNAs in 156 Nursing Facilities:
4 percentile ranked groups, 2004
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A quality workplace earns staff recommendation
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A quality workplace creates QoService for resident
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A quality workplace results in better state surveys
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A quality workplace makes business sense
If you do not plan to use the results of your employee
satisfaction survey to improve the work
environment, it is far better that
you not conductthe survey at all.
If you do not plan to use the results of your employee
satisfaction survey to improve the work
environment, it is far better that
you not conductthe survey at all.
Using Satisfaction DataUsing Satisfaction Data
» One member of the leadership team must be responsible and held accountable for managing this initiative— Human Resources— Department Manager(s)— Administrator/Assistant Administrator— Staff Development
» One member of the leadership team must be responsible and held accountable for managing this initiative— Human Resources— Department Manager(s)— Administrator/Assistant Administrator— Staff Development
Using Satisfaction DataUsing Satisfaction Data
» Use current structures or create new ones— QA&A committee— Staff meetings— Neighborhood/unit meetings— Interdepartmental teams— Focus groups
» Use current structures or create new ones— QA&A committee— Staff meetings— Neighborhood/unit meetings— Interdepartmental teams— Focus groups
Communicating resultsCommunicating results» Determine what you want to communicate initially
and to whom — Depends on your current facility structure (e.g.
neighborhoods vs. units; universal workers vs. departments)
» Consider the current culture of your community when considering how to proceed
— Use a bulletin board to post results
— Pull together an employee group to obtain feedback
— Publish results in a newsletter format
— Have unit/team meetings to present the results
— Have an all staff meeting on each shift
— Initially present the results to department heads
» Determine what you want to communicate initially and to whom — Depends on your current facility structure (e.g.
neighborhoods vs. units; universal workers vs. departments)
» Consider the current culture of your community when considering how to proceed
— Use a bulletin board to post results
— Pull together an employee group to obtain feedback
— Publish results in a newsletter format
— Have unit/team meetings to present the results
— Have an all staff meeting on each shift
— Initially present the results to department heads
Where do we start?Where do we start?
» Choose the issues— Start with “low hanging fruit”
— Choose an area where you know you can show staff that you are listening to them
— Choose an area which is important to the staff even if you may not have scored too badly
— Choose an area where you know you can achieve results quickly
— Choose an area which is no surprise because you’ve “heard it before”
» Choose the issues— Start with “low hanging fruit”
— Choose an area where you know you can show staff that you are listening to them
— Choose an area which is important to the staff even if you may not have scored too badly
— Choose an area where you know you can achieve results quickly
— Choose an area which is no surprise because you’ve “heard it before”
My InnerView’s reportshelp you to choose
the topic(s) which aremost important
to your staff.
My InnerView’s reportshelp you to choose
the topic(s) which aremost important
to your staff.
1. How residents, families and staff rate your care and services
• Your average score on each item:
1 – 4: “Poor” ”Fair” ”Good” ”Excellent”
• Rank order all items by their average score:
1 – 100: lowest to highest ranking score
2. How much each item influences residents, families and staff to recommend the facility to others.
• Correlate each item with “Recommendation”
0 - 1: no correlation to strongest correlation
• Rank order all items by their correlational strength:
1 – 100: lowest to highest ranking correlation
Quadrant analysis: Two key concepts
The Quality Quadrant and Action Priorities
1 ---------- Lowest to highest ranking correlation -------- 100
Recom-mendation
Item score
Su
cces
ses
You have little control over customer expectations
Yo
u c
an m
eet
cust
om
er e
xpec
tati
on
s
C.
Secondary opportunties
D.
Primary opportunities
B.
Primary strength
A.
Secondary strength
Ch
alle
ng
es
1 --
- L
ow
est
to h
igh
est
ran
kin
g s
core
1
00
Goal
Just ask why!Just ask why!
