10 Strategies to Improve Employee Engagement in Healthcare

Brandon Daniell
1 day ago
6 min read

Key Strategies to Improve Employee Engagement in Healthcare

Two-way texting achieves a 98% open rate and reaches the 80% of healthcare workers who lack regular computer access - making it one of the most effective channels for real-time staff communication
Recognition reduces burnout by 73% and increases happiness by 82%, while clinical ladder programs can cut turnover from 14% to just 4%
Frontline managers account for 70% of the variance in team engagement, yet 40% are in their first leadership year with limited training - making manager development a high-leverage investment
Scheduling flexibility is the top priority for early-tenure nurses and could retain 46% of retirement-eligible nurses considering leaving
Organizational-level changes - not individual resilience training - are the most effective way to address burnout, which costs U.S. employers $300 billion annually
Psychological safety makes employees 2.1x more motivated; implementing a Just Culture framework can increase safety reporting by 300%
Childcare benefits reduce turnover by 50%, yet only one-third of hospitals currently offer them - presenting an opportunity for differentiation

Implement Two-Way Texting for Real-Time Communication

Around 80% of healthcare workers are frontline staff without regular computer access, which makes email an unreliable way to reach them.

McKinsey research shows that over 30% of healthcare workers leave employers because they don't feel listened to - a problem that real-time communication can directly address.

Two-way texting offers a solution: SMS achieves a 98% open rate compared to just 20% for email, with average response times of 90 seconds versus 90 minutes.

This channel works well for shift scheduling alerts, emergency communications, pulse surveys, recognition messages, and onboarding touchpoints.

The results speak for themselves. In our case study, Lovelace Health System used two-way texting to reach 3,600 employees during the COVID-19 crisis, sending over 46,000 messages with supportive content, PPE reminders, and employee assistance program information - resulting in improved staff morale during an incredibly difficult time.

Our case study with a Fortune 500 home health agency shows how text messaging boosted participation in their employee wellness program, achieving a 70% increase in engagement.

An additional 5,079 employees completed their wellness activities, and 82% recommended text reminders as a permanent tool.

Capital Area Transit System provides another compelling example from our case studies.

They reached 4,000 remote employees for HR communications and benefits enrollment through texting, achieving over 100% link utilization with only a 6% opt-out rate - proving that text messaging can effectively engage even hard-to-reach, deskless workers.

Build a Culture of Meaningful Recognition

Recognition has a measurable impact on wellbeing: it reduces burnout by 73% and increases employee happiness by 82%, according to the Achievers Workforce Institute.

There's also a direct link to retention, with 69% of employees saying they would stay longer at an organization that provides more acknowledgment.

The DAISY Award, now implemented in over 6,550 healthcare facilities globally, has published research showing meaningful recognition decreases burnout and increases compassion satisfaction among nurses.

Effective recognition works best at three levels: formal awards like annual ceremonies (5-24% of recognition moments), informal acknowledgment such as project celebrations (25-75%), and day-to-day appreciation (75%+).

At CHRISTUS St. Michael Health System, building manager accountability for recognition led to a 2.9% drop in nurse turnover and a 6x increase in near-miss safety reporting.

One insight worth noting: healthcare workers consistently rank extra paid time off as their most valued reward - addressing burnout while demonstrating appreciation.

Create Systematic Listening and Feedback Loops

Collecting feedback only matters if you act on it.

Press Ganey data shows that organizations sharing survey results and involving teams in improvement planning see 23% higher engagement than those that don't.

UCHealth demonstrates what a robust listening program looks like: they survey 26,000+ employees three times annually with pulse follow-ups, achieving a 15% increase in engagement and 18% increase in trust in leadership within the first year.

Perhaps more telling, there's a 19-point engagement difference between teams that discuss survey results versus those that don't.

Your listening program should include annual engagement surveys, lifecycle surveys at 30/60/90 days, pulse surveys during organizational changes, leadership rounding, and stay interviews with high performers.

The investment is worth it - poor communication costs U.S. hospitals approximately $11 billion annually.

Invest in Professional Development and Career Pathways

Clinical Ladder Programs Cut Nurse Turnover by 70%

Clinical ladder programs deliver strong returns when implemented well.

One study of 23,279 nurses found that participants had turnover of just 4.20% compared to 14.09% overall - resulting in 777 fewer departures and estimated savings of $47.5 million.

Tuition assistance shows similar promise, with research indicating $1.29 saved for every $1 invested.

Beyond ROI, 84% of employees say tuition assistance was important in their decision to join an organization.

Mentorship programs also move the needle, with 83% of participants saying the experience positively influenced their desire to stay.

Overall, organizations offering professional development have employees who are 15% more engaged and show 34% higher retention rates.

