Two nurses. Same job; different hospitals. One provides great care for patients, the other doesn’t. Why?

Jordan has worked at Stanford Health Care as a clinical nurse in the orthopedic department for the past three years. In a recent interview with us, she described how thrilled she is to be in a role whose entire purpose is helping people get better one by one. In particular, she loves what she calls the interdisciplinary approach, in which the family, the case manager, the physical therapist, the physician, the occupational therapist, the social worker, and the nurse all come together to choose the best care for each patient.

Fritz has been a clinical nurse for about the same amount of time, but he works for a different department in a different hospital. He works the same long hours Jordan does, but unlike her, he is not part of an interdisciplinary unit. He is merely one of 76 nurses, all of them assigned to rotating shifts whose members change from one week to the next, and all of them overseen by two administrators and one nurse supervisor. He is struggling. He embarked on his nursing career with as much passion to help people as Jordan did, but now he’s tired, burned out, and thinking about quitting. (Jordan is a real person, whereas Fritz is a composite of several nurses we spoke with.)

Both Jordan and Fritz face incredible daily pressures at work. The job is inherently stressful, the system under strain, the paperwork endless, the emotional burden of caring for the ill weighty, the risk that errors may lead to lawsuits a constant worry. For Fritz the stress lands heavily. His feeling, as he gets on the bus every morning to head to the hospital, is that he’s going through the motions, surviving the experience at work, trying to keep it all at bay. He’s just not engaged in his work. Something different is happening for Jordan. Something about her experience at work is lifting her up, not pulling her down. She is fully engaged — and her patients’ health outcomes reflect that.

Jordan and Fritz happen to be nurses, but they could be any pair of workers anywhere in the world today, one thriving, the other just muddling through. A question that weighs on employers today is how to make Fritz more like Jordan — how, in other words, to create more highly engaged employees. Organizations’ track record at doing this is mixed, to say the least. We wanted to understand what was going wrong.

Why We Care About Engagement, and How We’ve Been Getting It Wrong

What, exactly, is engagement? At a gut level we know that it has something to do with how involved people are in their work and how enthusiastic they are about it. But by defining engagement more precisely as a set of attitudes, we have been able to measure it — and understand its impact on performance. From research beginning at the Gallup Organization in the 1980s and 1990s, and continued since then by many others (including both of us), we know that certain employee attitudes can help predict productive employee behaviors, and that companies and managers and individuals can take action to improve or change those attitudes. We also know that the attitudes seem to cluster around consistent themes, such as a clear sense of purpose, a commonly held notion of what’s valuable or important, feelings of psychological safety, and confidence about the future. We know that when we find these clusters expressed in one person, one team, or one company, we can label that expression “engagement.” Finally, we know that engagement — when measured using a few precisely worded statements about the employee’s own feelings and experiences — identifies a situation at work that leads to productivity, innovation, retention, and much more.

But when we look at aggregated levels of engagement across time and across countries, it quickly becomes clear that whatever organizations have been doing to improve these outcomes — from efforts around company culture to rigorous performance management — isn’t working. One of us (Marcus), building on his engagement work with the Gallup Organization, recently joined the ADP Research Institute (ADPRI) to lead its investigations into people and performance at work. He and his team have now completed the most extensive and methodologically consistent global study of engagement yet undertaken, in which a representative sample of working adults from 19 countries — 1,000 respondents in each country — were asked to respond to eight statements designed to measure engagement reliably. (Read more about the study in the sidebar “The Ingredients of Engagement,” at the end of this article.) This study reveals, among many other findings, that only about 16% of employees are fully engaged at work, like Jordan, while about 84% are just going through the motions, like Fritz.

These results are no happier than those revealed in earlier surveys conducted over the years by Gallup and others. And since we know that employee engagement drives employee productivity at the level of the business unit, it’s hardly surprising that over the past 40 years the growth in per-person productivity in the United States has also been anemic, hovering barely above 1% a year, while other developed countries, such as the UK and Germany, seem to be doing even worse. Clearly we need to find another way.

The key is to understand what actually drives engagement. For years we’ve been getting this wrong. Most of us, when evaluating the difference between Jordan’s and Fritz’s experiences, tend to jump to one of two explanations. The first is that something about Jordan’s hospital works for her, and something about Fritz’s hospital doesn’t work for him. So to improve his life and performance at work, the focus should be Fritz’s hospital as a whole: It should offer more support to its nurses. Its commitment to work/life balance should be more explicit. It should talk up its “talent brand” and describe ever more clearly the sort of nurses it seeks to attract and how it wants them to behave so that all can better understand how they ought to perform. The common name for this idea is culture — and although companies that prioritize culture, and thereby the experience of their people, are taking an important first step, addressing the employee experience at the company level is an incomplete solution.

