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Employee Engagement from the Ground Up—Careful Hir ing and Onboarding Create a L asting Foundation By Richard Davis, SHRM-SCP, SPHR

PHARMACISTS AND PHARMACY TECHNICIANSThis INFUSION article is cosponsored by Educational Review Systems (ERS), which is accredited by the Accreditation Coun-cil for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. ERS has assigned 1.0 contact hours (0.1 CEU) of continuing education credit to this article. Eligibility to receive continuing education credit for this article be-gins January 21, 2016 and expires January 21, 2019. The universal activity numbers for this program are 0761-9999-16-H04-P and 0761-9999-16-H04-T. Activity Type: Knowledge-Based.

NURSESEducational Review Systems is an approved provider of continuing nursing education by the Alabama State Nurses Association (ASNA), an accredited approver of continuing nursing education by the American Nurses Credentialing Center, Commission on Accreditation. Program # 05-115-16-001. Educational Review Systems is also approved for nurs-ing continuing education by the state of California, the state of Florida, and the District of Columbia. This program is approved for 1.0 hours of continuing nursing education. Eligibility to receive continuing education credit for this article begins January 21, 2016 and expires January 21, 2019.

DIETITIANSEducational Review Systems (Provider number ED002) is a Continuing Professional Education (CPE) Accredited Provid-er with the Commission on Dietetic Registration (CDR). Registered dietitians (RDs) and dietetic technicians, registered (DTRs) will receive 1.0 hour or 0.1 continuing professional education unit (CPEU) for completion of this program/mate-rial. Eligibility to receive continuing education credit for this article begins January 21, 2016 and expires January 21, 2019.

Dietitian Knowledge Level: 2Dietitian Learning Codes:

1070 Leadership, critical and strategic thinking 5030 Home care 6080 Training, coaching, and mentoring 7090 Human resources management, labor relations

Continuing education credit is free to NHIA members, and available to non-members for a processing fee. To apply for nursing or pharmacy continuing education, go to www.nhia.org/CE_Infusion and follow the online instructions.

CPEAccreditedProvider

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Approval as a provider refers to recognition of educational activities only and does not imply Accreditation Council for Pharmacy Education, ERS, or ANCC Commission on Accreditation, approval or endorsement of any product. This Continuing Education Activity is not underwrit-ten or supported by any commercial interests.

This continuing education article is intended for pharmacists, pharmacy technicians, nurses, dietitians, and other alternate-site infusion professionals.

In order to receive credit for this program activity, participants must complete the online post-test and subsequent evaluation questions available at www.nhia.org/CE_Infusion. Participants are allowed two attempts to receive a minimum passing score of 70%.

EDUCATIONAL LEARNING OBJECTIVES1. Differentiate between employees who are engaged, not engaged, and disengaged.2. Explain the manager’s role in employee engagement.3. List five tips for hiring and onboarding engaged workers.

AUTHOR BIORichard Davis, SHRM-SCP, SPHR, has more than 30 years of executive management and consulting experience. He formed McClain Group in 1992 to provide talent management consulting, training, and executive recruiting services to clients nationwide. Davis’ health care experi-ence includes executive management positions with Hill-Rom in South Carolina, Tennessee, New England, and Canada; and as Vice President of Human Resources for Barnes Healthcare Services, a full-service home infusion provider out of Valdosta, Georgia. He is certified as a Senior Professional in Human Resources by the Human Resources Certification Institute and as a Senior Credential Professional by the Society for Human Resource Management. Davis graduated from The Citadel and currently lives in Charleston, South Carolina.

AUTHOR DISCLOSURE STATEMENTThe author declares no conflicts of interest or financial interest in any product or service mentioned in this program, including grants, em-ployment, gifts, stock holdings, and honoraria.

