We're going to finish off our formal lectures with Dr. Shalkot, who's going to talk to us about something that I think we need to really think about and we need solutions for quite honestly, enhancing the employee experience and maintaining staff morale and managing a disruptive staff member. So Asma, if you could rejoin us. Thank you so much, Raj. And I'll pick up where Jim left off, celebrating excellence. All right, these are my disclosures. So we'll be talking about defining the employee experience and why it matters. How do we measure the employee's experience, tools to improve that experience and morale? What defines disruptive behavior, what its impact is, and how do we address it? Let's talk about employee experience. There's a set of perceptions that the employees have about their experiences at work in response to their interactions with the organization. So there's a spectrum of employee experience, and it starts, as many of us know, from starting to attract the top talent to hiring, onboarding, and then the steps become very crucial. We have to keep them engaged, performing at their best, develop and allow professional growth, and the last step is when they depart, hopefully it's a positive exit experience. What I'll mainly focus on is the engagement piece. This truly defines longevity and associated with employee satisfaction. So the drivers of employee experience are several, but it's a sense of belonging. You have to give them a sense of purpose. You have to reward them for their achievements. They have to have things that make them happy, and there needs to be a vigor and a priority in acquiring all these skills. You can see the employee experience pretty much is tied to outcomes, which is work performance, also the discretionary effort that they're willing to put in, and long-term retention, which in turn benefits the organization. So what does a positive employee experience look like? The sense of belonging is feeling part of a team or organization. The purpose is understanding why their work matters. The achievement is sense of accomplishment in the work that they're doing. Happiness is the pleasant feeling arising in and around work, and vigor is presence of energy, enthusiasm, and excitement at work. And as we saw on the previous slide, that hustle factor. So why does this employee experience matter? Well, we want lower turnover intention or rates, 47% turnover with unengaged employees versus 17% with engaged employees over several years has been reported. There's higher discretionary effort. They're willing to go that extra mile to help the unit in succeeding in its goals. And it's truly directly related to healthcare outcomes. It can result in improved patient satisfaction, clinical outcomes, enhanced service efficiency, and reduced patient revisits, and more likely to recommend organizations to others if the employees are happy and in turn, patients are satisfied. And if that doesn't convince you, here are some other statistics that show us why the employee experience is so important. A positive or a higher quality of employee experience is associated with 40% lower absenteeism, 24% lower turnover, 17% higher productivity, 70% fewer employee safety accidents, and 20% higher sales, or in this case, patient volumes. It also leads to higher safety outcomes, 40% fewer quality incidents, lower turnover, higher customer metrics, and fewer patient safety incidents, and higher profitability for the organization in the long run. Employee experience drives patient experience, and we certainly see that in our endoscopy unit. The nurses spend much more time, the nurses in tech, with the patient than we ever do. Each one point increase in employee satisfaction score leads to a 0.5 improvement in patient satisfaction scores. And as you know, in this world of press ganey surveys, patient experience truly drives not just reimbursement, but repeat referrals. So there's multiple tools to measure the employee experience. Here are some of the survey tools, and I mentioned one of them to you, the press ganey survey. And the first step is, and this has truly been the theme of our course, is to improve something, we need to measure it. So taking employee engagement surveys very seriously. These are things that are sent out routinely, and they're not to be taken lightly. And there should be some action or follow up to them, so that the employees understand that these are important and being taken into account. Making sure each manager gets their own report score. What does their team engagement look like? Where are they scoring? What is the average engagement score through the company? And how does your team compare to that engagement score? And then share the results with your team. Our nursing unit has a weekly huddle. And then we have two meetings twice a month where we actually block endoscopy and have an all staff meeting talking about some of these things that lead to employee engagement. What do we know about the employee experience? Well, there's limited study on endoscopy unit employee experience. And the existing literature comes from other areas, but it highlights the following best practices. Promoting a high level of leadership practice, meaning empowering the staff to take on tasks and responsibilities. Supporting them through managerial staff support. What this looks like is having additional schedulers or other support so that every person can do their job in an efficient and organized manner. Having a commitment from the organization to meeting these best practices. Having contentment at work and creating an environment that fosters people's ability to work at their best. And this starts from leadership. Leaders truly set the tone. They set expectations, they set goals, they provide feedback, they solicit input, and then they act on that input, providing feedback and measure and remeasure. 