2013 Employee Satisfaction Results

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2013 Employee Satisfaction Results

In April of 2013 all ECDHD employees were given an opportunity to complete a

voluntary employee satisfaction survey online. Out of 79 employees employed at the time of the survey 29 or 37% completed the survey. This is down from the 47% last year but still represents more than one in three employees. This report covers the results of the latest survey and compares the current results to past results and when available looks at how the staff compare with other populations of employees in similar settings.

Trending graphs are given for each question comparing the results from 2013 with results from 2005, 2006, 2007, 2008 and 2012. With the exception of the survey in 2012 the previous surveys had been given in the fall and winter (October to December). No employee satisfaction surveys were given in 2009-2011, the last survey was done in December of 2008 and the next survey in March of 2012, making a gap of thirty nine months. The questions have remained the same for all the years given with a new question added from 2008 forward.

Employee Satisfaction Goals:

The main goals for ECDHD is to work to improve our employee satisfaction rates from year to year and to understand what are the areas of strengths and weaknesses. The survey will be divided up into some major categories for this report to include:

1) Overall Job Satisfaction which is covered in Questions 1-9, 2) Overall Employment conditions, employee support and training which is covered in Questions 10- 24, and question 28, 3) Overall views of Management which is covered in Questions 25-27, 4) Culture of the agency which is covered in Questions 29-33.

Section One: ECDHD Employee Overall Satisfaction

In looking at the results of our survey for 2013 while we do not have an overall job satisfaction question, we have nine questions related to overall job satisfaction asked to employees. The average of the nine questions related to Overall job satisfaction was 89.11% up from 77.44% in 2012. This represents a significant improvement. The lowest area was satisfaction with salaries.

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Question 1: How would you honestly rate your overall satisfaction in Job Duties/workload?

Workload was also explored in the National Surveys reviewed however the questions were very different. 25% of the US workforce and US healthcare workforce feels that they have more work than they can finish. The percentage is higher in a National CHCs study with 32% of the workforce feeling that they have more work than they can finish. Question 2: How would you honestly rate your overall satisfaction in Salary?

Salary adjustments are usually slated for the end of May beginning of June and are included in the board approved budget. While this is one of our poorest measures it is

Excellent Good Fair Poor

2005 22 67 7 4 2006 30 43 14 14 2007 31 49 18 3 2008 18 67 12 3 2012 33 48 15 4 2013 29 63 5 3 0 10 20 30 40 50 60 70 80 P e rc e n ta g e 1. Job Duties/workload

2005 19 59 22 0 2006 14 49 27 11 2007 0 46 46 8 2008 3 58 27 12 2012 7 39 41 13 2013 3 60 32 5 0 10 20 30 40 50 60 70 P e rc e n ta g e 2. Salary 2013 Notes on Question 1 30% of employees felt that the workload was

excellent, dropping 3% from last year which was the best of the years recorded.

92% felt that the job duties and workload were

excellent or good, this is the best year ever recorded.

2013 Results: Only 3% of staff felt the salary was excellent (the lowest recorded level), however, 63% were in the top two brackets. In 2005 78% of employees felt that their salary was Excellent or Good this was the highest percentage, 2013 was higher than the 2012 levels at only 46%.

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still higher than the three comparisons. According to NACHC (January 24th_{, 2013}

PowerPoint) the US comparison is that 22% of employees are extremely or somewhat unsatisfied with their salary, this is the same for US healthcare workers. 27% of US CHC staff are unsatisfied or extremely unsatisfied with their salary.

Question 3:

How would you honestly rate your overall satisfaction in Working Conditions?

Question 4:

How would you honestly rate your overall satisfaction in Supervision?

2005 55 41 0 4 2006 35 35 19 11 2007 18 57 23 3 2008 15 64 18 3 2012 20 61 17 2 2013 16 76 8 0 0 10 20 30 40 50 60 70 80 P e rc e n ta g e 3. Working Conditions

2005 48 41 7 4 2006 35 27 27 11 2007 28 46 21 5 2008 33 46 18 3 2012 46 39 13 2 2013 39 53 8 0 0 10 20 30 40 50 60 P e rc e n ta g e 4. Supervision

In 2005 our best year more employees felt that their working conditions were Excellent or Good at 96%.