Questions or comments regarding this article should be directed to Richard@McCkainGroupLLC.com

If you read most business journals or trending business and leadership books, you must have noticed that employee engagement is a prominent topic among management

gurus. It has become the newest in a long line of business expressions regarding the work environment, and for good reason. But, what exactly does engagement mean?

Human resource experts define employee engagement as “the deep and broad connection that employees have with a company, as well as their voluntary and enthusiastic com-mitment to its success.”1 Engagement is not merely happi-ness or satisfaction with a job, it is an indicator of emotional commitment to the organization and its goals.2 Engagement can be seen in the extent to which an employee puts discre-tionary effort into his or her work, in the form of extra time, brainpower, and energy. Essentially, it is being fully involved and enthusiastic about your job and the organization.

In an environment where health care providers are dealing with significant reductions in reimbursement, increases in the cost of doing business, and the constant threats of au-dits, employee engagement seems to be the last area where

a company may be likely to prioritize its focus—or be able to have a positive impact amid so many challenges. But consid-er this: in a study conducted by Gallup across multiple indus-tries with companies of various sizes, it was found that ac-tively disengaged employees cost U.S. companies $450 - $550 billion in lost productivity per year.3 That’s right—BILLIONS!

Engagement Categories1. Engaged employees work with passion and feel a pro-

found connection to their company. They drive inno-vation and move the organization forward.

2. Not Engaged employees are essentially “checked out.” They’re sleepwalking through their workday, putting time—but not energy or passion—into their work.

3. Actively Disengaged employees aren’t just unhappy at work; they’re busy acting out their unhappiness. Ev-ery day, these workers undermine what their engaged coworkers accomplish.

Source: Gallup

Engagement is not merely happiness or satisfaction with a job, it is an indicator of emotional

commitment to the organization and its goals.

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According to that same study, less than one-third (30%) of U.S. employees are fully engaged in their work. A startling 50% have mentally checked out, and 20% are actively dis-engaged and sabotaging the efforts of co-workers.3 Other statistics reveal just how elusive employee engagement can be. For example, only half of new hires are confident they made the right decision accepting the offer, and more than half (51%) of employed workers are either actively seeking or open to a new job.4,5

As a growing field with a wealth of new career tracts, health care can be an especially challenging place for em-ployee engagement. With turnover rates approaching 20% (in 2014, the voluntary turnover rate for health care was 13% and the total turnover rate was 17%) new hires who fear making the wrong choice or employees who become disen-gaged can easily find a new opportunity.6 Clearly, engaging and developing employees is a prudent retention strategy—and a strategic remedy for the high cost of turnover.

Management’s Role in Engagement

We have all seen the telltale signs of disengaged employees: low morale, absenteeism, tardiness, poor sales results or poor quality output, customer complaints, lack of coopera-tion, and constant complaining about the company. Employ-ees who are not engaged are difficult to work with—in fact,

many good employees go out of their way to work around their disengaged colleagues, which quickly saps productivity.

On the flip side, engaged workers are more likely to be top performers and in general are more productive. Research has found that the top 25% of teams (the best managed) versus the bottom 25% of teams in any workplace have nearly 50% fewer accidents, 41 fewer quality defects, and incur far less in terms of health care costs (see Exhibit 1).3 Furthermore, Gallup asserts that, “The 30% of engaged employees in the U.S. come up with most of the innovative ideas, create most of a company’s new customers, and have the most entrepre-neurial energy.”3

Exhibit 1 Performance Outcomes Affected by Employee Engagement• Customer rating• Profitability• Productivity• Turnover • Safety incidents• Inventory shrinkage/theft• Absenteeism• Patient safety incidents• Quality

Source: Gallup

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How can you boost employee en-gagement? Surprisingly, managers who focus on their employees’ strengths can practically elim-inate active disengagement.3 So, while it may be tempting to blame wages, benefits, and lack of motivation on the part of a struggling employee, the truth is that management practices have the most sig-nificant impact on declining engagement.

