Is anyone listening?

Nancy Anderson, RN, MA, Senior Vice President of Engagement Solutions
Nancy Anderson, RN, MA, Senior Vice President of Engagement Solutions

In my last blog, I shared some thoughts about people-focused managers as a key factor in creating a culture of engagement. This month I want to voice my opinion about employees having an active voice in your facility!

Just for a moment, walk in the shoes of a frontline employee…

You are at the heart of delivering care and/or service to patients/residents. You are keenly aware of what works and what doesn't work as you perform your day-to-day tasks. If anyone were to ask you for things that could be done to make things better for patients, or make a work process more efficient, you most likely would have plenty of ideas. Sure, you could offer your ideas, but would anyone listen? Your work is performed within whatever systems and processes the “higher-ups” put in place for care and service delivery. You're willing to share your ideas, but you're not sure if it's safe to do so, or if you would be seen as credible.

Employees want to be heard. They want to contribute to the success of their organization and they want to know that their input is taken seriously. If you don't encourage employees to share their ideas for improvement, you are missing out on some great time and cost saving ideas! Employees are closest to the work and are acutely aware of the barriers that prevent work from getting done efficiently. But unless they know you are interested in hearing their suggestions, they are not likely to come forward with their ideas.

If you create an open environment for communication, and formal processes for employee input, you can benefit from the voice of your employees. But how can you promote active voice of employees? Here are three tips:

Tip #1: Involve employees in decision making.

When making a decision that impacts your employees, their perception of fairness increases if they have the opportunity to be involved in the decision making process. There are generally four different levels of decision making involvement:

  • No involvement – manager decides and announces the decision (directive decision)

  • Supervisor gathers input from employees and then decides (consult decision)

  • Supervisor gathers input and the team votes on the options (democratic decision)

  • Supervisor and team collaborate on the decision to reach an agreement that all can support (consensus decision)

There is a time and place for each type of decision making. Sometimes it's very appropriate for you to make a decision and announce it, especially when the decision is time-sensitive and/or relates to a quality or safety issue.

In another situation, it may be appropriate for you to work for consensus, meaning all of your team members have talked through the issue, provided their input and have reached a decision that all can support. Involve people in decision making whenever possible as you will increase employee perception of fairness. Even if the final decision doesn't go their way, employees will feel that they've been heard and that the decision making process was fair.

Tip #2: Establish formal and informal processes for employee input.

For employees to have a voice in your facility there must be processes and channels through which voices can be expressed. You have to have an environment that encourages employee voices to be heard and managers who will actually listen! In addition to formal methods like engagement surveys, town hall forums, brainstorming, and solution groups, encourage managers to capitalize on in-the-moment methods such as hallway conversations, team huddles, and employee rounding to give voice to employees.

Tip #3: Make it safe for employees to speak up.

From a nursing assistant on a short stay unit:

“My manager has never once asked me for my ideas or input. And when I told her about not having enough linen for my patients, she didn't do anything. When I run into barriers that get in the way of me doing my job, what should I do? When I don't have the equipment I need, when I see a co-worker taking shortcuts that aren't safe, when I have an idea about how to make things better… do they even want to know?”

Speaking up can feel like a risk. Most employees don't want a reputation as a troublemaker. They don't want to damage their relationship with their manager or organizational leaders. And the higher your position in the organization, the less likely your employees will feel comfortable providing input, especially constructive criticism! However, don't ask employees to speak up unless you are genuinely prepared to listen. This means investing in preparing your managers and supervisors to be exceptional listeners. People will not speak up if they feel like they are being judged or if they don't trust their manager. Leaders must create a safe environment for people to give their opinions and share their ideas.

Appreciate and value employee input

When employees feel like they have a voice in their organization, it reinforces their sense of significance. It also contributes to their sense of control knowing that they can influence matters that affect them. When employee input is appreciated and valued, employees are more likely to contribute valuable ideas.

Next month, we will continue our series with some thoughts on another key attribute of a culture of engagement: Meaningful connectedness.

Nancy Anderson, RN, MA, is the SVP of Engagement Solutions for Align. In her role, she provides strategic leadership and supports development of solutions to help providers successfully build and sustain a culture of engagement.

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