1.
Thomas Tonkin, Ph.D.
and
Lynn Howe RN. MS. CEN, CCRN
Driving Engagement: The Link between
Staff Buy-in and Quality Care

2.
Thank You to All of Our Attendees!

3.
Dr. Tom Tonkin
Principal, Change Management and Transformation Thought Leadership &
Advisory Services
Dr. Tonkin is an executive in Professional Services and Software Sales arena and has over 25
years of business and technology experience.. Dr. Tonkin is also a speaker at leadership and
business conferences where he also presents throughout the year.
Today’s Speakers
Lynn Howe RN. MS. CEN, CCRN
Regional Sales Manager for Cornerstone
Lynn has over 27 year of clinical experience ranging from Emergency Department Staff Nurse to
Director of Clinical Education. She is board certified nurse for both Emergency and Critical Care.

4.
What is Engagement anyway?

5.
Employee engagement is a property of
the relationship between an organization
and its employees. An "engaged
employee" is defined as one who is fully
absorbed by and enthusiastic about their
work and so takes positive action to further
the organization's reputation and interests1.
Employee engagement is a workplace
approach resulting in the right conditions
for all members of an organisation to give
of their best each day, committed to their
organisation’s goals and values, motivated
to contribute to organisational success,
with an enhanced sense of their own well-
being3.
Disengagement is a problem. A 2014 Gallup
poll revealed only 31% of employees in the
United States reported that they were
engaged by their jobs in 2014. A full 51%
were still “not engaged” and 17.5% were
“actively disengaged.
”Disengagement refers to a lack of
enthusiasm and commitment to work or a
workplace2.

6.
Intra-role
behaviors that
benefits the
individual
Example:
Being
Punctual
Compliance
Extra-role
behaviors that
benefits the
organization
Example:
Helping others
finish their
work
Altruism
Engagement = Organizational Citizenship Behavior (OCB)4

7.
• Conscientiousness - Conscientiousness refers to impersonal behavior
that benefits the organization as a whole.
• Sportsmanship - Sportsmanship is an employee’s willingness to deal
with poor situations without complaining.
• Courtesy - Courtesy is demonstrated by preventing organization
problems through communication and general consideration for
others.
• Civic Virtue - Civic virtue is participating in the life and culture of the
organization; this is not considered behavior that is targeted at
individuals, rather, this behavior targets the organization.
• Helping behavior - Helping behavior includes altruism, peacekeeping,
and cheerleading.
Revised View of OCBs5
7

8.
Compliant Tasks
• Task that are part of the job description.
• These emanate with a motivation of “what I have to do”
Altruistic Tasks
• Tasks that are beyond the job description.
• These emanate with a motivation of “what I want to do”
OCBs as Tasks4
8

9.
So, I can we motivate Altruistic
Behaviors?
9

10.
What happens before Altruistic behaviors?6
Altruistic Behaviors
Job Satisfaction
Perceived Fairness
Person-Org Fit
Leader’s Relationship

11.
• Need for Achievement (Learning and Development growth
path)
• Leader Consideration (Good boss that listens)
• Motivation (Want to do)
Elements of Positive Job Satisfaction (Top 3)7
11
Job Satisfaction
Learning and
Development Growth
Leader Consideration
Motivation

12.
Lynn Howe, Regional Sales Manager
Engagement Outcome

13.
Lynn has over 27 year of clinical experience ranging from
Emergency Department Staff Nurse to Director of Clinical
Education. She is board certified nurse for both Emergency and
Critical Care.
As an industry recognized expert Lynn offers healthcare
organizations specific solution to advance both business and
clinical outcomes by enhancing employee engagement,
competency assessment and employee development strategies.
In addition Lynn holds inept understanding of Joint Commission
and Magnet standards
Lynn holds an Associates Degree in Nursing from Beth Israel
Medical Center, BSN from Alfred University and a MS. in
Human Resource Management and Labor Relations from New
York institute of Technology
Lynn is now a Regional Sales Manager for Cornerstone.
Lynn Howe RN. MS. CEN, CCRN
13

14.
Medical Errors Now Third Leading Cause of
Death in the U.S.
14

15.
15

16.
The Mary Lanning HealthCare Story
16

17.
• IOM to Err is Human
• IOM Crossing the Quality Chasm
• IOM Future of Nursing
• AHRQ
• Joint Commission
• QSEN
• Affordable Care Act
The Interrelationship
17
ReimbursementEngagement
Retention +
Recruitment
Safety Satisfaction
Quality
Outcomes
Competency

