In health and social services, we are facing a serious workforce shortage complicated by a fatigue in our remaining workforce. Many organizations have 25% unfilled positions with 40% of staff wanting to leave their positions or change careers. Today’s care workforce is faced with new challenges that are taking a toll on their emotional and physical well-being. There has been an increase in the amount of mental health conditions, such as depression and anxiety, among care professionals. This is largely due to the fact that we are now facing a whole new set of challenges such as working in an increasingly complex environment with more demanding work schedules. As a result, the care workforce is becoming less resilient and more at risk for burnout. How can providers attract new staff, and retain and support existing staff so that they can provide high-quality services?
Why are Care Workers Burning Out?
COVID-19 has placed extraordinary pressure on care workers in health care, social welfare and mental health. These professions have a history of direct contact with patients and clients who seek help during times of need. A recently published study (Prasad et. al., 2021) surveyed over 20,000 health workers across 42 organizations around occupational stress. The study found that a majority of workers feared exposure to COVID-19 and transmission to family members. Over one third reported anxiety and depression. Nearly half reported work overload and burnout. The study reports it found that “stress is higher among nursing assistants, medical assistants, social workers, inpatient workers, women and persons of color, is related to workload and mental health, and is lower when feeling valued.”
Why care workers don't feel valued
Healthcare workers are burning out because they have too much work to do, and they feel like the work that they do get done is not valued. Care workers may feel like they cannot provide the level of care needed in settings because there are not enough staff members and resources available. This leads to frustration. When care workers do not receive respect and appreciation, this can lead to emotional and physical exhaustion. Some care workers feel that their managers and supervisors do not appreciate them. Some feel that their co-workers do not appreciate them. Some feel that they are not appreciated by the people they care for. Some feel that all three groups do not appreciate them. Programs that are effective at improving employee health and reducing chronic diseases can reduce costs for both employees and employers.
What happens when care workers are overloaded?
In addition to feeling undervalued, care workers can experience occupational stress related to their duties. Care workers can feel physical danger because of the risks they take when treating people, which can lead to emotional and mental exhaustion. Some care workers, for example, work too hard without getting enough sleep or taking a break from their job. Some care workers don’t have enough time to spend on themselves because they are too busy working overtime to care for others. This can lead them to be too stressed out, which can cause them to have more negative feelings and thoughts about their job.
What Can We Do to Build Resiliency in Our Workforce?
In order to address this problem, we need to expand our current approach. We have been focusing on implementing wellness programs, employee assistance programs (EAP), and rolling out subscriptions to mental health apps to help workers outside work. While these are essential supports for workers, more needs to be done to identify if these wellness benefits are effective in relation to the internal company culture and staff duties within an organization. True workforce well-being relies on three pillars: 1. Work Culture, 2. Position Fit, & 3. Employee Health and Wellness. At the intersection of these three determinants of workforce well-being lies the healthiest and most productive care workers.
What is a workplace wellness program?
A workplace wellness program is a part of an overall initiative to create a healthier workforce that will improve employee productivity, lower healthcare costs, and reduce sick days. It focuses on wellness behaviors that improve health.
A typical workplace wellness program includes the following key components:
- Encouraging healthy lifestyle choices through education and resources.
- Promoting healthy eating and physical activity through onsite resources, policies, and programs.
- Helping employees make good decisions about their health and mental health with the help of online tools.
- Providing access to resources through Employee Assistance Programs (EAPs).
How Do We Know if our Employee Health & Wellness Programs are Helping?
Workforce wellness approaches for care workers can improve employee health and reduce chronic diseases. Programs that improve employees’ physical, emotional, intellectual, and social well-being help reduce costs for employers (by reducing absenteeism or increasing productivity) and provide better care to patients. However, providers may not see the rewards of their investment in these resources if they do not track the use and effectiveness of each component. Employee resources that are not promoted, not used, or not well matched to staff needs can result in high costs to providers without positive outcomes. While providers can track absenteeism before and after the implementation of a wellness program, those gross measures are not sensitive enough to identify adjustments to wellness program components which could lead to an increased positive impact on the workforce.
