The proof is in the pudding

The proof is in the pudding

A lot of ink has been spilled over the relationship between worker engagement and customer satisfaction.  In some of the WorkersCount and NursesCount blogs we have touched on this (“the secret to driving service as a business differentiator” and “which comes first, customers or employees?”).  In healthcare it is a widely accepted linkage, as it is also in retail and most personal-service industries.  Yet it has been limited to “truisms, common sense, wisdom from experience and anecdotes.”  It has indeed been an elusive connection to document.  Until now.

WorkersCount and NursesCount (and PatientCount) simultaneously monitor both worker engagement and workplace satisfaction directly against customer (patient in healthcare) service satisfaction and outcomes.  This is an industry-first in healthcare and all of general industry in terms of data modeling and actionable insights.  And unlike any data service, this data is gathered is in real-time, on a daily basis.

A Case In Point

Warning signs and risk areas

In a healthcare client of WorkersCount, the challenges were several.  The first challenge:  Move the general customer engagement index from 4.6 (out of 5) upwards towards 5.  Even a small increase in this index is very difficult, yet executive management felt strongly that this was a mediocre score, and signaled problems. 

The next challenge:  Address a recently exposed problem of engagement in a particular cohort (in this case, workers with over 5 years of tenure).  There was a plateau and even a slide in job satisfaction.  Executive management felt that this was a particularly high-risk item, as these workers represented key experience, expertise and were in leadership roles working on business-critical projects and programs.  Turnover in this area would be particularly painful and potentially disastrous to the organization.

The WorkersCount (and NursesCount and PatientCount) process

The exec team implemented WorkersCount’s daily check-in service, which was done without the need to dig-into the HRIS system or any proprietary or sensitive system in the healthcare organization, including HIPAA or HCAHPS areas.  It runs independently in the cloud and uses social sign-on to make daily check-ins (a hallmark of WorkersCount’s services) fast, fun and easy.  It’s a daily reminder with a link, and a 30-second check-in process that’s anonymous.  It asks workers only two questions:  a baseline “how is your life at work today” question, and a second “question of the day” that rotates among a broad list.  Only two questions are asked per daily check-in, so it’s fast and fresh every day.

A bit of fun on the way to 30-50% daily participation

Workers were encouraged to participate (voluntary), with the pledge from management that this was a safe, anonymous way to make their voices heard, and to help drive a better workplace for all (workers and “customers”).  Using simple gamification to inject a bit of fun, and keep things interesting, individuals were rewarded with lunch, or cinema tickets, or dinner at random, or from groups that had high participation.   The system does not link any particular user “votes” or input with a user identity.  It is completely anonymous.

With a daily pulse on employee engagement, managers could actively manage employee engagement and make adjustments in days, not weeks or months. They could see where they were strong and where they were weak. They could see where they had engagement gaps, take actions, and actually see whether their actions resulted in real improvement.  The system became a daily and weekly insight or “pulse” of the organization that could be used as a true management tool. 

Startling results

By the end of the measurement period some startling discoveries were made, both from the raw data and more importantly from the interpretation and insights of the reports and data by the management team, working groups and nursing staff.

Here are some highlights:

Eliminating “hell days”

Wednesdays and Thursdays were particularly low days.  Upon review of the data week-over-week and in context with benchmarks, the nurses council and the exec team hit upon an obvious, but hidden issue.  Surgeons were scheduling elective procedures on Monday and Tuesday.  Backlogged procedures were stuffed into Wednesdays and Thursdays because many surgeons had a habit of taking time off on Fridays.

Quick and effective adjustments

These are the simple and inexpensive fixes that were able to be made immediately (not months after complex analysis):  Manage overall scheduling more carefully to spot “stuffing” trends like this, and manage doctors more closely to prevent mass exodus on Friday (or any day)  -- for whatever reason. 

Cost- nil.  Impact:  Great.  Timing:  Immediate.

Diagnosing the “happiness plateau”

A completely hidden set of issues emerged with respect to the more experienced managers.  These were the ones with over 5 years of tenure, and had the lowest scores around overall job satisfaction. In fact only 29% of this group reported being happy about work.  This was a huge risk area.  What the service quickly exposed were several gaps that executive management did not see coming:

·      40% had to work long hours to get things done

·      53% were not satisfied with the recognition they received

·      50% did not feel they had a positive work environment

 and the most alarming bit of information that workers willingly shared:

·      43% were regularly taking calls from recruiters

 These were the most experienced and seasoned managers in the organization.  They had apparently been “suffering in silence” for some time—perhaps years.  Yet the exec team had not been able to surface these straightforward management gaps until now.  And it was done in weeks, not months.

Swift, simple and inexpensive solutions

Solutions were swift and obvious.  Re-evaluate project timelines and expectations.  Get more frequent feedback on staffing levels for projects and departments.  Make it a formal priority to give recognition and credit for projects that may have been “invisible” to all but a few.  Go deeper about ways of creating a more “positive” work environment.  Track workers into career paths that were exciting and meaningful within the overall organization.

Cost:  nil.  Impact:  Tremendous.  Timing: immediate.

Update—this group posted an immediate 17 point gain in satisfaction, dropped their “willingness to take a recruiter’s call by over 50% and contributed greatly to the overall organization's 13 point overall general engagement improvement.

This was in just 120 days.  The process is still accelerating and improving at this organization. 

When the “standard” customer survey was tabulated, management was able to post the increase they were looking for and more.  In just 120 days the 4.6 score jumped to 4.75, which was a very big single-period swing, and it continues to edge upwards.

What about customer satisfaction?  Did the elimination of “hell days” (Wednesdays and Thursdays) and the other changes impact “customer” satisfaction as well?  It did.  The external customer satisfaction index climbed substantially during this period, after a pattern of decline.  Here’s what it looked like when compared together:


We have mounting empirical evidence that links worker engagement to customer satisfaction.  More importantly, using the WorkersCount methodology, reporting and check-in data, management has shown that hidden issues emerge quickly, causes are identified more rapidly and fixes or changes can be implemented (immediately in some cases) that are inexpensive and have high impact across the organization and customer base. 

It doesn’t have to be hard, and the adjustments and "course corrections" need only be small, as long as they are part of a continuous improvement drive from good to great.  All organizations need to do is decide, then make a commitment and then listen to workers and customers.  It's astounding what your customers and workers will tell you ---if you only listen and give them a voice.   The rest will quickly emerge from the talented and committed teams across the organization.

In the journey from good to great, this is one of the lasting lessons: listening works.

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