The Real ROI of Engagement in Healthcare

Employee engagement is often seen as one of those quality-of-life metrics rather than a financial driver. However, as more leaders look for ways to improve revenue cycle outcomes and patient satisfaction, it’s clear that employee engagement is more than a soft metric. These days, it’s a necessity.

“Engagement isn’t just about morale,” explained Sarah Goad, Senior Director of Patient Access at Ensemble Health Partners. “It really is a measurable driver for performance.”

In Goad’s case, the results of investing in employee engagement spoke for themselves:

• Increased employee engagement scores by 21%
• Reduced turnover
• Improved point-of-service collections by 11%
• Decreased denials
• Sarah Goad and her tea

m at Ensemble Health Partners, who specialize in revenue cycle management, joined us for a recent webinar on this topic. You can watch the full session here for more strategies and lessons learned.

However, we’ve since distilled some of that knowledge into the following.

Employee Engagement’s Impact on Patient Care

When asked about indicators that there’s an engagement issue, Lea Padilla, Associate Vice President of Patient Access with Ensemble Health Partners, starts with patient experiences. ”When you walk in the door. Are people smiling and saying hi?” Padilla then elaborates, going on to explain that, if staff are putting computer screens between themselves and patients, that’s a big indicator of engagement challenges.

On the other hand, positive employee engagement often leads to better patient care, in addition to increasing revenue. It’s estimated that engaged employees perform about 20% better than their unengaged counterparts, which affects the patient experience. It’s understandable – happier people tend to extend that cheerfulness to others.

So, how do you start engaging employees longterm? A pizza party isn’t going to cut it.

Employee Engagement Strategies in Healthcare That Drive Results

While it is a process to improve engagement, there’s a framework to help you structure your efforts and timeline.

• Set goals, even if they’re high-level
• Include voices from all department levels of your healthcare organization
• Establish a survey cadence
• Create a plan of action, prioritizing quick wins and long-term initiatives
• Keep communication clear and consistent

Following this structure can help with sustainable, meaningful change. Here’s what it looks like on a deeper level for each step.

Set Meaningful Goals

During the goal-setting stage, there’s a balance in having too many goals and too few. Start with broader goals such as “decreasing denials” or “increasing revenue” From there, drill down into specifics – what smaller goals lead to those larger objectives? It could be additional training, engaging employees, better communication – there’s no shortage of possibilities.

The other side of setting goals is how you’ll measure them. Of course there are the actual analytics and financials, but what about the harder-to-measure aspects like communication? That’s where surveys come in.

Set Up Employee Surveys for Collective and Individual Progress

Surveys and hard data tend to go hand-in-hand. They validate each other, and are stronger when used together, especially when it comes to employee engagement. If the hard metrics are off but the engagement is great, there’s a disconnect. Likewise, if the hard metrics are great but engagement is down, that could lead to increased turnover and cost to replace, train, and onboard.

The first employee survey sets the baseline for where everything is in the current state of the organization, before any additional changes are implemented.

Surveys also provide valuable insight into where your teams think the problems are, and wouldn’t they have unique insight? They’re the ones using the systems, collaborating, and on the frontlines.

According to Goad, “Through surveys, we were able to really identify and hone in on key areas that we saw for improvements.” In working with one health system in particular, she explained what the responses brought to light, “It was around leadership, innovation, action, and recognition.”

Every leader then met with their respective associates to talk about the survey, what it meant to them personally, and where there was opportunity to personalize the things that would be impactful to them. Doing this empowered associates to create some of the solutions rather than someone else making all the decisions for them.

Once the survey responses are complete, it’s time to empower staff and leadership alike to help shape solutions.

A Voice at Every Level

Frontline and leadership roles alike need a voice, especially since experiences across the organization will be different depending on a person’s roles and expectations. By including voices from across the organization, you can have a fuller picture of where strengths are, as well as the best opportunities for improvement and growth.

That said, there needs to be a smaller group of key changemakers. The best way to include more voices is through intentional surveys. As stated in the previous section, surveys lead to deeper conversations, ideas, and problem-solving.

After the surveys and associate meetings, Goad’s team created a shared spreadsheet where anyone and everyone could contribute to it. “It was a visible sheet in their office, as well as something that was housed in their repository,” she explained. From there, they implemented a “stoplight system” to provide transparency and trust.

The “stoplight system”:

• Green: the idea was implemented
• Yellow: the idea was in progress
• Red: the ideas a “no” at this time, with notes as to why

The visual made progress trackable in real time, making it easy for everyone to see and check on. We’ll get into that more later.

Prioritizing, Planning, and Execution

With your goals defined and survey feedback in hand, the next step is to organize your engagement strategy into a realistic, actionable plan. One of the common traps facing healthcare leaders is trying to do everything at once. That’s a recipe for burnout — not just for staff, but for leadership, too.

Instead, break down initiatives into two tracks: quick wins and long-term priorities. In Goad’s case, “We took a step back and realized that we needed to make some quick wins with the team, so we could have a positive impact on multiple metrics, not just our KPIs.”

Quick wins sustain engagement because people can see progress, helping stave off that project fatigue, and boost morale.

Goad’s team applied this exact mindset. After identifying those gaps in leadership, communication, and training, they rolled out a multi-layered engagement plan, focusing on the quick wins to gain – and keep – momentum.

Communicate Clearly and Consistently

Clear communication keeps teams aligned and engaged throughout initiatives. So often a project seems to fall into a void in many people’s minds all because they don’t hear about it. “Out of sight, out of mind” is a real problem.

However, bad communication may give the unintentional message that the organization doesn’t care about the initiative. Excitement peters off. The progress may not only be undone, but engagement dips below what it was before. This is often described as “negative value add”, when doing something badly can be worse than not doing anything at all.

What does good communication look like?

• Emails that highlight progress, share timelines, and recognize individuals driving the work.
• Brief overviews in meetings where it’s pertinent.
• Updating progress on the “stoplight” spreadsheet.

For Ensemble, they also implemented something called “tea times” where executive-level presence engaged with the frontline teams, breaking down some of those traditional barriers. It provided time to check in on the initiative’s progress, and feedback could happen in real-time without having to wait for the next survey.

By communicating messages with value consistently and intentionally, teams can keep teams in the loop and invested.

Start Small. Stay Consistent. See Results.

Improving employee engagement doesn’t require massive overhauls or costly programs — but it does demand consistency, intentionality, and trust. As Sarah Goad and her team showed, small shifts in how you listen, communicate, and act can lead to measurable gains in everything from financial performance to team morale.

Healthcare organizations are under more pressure than ever to deliver results — for patients, staff, and the bottom line. But real transformation starts from within. When employees feel heard and empowered, they don’t just show up — they step up.

If you’re looking to create a culture where engagement drives outcomes, the best time to start is now. And the best place to start? A conversation with your team.

To learn more, take a look at the webinar: Watch Now

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Sources:

Janes, Gillian PhD; Mills, Thomas PhD; Budworth, Luke PhD; Johnson, Judith PhD; Lawton, Rebecca PhD. “The Association Between Health Care Staff Engagement and Patient Safety Outcomes: A Systematic Review and Meta-Analysis.” Journal of Patient Safety,

https://journals.lww.com/journalpatientsafety/fulltext/2021/04000/the_association_between_health_care_staff.10.aspx