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Healthcare worker engagement is rising, but high turnover persists


One in five workers left their jobs within 12 months, and leaders are less engaged. Jessica Dudley of Press Ganey talks about a new report on engagement.

Healthcare workers are showing more engagement in the workplace for the first time since the beginning of the COVID-19 pandemic, according to a report from Press Ganey.

Jessica Dudley, Press Ganey’s chief physician officer and general manager for employee experience, sees progress in worker engagement and room to improve.

Jessica Dudley, Press Ganey’s chief physician officer and general manager for employee experience, sees progress in worker engagement and room to improve.

At the same time, one in five healthcare workers left their jobs in a 12-month span, so high turnover remains a problem, according to the report, which was released Thursday. In addition, one-third of the workforce is not engaged, so the number of dissatisfied workers remains a challenge for health organizations. Healthcare leaders appear to be less engaged, the report states.

On a note that may be encouraging to hospital leaders, nurses are showing more engagement. Nurses have been voicing frustrations about high levels of burnout and understaffing, so the uptick in engagement among nurses may be welcome news.

Overall, the rise in engagement from healthcare workers deserves attention, says Jessica Dudley, MD, Press Ganey’s chief physician officer and general manager for employee experience.

“We could be going in a very different direction and the fact that we are now going up is huge,” Dudley tells Chief Healthcare Executive®.

‘The right direction’

Healthcare organizations have recognized that they need to address the well-being of their workers, and that’s driving some of the gains in engagement, Dudley says.

As she says, “If you talk to a hospital leader over the last two years, besides financial challenges, I think every single one of them would have said, ‘We know our workforce is struggling, and this is our biggest problem.’”

More than two-thirds (69%) of healthcare employees are engaged or highly engaged, according to the report.

The report evaluates engagement on a five-point scale, and found employee engagement rising from 4.02 to 4.04. Press Ganey describes engagement as a mix of job satisfaction and willingness to recommend the employer to others.

Dudley says she’s especially heartened by the improved engagement scores among nurses (3.85 to 3.89). When she spoke to Chief Healthcare Executive Thursday, she was at a conference focused on the well-being of nurses.

“There's been such a focus, as there needed to be, in addressing these challenges, especially in the nursing space. So yes, thank goodness we're going in the right direction,” Dudley says.

Health organizations shouldn’t rest on their laurels.

“Nobody should let up,” Dudley says. “And organizations that have really leaned in to focus on nursing, including nurse leaders and frontline, this is not the time to kind of sit back and say, ‘We're good,’ because we're not good. There is a long way to go and continuing to improve this.”

Too many walking away

Nearly one-third of workers are disengaged, and Dudley says organizations need to do their homework to understand why they aren’t satisfied. She also suggests taking a look at groups of employees that may not be getting enough attention, such as advanced practice providers.

“The focus that's been given to nursing looks like it's reaping real rewards and improvement, still a long way to go but definitely the right direction,” she says. “There are other pockets of the workforce that globally still don't look great, and probably need a more intensified focus.”

Even with higher marks on employee engagement, too many healthcare workers are leaving their jobs, the report suggests. One in five workers who were employed by a healthcare organization in 2022 left that employer in 2023. Among those with less than two years in tenure, 1 in 4 chose to walk away, the report states.

Turnover “is higher than we'd like to see and I would say it deserves continued focus,” Dudley says.

Healthcare organizations face more competition from other sectors, especially non-clinical jobs that can offer the ability to work remotely, she says.

“It does create more challenges when I think they're being lured away by opportunities that create maybe more flexibility,” Dudley says. “So it's a little bit more pressure on us to figure out how we continue to provide flexibility in the healthcare space, so that we can compete with that portion of our workforce that could work anywhere.”

Less engagement among leaders

Some healthcare managers are showing less engagement in their roles, a finding that Dudley says is troubling. Engagement scores among healthcare managers have fallen for three years, dropping 3.7% (from 4.38 to 4.22 on Press Ganey’s 5-point scale).

“This is one of the things that does concern me the most,” Dudley says.

If leaders aren’t engaged, the employees they supervise are less likely to be happy in their jobs, and organizations could lose those workers. Workers who say they have weaker relationships with their leaders are 44% more likely to leave than those with good relationships with their managers, the report states.

“It's so clear that if your leaders are not doing well, and if they're not engaged, then those that are reporting to them, they're not going to want to stay,” Dudley says.

Organizations should consider more professional development for their managers, especially younger leaders who have been elevated to new roles in recent years.

“This is something that I think got pushed to the side a little bit during the pandemic, which is how important it is to train up our leaders,” Dudley says.

“There was a lot of promotion of younger and less experienced employees into leadership roles,” she adds. “That's awesome. We're all about advancement, but that also requires training.”

Improving employee engagement

Health systems can gain traction in retaining workers by listening to their concerns, a step that’s not expensive. Leaders need to engage in rounding and be visible, Dudley says.

Healthcare organizations can conduct surveys to measure engagement and allow workers to show why they’re dissatisfied. But after getting workers to speak their mind, organizations need to be ready to take steps to help their employees.

“It is not enough though, to just kind of survey and feel like you've done something,” Dudley says. “In fact, I tell people, the only thing that's worse than not doing a survey is surveying and not doing anything with the data. So yes, survey them, take your data and go deeper.”

Healthcare organizations can also look at their surveys of patients, who often share similar concerns to workers, and begin to “connect the dots,” she adds.

Dudley points to the need to train leaders to create a culture of inclusion on their teams.

Healthcare organizations need to take accountability for improving engagement.

Many of the organizations that have the most success in employee engagement are the ones “most focused on wanting to improve,” Dudley says.

“When they slip even the tiniest bit, they are so intent on finding those reasons and fixing them,” she says. “So that accountability is really important.”

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