Train Frontline Managers to Lead, Not Just Manage

Frontline managers directly supervise up to 80% of the workforce, yet 40% are in their first year of leadership with limited people management training.

This gap matters because Gallup research confirms that 70% of the variance in team engagement comes down to the manager.

Press Ganey data reinforces this: employees with weaker leader relationships are 44% more likely to leave.

The flip side is equally compelling - when float pool managers at one Magnet-recognized organization implemented visibility, communication, and recognition strategies, RN 12-month turnover dropped from 45% to less than 15% within two years.

Servant leadership training is one evidence-based approach, associated with reduced burnout and turnover across 37 published studies.

Give Staff a Voice Through Shared Governance

Shared governance gives clinical staff decision-making authority over their practice, and the evidence supports its impact.

Research across 425 hospitals found that higher levels of nurse engagement in shared governance were associated with higher HCAHPS patient satisfaction scores, with nurses significantly less likely to report burnout or intent to leave.

This approach operationalizes autonomy - one of three fundamental psychological needs identified by Self-Determination Theory as necessary for engagement.

A 10-week implementation in one ambulatory nursing clinic produced a 40% increase in staff engagement on implemented projects.

Clinical outcomes improve too, including reduced catheter-associated infections, hospital-acquired pressure ulcers, and falls with injuries.

Offer Scheduling Flexibility That Fits Real Lives

46% of Retirement-Eligible Nurses Would Stay for Flexibility

Scheduling flexibility is the top-ranked priority for early-tenure nurses, with 46% selecting self-scheduling as their number one choice.

Among retirement-eligible nurses, 46% say they would reconsider retirement if given schedule flexibility - a finding that matters given projections of 1 million nurses retiring between 2027-2030.

Cleveland Clinic's flexibility model offers a practical template: staggered shifts at nonconventional times, flexible shift lengths, team scheduling with consistent cohorts, and split positions across multiple units.

At UNC Health, adopting a digital scheduling platform saw float nurses double their monthly shift commitments from 4 to 8 shifts.

Research shows self-scheduling specifically decreases absenteeism and improves team collaboration.

Address Burnout at the Organizational Level

Burnout costs U.S. employers an estimated $300 billion annually in lost productivity, healthcare expenses, and turnover.

The scale in healthcare is staggering: 93% of workers report being stressed and stretched too thin, with 82% experiencing emotional and physical exhaustion.

The CDC's Impact Wellbeing campaign emphasizes that organizational-level changes - not individual resilience training - are the most effective way to reduce burnout.

Johns Hopkins' RISE program provides one model, offering 24/7 peer support for stressful clinical events across 140+ healthcare organizations globally.

Teams participating in group stress management interventions report 32% lower burnout and 25% higher job satisfaction.

Companies with robust wellness programs report 23% higher employee satisfaction and 28% lower turnover.

Foster Psychological Safety and a Just Culture

Employees who feel psychologically safe are 2.1x more motivated, 2.7x happier, and 3.3x more enabled, according to BCG research.

Yet more than 50% of healthcare staff believe event reports are held against them, with fear being the number one reason for underreporting worldwide.

Just Culture provides a framework to address this, distinguishing between human error (requiring consolation), at-risk behavior (requiring coaching), and reckless behavior (requiring discipline).

At UCLA Health, implementing a 24/7 safety reporting line and "flattening the hierarchy" produced a 300% increase in safety reporting.

TeamSTEPPS training, completed by more than 1.5 million healthcare workers, offers an evidence-based framework for building psychological safety across teams.

Ensure Compensation and Benefits Stay Competitive

51% of Nurse Practitioners Cite Inadequate Pay as Burnout Factor

Compensation remains foundational - 51% of nurse practitioners cite inadequate pay as a contributor to burnout.

The 2025 AMGA survey shows 4.9% compensation increases across healthcare specialties, with primary care seeing 7.4% year-over-year growth.

Beyond base pay, targeted benefits make a difference.

Federal student loan programs offer up to 85% forgiveness through the Nurse Corps, while some states like Michigan provide up to $300,000 tax-free.

Childcare benefits can reduce turnover by 50% according to Bright Horizons data, yet only about one-third of hospitals currently offer them - presenting an opportunity for differentiation.

How you communicate benefits matters too.

In our case study, VBA used two-way texting for employee benefits enrollment, achieving a 78% enrollment response rate and eliminating costly onsite enrollment disruptions.

The takeaway: making benefits accessible and easy to understand can be as impactful as the benefits themselves.

Two-Way Texting Isn't Just for Patients

You've just read ten strategies to boost engagement - but implementation starts with solving a fundamental problem: actually reaching your workforce.

Dialog Health's HIPAA-compliant two-way texting platform helps hospitals, health systems, and ASCs communicate with every employee, not just those sitting at a computer.

Healthcare organizations using Dialog Health have achieved: