KPIs for measuring employee engagement in healthcare

measuring healthcare employee engagement
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Before the Covid pandemic even started, there were already rumblings in the healthcare industry about the burnout and disengagement of healthcare workers.  A 2013 Harvard Business Review study showed that only 44% of U.S. hospital workers were highly engaged at work, and an early 2020 report showed that 42% of physicians were burnt out. Then, along came Covid.Employee Engagement in Healthcare.

Workloads started rising precipitously, protocols were constantly changing, and healthcare workers were facing unprecedented issues. A survey by Mental Health America in 2020 found that 93% of workers were experiencing stress, and 76% were reporting exhaustion and burnout.  And as time has gone on and the pandemic continues to ebb and flow, 1 in 4 American healthcare workers have considered leaving their current jobs and going into another field. In fact, the World Health Organization is estimating a shortfall of more than 10 million nurses by 2030.

While the U.S. Department of Health and Human Services announced the availability of an estimated $103 million in funding to reduce burnout and promote mental health among the health workforce, healthcare organizations will need to do more to address these ongoing issues. In order to reduce employee turnover, increase employee engagement, attract top talent, improve care quality and succeed as a business, leaders will need to understand the wants, needs, and concerns of their healthcare staff – and address them accordingly. One of the best ways to start this process is to measure KPIs, or Key Performance Indicators.

What are Key Performance Indicators?

A KPI – Key Performance Indicator – is a way to measure the engagement of your employees and take a deep dive into how well your business is doing in meeting the predetermined goals you have set for your employees and organization. According to, “KPIs provide a focus for strategic and operational improvement, create an analytical basis for decision making and help focus attention on what matters most.” And while there are different types of KPI measurements to track, in this post we are discussing Employee Measures, which are focused on behavior and performance necessary to judge employee engagement, execute strategy, and meet goals.

So, how do you go about setting up healthcare worker engagement KPIs and what kind of indicators will you need to track? While every healthcare organization has its own measurement of what success looks like, there are many KPIs that are generally used across most industries, and they can be adjusted to meet the needs of you, the healthcare communications professional.

A Gallup poll of over 200 hospitals found that the higher the engagement level of nurses, the lower patient mortality was. And according to another Gallup report, companies with highly engaged workforces outperform their peers by 147%, so it’s definitely important to track your KPIs and make sure your healthcare workforce is engaged!

KPIs for measuring employee engagement in healthcare

Employee Net Promoter Score

The Net Promoter Score (NPS) was originally created to track the satisfaction levels of customers, so businesses could make adjustments based on the data in order to make their customers happier. It was developed by Fred Reichheld, and is based on asking a singular question and scored on a 0-10 scale. 

The Employee Net Promoter Score, or eNPS, does the same thing but rather than measuring customer satisfaction, it measures the satisfaction of your employees. Here’s the question to ask:

“How likely would you recommend working at our healthcare organization to a friend or colleague?

Once you receive your responses, you can divide them into three categories:

  • 9-10 are 100% promoters
  • 7-8 are neutral promoters
  • 0-6 are detractors

If an employee would be willing to recommend someone they care about come work at your organization, that’s a good sign they are satisfied with working there. After all, who would subject a loved one to a poor employee experience? Since we all know that one of the best ways to land a new job is through a referral from a current employee, a good eNPS score shows that your organization is viewed favorably by its employees.

With stories of nurses jumping ship from a typical in-house hospital job to become travel nurses because of shortages and the paychecks being offered, knowing what your employees think about your organization is key to reducing that (potential) turnover and corresponding costs. If you see a high number of detractors in your responses, you will know that you have work to do to increase employee engagement and experience.

Employee Satisfaction Index (ESI)

Unlike eNPS, the ESI is based on more than just one question and they are answered on a 1 to 10 scale. These surveys are typically three questions, and the answers are combined in order to get an overall view of employee satisfaction at any given time. The standard questions are:

Question 1 – How satisfied are you with the workplace?

Question 2 – How well does the workplace meet your expectations?

Question 3 – How is the workplace compared to an ideal workplace?

These questions are answered on a scale of 1 to 10, and calculated as follows:

ESI = (question mean value/3) x 100

Employee turnover rate

If you have been watching more of your healthcare staff heading for the exit recently, it’s definitely time to start calculating the employee turnover rate (ETR) at your organization. When employees aren’t happy, they will start looking for new opportunities – and in this market, during a pandemic, your healthcare workers may have plenty to choose from. Measuring your turnover rate reveals how well your organization is able to retain top talent and if you are meeting the needs of your employees.

Studies have shown that 17.5% of first-year nurses leave their job within that first year, and up to 57% leave within two years, with most new nurses citing “limited support” from their healthcare employer as the primary reason. The time to recruit another RN can take up to 126 days at a cost of $44,400, which results in an average hospital losing up to $7 million each year just covering for turnover!

To measure ETR, you note the numbers of employees you have left a company within a certain time period, divide that by the average number of employees on staff at that time, and multiply it by 100.  This gives you your turnover rate for whatever time period you are tracking. Are you seeing a high percentage of turnovers? It’s time to work on your employee experience and engagement program in order to keep your current staff, lower recruiting costs, and avoid the high costs of replacing your healthcare workforce.

