IBM Analytics

Thought Leadership Whitepaper

The Employee Experience of

Healthcare Workers
A study of the impact and drivers of a more human workplace
The Employee Experience of Healthcare Workers

In 2016, the IBM Smarter Workforce Institute and The Employee Experience Index
Globoforce’s WorkHuman Research Institute® joined forces to As explained in detail in The Employee Experience Index: A
conduct a major, global research study to find out what makes new global measure of a human workplace and its impact, the
a great employee experience. Employee Experience Index is a 5-dimension, 10-item index
that captures the core facets of the employee experience.
According to the study, employee experience was defined as a
set of perceptions that employees have about their experiences The Employee Experience Index measures:
at work in response to their interactions with the organization. • Belonging – feeling part of a team, group or organization
A positive – and ultimately human – employee experience, in • Purpose – understanding why one’s work matters
which employees are able to invest more of their whole selves • Achievement – a sense of accomplishment in the work
into the workplace, can be powerful in improving employee that is done
outcomes such as performance and retention1. • Happiness – the pleasant feeling arising in and around

work
In fact, healthcare could be considered the most ‘human’ of • Vigor – the presence of energy, enthusiasm, and
endeavors as the performance of healthcare professionals such excitement at work
as physicians and nurses directly affects the physical and mental
well-being of patients. Research has already clearly identified
links between healthcare work attitudes and patient outcomes2, The original research not only defined the Employee
as such employee experience is an important concept worthy of Experience Index, it also went on to look at what drives
attention. employee experience and what results organizations can expect
when they create a more positive and human organization.
Global cross-industry research findings were published in a The framework for these relationships is shown in Figure 1.
white paper The Employee Experience Index: A new global
measure of a human workplace and its impact. In this paper, we
focus on the employee experience specifically of those working
in healthcare in the United States to answer the following
questions:

• What impact could a positive employee experience have

on workforce outcomes?
• How could healthcare organizations drive more positive

and human employee experiences?

2
Figure 1. A framework of drivers and impact of employee experience at work

Human Workplace
Practices Employee
Experience Outcomes
• Organizational trust
Leadership and
Management • Coworker relationships • Belonging • Work performance
• Meaningful work • Purpose • Discretionary effort
Behaviors and Achievement • Retention
• Recognition, feedback •
actions
and growth • Happiness
• Empowerment and voice • Vigor
• Work-life balance

Employee experience has its beginnings in the direction and Employee experience linked to
support of leaders and managers, who drive organizational performance and retention
practices that create the employee experience. Ultimately, a Our research reveals that healthcare employees who experience
positive employee experience is associated with improved a sense of belonging, purpose, achievement, happiness and
employee outcomes such as better job performance, increased vigor perform at higher levels and are more likely to contribute
discretionary effort and higher retention. “above and beyond” expectations. They are also less likely to
quit.

3
The Employee Experience of Healthcare Workers

Positive employee experience linked to more effort Positive employee experiences linked to retention
More dramatically perhaps, healthcare employees with more Talent retention is a challenging issue for many organizations,
positive experiences at work are much more likely to report including those in the healthcare sector. Healthcare providers
significantly higher levels of discretionary efforti (98 percent face significant cost challenges from attrition, not only because
compared to 67 percent) (Figure 2). In a healthcare setting, of the resulting need to recruit and onboard new healthcare
this is likely to have a direct impact on patient satisfaction and employees, but also because of the use of temporary staff and
outcomes; research studies have identified links between the payment of overtime to cover any shortages. The good news is
discretionary behaviors of healthcare professionals (e.g., that a more positive employee experience could help. Our
nurses, doctors, pharmacists) and hospital performance in analysis reveals that healthcare workers with low Employee
terms of service efficiency, patient satisfaction, patient re-visit Experience Index scores are more than twice as likely to say
and recommendations to others4. they want to leave compared to those with more positive
experiences. The difference is 27 percentage points (48 percent
The results of these analyses suggest a positive employee vs. 21 percent) (Figure 3).
experience can contribute to higher motivation to apply extra
effort at work and go “above and beyond” typical job Figure 3. Positive employee experience is associated with lower turnover
responsibilities. intentionii