Currently 92% of employees feel that their working

conditions are

Excellent or Good (up significantly from 2012)

Satisfaction with Supervision is at the highest level ever! 93% of employees feel that their supervisor is Excellent or Good. 0% feet that Supervision is Poor. This speaks well of the current Senior Management and Management Team.

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Gallup research shows that supervisors play a crucial role in worker wellbeing and engagement. Gallup research indicates that a positive relationship with the supervisor has an important effect on employee engagement. Recent trends are very positive.

Question 5:

How would you honestly rate your overall satisfaction in training/orientation?

Question 6:

How would you honestly rate your overall satisfaction in company policies?

2005 22 59 15 4 2006 32 30 32 5 2007 15 54 23 8 2008 21 42 30 6 2012 20 65 11 4 2013 18 58 21 3 0 10 20 30 40 50 60 70 P e rc e n ta g e 5. Training/Orientation

2005 7 71 22 0 2006 30 32 22 16 2007 15 31 36 18 2008 9 46 36 9 2012 30 50 20 0 2013 18 71 11 0 0 10 20 30 40 50 60 70 80 P e rc e n ta g e 6. Company Policies In 2012 85% of felt that the training/orientation was Excellent or Good. In the worst year only 62% felt that we had a training/orientation program that was favorable. This year the rate was 76%

The agency’s

company polices are viewed favorably by 89% of employees. The past five years the agency has worked hard to update, review and improve the policies. There were no employees who viewed the policies as poor in 2012 or 2013.

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Question 7:

How would you honestly rate your overall satisfaction in Benefits?

Question 8:

How would you honestly rate your overall satisfaction in advancement Opportunities?

2005 19 63 15 4 2006 22 39 25 14 2007 13 36 44 8 2008 12 46 30 12 2012 15 46 37 2 2013 18 50 29 3 0 10 20 30 40 50 60 70 P e rc e n ta g e 7. Benefits

2005 19 63 7 11 2006 28 33 25 14 2007 18 44 26 13 2008 12 55 21 12 2012 17 48 22 13 2013 16 55 21 8 0 10 20 30 40 50 60 70 P e rc e n ta g e 8. Advanced Opportunites

Of our ECDHD employees at this time 68% view their benefits as favorable. This is interesting as only 36% of employees are taking health insurance. In 2013 there was a change to how employees view advancement opportunities over the past years surveys. About 71% feel they have excellent or good opportunities to advance with the agency, this is the second best with only 2005 better.

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Question 9:

How would you honestly rate your overall satisfaction in our company image?

Section 2: Overall Employment conditions, employee support and training. This next section of fifteen questions will address some other indicators of overall employee well-being. Many these indicators deal with the ability of the staff to

communicate their needs and expectations. The average for this section is 91.53% up only slightly from 2012 when the average was 91.33%.

It appears that supervisors are quite good at communicating their expectations to employees as 98% in 2012 and 100% in 2013 of our staff know what is expected of them at work, however, it appears that employees that may not have the right equipment and materials to do their job well and the trend is increasing 9% of our employees in 2012 reported that they do not have the right materials and equipment to do their jobs, this has increased to 13% in 2013. In April and May 2013 after this survey was released we have been updating and replacing some non-functional equipment (printers and computers).

Communication is one of the most critical elements in the workplace in fact it is listed as one of the top ten drivers of job satisfaction. We have many questions that address communication between the employee and supervisor. Most employees feel free to discuss concerns with their immediate supervisor and believe they are fair.

