10 Steps to Improve Employee Engagement and Drive Results

Bob Kelleher, CEO and founder of the Employee Engagement Group and author of Louder Than Words: 10 Practical Employee Engagement Steps That Drive Results, says employee engagement is intricately linked to organizational success, but that it shouldn't be mistaken for employee satisfaction.

"Employee satisfaction might be a byproduct of engagement, but engagement is more about employees working toward an organization's goals and the company's overall well being, which is critical to an organization's performance," he says.  

Engagement is particularly important in a hospital, where employee performance largely drives overall performance on various indicators — such as quality and satisfaction. In order to improve engagement, Mr. Kelleher offers 10 steps — which are discussed in more detail in his book — for hospitals and other organizations,


1. The link to high performance.
Organizations must make the business case for high performance and need to link assessment of individual employee performance to measurable and objectionable goals. Clear, consistent communication should continually keep employees informed about the organization's performance, and leaders should give explanations for and plans to improve any underperformance.

In Mr. Kelleher’s book, Louder Than Words, he shares this example.

"At Boston’s Beth Israel Deaconness Medical Center, CEO Paul Levy and his staff faced grave financial hurdles during the recession of 2009. Faced with a $20 million-dollar deficit that might have forced 600 layoffs, Levy asked for alternative recommendations from his employees. Suggestions from staff included suspension of the hospital’s 401K match along with several concessions on the part of senior staff: pay cuts accompanied by a freeze on salary increases and bonuses.

Kelleher, B. (2010). Louder Than Words: 10 Practical Employee Engagement Steps That Drive Results. Portland, Ore.: BLKB publishing, pages 46-47.

By openly discussing the financial realities facing BIDMC and seeking input, Paul was making a business case that the hospital needed to return to high performance. "Eventually, the hospital saw their $20 million dollar shortfall turn to a $10.3 million surplus, during which time they we able to reinstitute pay increases," says Mr. Kelleher in his book.


2. It starts at the top. Embedding employee engagement and high performance in an organization's culture require a high level champion.

"You shouldn't outsource your employee engagement or just delegate it to HR or corporate communication," says Mr. Kelleher. "The entire leadership team, including hospital executives and key physicians need to practice the same principles and values that they want the rest of the hospital to exhibit." Never underestimate the shadow leaders cast within an organization.

3. Engage first-line leaders. Once high level leaders are committed, the organization needs to gain the buy in of line leaders, such as department managers, and ensure they are capable of overseeing the performance of their subordinates. Mr. Kelleher says the importance of line leaders is sometimes underestimated, but in actuality, one of the most significant drivers of engagement is an employee's relationship with his or her line manager. As a result, it's critical hospitals have engaged line managers with the skills to promote engagement in others.

"[Hospitals may] assume that if you're a good nurse, you'll be a good manager of nurses. Then we put someone in charge and sit back and wonder why he or she is not successful," says Mr. Kelleher. "They may have no training or perhaps they're better suited just acting as an excellent care giver."

4. Communication. Mr. Kelleher calls communication the cornerstone of engagement. "So much of an engaged culture is driven by how leaders communicate with employees," he says. Hospitals should promote open communication between leaders and employees and should leverage both traditional methods to achieve — such as open door policies and town hall meetings — as well as newer methods — such as CEO blogs and other social media initiatives.

5. Individualize your engagement. Just as no two employees are the same, neither are their engagement drivers. Some are driven by personal achievement, some by recognition and others by safety and security. Often these differences are generational, so a hospital may consider training managers on how motivators vary by generation. "Line managers need to know the motivators of their employees and use those to drive engagement," says Mr. Kelleher.

6. Create a motivational culture. While managers can certainly take a number of steps (such as the ones outlined here) to encourage motivated employees, Mr. Kelleher does not believe it is the responsibility of managers to actually motivate each employee. Instead, managers should focus on creating an overall culture that encourages self-motivation. Here are some questions to ask: Does the manager provide opportunities to advance? Are employees' ideas and opinions solicited? Are employees allowed to question the status quo? Is there open, honest and frequent communication? Are employees empowered to make decisions? Is there a culture of recognition?

7. Create feedback mechanisms. Hospitals must ensure employee feedback is actively sought and taken seriously. If employee opinions aren't valued, it can greatly reduce their motivation to do "what's best for the company." Mr. Kelleher cites employee engagement surveys as valuable feedback mechanisms as well as 360-degree feedback programs that are used to assess managers. Although Kelleher claims 360-degree assessments are an important feedback tool, he cautions that hospitals should conduct training before implementing. "You want to make the focus on staff development, not an exercise to criticize," he says.

8. Reinforcement, rewards and consequences for behaviors. In order to maintain engagement, hospitals must demonstrate that high performance is rewarded and poor performance has consequences. "Once you tolerate mediocre performance, you give the impression to others that  underperformance is acceptable," Mr. Kelleher says. "When you do this, you actually disengage your performers."

Mr. Keller provides a recent example of a company that provided a 10 percent bonus to all employees, across the board. While the move sounds good in theory, he argues it rewards all performers equally, which actually undermines a culture focused on improving performance. "An employee who's busting his hump sees that the person not pulling his weight got the same increase, so there's no motivation to keep that high performer at the same level," he says. “And there is no motivation for the underperformer to improve."

9. Track and communicate progress and success. "We assume that employees don't want to fail, so we have to link failure or success to performance," says Mr. Kelleher. Creating that link requires tracking progress through metrics and then sharing progress openly with employees through various forms of communication. Employees should always know what metrics the hospital is using to assess performance and how the organization is currently performing against those metrics. For example, a hospital might share its rate of infections on a regular basis as well as how it compares to other institutions on this measure. Given that employees and their leaders share a common goal (they both want to succeed), it is important for all employees to understand the scorecard.

10. Hire and promote engaged employees for your culture. "I tell some of my clients, 'you don't have an engagement issue; what you have is a hiring issue,' says Mr. Kelleher. The key to an engaged culture is hiring and retaining employees that can thrive within your organization's culture of performance. Mr. Kelleher recommends that hospitals focus on identifying the shared behaviors and traits  of  the best performers in the organization and then seek out job applicants that share those qualities. "Skills and education are always emphasized in the hiring process, but I would argue a set of consistent behaviors and traits that align with the organization are even more valuable in a hiring decision," he says. 

Learn more about the Employee Engagement Group.

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