Children's Nebraska Exceeds Retention Goal by 1% and Boosts Well-Being Through "People First" Culture and Respect-Focused Nudges
- Overall retention reached 88.7% (goal: 87.1%); first-year retention reached 79.1% (goal: 74.1%)
- Significant increases in favorability for all six well-being items among staff
- Respect-focused nudge recipients showed +3.2 point improvement on core respect items vs. non-recipients
When CEOs talk about cultural compatibility during mergers, it can often be overstated. There are invariably going to be differences in cultures, regardless of similarity.
What Was the Opportunity?
Over the past two years, Children's Nebraska has focused on improving employee and provider engagement through meaningful implementation of action plans that address key drivers. The organization's approach combines enterprise-wide priorities with local action planning at the business unit, service line, and department levels.
Well-being has been a consistent driver of engagement at Children's, forming a pillar of the organization's "People First" culture. In 2024, listening data identified physical safety, workplace violence, and resource access as areas requiring attention. Building on that foundation, 2025 survey data surfaced new opportunities around change management and psychological safety — specifically respect, one of the organization's core values.
Provider burnout, driven by change saturation and administrative burden, remained a concern. Well-being needs, change management challenges, and the imperative to strengthen respect across the organization were at the core of Children's Nebraska's comprehensive agenda for 2025.
What Was the Solution?
Children's Nebraska implemented a multi-layered approach that addressed well-being, safety, change management, and respect through both enterprise-wide initiatives and targeted local action.
Well-being and safety infrastructure (2024 foundation). The organization established a house-wide Behavioral Escalation Response Team (BERT) to address workplace violence and physical safety. Teams with responsibility for safety — environment of care committee, safety and well-being council, and security — coordinated workflows and communications. A comprehensive well-being platform launched for all team members, providing resources for emotional, physical, financial, community, and social well-being.
Standardized change management practices. Change management was taught to all leaders through leadership development curriculum, supported by certified change management practitioners, thereby addressing the change saturation that was contributing to provider burnout.
Organization-wide High Impact Team on Respect. Children's launched a dedicated initiative to operationalize their value of respect:
- Defined respect in observable, behavioral terms
- Delivered training to all people-leaders with support for local training
- Established goals for all Directors to develop and implement respect-specific action plans
- Created an aligned award system to recognize high-level performance and outcomes
- Piloted nudges with emphasis on respect behaviors
Targeted provider engagement interventions. Following a Perceptyx-led provider engagement results workshop, Children's implemented targeted actions:
- Improved communication and feedback loops by clarifying division chief roles and practicing change management
- Reduced provider burden through AI tools, tip sheets, and time-saving innovations for EMR and administrative tasks
- Ensured providers have adequate access to well-being resources through targeted communication and awareness events
- Added high-need on-site resources including counseling and exercise facilities
- Applied for the AMA Joy in Medicine Award to access additional resources and celebrate successes
What Was the Impact?
Children's Nebraska's sustained commitment to acting on insights has yielded significant, measurable improvements across the organization.
Retention exceeded goals. Overall retention reached 88.7%, exceeding the 87.1% goal. First-year retention reached 79.1%, exceeding the 74.1% goal. These are critical metrics for a healthcare organization competing for talent in a challenging labor market.
Well-being improved significantly. The 2025 census survey showed significant increases in favorability for all six well-being items among staff. For providers, two well-being items showed significant improvement, though the overall provider well-being category showed opportunities for continued improvement.
Engagement increased for both staff and providers. The census survey showed statistically significant increases in overall engagement for both populations.
Safety perceptions improved for BERT team members. Members of the Behavioral Escalation Response Team showed statistically significant improvements in favorability for perceptions of patient safety, recommendation for safe care, and perceptions of staff and provider safety, thereby validating the impact of the safety infrastructure investment.
Change management training drove rapid improvement. Between February 2025 and June 2025, teams where Directors participated in change management leadership development showed improvements in favorability of 6 to 21 points on all change management items. This training supported successful people-management of large-scale changes including opening a behavioral health center, supply cost savings initiatives, and implementation of a new supply ordering system.
Patient experience exceeded goals. Patient Experience Net Promoter Score reached 84.4, exceeding the 83.3 goal, which demonstrated the connection between team member experience and the care experience for patients and families.
Nudge recipients outperformed on respect and engagement. Employees who received respect-focused nudges showed measurably different outcomes compared to those who did not:
- Core respect item favorability increased +3.2 points vs. non-recipients
- Increased favorability in recommending Children's as a great place to work
- Increased favorability in perceptions of respectful treatment from supervisor
- Increased favorability in recognizing support for staff involved in patient safety errors
- Increases in overall engagement and provider intent to stay
Respect pulse revealed targeted opportunities. While the overall core respect item showed no significant change across Children's, large differences at the department level indicated that cascading the respect concept and resources to the team member level was essential. Areas that did cascade training showed the greatest gains, along with significant improvement in recommending Children's and safety perceptions.