2005 37 55 7 0 2006 39 42 17 3 2007 26 52 21 3 2008 15 61 21 3 2012 30 50 17 2 2013 32 58 10 0 0 10 20 30 40 50 60 70 P e rc e n ta g e 9. Company Image In 2013 90% of ECDHD employees believe that the company image is favorable, with 0% believing the

company image is poor. This is the most positive perception by

employees of ECDHD image since 2005.

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The lowest score in this section was 79%, dropping 10 points in the past year on the question someone has talked to me about my progress.

Question 10. Regarding your employment here do you know what is expected of you at work?

Question 11. Regarding your employment here do you have the materials and equipment you need to do your work right?

Yes No 2005 85 14 2006 91 9 2007 98 3 2008 94 6 2012 98 2 2013 100 0 0 20 40 60 80 100 120 P e rc e n ta g e

10. Do you know what is expected of you at work? Yes No 2005 96 4 2006 83 17 2007 87 13 2008 97 3 2012 91 9 2013 87 13 0 20 40 60 80 100 120 P e rc e n ta g e

11. Do you have the materials and equipment you need to do your work right?

This measure was very positive as well with 100% of our staff who know what is expected of them at work.

Another of the top drivers of employee satisfaction is how well job responsibilities are defined, the more defined the more employee satisfaction.

Approximately 1 in 10 of

employees do not feel that they have the right materials and equipment to do their work right.

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Question 12: Regarding your employment here at work, do you have the opportunity to do what you do best every day?

Question 13: Regarding your employment here in the last six months, have you received recognition or praise for doing work?

12. At work, do you have the opportunity to do what you do best every day?

Yes No 2005 85 15 2006 79 21 2007 85 15 2008 82 18 2012 93 7 2013 84 16 0 10 20 30 40 50 60 70 80 90 100 P e rc e n ta g e

13. In the last six months, have you received recognition or praise for doing good work?

This was most positive as 100% of our employees who took the survey answered this question favorably. This is one of the top ten drivers of Job Satisfaction according to the NACHC studies.

This is an area that we seem to have slipped backward on, dropping from 93% to 84%.

The degree to which work is respected is one of the top ten drivers of Job Satisfaction for all staff clinical or non-clinical.

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Question 14: Regarding your employment here does your supervisor or someone at work seem to care about you?

On the NACHC employee survey items such as “staff members trust and respect each other” were selected by 96% of employees as important, but scored as occurring only 65% of the time. The item “The people you work with demonstrate a sense of team spirit and helpfulness” was identified by 95% of health center staff nationwide as

important and scored as occurring only 75% of the time by those completing the survey. Question 15: Regarding your employment here is there someone at work who

encourages your development?

14. Does your supervisor or someone at work, seem to care about you?

Yes No 2005 85 15 2006 91 9 2007 85 15 2008 85 15 2012 91 9 2013 97 3

15. Is there someone at work who encourages your development?

On this indicator in 2013 we had the highest level ever at 97% , tying directly with the previous question.

In 2013

employees gave this the highest score ever since 2005 with 97% of those who

completed the survey feeling that someone at work cares about them.

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Question 16: Regarding your employment here at work do your opinions seem to count?

Question 17: Regarding your employment here does the mission and purpose of the company make you feel your job is important?

ECDHD has a lot to offer staff including the motivation and commitment that comes from serving the community in a variety of prevention activities such as reducing

Yes No 2005 75 25 2006 66 34 2007 69 31 2008 64 36 2012 82 18 2013 82 18 0 10 20 30 40 50 60 70 80 90 P e rc e n ta te

16. At work, do your opinions seem to count?

17. Does the mission/purpose of your company make you feel your job is important?

This indicator showed significant

improvement in the past two years over early years with 82% of all employees who completed the survey believing that their opinion was important to the agency.

95% of those who

completed the survey felt that the mission or the purpose of the company make them feel that their job is important. The mission of public health and community health centers are very different than the mission of for profit agencies.

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obesity, youth alcohol use, tobacco use and WIC. In addition we provide quality health care to those who would otherwise be underserved, giving employees an opportunity to help others and enabling them to make good use of their skills and abilities. According to NACHC the most satisfying aspect of working at a CHC is helping the medically disenfranchised and making a difference in their lives.

