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It’s our annual employee engagement time! As I discuss this topic with senior leaders and we prepare for the engagement survey, I reflected on my efforts within the last year with my management and front-line team. I have some insightful thoughts about engagement to share in this month’s column.

Why is engagement important to organizations?

Research and data from Press Ganey advise leaders that employee engagement is critical to productive and efficient work environments. Employees who share ideas, and participate in projects, are invested in the operation and any departmental improvements. When employees are engaged, work is enjoyable, and patients are not only happy but are provided safe care and increased quality of service. Engagement is therefore a reflection of our leaders and the overall effectiveness as a team and thus organization. Organizations use engagement scores to identify leadership strengths and opportunities to address.

Will we have engaged workers all the time?

In our current volatile and chaotic operation, I questioned myself and colleagues on the possibility to have engaged workers. Is this even a reality in today’s operation? We now live in an environment where we are seeing new faces every 13 weeks. Travelers are focused on living their best lives with increased compensation, and work-life balance. They come in to assist the organization to the best of their ability but are not necessarily invested to help support change nor are most thinking about the future state of the organization. Temporary travelers are satisfied and get the work done but are not necessarily engaged. 

Even without travelers, is employee engagement a focus of the current workforce? Does it depend on the generation of the workforce, or the new health care environment we operate in? I am curious to see how engagement morphs over the next few years.  

Many of us mix up lack of engagement for disengagement. However, a person who is not engaged is neither disgruntled nor actively looking to resign from their job. They exist to fulfill their job requirements sometimes at the bare minimum or just “doing their thing” effectively.

Then, some are actively disengaged and dissatisfied. These employees are often identified by their lack of initiative, unwillingness to work extra, frequent complaints from the team, absenteeism, and poor quality or lack of pride in their work output. In addition, these employees can be negative and unmotivated. Their attitude and bare minimum work output can affect the team often instigating an epidemic of negativity and dissatisfaction.

Underlying reasons for disengagement

As organizations obtain focus on engagement, leaders need to understand the root cause of this disengagement to tackle it effectively. Some possible causes I have learned over the years include: 

  1. Life stressors. Navigating through personal challenges causes stress to bubble over into work and cause disengagement due to nonwork events that consume their attention.
  2. Misinformation or lack of information. When there is ambiguous information about the operation, staff attempt to fill in the blanks which may be inaccurate contributing to misperceptions and thus negativity.
  3. Unable to process negative emotions, or no outlet to share their feelings. When staff is unable to manage their emotions, they may withdraw and appear disengaged.
  4. Facing decision dilemmas. When staff is contemplating leaving or staying, they may become stressed as the employee is unable to navigate decision-making productively.
  5. Lack of recognition. When an employee has done something significant for the organization but there is no recognition for the efforts, or perhaps someone else got the recognition, they may be angry, and disappointed.
  6. Inequity in compensation. This is prominent in our current health care climate where permanent staff are performing the same work, training travelers, and in some cases contributing more to support the operation but are not paid the same as the travelers. Or perhaps the incentives are not sufficient to match their efforts. Theories like the expectancy and equity theory help us to understand why staff experience hurt, and anger when evaluating their efforts and the return of their efforts in the form of compensation.
  7. Going through stuff. Some days are good, and some days are bad. It is not every day that employees feel like the world is filled with rainbows and unicorns. The bad periods may last more than a few days, and they may need to work through that independently. 
  8. Burnout and fatigue. The long hours, challenges, critically ill patients, and doing more with fewer resources take a significant toll on employees. Some are just trying to survive and have no energy for anything else within the operation.

Strategies leaders can use to improve engagement in a chaotic and volatile imaging environment