Children's will continue to focus action plans on Respect and Well-being, measuring further outcomes through the 2026 census survey.
By employing a listening strategy and leveraging a platform that gives you objective data, it’s invaluable to informing your people strategy,” says Miller.
The Impact
Improvements in employee engagement, retention, and leadership support
The employee listening strategy delivered significant benefits:
Discovery of Engagement Hotspots: The data revealed previously unanticipated issues across different business units that leadership had assumed would be more insulated from M&A activity. “We thought our people challenges, such as retention, were only in our wholesale banks, but the reality is they were in our frontline and branches as well,” notes Miller. This insight allowed for more targeted action planning and interventions.
Identification of Cultural Misalignments: The surveys exposed important differences in how each organization interpreted the bank’s core values. While both banks considered themselves people-centric, their practical approaches differed significantly. “[Some of the people from American National Bank] perceived us to be more process-oriented... they really didn’t understand why we had all these ‘hoops’ to jump through,” explains Miller. “They saw that as an example of, ‘Hey, we can be flexible and nimble when we need to service a customer.’ But for us, it was like, ‘Wow, that’s a really risky proposition.’ We leveraged the data and insights to then go and have conversations with those leaders and action plan around it.” Subsequent surveying showed that this “values gap” had indeed narrowed.
Acceleration of Technology Investments: Insights from the survey revealed significant technology gaps that negatively impacted productivity and employee experience. For example, American National Bank, the acquired institution, had implemented innovative tools like DocuSign to streamline loan administration. However, these capabilities were lost during the transition to Atlantic Union Bank, creating frustration among employees. “For your job to be easy, and then to come to Atlantic Union Bank and have the thing that makes it easy go away... that degrades the experience all the more,” explains Miller. This degradation in the employee experience also risked reduced productivity and retention.
Recognizing this as an acute pain point, Atlantic Union Bank acted swiftly. They worked cross-functionally with their technology and operations teams to reprioritize the DocuSign project within their existing roadmap. This decision was driven by the understanding that reinstating such tools was essential for retaining talent and improving engagement. The initiative had a meaningful impact on teammate work experience, engagement, and retention. “The most powerful thing we heard is, ‘You listened. You leveraged this information and did something with it. That reaffirmed the commitment to the combined organization and retention in the long term,’” says Miller.
Expansion of Leadership Visibility: Listening data showed that new markets without an existing Atlantic Union leadership presence struggled more during the transition. “It felt like the blind were leading the blind,” says Miller. This led to a strategic change in their integration approach, ensuring the physical presence and accessibility of legacy leadership in new markets.
Lessons for the Future
Improvements in employee engagement, retention, and leadership support
The insights gained have now become part of Atlantic Union Bank’s M&A playbook, directly informing their approach to future growth. “The lessons learned from our listening strategy have literally been written into our playbook for future state M&A,” Miller explains.
The impact extends beyond immediate integration concerns. The data now informs executive goal-setting and accountability measures as well, with leaders being evaluated on their contribution to successful integration outcomes. “Senior and executive leadership has a responsibility to support the success of the integration,” says Miller. “Thanks to Perceptyx’s platform, we can measure engagement, where we see hotspots, where we’re seeing risk to retention, and where we’re seeing far-reaching positive impacts.”
Senior and executive leadership has a responsibility to support the success of the integration,” says Miller. “Thanks to Perceptyx’s platform, we can measure engagement, where we see hotspots, where we’re seeing risk to retention, and where we’re seeing far-reaching positive impacts.
Looking ahead, Atlantic Union Bank continues to refine its employee listening strategy, particularly as it manages the challenges of back-to-back acquisitions. “Merger fatigue is real,” acknowledges Miller. “We have to prioritize our investment in time to ensure that we are not losing momentum around teammate engagement and actioning on the insights we had, amid a lot of different distractions. In the instance of back-to-back mergers, we have to be mindful of the future integration but also continue attending to the teammates who have joined in the not-so-distant past.”
Objective data has been instrumental in helping the company interpret feedback and insights, explains Miller: “It is imperative to run pulse surveys during a merger and respond to that data before going into the next merger.” This approach provides valuable lessons learned as they prepare for their next acquisition. Another focus area for Atlantic Union Bank moving forward is leveraging features that support action planning: “[Perceptyx has] made [action planning] so easy, it’s so seamless.”