Firstup allows us to make it happen
“The best way to reduce turnover is to increase engagement. One of the best ways to energize the team about the work they’re doing is to highlight it for the rest of the organization to see.”

Online company ratings

Ever think of applying for a job at a company and head on over to their page to see what people are saying about them? You’re not alone. 

Most job seekers not only look up the requirements for a certain position, but many of them also look up the “inside details” of a company. Those inside details come from current and past employees alike, and are in the form of reviews, complaints, management issues, salary ranges, etc., –  information you are not going to get from a recruiter or an HR leader you are interviewing with. That’s information that can only come from those “in the know.” This is why it’s important you regularly check on your company’s rating on sites like Glassdoor and Indeed. Seeing a string of bad reviews from past and present employees? That’s certainly not going to aid you in finding the right talent for open positions as it paints your healthcare organization in a negative light. 

Knowing what is being said about you in online forums and employment sites can help you understand where your engagement strategy needs some work, as well as where it’s succeeding. 


While healthcare is certainly an industry where workers should call in sick when they need to, there is a difference between someone taking time off occasionally and someone regularly missing work. When days off become too frequent, it becomes a problem and is called absenteeism. Workplace absenteeism is an ongoing pattern of missing or skipping work without reason, and it is closely related to employee satisfaction.

Healthcare workers regularly taking unscheduled days off not only hurts team morale and shifts work onto other team members, but it also costs companies a small fortune. The Centers for Disease Control and Prevention Foundation states that absenteeism costs employers $225.8 billion a year in terms of lost productivity. These costs can usually be separated into two categories:

Direct impacts: Wages for employees who aren’t working, overtime costs for those that are, and any replacement/recruiting costs.

Indirect impacts: This has a more significant effect on the company beyond the direct financial costs. Delayed delivery of work, lower-quality care, loss of team morale and engagement, and employee burnout are all indirect costs of chronic absenteeism. 

So how do you go about measuring absenteeism and seeing if it’s a “normal” percentage for your industry or causing severe issues? To calculate your percentage, take the number of absences in a given time frame, divide it by the time frame, and multiply it by 100 to get the percentage rate of absenteeism.

Number of unexcused absences/total period x 100 = % of Absenteeism

While there can be many different reasons for someone to start missing work on a regular basis, the top reasons – aside from illness – are low employee engagement and burnout. If an employee at your healthcare organization doesn’t feel valued and isn’t being heard, it shouldn’t come as a surprise that they will return that feeling to their employer. And if they are being pushed past their limits, as we have all heard about during the Covid pandemic, healthcare staff can burn out very quickly. 

By tracking absenteeism rates, you will be able to concentrate your efforts on fixing the problem before it becomes even bigger. And for some ways to prevent absenteeism in your workplace, check out 6 ways to prevent absenteeism in the workplace.

Vacation days taken

We all need to take days off in order to rest and recharge, but does everyone do it? Turns out, many don’t. Did you know that 50% of U.S. workers don’t use their paid vacation days?

If your healthcare workers are not taking their time off, it’s important to know their reasons. Is it because feel they will be judged for doing so? They may be replaced? Or are they so buried in work that they can’t afford to take some time off now and then?

While at its peak, the pandemic forced healthcare professionals to stay on the job because of the caseload. But now, as we are headed towards it being endemic, it’s important they start taking off the time they need when they can. A healthy work-life balance is vital to the employee experience and promotes a healthy work culture and positive employee engagement. So take a  look at how your staff is using (or not using) their vacation days as compared to the number they are allowed to take, and make adjustments. Here at Firstup, we offer a cash bonus for those employees who take 5 consecutive days off in a row, that’s how much we believe in the importance of downtime!

Active communication platform users

The importance of a digital workplace has never been clearer as so many employees, across a myriad of industries, have started working a hybrid schedule. In healthcare, though, working fully remote is not really a possibility. Instead, healthcare organizations have the struggle of communicating with a widely-dispersed workforce who are always on the move and need to be mobile, whether on the frontlines, tending to patients, visiting different clinical settings, or maybe – as old-fashioned as it sounds – making housecalls. In hospitals and other healthcare facilities, up-to-date communication is vital and you need a way to message your teams and reach them wherever they are. That’s why implementing a successful workforce communication platform is so important…but even more important is that your staff accesses and uses it!

Being able to push messages and notifications to your entire healthcare workforce (or only a specific group), no matter what type of device they are on or where they are located, keeps employees engaged and makes for an improved digital employee experience. The more useful they find this information, the more likely they are to use the platform. So if you are seeing low adoption rates across your organization, your workers may not be getting the value you think you are delivering. 

For tips on developing a successful communications platform, and ensuring your team adopts and uses it, check out our post Centralizing communications to reach a mobile healthcare workforce.


Tracking KPIs, and working to bring up your numbers on the KPIs that are important to you, can help you build a more engaged workforce and thus a more successful business. It’s a valuable way to assess how your healthcare workers are feeling, what issues they may be having, what improvements should be made, and make your team feel heard and understood.   

By measuring your employee engagement and experience KPIs, you can boost employee performance and job satisfaction, increase company loyalty, improve retention and recruitment, and support the objectives of your healthcare organization. Start building – and tracking – your key performance indicators today!

Download our latest case study and learn how Providence reaches 120,000 dispersed frontline workers and improved patient care with an 8x increase in caregiver engagement

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