Healthcare Design - December 2013 - 44

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saw a 46 percent decrease in absenteeism from
the previous year. Within the same year, Adelante
Healthcare Surprise reported a 21 percent
increase in turnover and a
29 percent decrease in absenteeism.
Additionally, each year Adelante Healthcare
distributes an online employee engagement
survey to all employees. Over the last four years,
Adelante Healthcare Mesa has consistently had
the lowest employee engagement score of all
seven sites within the organization, trending a
4 percent increase in employee engagement
year over year. For 2013, the Mesa site reported
a 5 percent increase in employee engagement
during a year where employees saw their benefit
shares increase and their merit pool decrease.
These same organizational challenges contributed to a 21 percent decrease in employee
engagement at the Surprise facility, an overall
spread of a 26 percent difference for the year
between the two sites.
These results suggest that the reduced stress
on staff and the increased satisfaction with the
interior environmental quality of their workspace
associated with the features of LEED certification may contribute to how employees cope with
challenging organizational issues. This increased
satisfaction and engagement at the Mesa
location is aligned with Adelante Healthcare's
belief that "employee engagement is the truest
measure of an employee's commitment to the
organization's mission, vision, and goals," correlating to a greater commitment to the organization as a whole.

44

HCDmagazine.com 12.13

research associated with non-LEED acute
care environments, but didn't show any
statistically significant differences between
the stress levels at Surprise and Mesa.
These results suggest an alignment between
features associated with LEED certification
and EBD principles of access to light and reduced noise levels that correlate to reduced
stress levels for nurses. These findings create a baseline for further research to explore
the associations between LEED and EBD
as they relate to staff stress in outpatient
environments.
Advancing the baseline
The advent of healthcare reform has led to
an increasing trend to ambulatory care, and
a 2009 literature review by Gowri Betrabet

Above: IEQ survey results capture
the staff satisfaction scores at both
the Mesa and Surprise sites for the
categories of daylighting, electric
lighting, acoustics, and speech
privacy. Below: Results from the
Nursing Stress Scale conducted at
both sites are compared to prior
research in non-LEED and LEED
facilities.

EMMA MATEY

Staff stress
Adelante Healthcare also conducted a survey
on staff stress levels. This research leveraged
work conducted in 2010 by Carol Kleihauer
that compared nurse stress levels in LEEDcertified facilities with nurse stress levels found
in non-LEED facilities using the Nursing Stress
Scale (NSS), a validated 34-question survey
developed in 1981 by Pamela Grey-Toft and
James Anderson to assess nurse stress within
the acute care environment. Kleihauer's prior
research reported a statistically significant
difference between all factors and the overall
weighted average for a LEED-certified acute
care facility versus that of a non-LEED acute
care facility. The online survey, which was distributed to the nursing staff at the Surprise and
Mesa locations, revealed a decrease in staff
stress within both facilities of approximately half
the stress level of those reported in the prior
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Healthcare Design - December 2013

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