Question 18: Regarding your employment here are your associates and fellow employees committed to doing quality work?

Question 19: Regarding your employment here would you describe your working relationship with fellow workers as being pleasant?

Yes No 2005 70 30 2006 77 23 2007 75 26 2008 82 18 2012 84 16 2013 84 16 0 10 20 30 40 50 60 70 80 90 P e rc e n ta g e

18. Are your associates committed to doing quality work? Yes No 2005 100 0 2006 86 14 2007 90 10 2008 94 6 2012 93 7 2013 97 3 0 20 40 60 80 100 120 P e rc e n ta g e

19. Would you describe your working relationship with fellow workers as pleasant?

Over the years it has been a

growing trend that our employees believe that their co-workers are committed to doing quality work. This has increased 14% since 2005.

Pleasant working relationships with co-workers help

employees to be engaged and feel a connection to the agency. In 2005 100% of the of the

employees felt they had a pleasant relationship with co-workers, this year the rate is 97%. A healthy work

environment moves the organization forward, at 97% we are higher than the Gallup averages discussed below.

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Gallop reports that when survey respondents were asked how they would characterize their interactions with their coworkers, 86% of engaged employees said their

interactions with coworkers were always positive or mostly positive. The findings for less engaged workers showed significantly different results: 72% of not-engaged workers characterized these interactions as always or mostly positive, compared to just 45% of actively disengaged workers.

Question 20: Regarding your employment here in the last six months has someone at work talked to you about your progress?

Do some employees feel that the evaluation does not include a discussion of their progress? We have lost all the 11% points previously gained.

Question 21: Regarding your employment here in the last year have you had opportunities at work to learn and grow?

20. In the last six months, has someone at work talked to you about your progress?

Yes No 2005 85 15 2006 94 6 2007 85 15 2008 79 21 2012 89 11 2013 92 8 P e rc e n ta g e

21. In the last year, have you had opportunities at work to learn and grow?

In 2005 as a result of this survey we changed how we do employee

evaluations to do them every six months. So while we have a formal process every six months employees feel that they are not having

discussions on their progress.

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Question 22: Regarding your immediate supervisor and training: My supervisor gives clear and understandable instruction.

Question 23: Regarding your immediate supervisor and training: I feel free to discuss my ideas and concerns with my immediate supervisor

22. My supervisor gives a clear and understandable instruction. Yes No 2005 85 15 2006 71 29 2007 77 23 2008 82 18 2012 86 14 2013 92 8 0 10 20 30 40 50 60 70 80 90 100 P e rc e n ta g e

23. I feel free to discuss my ideas and concerns with my immediate supervisor. This is a good indicator of communication from the supervisor to employee. At 97% it is the strongest it has been since we started surveys.

Highest level since inception of survey.

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Question 24: Regarding your immediate supervisor and training: I believe my immediate supervisor is fair and unbiased.

Overall views of Management

While ECDHD has always had good senior management, new ways of doing things have taken place with management changes and it shows on the employee satisfaction surveys. The lowest rating in this section was 81% in 2012 and the average was

83.75%, in 2013 the lowest score was 84% and the average was 92%. Question 25: Management demonstrates a true concern for its employees.

24. I believe my immediate supervisor is fair and unbiased. Yes No 2005 81 19 2006 77 23 2007 71 29 2008 78 22 2012 84 16 2013 84 16 0 10 20 30 40 50 60 70 80 90 P e rc e n ta g e

25. Management demonstrates a true concern for its employees.

Nine out of ten employees believe their supervisor is fair and unbiased.

Highest level since inception of survey with our agency. There is always room for improvement and we should keep focusing on this area since it is a key indicator of employee retention and happiness.

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The very top driver of employee satisfaction according to NACHC is that “attention is paid to providing staff satisfaction”. According to the NACHC survey the main reason for job dissatisfaction is unsatisfactory leadership in senior management.