Figure 2. Employee experience is positively associated with

Top 25% highest Employee
discretionary effort at work 21%
Experience Index scores

Top 25% highest Employee Bottom 25% lowest

98%
Experience Index scores Employee Experience 48%
Index scores

Bottom 25% lowest

Intend to leave
Employee Experience 67%
Index scores
Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee
Experience Index Study (n=495)
Discretionary effort Note: The scores above are reported as percent favorable, the average level of agreement
across the two items that measure turnover intention.v
Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee
Experience Index Study (n=495)
Note: The scores are reported as percent favorable, the average level of agreement across
the three items that measure discretionary effort.

Discretionary effort refers to employee activities that are beneficial to the organization but not necessarily part of the job. It was measured by respondents reporting that
i

they were always willing to give more effort to get the job done, they enjoyed devoting a lot of extra effort to their work, and consistently went above and beyond what is
expected of them at work.

ii
Turnover intention was measured by respondents reporting that, within the next 6 months, they were seriously considering leaving their organization and planning to look
for a new job.

4
Positive employee experience linked to better work Leadership Sets the Stage
performance Leaders and supervisors play a powerful role in setting the
Healthcare workers with Employee Experience Index scores in overall tone and direction of an organization, effectively setting
the top quartile are more likely to report high levels of work the stage for a more positive employee experience5. This
performanceiii than those whose scores are in the bottom begins with a high level of clarity around future direction and
quartile (12 percentage points higher) (Figure 4). However, it why employees matter in successfully moving the organization
is worth noting that work performance is high even for those forward.
with low Employee Experience Index scores (86 percent). This
is a notably higher figure than for our global cross-industry Our data suggest there is room for improvement. For instance,
analyses, where high levels of work performance were reported 39 percent of healthcare workers do not feel their senior
for 73 percent of respondents. (See our white paper The leaders are providing clear direction about where the
Employee Experience Index: A new global measure of a human organization is headed. Providing more clarity would help
workplace and its impact. for more details.) senior leaders to more fully align employees and their
behaviors with organizational goals.
Figure 4. Employee experience is positively associated with work
performance Managers and supervisors also play a crucial role in creating a
positive work environment, by providing a level of
Top 25% highest Employee personalized support and commitment to their teams.
98%
Experience Index scores
However, almost one third (31 percent) of employees in our
sample do not feel their managers were effective in serving and
Bottom 25% lowest
Employee Experience 86%
supporting the team.
Index scores

Figure 5. Leader and manager practices linked to employee experience

Work performance
Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee 39%
Experience Index Study (n=495) Senior leaders give
Note: The scores are reported as percent favorable, the average level of agreement across
the three items that measure job performance.
employees a clear picture
17% 22% 61%
of the direction the
organization is headed
Disagree Neutral Agree
Creating the ideal employee experience
My manager serves and
Our study has clearly made the case that employee experience 14% 17% 69%
supports the team
matters in the healthcare industry. The question that naturally
arises is “what can healthcare providers do to improve 31%
employee experience?” We examined two primary sets of Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee
Experience Index Study (n=495)
driving factors – leadership and workplace practices – that can
provide organizations with the tools and insight they need. A
preliminary exploration of these workplace behaviors and
practices is provided below.

Self-reported work performance was measured by respondents reporting that, in the last three months, they had been very productive at work, worked hard to get their job
iii

done on time, and completed work to a high standard.

5
The Employee Experience of Healthcare Workers

Human Workplace Practices Make the Experience Figure 6. Organizational integrity and co-worker support are associated
with a positive employee experience
Leadership initiates momentum towards a positive employee
experience, while workplace practices carry that momentum When employees agree the When employees agree
organization consistently acts coworkers help each other
forward.
with integrity: out at work if needed:

Employees in all industries are bringing much higher

expectations to the workplace and making greater demands of
their work experiences6. Practices that acknowledge the
uniquely human qualities of the workplace address these new 84% 81%
report a more
report a more
expectations. These practices can be viewed across multiple positive employee
positive employee
experience
experience
levels: environment, work and person. vs. 46% when they
vs. 47% when they
do not agree
do not agree

