Appendix A: Methodology

The Employee Engagement and Training in Healthcare Organizations survey was conducted by Cox eLearning Consultants (COX) in June and July, 2014, on behalf of Cornerstone OnDemand. The total number of participants in the study was 482; of those, 375 respondents (77.8%) completed the entire survey. This report is solely based on completed surveys. For each question and sub-question, an analysis and interpretation of the results is provided.

The study has a margin of error of +/- 5 percentage points at the 95% confidence level. The margin of error, or confidence interval, means that we can be certain that if the entire population was surveyed (not just a sample of the population, as was done for this survey), the entire population would have selected the same answers within the plus-or-minus number.

The confidence level indicates that we can be certain that we would receive the same results if the survey was repeated. It expresses how frequently the true percentage of the population would pick an answer that lies within the confidence interval. The 95% confidence level indicates that we can be 95% certain of this (Creative Research Systems).

The n refers to the sample size – the number of survey respondents or responses – depending on the question.

The target audience consisted of contacts from the COX business database with these demographics:

  • healthcare employees in the human resources function at the manager level or higher
  • in both for-profit and not-for-profit healthcare organizations
  • in organizations with at least 3,000 employees
  • located only in the United States

Respondents also included c-suite executives, managers involved in learning and/or training, and some representatives from the patient care side of organizations.

Within the survey instrument, and periodically in this report, the acronym “HCM” is used, which represents human capital managment. The acronym “LMS” represents learning management system.

In some cases, questions permitted respondents to select more than one response; in those cases the totals do not equal 100.0%. Percentages shown in some graphs may not exactly match percentages shown in the corresponding tables due to rounding.

The full results of the study, including a summary of the responses to each question, can be seen in Appendix A.

Appendix B: Survey and Results by Question

Please note: Questions with an asterisk (*) are required.

I. Introduction

Before we get started, we’d like to define a few terms.

When referring to “employees,” we mean everyone in your organization who is directly employed there, regardless of whether they are full-time, part-time or contractors. This can include doctors, nurses, administrative staff, etc.

When referring to “HR systems,” we mean people management software systems, e.g., those used for recruiting, training, performance reviews, etc. Using this definition, compensation management software is considered a “system,” whereas something like Microsoft® Word® or Excel® are considered “applications,” and therefore are not HR systems.

*1. Please indicate your job role in your organization.

Respondent's Job Role

#

%

C-Suite

28

7.5%

Executive VP / Senior VP / Vice President

56

14.9%

Senior Director / Director

125

33.3%

Senior Manager / Manager

74

19.7%

Assistant Manager / Associate Manager / Supervisor

22

5.9%

Associate / Assistant / Coordinator

31

8.3%

Administrative

15

4.0%

Other

24

6.4%

Total Responses

375

100.0%

Total Respondents

375

 

 

Respondent's Job Role - Other

#

%

Recruiter

5

20.8%

Medical/Nursing care

3

12.5%

Specialist

3

12.5%

Training/Education

3

12.5%

Consultant

2

8.3%

Unspecified

6

25.0%

Sales

1

4.2%

Systems Engineer

1

4.2%

Total Responses

24

100.0%

Total Respondents

24

 

*2. Please indicate the department in which you work, within your organization.

Respondent's Department

#

%

Recruiting / Staffing / Onboarding and related

53

14.1%

Payroll / Benefits / Compensation and related

31

8.3%

Training / Learning / Organizational Development

76

20.3%

Compliance / Compliance Reporting

11

2.9%

Employee Engagement and related

24

6.4%

Other

180

48.0%

Total Responses

375

100.0%

Total Respondents

375

 

 

Respondent's Department - Other

#

%

All of the Above / HRIS

72

40.0%

Administration / C-Suite

41

22.8%

Patient Care / Nursing

15

8.3%

Health and Wellness of Populations

11

6.1%

Sales / Business Development

9

5.0%

Quality / Compliance

8

4.4%

Marketing / Public Relations

7

3.9%

IT / IS / Data Analysis

6

3.3%

Counseling / Psychiatry

2

1.1%

Diversity & Inclusion

2

1.1%

Legal

2

1.1%

Government Relations

1

0.6%

Home Care

1

0.6%

Laboratory

1

0.6%

Outsourcing / Contracting

1

0.6%

Pharmacy

1

0.6%

Total Responses

180

100.0%

Total Respondents

180

 

II. Employee Engagement

*3. Speaking in general terms, please tell us how engaged you think the employees are in your organization.

