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Crawl, Walk, Run, Sprint: Employee Listening at MetroHealth

Crawl, Walk, Run, Sprint: Employee Listening at MetroHealth

MetroHealth’s commitment to health and wellness extends beyond the immediate treatment of the ill and injured, with an equal emphasis on preventive care, teaching, discovery, and teamwork. Each patient is treated in an environment of inclusivity, with a diverse workforce that mirrors the breadth and depth of the communities they serve. Key to its sustained recognition as one of the “Northcoast 99 - Best Places to Work in Northeast Ohio” is a strategic focus on employee listening. Through listening to its people, MetroHealth ensures alignment between the workforce and the organization’s goals, while fostering an open, engaged environment that values employee input.

The Path to Perceptyx: A Foundational Partnership

Elizabeth Clegg, Director of Listening for MetroHealth, pointed to the introduction of the Perceptyx People Insights Platform as a crucial element in MetroHealth’s strategy. According to Clegg, “Our relationship with Perceptyx is foundational.” The opportunity for us came about when we laid the foundation with a multi-year contract. In doing so, we’re giving consistent, easy-to-access data to all of our leaders. Along with the census survey, the platform’s additional features really just add another layer of icing on the cake thanks to the self-service capabilities of the Ask product and the ability to use the Dialogue product for crowdsourcing.”

Explaining the selection process, Clegg stated that MetroHealth used a multidisciplinary team to evaluate potential partners, focusing their search on ease of use and accessibility. Cheryl Forino Wahl, MetroHealth’s Chief Employee Engagement Officer, added that being able to provide consistency in a healthcare environment subject to constant change was key, along with the numerous customization options offered by Perceptyx. “Our appreciation for the team has grown over time, and the customer service and the true partnership have not only evolved but enabled us to go from the crawl stage to the sprint stage of our listening strategy.”

"Our appreciation for the team has grown over time, and the customer service and the true partnership have enabled us to rapidly progress from the crawl stage to the sprint stage of our listening strategy.”

-  Cheryl Forino Wahl, J.D. | Chief Engagement Officer, MetroHealth

doctor speaking to woman

An Accelerated Journey to Create a Culture of Listening

Elizabeth Clegg noted that one of the key factors that motivated MetroHealth to partner with Perceptyx was the company’s readiness to meet the organization where it was. “We had done multiple surveys before, years over years. Every year there was a different vendor and different set of questions, so trending was really not feasible at that time. Having a partner that was willing to meet us where we were, and then having the opportunity to expand, was something that was very attractive to us.”

With the support of Perceptyx, MetroHealth was able to follow a four-step “Crawl, Walk, Run, Sprint” approach to building a strong listening culture. The first step, “Crawl,” involved making a case for leadership, creating the engagement structure, building the team, and obtaining buy-in. At this stage, Forino Wahl and Clegg emphasized the importance of data, KPIs, sharing success stories, and providing resources to support leaders in creating action plans.

The second step, “Walk,” focused on establishing a listening strategy, expanding listening channels, and prioritizing metrics and KPIs. MetroHealth leaned into its partnership with Perceptyx to create an 18-month engagement strategy, including pulse and exit surveys. The arrival of Dr. Airica Steed as the new CEO in December 2022 marked the beginning of MetroHealth’s “First 100 Days of Listening, Learning, and Action.”

For its third step, “Run,” MetroHealth involved leaders in listening and established goals and tracking methods. The organization introduced CEO listening sessions, initiated an “Ask the CEO” email, implemented leadership rounding, and began integrating feedback across multiple channels. It also stressed the importance of setting system-wide goals related to survey participation and action planning, as well as accountability for leaders related to meeting these goals.

Lastly, in the “Sprint” phase, MetroHealth stressed the need to close the loop, let listening drive decisions, aggregate data, and communicate relentlessly. As the data began to roll in from the organization’s commitment to listening, Forino Wahl and Clegg could start to assess the effectiveness of this approach, as well as the opportunities for improvement.

doctor looking at ipad

Using the Census Survey to Help Achieve ANCC Magnet Certification

Addressing the initial listening strategies deployed during this four-stage process, Clegg said, “We have the survey results. I would say that our organization is open to listening, and looking to listen as efficiently as possible.” She stressed the importance of foundational elements, such as the census survey, but also noted the need for additional elements.