Question 26: Management is willing to listen to the suggestions of employees.

Question 27: Management is willing to make corrections and changes in the company.

26. Management is willing to listen to the suggestions of employees. Yes No 2005 81 19 2006 77 23 2007 62 39 2008 75 25 2012 81 19 2013 90 10 0 10 20 30 40 50 60 70 80 90 100 P e rc e n ta g e

27. Management is willing to make corrections and changes in the company.

Scores have increased steadily since 2007 when they were low at 69%, this years 97% is most likely related to QI teams which have increased yearly. Scores have increased steadily since 2007 when they were low at 62%, the 90% is our highest level to date.

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Question 28: I’ve received the training I need to do my job.

Culture of the agency

The next four questions deal with agency culture. In our agency there is the potential for many competing cultures. The East Central culture vs the Good Neighbor Culture, the conflicting needs of patients, families, counties, communities, providers, federal agencies, insurance companies, etc. can create inconsistencies and mixed employee messages.

In addition to the issues mentioned earlier, there are many programs that could become “silos,” where each department or program operates independently, without

understanding the full implications of its actions on others. Over the past several years we have worked to reduce or eliminate competing cultures. We have worked together better than ever before and I believe that is a large part of why our employee surveys are improved and are so positive.

Another part of culture is healthcare culture. Many have said that a culture of blame has been pervasive in healthcare. Because medicine was often viewed as the work of a sole physician (or other professional) working with an individual patient, when

something did not go well the automatic reaction was to try to determine who was at fault and, often, to discipline them. This “shame and blame” approach leads to hiding rather than reporting of errors, and thus is does not lead to a culture of safety. Over the past six years we have worked to encourage people to report problems rather than hide them, so they can be addressed.

In 2012 the average for the first four questions was 85% the average in 2013 is 88.5% which is an improvement over the previous year.

28. I've received the training I need to to do my job. This was an area we discussed at length last year, plans for more training have been developed in some areas to include more emphasis on orientation. More work needs to be done but the 97% is the best we have had in this area.

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Question 29: I feel this company has been aware of the work I do and gives appropriate attention to my efforts and recognition for my achievements.

We have had several employee recognition events over the past several years that have cost the company relatively little but have made a positive difference to our employees. Ambassadors our internal employee operated employee recognition program provides much assistance.

Question 30: I find the workload to be fair.

29. I feel this company has been aware of the work I do and gives appropriate attention to my efforts and recognintion for

my acheivements Yes No 2005 70 30 2006 63 37 2007 74 26 2008 67 33 2012 77 23 2013 81 19 0 10 20 30 40 50 60 70 80 90 P e rc e n ta g e

30. I find the workload to be fair. Most of our employees, 81% feel that the workload is fair. This is the highest percentage we have ever had in the history of the survey and is higher than the US healthcare average. Scores have increased steadily since 2007 when they were low at 72%, the current rate is the highest it has been. Making our employees feel appreciated needs to be a priority every day of the year.

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Of the overall US workforce 48% feel that their workload is challenging but fair and this compares with 50% of the US healthcare workforce and CHC workforce feeling the same way.

Question 31: Would you recommend a friend to work at our company?

Question 32: If you saw something that negatively affects patient care do you feel you could speak up freely?

31. Would you ever recommend a friend to work at our company? Yes No 2008 78 22 2012 91 9 2013 92 8 0 20 40 60 80 100 P e rc e n ta g e

32. If you saw something that negatively affects patient care, do you feel you could speak up

freely?

This is a critical indicator of employee satisfaction. We have 94% of our employees who would recommend our company to a friend. This represents a significant improvement over 2008. Work still needs to be done on this measure to ensure patient safety.

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Question 33: As far as you knowledge, how often are mistakes in patient care reported?

The purpose of this document is to learn where we were in the past and where we were in April of 2013 and to discover how we can use these results to improve our numbers of engaged satisfied employees.