Nationwide, only 41% of employees report know-ing what their compa-ny stands for and what makes its brand different from competitors.3 That lack of clarity can easily translate to job description as well. Many employees fail to engage when the expectations of their job have not been effectively communicated—or change without their knowledge—leaving them to wonder if they are meeting the standards set for them. Employees also lose passion for their jobs when they are not given the necessary tools, space, and authority to be successful. Without consistent and objective feedback on performance, their confusion and disengagement only in-creases. It does not take long before such an employee feels that what he or she does is unimportant, won’t make a difference anyway, and is not worth the extra effort.

Other forms of management malpractice include shifting targets and expectations, as well as failing to practice ac-tive listening. Both of these practices can create a lack of trust between the manager and employees. Office politics can also affect the relationship. For example, a huge engage-ment killer is when a supervisor or manager takes credit for the hard work of an employee or when all employees are treated the same regardless of their level of contribution. Engaged employees should be recognized for their efforts, and poor performers should be held accountable for not meeting expectations.

By contrast, effective managers work hard to maintain the positive self-esteem of all employees. Effective managers engage in active listing and respond with genuine empathy. Effective managers involve others in solving problems and al-

low employees to feel like they make a difference. Effective managers are able to build trust and loyalty, even in the midst of correcting the perfor-mance of an employee.

Great managers practice many behaviors that build high-performing, highly engaged employees—the most critical of which were famously documented in the man-agement bestseller, First, Break All the Rules.7 In this article, we’ll focus on the critical aspects related to bringing new employees into the organization and building engagement from the ground up. The following behaviors from First, Break All the Rules apply to our scope of study:7

• Selecting the best person for the job. Great managers select for talent and potential, not just experience.

• Setting the expectations for the job. Great managers de-fine the outcomes, not just the action steps necessary to complete a task.

• Motivating the person by focusing on the strengths of the employee and not by pointing out weaknesses.

• Developing the employee by identifying the right fit, not just the next rung on the ladder.

Employee engagement can be won or lost in the onboarding process.

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Hiring for Engagement

Employee engagement can be won or lost in the onboarding process. Onboarding is not just getting the employee to the first day on the job. Onboarding is a crucial part of an effec-tive and integrated talent management strategy that begins when details of a position are created all the way through a new employee becoming fully trained and comfortable in his or her position.

The first step is to hire the best person for the job, and that means fully comprehending the job. Even before a search be-gins for an open position, an organization—whether big or small—needs to identify the core competencies required for the position and develop a detailed job description. A com-pany needs to know what it is looking for before the hiring team starts looking.

This process should look beyond the job duties and also describe the desired skills and qualities of the ideal candi-date. For instance, if a Customer Service Representative is being hired, a core competency might be “dealing with con-flict.” A Pharmacy Technician should demonstrate “attention to detail.” A General Manager may require the “ability to manage change.” Sales professionals should have the “ability to convince and persuade,” and so on. We will detail how es-tablishing core competencies align with a strategic interview process later in the article.

Once the job description is created and the core compe-tencies are established, the search itself needs to be orga-nized and managed. Will an outside recruiting agency be part of the search? Keep in mind that a professional recruit-ing firm will be contacting candidates who are not actively seeking other employment and may not even look at job boards or company job postings. This allows the organiza-tion to tap into an additional level of potential hires, many of whom may be top performers in their current roles.

Many companies have a robust Applicant Tracking System (ATS) that allows jobs to be posted on multiple job boards, social media, and business networking sites. For companies that do not utilize an ATS, job boards can include nation-al and regional sites. It’s also helpful to post open positions on industry-specific association sites or sites specific to the health care space. As the resumes and applications begin to arrive, care must be taken to evaluate the experience and

qualification of each candidate against the core competen-cies developed. Assessing talent should never be a beauty or popularity contest.

