MHA 543 Week 4 Employee Engagement Survey and Action Plan Example

From Scores to Action: Designing, Reading and Acting on an Employee Engagement Survey So Staff Believe Their Answers Matter

[Student Name]

University of Phoenix

MHA/543: Tackling the Talent War in the Health Sector

Week 4 Assignment

[Instructor Name]

[Date]

The health system, its survey items, response rates, scores and action plans are composites written for a model paper; research findings come from the sources cited.

During a listening session on the medical-surgical unit with the highest turnover, the vice president of talent at the composite Omaha health system asked why so few nurses had answered the last engagement survey. A nurse with eight years on the unit answered for the room: nobody fills it out anymore because nothing ever changes. Participation had fallen to 41%. This paper describes how the system redesigned its survey and, more importantly, what it did with the results.

What Engagement Means

Engagement describes how connected, committed and energized employees feel about their work and organization. It differs from satisfaction, which can be high among people who are comfortable but not invested. For a health system, engagement matters because it relates to whether people stay and how they care for patients.

Why Leaders Should Care

Engagement is linked to results. When researchers pooled survey and performance records from thousands of work units in dozens of companies, units whose employees were more engaged consistently had more satisfied customers, higher productivity and profit, fewer departures and fewer accidents, and the links were strong enough to matter in practice (Harter et al., 2002). Units, not whole organizations, are where engagement and its effects live.

What Went Wrong Before

The previous survey had 78 items, took 25 minutes and reported results six months after administration as a system-wide average. Managers received long reports but no guidance, and most took no visible action. Staff concluded that answering was pointless.

Why Follow-Through Matters

Research on organizational surveys supports the nurse's view. A study reexamining survey feedback and action planning found that employees who reported that their organization shared results and acted on them had markedly more favorable attitudes than those who saw results but no action, or saw nothing at all (Church et al., 2012). A survey without action does not just waste time; it teaches employees that their voice does not matter.

The Redesigned Survey

The new survey has 20 items and takes under ten minutes. It measures engagement with a short validated index, plus items on manager support, workload, teamwork, safety, recognition, growth and intent to stay. Two open questions ask what one thing would make the unit a better place to work and what the organization should stop doing.

Protecting Confidentiality

An outside vendor administers the survey. Results are reported only for groups of at least eight respondents, and comments are screened to remove identifying details. Leaders explained these protections in every staff meeting before the survey opened.

Encouraging Participation

The survey ran for three weeks, with protected time on each shift to complete it, and managers shared daily participation rates without pressuring individuals. Leaders emphasized one message: this time, results will come back to your unit within a month and you will help decide what to do.

Results

Participation rose to 76%. Overall engagement was moderate, but results varied widely across 64 units. The lowest-scoring units shared low ratings on workload and manager support; the highest shared strong manager support even under heavy workload. Intent to stay tracked engagement closely.

The Role of Managers

The results pointed to managers. A study of 2,813 physicians found that how physicians rated their direct supervisors' leadership tracked closely with their own burnout and satisfaction, and that better-rated supervisors had less burned-out teams (Shanafelt et al., 2015). The system's own data showed a similar pattern for nurses and their managers.

Unit Conversations

Within 30 days of results, every manager held a conversation with staff, facilitated by a trained human resources partner for low-scoring units. Staff reviewed their unit's results, discussed what the scores meant and suggested actions.

Reading the Comments

The open questions drew more than 3,000 comments. A team coded them by theme. The most frequent answers to what would make the unit better were adequate staffing, breaks that actually happen and managers who are present. The most frequent answers to what the organization should stop doing were changing schedules at short notice and asking staff to complete mandatory online modules during shifts. Several comments were simply thanks for asking again.

Sharing System Results

The chief executive presented system-wide results at open forums on every shift within three weeks, including the low scores and the themes from comments, and named three system-level actions: the workload targets already planned, a fixed schedule posting date across all units and moving mandatory modules to paid, protected time. Presenting unflattering results openly signaled that this survey would be different.

A Unit That Improved

One unit illustrates the process. Its staff rated workload and recognition lowest. In its conversation, nurses asked for a break relief nurse on day shift and for peer recognition. Both actions were in place within two months. The unit's pulse survey four months later showed engagement up by 11 points, and no nurse had resigned in that period, compared with three in the same months a year earlier.

Pitfalls Avoided

The system avoided practices that damage trust: no manager was punished for low scores in the first year, no attempt was made to identify who wrote which comment and no unit was asked to raise its scores by a target number, which can pressure staff to answer favorably rather than honestly.

Two Actions per Unit

Each unit chose no more than two actions, so they could be completed. Examples included a fixed schedule posting date, a break relief nurse on day shift, monthly recognition by peers and a manager's regular presence on night shift.

You Said, We Did

Each unit posts a simple board: what staff said, what the unit is doing and when it will be done. System-wide themes, such as workload on medical-surgical units, go to executives, who report back on actions such as the new workload targets.

Supporting Low-Scoring Managers

Managers of the ten lowest-scoring units received coaching and a peer mentor from a high-scoring unit. Two managers who could not improve over a year moved to other roles.

Pulse Surveys

A five-item pulse survey every four months checks whether actions are working, without waiting for the next full survey.

Linking Survey Results to Other Data

The talent team combined unit engagement scores with turnover, overtime, sick time and patient experience data. Units in the lowest quarter for engagement had nearly twice the turnover of those in the highest quarter and lower patient ratings of nurse communication. These links helped executives treat engagement as an operational measure rather than a morale score.

Measures

Measures include participation, engagement by unit, completion of unit actions, intent to stay and turnover, reviewed quarterly by the executive team and annually by the board.

Conclusion

The nurse was right: a survey that changes nothing teaches people not to answer. Research linking unit engagement to outcomes, and showing that attitudes improve when results are acted on, shaped a shorter survey, unit-level analysis, staff conversations, two actions per unit and a visible report back. The survey became a tool for change rather than a ritual.

References

Church, A. H., Golay, L. M., Rotolo, C. T., Tuller, M. D., Shull, A. C., & Desrosiers, E. I. (2012). Without effort there can be no change: Reexamining the impact of survey feedback and action planning on employee attitudes. In A. B. Shani, W. A. Pasmore, & R. W. Woodman (Eds.), Research in organizational change and development (Vol. 20, pp. 223-264). Emerald. https://doi.org/10.1108/S0897-3016(2012)0000020010

Harter, J. K., Schmidt, F. L., & Hayes, T. L. (2002). Business-unit-level relationship between employee satisfaction, employee engagement, and business outcomes: A meta-analysis. Journal of Applied Psychology, 87(2), 268-279. https://doi.org/10.1037/0021-9010.87.2.268

Shanafelt, T. D., Gorringe, G., Menaker, R., Storz, K. A., Reeves, D., Buskirk, S. J., Sloan, J. A., & Swensen, S. J. (2015). Impact of organizational leadership on physician burnout and satisfaction. Mayo Clinic Proceedings, 90(4), 432-440. https://doi.org/10.1016/j.mayocp.2015.01.012