Improving workforce experiences at United States Federally Qualified Health Centers: Exploring the perceived impact of generational diversity

This qualitative study aimed to explore a multigenerational workforce’s impact on employee engagement as perceived by Federally Qualified Health Centers’ (FQHCs) C-suite executives. It sought to answer one research question: What is the perceived impact of generational diversity on employee engagement of Federally Qualified Health Centers (FQHCs) in the United States? This cross-sectional study was national. Primary data were collected using a self-developed, two-part survey instrument: (1) eight demographic questions and (2) two open-ended, short-answer questions. Cognitive interviews, reviews by five subject matter experts, and a pilot study were completed to ensure the instrument’s validity and reliability. Demographic data were analyzed using Minitab V19, and qualitative data were analyzed using MAXQDA V2020. The final sample (n=81) represented 6% of the 1,400 U.S. FQHCs and consisted of respondents from all five U.S. geographic regions: Northeast, Southeast, Midwest, Southwest, and West. Of the 81 FQHCs, one-third had a four-generation workforce, and over one-half had a five-generation workforce. A multigenerational workforce was important and necessary because of enhanced work creativity, improved problem solving, and a better representation of FQHCs’ diverse patients. Conversely, a multigenerational workforce also presented challenges, including the need to address generation-specific expectations, family dynamics, rewards and recognition, technology proficiency, and learning and training opportunities. Engaging a multigenerational workforce presented benefits and challenges. The benefits included fostering a sense of learning culture, transferring knowledge and skills, and promoting more representative patient communities which FQHC employees served. The challenges included varied expectations, different communication styles, and inter-generation perceptions in healthcare workplaces.