Employee listening, HR function, Change management
Employee listening, HR function, Change management
What the teams already knew.
What the teams already knew.
Published on · Updated on
From engagement survey to decisions that change work. An engagement survey flags a difficulty. It does not say what to change. At a pharmaceutical company, around a hundred patient advisors made this journey in five months: confidential interviews, a questionnaire built on what they had said, workshops with their managers, then two decisions explained and put to the test. The case, published by Harvard Business Review, shows what separates a score from a decision, and the role an HR department can play in it.
From engagement survey to decisions that change work. An engagement survey flags a difficulty. It does not say what to change. At a pharmaceutical company, around a hundred patient advisors made this journey in five months: confidential interviews, a questionnaire built on what they had said, workshops with their managers, then two decisions explained and put to the test. The case, published by Harvard Business Review, shows what separates a score from a decision, and the role an HR department can play in it.
At the headquarters of a pharmaceutical company, around a hundred advisors support patients with a serious illness every day. They answer their questions about treatment, help them resolve insurance problems and follow up with them so they renew their prescriptions. Many hold advanced degrees and have clinical experience.
They work in a separate area, behind a glass partition with locked access to protect health data. But when they say they feel “behind the glass”, they are also talking about their place in the organisation.
Two years earlier, the company had installed an AI-powered dashboard. It automates call preparation, which used to take an hour or more. Every morning, the advisors receive their list. They appreciate the administrative time saved.
Yet internal surveys point to difficulties with their autonomy and with how much their voice counts. The company has a warning sign. It wants to understand what needs to change.
The case, told by Constance Noonan Hadley and Deborah Lovich in Harvard Business Review, raises a question familiar to HR directors: how do you move from a survey result to a decision that helps teams?
Understanding what gets in the way of the work
The company launches an initiative with Boston University’s Institute for Leadership & Work. Frontline employees take part in steering it, alongside HR managers and data science staff. The whole process runs over five months.
The project team starts with confidential one-hour interviews with about 20% of the group. The questions cover what gives the work meaning, what makes it harder, and moments of pride or frustration.
The advisors then describe a specific tension. They love their mission and value the help the dashboard gives them. But its instructions sometimes make them spend too much time on refill calls, at the expense of conversations they consider more useful to patients: precautions to take with the medication, coverage difficulties or questions about how to use it.
This finding opens up a possibility: adapting the tool so it better supports their work.
A fifteen-minute questionnaire, built from the interviews, then measures the scale of the difficulties. Nearly two-thirds of the group respond. Of these respondents, 63% say they are looking for another job: about half internally, the others both internally and externally.
One HR manager admits having underestimated how many people were already looking. The free-text answers shed light on this result: the advisors feel treated like call-centre employees. They want more quality time with patients and more control over their work.
The initial score flagged a difficulty. The interviews and the questionnaire now describe it precisely enough to act.
Making the results a matter for collective work
In the following weeks, the project team shares the results and invites volunteers to explore them further. Three workshops bring together 21 frontline employees and five district managers.
One rule becomes a central point of discussion. The algorithm requires a refill call seven days after the planned medication renewal date. Yet the advisor sometimes knows the patient’s situation and considers the call premature or unnecessary.
The discussions also reveal inconsistent messages about performance criteria and career prospects. The question therefore goes beyond adjusting a tool: it concerns the advisors’ scope for decision and the way their work is evaluated.
Employees put forward and rank 38 ideas. The results and proposals are then shared with the whole group by email and at a meeting. The collective work produces 18 changes judged promising. Management chooses two that can be done immediately, and explains the reasons and constraints behind this choice.
The selection thus becomes understandable for those who contributed. Everyone can see what their participation has helped move forward.
Understanding what gets in the way of the work
The company launches an initiative with Boston University’s Institute for Leadership & Work. Frontline employees take part in steering it, alongside HR managers and data science staff. The whole process runs over five months.
The project team starts with confidential one-hour interviews with about 20% of the group. The questions cover what gives the work meaning, what makes it harder, and moments of pride or frustration.
