You cannot pay people enough to care. But it is possible to attract and retain great talent and bring out the best in them by fully engaging employees in a shared purpose, giving them a sense that their work is worthwhile and that they are making a difference in the world. That is the culture effect on health care staffing.
Health care organizations (HCOs) have a built-in advantage when it comes to creating lasting relationships with our employees. Many people drawn to our sector tend to come with a pre-existing sense of purpose to help people and to make the world a better place. The challenge for organizations is to build an infrastructure that cultivates, nurtures and supports this potential.
Leaders do not get to decide if their organization has a culture—each organization does. But leaders do get to decide if they will intentionally shape a culture with careful and values-based intention. Will you invest in culture as a differentiator, as an attractor and accelerant? At BAYADA, this is how we see our mission, vision, values and beliefs, articulated in a credo known as The BAYADA Way. We have discovered several takeaways that other HCOs may find useful.
The State of Engagement
This is a pivotal time for leaders in home health care. Competition for talent has never been more intense. There has never been a more drastic and growing shortage of caregivers. U.S. workers live with a deteriorating sense of employer-employee loyalty (in both directions), and their work relationships feel more transactional and impersonal than ever before. Accelerated by the COVID-19 pandemic, many homecare organizations are changing the ways they do business, adding stress and disconnection.
In 2024, Gallup notes a stagnation in employee engagement and recommends re-tooled strategies to support organizational culture. Gallup also reports that a sense of connection with mission and purpose can drive employee excellence and retention, and that clear communication from leaders can build trust and confidence.
Cultural engagement can help you get the most out of the talent you have. When managers recognize and develop workers’ strengths and employees feel excited and passionate about their work, they give
more of their enthusiasm and commitment and are more willing to reach into that hidden reservoir of “discretionary effort.” Disengaged teams, on the other hand, correlate with lower profitability and higher turnover.
According to Deloitte Insights, mission, values and contributions to society are driving employee engagement. Nearly every element of the employee experience impacts an employee’s commitment to their work, including a sense of meaning and trust in organizational leadership. As Generation Z will continue to expect more from their employers and prioritize meaningful work, the culture’s effect on staffing cannot be ignored and provides one of the most readily available accelerators of organizational outcomes.
A Culture Infrastructure
The basic cycle of our culture infrastructure is to:
Communicate The BAYADA Way as our North Star at all levels
Provide regular, interactive touchpoints that help to align our ways of doing business with our common purpose and values
Intentionally curate organizational rituals that nurture and reinforce The BAYADA Way
Solicit feedback from employees, clients and candidates to regularly assess how we are delivering on brand promises
Regularly measure and interpret employee engagement and correlated business results
Regularly cascade the latest data on what we are doing well and what we need to improve at team and enterprise levels, tasking working groups to devise solutions
Regularly cascade new solutions and objectives, along with any tools leaders will need to communicate and implement improvements within their teams
BAYADA has many culture touchpoints, but these are some notable ones:
Learning Map Training: Built into onboarding and leadership development processes, these interactive trainings help employees see how their role and talents fit into the big picture of mission and vision.
Key Action of the Week: Programmed, weekly discussions relate a tenet of The BAYADA Way to a team’s work, helping individuals internalize how they make a difference on their team and in the mission, vision and values of the company.
Community Key Action of the Week: Weekly online discussions that anyone can join give individual employees the opportunity to interact with each other across levels and functions and to internalize how roles are all connected toward a common goal.
Conversations on Diversity, Equity, Inclusion and Belonging: Popular interactive monthly webcasts give panelists the opportunity to tell their stories and viewers the opportunity to ask questions, build mutual understanding and cultural competency and develop a sense
of belonging.
BAYADA Celebrates: This interactive employee web platform builds camaraderie through featured photos, videos, news, award nominees and winners, opportunities for scholarships and other rewards and recognition programs, e-cards for easy sharing, and employee posts and comments on jobs well done.
BAYADA Hero Awards: Categorized by job role, employees are nominated for exemplifying core values and are celebrated at local, regional and national levels.
Outcomes of the Culture Effect
Building a mature infrastructure to support culture has taken significant time, energy and resources. As a priority, it is central to BAYADA’s people-first philosophy. Strategically, we are finding that when we focus on attracting qualified, culturally aligned talent, profitability and growth naturally follow.
Even in times of stress, a strong, values-based culture creates more “stickiness” in staffing. While it certainly does not mean that we retain everyone, it does help BAYADA build a deep relationship with employees who align with our values and mission. One of our key performance indicators (KPIs) has been BAYADA’s unusually high employee engagement score, which has remained stable even when most health care providers’ engagement scores took a significant hit during the COVID-19 pandemic. We are scoring above the 99th percentile on questions related to safety, flexibility, work-life balance, fair treatment, diversity, equity, inclusion, belonging and feeling satisfied, valued, cared for, and respected. Correlated business KPIs have included double-digit revenue growth in 2023. Central to how and why our business processes and talent models need to evolve, this also helps slow the “leaky bucket” of employee retention.
Recommendations
For leaders who want either to start building or to invest more in a culture infrastructure, do not forget these essential steps:
Identify and clearly communicate your organization’s values and teach managers how to put them into action. One of the key guidebooks we used was “Managing by Values” by Ken Blanchard and Michael O’Connor.
Intentionally plan the key activities that make up your culture cycle, then build and refine the infrastructure and cadence. For inspiration, see the Studer Group’s Healthcare Flywheel and “Hardwiring Excellence: Purpose, Worthwhile Work, and Making a Difference” by Quint Studer.
Measure and refine cultural engagement with the best tools for your organization. This will include
the most relevant and effective employee experience survey and management tools.
Please note that the tool does not need to be expensive or overly sophisticated. The simple discipline of regularly measuring your progress, communicating the results and acting on the feedback will establish confidence and inspire your people to be open and honest.
With these three basic building blocks, HCOs can lay a strong foundation capable of sustaining meaningful, fulfilling and “stickier” employment experiences.
