Transformational Leadership: One Emergency Department’s Journey
Author DetailsMark Goldstein, MSN, RN, EMT-P I/C
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Session C presented Thursday, September 27, 1:00-2:00 pm Purpose: The purpose of shared governance is to guide best practice by having associates research, survey, test, evaluate and implement change. Servant leadership provides staff empowerment, the opportunity for growth and the ability to lead others which yields higher associate engagement and satisfaction. This also has an effect on patient satisfaction as well. Staff retention is part of the resiliency process that adds value to the organization, improves stewardship, and improvise the morale of a department which also provides and collaborative team. Recognizing associates, identifying their needs, and encouraging a staff-lead approach partnered with visionary leadership promotes retention. Design: A descriptive design using a questionnaire with a convenience sample of emergency department staff. The survey (e.g. Press Ganey) provided the department leadership with national benchmarking as well as comparison to other workgroups in the organization. Data were analyzed using descriptive correlative design. The survey measures issues that relate both employee satisfaction and engagement. The second survey was the Press Ganey Patient Satisfaction Survey. These patient surveys are randomized and measures patient satisfaction. Setting: The setting was a suburban level 1 trauma center. Participants/Subjects: There were 118 associate surveys distributed, 75 surveys were completed (resulting in 64% response rate). Methods: A descriptive design using a questionnaire with a convenience sample of staff. The survey (e.g. Press Ganey) provided the department leadership with national benchmarking as well as comparison to other workgroups in the organization. Data were analyzed using descriptive correlative design. The survey measures issues that relate both employee satisfaction and engagement. The second survey was the Press Ganey Patient Satisfaction Survey and are randomized and measures patient satisfaction. The third metric we used was our annualized turnover rate and vacancy rate. Results/Outcomes: The workgroup has a mean score (overall rating) of 91 (on a scale 0-100). Table 1 reports responses were ranked by the respondents: “The person I report to treats me with respect” (4.52 vs. 4.34; 95% favorable), “The person who reports to me is a good communicator” (4.37 vs 3.94; 91% favorable), “The person I report to cares about my job satisfaction” (4.21 vs. 4.11; 84% favorable), “The person I report to encourages teamwork”. (4.41 vs. 4.20; 97% favorable), “I respect the abilities of the person to whom I report” (4.48 vs. 4.24; 96% favorable). Many questions ranked leadership and management as a high performer. Table 2 reports top box percentile improvement of patient satisfaction scores (e.g. Press Ganey) respective of nursing. Table 3 reports our FY15 turnover rate was 35.24% and the vacancy rate was 25%. Our FY17 turnover rate improved to 18.98% with a vacancy rate of 1.9%. Implications: Transformational leadership is essential for a positive change in healthcare. Our data identifies an engaged and satisfied workforce. Several elements of transformational leadership are being authentic, having emotional intelligence, being a “Coach, Guide and Mentor”. These attributes enable leaders to have an engaged and satisfied clinical staff, have higher patient satisfaction scores and exceptional patient outcomes. Engaging staff and leadership together yields better results.