The Environment
Employees expect their organizations to be responsible and act
with integrity in dealing with all manner of stakeholders,
Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee
including employees themselves. When they do, a full 84 Experience Index Study (n=495)
Note: The scores above are reported as percent favorable, the agreement level of the survey
percent of healthcare workers describe a positive employee question.
experience, 37 percentage points higher than when those
expectations are unmet. See Figure 6.
The Work
The drivers of employee experience also extend to the work
Supportive coworker relationships are also an important
itself. Meaningful work ensures that healthcare employees’
driver of a positive work experience. When those relationships
skills and talents are being fully utilized and there is greater
are present in the workplace, healthcare employees report a
alignment to shared, core values. According to our data, full
much more positive employee experience than when that
utilization of skills and alignment to core values are related to a
support is absent (81 percent compared to 46 percent) (Figure 6).
45 to 48 percentage point increase in employee experience for
healthcare workers (Figure 7). Employee experience is just 36
percent when employees do not report their work is consistent
with organizational values, compared with an Employee
Experience Index score of 81 percent when healthcare
employees’ work is consistent with those core values.

6
Figure 7. Meaningful work associated with a positive employee experience Figure 8. Feedback, recognition and growth associated with positive
employee experience
When employees agree When employees agree
their work is consistent with their job makes good use of When employees agree When employees agree
organization’s core values: their skills and abilities: they receive recognition they receive feedback on
when doing good work: work performance:

81%
report a more
82% 85% 81%
report a more report a more report a more
positive employee
positive employee positive employee positive employee
experience
experience experience experience
vs. 36% who
vs. 34% who vs. 47% who vs. 49% who
do not agree
do not agree do not agree do not agree

Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee
Experience Index Study (n=495) Experience Index Study (n=495)
Note: The scores above are reported as percent favorable, the agreement level of the survey Note: The scores above are reported as percent favorable, the agreement level of the survey
question. question.

Also critical to positive employee experiences are feedback The Person

and recognition of performance, as well as opportunities for Shifting the focus to practices that impact individuals
professional development and growth. Eighty-five percent of themselves, a positive employee experience emphasizes the
healthcare workers who receive recognition of their benefits of greater freedom through empowerment and
performance, and 81 percent of those receiving feedback opportunities for their voices to be heard. Also important is
reported a positive employee experience, compared to 47 and the time for employees to pursue non-work activities and
49 percent, respectively, of workers that did not (Figure 8). recharge.

7
The Employee Experience of Healthcare Workers

Within a human workplace employees are given the freedom Figure 10. Work-life balance associated with positive employee experience
to decide, and opportunity to participate in, determining how When employees agree their
work is best accomplished. Healthcare workers who feel their work schedule is flexible When employees agree they
enough for them to meet have the chance to recharge
ideas and suggestions matter are more than twice as likely to family/personal responsibilities: when not at work:
report a positive employee experience than those who don’t (87
percent vs. 43 percent). A similar pattern emerged among
healthcare workers who had the freedom to decide how to do
their work (83 percent vs. 49 percent) (Figure 9).
80%
report a more
82%
report a more
Figure 9. Empowerment and voice associated with positive employee positive employee positive employee
experience experience
experience
vs. 60% who vs. 57% who
When employees agree they do not agree do not agree
When employees agree their have the freedom to decide
ideas and suggestions matter: how to do their work:

Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce

Employee Experience Index Study (n=495)

83%
Note: The scores above are reported as percent favorable, the agreement level of the

87%
report a more report a more
survey question.

positive employee positive employee

experience experience
vs. 43% who
do not agree
vs. 49% who
do not agree
Conclusion and recommendations
Our study identified five components of employee experience
— belonging, purpose, achievement, happiness, and vigor —
and revealed that more positive employee experiences are
Source WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee
linked to better performance, extra effort at work, and lower
Experience Index Study (n=495) turnover intentions.
Note: The scores above are reported as percent favorable, the agreement level of the survey
question.

