10-Year Low: Employee Engagement

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According to a recent Gallup poll, U.S. employee engagement dropped to 31%—its lowest point in a decade—matching levels last observed in 2014. At the same time, the percentage of actively disengaged employees rose to 17%, also echoing figures from 2014. This represents a two-point decline since 2023 and continues the downward trend after engagement peaked at 36% in 2020.  Gallup’s survey pinpoints three key factors behind the decrease in engagement: (1) diminishing clarity of job expectations, (2) reduced perception that someone at work genuinely cares about employees, and (3) fewer instances of encouragement for professional development. These elements are essential for creating a supportive and growth-oriented workplace. Managers directly responsible for setting clear expectations, showing care, and promoting development are themselves struggling—with only 31% reporting high engagement. The negative trend is especially pronounced among younger employees under 35, including Gen Z workers. Their engagement suffered a steep decline, particularly in fundamental elements such as recognition and adequate resources to do their jobs well. Additionally, specific sectors like finance, insurance, transportation, technology, and professional services recorded marked drops in engagement. Despite the economic context—where job vacancies exceeded hiring rates—fewer people in 2024 felt it was a good time to find a job, and quit rates, though slightly lower than historic highs, remain near long-term averages. While overall labor productivity has improved, these gains can stem from factors outside of workplace engagement (such as technological advancements) and do not necessarily reflect the quality of work or an energized workforce. Gallup attributes declining engagement and rising employee detachment to rapid organizational change, hybrid and remote work challenges, shifting customer and employee expectations, and ineffective performance management practices. Nonetheless, some organizations maintain engagement levels twice the national average by clearly defining their workplace culture, aligning it with organizational purpose, and focusing on strong, supportive managerial relationships. Gallup advises leaders to clarify their vision, upskill managers, and select individuals who naturally inspire and engage teams. This reverses the downward trend in employee attachment and creates a more resilient and high-performing work environment.

In recent years, employee engagement has become a key focus for organizations seeking to foster a productive and positive work environment. Within healthcare, where the stakes are uniquely high due to patient outcomes and well-being, these findings raise urgent questions about enhancing staff engagement and supporting those who provide critical care. Healthcare institutions rely on an engaged workforce to deliver safe, high-quality care. From nurses who interact directly with patients to administrative professionals who ensure smooth operations behind the scenes, every role plays a part in maintaining patient satisfaction and positive outcomes. When employee engagement suffers, healthcare organizations face consequences that can include higher staff turnover, burnout, reduced patient satisfaction, and potentially compromised patient safety. Thus, understanding the factors behind falling engagement levels and addressing them swiftly is critical for healthcare leaders.

Gallup’s research, based on online surveys of 79,087 employed U.S. adults throughout 2024, indicates that employee engagement peaked at 36 percent in 2020. Since then, it has gradually declined, now settling at 31 percent. This downturn is particularly concerning because each percentage point drop represents about 1.6 million employees. In healthcare, where staff are often asked to take on significant physical and emotional burdens, disengagement can spread rapidly if not addressed. The pandemic era, while initially giving a temporary boost to engagement — perhaps due to a shared sense of mission and urgency — has revealed deeper stressors, burnout, and systemic challenges. Furthermore, 17 percent of employees in 2024 reported feeling actively disengaged, matching the levels observed a decade earlier in 2014. Active disengagement goes beyond mere dissatisfaction; it can translate to negative attitudes or behaviors that undermine team morale. In a hospital or clinical environment, a single actively disengaged team member can have an outsized influence, jeopardizing their performance and the efficiency and cohesion of the entire care team. The Gallup poll measured 12 elements of employee engagement, three of which significantly declined by three or more percentage points in 2024:

1. Clarity of expectations: Employees thrive when they know what is expected of them. In healthcare, precise role definitions, protocols, and objectives are essential for safe patient care. Ambiguous instructions or constantly shifting protocols—often exacerbated by staffing shortages or evolving treatment guidelines—can erode trust and lead to errors.
2. Feeling someone at work cares about them as a person: Healthcare roles can be intensely stressful. When nurses, physicians, and allied health professionals do not feel cared for by their managers or colleagues, the cumulative stress can magnify and lead to burnout. A supportive environment that prioritizes employee well-being can mitigate the risk of fatigue and mental health struggles.
3. Encouragement of development: Continuous learning is central to healthcare, where new research, treatments, and technologies emerge regularly. Lack of development opportunities or perceived disinterest in professional growth can deplete employees’ sense of purpose, particularly among younger staff actively seeking growth.

