Employee Engagement in Healthcare

by Daniel Hannig

Employees working in the healthcare sector often enter this line of work because of their motivation to help and care for other people. This makes healthcare an area where employee engagement comes naturally with the job. Or so one might think. In reality, there are many factors that make it increasingly hard to maintain a high level of Employee Engagement in healthcare. However, there are also very convincing examples which prove that this is indeed possible, as one Dutch company demonstrates in particular.

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”If people are not engaged, they look for other options. Patients have options too” – Anthony Armada, COO, Verity Health Systems

Healthcare is an area of work often defined by long hours and a stressful work environment. Add to this regular budget cuts, increased maintenance costs and the constant expectation to deliver high patient satisfaction scores, and you end up with a perfect recipe for anything from motivation loss to burnout. In order to prevent this, many hospitals and healthcare institutions have turned to adopting methods to increase Employee Engagement within their organisations. In the cases where this was successful, management not only saw an increase in motivation and happiness with the employees, but also with the patients directly.
There is one organization that has shown immense impact in the past ten years in the Netherlands and is now continuing to do so globally.

Employee Engagement in Healthcare ‒ Best Case Scenario

The story of Jos de Blok and his healthcare organization Buurtzorg can be described as nothing else than a huge success. Let us start off with some background information: Jos de Blok is a trained nurse who was highly unsatisfied with the way healthcare was being implemented in the Netherlands. What bothered him specifically was the fact that the healthcare industry, which is supposed to have the interest of the people at its core, was being operated like machinery, focussing primarily on efficiency gains at the cost of elements such as empathy and kindness.

He quit his job and decided to start his own healthcare organization. This was back in 2006. Nowadays, Buurtzorg (which roughly translates to “neighborhood care”) has grown from one team to 850 and is active in 24 countries. Patients and nurses love Buurtzorg so much that, during the past ten years, healthcare workers have been deserting traditional nursing companies in droves. Buurtzorg receives emails from healthcare workers wanting to jump ship on a monthly basis. The question that naturally comes to mind at this point is: How did they do it? What is it that they do differently that makes them so successful?

Putting The “Care” Back In “Healthcare”

Buurtzorg has developed a business model that puts humanity before bureaucracy. The philosophy that they have applied looks like this: Instead of trying to uphold high efficiency through close monitoring and standardized processes, Buurtzorg has reduced bureaucracy and hierarchy to the lowest level possible. How does this look in practice? Buurtzorg is organized almost completely by self-managing teams who create self-managing clients. This means that instead of having one general body administrate the whole organizational structure, the teams take care of everything themselves without having to run everything by “corporate”. This in turn leaves a lot of room for operational freedom which has been used to successfully shift the human element to the center of Buurtzorg’s business model. This human element mainly consists of communicating with and listening to the clients. The first thing a healthcare worker does is sit down with the client and have a cup of coffee. This helps build up rapport and also gives the client a chance to share what it is he/she actually needs, which in turn gives the nurse an idea of how to approach this issue in the best way possible. In essence, it means that the health care workers take the time to find out what the real problem is instead of just “taking care of business” by administering the medicine their protocol tells them to administer and then leaving. In a way, Buurtzorg has made healthcare what it was all about in the first place: taking care of people.

Self-Managing Teams

Buurtzorg has empowered their employees to a level that they manage themselves. Their self-managing teams have professional freedom with responsibility. A team of 12 work in one neighbourhood, taking care of people needing support as well as managing the team’s work. A new team will find its own office in the neighbourhood, spend time introducing themselves to the local community and getting to know general practitioners, therapists and other professionals. The team itself decides how they organize the work, share responsibilities and make decisions.

Self-Managing Clients

As already mentioned, it is not only about empowering employees, but also about empowering the clients. The idea is to give the clients as much autonomy as possible by creating an informal network consisting of neighbours and family that are willing to help the patient, if he/she should have any problems. This informal network is extended by a network of professional physicians and naturally the professional expertise offered by the nurses themselves.

Buurtzorg’s Impact On Healthcare

This business model of healthcare empowers and also requires nurses to take care of all the needs that the client has, which has naturally led to a higher cost per hour. However, the autonomy that is created and carried out by the clients in the end leads to fewer hours in total. At the end of the day, the Buurtzorg model has reduced the hours of caregiving by 50%, saving the Dutch social security system hundreds of millions of Euros a year (Ernst & Young documented savings of around 40% to the Dutch health care system a couple of years ago). On top of this, client satisfaction rates are the highest of any healthcare organization. Staff commitment and contentedness are reflected in Buurtzorg’s title of “Best Employer” (four out of the last five years).

Employee Engagement In Healthcare ‒ An Outlook

The success and popularity of Buurtzorg shows quite clearly that the old healthcare system, restrained by hierarchies and bureaucracy, is overdue and in need of change. Many countries have now either gotten in direct contact with Buurtzorg or adopted a system that is very similar to the one Buurtzorg uses. With life expectancy rising in general, a shift from a system with a bureaucratic approach to one that has humanity at its core is definitely a development we should embrace and support.


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