Duke Health System Employee Survey Evaluates Work Culture

Duke University Medical Center
Monday, 3 April 2000

The first comprehensive survey of employees of the Duke University Health System showed that most feel they impact positively on the care of the system's patients and often achieve extraordinary performance but believe their pay or opportunities for advancement need improvement.

A total of 6,207 employees of Duke Hospital, Durham Regional Hospital, Raleigh Community Hospital, Triangle Hospice and Duke Community Infusion Services completed the survey last fall for a 60 percent response rate. Although not part of the health system, employees of Duke's Private Diagnostic Clinics also participated because of its close relationship to the health system.

The survey was designed to help to develop a better work environment at the Duke University Health System (DUHS).

"The survey results were very helpful," said Michael Israel, vice president and chief of hospitals and clinical facilities. "We learned that employees value that they're making a difference with patients and customers, and that working at an institution that offers the best medical care is important to them. We also learned where we have room to improve, and are setting up teams to work on those areas. Our employees put a lot of effort into sharing their views about our work culture and how to make it better. Now we plan to work with staff to use that information, and bring DUHS closer to what our people say they value."

Sibson & Co., the consulting firm that helped develop the survey and analyze the results, said the number of employees who participated across all health system entities was far more than enough to give the results statistical validity. In addition, the diversity of survey participants - by gender, race, occupational grouping and health system entity - accurately represents that of overall health system staff members.

There were 93 statements on the half-hour survey, divided into different topics. Participants were asked to rate how strongly they agreed or disagreed with each statement on a five-point scale, as well as to rate each statement's importance on a three-point scale.

The following categories ranked highest on a five-point scale that combines satisfaction and importance ratings:

Orientation - This category was made up of five statements, such as, "I received essential information about my benefits and employment in a timely manner during my orientation." overall score of 4.02 out of a possible 5 indicates that most people felt welcome when they began working at Duke.

Challenging work that makes a difference: This category consisted of 11 statements, including, "My job is challenging" and "I often give extraordinary effort." An overall 3.66 rating reveals that the majority of respondents feel their work can positively impact patients or customers, and that this is very important to them.

Appreciation of individual and team performance: Comprised of 12 statements, this category included statements like, "I receive the support I need from my supervisor" and "When my immediate work group works well as a team, we are recognized as a team." An overall 3.60 rating indicates that most respondents receive support from their supervisors and co-workers.

Affiliation with a world-renowned organization: The six statements in this category included, "I am proud to tell others that I am part of this organization." An overall score of 3.49 reveals that the majority of those surveyed are pleased with their connection to the Duke University Health System.

The following areas received the lowest ratings on the five-point scale assessing the combination of satisfaction and importance:

Rewards that are consistent: The six statements in this category included, "Outstanding performers are paid better than those who are doing 'just-OK.'" A rating of 2.39 says that staff members feel that mediocre work is being rewarded in the same ways as outstanding performance.

Opportunities to develop: This category consisted of 10 statements, including "I have a mentor (coach) at my organization who helps me with career development" and "Employees at my organization are well-prepared for new challenges." The 3.11 score indicates that participants would like more opportunities to develop their skills.

Current Benefits: The 11 statements in this category include, "I understand what my benefits are," and "The dental benefit meets my needs." The 3.36 rating indicates that staff would like enhanced benefits.

Team environment: This 16-statement category included statements such as, "I feel that the top leadership of my organization uses the different backgrounds and abilities of all staff in a positive way" and "A process exists for regularly obtaining employees' opinions and suggestions." The 3.36 rating says that most respondents would like to see more teamwork at Duke.

According to the survey, only 23 percent of respondents are confident that DUHS senior leaders will take action in response to the survey findings.

"The health system administration recognizes the skepticism of some staff members," Israel said. "Because we understand that we have a considerable amount of work to do to move Duke to the 'ideal' work culture, we want to involve staff from throughout the health system in that effort, beginning now. We hope the doubters will take an active role in making the improvements that will emerge in response to the survey results."

Israel said two teams composed of senior leaders and operating staff from within the health system are being formed to address two key issues that employees were dissatisfied with and which they gave high importance - pay and performance, and opportunities to advance.

"A work culture is shaped by the daily actions of every single person in the organization," said Clint Davidson, vice president of human resources at Duke. "To further develop and strengthen the DUHS work culture, all staff members must challenge themselves in their day-to-day actions and interactions to help move Duke closer to its ideal."

For more information, or to contact Duke University Medical Center, see their website at: www.mc.duke.edu