We also identified the key organizational practices that drive

more positive employee experiences: organizational trust;
More positive employee experiences are also associated with
co-worker relationships; meaningful work; recognition,
employees’ flexibility to manage their work and other aspects
feedback and growth; empowerment and voice; and work-life
of their lives. We see a 20 percentage point difference in
balance.
employee experience when work schedules are flexible (Figure
10). Furthermore, there is a 25 percentage point difference in
employee experience when healthcare workers have an
opportunity to recharge when they are not at work (Figure 10).

8
Several recommendations emerge for cultivating more positive interest to HR and business leaders. In 2016, the
work experiences and achieving better results in the healthcare WorkTrends survey was administered by the IBM Smarter
sector: Workforce Institute in 45 countries and territories, in a
cross-section of industries, thousands of different organizations
Diagnose and all major job families. Globoforce was a key collaborator
• Listen regularly to the voice of your employees (through on the employee experience content of the 2016
platforms such as census and pulse surveys, social WorkTrends survey.
listening, etc.) to understand the nature of their
experiences at work. About IBM and the IBM Smarter
• Conduct a drivers analysis to diagnose the culturally
Workforce Institute
relevant practices in your organization that are strengths Today’s human resources organizations need to attract and
to build upon or areas for improvement. grow top-performing talent, create engaging social and
collaborative cultures, and connect the right people to get
Act work done. IBM solutions combine market-leading talent
• Recognize the unique role that leaders and supervisors
management and social collaboration tools with the power of
play in defining employees’ work experience, and enable workforce science and advanced analytics. We help
supervisors to design experiences consistent with core organizations build impassioned and engaged workforces, and
values. deepen client relationships that can lead to measurable
• Ensure the organization’s actions are conveying the values
business outcomes. To learn more about IBM Smarter
intended and nurture an environment that reinforces Workforce solutions and services, please visit www.ibm.com/
mutually supportive co-worker relationships. software/smarterworkforce
• Help employees understand the deeper meaning of their

work and how it contributes to the wider organizational The IBM Smarter Workforce Institute produces rigorous,
purpose and goals. global, innovative research spanning a wide range of workforce
• Treat performance as a continuous conversation, fueled by
topics. The Institute’s team of experienced researchers applies
social recognition, feedback and growth opportunities. depth and breadth of content and analytical expertise to
• Offer employees opportunities to participate in decision-
generate reports, white papers and insights that advance the
making and trust them with the autonomy they need to collective understanding of work and organizations. This white
find the best paths to achieving success. paper is part of IBM’s on-going commitment to provide highly
credible, leading-edge research findings that help organizations
About WorkTrends™ realize value through their people.
WorkTrends™ is a research program initiated in 1984,
originally designed to track trends in specific workforce themes To learn more about IBM Smarter Workforce Institute, please
over time. WorkTrends has evolved to a large global online contact us at [email protected]. Follow @IBMSmtWorkforce
survey completed by workers from a cross-section of industries on Twitter or visit our website:
around the world, on a variety of contemporary topics of www.ibm.com/software/smarterworkforce/institute

