Employee engagement remains a crucial focus for healthcare leaders grappling with staffing shortages and meeting productivity and care quality standards. In 2024, only 32% of U.S. employees report being actively engaged at work, while nearly 18% feel “actively disengaged,” according to Gallup polling.
This growing divide highlights the need for strategies that foster a positive, purpose-driven workplace culture, particularly in the healthcare sector, where engaged employees are more likely to deliver responsive and compassionate patient care.
A Nov. 12, 2024, MGMA Stat poll explored how health leaders’ employee engagement scores have changed over the past year. Among 260 applicable responses, 40% of health leaders reported that engagement scores improved, while 15% reported a decrease in engagement scores, and 23% indicated scores stayed the same. The remaining 21% were unsure about their organization’s engagement trends.
For the 40% of leaders who saw improvements, some key drivers were:
- Increased one-on-one check-ins
- Enhanced benefits
- New recognition programs
Others credited compensation adjustments and culture-building efforts as essential to creating a supportive environment.
For the 15% of members reporting decreases, factors that were prevalent included:
- Burnout
- High turnover
- Staffing shortages
- Wage dissatisfaction
As one respondent explained, “Employees are not being paid enough to make ends meet.”
Meanwhile, among the 23% who reported steady engagement, consistent pay and benefits were common factors. “Our engagement is always above 92% and has stayed that way,” shared one respondent, adding that leadership stability and recognition programs such as “staff meals and fun events” helped sustain employee morale.
These responses reflect the diverse approaches and ongoing challenges in managing employee engagement in the healthcare industry, highlighting the need for a holistic approach that addresses critical issues like burnout, fair wages and adequate staffing. Beyond addressing these fundamentals, fostering a supportive culture, aligning values and helping employees find purpose in their roles can play a powerful role in preventing burnout and strengthening retention.
By acting on both practical and cultural fronts, healthcare organizations can create an environment where staff feel both supported and motivated.
Insights from the 2024 Leaders Conference on employee engagement
At the 2024 Leaders Conference, Tracey Schwartz, Vice President of Operations at Ascension Medical Group, and Ron Menaker, Administrator for Radiology, Mayo Clinic, outlined key strategies to build employee engagement — from aligning organizational values to creating opportunities for career growth and promoting workplace joy — during their session, “Enhancing Employee Engagement to Optimize Retention.”
Defining employee engagement
According to Schwartz, employee engagement reflects "the level of enthusiasm and dedication somebody feels towards their job." This sense of commitment is crucial because, as Schwartz explained, engaged employees are more productive, responsive and committed to high-quality patient care.
“When employees are engaged,” Schwartz noted, “productivity increases ... they’re not on Facebook quite as much. They’re not playing on their phones. They’re not looking for other jobs. They are doing more things that benefit your organization.”
Beyond improving employee retention, high engagement levels positively impact patient care. Engaged employees are more responsive to patient needs, whether it is returning calls, answering patient support messages faster or following up on orders.
Schwartz referenced Maslow’s hierarchy of needs to explain the foundation of employee commitment. For employees to be fully engaged, their basic needs — such as safety and security at work — must be met first. “If your associates don’t have those [basics], they can’t think about anything else,” she noted. Only then can they form meaningful connections with colleagues and find purpose in their roles.
A powerful example of purpose-driven engagement came from one of Schwartz’s associates, who had lost his brother to unmanaged early-onset diabetes. “Because of that experience, he had a heart for primary care — to make sure other families didn’t go through that same challenge,” she shared. For him, the work was deeply personal, transforming his job into a mission. This story, Schwartz emphasized, shows how personal connections to the work can inspire dedication and help employees find fulfillment and purpose.
While purpose and connection are key to engagement, they’re part of a broader picture. The speakers next introduced the PERMA model, a foundational framework for cultivating lasting happiness and well-being that can be seamlessly applied to the workplace.
Related:
The PERMA model: A framework for flourishing
"I’ve heard some people say, ‘Man, this work is not very pleasurable,’” Menaker explained. “But work isn’t really supposed to be pleasurable — pleasure is for things like a massage or eating a good meal.”
“Happiness, though, lasts a bit longer,” he continued. “It’s about flourishing, and flourishing includes elements beyond short-lived pleasures.”
The PERMA theory of well-being, initially developed by positive psychologist Martin Seligman, comprises five elements — positive emotions, engagement, relationships, meaning and accomplishment — each building toward long-lasting happiness and satisfaction:
- Positive emotions: Cultivating a positive atmosphere at work by acknowledging achievements and maintaining respectful interactions contributes to employee satisfaction. Positive emotions set the tone for a supportive and motivated workplace.
- Engagement: The feeling of “flow” or being absorbed in one’s work tasks is a major indicator of engagement. Engaged employees are naturally aligned with their responsibilities and are motivated to achieve excellence.
- Relationships: Strong relationships are essential for a cohesive team environment. Menaker highlighted the importance of trust and camaraderie, mentioning that teamwork at Mayo Clinic begins with reviewing shared values, reinforcing their role in relationship building.
- Meaning: Employees need to feel that their work has significance. Schwartz’s example of an employee driven by a personal tragedy to help others illustrated how finding personal relevance in work enhances commitment.
- Accomplishment: Recognition and a sense of achievement reinforce the value of employees' contributions. Feedback mechanisms and development opportunities discussed in the session contribute significantly to this element.
Each element of the PERMA model can foster a more meaningful work environment where employees feel valued, connected and motivated to excel. Building on these foundations, the speakers introduced a practical five-point model — values alignment, appreciation, feedback, development and joy — representing actionable steps that leaders can use to enhance engagement.
Values alignment as the foundation of workplace culture
Menaker underscored that values alignment is not just a philosophical concept but an actionable approach to building a cohesive and motivated workforce. To foster a genuine culture where values guide daily decisions and behaviors, Menaker shared specific steps leaders can take to weave these principles into the very fabric of their organizations:
- Start meetings with a value: Menaker shared that at Mayo Clinic, “we start every meeting with these values.” This practice encourages regular reflection on values and can be implemented by leaders to reinforce organizational principles consistently.
- Avoid values becoming mere “plaques on the wall”: Menaker warned against values that are passively displayed without active engagement, as this can create “mistrust and cynicism.” Leaders can combat this by actively incorporating values into daily operations and decision-making, keeping values dynamic and alive in the organization.
- Change behaviors to shape culture: "You don’t change your culture; you change behaviors which shape your culture,” Menaker emphasized. This suggests that to strengthen values alignment, leaders should identify specific behaviors that embody organizational values and focus on reinforcing those behaviors to shape a positive culture.
- Treat culture as a strategic asset: Menaker called culture the “ultimate strategic asset” because it’s unique to each organization and “happens millions, if not billions, of times over the course of a year.” Leaders should therefore view culture as central to their strategic goals, integrating values into every level of the organization to maximize long-term engagement and success.
These steps create a foundation for meaningful engagement by establishing a clear, values-driven culture. By aligning actions and behaviors with core principles, leaders reinforce integrity within their teams and cultivate an environment where employees feel connected to the mission. This values-based approach naturally extends into other areas of employee engagement, from personalized appreciation to development and feedback, further strengthening the bonds between individuals and their work.
Related:
- Formalizing values review: An organizational strategy to shape culture (MGMA article)
- The impact of values on organizational success (MGMA article)
- Shaping a culture: Implications for leaders (MGMA article)
- Engaging staff and fostering joy at work (MGMA article)
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