The advisors then describe a specific tension. They love their mission and value the help the dashboard gives them. But its instructions sometimes make them spend too much time on refill calls, at the expense of conversations they consider more useful to patients: precautions to take with the medication, coverage difficulties or questions about how to use it.
This finding opens up a possibility: adapting the tool so it better supports their work.
A fifteen-minute questionnaire, built from the interviews, then measures the scale of the difficulties. Nearly two-thirds of the group respond. Of these respondents, 63% say they are looking for another job: about half internally, the others both internally and externally.
One HR manager admits having underestimated how many people were already looking. The free-text answers shed light on this result: the advisors feel treated like call-centre employees. They want more quality time with patients and more control over their work.
The initial score flagged a difficulty. The interviews and the questionnaire now describe it precisely enough to act.
Making the results a matter for collective work
In the following weeks, the project team shares the results and invites volunteers to explore them further. Three workshops bring together 21 frontline employees and five district managers.
One rule becomes a central point of discussion. The algorithm requires a refill call seven days after the planned medication renewal date. Yet the advisor sometimes knows the patient’s situation and considers the call premature or unnecessary.
The discussions also reveal inconsistent messages about performance criteria and career prospects. The question therefore goes beyond adjusting a tool: it concerns the advisors’ scope for decision and the way their work is evaluated.
Employees put forward and rank 38 ideas. The results and proposals are then shared with the whole group by email and at a meeting. The collective work produces 18 changes judged promising. Management chooses two that can be done immediately, and explains the reasons and constraints behind this choice.
The selection thus becomes understandable for those who contributed. Everyone can see what their participation has helped move forward.
The interviews opened up the work; the organisation followed it through.
The interviews opened up the work; the organisation followed it through.
Article
Article
The interviews opened up the work; the organisation followed it through.
Article
Two changes put to the test
The first change concerns refill calls: the window moves from seven to fourteen days. Advisors have more latitude to choose when a call seems necessary to them.
The second concerns how they are supported: a clearer competency framework and a structure for monthly reviews with their manager.
The company tests these changes against hypotheses and indicators defined in advance. For refill calls, employees think a wider window can give them back some flexibility without compromising continuity of treatment.
The first results are encouraging. The article reports that calls are made within ten days on average, even though advisors can wait up to fourteen days. Medication renewal rates remain stable. All district managers implement the new framework on schedule.
After the pilot, the results are presented to the teams again. The authors then report a steady improvement in internal survey scores, while the changes continue and the approach extends to other departments. They do not quantify this improvement and report no drop in staff turnover.
What moved the situation forward can be identified: an obstacle described, solutions discussed, a choice explained and effects observed. The interviews opened up the work; the organisation followed it through.
What this changes for HR directors
Ashley Goodall sheds light on this step in “A Radical Rethink of HR”. He urges HR to know employees’ working conditions first-hand, so it can champion improvements that benefit both teams and the company.
At Cisco, he recounts, managers could launch a short engagement survey within their own team. The results came back to them within a few days. They could discuss them with employees and decide on adjustments to the way they worked. HR then aggregated the results to track the experience across the organisation.
This arrangement makes the data immediately useful to those who produce it. It complements the overall view with the capacity to act locally.
Goodall takes the proposal as far as the organisation of the function: each HR professional could follow a portfolio of teams and talk regularly with their managers and members. It is a proposed model, whose application depends on the company’s resources and context. It nonetheless raises a concrete question: what place does the way the HR department works leave for first-hand knowledge of the work?
The pharmaceutical case sets another requirement: preparing what follows the listening. Who can change the rule that was flagged? On what criteria will a first experiment be chosen? When will the team learn the results? The HR director can bring together the managers concerned and make sure these questions get an answer.
Hadley and Lovich point out that outside advisers can help, but that what matters most is the internal capacity to listen, to involve employees and to adjust changes over time.
Following through on wider listening
One practical difficulty remains: offering an in-depth one-to-one conversation to more people. At Spentia, we use Aria, our conversational AI, to conduct confidential interviews that can last half an hour or more. An interview can thus be offered to every employee within the chosen scope. The conversations document day-to-day difficulties, as well as the ideas and practices that work. The material collected is consolidated and anonymised, then analysed by our partners.
