A massive survey of Duke University Health System employees found several lingering concerns about the organization's work culture and revealed widespread distrust of the administration's willingness to make the necessary changes.
In response, senior Health System officials have vowed to improve the environment for employees, and they have set up two teams to address employees' concerns about opportunities for career development and rewards and recognition for good work.
Even with the financial pressures facing the Health System, Mike Israel, vice president for hospitals and clinical facilities, said the organization is willing to commit significant resources to improving the workplace culture. "This is a priority," he said. "Employees are the lifeblood of this organization, and they are a priority, and we've got to invest in our employees and... we'll do as much as we possibly can."
But no matter how much money the Health System spends, selling the plan to employees will likely be an uphill fight. In the survey, which was administered last fall, only 23 percent of the employees who responded said they were confident that the senior leadership would take action in response to the survey.
And some employees interviewed Monday said they continue to hold these beliefs. Nurse Terry Kelly said everyone he knew returned negative responses. "In my opinion, the reason they took so long to put out [the survey results] is because it took this long to put a positive spin on it," he said.
Administrators said they recognize this skepticism and hope to show employees that this perception is not accurate. "What we hope to do is bring in improvement and [to] bring in change and not put this report on a shelf," said Brenda Nevidjon, chief operating officer of Duke Hospital.
In its efforts, the administration is taking the 23 percent confidence rate as a direct challenge, said Deborah Horvitz, director of Human Resources communications. At a recent retreat, she said, "Mike Israel put that number up there and said, 'What are we going to do to prove them wrong?'"
Israel said Monday that he would be disappointed to see that number recur in the next survey.
The confidential survey was administered by a private firm to all DUHS employees, a category that does not include physicians. The respondents-6,207 or 60 percent of the employees, coded responses to 93 different statements. For each statement, such as "I receive the support I need from my supervisor," each person responded indicated level of agreement using a five-point scale and indicated the importance of that topic using a three-point scale.
Israel acknowledged that until last fall, administrators had not gathered enough employee feedback. "The Health System or the Medical Center has not done a survey for the better part of seven or seven and a half years and that's probably part of some of the issues that were out there," he said. "It's long overdue."
Some of the survey results reflected well on the Health System's workplace culture, with employees returning positive ratings in several areas, including orientation (4.02 average on a five-point scale), providing challenging work (3.66), appreciation of individual and team performance (3.6) and affiliation with a world-renowned organization (3.49).
"Yes, I think they definitely appreciate you," said receptionist Wallace Smith. "Here in radiology you get complimented all the time."
The findings were less positive on consistent rewards (2.39), opportunities to develop (3.11), current benefits (3.36) and the team environment (3.36). The survey showed that the rewards and job opportunities categories had significant employee interest, so these two areas became the ones that administrators are targeting.
Teams of administrators and employees will tackle these two problems, working intensively and bringing forth recommendations by mid-June, said Horvitz. She added that this change would not be easy. "The hard part is just changing any culture..., and particularly one that is so large and so decentralized as Duke."
However, despite the Health System's size and multiple communities, Horvitz said there were no significant differences in responses based on demographics, including race, gender, occupational group or location within the Health System.
Caroline Wilson contributed to this story.
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