The screening and interview process must also be very structured. As qualified candidates are identified, companies should create interview teams. These teams could encompass human resources, management, peers, and in some cases, direct reports. Interview questions should be created to re-flect the core competencies identified in the early stages. If a company does a great deal of hiring, it is crucial that those involved in the interview process be trained in interviewing methods that provide objective feedback. The team should be focused on past behavior as an indicator for future per-formance. In other words, how a candidate performed with his or her former employer. The “gut” has no place in this pro-cess. Regardless of the size of the company and even in the absence of a dedicated recruiting or human resource staff, an objective evaluation of each candidate can be completed by comparing past performance against core competency.

When interviewing, regardless of the question, try to find out what specific task or situation the candidate experi-enced. Next, get specifics on what action steps the candi-date took related to that particular situation or task. Lastly, find out the results of the action. The acronym to describe this type of interview answer is STAR (situation/task, action, result). With this complete answer, it is easier to evaluate a previous experience and how it might relate to success in the position for which the candidate is being evaluated. Based on the core competencies discussed earlier, a behavioral question for a Pharmacy Technician under “attention to de-tail,” could be “Tell me about the last mistake you made.” Or, “Tell me about a time where you were working on multiple tasks at the same time.”

It is also beneficial to use some type of assessment tool provided by a reputable company that is validated and re-liable for hiring. Just remember that only “normative” type assessment tools are validated in the hiring process. Most “personality” type assessments are not normative. An effec-tive assessment tool will measure responses by a candidate against a benchmark or performance model created for each position based on behavioral characteristics. The most im-portant component in an assessment tool is the ability to measure for “job fit.”

An objective evaluation of each candidate can be completed by comparing past performance against

core competency.

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During this whole process someone on the interview team needs to keep candidates updated on the process. As a recruiter, I have seen many companies lose highly qualified candidates because they failed to provide timely feedback and demonstrate their sincere interest.

Last year, U.S. businesses were at a 13-year high in time taken to fill open positions—an average of 25 working days.8 Larger employers are taking even longer at over 58 working days.8 Although there is no data in this regard on the home and specialty infusion industry, it can be assumed that the need for more specialized experience and the frequency of low-supply/high-demand positions, the time to fill might be even higher.

Once a candidate is extended and accepts an offer, an offi-cial offer should be generated in a timely fashion. One quick human resources suggestion is to provide salary or wage information in a pay period amount or hourly rate rather than an annual figure. Although it’s a stretch, there have been court cases where poorly fitting candidates successful-ly argued that the offer letter was a contract for one year’s employment, thus preventing them from being terminated. After the offer letter is signed and returned, establish a start date and provide the candidate with paperwork that can be completed prior to the first day. Also, keep in touch. If the candidate has to give notice to his or her current employer, do not let that time go by without contacting to ensure all is still good for that planned start date. Some states actually have a template for new employee notification.

Onboarding for Engagement

Before a new hire arrives for his or her first day, have a plan. Coordinate who will meet the new employee when he or she arrives, and how their time will be spent the first week on the job. Do not give the new employee the impression that the company is unsophisticated and unprofessional for lack of planning. The supervisor or manager responsible for the suc-cess of the new employee should sit down on the first day to review the detailed job description, provide an opportunity for candid dialogue, and answer questions.

If the new position is an intake or patient care coordinator, customer service representative, or reimbursement type posi-tion, do not make the mistake of having the new hire shadow your best veteran employee in that position. I have seen first-hand how easily a new hire can become overwhelmed and discouraged watching the best administrative person, who knows all the shortcuts, work circles around everyone else. In

one case, the new employee quit after the first week. Why? In an exit interview, she shared that the competency demon-strated by the star would be impossible to duplicate. Thinking, “I will never be able to do that,” the new hire quickly became disillusioned and disengaged.

Shadowing a single current employee for a day or two is a limited training program for other reasons as well. What’s needed is a structured program. Effective training creates an EDGE: explain, demonstrate, guide, and enable (see box), and should continue until the new hire demonstrates total profi-ciency in the job duties.