This ability to widen listening underlines the importance of the work that follows. The findings must be discussed with the teams, solutions examined, trade-offs made and the effects of the decisions reviewed. The quality of this follow-through determines what the organisation can draw from what people have said.
At the pharmaceutical company, the surveys had raised the alarm. The advisors helped understand the obstacles and design the changes. Management chose to put them to the test.
For an HR director, a good starting point is to take a survey result back to the team concerned and ask what, in their daily work, might explain it. Then agree with them on what comes next.
Further reading
Sources
Constance Noonan Hadley and Deborah Lovich, “Frontline Workers Know How to Solve Your Organization’s Biggest Problems”, Harvard Business Review, 20 July 2026, reprint H099A2.
Ashley Goodall, “A Radical Rethink of HR”, MIT Sloan Management Review.
Two changes put to the test
The first change concerns refill calls: the window moves from seven to fourteen days. Advisors have more latitude to choose when a call seems necessary to them.
The second concerns how they are supported: a clearer competency framework and a structure for monthly reviews with their manager.
The company tests these changes against hypotheses and indicators defined in advance. For refill calls, employees think a wider window can give them back some flexibility without compromising continuity of treatment.
The first results are encouraging. The article reports that calls are made within ten days on average, even though advisors can wait up to fourteen days. Medication renewal rates remain stable. All district managers implement the new framework on schedule.
After the pilot, the results are presented to the teams again. The authors then report a steady improvement in internal survey scores, while the changes continue and the approach extends to other departments. They do not quantify this improvement and report no drop in staff turnover.
What moved the situation forward can be identified: an obstacle described, solutions discussed, a choice explained and effects observed. The interviews opened up the work; the organisation followed it through.
What this changes for HR directors
Ashley Goodall sheds light on this step in “A Radical Rethink of HR”. He urges HR to know employees’ working conditions first-hand, so it can champion improvements that benefit both teams and the company.
At Cisco, he recounts, managers could launch a short engagement survey within their own team. The results came back to them within a few days. They could discuss them with employees and decide on adjustments to the way they worked. HR then aggregated the results to track the experience across the organisation.
This arrangement makes the data immediately useful to those who produce it. It complements the overall view with the capacity to act locally.
Goodall takes the proposal as far as the organisation of the function: each HR professional could follow a portfolio of teams and talk regularly with their managers and members. It is a proposed model, whose application depends on the company’s resources and context. It nonetheless raises a concrete question: what place does the way the HR department works leave for first-hand knowledge of the work?
The pharmaceutical case sets another requirement: preparing what follows the listening. Who can change the rule that was flagged? On what criteria will a first experiment be chosen? When will the team learn the results? The HR director can bring together the managers concerned and make sure these questions get an answer.
Hadley and Lovich point out that outside advisers can help, but that what matters most is the internal capacity to listen, to involve employees and to adjust changes over time.
Following through on wider listening
One practical difficulty remains: offering an in-depth one-to-one conversation to more people. At Spentia, we use Aria, our conversational AI, to conduct confidential interviews that can last half an hour or more. An interview can thus be offered to every employee within the chosen scope. The conversations document day-to-day difficulties, as well as the ideas and practices that work. The material collected is consolidated and anonymised, then analysed by our partners.
This ability to widen listening underlines the importance of the work that follows. The findings must be discussed with the teams, solutions examined, trade-offs made and the effects of the decisions reviewed. The quality of this follow-through determines what the organisation can draw from what people have said.
At the pharmaceutical company, the surveys had raised the alarm. The advisors helped understand the obstacles and design the changes. Management chose to put them to the test.
For an HR director, a good starting point is to take a survey result back to the team concerned and ask what, in their daily work, might explain it. Then agree with them on what comes next.
Further reading
Sources
Constance Noonan Hadley and Deborah Lovich, “Frontline Workers Know How to Solve Your Organization’s Biggest Problems”, Harvard Business Review, 20 July 2026, reprint H099A2.
Ashley Goodall, “A Radical Rethink of HR”, MIT Sloan Management Review.