My work is stressful —
I gave Mrs. J her supplementand she threw up —
No one told me she had beensick all morning —
My work is stressful —
I gave Mrs. J her supplementand she threw up —
No one told me she had beensick all morning —
There is no communication between the morning and evening shifts of CNAs —
There is no communication between the morning and evening shifts of CNAs —
Take Home TipsTake Home Tips
» Just ask until there are no more ‘whys’ to ask
» Focus on systems and processes
» LISTEN
» OBSERVE
» Don’t BLAME
» Involve the team
» Just ask until there are no more ‘whys’ to ask
» Focus on systems and processes
» LISTEN
» OBSERVE
» Don’t BLAME
» Involve the team
Turn InformationInto KnowledgeTurn InformationInto KnowledgeStudy current processStudy current process
Gather more informationGather more information
Evaluate processEvaluate process
Identify contributing factorsIdentify contributing factors
Determine root cause(s)Determine root cause(s)
Develop Drill Down QuestionsDevelop Drill Down Questions
Issue – OrientationDrill down suggested questions:» New CNAs are oriented specifically to their unit» New CNAs are oriented specifically to their shift » New employees are taught the proper use of equipment
which they will be using» New employees are shown the location of the supplies
and equipment they need to do their job» New employees are assigned to a mentor or a
buddy system» New employees are not given a full a workload initially,
but in gradual steps» New employees are introduced individually to the
residents assigned to them
Issue – OrientationDrill down suggested questions:» New CNAs are oriented specifically to their unit» New CNAs are oriented specifically to their shift » New employees are taught the proper use of equipment
which they will be using» New employees are shown the location of the supplies
and equipment they need to do their job» New employees are assigned to a mentor or a
buddy system» New employees are not given a full a workload initially,
but in gradual steps» New employees are introduced individually to the
residents assigned to them
Use the Workplace Scaleas Starting PointUse the Workplace Scaleas Starting Point
»Pay compared to other nursing homes
»Safety of workplace
»Adequate equipment and supplies to do your job well
»Work allows you to make a difference in people's lives
»Co-workers work as a team
»Fair performance evaluations
»Staff are respectful of residents
»Helps you get to deal with job stress
»Communication between shifts
A Valuable ResourceA Valuable Resource
» “Better Jobs Better Care: Issue Paper”— No. 7/April 2007— “Respectful Relationships: The Heart of
Better Jobs Better Care”
» Link to this paper— http://www.bjbc.org/Page.asp?PgID=27
» This paper addresses the key issue of the long-term care workforce — RESPECT
» “Better Jobs Better Care: Issue Paper”— No. 7/April 2007— “Respectful Relationships: The Heart of
Better Jobs Better Care”
» Link to this paper— http://www.bjbc.org/Page.asp?PgID=27
» This paper addresses the key issue of the long-term care workforce — RESPECT
Whether individuals feelrespect in the workplace is largely a function of how they are treated by their supervisors,their clients and family membersor advocates and,many times, their peers,particularly for new workers.
Whether individuals feelrespect in the workplace is largely a function of how they are treated by their supervisors,their clients and family membersor advocates and,many times, their peers,particularly for new workers.
Studies suggestthat the quality
of these relationshipshas a defining impacton workers’ decisions
to stay on the jobor leave to pursue
opportunities elsewhere.
Studies suggestthat the quality
of these relationshipshas a defining impacton workers’ decisions
to stay on the jobor leave to pursue
opportunities elsewhere.
Lessons LearnedPractical SuggestionsLessons LearnedPractical Suggestions
» Take a “relationships inventory”
» Listen to what workers say about respect
» Identify changes necessary to “operationalize” respect
» Think in terms of maximizing human potential
» Understand the needs of new immigrants and non-English speakers
» Commit to making continuous improvement
» Take a “relationships inventory”
» Listen to what workers say about respect
» Identify changes necessary to “operationalize” respect
» Think in terms of maximizing human potential
» Understand the needs of new immigrants and non-English speakers
» Commit to making continuous improvement
Take a “relationships inventory”Take a “relationships inventory”
» Do managers at all levels of your organization have positive and professional relationships with the people they supervise?
» Does the disciplinary action make up a large portion of interaction between frontline staff and managers?
» Do direct care staff see managers as mentors they feel comfortable going to for advice and problem solving?
Without a foundation of healthy relationships among frontline workers and between direct care workers and their supervisors, other initiative to create a more respectful work environment are unlikely to be successful.
