Nowadays, the healthcare industry seems to be going through a number of changes at once, some of them positive, while others are considered rather controversial. However, the purpose of this paper is to determine whether the lack of staff involvement is a stressor, which affects the quality and safety of care. The efforts related to increasing work engagement in the healthcare industry are the latest addition to the Triple Aim, which is now known as the Quadruple Aim (Jacobs et al., 2018). In 2007, the Institute for Healthcare Improvement decided to issue a set of objectives to guide each and every healthcare organization in the U.S. in regard to system optimization (Fitzpatrick, Bloore, & Blake, 2019). The Quadruple Aim adds improving the work environment to the initial set of goals, which includes “improving the patient experience of care (…), improving the health of populations, and reducing the per capita cost of healthcare” (Fitzpatrick et al., 2019, p. 185). The issues of employee shortages, work-related stress, and high turnover rates in clinical settings are all ultimately tied to the lack of organizational initiatives targeted at increasing staff involvement.
In order to fully grasp the scope of the problem at hand, it is imperative to examine the latest statistics. First, it is crucial to acknowledge the fact the healthcare industry has more workers than any other sector in the United States’ economy. After all, even during the finical crisis of 2007-08 and amid the COVID-19 pandemic, the rates of employment in the medical settings continued to rise (Reed, 2019). However, despite employing millions of employees, research demonstrates that the healthcare industry only has around 40% of highly engaged employees (Reed, 2019). This explains high turnover rates in the industry as well as a constant need for competent medics. The nation’s hospital executives, including one of the board members at Premier Health whom I have had a pleasure to converse with, express their concern over the increasing demand for workers after the retirement of the baby boomer generation workforce. Therefore, it is apparent the medical sector is facing the problem of specialist deficiency, including nurses and clinicians.
In terms of the impact of employee shortages on my hospital specifically, I have uncovered that the issue is more dangerous than ever. Only in the last year, I have witnessed 5 nurses retiring and a dozen more quitting after a year or two of working. One of the primary causes has been the COVID-19 pandemic although some stated personal issues and a general lack of interest as their reasons for leaving. As a result of shortages, our directors have considered merging with another local institution in the hopes of creating a big medical center in Ohio.
Another problem, which originates from the absence of lack of staff engagement, is high turnover rates. According to Reed (2019), the American Health Care Association reports unfortunate figures, which indicate that “the median turnover rate for direct care staff in skilled nursing centers is 43.9%” (para. 5). This is directly related to employee dissatisfaction and burnout, both of which seem to occur rather regularly for medical professionals.
The impact of high turnover rates is incalculable as it has direct influence on the quality of care provided by an organization. The lack of commitment and engagement from staff leads to various complications, decreased productivity, and more risks to patient safety. The absence of emotional involvement from nurses and clinicians results in significant financial losses as well, according to the representatives of Premier Health. Furthermore, it is evident that my hospital (Miami Valley Hospital) spends much more money on new employee training and orientation of the turnover rate is high.
In regards to the scholarly research surrounding the topic of staff engagement, the two works this paper is going to examine are the piece by Havens, Gittell, and Vassey (2018) as well as the article by Fitzpatrick, Bloore, and Blake (2019). Havens et al. (2018) aimed to determine how exactly the efforts of patient experience improvement, such as the Triple Aim, impact nurse-related outcomes, including burnout, job satisfaction, and others. They acknowledged that the process of integrating initiatives targeted at improving the quality and safety of care often had a detrimental effect on the well-being of medical professionals. Through the use of surveys to evaluate relational coordination, Havens et al. (2018) concluded that improving the work experience of care providers leads to “increased job satisfaction, increased work engagement, and reduced burnout” (p. 132). Thus, healthcare organizations have to take into consideration that the attainment of the initial goals underlined in the Triple Aim is impossible without adopting the Quadruple Aim.
As for the research conducted by Fitzpatrick et al. (2019), it was primarily focused on the interventions targeted at improving the work environment for healthcare professionals. They concluded that these efforts were a contributing factor in the improvement of overall quality and safety of care. Decreasing emotional exhaustion and reducing the risk of burnout results in nurses and clinicians experiencing joy in work, which then positively affects patient outcomes.
In order to efficiently apply the research related to staff engagement, it is imperative to follow a set of strategies. First, it is crucial to ensure healthcare professionals are involved in decision-making, which means that they ought to participate in hospital affairs and governance (Fitzpatrick et al., 2019). In turn, this will empower them and give them the proper support to make a valuable impact. In terms of the negative aspects of such a strategy, putting too much pressure on employees to run the hospital and make the majority of the decisions can have the opposite effect. Another strategy involves authentic leadership, which would allow nurses to have someone they can go to for advice or support. On the one hand, this reduces emotional distress and facilitated communication (Park et al., 2018). However, there is a risk employee at Premier Health will become overly reliant on their hospital’s leadership. Programs for professional advancement are another effective way of increasing staff engagement. However, it is important to acknowledge that the participation has to be voluntary as to not put more pressure on workers to spend extra hours on “professional growth.”
In conclusion, it is apparent that technological advancements, highly publicized instances of health inequities, as well as the rising cost of insurance plans, are all pressing issues, which affect the way care providers deliver medical services. However, the most prominent issue is the neglect of employee experience and satisfaction in an effort to follow the established patient-centered standards of healthcare delivery. In order to ensure the staff is engaged and involved, it is imperative to make it possible for nurses and clinicians to participate in hospital decision-making, ask for help from authentic leaders, and to advance professionally.
References
Fitzpatrick, B., Bloore, K., & Blake, N. (2019). Joy in work and reducing nurse burnout: From Triple Aim to Quadruple Aim. AACN: Advanced Critical Care, 30(2), 185–188.
Havens, D. S., Gittell, J. H., & Vasey, J. (2018). Impact of relational coordination on nurse job satisfaction, work engagement and burnout. JONA: The Journal of Nursing Administration, 48(3), 132–140.
Jacobs, B., McGovern, J., Heinmiller, J., & Drenkard, K. (2018). Engaging employees in well-being. Nursing Administration Quarterly, 42(3), 231–245.
Park, B., Gold, S. B., Bazemore, A., & Liaw, W. (2018). How evolving United States payment models influence primary care and its impact on the Quadruple Aim. The Journal of the American Board of Family Medicine, 31(4), 588–604.
Reed, R. (2019). The importance of employee engagement in healthcare. Rewardian. Web.