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Cultivating employee voice to enhance organizational performance within healthcare organizations

Insight Article - December 5, 2019

Culture & Engagement

Bob Sachs PhD
Michael Papay
In healthcare, perhaps more than in any other industry, operational issues have a huge impact on the employee experience and, in turn, patient outcomes. For years, healthcare operations have focused on eliminating waste and reducing costs. Today’s successful healthcare organizations are also continually seeking ways to improve the patient experience.

Enlisting employees in creating solutions rather than just implementing them is critical to achieving positive outcomes. Research demonstrates the significant benefits associated with healthcare organizations that encourage and enable employees to offer ideas on how to improve their workplace and enhance organizational performance. Some of these benefits include:
  • Optimizing the insights of employees closest to the customer to improve customer experience
  • Identifying ideas to improve performance
  • Surfacing concerns that impact productivity and employee retention
  • Better engaging employees to enhance organizational agility and innovation 
  • Understanding employee perspectives that inform organizational decisions
  • Leveraging diversity of thought, background, experience, level and role.
In short, giving employees a voice about topics that matter can help to improve the operational performance of a healthcare organization while enabling it to become more responsive to patient needs.

Creating a work environment that supports employee voice 

A critical variable to giving employees a voice is creating an environment in which they feel safe enough to express their ideas. Leadership behavior is key to creating this climate of safety. In healthcare, there’s a great deal of nuanced information, so much so that no one person can have all the answers. Consequently, leaders need to be humble, asking employees questions to tap their wisdom. Showing interest in the insight of others leads to better outcomes and more realistic expectations for all employees.

Another key element of employee voice is a commitment to inclusive decision-making. Employees don’t come to work to be surveyed and analyzed. They want to know their work is making a difference, their opinions and insights will be used to improve the organization, and that they will be included in the conversation and decision-making with leaders and managers.

In traditional organizations, decisions are often made by a small, narrowly defined set of leaders. To successfully engage frontline managers and employees who will execute on those decisions, leaders need to include everyone’s voice in topics that matter (e.g., values, culture, strategy, change, process improvement). This helps employees feel connected to the organization and empowered to drive change. Employees are far more likely to get on board with decisions if they understand and contribute to the reasoning behind them.  This kind of involvement increases the likelihood that they will support implementation, make the organization more resilient to change, reduce burnout and help with talent retention.

Case study: UCHealth

UCHealth is an award-winning academic healthcare system with more than 23,000 employees, 12 hospitals and more than 100 clinics. 

Matthew Gosney, EdD, vice president of organizational development at UCHealth, and his team knew that higher levels of employee satisfaction typically lead to better performance and better patient outcomes in healthcare. With the goal of increasing employee satisfaction, they decided to evolve the employee voice process at UCHealth.

When choosing an employee feedback platform, the UCHealth team needed a solution that could help a large organization navigate various locations and communities, as well as multiple types of employees. They wanted to be able to ask and interpret open-ended questions. They also wanted their already busy staff to be able to take the assessments quickly and easily, and have the ability to compare responses from various teams and business units. 

After evaluating vendors, UCHealth decided on a crowdsourced employee voice platform and partnered to come up with what they call the “Employee Voice Model,” with the following desired outcomes:
  • Engagement: A workforce excited about working for UCHealth that gives their best efforts
  • Trust and transparency: Employees should know and trust that someone listens to their input.
  • Immediacy: Employees should know that their suggestions or comments are acted on.
  • Alignment: Maintaining communication and alignment throughout the organization is critical.

Crowdsourcing enabled UCHealth to reduce the number of questions on their employee surveys from 45 to just six. “We chose six questions that were highly actionable and gave us a quick opportunity to engage our employees and get feedback fast,” Gosney said. “The pulse was open for two weeks and then we moved into the next phase, which we called the engagement summit. We brought leaders together in a forum led by the chief executive officer (CEO) in their region for a root cause analysis and best practice conversation.”

With a CEO-led conversation, employees knew their feedback was important and the problems that needed to be addressed. It also modeled for organizational leaders how to have similar follow-up conversations with their staff.

Gosney explained, “A month after that first crowdsourced Employee Voice pulse, leaders went back to employees and asked, ‘Has anyone talked to you about your Employee Voice results?’ This created transparency and accountability. Then we repeated the process all over again. The second check-in we asked, ‘Have any changes been implemented, and what impact has it had on your team?’”

The entire process of the UCHealth pilot ran in a very abbreviated time frame. “We had very little expectation that we were going to drive engagement noticeably; really we were looking at an action check-in,” Gosney said “We were, frankly, astounded to see that we did improve employee engagement by a notable amount, and we improved across the board. Across all of our questions, we saw improvement between 2% and 4%. That includes ‘enthusiasm,’ which is actually the engagement question: ‘Are you enthusiastic about working for UCHealth?’ There we saw 4% improvement.” Employee Voice improved engagement throughout the organization in a very short amount of time. UCHealth also saw an increase in patient satisfaction scores as engagement increased.

Over the past two years, UCHealth’s Employee Voice process has delivered an 8% increase in overall engagement, a 13% increase in connection to the organization’s mission and a 15% increase in leader trust. “What these results demonstrate is that engagement truly is a function of a leader’s willingness and commitment to engage in transparent, authentic conversations with their team,” Gosney said. “And when those conversations lead to tangible action, the results can be extraordinary.”

Tips for healthcare leaders

The more relevant and actionable the employee input, the more valuable it is to the organization and the more likely leaders will respond positively, which reinforces the continued expression of employee voice. Here are some actions healthcare leaders can take to create a virtuous cycle of actionable insight:
  1. Develop business understanding. Employee voice will be more relevant the better employees understand the organization’s business including key performance drivers and indicators, customers’ expectations, and competitors.
  2. Communicate organizational priorities. Employees need to understand the top organizational priorities and appreciate how the work they do contributes to achieving those priorities. When employees have a “line of sight” their inputs can be more on target.
  3. Build performance improvement skills. When employees are equipped to analyze performance and generate and test improvement ideas, their inputs will likely reflect data and good thought.
  4. Provide opportunity to reflect. Organizations demonstrate real interest in employee insights by asking for them and by structuring opportunities for them to think about the organizational priorities and develop their ideas. 
  5. Build the ability of employees to offer actionable insights. Actionable insights include facts and evidence, a clear context for application and specific actions that should be taken. These insights are built on business understanding, awareness of organizational priorities, and having the time and skills to examine performance.
  6. Visibly recognize contributions. Employees are encouraged to offer ideas when they observe the organization demonstrating appreciation for those ideas. This recognition can also reinforce the kind of ideas that provide organizational value.
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About the Authors

Bob Sachs
Bob Sachs PhD
Senior Talent Advisor Sachs Talent Advisors

Bob Sachs is a talent advisor and executive coach who has focused his career on helping companies enhance organizational performance by designing and implementing systems and processes to ensure they have the right people, performing the right work motivated to produce superior results. As vice president, National Learning and Development, Kaiser Permanente, Sachs’ responsibilities included succession management, leadership development and supporting the overall learning agenda of the organization.  
Bob Sachs can be reached at

Michael Papay
Michael Papay
Co-Founder & Chief Executive Officer Waggl

Michael Papay is a technology entrepreneur with almost 20 years of experience building and leading software as a service (SaaS) businesses within the discipline of human capital management. Over the past 20 years, the products Papay and his teams created have improved the performance and engagement of countless organizations and hundreds of thousands of employees around the globe. As co-founder and chief executive officer of Waggl his mission is to transform the way organizations use Employee Voice to listen and improve employee experience and, in turn, the organizational performance. Michael Papay can be reached at 


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