  • Show that you care. Spend time rounding. Get to know the human behind the worker. Human connection is amazing and has powerful long-lasting effects to include generating loyalty. Learning more about the team; who they are, what makes them happy, and what causes them grief, anger and disappointment in the organization will allow you, as a leader, to build genuine connections. Relationship building is a lifelong journey. Keep at it, don’t expect to form these relationships overnight. This can take even longer if the team experienced “bad” leaders.
  • Allow employees not to be engaged. It’s OK. Remember, people are not meant to be fixed. When your team members are ready to be engaged, they will bounce back. Sometimes you have to allow them the space to be rebellious, dissatisfied or disengaged. As long as it is not affecting the overall operation, give your staff the space to survive before they can thrive.
  • Have crucial conversations, especially with those that are showing signs of infecting the department. Avoid accusatory conversations but instead, try to understand what is causing the negative behavior to manifest. Consider starting the conversation with “I noticed you are not yourself lately, is there anything I can do to help, something we can work out together?”
  • Learn how they feel appreciated. I sent a survey to ask simple questions such as your favorite snack, what you like to do when you are off, and what recognition and a thank you look like to you. I try to memorize these so that when I chat with employees, I can speak directly about what matters most to them. At a recent conference, there was a conversation about giving employees gift cards. One comment was that an employee may feel insulted by a gift card of a certain value. Some of us were shocked at the comment but this provided testimony to how important it is for leaders to know what strategies are effective in making their team feel appreciated. Appreciation and recognition are not a one size fits all approach.
  • Use champions and ask for help from valuable resources. Employee health and wellness, motivational speakers or staff sharing positive stories are all small ways that can help plant positive seeds to improve attitudes and overall mindset. You do not need to deploy strategies on your own. Use champions to support engagement initiatives. Keep in mind not everyone is ready to internalize messages so there must be continued efforts to use champions over time.
  • Be vulnerable. Often leaders are hesitant to be vulnerable with their team. It is a risk but depending on the situation, and the maturity of your team, consider being vulnerable. Letting your team know that you are genuinely doing your best to support them and sometimes you may not get it right, or may overlook a celebration, or may not meet their expectations. I often remind my team to prod me if there is something I have overlooked, or if an action is taking too long to happen. The operation has competing demands, so I ask to let me know the priority of an issue so that it is addressed in a timely fashion.
  • Engage senior and lateral leaders. Engagement is not just for imaging managers and directors. It is a leadership team effort. The active presence of senior leaders and directors from other departments is beneficial. Staff will notice the involvement of everyone and recognize the collaborative effort to be better together.
  • Do not make promises. If staff is waiting on improvement in working conditions, pay, updated equipment, improved processes, or any other requests to increase their satisfaction and keep them engaged, keep them informed every step of the way without making promises. Sometimes when leaders relentlessly advocate for staff and the operation, C-suite leaders may not be ready to act upon an initiative which can cause significant disappointment to staff if a promise you made goes unfulfilled.
  • Don’t stop trying. Do not be discouraged if engagement scores are not where you were anticipating based on your efforts. Everyone in your team has their individual expectations of us as leaders. Sometimes we may fall short of meeting all of those. Consistency in your engagement efforts is key
  • Listen to and acknowledge employees’ voices. Act on their suggestions and solutions, and follow up on what they shared. When employees present ideas consistently and it is not acted upon, they will lose interest and become disengaged. You may not be able to act upon every idea or suggestion, but you can certainly let them know the status of whether the idea will be temporarily tabled. Maintaining their passion and spirit is key to engagement.
  • Evaluate the workload. Doing more with fewer resources increases negativity and frustration which spread like wildfire. Check-in with staff to understand their workload and any negative consequences they may be facing and address it immediately, or at least establish a plan of action with a timeline.
  • Learn about their goals. Don’t wait for evaluation time, but do frequent check-ins so you have an idea of what they are seeking in their jobs. This way you can identify those who are thirsty to give more, and those that may need to “take a knee” to rejuvenate and re-energize.
  • Take the time to celebrate milestones both big and small. This is one of the best ways to acknowledge their efforts.
  • Engage in regular feedback. Waiting for an annual survey is not ideal. Quarterly feedback, impromptu one on ones, or staff focus groups throughout the year will assist in ensuring you are attentive to your team and taking timely action.
  • Work in the trenches with your team. There is no greater testimony to supporting your team than working side by side with them. Walking the talk and leading by example inspires and motivates others tremendously thus increasing their level of commitment and engagement.

I share with you these strategies I have tried or continue to try with and without success. What a year it has been! There have been more downs than ups, but I give myself some slack for not always getting it right or just purely not being able to meet the demands and expectations of everyone.

As a leader, I want to be attentive to everyone, and every aspect of the operation. With the never-ending flow of challenges, I did not have that opportunity to spend the time in areas that I wanted to, as I was drinking from the operational firehose for the majority of the year. 

What I realized from continuous efforts to improve engagement in an operation riddled with challenges is that: 

  • You have to keep trying. Repeat old strategies that you thought did not work. Communicate your efforts and ask for feedback.
  • Ask staff for their input on what is meaningful to them, and what engagement looks like to them so you can ensure focused efforts. Employee engagement is not just spearheaded by one person. It takes a village to improve employee engagement.
  • If you end up with disengaged employees, it is OK to be OK with these employees. As a leader, we need to understand where our folks are mentally. Provide the space they may need while disengaged for their own healing and recuperation.
  • Accept that engagement scores are not a complete picture of your effectiveness as a leader. 
  • Engage in continuous feedback which you can act upon to help increase the effectiveness of your engagement efforts.

Remember, there is no foolproof one size fits all strategy, but it is imperative that we display an unwavering commitment to trying multiple strategies to support our staff, especially as we navigate the challenging health care environment we face. •

Nicole Dhanraj, Ph.D., SHRM-SCP, PMP, GPHR, CPSS, CRA, R.T(R)(CT)(MR), is a radiology systems director for Northern Arizona Healthcare.



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