One such element involved utilizing Perceptyx for assistance with recertifying the organization’s Magnet status, which is awarded by the Magnet Recognition Program of the American Nurses Credentialing Center (ANCC). The Magnet Recognition Program recognizes healthcare organizations for quality patient care, nursing excellence in patient care, and innovations in professional nursing practice. Achieving Magnet status is the highest level of honor awarded by the ANCC and is recognized nationally as the “gold standard” of nursing excellence. Keeping this designation is essential to MetroHealth’s core business of serving the public, but the data-gathering demands can place a heavy burden on staff and administrators.

"We had done multiple surveys before, years over years. Every year there was a different vendor and different set of questions, so trending was really not feasible at that time. Having a partner that was willing to meet us where we were, and then having the opportunity to expand, was something that was very attractive to us.” -  Elizabeth Clegg | Director of Listening, MetroHealth

To combat survey fatigue, MetroHealth introduced Magnet questions into its annual survey to minimize the number of separate surveys employees had to complete. This move proved beneficial, contributing to a 9% increase in the organization’s employee response rate to the census survey — up to 62% from 53% the prior year — and aligning resources in the nursing department with overall engagement efforts.

When asked if integrating the Magnet certification process with the main survey was more efficient, Clegg responded affirmatively. “Getting those resources from nursing who were able to ‘buy in’ to the overall engagement survey was a big driver and a key success factor for us.”

nurse checking blood pressure

Overcoming Challenges and Seeing Results

Despite several operational challenges, including the opening of two new hospitals, MetroHealth managed to increase its survey response rate. “What’s really incredible is that not only did we increase the response rate by nine percentage points, we did so even as we were asking our people to answer those questions for the second time that year,” said Cheryl Forino Wahl. 

Looking ahead to 2023, the team is optimistic about getting even greater participation as they plan to conduct a single survey for the nurses that will address Magnet status. This approach to listening efficiency exemplifies MetroHealth’s commitment to streamlining processes and maintaining high employee engagement.

doctor speaking to family

The 1-2-3 Action Planning Method

To ensure that its staff truly feel heard, it wasn’t enough just to listen. MetroHealth Systems had to embark on an action-oriented journey. It was a necessary transition catalyzed by the arrival of Dr. Steed as CEO and driven by an increased focus on participatory values.

Elizabeth Clegg emphasized the crucial role of participation. “You can’t do anything without the majority of our staff participating. So, we have to make sure that folks feel heard — and that means acting on what they’re saying,” she said. 

A vital part of MetroHealth’s engagement strategy revolves around its 1-2-3 action planning method. This method focuses on simplicity and efficiency, encouraging managers to focus on one issue, take two actions about it, and discuss it three times.

The organization uses listening to track metrics like pride in the organization, monitoring lower-performing areas and offering them additional guidance and support. For higher-performing areas, MetroHealth celebrates success and hosts panels to share best practices. “We’re offering the products and resources, and we’re also making sure everyone has the data they need to succeed,” Clegg explained. “But we have to have a uniform action planning process behind it that will drive everything forward.”

metrohealth-aboutme – 1

The Power of the Perceptyx Platform

Clegg pointed out that the small engagement team at MetroHealth isn’t capable of pushing custom-made action planning reports to each manager, which is why the simple, user-friendly features of the Perceptyx People Insights Platform have proved essential. The platform empowers managers to own their engagement strategies without becoming overwhelmed with data analysis.

This has enabled the MetroHealth team to shift their focus away from platform navigation to meaningful conversations around data and action planning. It has proven beneficial to spend this extra time on improving engagement, rather than teaching managers how to use the platform. “The ability to look at comments, along with the ability to see and compare their data to the organization is extremely helpful,” said Clegg. The straightforwardness of the platform is especially helpful given that many of the 600 or so managers are not data analysts and need to be able to easily use the technology.

One of the more valuable aspects of the platform is its ability to generate actionable reports. “The executive PowerPoint presentation of the survey results that’s generated from the survey includes high-level results for each manager and is usable right out of the box,” Clegg pointed out.