54% of respondents in a survey said that they did not feel that they regularly got the respect from their leaders. I know we all get busy in our practices, but we should never ignore taking the time and meeting with the staff and going over what's been going well and encouraging them to keep up their great effort. For those who said they were respected by their leaders, 89% reported greater enjoyment and satisfaction with their job. 92% reported a greater focus and prioritization, and 55% reported being more engaged at their work. And all these things are tied to patient outcomes and longevity of the employee. So maintaining staff morale, communication is key. I mentioned a morning huddle every day, and then our bi-monthly, our twice monthly meetings, other communication could be in the form of emails, newsletters, or other communications. Having employee development plans, giving them something that they want to do for professional growth, having frequent, consistent staff meetings, having employee engagement teams, and we recently started nursing unit councils, allowing co-management and sharing of some of the responsibilities and decision-making. And then finally, recognizing them and celebrating them, as Jim alluded to. Remember, thank you is free, and we don't do it often enough. So this is the frequency at which supervisors say thank you for a job well done, and how it directly correlates to an employee either staying or leaving the company. And you can see that when a supervisor never says thank you, that is most likely associated with the employee leaving the company, and supervisors that daily or frequently recognize their employees have the highest retention rates. All right, switching gears a little bit. What is disruptive behavior? Healthcare providers and staff's interactions with other healthcare personnel, patients, or family members that interferes with patient care or adversely affects the healthcare team's ability to work effectively. What does disruptive behavior in healthcare look like? Well, it's seen across all healthcare disciplines, and it's seen more frequently in positions and individuals in positions of power. Women are more likely to be affected. Disruptive behavior in healthcare is common. Nearly a third of healthcare professionals say that they experience it either weekly or monthly. The most negative impact is from a member of their own discipline or of their own unit or team. What are the impacts of disruptive behavior? At the patient level, it can result in dissatisfaction or loss of trust. It can lead to surgical or medication errors. There can be delays in treatment, and perhaps the most severe outcome of increased risk of patient deaths. For staff, it can negatively impact job satisfaction and staff retention. And at the organization level, there can be an erosion in loss of market share and also erosion of revenue and profits. So addressing disruptive behavior, it truly is a multi-step process. The first step is identifying the problem, followed by analyzing the behavior that's leading to that disruptive behavior, then discussing the behavior, and this should be done in a neutral and perhaps a fairly open format, followed by development of a performance improvement plan. And then there needs to be good follow-up, so it's a closed-loop communication such that there's monitoring, ongoing monitoring of the performance with scheduled follow-up meetings and ensuring accountability, and when improvement is seen, recognizing and acknowledging it. Performance improvement plans. Many of us have these, and if you don't, I highly recommend that you think about developing one because these do get needed fairly commonly. What it is is it's a deficiency statement, and then it goes over an action plan with some specific goals, the timeframe for achieving those goals, specific measurements that signify achieving those goals. It sets expectations so that it outlines what are the consequences of not meeting those goals, and then there's feedback sessions where education, help, support, and then follow-up is provided. The ideal system for addressing disruptive behavior is to base evaluations on data, such as evidence of compliance with performance standards. What would be fair is an evaluation process that is open and unbiased, and it should also be responsive so that when problems are identified, they should be treated proactively and in a very timely and swift manner so they don't accumulate or escalate. So in summary, the employee is the fundamental element of a healthcare organization. They are truly the cogs in the wheels that run any well-functioning organization. Effective employee experience is crucial to ensure optimal clinical outcomes, enhance patient satisfaction scores, and prevent financial losses. Leadership and managerial support sets the stage for employee experience, and workplace practices make the experience. Employee units should include measures of employee experience in their quality improvement processes. Disruptive behavior interferes with or adversely affects patient care and or the team's ability to work effectively. Disruptive behavior is frequently encountered, noted in all disciplines and across all healthcare team members. Disruptive behavior negatively impacts patient staff and the organization. The ideal system for addressing disruptive behavior should be fair, objective, and responsive. And with that, I'll stop here and hand it back to Raj.

employee experience

staff morale

disruptive behavior

engagement

employee development plans