Employee Satisfaction

:
What do we do with the
data?

Surriya Shahnaz

Objectives
The participant will be able to:
— Identify three issues which staff say
cause them to recommend a nursing
workplace 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

Mission

To provide long-term care
leaders evidence-based
management tools to
better achieve their
organization’s goals

Providers will commit to focus on at least 3 of 8 measurable goals .

so that residents regularly receive care from the same caregivers . Improving consistent stay. Improving pain management for short 4. OPERATIONAL/ CLINICAL GOALS: PROCESS GOALS: 1. Assessing restraints resident and family satisfaction with the 3. post-acute nursing assignment of nursing home residents home staff. Increasing staff residents retention 4. Reducing use of quality daily physical 2. Establishing individual pressure ulcers targets for improving 2. Reducing high risk 1. Improving pain management for longer quality of care term nursing home 3.

Looking at National Results .

National Employee Satisfaction Survey Results 2006 Nearly 107.000 responses .

933 nursing homes in 49 states and D.» First nationwide report » 1. participated in 2006 NOTE: Alaska not included .C.

FIGURE 2a Employee’s age .

FIGURE 2b Employee’s job category .

FIGURE 2d Length of employment .

FIGURE 1 SATISFIED NURSING HOME WORKERS BY CATEGORY Based on the percent of total weighted respondents who rated their overall satisfaction as “excellent” or “good” in each job category .

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An Exercise: What Matters Most? .

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Survey items: 1 Quality of orientation 11 Safety of workplace 2 Quality of in-service education 12 Adequacy of equipment/supplies 3 Quality of resident-related training 13 Sense of accomplishment 4 Quality of family-related training 14 Quality of teamwork 5 Comparison of pay 15 Fairness of evaluations 6 Care (concern) of supervisor 16 Respectfulness of staff 7 Appreciation of supervisor 17 Assistance with job stress 8 Communication by supervisor 18 Staff-to-staff 9 Attentiveness of management communication 10 Care (concern) of management .

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FACTORS THAT DRIVE WORKFORCE RECOMMENDATION Ranked correlations (p < 05) between employee workplace recommendation and employee satisfaction items .

TABLE 5 FACTORS THAT DRIVE WORKFORCE RECOMMENDATION (continued) Ranked correlations (p < 05) between employee workplace recommendation and employee satisfaction items .

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TABLE 6 PRIORITY ITEMS FOR NURSING STAFF Ranked by average scores and correlations with workplace recommendation .

FIGURE 3 Recommendation for care .

FIGURE 3 Does not total 100% due to rounding Recommendation for job .

FIGURE 3 Overall satisfaction .

TABLE 1 TRAINING May not total 100% due to rounding .

TABLE 2 WORK ENVIRONMENT May not total 100% due to rounding .

TABLE 3 SUPERVISION May not total 100% due to rounding .

TABLE 4 MANAGEMENT May not total 100% due to rounding .

What does research tell us about satisfaction survey data? .

What about employee data? What do we know today? .

Key Performance Drivers lower higher nursing family assistant satisfaction turnover higher higher employee family satisfaction satisfaction .

Key Performance Drivers higher satisfaction higher among occupancy families rates and employees .

Key Performance Drivers better higher clinical satisfaction outcomes among related families to falls. and employees pressure ulcers and catheters .

SUMMARY OF RELATIONSHIPS Improve Staff care outcomes Satisfaction Improve relationships HR Decrease nurse absenteeism Decrease nurse turnover Decrease nurse turnover Resident/Family Financial Satisfaction Increase occupancy .

Facilities with higher family satisfaction have better work environments EMPLOYEE ENVIRONMENT SCORE (%) Mean = 68.0 < 54% 54% to 58% 58% to 64% > 64% FAMILY SATISFACTION .

Facilities with higher family satisfaction have better employee training EMPLOYEE TRAINING SCORE (%) Mean = 57.1 < 54% 54% to 58% 58% to 64% > 64% FAMILY SATISFACTION .

