“Clients don’t come first. Employees come first. If you take care of your employees, they will take care of your clients.”—Sir Richard Branson
Ask healthcare leaders about the most significant challenges they face, and most will say workforce is one of their top three.1 This is especially true in the world of post-acute care. Simply put, there are not enough qualified nurses, therapists, aides, and other key staff to serve residents.
National studies show a widening gap between an aging population and the declining workforce available to serve them.2 Contributing factors include the increase in medically complex residents, shorter stays in long term care, and more regulation.
Who Should Be Our Priority?
As health care providers, we’re in the people business, serving various levels of care. If we are to succeed, where should our priority be? Who should be our primary “customer”? The pivotal question becomes: “If we’re going to do the best work we can with a limited workforce, who comes first? The resident or patient? Or the employee?”
Employees should always come first, as they are the connection between the services we provide and those we serve. If our teams aren’t happy at work, appreciated for their hard work, and empowered in their roles, why should they stay? How will their attitude impact our residents or patients and their families?
Developing any employee-first program requires a shift in priorities and focus—a cultural change. The key to success is our willingness to reframe our thinking and reshape our attention and efforts toward staff, believing that this shift will, in turn, produce positive customer satisfaction and increased quality outcomes.
The first three steps in developing an employee-first culture are:
1) Identify positive impacts for your organization.
Employee-first culture does not mean that patient care is not important. Rather, when the focus is on the well-being of employees first, staff naturally put more emphasis on the well-being of patients. It is important for healthcare professionals in all settings to explore the emerging trend of employee-first culture, the key characteristics of an employee-first culture, examples of how non-healthcare providers have implemented it with success, and potential barriers to success.
Tip: Do your homework. Identify how embracing an employee-first culture could impact your organization, increase employee engagement and retention, and enhance the connection between team members and residents.
2) Educate leadership about the cultural changes ahead.
Employee-first culture is characterized by a working environment that focuses on commitment to the wellbeing of staff and the building of relationships. Because of the trend toward person-centeredness and the focus on workforce development, organizations are recognizing a new approach to the Golden Rule—i.e., if we ask staff to treat others in a person-centered, caring, committed way, then providers will treat staff in a similar way.
Tip: Conduct an assessment of baseline status to determine a starting point for an organization. Start discussions of the role of the leader in making this paradigm shift and setting goals for success.
3) Cast the vision, improve communication, build trust, and make it fun!
Creating an employee-first culture is vital because it allows residents to experience the personal side of the staff. Giving employees an open, accommodating work environment and a listening ear is the only way this information can be learned and applied by leaders.
Tip: Engage in discussions about the characteristics of trust, communication, conflict management, community building, and fun as part of an employee-first culture.
The bottom line is that most organizations have much to learn and little to lose by exploring an employee-first culture. Other industries have pioneered the path ahead and have demonstrated that the upside benefits far outweigh assumed risks.
- Stempniak, M. (2019). Staffing 'crisis' hitting directors of nursing hard, new industry analysis finds. McKnight's Long-Term Care News. https://www.mcknights.com/news/staffing-crisis-hitting-directors-of-nursing-hard-new-industry-analysis-finds/
- Bodenheimer, T., Chen, E., & Bennett, H. D. (2009). Confronting the growing burden of chronic disease: Can the U.S. healthcare workforce do the job? Health Affairs, 28(1).