» Do managers at all levels of your organization have positive and professional relationships with the people they supervise?
» Does the disciplinary action make up a large portion of interaction between frontline staff and managers?
» Do direct care staff see managers as mentors they feel comfortable going to for advice and problem solving?
Without a foundation of healthy relationships among frontline workers and between direct care workers and their supervisors, other initiative to create a more respectful work environment are unlikely to be successful.
Listen to what workers say about respect
Listen to what workers say about respect
» When workers say they feel a lack of respect, it often reflects their sense that no one is listening to them.
» Everyone knows how to listen but knowing how to listen to information that is emotionally charged is difficult.
» Responding without blaming or being judgemental requires training and practice.
» When workers say they feel a lack of respect, it often reflects their sense that no one is listening to them.
» Everyone knows how to listen but knowing how to listen to information that is emotionally charged is difficult.
» Responding without blaming or being judgemental requires training and practice.
Identify changes necessary to “operationalize” respectIdentify changes necessary to “operationalize” respect
» Review existing P&Ps to understand what changes, big or small, will make workers feel more respected, valued and heard.
» Do you have a process in place to provide emotional support to workers who are caring for consumers or encountering family members who are verbally or physically abusive?
» How does your organization support workers who feel they are being discriminated against?
» Review existing P&Ps to understand what changes, big or small, will make workers feel more respected, valued and heard.
» Do you have a process in place to provide emotional support to workers who are caring for consumers or encountering family members who are verbally or physically abusive?
» How does your organization support workers who feel they are being discriminated against?
Think in terms of maximizing human potential.
Think in terms of maximizing human potential.
» When workers have the opportunity to improve themselves, personally or professionally, they feel better about themselves and have a more positive attitude about their workplace.
» Do you have a career track for direct care workers?
» Do you offer educational opportunities through scholarships or on-site distance learning?
» When workers have the opportunity to improve themselves, personally or professionally, they feel better about themselves and have a more positive attitude about their workplace.
» Do you have a career track for direct care workers?
» Do you offer educational opportunities through scholarships or on-site distance learning?
Understand the needs of new immigrants and non-English speakers
Understand the needs of new immigrants and non-English speakers
» Does your workforce include immigrants or those with limited English skills?
» How well do you understand their customs?
» What are you doing to help them operate in their new language and cultural environment?
» Does your workforce include immigrants or those with limited English skills?
» How well do you understand their customs?
» What are you doing to help them operate in their new language and cultural environment?
Commit to making continuous improvement
Commit to making continuous improvement
» There is no “one-time fix” for creating a respectful work environment
» To be successful, the work must be an ongoing process, fully supported by all levels of people within the organization and owned by more than one person
» One innovation to create a more respectful work environment is likely to lead to another as workers feel more empowered to articulate their needs and interests.
» There is no “one-time fix” for creating a respectful work environment
» To be successful, the work must be an ongoing process, fully supported by all levels of people within the organization and owned by more than one person
» One innovation to create a more respectful work environment is likely to lead to another as workers feel more empowered to articulate their needs and interests.
“A resident’s satisfaction with his/her relationship to nursing staff was found to be significantly related to the proportion of CNAs on the resident’s unit who said they intended to stay in the job, and to the proportion of CNAs who had positive relationships with their supervisors.”
- Bishop, October 2006
“A resident’s satisfaction with his/her relationship to nursing staff was found to be significantly related to the proportion of CNAs on the resident’s unit who said they intended to stay in the job, and to the proportion of CNAs who had positive relationships with their supervisors.”
- Bishop, October 2006
Using employeesatisfaction surveys
will help leadersto improve thetenure of staffby addressingthose issues
most important to them.
Using employeesatisfaction surveys
will help leadersto improve thetenure of staffby addressingthose issues
most important to them.
Don’t miss thisvaluable opportunity
to improve quality of lifefor your residents
by improvingquality of life
for your employees
Don’t miss thisvaluable opportunity
to improve quality of lifefor your residents
by improvingquality of life
for your employees
QUESTIONS?
Contact:Mary Tellis-Nayak
QUESTIONS?
Contact:Mary Tellis-Nayak
773-942-7525
773-942-7525