How Healthcare HR Teams Can PROPEL Their Organizations to Improve

Senior Director of Marketing

Healthcare is rapidly changing. Amid the industry’s ongoing turbulence, physician and staff engagement are suffering. Burnout and turnover rates can be especially high, and can have particularly high costs, with dissatisfaction contributing to poor performance and preventable medical errors.

Boosting morale ultimately translates to happier employees and better, safer patient care. One strategy that has proven effective begins with healthcare HR professionals integrating policies and programs that focus energy on the people who are good employees and who want to do their best.

This positive psychology is the basis of Dr. Tom Muha’s approach; Muha is a psychologist, founder of the PROPEL Institute and author of “PROPEL to Quality Healthcare: Six Steps to Improve Patient Care, Staff Engagement, and the Bottom Line.” By implementing PROPEL principles within their practices, hospitals or health systems, HR teams can improve both employee and patient satisfaction.

What is PROPEL?

Muha says his inspiration for PROPEL came from personal experience, having been the victim of a medical error. “I got curious about whether or not it might help the doctors and nurses to feel better themselves as individuals and as providers and as teams, and with that, improve patient care,” he says.

He developed a framework that starts with identifying and recognizing people who are doing good work and then cultivating their ongoing efforts and engagement through positive reinforcement vis-a-vis PROPEL’s six core principles:

  • Passion
  • Relationships
  • Optimism
  • Proactivity
  • Energy
  • Legacy

PROPEL in Action

The first study Muha did was with a labor and delivery group with a 1 percent job satisfaction rate, a 3 percent job engagement rate and a 100 percent turnover rate among new nurses.

“They were desperate,” he says. “They tried all different kinds of programs. Nothing seemed to turn it around.”

He helped the nurse manager shift her focus and energy: She started giving poor performers 20 percent of her time and investing the other 80 percent of her time in the rest of her staff — instead of the other way around.

“As soon as she started focusing on better people, her level of well-being went way up,” Muha says. “Most of her day was dealing with people in the trenches, who wanted to provide good patient care, who wanted to build a good team of people to work together.”

Here’s how that labor and delivery group implemented the six PROPEL principles:

  • Passion: Muha asked nurses on the unit to identify their values and vision for their work environment. In response they described how they wanted to build camaraderie, teamwork and professionalism. Right out of the gate, by helping them reconnect with their core purpose for choosing nursing as a career and giving them ownership, “we increased people’s passion for wanting to do a good job,” Muha says.
  • Relationships: Building camaraderie, teamwork and professionalism boiled down to building stronger relationships. Based on the idea that you need five positive interactions for every one negative interaction in order to build a high-performing team, staff members started checking in with each other more often, offering an extra set of hands, asking each other about weekends and families. 
  • Optimism: Figuring out how to stay positive even when confronted with problems was another challenge. Muha helped the team develop a resilient mindset and the belief that they could find solutions. “They believed they could grow and learn and things could get better,” he says.
  • Proactivity: Instead of waiting to react to problems, he helped the team recognize that challenges exist, and he cultivated the belief that they have capabilities and attributes that enable them to rise to those challenges and play to their strengths. He says he posed a question for the team: “What are your best qualities and how can you use those to be at your best?” As soon as the nurse manager started answering those questions, she started to thrive.
  • Energy: “You can’t take care of others unless you take care of yourself,” Muha says. Here, he helped staff members on the unit focus on self-care, on leaving work on time, going home and being with loved ones, and getting enough sleep.
  • Legacy: The team of nurses knew they wanted to make a meaningful difference with their work. They started taking new nurses under their wings. They worked to bring good qualities to interactions and to help one another. “Legacy is about taking care of others,” Muha says.

One year after starting to implement PROPEL, the job satisfaction rate on the unit had gone from 1 percent to 85 percent; engagement went from 3 percent to 87 percent; and turnover among new nurses decreased from 100 percent to 20 percent.

“That was story one, day one, month one, year one,” Muha says. “Imagine, 12 years later we did 80-some units in a major academic medical center: thousands of nurses, hundreds of leaders. And of course we’ve been many other places since then.”

Muha trains leaders to put PROPEL principles into place in their hospital units and physician practices. His overarching advice is simple: “You’re still going to deal with problems,” he says. “How do you deal with them optimistically?”

That’s advice we can all consider as we improve the way we provide care.

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