9
The Employee Experience of Healthcare Workers

About Globoforce and the WorkHuman Figure 11. Employee Experience Index scores in the healthcare sector
Research Institute
Pioneer of the WorkHuman® movement, Globoforce helps Employee Experience Index 74%
make work more human for millions of people and Belonging 75%
organizations worldwide. Its cloud-based social recognition
software helps build award-winning cultures where employees Purpose 80%
feel more appreciated and socially connected at work – driving
Achievement 80%
a sense of belonging and inspiring the entire organization to
reach its full potential and achieve business success. Founded Happiness 77%
in 1999, the company is headquartered in Framingham, Mass.,
Vigor 60%
and Dublin, Ireland.
Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee
The WorkHuman Research Institute at Globoforce is Experience Index Study (n=495)
Note: The scores are reported as percent favorable; that is, the Employee Experience Index
dedicated to the understanding and application of global score is the average level of agreement across the ten items in the Index. The score for each
employee experience dimension is the average level of agreement across the two items that
workplace practices that create more engaged, productive, and measure that dimension.
ultimately more human work cultures. In collaboration with
leaders in the human resource industry and global research Employee Experience Index scores by job level
experts, the WorkHuman Research Institute publishes It appears that the more senior you are in the healthcare sector,
original research on current trends that affect and influence the the more positive your employee experiences (Figure 12).
employee experience, culture management, and leadership.
Individual contributors (employees who do not manage others)
To learn more about Globoforce, visit: http://www.globoforce. report a lower level of employee experience (70 percent) than
com or follow us on Twitter @Globoforce or LinkedIn: http:// managers (85 percent), a gap of 15 percentage points.
www.linkedin.com/company/globoforce
In fact, such a gap is not unique to the concept of employee
Appendix A: Demographic Analyses of experience. In other studies of worker opinions, we often find
that managers tend to answer a range of work attitude
Employee Experience Index
questions more positively than individual contributors. One
possible explanation could be that managers are more likely to
Employee Experience Index scores by dimension be involved in decision making in organizations, and
The global Employee Experience Index score from our involvement is associated with positive attitudes.7
research sample is 74 percent. This is quite positive, but leaves
some room for improvement. Of the five dimensions of the Figure 12. Employee Experience scores increase with job level
Employee Experience Index, purpose and achievement are the
highest (80 percent) and vigor at work is the lowest (60 Individual Contributor 70%
percent) (Figure 11).
Front-Line Supervisor 81%

Mid-Level Manager 85%

Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee
Experience Index Study (n=495) Note: The scores are reported as percent favorable, the
average level of agreement across the ten items in the Index.

10
Employee Experience Index scores by generation Figure 14. Recognition programs linked to greater employee experience
Despite the popularity of the notion of generational
differences, scientific research suggests that differences in work Yes, we have a program that
attitudes are generally very small.8 In fact, an IBM Smarter provides awards based on 82%
demonstrating our core values
Workforce Institute study showed that only 0 to 2 percent of
work attitude differences can be attributed to generation.9 Yes, we have a recognition program,
75%
but it’s not tied to our core values
In line with these previous findings, our research reveals no
No, we have no formal recognition
significant differences across generations in their employee 66%
program at my company
experiences (Figure 13). All generations in the healthcare
sector report similar levels of the employee experience Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee
Experience Index Study (n=495)
dimensions. Note: The scores above are reported as percent favorable, the average level of agreement
across the ten items in the Index.

Figure 13. No difference in employee experience across generations

Teams and employee experience
Millennials 76% Social relatedness is a basic need of human beings11 and that
need is often met in people’s work interactions with each other.
Generation X 73%
And this is reflected in our Employee Experience Index; our
Boomers 74% research confirms that healthcare sector employees working in
a team report slightly more positive work experiences than
Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee those who work on their own (78 percent vs. 69 percent)
Experience Index Study (n=495)
Note: The scores are reported as percent favorable, the average level of agreement across the (Figure 15).
ten items in the Index.

In sum, our survey results reveal that Employee Experience

Recognition and employee experience
Index levels vary by job level, whether employees work as part
The need to be recognized and appreciated is deeply ingrained
of a team or as an individual, and whether the organization
in us.10 As a result, we would expect that employees in
offers recognition programs.
healthcare organizations with recognition programs are more
likely to receive acknowledgment and recognition for a job
Figure 15. Teamwork linked to more positive employee experiences
well done and, consequently, to have a more positive employee
experience.
Team 78%

Our research confirms this is the case (Figure 14). Healthcare Individual 69%
workers who report that their organizations offer recognition
programs, and particularly those that provide rewards based on Source: WorkTrends™ 2016 US healthcare worker sample for the IBM/Globoforce Employee
Experience Index Study (n=495)
demonstrating core values, have a considerably higher Note: The scores are reported as percent favorable, the average level of agreement across the
ten items in the Index.
Employee Experience Index scores than those in organizations
that do not offer formal recognition programs (82 percent vs.
66 percent).

11
The Employee Experience of Healthcare Workers

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Laschinger, H. K. S., & Leiter, M. P. (2006). The impact of
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