How hospices are using technology to give care workers a voice during the global health crisis

Cath Everett Profile picture for user catheverett March 22, 2022 Audio mode
Listening to the voice of your employees can make all the difference in staff retention terms. Here are two hospices that mastered the art during the pandemic and have reaped the benefits.

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Times were tough for care workers during the pandemic, with the impact on front line staff operating under difficult conditions being severe and prolonged.

At such a time, looking after the wellbeing of employees in the face of challenges such as low staffing levels, a lack of basic supplies and understandably emotional residents and families, is just as vital as looking after the residents themselves. A failure to do so can result in an epidemic of everything from anxiety and depression to burnout.

One organization that took these challenges seriously was Acorns Children’s Hospice, which has sites across the West Midlands and parts of South West England. When Matt Bullock, Director of People and Culture, joined the organization in August 2020, he decided to undertake a “cultural diagnostic” to understand just how its 410 employees felt about matters across all areas of the business.

To obtain such information, Bullock conducted a big organization-wide survey and held focus groups to obtain feedback and insight into key issues, such as how engaged and connected they felt to the organization’s vision, mission and purpose, whether they felt listened to and what they felt about their managers and senior leadership team.  

As part of the process, rather than undertake a more traditional annual survey, the decision was made to introduce Winningtemp’s cloud-based employee experience platform at the end of October 2020. Bullock explains the rationale:

The challenge with traditional annual surveys is that the findings are only really valid at the point you do the survey and they don’t give comparative insights into how things have improved. When looking at the cost of undertaking an annual survey, we also found Winningtemp came out more or less the same. So it made sense to have something that could be used on a continual basis and that could give our managers regular insights into what their team was feeling, which was one of the deciding factors.

To create a benchmark, the AI-based system asked the entire workforce 70 questions divided into nine key categories, including job satisfaction, personal development and team spirit. Every two weeks, staff are asked a further six tailored questions based on their previous responses, to which they reply on an anonymous basis with a smiley face based on the traffic light system.

They also have the option of leaving anonymous comments and can either grant or deny permission for their managers to view what they have to say. If permission is denied, messages go only to the people team’s systems administrators in order to ensure the matter is addressed at that level.

Managers, on the other hand, have access to a dashboard that provides them with a fortnightly report based on a temperature check of their team (rather than individuals) across all nine of the system’s categories, enabling them to take action, if required. Bullock says:

It’s important to look for things to celebrate and understand where they’re going well, but in those areas where scores are lower, it’s also important to share outputs and explore the whys with the team. It’s about letting people know they’ve been heard and involving teams in being part of the solution. This not only helps drive change at the team level but also feeds into the policies, processes and practices of the wider organization.

Creating wider cultural change

Such considerations have been an important part of a wider cultural change programme at the organization, which has been taking place over the last 18 months. Innovations include the introduction of a new behaviour framework and revamped value and recognition scheme, which awards employees and volunteers on a monthly, quarterly and annual basis if they go above and beyond the call of duty in ways that are linked to the organization’s values. As Bullock explains:

All of these activities are driving overall change, but at the heart of it, you have to understand how people are responding to that change. A lot of things were done as a result of feedback, such as the refreshed value and recognition scheme. This rewards behaviour that’s in line with our values, which means it’s self-perpetuating.

Other benefits include an increase in employee satisfaction scores from 7.1 to 7.8 and a Net Promoter score that has leapt from seven to 21. As Bullock points out:

The biggest change is that people now feel as if they have a voice. So when they feed something in, they know they’ll be acknowledged and something will be done about it. Previously, they felt they had nowhere to go or if they did, their voice wasn’t heard, so it’s genuinely been a major shift.

One example of input that was acted on was changes to care worker shift patterns, which not only proved beneficial to them personally but also delivered better levels of coverage and service for the business.

That the system’s dashboard provides managers with tailored prompts and guidance on how to hold difficult conversations relating to issues covered in each of its nine categories also means they now feel more “empowered” to address challenges as they arise too.

But there are change management considerations when going down this route. For instance, says Bullock:

We were careful to set the tone that this was about giving meaningful, constructive feedback and it shouldn’t be a personal attack or character assassination. There was also a perceived fear that some comments may not go down well, but I and the other directors made it clear that we wanted to hear everything, whether we found it comfortable or not. The idea is that if you don’t understand what people are feeling, there’s little chance of bringing about a cultural shift. But we had to keep repeating those messages again and again, being persistently consistent, before we got total acceptance.

Although it took about six months to build up the necessary trust, Bullock believes that honesty and transparency are key to the process.

We said ‘we hear you and we know you don’t like this or that, so what do we need to change, and we’ll tell you what we’re able and not able to do?’ You have to dig deeper and keep on having those conversations to make it part of an organizational culture that is based on the idea of ‘we talk about things for good or bad and we want to learn’. But it takes effort and determination and courage and it also highlighted for us the other challenge of equipping leaders with the right skills to actively engage and be comfortable in talking about issues with their team.

The art of creating a happy workforce

Another organization that adopted a similar approach to the Acorns Children’s Hospice is the Mary Stevens Hospice in Stourbridge in the West Midlands. As the pandemic took hold, it realised that it needed to do more to apply its motto of ‘care, compassion and kindness’ to its staff as well as its patients and their families.

Being a charity that receives most of its funding from legacies, donations and fundraising activities, it also understood that it was unable to match NHS salaries. But as Gerry Crow, the Hospice’s Director of Operations and Support, says:

A hospice needs two critical things: a happy workforce and IT connectivity to deal with patient data and prescriptions, and if you’ve not got those, you’ve got problems. So we needed to think about how we could do more for our employees while still directing most of our money towards patient care. We were initially looking more at how to retain rather than attract staff but we now hope the work we’ve done will help to attract people too.

Towards the end of last May, it also rolled out Winningtemp’s employee experience system as part of a wider health and wellbeing strategy, overseen by a dedicated steering group. Among other things, this saw the introduction of an employee assistance scheme, personal health assessments and 15 staff members being trained as mental health first aiders.

But although its new system is only one tool in a bigger toolbox, it has played its part in changing the culture of the Hospice too. Crow explains:

The most significant benefit we’ve gained is that it’s given everyone a voice no matter who they are. So at our last big team meeting, we put up our Winningtemp data, which showed the performance of both the whole company and the different teams, and we asked ‘how would you like us to change?’ In the past, the senior leadership would have made those kind of decisions alone, but now everyone has their say.

Another advantage for the Hospice is that the system makes clear where it is performing well and where there is room for improvement. It found, for example, that more work needed to be done in staff development terms, which has now led to each manager being assigned a dedicated training budget.

One of the biggest challenges the Hospice faced though was in persuading employees that the system was totally anonymous. Another was encouraging managers to respond to each staff comment, whether positive or negative, in order to encourage them to continue contributing. But as Crow says:

Human nature being what it is, you tend to focus on the negatives and it can bring you down a bit initially. But the secret is not to take it personally. We’ve also set up an email group for managers to discuss things and ask for help if they need it, and we meet once a quarter to talk about what’s going right or wrong and what we can do to bring about change. So while not every comment will be positive, they’re actually really useful as they provide the information you need to do something about it.

My take

The value of listening to your employees not only to give them what they need but also to benefit the business tends to be underestimated. But in these days of the Great Resignation, hearing what people have to say and acting on it could well make all the difference in staff retention terms.

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