By Julian Birkinshaw and Simon Caulkin, contributors

) — Employee engagement is, as they say, a no-brainer. There are stacks of literature

showing that companies with committed employees who feel strongly about their organization do better financially than those with indifferent employees. In many cases, too, improvement is actually quite easy to achieve.

Large numbers of employees work in silos, with deep functional expertise but no line of sight to the person ultimately buying their product. Yet it turns out that exposure to customers can be a powerful source of insight and motivation.

That is what pharmaceutical giant Roche found when a team devised an experiment to put the engagement proposition to a test. But, in the end, it wasn’t quite as simple as that.

The Roche team realized it would be easy to get stuck at a high level of abstraction in a study of this type, so they focused on a simple, straightforward hypothesis: that a deeper emotional understanding of the company’s real value to patients and society would deliver extra engagement among employees.

The team believed its employees were already engaged and well-informed, yet there was fuzziness about the company vision. Compared with the famous NASA janitor who, when asked what he was doing, replied, “putting a man on the moon,” Roche employees sometimes have a less clear line of sight between their day jobs and what they are meant to achieve.

“If you ask people, ‘What do we do?’ you’ll get the answer that we are a commercial organization that makes life-saving medicines that have a massive impact on people’s lives,” says Rob Rylance, one of the leaders of the study. “But when you start peeling that back, is this actually resonating emotionally with people or resonating as emotionally as it can?”

Probably not. But the thinking was if patients and patients’ experiences could be brought into the organization (particularly for those employees who rarely had direct contact with them), it would help everybody to not only focus their daily priorities and actions but also give them a better sense of the company’s guiding mission.

What was the best way of doing this? Among a number of possibilities — hospital or hospice visits, meeting doctors or scientists — the team quickly decided on the simplest and most direct intervention of all: getting a single patient to talk face-to-face about his or her experience of illness and treatment.

The experiment would be attractively direct. Two similar groups of around 30 employees, most of them from non-customer-facing departments, would complete a straightforward, 17-question engagement questionnaire (consisting of statements such as I am proud to work for Roche, I feel a strong sense of commitment, I am willing to go beyond the requirements of the job, The Roche vision is meaningful to me in my daily job — and so on). One of the groups would then meet the chosen patient and watch a marketing presentation on the implications and dynamics of his or her disease, after which both the control and interventional groups would answer the engagement questions again.

Why is it so hard to do what we know is right?

The experiment went ahead as planned. After the patient had spent an hour talking and answering questions about the experience of having the disease, the group heard a presentation about the demographics and incidence of the disease to give them some broader context. The groups took the questionnaire again and gathered for a feedback session two months later to hear the results.

Statistically, the impact was detectable but small (bearing in mind that numbers involved were low, and before-and-after times short). Even so, on the questions involving pride, passionate belief in Roche’s intentions and the meaningfulness of the company vision for daily work, the group that met the patient scored higher than the other group and higher than its own scores before the patient meeting.

The verbal feedback was much stronger. One set of findings recognized the power of patient stories to generate emotional reactions, put a context around dry facts and figures, and generate personal insights on where individuals and the company can make a difference. But another set revealed disappointment with Roche’s internal communication, which was perceived to be lopsided, privileging scientific and financial information over the patient agenda and experience.

As far as participants and sponsors were concerned, the engagement hypothesis was confirmed. Hearing patients tell their stories did underline the meaning of the job, the positive role of the company, and the connection between the two. But, in a sense, that was obvious from the start. “It’s something we faced all along,” a member of the design team says. “Lots of people, including senior management, were saying, ‘Guys, your hypothesis is a no-brainer; of course it will work.’”

But — and here is the twist — that realization opened up a completely different management issue, perhaps even more significant than engagement: if everyone agrees it’s both important and obvious, why aren’t we doing it already? Why is it so difficult to turn a really powerful insight into something that actually changes behavior? Pushing it further, why do companies find it so hard to do things that they know are necessary, sensible and right?

Changing everyday behavior, not creating new programs

The fact that the answers are known does not make the practical solution easier. It is not that these things are hard in themselves — how hard is it to get a patient in front of already committed employees? The trouble is that these things are often “important” rather than “urgent.”

Too many companies are mired in bureaucracy, which makes it difficult to protect time for things that are perceived as non-essential. For all employees to come in contact with customers, support from top management and drive are essential so that such events “become more of a way of life rather than a project,” says the team. “You can’t do this once every 10 years if you want to get any benefit from it — it’s got to be part of what happens to you in your working life.” But top management time is limited, and the calls on it limitless.

In short, inside most companies, ‘hard’ trumps ‘soft’ every time. Scientific and financial data is often communicated widely inside companies — but not the customer experience, a decidedly “soft management” practice. Yet soft management directly tied to people and relationships is where the majority of the money is spent. So, it is also potentially the place where the scope for improvement is greatest.

What if some time and money were set aside to take patient-centricity seriously? For example, the company might give every employee a day or two a year to do something from a menu of activities around patient engagement — volunteering at a hospital or hospice or accompanying a sales rep or doctor on a field trip. The team at Roche has been mulling over such possibilities.

“This is a huge financial commitment; but, do you know what, you’d get the benefit back in spades, you really would,” says a team leader. And that was the conclusion: putting every employee in the customer loop on a regular basis could strengthen the entire culture of the company. Every time a Roche employee met with a customer, the employee would leave more engaged in the work of the company. “You’d have to be pretty cold-hearted not to walk back into the office a little more proud, a little more engaged, than you were before.”


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