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DURHAM, N.C. - The first comprehensive survey of employees
of the Duke University Health System showed that most feel they
impact positively on the care of the system's patients and
often achieve extraordinary performance but believe their pay
or opportunities for advancement need improvement.

A total of 6,207 employees of Duke Hospital, Durham Regional
Hospital, Raleigh Community Hospital, Triangle Hospice and Duke
Community Infusion Services completed the survey last fall for
a 60 percent response rate. Although not part of the health
system, employees of Duke's Private Diagnostic Clinics also
participated because of its close relationship to the health
system.

The survey was designed to help to develop a better work
environment at the Duke University Health System (DUHS).

"The survey results were very helpful," said Michael Israel,
vice president and chief of hospitals and clinical facilities.
"We learned that employees value that they're making a
difference with patients and customers, and that working at an
institution that offers the best medical care is important to
them. We also learned where we have room to improve, and are
setting up teams to work on those areas. Our employees put a
lot of effort into sharing their views about our work culture
and how to make it better. Now we plan to work with staff to
use that information, and bring DUHS closer to what our people
say they value."

Sibson & Co., the consulting firm that helped develop
the survey and analyze the results, said the number of
employees who participated across all health system entities
was far more than enough to give the results statistical
validity. In addition, the diversity of survey participants -
by gender, race, occupational grouping and health system entity
- accurately represents that of overall health system staff
members.

There were 93 statements on the half-hour survey, divided
into different topics. Participants were asked to rate how
strongly they agreed or disagreed with each statement on a
five-point scale, as well as to rate each statement's
importance on a three-point scale.

The following categories ranked highest on a five-point
scale that combines satisfaction and importance ratings:

Orientation - This category was made up of five statements,
such as, "I received essential information about my benefits
and employment in a timely manner during my orientation."
overall score of 4.02 out of a possible 5 indicates that most
people felt welcome when they began working at Duke.

Challenging work that makes a difference: This category
consisted of 11 statements, including, "My job is challenging"
and "I often give extraordinary effort." An overall 3.66 rating
reveals that the majority of respondents feel their work can
positively impact patients or customers, and that this is very
important to them.

Appreciation of individual and team performance: Comprised
of 12 statements, this category included statements like, "I
receive the support I need from my supervisor" and "When my
immediate work group works well as a team, we are recognized as
a team." An overall 3.60 rating indicates that most respondents
receive support from their supervisors and co-workers.

Affiliation with a world-renowned organization: The six
statements in this category included, "I am proud to tell
others that I am part of this organization." An overall score
of 3.49 reveals that the majority of those surveyed are pleased
with their connection to the Duke University Health System.

The following areas received the lowest ratings on the
five-point scale assessing the combination of satisfaction and
importance:

Rewards that are consistent: The six statements in this
category included, "Outstanding performers are paid better than
those who are doing 'just-OK.'" A rating of 2.39 says that
staff members feel that mediocre work is being rewarded in the
same ways as outstanding performance.

Opportunities to develop: This category consisted of 10
statements, including "I have a mentor (coach) at my
organization who helps me with career development" and
"Employees at my organization are well-prepared for new
challenges." The 3.11 score indicates that participants would
like more opportunities to develop their skills.

Current Benefits: The 11 statements in this category
include, "I understand what my benefits are," and "The dental
benefit meets my needs." The 3.36 rating indicates that staff
would like enhanced benefits.

Team environment: This 16-statement category included
statements such as, "I feel that the top leadership of my
organization uses the different backgrounds and abilities of
all staff in a positive way" and "A process exists for
regularly obtaining employees' opinions and suggestions." The
3.36 rating says that most respondents would like to see more
teamwork at Duke.

According to the survey, only 23 percent of respondents are
confident that DUHS senior leaders will take action in response
to the survey findings.

"The health system administration recognizes the skepticism
of some staff members," Israel said. "Because we understand
that we have a considerable amount of work to do to move Duke
to the 'ideal' work culture, we want to involve staff from
throughout the health system in that effort, beginning now. We
hope the doubters will take an active role in making the
improvements that will emerge in response to the survey
results."

Israel said two teams composed of senior leaders and
operating staff from within the health system are being formed
to address two key issues that employees were dissatisfied with
and which they gave high importance - pay and performance, and
opportunities to advance.

"A work culture is shaped by the daily actions of every
single person in the organization," said Clint Davidson, vice
president of human resources at Duke. "To further develop and
strengthen the DUHS work culture, all staff members must
challenge themselves in their day-to-day actions and
interactions to help move Duke closer to its ideal."