The results of this survey will be shared with the following groups: • The Quality Assurance Council at the April Meeting

• An overview with the management team at the May Meeting • The personnel committee of the board at the May Meeting • The Senior Management Group at the May 6th Meeting • The ECDHD and GNCHC boards at the May Joint Meeting

• The employees as a whole by posting it on the X-drive after the May meeting In 2013 the agency showed improvement in all four areas of performance, some areas improved more than others. NACHC provides the following list of the top ten drivers of Job Satisfaction, most of these items we are measuring in our current employee

satisfaction survey.

Always Sometimes Almost

Never Never I don't know 2008 30 30 15 3 22 2012 49 21 14 5 11 2013 35 46 8 3 8 0 20 40 60 80 100 P e rc e n ta g e

33. As far as you have knowledge, how oftern are

mistakes in patient care reported? When you remove the 8% who do not know and most likely work in non-clinical areas those answering in the top two tiers will be 88% of staff. In 2008 76% answered in the top two favorable fields. All mistakes in patient care need to be

reported to ensure safety. In 2012 78% answered in the top two tiers, however nearly 50% said mistakes are always reported.

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Top Ten Drivers of Job Satisfaction 1. How well job responsibilities are defined

2. The degree to which the work done is respected 3. The effectiveness of communications

4. How well work is divided within departments 5. The program/policy of reward and recognition 6. How well the agency fulfills its mission

7. The degree to which staff abilities and skills are used 8. Immediate supervisors

9. Documentation/paperwork/record keeping 10. Opportunities for advancement

Employee Satisfaction Survey Action Plan for 2013:

The Senior Leadership team met to review the job satisfaction surveys on Monday May 6th_{, 2013 In reviewing the employee satisfaction results the following items stood out:}

Positives: In reviewing the employee satisfaction surveys we know that the employees who took the survey:

1. In all four of the areas reviewed there was improvement.

2. Overall employee job satisfaction improved the most over the past year moving from 77.44% to 89.11%. See Questions 1-9

3. The lowest area of employee job satisfaction is salary. See Question 2. 4. The Overall employment conditions has been one of our highest areas in the

past and this year 91.53% of answers are in the highest two brackets. This is a slight improvement (not statistically significant) over last year’s 91.33%.

5. 100% of employees know what is expected of them at work. This is the first time we have seen this level.

6. Overall the views of management have improved over the past year and is the second highest area of improvement moving from 83.75% to 92%. It is now the highest point of employee satisfaction.

7. The culture/working environment of the agency also improved from 85% to 88.5%.

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Areas for Improvement: In reviewing the employee satisfaction surveys we know that the employees who took the survey:

1. Salary had lower rates of satisfaction than other components of the overall satisfaction; people many not understand how salary is set. Question 2

2. Not everyone felt that they had the right materials and equipment to do their job right. This area has become more negative over the past year. Question 11 3. Not all of our employees feel that they are trained correctly. Question 28 4. Sometimes for some positions there is no formal training program. Question 28 5. Need a stronger training package for new employees. Question 28

Action steps for 2013-2014:

1. Continue to offer employees an opportunity to provide input regarding overall employee satisfaction on an annual basis. Explore contracting with NACHC or another service to do the survey and move it out of our employee workload. 2. We need to continue to follow-up on Question 11 and find out what equipment

and resources our agency needs.

3. Provide transparency in the results of employee satisfaction by continuing to post on the X-drive.

4. Continue to work on the employee training and orientation program for all staff through the management team.

5. Complete the interpreter training program in the next 12 months.

6. Continue to work to provide competitive compensation for all employees, by offering pay raises in 2013.

7. Continue to review job descriptions at the time of employee evaluations to make sure job responsibilities are well defined.

8. Maintain regular lines of communication with staff through EWS messages, employee memos and departmental meetings to keep staff informed about their work expectations and benefits.

9. Communicate and promote the mission of the agency to the staff.

10. Encourage staff to always share any patient care mistakes without fear of repercussions.