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Why employee engagement matters for optimal healthcare outcomes

Coauthored by Milissa Eagle, MA, Director of Workforce Analytics.

Employee engagement is a powerful thing. When your employees are engaged, they enjoy their work, advocate for the organization to others (for work and/or care), and are more likely to stay in their jobs.

We analyzed feedback from 1.72+ million employees, nurses, and physicians, across 509 organizations and more than 4,500 facilities, to gauge the state of healthcare workforce engagement. Our data shows that higher employee engagement is strongly correlated with performance across three key areas of focus for the healthcare industry.

  1. Patient experience 
  2. Safety 
  3. Diversity, equity, and inclusion (DEI) 

When engagement is high, performance in these areas is also high, and high performance reinforces engagement—creating a positive cycle of improvement.

The critical link between employee experience, patient experience, and clinical outcomes

We’re all well aware of the harsh realities our industry currently faces. Workforce engagement—across employees, physicians, nurses, and even healthcare leaders—plummeted during the pandemic. This exacerbated issues like burnout and front-line caregiver shortages. And, as our workforce suffered, the patient experience suffered too.

Organizations must make engagement a top priority to jump-start the cycle of improvement and, in turn, drive performance across all areas. That means nurturing an environment where people feel included, respected, and involved in decision-making.

Organizations in the top 25% of engagement performers score, on average, 38 percentile points higher on “Likelihood to Recommend” for care in the inpatient setting than organizations in the bottom 25% of engagement performance.

Engaged employees are more attentive and involved at work. They’re more likely to make the extra effort, dig deeper to get to know their patients, and go above and beyond to make people feel respected, treated with dignity, and truly cared for. Engaged employees are keenly aware of their role in providing top-of-the-line care—leading to positive outcomes. Knowing they have the right resources and tools to deliver excellent, safe care gives them the confidence to perform their jobs at the highest level.

A patient's entire perception of the organization might be based on their interactions with a single employee. And that’s all the more reason to create an environment and experience that allows each employee to engage and feel empowered to provide compassionate and empathetic care to every patient they interact with.

Why engagement matters: Patient experience performance is higher at facilities with strong workforce engagement.

Engaged employees embrace a culture of safety in healthcare

People want to feel safe at work. While contracting an illness or disease is always possible in a healthcare setting, healthcare workers must also contend with the potential threats of violence against caregivers by patients, bullying internally, and the physical, mental, and emotional toll of working in a high-stress, high-stakes environment day after day.

In the U.S., 2 nurses are assaulted in the workplace every hour.

Healthcare organizations must commit to the principles of zero harm and high reliability, both of which accelerate improvements in employee and patient safety. While employees are doing all they can to prevent harm to patients, they must feel assured that their organization has measures in place to protect them from harm too.

Facilities that perform in the top 25% on safety culture rank, on average, 68 percentile points higher on engagement than those performing in the bottom 25% on safety culture. 

Engaged and attentive employees are more likely to notice unsafe conditions and other threats. Safety also includes psychological safety—that is, an environment in which employees feel comfortable speaking up, reporting errors or potential risks to colleagues and supervisors, and sharing ideas without fear of punishment. Psychological safety is critical across all types of industries, but the nature of our work, in healthcare, raises the stakes if any error is made. Plus, an organizational commitment to safety is a key driver of employee engagement and retention.

Put simply: When employees believe leadership prioritizes safety and continuously pursues zero harm, they’re less likely to leave.

Diversity, equity, and inclusion (DEI) in healthcare 

Human beings—across all ages, races, gender identities, backgrounds, locations, and so on—have a need for, and right to, healthcare. The healthcare workforce, like the population it serves, is diverse—and, thankfully, growing even more so. 

When the workforce doesn't perceive DEI as an organizational priority, 2x as many employees are at risk of leaving.

Our data shows that DEI and employee engagement are tightly connected. When we look at key drivers of engagement and retention, we see that respect and an organizational focus on diversity and equity are critical to improving these areas. A culture centered around embracing the ideas and innovations stemming from a diverse array of backgrounds, experiences, and viewpoints helps to improve engagement as well as care delivery.

A commitment to DEI in healthcare helps eliminate inequities in healthcare and ensure that everyone gets the care that they need and deserve. Recognizing the contributions of a diverse workforce keeps employees engaged and involved—and excited about the contributions they’ll make in the future. A commitment to DEI is also strongly correlated to retention: When the workforce doesn't perceive DEI as an organizational priority, twice as many employees are at risk of leaving.

In short, employee engagement in healthcare is a powerful thing. The challenges of the pandemic served as a harsh reminder of the important role engagement plays in our healthcare workforce and, ultimately, the quality of care patients receive. By focusing on engagement, we can drive a better patient experience.

For more in-depth insights around employee engagement, its benefits, and how to improve it, download our report: “2023: The state of workforce engagement.”

To discuss how to optimize your organization’s employee engagement strategies, reach out to a member of our workforce team.  

About the author

As Chief Clinical Officer, Jessica leads efforts to support organizations in increasing clinician engagement and improving patient care outcomes, particularly among physicians. Her areas of expertise include leadership development, clinical care redesign through outstanding teamwork, addressing clinician burnout, and advancing professional fulfillment. Jessica also leads Press Ganey’s Workforce Well-Being Collaborative, an initiative designed to help healthcare organizations identify the varied and disparate needs of their workforce and enable them to respond to their physical, emotional, financial, and operational needs in both the near term and beyond.

Profile Photo of Jessica C. Dudley, MD