Employees' Level of Engagement

#

%

Very engaged

47

12.5%

Engaged

144

38.4%

Somewhat engaged

170

45.3%

Not very engaged

14

3.7%

Not at all engaged

0

0.0%

Total Responses

375

100.0%

Total Respondents

375

 

*4a. When it comes to employee engagement, which issue is having the most negative effect on your organization’s engagement levels?

Issue with Greatest Negative Effect on Engagement

#

%

Merger and acquisition activity / rumors

43

11.5%

Changing mandates and regulations (ICD-10, HCAHPS, etc.)

78

20.8%

Transition from paper records to electronic records

23

6.1%

Frequent changes of supervisors / managers in some departments

48

12.8%

Organizational focus is more on patients; we view employees as a means to an end

49

13.1%

Clinical turnover and a shortage of nurses

47

12.5%

Other

87

23.2%

Total Responses

375

100.0%

Total Respondents

375

 

 

Issue with Greatest Negative Effect on Engagement - Other

#

%

Change of all kinds / Presure to grow / Unpredictability of daily business

17

19.5%

Communication issues

15

17.2%

Budget cuts / Cost reduction pressures / Demand for increased revenue / Lack of gov't funding

13

14.9%

None

9

10.3%

Politics / Corporate issues / Union challenges

8

9.2%

Layoffs recently / Threat of future layoffs

6

6.9%

Other

5

5.7%

Wages low / Benefits not comparable to other organizations

6

6.9%

Employee development / Training is lacking

4

4.6%

Staff stretched thin / Workload too high / Employee turnover in non-patient care positions

4

4.6%

Total Responses

87

100.0%

Total Respondents

87

 

*4b. You indicated that merger and acquisition activity is a concern. Please tell us what role your organization is playing in that activity.

Merger & Acquisition Activity by Respondent's Organization

#

%

We are in the process of acquiring another organization.

2

4.5%

We are in the process of being acquired by another organization.

12

27.3%

We recently acquired another organization.

7

15.9%

We recently were acquired by another organization.

7

15.9%

I am concerned about industry consolidation in general affecting employees.

9

20.5%

Other

7

15.9%

Total Responses

44

100.0%

Total Respondents

44

 

 

Merger & Acquisition Activity by Respondent's Organization - Other

#

%

Divesting of low-performing facilities

2

28.6%

M&A as means to grow

1

14.3%

Considering consolidation

1

14.3%

Merger currently underway

1

14.3%

Rumors

1

14.3%

Merger recently completed

1

14.3%

Total Responses

7

100.0%

Total Respondents

7

 

*5a. When it comes to the issue that is most negatively affecting your organization’s engagement levels, how prepared is your organization to address it?

Organization's Preparedness for Addressing Most Negative Issue Affecting Engagement

#

%

We have strategies and HR systems in place that address our needs for today and for the future.

110

29.3%

We have some strategies and HR systems in place to address the issue today, but they are only the beginning of what is needed.

176

46.9%

We do not have a formal strategy or HR systems in place, but the organization is developing a strategy.

52

13.9%

We do not have a formal strategy or HR systems in place.

16

4.3%

Don’t know

21

5.6%

Total Responses

375

100.0%

Total Respondents

375

 

*5b. Please indicate what is preventing a formal strategy from being developed. (Please select all that apply.)

Situation Preventing a Formal Engagement Strategy from Being Developed

#

%

There isn’t enough time in the day

24

18.5%

We don’t have the employee bandwidth to address this issue

15

11.5%

Lack of budget

19

14.6%

Our organizational culture does not lend itself to this

21

16.2%

We do not know where to start - lack skillset or knowledge for the project

2

1.5%

We are starting and stopping due to other issues that arise, which appear to be more urgent

36

27.7%

We cannot get senior management’s approval

9

6.9%

Other

4

3.1%

Total Responses

130

100.0%

Total Respondents

68

 

*6a. Is your organization taking actions to measure whether - and to what level - your employees are engaged in the workplace?

