Health care worker catch-22 poses staffing challenge

December 07, 2011
by Diana Bradley, Staff Writer
While the satisfaction and engagement of health care employees and physicians is rising, national experience reveals that the closer an employee is to a patient, the lower his or her workplace satisfaction and engagement, according to the 2011 Pulse Report from Press Ganey Associates, Inc., a patient health care survey provider.

This is a catch-22 situation, as health care organizations want staff to continue to be satisfied and engaged, but also want them to be close to patients. Year after year, those who are closest to patients tend to have lower Hospital Consumer Assessment of Healthcare Providers and Systems survey scores. This is due to the management-enforced front line pressures to ensure patients receive the best experience they can, according to Debbie O'Brien-Paller, senior vice president, consulting and education services at Press Ganey. Various steps are being taken to counteract this high-priority issue.

"Over the last decade, health care leaders in their desperation to do something about this were just going out and telling nurses and direct caregivers, 'Say this, do that,'" she told DOTmed News. "They called it scripting -- we were scripting nurses into saying certain things. A big turn over the past year is that rather than telling front line caregivers how to engage and satisfy patients, caregivers are now being motivated to see things from the individual patient's point of view."

By implementing this new strategy, O'Brien-Paller noted that caregivers would "reach into themselves" to deliver the more genuine care patients want to receive. She added this would take away caregivers' dissatisfying and disengaging pressures.

According to Press Ganey's report, fiscal and administrative service workers are more engaged than all other types of workers. Oncology practices experience the highest level of overall patient satisfaction, followed by cardiovascular disease and cardiology; and physicians specializing in pathology, radiology and pediatrics are the most satisfied -- these same three specialties had the highest satisfaction in 2010. Patients with cancer and heart disease tend to develop significant relationships with their doctors and the practices that serve them. In comparison, physicians specializing in general surgery, pulmonary disease and gastroenterology were the least satisfied. This marks a change from 2009, when cardiovascular disease and hospitalists ranked the lowest in satisfaction. The increase in hospitalist satisfaction and engagement is vital to hospitals being able to achieve goals related to patient safety, quality and patient satisfaction, the report noted.

Engagement and satisfaction are two psychological conditions of health care workers, each measured very differently, according to O'Brien-Paller.

"Being satisfied means you get what you need from your employer; and being engaged means you feel that you can give back from yourself," she said. "The research we have done shows there is a strong statistical significance in the correlation between employee partnership and patient satisfaction."

There has been an ongoing upward trend in physician partnership over the past five years, although improvements are still required, according to Press Ganey's report. Providing feedback to hospital leaders is a key factor in employee satisfaction and engagement, as evidenced by three of the five items in the Employee Partnership Priority Index, which include influencing policies/decisions, listening and asking for opinions. Coaching and recognizing performance are the other two items.

"Hospital leaders tend to get frustrated by the fact they have to give employees everything they need and want to satisfy them," said O'Brien-Paller. "Instead of being frustrated, I would encourage health care leaders to inspire, educate, recognize and reward staff. Let them find their own way to figure out and deliver what the patients they are caring for want."