These issues can be especially pronounced for healthcare workers. The relentless demands of patient care and administrative pressures can create an environment where clarity, emotional support, and development often fall by the wayside. Gallup’s findings signal that the decline in these engagement elements is not only a problem in corporate settings but also has broad implications for frontline workers and their patients.

One of the most noteworthy aspects of the Gallup findings is the pronounced drop in engagement among employees younger than 35. Younger healthcare workers, including newly minted nurses or early-career allied health professionals, may be entering the workforce with high expectations for mentoring, career progression, and meaningful work experiences. When these expectations go unmet—particularly in a high-stress environment like healthcare—disillusionment can quickly occur. This demographic prioritizes work-life balance, career development, and mental health. If healthcare organizations do not cater to these needs, they risk losing talent to other sectors or burning out their future leaders before they can make a sustained impact. In healthcare, engagement is more than a metric—it is directly tied to patient outcomes. Highly engaged staff are more vigilant about patient safety, more likely to communicate effectively with colleagues, and more driven to pursue excellence in clinical tasks. Conversely, disengagement can lead to preventable mistakes, reduced adherence to best practices, and a lack of innovation in patient care strategies. Moreover, when staff feel valued and supported, they are more likely to remain in their positions long-term, reducing turnover costs and preserving institutional knowledge. Engagement also influences how healthcare professionals approach patient interactions. Engaged employees often exhibit greater empathy and compassion, positively affecting patient satisfaction and overall experience. With reimbursement models increasingly tied to patient satisfaction scores and quality metrics, healthcare organizations have a financial and ethical incentive to cultivate engagement across all workforce levels. Gallup’s recommendations for leaders are especially pertinent to healthcare organizations. Here are a few to consider:

1. Define workplace culture and align it with organizational purpose. A hospital, clinic, or health system's overarching objective is to provide quality patient care. This objective must be articulated and embedded into everyday routines, policies, and decision-making processes.
2. Develop a plan to upskill managers in relationship-building, accountability, and goal-setting. Nurse managers and department leads play a pivotal role in shaping team dynamics. Equipping them with the skills to build trust, foster accountability, and set clear goals can help create an environment where expectations are understood and staff feel recognized.
3. Select managers capable of inspiring and engaging their teams. Too often, healthcare workers are promoted into leadership roles based on clinical expertise rather than managerial potential. While clinical competence is essential, the ability to inspire, coach, and support a team is equally vital. Identifying and training individuals with strong interpersonal skills can lead to more cohesive and motivated teams.

Beyond Gallup’s broad suggestions, healthcare organizations might consider a few additional strategies:

• Implement structured mentorship programs: Pair seasoned professionals with newer staff to facilitate knowledge transfer and emotional support. This can help younger employees feel more connected to the organization and the profession.
• Offer flexible scheduling and robust well-being initiatives: Burnout is a critical issue in healthcare, and flexible schedules, mental health resources, and wellness programs can help staff recover and stay engaged.
• Engage in regular feedback loops: Frequent check-ins and real-time feedback can help managers identify issues early and respond with tailored solutions.
• Recognize achievements publicly and often: Healthcare can be emotionally taxing, and consistent recognition—whether through awards, peer shout-outs, or simple thanks—can remind staff that their efforts matter.

Employee engagement is not static; it can improve or deteriorate based on various internal and external factors. The data shows a dip to 31 percent engagement among U.S. employees, and heightened disengagement should act as a clarion call for healthcare leaders. While the challenges are numerous—staffing shortages, high patient loads, and lingering pandemic-era pressures—there are opportunities to reimagine the healthcare workplace. By investing in managers who champion staff well-being, create a supportive culture, and actively nurture professional development, healthcare organizations can uplift employees and patients. The stakes for healthcare institutions are exceptionally high. Each nurse or physician who becomes disengaged represents an individual at risk of burnout and a potential compromise in patient care. To maintain standards of care and uphold patient trust, healthcare leaders must prioritize engagement strategies that ensure every team member feels valued, supported, and invested in the organization’s mission. By doing so, they will combat the current downward trend and create a more resilient and thriving healthcare system capable of withstanding future challenges.

Reference

Gallup. (2024). U.S. employee engagement needs a rebound in 2024. https://www.gallup.com/workplace/654911/employee-engagement-sinks-year-low.aspx?utm_source=gallup_brand&utm_medium=email&utm_campaign=gallup_at_work_january_1_01142025&utm_term=information&utm_content=us_employee_engagement_sinks_to_10-year_low_textlink_2