Collaborative Growth & Opportunities for Future Success

Even as MetroHealth’s employee listening program begins to deliver promising results, Cheryl Forino Wahl, Elizabeth Clegg, and their team members remain keenly aware of the opportunities for improvement that lie ahead.

“As we continue to cultivate a deeply engaged workforce, we’re turning our attention to optimizing the efficiency of our listening strategies,” shared Clegg. At MetroHealth, a multitude of feedback channels ensures every voice is heard, from one-on-one dialogues to collective and departmental conversations. “The feedback we’ve received through this comprehensive approach has been invaluable. Now, our challenge lies in streamlining these listening avenues, allowing us to maintain our broad scope while focusing more closely in specific areas.”

However, the primary opportunity involves interpreting and acting on all the data the organization has collected. “Two of our engagement drivers are related to Equity, Inclusion, and Diversity (EID),” Clegg said. “We’re making an effort to strengthen these areas. For example, we will soon be introducing a respect module, which is live training for all our employees.”

Clegg emphasized the importance of understanding the levers affecting their key drivers. For instance, they’ve identified a decline in the satisfaction with benefits due to an increase in costs. These data-driven insights are helping the organization effectively target the most important issues for CEO Dr. Steed and her team to address.

"The PowerPoint executive presentation of the survey results that’s generated from the survey includes high-level results for each manager and is usable right out of the box. This means you don’t have to take the output and edit it each time. This is an incredible value add.”

-  Elizabeth Clegg | Director of Listening, MetroHealth



Philosophical Alignment with Perceptyx

Describing MetroHealth’s relationship with Perceptyx, Clegg noted, “I really feel like we’re in this together. They’ve met us halfway and helped us push further.” The platform’s ease of use and the company’s commitment to partnership are two qualities that have strongly resonated with MetroHealth.

Cheryl Forino Wahl underscored the importance of philosophical alignment with Perceptyx. “We’re deeply interested in working together and continuing to grow our relationship,” she said. “Listening clearly enables employees to feel like they matter, to know that they’re important, and that’s the environment that we want for our employees.”

Both Clegg and Forino Wahl acknowledged the expertise they have gained from partnering with Perceptyx. “You give us access to a level of expertise that we don’t have, which is extraordinarily valuable,” said Forino Wahl. The team benefits from the ability to strategize and seek advice from experts who have Ph.D.-level backgrounds in industrial-organizational psychology and data science.

With its listening strategy firmly in place, MetroHealth continues to invest in and prioritize its people. The collaboration with Perceptyx has enabled the organization to take actionable steps toward realizing their objective: creating a culture where people “come for the mission and stay for the culture.”  


About MetroHealth

Founded: 1837

Industry: Healthcare

Corporate Headquarters: Cleveland, OH

Employees: 5,000

Annual revenue: $5.5 billion (2022)


Customer Success Snapshot

The Challenge:

  • Cultivate a culture of comprehensive, continuous listening in a fast-paced healthcare setting
  • Address the issue of employees feeling unheard in key decision-making processes
  • Gather data-driven insights to guide the organization during a leadership transition and further equity, inclusion, and diversity (EID) initiatives

The Solution:

  • Partnered with Perceptyx to launch a multi-channel listening strategy, capturing the voices of employees on an individual, collective, and departmental basis
  • Executed a combined Magnet nursing certification and census survey to assess employee engagement and experience while also gathering data for ANCC Magnet recertification; this combined survey achieved a 62% response rate, up 9% from the prior year’s census-only survey
  • Utilized employee listening data to answer pressing questions about EID and fairness in pay
The Outcomes:

  • Actively addressed the issue of employees feeling unheard by including their voices in key decision-making processes such as the building of new facilities
  • Developed targeted initiatives based on data-driven insights, including a respect-based training module and a leadership rounding initiative
  • Utilized feedback from employees to review and plan adjustments to benefits and pay structures, and to further strengthen EID metrics
  • Implemented ongoing measures to monitor the impact of these initiatives on employee satisfaction and engagement
  • Fostered a strong and beneficial multi-year partnership with Perceptyx

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