All too often, we miss out on opportunities to learn from another area of our business. One clinical approach that can be emulated throughout the hospital is evidence-based practice, which integrates current research, caregiver perspectives and experience, and patient preferences. [For more information, see Evidence-Based Practice in Nursing & Healthcare by B. Melnyk and E. Fineout-Overholt;Philadelphia, Lippincott Williams & Wilkins, 2005.]

Physicians and nursing professionals have been using EBP in various forms since the 1970s to improve patient care outcomes. Its longevity is due to its documented success in many different areas, including infection prevention and patient falls.

In more recent years, scholars have studied and written about evidence-based leadership and evidence-based management. A logical progression in this thinking is evidence-based employee engagement. Employees are engaged when they are satisfied (they like what they do), energized (they put effort behind it) and productive (their work contributes to organizational goals). Leaders who are effective in engaging others are facilitators of the engagement process. Because no one external source can motivate an employee, providing an environment that encourages intrinsic motivators is critical.

Using EBP as a model, leaders practicing evidence-based employee engagement can take into account current research, the leader's perspectives and experience, and employee preferences.

Current Research

We know that engaged employees produce better results. Studies conducted by human resources consulting firms and prestigious universities, and published in scholarly journals and popular business magazines, all show that engaged employees have a positive effect on business outcomes. But that doesn't mean that leaders behave in ways that engage their employees. Consider what we know about hand washing and infections: Everyone agrees that hand washing cuts down on infections, yet clinicians still often neglect to wash their hands. Therein lies the challenge of employee engagement — the research may be clear, but the leaders and employees must incorporate its lessons into daily practice.

The Leader's Perspectives and Experience


As a leader, have you spent time thinking about engagement yourself? Have you held regular discussions with your leadership team to tap into their perspectives and experiences? All too often, we focus on actions and outcomes at work at the expense of missing out on the beliefs and mindsets that drive them.

As a way to learn more about others' perspectives and experiences, ask three questions at your next leadership team meeting and really listen to the responses:

  1. What about engagement (being satisfied, energized and productive) did you learn as a front-line employee?
  2. How have these beliefs changed since you've become a leader?
  3. What effect do your beliefs have on your ability to create an engaging environment?

Until leaders are honest about their own biases, negative beliefs and mindsets, they will remain unproductive when it comes to engagement. Many organizations shy away from these types of discussions and miss out on a valuable opportunity to create positive change.

Employee Preferences

The final piece of the evidence-based employee engagement puzzle is employee preferences. Many health care organizations conduct employee engagement surveys that help focus on what needs to improve. This information can be helpful to involved and interested managers who believe in the power of engagement and make the time to focus on it.

The often-missing element is one-on-one knowledge of employee preferences. Many nurse managers are overseeing 50 employees, so this becomes a daunting task. Other managers are responsible for front-line duties that take away the time needed to really get to know employees. While these challenges won't diminish anytime in the near future, highly effective leaders see engagement as a key priority and make time to learn about employee preferences.

Here are three questions to ask employees to learn more about their engagement preferences:

  1. Tell me about a time in the last week when you were satisfied and energized at work. What were you doing?
  2. What could I stop, start or continue doing to help you feel more engaged at work?
  3. What obstacles do you routinely face that prevent you from being engaged?

Because engaged employees produce better results, there needs to be a daily connection to each employee and his or her preferences. I'm not suggesting that you, as a manager, should do all the work; I'm saying that you need to show interest and share the accountability for engagement.

The Future of Evidence-based Employee Engagement

Many studies show that key health care metrics — including patient satisfaction, safety, infection prevention and readmission rates — improve when employee engagement is high. Using the three questions listed, current leaders have an opportunity now to transfer skills learned from years of EBP success to this timely topic.

Adopting an evidence-based employee engagement approach that combines current engagement research, leadership insights and employee preferences, leaders can positively impact important business results without subtracting from the bottom line.

Vicki Hess, R.N., M.S., C.S.P., is a principal at Catalyst Consulting LLC, in Owings Mills, Md.