Actions Organizations are Taking to Measure Employee Engagement

#

%

Yes, we measure both if an employee is engaged and to what extent an employee is engaged

179

47.7%

We measure only if an employee is engaged

44

11.7%

We measure only to what extent an employee is engaged

16

4.3%

No, we do not measure either of these

95

25.3%

Unsure / Don’t know

29

7.7%

Other

12

3.2%

Total Responses

375

100.0%

Total Respondents

375

 

 

Actions Organizations are Taking to Measure Employee Engagement - Other

#

%

Will be measuring in the near future

3

25.0%

Not at this time

2

16.7%

We regularly survey employees

2

16.7%

Data is gathered but not all issues are addressed

1

8.3%

Measure to respond to regulatory requirements, including engagement, but do not act upon the data

1

8.3%

Only some employees are measured for engagement

1

8.3%

We have surveyed on aspects of engagement, then selected issues to be addressed

1

8.3%

We measure satisfaction not engagement

1

8.3%

Total Responses

12

100.0%

Total Respondents

12

 

*6b. Does your organization have a plan in place – or is it taking steps to develop a plan to address employee engagement over the next six months?)

Does Organization Have a Plan in Place - Or Taking Steps to Develop a Plan - To Address Employee Engagement Over the Next Six Months

#

%

Yes

201

80.1%

No

17

6.8%

Unsure / Don’t know

33

13.1%

Total Responses

251

100.0%

Total Respondents

251

 

III. HR Solutions Used

*7. Thinking about how your organization handles talent management, which of the following areas are of greatest concern to your organization? (Please select all that apply.)

Areas of Greatest Concern to the Organization Regarding Talent Management

#

%

Attracting people with the right qualifications to fill our open positions

250

23.9%

Managing employees to their highest potential

205

19.6%

Offering pay and benefits that are competitive in the marketplace

151

14.4%

Creating plans for employees to move to increasingly higher levels of responsibility, if desired

113

10.8%

Ensuring our employees receive the training they need for patient care

109

10.4%

Training employees on organizational policies and procedures

76

7.3%

Making sure employees receive training for compliance

80

7.7%

Generating routine and audit-required reports on employees and their training/development/ actions for various regulatory agencies

45

4.3%

Other

16

1.5%

Total Responses

1,045

100.0%

Total Respondents

375

 

 

Areas of Greatest Concern to the Organization Regarding Talent Management - Other

#

%

Development of infrastructure / systems

3

17.6%

None

3

17.6%

Qualifications and development of talent

3

17.6%

Employee buy-in

2

11.8%

Branding

1

5.9%

Changes in healthcare environment

1

5.9%

Managing the system to its highest potential

1

5.9%

Orientations and on-boarding processes

1

5.9%

Retaining employees in challenging circumstances

1

5.9%

Succession planning

1

5.9%

Total Responses

17

100.0%

Total Respondents

16

 

*8a. Please indicate which of the following HR systems (e.g., training, performance, recruiting, etc.) your organization currently uses.

HR Systems Currently Used by Respondent's Organization

#

%

We do not use any formal HR systems in our organization; it’s all on paper and/or within spreadsheets or other electronic documents.

45

12.0%

We use multiple HR systems, but some processes are still on paper and/or within spreadsheets or other electronic documents.

137

36.5%

We use multiple systems for human resources.

147

39.2%

We use an all-in-one system that manages all areas of HR.

46

12.3%

Total Responses

375

100.0%

Total Respondents

375

 

*8b. Please indicate which HR solutions your organization has in place. (Please select all that apply.)

HR Solutions in Place Within Respondent's Organization

#

%

Recruiting & applicant management

229

21.1%

Onboarding

125

11.5%

Performance management

193

17.8%

Compensation management

145

13.4%

Succession planning

56

5.2%

Learning and development

177

16.3%

Compliance management

139

12.8%

Other

21

1.9%

Total Responses

1,085

100.0%

Total Respondents

284

 

 

HR Solutions in Place Within Respondent's Organization - Other

#

%

Do not know

6

30.0%

Employee-oriented systems: Health/wellness, Online benefits enrollment, Application system, Time and attendance, Electonic personnel record, Financial management

6

30.0%

HRIS database / HRMS

3

15.0%

None

2

10.0%

Application system (but no applicant tracking system)

1

5.0%

CRM (customer relationship management)

1

5.0%

Other internal ("home grown") systems, not specified

1

5.0%

Total Responses

20

100.0%

Total Respondents

21

 

IV. Organizations’ Readiness for Change

For the next three questions, please indicate how prepared you think your organization is by rating it on a scale of 1 to 5, where 1 means “Completely Unprepared” and 5 means “Completely Prepared.”

