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Are you ready for an employee survey?
Before making changes in a practice, a survey can tell you what your employees think and open the lines of communication.
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| Steps to developing an internal survey |
Source: Slagle JP |
Communication has always been a vital part of relationships – whether with your spouse, your patients or your referring doctors – but in most situations, the communication lines are reasonably easy to manage. Unfortunately, as your ophthalmology practice grows, communication with employees takes on a whole new level of complexity. Communication is one of the main problems in marriages, and that involves just two people. Can you imagine how much more difficult it is to communicate well when you have 50 to 100 employees at multiple locations?
At some point, your practice may reach a size where the administrator and lead physicians have a difficult time getting a “pulse” of the overall employee team. While long van drives to outreach locations and impromptu meetings in the hallway may yield some insight into how a handful of employees feel, the opinions of one or two employees should not be driving decisions that affect everyone else. If you are lucky, those employees’ opinions represent the majority of the practice, but what if they do not?
I mentioned in a previous column (“Establish a long-term strategy for your practice,” Ocular Surgery News, January 1, 2004) that we are attempting to implement the Balanced Scorecard (BSC) strategic planning and measurement approach in our office. One of the key foundations of the BSC approach is that a company’s human capital – the employees – account for most of the value of a company. A company with loyal, knowledgeable employees will be more profitable and competitive than a company with high turnover and disaffected staff. Of course we all want engaged employees; the question is whether we are ready to create an environment that keeps and challenges good employees. But even before we try to change our environment, we have to know where we stand with our employees, and an employee engagement survey may be the tool to assess that in larger practices.
Reasons for a survey
As part of our transition into the BSC approach, we performed our first comprehensive employee engagement survey this past January. Relying primarily on an excellent employee survey resource book (“Employee Surveys and Employee Survey Question Guidebook Package” by Paul Connolly), we were able to develop a 106-question survey that asked for employee input on overall satisfaction, company strategy, pay and benefits, performance evaluations, their immediate supervisor, the management team and doctors and their co-workers. Employees were given 2 weeks to complete the survey and were paid to complete it at work or at home. Because we surpassed our 90% participation goal, the employees were awarded casual Fridays the next month. The anonymous surveys were collected by our office secretary, who entered the results into a database and then provided the management team with summary results.
Why perform an employee survey? There are certainly plenty of reasons to skip it. First, an employee survey, and ours specifically, gives employees the forum to rate and give written feedback on their specific manager, and several members of our management team questioned the value of such an exercise. Second, developing and introducing the survey took approximately 40 hours of my time, and it took our secretary nearly 80 hours to tabulate the quantitative results and type 23 single-spaced pages of written comments. Third, mismanaging an employee survey can be worse than never doing the survey. Finally, the entire process requires quite a bit of soul-bearing on the part of the management team and a recognition that receiving the results is just the start of a multi-year process.
Despite those drawbacks, we forged ahead with the survey for several important reasons. First, we wanted to be able to establish several key employee measurements before we dove into the BSC strategy so that we could later assess if the BSC was yielding dividends. Second, we have a pretty good feel of how the outspoken 20% of our employees think, but not the other 80%. The survey provided the 80% group with a structured, anonymous format that allows us to know what the “average” employee is thinking. Third, we know that our employees are intelligent people, and by presenting them with 106 thought-provoking questions, we were pretty sure they would give us written comments with substance.
Questions, answers
While all 106 questions had merit, we were particularly interested in results for the following questions, using a five-point rating scale from “strongly disagree” to “strongly agree.”
- I see myself working for this practice 3 years from now.
- I have looked for a job outside this organization in the past 6 months.
- Considering everything, I am satisfied working for this practice at the present time.
- I am proud to be part of this organization.
- Our practice emphasizes long-term strategy and vision.
The first four questions, either individually or as an average, will be included as a baseline score representing our employees’ attitudes as of January 2004. The fifth question ties directly into our BSC initiative. Until now, our practice has never had a short- or long-term strategy, and we wanted to measure if the employees knew this to see how well they grasp our first long-term strategy when it is launched mid-year. By establishing these baselines, we will be able to perform the survey each January and track our progress.
In addition to measuring changes from year to year, the survey is a good opportunity to compare yourself with other employers across the nation. The developers of the survey reference book (Performance Programs Inc.) also give companies the option to purchase normative results for several dozen questions in their database. We purchased the normative answers for 18 of our questions that represented anywhere from 6,000 to 30,000 survey responses across industries. In addition, membership ($160 per year) in the Society of Human Resource Management (www.shrm.org) also gives you access to other survey results, allowing us to compare our satisfaction score with results just for the health care industry.
Results
At the end of the survey, we asked each employee to identify his or her department, location and length of tenure so we could stratify the data. With 10 distinct departments tied directly to six senior managers, we expected results to vary by manager. Interestingly, results even varied between departments that share the same manager; the results demonstrated that a manager’s approach to different departments dramatically affected the survey results. As I explained to our managers before the survey was launched, it was not my intent to use the departmental results to evaluate a manager’s performance. However, the results have created some interesting dialogues with the managers, and hopefully they will use the results constructively to improve their weaker areas.
As I noted before, the process is not done when the results were in hand. After a series of meetings with the management team, we provided office-wide results and commentary to employees at a voluntary (but paid) staff meeting. The complete results were also posted on our Intranet. Several managers asked me to present departmental vs. office-wide results to their staff in small group settings, and these meetings elicited constructive feedback and a deeper employee understanding of the issues our company faces.
Now that the meetings are completed, the challenge is to act on the key findings to prove to employees that we will use the results to improve the company. Based on the survey, our biggest challenges are to increase communication, improve employee training and become more active in monitoring compensation levels in our market. Now the real work begins.