2 < 54% 54% to 58% 58% to 64% > 64% FAMILY SATISFACTION .Facilities with higher family satisfaction have better supervision EMPLOYEE SUPERVISION SCORE (%) Mean = 72.

5 < 54% 54% to 58% 58% to 64% > 64% FAMILY SATISFACTION .Facilities with higher family satisfaction have better management EMPLOYEE MANAGEMENT SCORE (%) Mean = 66.

Facilities with higher employee satisfaction have: » More residents without falls » More residents without pressure ulcers » More residents without acquired catheters » Less nurse turnover » More nurse stability » Less nurse absenteeism » Less nurse absenteeism » Higher occupancy .

6.502 families surveyed • November 2004 . Quality of leadership and quality of the workplace: The interface Nurses speak up! • A 2004 study • 156 nursing facilities in the Southeast • 3.579 CNAs.

Staff are respectful of residents 8. Helps you get to deal with job stress 9. Work allows you to make a difference in people's lives 5. Indicators of quality of workplace 1. Pay compared to other nursing homes 2. Fair performance evaluations 7. Safety of workplace 3. Co-workers work as a team 6. Adequate equipment and supplies to do your job well 4. Communication between shifts .

A quality workplace creates QoL for resident .

As Staff are Treated So will the elders be treated. .

A quality workplace results in better state surveys .

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 conduct the survey at all. .

Using 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 .

Using Satisfaction Data » Use current structures or create new ones — QA&A committee — Staff meetings — Neighborhood/unit meetings — Interdepartmental teams — Focus groups .

Communicating 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

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”

Quadrant analysis: Two key concepts
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

D. The Quality Quadrant and Action Priorities Recom- mendation 1 --. B.Lowest to highest ranking correlation -------- 100 You have little control over customer expectations . Challenges Secondary Primary opportunties opportunities Item score 1 ---------.Lowest to highest ranking score  100 You can meet customer expectations A. Successes Secondary Primary strength strength al Go C.

Just ask why! My work is stressful — I gave Mrs. John a supplement and she threw up — No one told me she had been sick all morning — .

There is no communication between the morning and evening shifts of nurses — .

Take 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 .

Turn Information Into Knowledge Study current process Gather more information Evaluate process Identify contributing factors Determine root cause(s) .

but in gradual steps » New employees are introduced individually to the residents assigned to them .Develop Drill Down Questions Issue – Orientation Drill down suggested questions: » New nurses are oriented specifically to their unit » New nurses 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.

Use the Workplace Scale as 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 .

their peers. . many times.Whether individuals feel respect in the workplace is largely a function of how they are treated by their supervisors. particularly for new workers. their clients and family members or advocates and.

. Studies suggest that the quality of these relationships has a defining impact on workers’ decisions to stay on the job or leave to pursue opportunities elsewhere.

Lessons Learned Practical 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” » 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. .

» Everyone knows how to listen but knowing how to listen to information that is emotionally charged is difficult.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. . » Responding without blaming or being judgemental requires training and practice.

» 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? . big or small. will make workers feel more respected. valued and heard.Identify changes necessary to “operationalize” respect » Review existing P&Ps to understand what changes.

» 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? .Think in terms of maximizing human potential.

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? .

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. the work must be an ongoing process. . Commit to making continuous improvement » There is no “one-time fix” for creating a respectful work environment » To be successful.

” .Bishop. October 2006 . and to the proportion of CNAs who had positive relationships with their supervisors.“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.

. Using employee satisfaction surveys will help leaders to improve the tenure of staff by addressing those issues most important to them.

Don’t miss this valuable opportunity to improve quality of life for your residents by improving quality of life for your employees .

asp?PgID=27 » This paper addresses the key issue of the long- term care workforce — RESPECT .org/Page. Resources » “Better Jobs Better Care: Issue Paper” — No.bjbc. 7/April 2007 — “Respectful Relationships: The Heart of Better Jobs Better Care” » Link to this paper — http://www.