The following is a summary of an article originally published in the Harvard Business Review. It explores how, in many organizations, leaders who attempt to elicit honest employee feedback often fail in their attempts to create meaningful dialogue. Urgent care providers must realize they have an important stake in this issue, as research shows when employees can voice their concerns freely, organizations see increased retention and stronger performance.
Most leaders will declare that they have an “open door policy” for employees to address their concerns, but in most cases their people rarely come to them with the unvarnished truth about what’s really going on in the company.
Rather, they withhold valuable intelligence, stay silent on suggestions on how to improve the business, or allow mistakes and bad decisions to continue.
And while many of these leaders understand the resulting negative organizational consequences, and indeed make efforts to get people to speak up, they often fail for two key reasons: fear of consequences, and a sense of futility.
The Fear Factor
When employees are afraid to speak their minds, they’ll simply stay silent about important workplace issues. And leaders worsen the problem by implementing these standard (yet ill-advised) practices:
- Relying on anonymous feedback. Although a common way to encourage frank employee input, researchers have determined this line of reasoning is flawed for three reasons:
- The very fact that the mechanism for providing feedback is anonymous in the first place underscores the risk of speaking up.
- Anonymity can cause an aggrieved manager to go on a witch hunt for the author(s) of negative feedback. For this reason, many employees use public internet for tasks like completing “anonymous” employee surveys.
- When thorny, potentially damaging, and controversial issues are anonymously documented, they’re difficult to address or resolve without “outing” the author.
- Issuing general invitations to come forward. An “open-door” invitation and attitude by itself is too passive, researchers find. Employees still have to seek out the boss and initiate the conversation, which can be intimidating. Additional problems with an open-door approach can occur when:
- The boss’s office is located too far away from employees. One example cited a manager who, although welcoming and cordial, had an office on another floor that took walking through four closed doors and three secretaries to access.
- When the boss is aligned with a particular initiative. Employees see this, and are hesitant to challenge it.
- Sending signals that you’re in charge. Bosses often send subtle but inadvertent clues that they’re in charge, known by social psychologists as “ambient clues.” For example, leaning back with hands clasped behind the head, seated behind a big desk is an intimidating posture that displays dominance, and makes employees more likely to freeze up.
The Futility Factor
Much more negatively impactful than fear was a sense of futility, according to researchers who conducted the workplace studies. In fact, when employees believed that managers would fail to act on complaints and concerns, the reticence to open up was almost twice as great. Researchers consistently saw three management behaviors that contributed to employees concluding that speaking up was futile:
- Failing to model free expression. Leaders who themselves aren’t vocal reinforce that attitude in their employees. For instance, at the conclusion of one external task force conducted by a science-driven company, middle management declined to present employee findings that would cast leaders in an unfavorable light to senior leadership. This blatant inaction, on the heels of extensive feedback, simply reinforced to employees that their voices wouldn’t be heard.
- Being unclear about the input you want. By not specifying the exact type of input sought, you run the risk of receiving too many disparate suggestions. Hence, when a leader fails to act on them all, you send the frustrating message that’s it’s pointless to even offer ideas.
- Providing no resources to address issues. Researchers consistently see leaders across a wide range of industries spend millions of dollars collecting feedback, only to fail to design any kind of systematic evaluation process for gleaning insights from that data.
Creating a More Vocal Culture
Research shows that although it’s difficult to get employees to speak up, it can indeed be done. Urgent care operators looking to gain valuable, business-improving insights from their care teams would do well to follow these research-backed best practices:
- Make feedback a regular, casual exchange – By soliciting input frequently, in informal ways, and holding face-to-face conversations with staff, leaders can make the ideas-sharing process feel natural and stress-free. In fact, leaders might even consider something like conducting a few meetings where the top agenda item is employee feedback.
- Be transparent concerning feedback processes – It’s important for leaders to inform employees exactly how they will execute feedback processes, as this is shown to reduce anxiety and increase participation. There should be an outlined agenda, clear guidelines, and solid commitments during each phase of the process.
- Reach out – The best way to find out what your employees really think and feel? Ask. Additionally, seek out feedback (often) from people who know things you don’t, like the customer-facing staff who deal with patients every day.
- Soften the power cues – Create a less intimidating environment by playing down your authority when soliciting employee feedback. This means ditching the lab coat and tie during informal sessions, and not sitting behind a big desk. Meet with employees on their turf, and listen intently to their suggestions and gripes.
- Avoid sending mixed messages – Soliciting feedback is about getting employees to relax and feel at ease. Therefore, don’t make the feedback tools and processes rigid and inflexible, and don’t shoot down ideas.
- Be the example – Employees who had bosses who consistently went to bat for them felt reduced feelings of futility. Having knowledge that a higher-up advocated for them and their concerns left many employees inspired and engaged.
- Close the loop – Gathering ideas and feedback is not enough. You must clearly show employees how you plan to use that information. And not only what your next move is, but what they can expect as a result. Closing the loop this way engenders confidence in the feedback process, and makes employees more likely to come forward in the future.
The takeaway for urgent care operators is twofold: First, realize how a more vocal culture can indirectly boost key performance metrics, and second, realize that creating a vocal culture is not easy. It takes a dedicated effort, along with an awareness of what leadership behaviors can both help and hinder the effort.
An urgent care clinic, with its fast-paced clinical environment amid myriad processes and workflows, is absolutely a workplace where honest employee feedback can help refine and improve the operation. The bottom line depends on leaders who embrace these best practices, and can clearly demonstrate to their care team that their opinions truly matter.
Alan A. Ayers, MBA, MAcc is Vice President of Strategic Initiatives for Practice Velocity, LLC and is Practice Management Editor of The Journal of Urgent Care Medicine.
