Secrets of High Engagement: Employee Engagement is the Foundation

Kirk Soileau, MHA, FACHE, CEO, Natchitoches Regional Medical Center, Natchitoches, LA


When Kirk Soileau joined Natchitoches Regional Medical Center (NRMC) back in 2013, employee engagement was in the 18th percentile and patients rated the emergency department in the 1st percentile. As a result, NRMC was losing market share with 59 percent migration of patients to other area hospitals.

So Soileau set some ambitious goals to energize the board, leaders, employees, and physicians. He wanted NRMC to aim high: to achieve the 95th percentile for patient satisfaction, be recognized as a top 100 hospital nationwide, and become a Malcolm Baldrige National Quality Award winner within five years.

Three years into this journey, employee engagement has jumped to the 87th percentile and the medical center was just named a top 100 hospital by the Safe Care Institute based on its quality and safety record. NRMC is just about to submit its first application to Baldrige, too.

“It’s a marathon; not a sprint,” Soileau explains. “We’re really building momentum now because everyone is very engaged in achieving these goals.” His secret? Communicate clear expectations, provide the right tools and support to meet them, and demand personal accountability for results. Here’s how he’s doing it:

Ironclad Standards of Behavior
Not only does every new employee sign NRMC’s standards of behavior at orientation, but every single employee is expected to re-sign them annually, just as employees at Studer Group do. The standards, which were developed by an employee committee, are non-negotiable. In fact, every associate knows that an excuse of “it’s not my job” will earn a termination.

Employee Forums for Engagement
At these quarterly roundtables for all employees, Soileau focuses on goals over the next six months, shares performance on financial metrics and quality, highlights a standard of behavior; and introduces new trainings.

Attendance is mandatory. If you don’t attend, you’re not eligible to participate in success share. It’s one reason why NRMC enjoys a 99 percent employee participation rate from its 730 associates on its annual engagement survey. (Only those who work 15 hours or more per week and have been with the organization 90 days are invited to take the survey.)

Stand-Up Meetings for Patient Concerns
“We have a relentless focus on zero patient harm,” notes Soileau. “So if we fail a patient, we call a 5- or 10-minute stand-up meeting to resolve it within one business day. If we can’t fix it that quickly, we pull the group back together.” (It’s perhaps no surprise then that the AHA Research & Educational Trust just featured NRMC in two national case studies for best practices on early elective deliveries and falls reduction.)

But stand-up meetings aren’t just for clinical errors. Any behavior that fails a patient counts. When one very ill patient was treated without compassion or timely registration in the ED recently, she was asked to come back and share her experience with the ED admissions team, nurses, triage RNs, and members of the quality team.

Reseating Managers on the Bus
When Soileau first joined the organization, leaders and employees were disengaged. People waited to be told what to do instead of bringing solutions.

So after performing 360-degree assessments on all managers and conducting highmiddlelow® performer conversations to assess strengths and weaknesses, leaders “re-seated” fully one-third of managers in new jobs.

Today, everyone at NRMC is positive, proactive, and committed. “You have to have a learning organization to have a safe organization,” Soileau adds. “It’s no different than time-outs in the OR. If a leader or associate is fearful for their job for acknowledging or addressing a safety or quality concern, then that’s a recipe for disaster. Today, we have hardwired a culture of honesty and proactive behavior.” Can a Baldrige Award be far behind?