EDGE

1. Think carefully about how to explain to others the way the skill is performed.

2. Then demonstrate the steps.3. And guide them as they practice.4. Lastly, provide the support they need to enable them

to use the new skill on their own.

To keep new hires engaged and to encourage them to become dedicated members of highly effective teams, managers should continuously ensure that they—and all employees— have the resources necessary to meet expec-tations as outlined in the job description. Hold regular meetings to discuss job performance versus job expecta-tions—regular meetings are a simple, yet effective tool for performance management.

While meetings facilitate communication, it’s important to note that too many meetings, or meetings that lack struc-ture can feel like a waste of time and actually disengage em-ployees. One suggestion is to have, at a minimum, a monthly meeting that results in three determinations known as KSS: What do you need to KEEP doing? What do you need to STOP doing? What do you need to START doing? It is im-portant to document action items that result from these meetings and follow up on employee steps taken. That en-sures there is no confusion and sets the stage if any correc-tion in performance is required.

When managers fear an employee is becoming disengaged, they must be able to have a calm, objective, and meaningful conversation about the employee’s discontent. This is a great time to discover the passions that might drive an employee to improve performance and become fully engaged. Find out what is important to the employee and how that can be in-tegrated in to his or her daily tasks at work.

Before a new hire arrives for his or her first day, have a plan.

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Be sure to do more than listen…hear what is truly being said. The goal is to move a disengaged employee to become that fully engaged, fully productive employee. Listening and not taking action only breeds mistrust. Resist the urge to pass judgment, as there are valid reasons employee motiva-tion wanes.

Managers must realize that good communication is the key to enhance employee engagement. Good communication be-gins with active listening, which helps managers and employ-ees better understand the dynamics that drive productivity. Good listening helps a manager respond rather than react, and it shows the employee that you care about them and their success. As Theodore Roosevelt said, “Nobody cares how much you know, until they know how much you care.”

The bottom line is this: Engaged employees know what is expected; they have the support and tools they need to do the job; and they know their manager cares about them as people. And, of course, engaged employees are the key to sustainable company success.

References

1. George Zarkadaki. Next generation employee engage-ment. Towers Watson. Available at: www.towerswat-son.com/en/Insights/Newsletters/Europe/HR-mat-ters/2015/12/next-generation-employee-engagement (accessed 12/17/2015).

2. Kruse K. What is employee engagement? Forbes. June 22, 2012. Available at: www.forbes.com/sites/kevink-ruse/2012/06/22/employee-engagement-what-and-why/ (accessed 12/17/2015).

3. Gallup. State of the American workplace: Employee en-gagement insights for U.S. business leaders. 2013. Avail-able for download at: www.gallup.com/services/176708/state-american-workplace.aspx (accessed 12/17/2015).

4. Jobvite. Job seeker nation study: An authoritative survey of the social, mobile job seeker. 2014. Available at: web.jobvite.com/rs/jobvite/images/2014%20Job%20Seek-er%20Survey.pdf (accessed 12/17/2015).

5. Boatman J and Erker S. Global selection forecast 2012. DDI/Oracle. Available at: www.ddiworld.com/DDI/me-dia/trend-research/globalselectionforecast2012_tr_ddi.pdf?ext=.pdf (accessed 12/17/2015).

6. Compensation Force. 2014 turnover rates by industry. Available at: www.compensationforce.com/2015/03/2014-turnover-rates-by-industry.html (accessed).

7. Buckingham M and Coffman C. First, Break all the Rules: What the World’s Greatest Manager Do Differently. 1999. The Gallup Organization. New York, NY.

8. Weber L and Feintzeig R. Why companies are taking lon-ger to hire. Wall Street Journal. Sept. 1, 2014. Available at: www.wsj.com/articles/companies-are-taking-longer-to-hire-1409612937 (accessed 12/17/2015).