The second explanation goes to the other end of the spectrum. Rather than focusing on the broad notion of culture, it explains the differences in performance and engagement between Jordan and Fritz in terms of who they are as individuals: Something’s right about Jordan, and something’s less than right about Fritz. The prescription then becomes to help Fritz become more engaged by giving him feedback on how he’s doing, developing him with more training, moving him around in hopes that a different role will bring different results, or, ultimately, replacing him with a nurse who will, with luck, be more like Jordan.

In essence, we have treated organizations like increasingly complex machines in which the humans are but component parts and in which the solutions to any ills involve tweaking the system from the top — by addressing culture broadly — or by upgrading the individual components, the humans, themselves.

But the ADPRI study that undergirds this article reveals a disarmingly simple, and hitherto largely neglected, way of increasing someone’s health and productivity at work. It turns out that the most effective way to improve Fritz’s lot, and that of his patients and his hospital, is to focus not on culture or on individuals as though they work in isolation but, rather, on what makes Jordan’s experience shine: her team.

The Case for Teams

To find the most-effective levers for creating engagement, we set about analyzing a number of variables for their power to explain why a particular employee might be fully engaged. Were older workers more disillusioned, and thus less likely than younger people to be fully engaged? Was high engagement best explained by a higher level of education? Did work status make a difference — meaning part-time workers were more engaged than full-time workers, or vice versa? The ADPRI study probed all these variables and more in an effort to discover which of them could best explain engagement and productivity. And as it turned out, the most powerful factor was simply whether or not respondents reported doing most of their work on a team. Those who did were more than twice as likely to be fully engaged as those who said they did most of their work alone. The local, ground-level experience of work — the people they worked with and their interactions with them — trumped everything else.

That makes sense. According to the ADPRI study, most work — in every industry, in every region of the world, and at every level in an organization — is actually teamwork; 83% of workers say they do most of their work in teams (although, as we’ll see, some teams are far more engaging than others). The team is the reality of your experience at work. You have responsibilities that seem to be connected to other people’s responsibilities; you have strengths that seem to be complemented by those of others; you have people over your left shoulder and your right, looking out for you, keeping your confidences, offering their reactions to your work, sharing your idea of what “good” is, chipping in when you seem overwhelmed, and giving their input when you get stuck. The quality of this team experience is the quality of your work experience.

To feel like you’re a part of a team doesn’t require you to be oriented to the company culture; neither does it require a particular training course or development initiative. Instead, it depends on whether your team leader and your teammates show up every day, talk to you, lean in to you, and support you. Your experience of your team drives many things: how productive you are at work; how happy you are at work; how creative, innovative, and resilient you are; and how long you choose to stay with your company. In other words, when it comes to your work, great teams and teamwork aren’t a nice-to-have; they’re a must-have.

The best — indeed, according to our research, the only — way to help Fritz feel and perform more like Jordan is to start with the needs of his team. And if we want to increase engagement and productivity at work, we must first understand why it’s difficult for organizations to see teams at work and how that’s now changing. Then we must direct our investments and energies at improving those team experiences.

Seeing Teams

Organizations can see boxes and lines on the org chart, but those fail to account for many actual teams. When the same ADPRI study asked respondents if they worked on more than one team — and how many of those teams could be found on the org chart — 64% said yes, and of those, three-quarters said their additional teams didn’t show up in the directory. Most work is teamwork, but about half the teams where it happens are invisible to companies.

That blindness stems from our tools. “We shape our tools, and then our tools shape us,” the saying goes. The tools that help us “see” our people — so-called human capital management tools that ensure that people are paid properly, are accounted for by the right departments, and are billed against the correct budgets — are all extensions of enterprise resource planning (ERP) tools, a significant part of whose function is organizing people into the right buckets. The source of truth regarding who lives in which bucket — marketing, say, or finance — and in which box in that bucket, is the human resources department. If a manager wants to formally add someone to his or her team, that manager has to call up HR and ask permission to move a “head count” (which basically means a paycheck) from one box to another. Approvals have to be applied for, budgets have to be consulted, permissions must be granted up and down the chain, until finally white smoke appears from the chimney and lo and behold, the new head count appears in a new box on the org chart.

https://hbr.org/2019/05/the-power-of-hidden-teams