Living values every day

How one Australian organisation elevated staff engagement and patient care

Most nurses feel a strong connection with the nursing profession; they feel proud to be nurses. But can the same be said for their connection with their organisations?

Our engagement data suggests not. Based on an aggregate set of nurse engagement data from hospitals around the world, only one in eight nurses report a strong connection to their organisations, whereas more than half feel a strong connection to and pride in being a nurse.

Discover how one Australian organisation strengthened this connection by making their organisational values come alive for nurses at the front line.

Engagement—defined as staff members who are inspired to help the organisation succeed—requires staff to feel a strong emotional connection with their organisation. Ultimately , employees need to feel personally involved and invested in organisational strategy to be willing to expend the discretionary effort characterised by engagement.

In our recent research initiative, Energising the Nursing Workforce, we suggest a three-step process to more effectively involve staff in organisational strategy. The first step: build the foundation for involvement by connecting the frontline to the organisation’s mission and values—in a way that they understand and see enacted in their day-to-day behaviours.

Building blocks of involvement

Contextualise organisational values for nursing staff

Our research suggests nurses feel most connected to their organisations’ values when they see them translated into day-to-day activities. People need tangible evidence of how their organisations’ values should influence their own behaviours—role modelling alone is not enough.

St John of God Health Care—a private, non-profit, Catholic system with 14 hospitals across Australia—designed their 'Foundations of Excellence' to achieve this goal.

In 2009, leaders at St John of God were concerned about a wide level of variability across sites—different practices, different cultures, and ultimately, different outcomes. The system’s Group Director of Nursing set out to identify a common set of expectations across the organisation for achieving consistent excellence in care.

Boomers and millennials share engagement drivers

Their goal was to make the organisation’s values come alive for frontline nurses by using language relevant to them and empowering them to define and adapt their behaviours. Ultimately, they wanted to create structures to inspire a culture change and encourage staff to hold themselves and each other accountable for living the organisation’s values every day.

Leaders used St John of God Health Care’s organisational core values as a foundation, but built on these by incorporating known drivers of nurse-specific engagement. The result was a set of seven 'Foundations of Excellence for Nursing and Midwifery' developed in 2010.

Creating meaningful nursing values

Make the vision come alive at the front line

St John of God didn’t stop there. Leaders wanted to ensure that individual nurses and other team members at the unit level could see and feel these 'Foundations of Excellence' come alive in their day-to-day work. This is the key to connecting staff to the organisation in a meaningful way, fostering the engagement that St. John of God was hoping to achieve.

So what did they do? Leaders designed and piloted an initiative to equip frontline staff on each individual unit with a template for assessing the unit’s key strengths and opportunities for improvement on each of the seven nursing and midwifery 'Foundations'. Each unit took the following steps:

  1. Selected a single 'Foundation' to focus on (based on staff input/perceptions as well as unit performance on various subscales of the Practice Environment Scale modified for use in Australia)
  2. Ranked the unit’s performance on the selected 'Foundation' using a template (shown in the graphic below) that outlines specific criteria related to that 'Foundation'
  3. Identified strengths and weaknesses of the unit based on these criteria

Excerpt from the 'Foundations of Excellence' assessment tool

Foundations of Excellence assessment tool foundation 3

Based on their findings, unit staff created an action plan to improve their performance against specific criteria related to the larger 'Foundation' of focus. Once the team felt that sufficient progress had been made, they moved on to a new objective, creating a cyclical process that was critical for constant, evolving improvement.

The example below is an action plan created by unit-level staff after they completed the assessment tool and identified a specific focus area. In this case, the area for improvement is "communication of team and individual performance between nurse manager and the team", which addresses the third 'Foundation of Excellence'.

Sample unit-level action plan

Committing to improvement

Targeted efforts pay off

Connecting unit-level priorities and actions to organisational values and empowering frontline staff through this process has had a positive impact on key metrics for St John of God.

In the first two years of pilot implementation, sites saw the average number of frontline nurses intending to stay with the organisation increase by eight percentage points.

To give a unit-specific snapshot, nurse engagement in the Emergency Department has increased significantly since 2009, and the unit’s relative performance on patient satisfaction jumped to the 99th percentile.

Targeted efforts pay off

Join St John of God Leaders for a Live Webconference

Leaders at St John of God are iterating on this process and improving it all the time. Don’t miss an opportunity to hear them share details about this initiative, provide an update on its current status, and answer questions from members.

Bring organisational values to life at the front line

Watch our on-demand member-led webconference featuring Kate Birrell, Group Director of Nursing, and Tammy Sandison, Group Clinical Projects Officer at St John of God Health Care.

In this presentation, they share details about their 'Foundations of Excellence' initiative and answer questions from participants.

Watch presentation

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