For example, messaging around wellness programs to help staff feel safe in using the resources, improving its use and effectiveness
“‘There still seems to be a pervasive sense among employees that EAPs are for particular and discrete problems like substance abuse or management issues,’ said Helen Darling, president, and CEO of the Washington-based National Business Group on Health. ‘The message EAPs really need to convey is that they’re a one-stop shop where employees can seek out help no matter their challenge.’ For employers of all sizes, an employee assistance program can be a low-cost, high-return benefit if implemented and communicated effectively. An easy way to say, ‘We care.'” (Reynolds, K, 2021).
Once messaging is established, increase communication and awareness of the wellness programs
Lisa McKeown of Nonprofit HR writes, “increasing awareness for your organization’s EAP is good for business. Why is it beneficial for an employer to provide an EAP for their staff? Facing life’s everyday stressors can take a personal toll on individuals, even impacting work attendance and performance levels. We all face stress and manage it differently; a little stress is normal. But when it becomes apparent that an employee’s stressors negatively impact their presence and productivity, it may indicate the need for additional support. Emphasizing your organization’s EAP keeps you a step ahead.”
How do you measure the effects of workforce wellness programs?
Online solutions, such as Opeeka’s Person-Centered Intelligence Solution (P-CIS), provide HIPAA-compliant HITRUST environments to allow confidential monitoring of wellness programs. Providers can access reports of program usage, wellness improvement indicators, and worker satisfaction with programs. This level of feedback supports providers in adjusting offerings that meet the workforce’s needs. Programs with low usage can be re-messaged or swapped out for new programs to try. Mental health apps not moving the needle on well-being indicators, such as health skills for wellness, can be discontinued and replaced with alternatives. Continuous monitoring of health & wellness programs leads to continuous improvements in the quality of offerings. This leads to increased employee health, less absenteeism, and improved productivity. But the employer will never realize the impacts of improved employee health and wellness outside of an organization if that employer is not also considering internal drivers of workforce well-being, such as company culture and employee-to-position fit.
What is Positive Work Culture?
Workforce resilience begins with the culture of the organization. A positive corporate culture is one that makes employees feel valued. Even the healthiest employees outside of work need a positive corporate culture to be productive.
One way to support a positive work culture is to establish organizational core values
Establishing and monitoring core values is a powerful way to establish and maintain core culture. For example, Opeeka’s core values listed above were established through focus groups and surveys of employees. Capturing employee voice builds strong company culture. Here are some suggested steps to establish employee-driven core values. By making employees’ voices central to the importance of the organization, the organization will build resilience in its workforce. For example, Opeeka’s P-CIS can capture and monitor employee opinions on organizational core values by quickly and easily capturing employee voices through questionnaires, surveys, and short pulse surveys through text/email. Employees can click on the pulse survey link and quickly and securely respond without login or password.
What are four steps to establishing core values for an organization?
- Review lists of potential core values (search online), and identify 20 that you think the organization does well today; Identify another 5 that you want to strive to do well in the future.
- Survey all employees on the 20 core values for how well they think you are doing today—survey employees on the importance to them for the additional five areas.
- Of the 20 surveyed, identify the top-rated core values (<10). These have become the organization’s core values today. Of the 5 surveyed, identify the top 1-2 areas of importance to strive to build strength.
- Schedule regular short pulse surveys (less than 10 questions) to ask about core values, at least quarterly.
A positive work culture means providing good support for good work and ensuring a good process
A positive work culture uses positive language. Change your organization's language on annual performance to be resilience-focused.
There is nothing more fear invoking an employee than waiting an entire year to endure a negative performance review on a document with judgmental phrasing. One way to earn trust is to create human resource and personnel policies that reflect that an organization values its workforce. Organizations that write policies with a resilience framework and focus on building strengths within personnel build stronger relationships with their employees.
Corporate culture begins with the language that the organization uses. Annual performance review templates, for example, often contain autocratic phrases. Organizations looking to change culture can rewrite policies and processes with success-focused wording aligned with organizational core values. For example, consider taking a strength-based approach to responses. In this case, the employee is rated on a Likert scale of strength from “skill needs development” to “centerpiece skill,” as seen in the figure below.
How do you create a language for success-focused performance?
- Espouse a resilience framework
- Focus on skills and strengths.
Identify employee professional goals - Communicate organizational goals
- Be solution focused
- Use compassionate wording
- Ask for feedback
- Identify ways to support
- Consider secondary trauma
- Reflect organizational core values
- Elicit ideas to improve process
- Don’t blame the people if you can fix the process
How can an organization improve culture by continuously checking in with employees?
What Is a Pulse Survey?
A pulse survey is a simple and efficient mechanism for “taking the pulse” of staff on just a few topics at a time. Unlike a traditional survey, which is often bound to measuring specific topics or content, pulse surveys’ content should be adjusted to meet real-time organizational goals. Pulse surveys should measure current status over the last week or up to 90 days.
The 3 Important Pulse Survey Elements:
Effective pulse surveys often have overarching elements which fall into the following 3 large categories or buckets:
- ‘Real-Time’ Responses. Since pulse surveys only have a few questions, they ensure you get quick, accurate, and a lot of responses. Remember: A ‘good survey response rate’ ensures larger and better data. Unlike traditional surveys, you do not have to wait one full year for pulse surveys. This helps address concerns as and when they arise, making organizations more agile.
- Tracking Actionable Data. Since pulse surveys focus on one aspect, you get clear and concise feedback that you can act on immediately. It makes it easy to devise new action plans and initiatives. These surveys can be instrumental in learning how staff sentiment about one thing or aspect changes over time. They are short and hence easy to deploy frequently.
- ‘Real Understanding’ Through Engagement. Since you have frequent and current information from the employees themselves, you can act to improve upon your organizational processes connected to employees. Organizations should know how employees regularly feel, not just a ‘one and done’ annual work review. Using staff pulse studies, organization administrators can investigate and understand the basics and ‘day-to-day’ aspects of their organization that affect employee experiences and workplace culture. Increased ‘employee voice’ translates into better staff productivity, morale, satisfaction, and retention.
How do you design a pulse survey around a topic?
Pulse surveys should focus on a specific topic that you feel impacts the performance of employees in the organization. The topic should be actionable, meaning that you plan to address the needs raised through the responses to the survey. An organization that asks about the challenges of its staff but does not address them risks further frustrating and demoralizing the staff.
- Outcome Questions. These are designed to measure trends or the impact of an initiative over time. It’s a good idea to use a scale for these questions to gauge the strength of feelings.
- Driving Questions. These questions help you determine the key drivers for the issues you are trying to measure. It could be agency practices, culture, or behaviors-the aim here is to identify actions and solutions.
- Open-Answer Questions. These questions invite employees to write their own responses. It’s an opportunity to gain deeper and more valuable insights. However, open-text questions can be hard to analyze, so keep them to a minimum.
The following example shows a pulse survey designed around teamwork. This survey can then be calibrated in P-CIS and scheduled to be texted/emailed to all employees before and after an intervention to improve teamwork.
How can you easily and quickly implement a pulse survey once it is designed?
Opeeka’s Person-Centered Intelligence Solution (P-CIS) has several advantages to quickly and easily implement workforce surveys.
- Opeeka provides several templates to start from for your workforce well-being survey as a suggestion. You can use your own surveys more modify one of these as a starting point.
- Automated insights use Success-Focused Artificial Intelligence (SF-AI) to pinpoint areas of focus that will impact workforce well-being the most.
- Longitudinal changes are tracked to see if your workforce well-being interventions are working and for whom.
- Quick and easy mobile-friendly email or text links allow staff completion in seconds.
What are 5 Factors of Pulse Survey Effectiveness?
- Purpose. It is crucial to have a plan to respond to the results. If the data show low satisfaction, what will you do? Don’t ask questions about topics you are unprepared to act on.
- Frequency. You must consider what aspects are being measured and how they will be affected over time. You may conduct a few surveys and then determine the right survey cadence for your organization.
- Spot-On Questions. This is imperative to solicit appropriate employee feedback. The questions must apply to your organization. Don’t include questions or responses that don’t relate to your employees. Use the templates, and customize what you must get actionable insights.
- Right-Size. Pulse surveys, by nature, are meant to be short and straightforward. You need to be mindful of that and not prepare long surveys such as annual or bi-annual employee satisfaction surveys. Another reason to keep them short is to encourage employee participation.
- Understand & Use Data. Use analytics on your data to uncover gap areas, discover trends and figure out patterns. Your feedback data is useless if you do not use it to bring about necessary changes.
How Can Organizations Achieve the Best Employee to Position Fit?
You will never have more of an employee’s attention and willingness to provide information than when hiring. It is essential at the time of hiring to listen and ask. Skills can be learned, and an organization can optimize retention by matching applicant values to organizational culture. It is essential to first establish the organization’s core values before hiring to meet those values. If you currently have or want to implement a pre-hiring assessment of core values and skills, P-CIS can help you understand which responses are most important for success in your organization. P-CIS machine learning and success-focused artificial intelligence (SF-AI) engines identify which combination of skills and values performs well in which types of positions. For example, care workers with medically fragile families at home may need to switch to less patient/client-facing roles to reduce anxiety for a period of time or longer. Understanding the needs of staff as they relate to the job’s duties is essential to ensuring ongoing employee-to-position fit. This fit should be evaluated annually and more often in highly changing environments.
Track goals annually to ensure ongoing fit to position
When an organization hires, it is common to ask applicants about professional goals. This question should be repeated each year to ensure that the employee’s professional goals continue to align with that of their position and advancement path. Consider the organization’s processes and procedures. Are staff overwhelmed with burdensome documentation? Can the organization diagram workflow and create efficiencies within processes for staff? It is a good time annually to re-evaluate the efficiency of processes. Ask staff where processes could be improved. Using P-CIS for documentation, for example, can reduce time spent filling out forms because P-CIS automates form completion from existing information.
What are the Benefits of Investing in Tracking Workforce Well-Being?
When employees are healthy, they have better performance in their job, leading to the top five organizational priorities influenced by employee wellness.
- Increased productivity
- Higher quality performance
- More employee engagement and morale
- Reduced benefit costs
- Increased safety
Summary of Steps to Build a Resilient Workforce
Workforce well-being is essential to the success of an organization. Employees are the most valuable asset, and they are hard to find and keep in this environment. There are several ways an organization can build and retain a resilient workforce, as summarized above.
Opeeka has created a Person-Centered Intelligence Solution (P-CIS) that can reduce time spent on documentation, increase structured communication with staff efficiently, monitor workforce well-being outcomes in real-time, direct efforts to improve workforce well-being and measure the impact of intervention efforts.
- Identify organizational core values
- Hire staff with values that match organization and position
- Find creative ways to compensate staff
- Rewrite policies with a resilience framework
- Evaluate processes and workload that burden staff
- Establish success-focused performance evaluations
- Engage workforce regularly with pulse surveys
- Monitor changes in workforce well-being over time
- Improve workforce well-being through purposeful interventions
- Take a person-centered approach and identify what works for whom
References
Prasad, K., McLoughlin, C., Stillman, M., Poplau, S., Goelz, E., Taylor, S., Nankivil, N., Brown, R., Linzer, M., Cappelucci, K., Barbouche, M., & Sinsky, C. A. (2021). Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: A national cross-sectional survey study. EClinicalMedicine, 35. https://doi.org/10.1016/j.eclinm.2021.100879
Reynolds, K. Employee Assistance Programs – Underlying Message, We Care. https://www.thinkinnovative.net/blog/employee-assistance-programs-underlying-message-we-care/. Accessed 10/3/2021.
McKeown, L. Jumpstart a Conversation about Your Organization’s Employee Assistance Program. https://www.nonprofithr.com/reintroducing-employee-assistance-program/. Accessed on 10/3/2021.