*9. Thinking about the mergers and acquisitions in healthcare and what your organization needs to adequately deal with them, please rate your organization.

Thinking about the mergers and acquisitions in healthcare and what your organization needs to adequately deal with them, please rate your organization.

#

%

5 - Completely Prepared

40

10.7%

4

71

18.9%

3 - In Line with Where We Should Be

179

47.7%

2

67

17.9%

1 - Completely Unprepared

18

4.8%

Total Responses

375

100.0%

Total Respondents

375

 

Rating Average

3.12

 

*10. Thinking about healthcare’s compliance and reporting requirements, and what your organization needs to remain compliant, please rate your organization.

Thinking about healthcare’s compliance and reporting requirements, and what your organization needs to remain compliant, please rate your organization.

#

%

5 - Completely Prepared

73

19.5%

4

118

31.5%

3 - In Line with Where We Should Be

144

38.4%

2

38

10.1%

1 - Completely Unprepared

2

0.5%

Total Responses

375

100.0%

Total Respondents

375

 

Rating Average

3.59

 

*11. Thinking about providing quality patient care and what your organization needs to adequately deliver on it, please rate your organization.

Thinking about providing quality patient care and what your organization needs to adequately deliver on it, please rate your organization.

#

%

5 - Completely Prepared

79

21.1%

4

122

32.5%

3 - In Line with Where We Should Be

143

38.1%

2

31

8.3%

1 - Completely Unprepared

0

0.0%

Total Responses

375

100.0%

Total Respondents

375

 

Rating Average

3.66

 

V. ROI on Training Investment

*12a. Does your organization currently link employee actions/behavior to patient outcomes in some way?

Does Organization Currently Link Employee Actions/Behavior to Patient Outcomes

#

%

Yes

176

46.9%

No

133

35.5%

Don't Know

66

17.6%

Total Responses

375

100.0%

Total Respondents

375

 

*12b. Please tell us in what ways your organization links employee behavior to patient outcomes. (Please select all that apply.)

Ways Organizations Link Employee Behavior to Patient Outcomes

#

%

We align employee goals with organizational goals, which ultimately tie back to patient care –  making sure we all share the same purpose.

130

26.4%

We do regular employee performance assessments and tie those back to learning and  development, to identify and address skills gaps.

123

24.9%

We do bedside employee assessments while employees are with patients.

37

7.5%

We deploy on-going training activities automatically based on an employee’s role, credentials and tenure.

90

18.3%

We encourage employees to proactively take additional training that will help them better assist patients and help them grow professionally.

102

20.7%

We do not do any of the above; we get reviews annually, but additional resources are not provided.

4

0.8%

Other

7

1.4%

Total Responses

493

100.0%

Total Respondents

176

 

 

Ways Organizations Link Employee Behavior to Patient Outcomes - Other

#

%

Patient Satisfaction Surveys and encourage naming staff who were good or poor in service

2

28.6%

Annual performance evaluations and feedback throughout year

2

28.6%

Developing a continuous electronic Performance Management System as part of our HRIS

1

14.3%

Raises are linked to outcomes of organization

1

14.3%

Declining revenue results in some items being cut

1

14.3%

Total Responses

7

100.0%

Total Respondents

7

 

*13. Please indicate your level of agreement with this statement:

Linking employee behavior to patient care, and monitoring those interactions, positively affects our organization’s bottom line and our return on the training investment.

Respondent's Level of Agreement with Statement:  Linking employee behavior to patient care, and monitoring those interactions, positively affects our organization’s bottom line and our return on the training investment.

#

%

5 - Strongly Agree

148

39.5%

4

142

37.9%

3 - Neither Agree Nor Disagree

77

20.5%

2

3

0.8%

1 - Strongly Disagree

5

1.3%

Total Responses

375

100.0%

Total Respondents

375

 

Rating Average

4.13

 

VI. Demographics
*14. What is the size of your organization in terms of number of employees? Please include full-time, part-time, contractors, temporary, etc.

Organization Size by Number of Employees

#

%

5,000 or more

103

27.5%

3,000 – 4,999

28

7.5%

1,000 – 2,999

85

22.7%

0 - 999

159

42.4%

Total Responses

375

100.0%

Total Respondents

375

 



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