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Quality and Safety as the Spark for Employee Engagement

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Introduction

In 1987, when Paul O'Neill became chief executive officer of Alcoa, the company's plants reported at least one worker sustaining an injury per week. Although the safety record of the company was on par with industry competitors' and considered acceptable given the inherent risk of working with molten metal, O'Neill found this injury rate appalling. On his first visit to the company's Tennessee-based aluminum smelter, he met with management at the plant and said, “From now on we are not going to budget for safety. If someone identifies anything that could hurt someone, I want you to fix it, and I will figure out a way to pay for it” [1].

Over the following years, O'Neill used the idea of safety to transform Alcoa's entire culture, encouraging workers at every level to identify potential safety problems and work to prevent them from causing injuries. As Charles Duhigg [2] described in The Power of Habit: Why We Do What We Do in Life and Business, he used the concept of “safety” to engage his employees in the process of improving Alcoa, harnessing previously untapped technical expertise and personal ingenuity and establishing the habit of excellence.

Engaged employees transformed Alcoa by making the workplace safer; reducing waste; increasing productivity; improving recruitment, retention, and morale; and improving customer service. By 1999, when O'Neill retired, the injury rate had declined from the 1987 figure of 1.86 lost days per 100 workers to 0.2 lost days per 100 workers, which made Alcoa safer than even the software development industry. This accomplishment is impressive in its own right, but its impact on the bottom line is truly staggering. Over that same period of time, Alcoa's employee workforce grew by a factor of 4 to 140,000, the company's value grew by a factor of 5 to $27 billion, and annual income grew by a factor of 6 to $1.5 billion [3].

Section snippets

Employee Engagement and Its Importance

As the Alcoa example illustrates, studies across many industries have linked employee engagement to higher performance. This linkage holds true even within health care. For example, in 2012, the National Health Service in the United Kingdom conducted a survey of 280,000 health care employees, which demonstrated that employee engagement scores correlated with lower patient mortality, higher patient satisfaction, lower staff absenteeism, lower staff turnover, and even lower infection rates [4].

Quality and Safety as the Road to Employee Engagement in Radiology

There are personal components to employee engagement that are not entirely in the control of an organization [5]. But management efforts that best predict employee performance include promoting autonomy, supervisory coaching, employee inclusion in decision making, and performance feedback and recognition [4]. The continuous quality improvement (CQI) cycle seeks employee representatives at every level of an organization, incorporating them in each step of the process and allowing them to voice

Conclusions

Radiology leadership has been able to leverage the significant technical innovations that have driven efficiency improvements over the past two decades. Today, radiology leadership can benefit greatly by investing in managerial innovations that foster employee engagement to increase workforce performance to meet the challenges ahead. This trend is reflected by the ACR's creation of the Radiology Leadership Institute. The efforts to reinvent radiology should start in your quality and safety

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