leaders in health care, we want to know how to make the experience better for patients and for our care teams. In academics, we want to strengthen educational experiences and excel at research. In the clinical operations, we want to provide quality care in a learning environment. To that end, we ask for feedback from our teams.
Sometimes, though, the feedback isn’t really what we (think we) want to hear, the data isn’t clear, or the next steps aren’t obvious. U of U Health uses two main surveys to get faculty and team member input: Waggl and WellCheck.
|Audience||academic employees||hospitals and clinics employees|
Both surveys cover similar domains and both are intended to examine the needs of the team, rather than serve as a leadership gauge. When we examine needs of our teams, we gain insight on how we can create environments conducive for engagement and improvement.
This article provides an approach to looking at U of U Health engagement survey results.
Is the data accurate?
The first question we often hear is: Is this data accurate? Follow up questions include: Does it represent my whole team? How do parts of the group compare to others? Sometimes, when these answers aren’t clear, paralysis sets in. The data gets pushed to the back burner and nothing changes. These surveys will never be 100% accurate. The responses from the surveys aren’t “right or wrong.” Rather, they give us a jumping off point to think about the needs of our teams, and not simply a referendum on our leadership.
What does a low score mean for my team?
First, let’s acknowledge the obvious. You’re human, you work hard, and you care a lot about your team. It’s hard not to take this feedback personally and that’s okay. It’s normal to not feel good about it. It can be hard to remember groups struggle for lots of reasons and the purpose of gathering data is to support teams, not punish individual leaders.
The impulse to “fix it” in health care is strong. Before heading into your group with, "You don't think I keep you informed?" Or, "You don't think you can tell me your opinions? Tell me why you can't tell me your opinions?"
Let's pause and consider ways to approach this feedback in a more thoughtful way.
Starting from a place of reflection and curiosity can help expose changes that have occurred over time that might have led to breakdowns in communication and team connection. There are many factors that can contribute to low scores in communication. It can often stem from interpersonal conflict or unclear roles and expectations. While addressing these can be tricky in the beginning, acknowledging the concerns and working toward improvement can have a high impact on the well-being of individuals and the effectiveness of the team.
We recommend you start with a few basic questions:
#1: Is my group ready to have a conversation about how we are doing?
Leaders and team members are often in different places about how safe it is to share opinions or provide critical feedback, especially in front of one another. Psychological safety is present when people can share their ideas without fear of retribution. Psychological safety is essential for high functioning teams, and it is important to know how your team is doing in this realm before you decide how to talk about the data.
There are a few survey questions that can shed some light on whether your team is ready to wade in. The communication domain consists of the following questions:
I can express my opinions without fear of retribution. (Waggl)
My input is sought, heard, and considered. (Waggl)
My immediate supervisor keeps me informed. (Waggl)
People here are held accountable for their words and actions. (WellCheck)
I feel comfortable bringing up problems and issues that I see. (WellCheck)
When you’re seeing a decrease or, for Waggl, yellow or red in these areas: Particularly in the question that asks about fear of retribution, we recommend connecting with a facilitator to help you determine next steps.
Facilitators who can help:
A facilitator will help you explore what might be contributing to low scores and chart a path forward. A facilitator can help ensure a process that helps people feel comfortable speaking up. Listening involves open and honest discussion of what’s working and what isn’t. It has to be a no-blame, no-shame, any-idea-goes exercise. Shutting someone down, even once, can prevent important information from surfacing.
When you’re team is feeling good: For those with a high degree of psychological safety, we recommend leaders share the data with their teams, acknowledging what the data appears to say.
With curiosity, ask questions like:
Does this data match what we see day to day?
Is this our reality?
What should we be doing as a group to address these concerns?
Something we should be doing more of? Less of?
#2: What does this question mean?
We also get a lot of questions about how to interpret the meaning of some questions. In addition to communication, we group the remaining questions into burnout and stress, respect, control and resources, and advancement.
Burnout is not a problem for me. (Waggl & WellCheck)
My work-related stress is manageable. (Waggl)
The important thing to remember is that stress and burnout are downstream, outcome variables. These scores are impacted by a myriad of things occurring upstream, like psychological safety, control and staffing. If these scores are low, a conversation about upstream drivers is the next step. What is contributing to burnout and stress for your group? You want to consider problems at the individual, team, and system level. One way to generate local insight is to use the Team Assessment Tool for Thriving. The tool takes a deeper dive into reflection questions and provides a score. You can repeat the assessment over time to learn what’s normal—and what’s not—for your individual team. If your team is ready to dig into local solutions, check out the Listen, Sort, Empower Tool.
My organization values and respects employees across gender, race, age, religion, ability, etc. (Waggl & WellCheck)
Results for this item tend to look positive in aggregate, but scores for this item can be lower when we start to break down results by historically marginalized groups. Low scores here track with issues related to burnout, stress, advancement, and communication. If you have not had any conversations related to equity, diversity and inclusion with your group or if your team scored low with this item, we recommend consulting with a facilitator before approaching this question. Addressing equity, diversity and inclusion is imperative for every employee to feel seen, valued and heard. It is important that no one feels singled out in the process.
I have control over my workload. (Waggl)
I have access to the tools and resources I need to do my job. (Waggl)
People on my team are held accountable for their words and actions. (WellCheck)
I feel comfortable bringing up issues and problems that I see. (WellCheck)
Control over workload is linked to stress, burnout, and decreased satisfaction with work. While increasing control can be challenging in healthcare settings, consider options when feasible, such as increased flexibility in work hours or location, ability to take vacation, and ability to provide input into workload or work type. The same goes for having access to the tools and resources needed to do a particular job. Listening and problem solving with your team may generate some practical solutions to address these issues. For struggles that require a more long-term approach, it is important to remember that simply acknowledging the problem and sharing what can and cannot be done about the issue can go a long way with your team.
I have adequate opportunities to advance my career at the University of Utah. (Waggl)
My manager sets clear expectations, manages performance, and provides useful feedback. (WellCheck)
Not everyone has big aspirations for their future career, but most people are interested in growing their role over time. Having time devoted to meaningful work is linked to more job satisfaction and less burnout. Consider asking your team members what brings them joy at work and cultivating an area of focus. Many faculty and staff need some coaching or mentorship to get there.
#3: How low is low? When should I be worried?
Well-being data is a moving target. During the pandemic, scores have gone up and down. In February 2022, burnout and work-related stress are definitely up. Faculty and staff turnover continue to be high.
The fatigue of two years of Covid is real. Groups that are markedly higher or lower than average for the institution are worth taking a deeper look. If you would like help looking at the data, reach out to the Hospitals and Clinics Organizational Development team (WellCheck), Waggl team (academic human resources), the Resiliency Center, or Health Equity Diversity and Inclusion. These teams can walk you through how to interpret results and discuss what next steps might look like. If you identify an individual who is struggling, resources are here.