Transforming Culture with Recognition: A Success Story

Case Study
Download the PDF version of the Grace Haven case study.

From hospitals to manufacturers; non-profits to Fortune 500s—the story’s the same: employee retention and morale are two of the most pressing issues managers and human resources directors face today. Want to learn how one organization turned their culture from hopeless to hopeful in just a few short months? Read on...

Condition: Critical
There are 36,000 assisted living facilities in the U.S., serving more than one million elderly patients. Across the country, these facilities are charged with employing staff in high-pressure positions that require responsibility, discretion, compassion, and flexibility.


In addition to these challenges, this industry also struggles with higher than average employee turnover, absenteeism, and low morale. Administrators at assisted living facilities must find practical and creative ways to keep staff engaged and satisfied so they can provide the superior level of service expected by residents and residents’ families.

No exception to this troubling statistic, Grace Haven Assisted Living in St. Johns, Michigan was feeling powerless after watching turnover soar and morale plummet beginning in early 2010. The company’s nearly 200% resident growth in a few short months had clearly put pressure on all staff, but a culture of dissatisfaction had been developing over time as well.
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Poor attendance was disrupting the day-to-day workflow and creating animosity among the staff. Accusations of favoritism were prevalent and in-fighting was a regular problem between shifts. In addition, resignations were so frequent that it was difficult to maintain the level of staff needed to keep the facility running effectively—and the extra strain on the workers only amplified their problems. Management knew that simply increasing the number of employees was only part of the solution.

Diagnosis: Appreciation Deficiency
Following a series of interviews with supervisors and staff, Grace Haven identified three key issues that needed to be addressed to reverse the steady decline in morale.

Issue 1: Insufficient employee recognition and performance evaluation

Through focus groups and conversations, we learned that the staff felt underappreciated and overlooked by managers. This was particularly true with the night shift, who had limited supervision and face time with managers. However, nearly all staff expressed a desire for both informal and formal job feedback. With the overriding management philosophy of "if you don’t hear from us, you’re doing fine," employees were insecure and hungry for positive reinforcement and acknowledgment of their hard work.

Issue 2: Lack of camaraderie

While the Grace Haven staff were mostly satisfied with their work and felt they provided exceptional care to residents, they were less likely to feel the same about their peers.

With no one—managers or fellow employees—acknowledging the commitment and dedication of these individuals it was difficult to realize the impact each was having on day-to-day activity or appreciate each other for their contributions to the organization’s goals. Staff did not feel they could rely on one another, and less than 30% felt satisfied with the overall care that residents received at Grace Haven. 

Issue 3: Poor attendance
Absenteeism interfered with everyone’s schedules, requiring last minute shifts in responsibilities and mandates for staff to work overtime. Call ins were not only inconvenient and disruptive to everyone involved, they also affected morale, workflow, and quality of resident care.

Prescription: Day-to-Day Recognition
After establishing the most critical issues, a comprehensive, customized employee recognition plan was developed, which set priorities to address them. Implementation included coaching sessions with management and informational meetings with all staff to help acquaint them with the new program.

Priority 1: Increase positive feedback

The Grace Haven management team made a commitment to improving job performance feedback and changing their recognition habits through a variety of strategies, including:



Manager Recognition: Each manager received binder, which contain themed lapel pins and note cards. These pin and note card combinations are given out for significant, above and beyond behaviors. Managers are encouraged to recognize at least once a month. The cards provide the recipient with a personal note of appreciation, and the pins serve as a conversation piece with residents as well as a badge of honor for excellent work.

Annual Recognition: To strengthen interpersonal relationships, management recognizes staff member birthdays with a birthday card signed by the supervisors, and they celebrate anniversaries with a Baudville"years of service" pin. The pins are worn with pride and demonstrate loyalty to the company. They also demonstrate to residents that they are in the hands of a devoted and experienced caregiver.
Priority 2: Encourage teamwork and build trust among peers

Management placed peer-to-peer Shout Outs™ pads in prominent places throughout the building and provided pens and instructions to promote participation. The program gives staff, residents, residents’ families, and managers the opportunity to write a recognition note that is posted on a public bulletin board for everyone to see. It also encourages team members to recognize one another, to become more aware and attentive of the work going on around them, and to see the contributions that others were making to the organization.

Priority 3: Reverse Absenteeism
Managers implemented an attendance award program using Baudville’s Tokens of Appreciation™. At regular all-staff meetings, the administrator awards a token to each employee who has achieved two weeks of perfect attendance. Staff members collect the tokens and redeem them for cumulative awards, starting with a simple casual day.

Rewards increase with the number of collected tokens; but must be redeemed at six, at which time the employee receives a $10 gift card. Tokens are recycled back into the program and the save and redeem process continues.

Recovery: Imminent 
Within one week of the program’s implementation, the level of interest and optimism increased noticeably. The positivity grew over time, and after 3 months many Grace Haven employees expressed satisfaction with the improved culture.

Win 1: A Whole New Attitude Evolved
With the recognition programs in place, management met the goal of increasing positive feedback. The number of employees who felt recognition to be a priority at Grace Haven increased 47% since the beginning of the program.

After 60 days, 78% of staff had given recognition and 68% had received it. One respondent said of the program, "I'm impressed at the progress!" And recognition has made employees feel more comfortable about communication in general. Both managers and employees acknowledge that communication has improved and verbal recognition has become a common occurrence.
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Win 2: Collaboration and Respect Increased
Before Shout Outs were implemented, only 26% of employees felt their coworkers were committed to quality work. After using the program for 60 days, that measurement increased 142%. Teamwork and trust increased among team members, and many employees were pitching in where needed. The Shout Outs helped them show appreciation for and become more aware of each other’s contributions. One staff member told us, "I feel it made us closer; people you didn't think cared, do." Employee confidence in leadership also experienced a 66% lift.

Win 3: Attendance and Accountability Improved
The increased sense of teamwork led to employees putting a greater value on attendance. After just 30 days—and then again at 60—managers needed more Tokens of Appreciation because they had given so many attendance awards. 90% of employees received at least one token award in the first 60 days the program was in place. Since the start of the program, attendance has improved dramatically.
In just a few months, the Grace Haven team saw improvement in every area measured. Overall satisfaction increased by 66%, with 64% of staff believing that their work culture has improved since the start of the program.

Grace Haven Assisted Living Director of Resident Care Bobbi Price had this to say about the changes: I just can’t get over the change! I see smiles in the hallways and a true spirit of cooperation among most of the staff. And, our attendance issues are all but solved. Plus, giving recognition has been such a rewarding experience. Seeing the pride and satisfaction on the faces of the recipients not only tells me it’s making a difference, it makes me feel good inside, too!

Get a Case of the Positives
You don’t have to be in the caregiving industry or in a morale crisis to benefit from an employee recognition program.

Simple day-to-day acknowledgements improve communication, and expressions of appreciation make team members feel valued. Overall, staff members feel more satisfied with their jobs, increasing both engagement and retention. In addition, incorporating peer recognition into your program gives team members ownership as well as a greater appreciation for the work that others do in the organization.

The Grace Haven team discovered that implementing regular recognition into their routine was easier than they expected. With the right tools in place, the organization has transformed into a highly engaged, positive workplace where employees are proud to work.

Download the PDF version of the Grace Haven case study.


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