18.
• Did:
• Education and training make a difference?
• Employees incorporate the knowledge into daily practice?
• Staff competency levels increase?
• Training increase employee engagement?
• Result in the outcomes we wanted?
• Return on our investment?
Ask – So What?
18

19.
• One person made a mistake does not mean everyone needs additional training
• Education is a reward not a punishment
• Competencies must be relevant to the staff
Changing Old Patterns
19
66% of L&D professionals
are having trouble getting today’s
employees to engage in L&D
offerings
only 37% of companies believe
their L&D programs are effective
less than 50% of workers report having completed a
course in the last 12 months
Source: Global Human Capital Trends 2016

20.
• Competency is not achieved by:
• Taking a test
• Passing a course
• Completing a checklist
• Application not the acquisition of knowledge
• Technical and behavioral competencies
Engaging Competency Assessment
20

21.
Require a sequence of steps followed in a specific
order.
21
Checklist
Application of knowledge in daily practice
Behavioral Competencies
• Demonstrates intuitive grasp of the clinical situation
• Anticipates and observes for significant clinical cues indicating
potential and actual deterioration in condition
• Intuitively initiates appropriate course of action deemed
appropriate for the situation
• Request changes in physicians orders due to change in
clinical condition
• Measure the effectiveness of clinical interventions based on
patient outcomes
• Proactively asks out peer sand experts for assistance when
need, including the rapid response team
Clinical Problem Recognition

22.
Checklist
• Generic, service line and unit specific
• Reused year after year
Competency Assessment
22
Initial Competency
Safety Validation
• Nurse Sensitive Indicators
• Core Measures
• Evidence-Based Practice
• Informatics
• Healthy Work Environment
• Communication
• Clinical Problem Recognition
• Safety
• Patient Experience
Behavioral Readiness Assessment
Checklist
• New Low Volume High Risk equipment &
procedures
Behavioral Assessment
• Competencies change every year
• Standardize competency selection process
• What’s new
• What’s changed
• What’s high risk
• What’s problematic
Annual Competency
Organizational Change
• Critical Thinking
• Self Reflection
• Prioritization
• Clinical Multitasking
• Compassion
• Delegation
• Collaboration
• Teamwork
• Ownership Accountability

23.
23

24.
• Enforces zero tolerance policy to address and eliminate
abuse and disrespectful behavior in the workplace
• Verbalizes commitment to accept personal responsibility
for establishing and maintaining health interpersonal
relationships based on equality and respect regardless of
job titles or levels of educational preparation
• Refuses to participate in a blame and shame culture of
horizontal violence toward co-workers
2017 Focus on Safety and Engagement Competency
24
Engagement
• Confidently and accurately anticipates potential
changes in patients condition
• Recognizes signs of early clinical deterioration
• Proactively asks out peer and experts for assistance
when need, including the rapid response team
• Anticipates and requests changes in physician order
due to changes in patients condition
Critical Thinking
• Adheres to organizational safety policies and procedures
and lends support organizations effort to develop a
culture of safety and quality patient care
• Articulates department outcome data metrics reflect units
success to provide high quality care
• Utilize technology to keep the patient safe from harm
• Comprehends errors and near misses to potentially
prevent future errors
• Encourages others to participate in organizational safety
survey to improve patient safety at the unit level
Safety

25.
Recommended Reading
25

26.
Questions or Comments?
26

27.
Thank You!

28.
References
1. Employee engagement. (n.d.). Retrieved October 12, 2016, from https://en.wikipedia.org/wiki/Employee_engagement
2. @. (n.d.). What is Employee Engagement - Engage for Success. Retrieved October 14, 2016, from
http://engageforsuccess.org/what-is-employee-engagement
3. Schaefer, L. (2015, May 12). Signs of Employee Disengagement and What To Do About It. Retrieved September
14, 2016, from http://www.skilledup.com/insights/signs-employee-disengagement
4. Smith, C. A., Organ, D. W., & Near, J. P. (1983). Organizational citizenship behavior: Its nature and antecedents.
Journal of Applied Psychology, 68(4), 653-663. doi: 10.1037/0021-9010.68.4.653
5. Organ, D. W. (1988). Organizational citizenship behavior: the good soldier syndrome. (pp. 1-43). Lexington:
Lexington Books.
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Organization: Does the Underlying Motive Matter?" (2012). Masters Theses & Specialist Projects. Paper 1159.
http://digitalcommons.wku.edu/theses/1159
7. Baker WK. Antecedents and consequences of job satisfaction: Testing a comprehensive model using integrated
methodology. Journal of Applied Business Research 2004;20(3):31
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