Innovating How You Train by Building an Engaged Workforce

By Amber Hogan Mitchell, DrPH, MPH, CPH

Today, it is no longer acceptable to think that employees learn much from a training session.  So often both trainer and trainees are so busy, preoccupied, or bored that attending a training session may be a more detrimental time and energy suck than not having one. That is, except if your facility, your employer, or you are thinking outside of the proverbial (soap)box.

Out of the (soap)box thinkers - the best healthcare employers - are transforming how they conceptualize, develop and roll out training and education for their employees.  They are moving away from dull, dusty annual training texts, pamphlets, and modules and toward employee professional development. They are developing programs, projects, and campaigns that create engaged employees.

According to management experts at the Ascent Group, “engaged employees are employees that feel as though they are truly valued at work; that their efforts directly contribute towards the mission and success of the company.”1 

As much as you may not want to admit it, healthcare facilities, no matter the size, are companies. They are in business to stay in business. They have employee identification numbers and have leases and utilities to pay and owe investors or stakeholders or even us as taxpayers, they rely on patients coming in for services so that they can pay bills and salaries. It doesn’t matter if they are academic, nonprofit, for profit, large, small, specialized, world-renowned, or in a strip mall – they are in business. Rather than selling widgets to consumers, they sell services to patients and communities who rely on them to receive the best product (or care) possible.

It may be time that we revamp how we think about training healthcare employees about infection prevention and occupational and environmental health and safety and rather retool our own minds to consider that we have a role to play in making our healthcare employers more successful businesses.  That means having more successful, better developed, and more confident employees.

Ascent, like other management firms, says that “Learning plays a key role in helping employees to get and stay engaged.” Many organizations have begun to rely heavily on the learning function for engagement support, but healthcare is behind other industries in this regard.

Regarding employee engagement, former Secretary of Treasury, Safety and Health Heavyweight, and Pittsburgh Aluminum Mogul Paul O’Neill has said "Every company I know of says somewhere in its annual report, 'People are our most important resource,' but my observation from all these places I had worked was that there was no evidence it was true."

If you don’t know if your employees feel as if they are the most important resource, he asks your institution to think about the following few questions that employees ask themselves when determining their worth and their confidence in their working environment. 

“Can I say every day I am treated with dignity and respect by everyone I encounter without respect to my pay grade, or my title, or my race, or ethnicity or religious beliefs or gender?”

“Am I given the things I need -- education, training, tools, encouragement -- so I can make a contribution to this organization that gives meaning to my life?”

“Am I recognized for what I do by someone I care about?'

Do your training sessions incorporate the consideration of these three questions? 

Here are a few things to consider in what I like to call the “O’Neill Educational Design.”

1. Dignity and Respect
If you have training sessions for nurses only, doctors only, environmental services only, or technical trades only, does that make employees feel they are treated differently with respect to pay grade or title?  Might that elicit feeling like they do not have your institution’s respect for the jobs that they do and how they impact others around them?  Might they feel they are treated differently as an employee compared to others?   Is perception of their value different? Do your training sessions include various disciplines from varied pay grades with different levels of experience?  Is there the opportunity to freely communicate during the sessions? Might these elements impact how engaged an employee may feel and subsequently impact what they take away from a training session? 

2. Tools and Encouragement
If you require employees to attend annual training sessions for something like bloodborne pathogens or surface disinfection, are they also given the tools to carry that out?  Are your non-managerial frontline employees given the ability to evaluate and select safer medical devices, PPE, and cleaners/disinfection materials that they feel secure and confident using?  Do newly trained employees feel empowered enough to feel they can help make utilization or purchasing decisions? After your training session, do you perform rounds or have their managers or peers encourage new, safer behaviors and practices?  Or like so many others, once the training is over, the training is over. See you next year.

3. Recognition
Do you do any pre-test or pre-evaluation prior to training to identify who employees care about most as it relates to their behavior and practice at work?  Do you just perform post-training quizzes and/or annual performance assessments submitted by supervisors and that’s it? This is similar to encouragement employees need to follow new or reinforced behaviors from training, but more specific to recognition they get from someone they care about.  This may not be their trainer or their manager. It may rather be a long-time peer, co-worker friend, attending physician, nurse administrator, floor EVS technician, their patient, their patient’s visitors, or their trainees or students. The only way you are going to know if an employee is receiving recognition by someone they care about when doing something you care about (e.g. action that is trained), is to ask them who they care about.

Here are some actions you can take immediately:

1. Get past the past.
We’ve always done it this way doesn’t work anymore.  We’ve always done it this way has resulted in higher than ever rates of patient and employee infections and illness.  It has resulted in multidrug resistant organisms and globally emerging infections.  It has resulted in high employee turnover and/or low job satisfaction.

Getting past the past is more interesting anyway. A great cure for boredom at work.  See implementing these new training methods as a personal and professional challenge.  Seek to be the best trainer or educator your facility has ever seen. Use your new tools to revamp how you teach or train and what you teach or train.

2. Ask more questions.
If you happen to be giving a training class or development course tomorrow, next week, or next month, begin by asking the employees in the class how many people they know in the class. If the answer is most or all, then chances are you haven’t included a diverse enough class to make them feel that they are put on par with others regardless of pay grade or title.

After each training module or section, as if your trainees/employees think they have the tools to carry out what they’ve learned. Ask if they’ve learned anything new compared to last year and if they did, what they will change or do differently or feel empowered to ask for.

Ask your trainees/employees what encouragement or positive affirmations they need initially and then on a regular basis to reinforce a new behavior, practice, or policy. 

Make sure their managers, supervisors, and your facility leadership know what you’ve learned from them. It’s not fair for you to know all of this if the people they interact with every day don’t.

3. Measure the difference.
Just because you are thinking that you are now treating employees less as trainees and more as engaged stakeholders in the company they work for doesn’t mean it’s working.  Be fair to yourself and think about some metrics you and your facility can use to gauge the success of new training and education methods. 

Measurements could be in the form of training course evaluations of the trainers, the media they use, and the content they provide. It could be performing a quick employee satisfaction survey or measuring employee retention or new employee recruitment. You could work with your infection prevention, environmental health and safety, worker health and safety, risk management, and human resources departments to measure differences in injury and illness rates, days away from work, workers compensation cases, select patient outcomes, or even reportable infection rates.

Ultimately, none of us are perfect and all of us have room to grow and to be more satisfied with ourselves. Thinking about innovative ways to train and educate employees; peers, floor staff, and leaders alike can only improve their (and your) level of engagement in your institution.  It provides them with a higher degree of “buy in” so that they are invested in not only the work they do, but also the care they provide, and the impact they both have on the success of the employer they work for.

References:

1. Improving Front-line Training 2010. Ascent Group.  http://www.ascentgroup.com/research/sum_pp_train.html
2. Paul O’Neill Values into Action.  Harvard Business School.  http://hbswk.hbs.edu/archive/3159.html
3. 'Habitual excellence': The workplace according to Paul O'Neill’ Pittsburgh Post-Gazette.  May 2012.  http://www.post-gazette.com/business/businessnews/2012/05/13/Habitual-excellence-The-workplace-according-to-Paul-O-Neill/stories/201205130249