Finding ways to improve employee engagement in healthcare is especially important, because the quality of a staff member’s attention can shape a client’s day. Blue Care, an Australian not-for-profit care provider, faced that challenge while building a model called Tailor Made care. The model focused on each person’s unique needs, so it called for understanding, engagement and flexibility from the people delivering it.
Blue Care used the FISH! Philosophy as a guide for how staff treated clients, families and colleagues. Its experience shows how an organization can connect employee engagement to better service: invite people into a shared idea, give peers a role in carrying it forward, and make room for care that sees the whole person.
What was Blue Care trying to improve?
Blue Care was founded in 1953 to deliver home care to seniors, people with disabilities and others in need throughout Queensland, Australia, an area 2.5 times the size of Texas. At the time described in the case study, it was one of Australia’s leading not-for-profit providers of community care, senior residential care and retirement living.
Its Tailor Made model was designed to focus on a patient’s quality of life and maximum independence. It also aimed to meet psychological and emotional needs, not only physical ones. That kind of care depends on staff who can notice what matters to each person and respond with judgment.
Blue Care set out to engage and empower staff, build personal commitment to Tailor Made care, and increase collaboration and innovation. The FISH! practices gave the organization a shared language: Choose Your Attitude, Be There, Make Their Day and Play.
What did Blue Care do to engage its staff?
Blue Care introduced the philosophy through FISH! Camps. Employees were invited, not required, to attend, and the invitation led to high turnout. Leaders took part alongside employees, rather than placing the program below them as a message for someone else to deliver.
The conversations connected the philosophy to daily work. One question asked, “How do we transform what has been seen as a task or job as an opportunity to make the client’s day?” It links engagement to purpose.
Blue Care also selected FISH! Agents in each area. These were people respected for their energy and influence, and they helped guide the infusion of FISH!. Local champions, called Starfish, kept momentum alive by planning fun projects and events and celebrating people who made a positive difference.
Special badges added another visible way to keep the conversation going. People who attended FISH! Camps or were observed living the practices could become Blue Swimmers and wear their “attitudes” on their badges. Staff and clients asked about the badges, creating genuine conversations about the power of choosing one’s attitude.
Six months after the philosophy was introduced, FISH! Agents created follow-up Master Classes. They shared lessons about what was working and developed new ideas. That follow-up matters because employee engagement strategies tend to fade when treated as a one-time event.
How did Blue Care connect employee engagement to person-centered care?
One way to improve employee engagement is to help people see that their judgment and attention matter. Be There means complete presence: physical, mental and emotional attention to the person in front of you. In care work, that presence can help staff learn the background behind a behavior and find a more human response.
Blue Care practiced Be There by getting to know clients and their backgrounds. The case study describes a resident who was increasingly agitated and difficult to care for. Staff knew he had been a plumber, so they allowed him to help the maintenance staff. His tools and “tinkering” were kept safe and supervised. He became calmer, happier and easier to help.
The lesson is broader than the example. Knowing a person’s history can turn a difficult moment into an opportunity for contribution and independence. In aged care and home care, staff can ask what a person enjoys, what work they once did, and what routines matter to them. Those details support tailored care and resident engagement while showing employees that their observations are valuable.
Play brought the same spirit of curiosity and creativity to dementia care. Blue Care facilities received regular visits from performers with Play Up. Using props and musical instruments, the actors engaged residents with gentle, playful energy. These dementia activities often drew residents into singing or dancing.
An analysis of mood charts showed that residents were happier after the visits, and residents had fewer falls. At one of Blue Care’s largest sites, use of anti-psychotic medication dropped 52% in the five months after the program compared with the five months before.
Play, in the FISH! sense, is not about being silly or ignoring the work. It means bringing curiosity, energy and creativity to how work is done while keeping safety, dignity and the person’s needs at the center.
Why do invited, peer-led programs often engage people more than required ones?
A required program can secure attendance, but attendance is not the same as commitment. An invitation gives people room to test an idea and decide what it means in their work, creating stronger ownership than a command.
The FISH! Philosophy treats culture as an ongoing conversation, not a rule that can be installed. Choose Your Attitude supports that approach by recognizing that people have personal power in how they show up, while also avoiding the mistake of telling someone to “just be positive.” Leaders make the strongest invitation through their own example.
Peer influence adds another layer. Employees often trust a respected colleague who understands the work and can show what an idea looks like in a real shift. FISH! Agents and Starfish gave Blue Care local people who could keep the practices connected to daily experience. A champion network can also spread recognition, gather ideas and notice where a team needs support.
Organizations can apply this without copying Blue Care’s exact structure. Invite a small group to explore an idea, ask respected employees to help shape it, and let teams adapt it to their setting.
How can leaders improve employee engagement day to day?
Managers account for much of the employee experience, so leadership behavior needs to match the culture an organization wants. Gallup’s State of the Global Workplace: 2026 Report found that manager engagement worldwide fell from 27% to 22% between 2024 and 2025, and reported that managers are increasingly only as engaged as the people they lead. That makes support for managers part of any serious employee engagement plan.
Blue Care’s leaders spent more time with employees at all levels. They made rounds with them to experience their work, understand their challenges and listen closely. This is leader rounding with a clear purpose: learning what the work feels like and what staff need to do it well.
Be There helps leaders listen without preparing a defense or rushing to the next task. A leader can name when they can give full attention and then be fully present at that time. Listening should lead to a real conversation and, where possible, a response.
Make Their Day also belongs in leadership. Timely, specific recognition tells people that their work was seen. A leader can name the behavior, explain its impact and choose a form of recognition that suits the person, whether that means a private thank-you or public appreciation. Peer recognition can be just as powerful when it is sincere and connected to the work.
Blue Care reported that surveys ranked it higher in employee engagement than all other benchmarking partners. It also reported that 60% of employees called it a “truly great place” to work, a number consistent with industry leaders. After FISH!, employees said leadership was more approachable, caring, fair, understanding and better listeners. Blue Care also reported solid gains in living its values of Compassion, Respect, Justice, Working Together and Leading Through Learning.
What results did Blue Care report?
Blue Care reported that 90% of clients said its services exceeded their expectations. It reported that 75% gave Blue Care the highest ratings and would enthusiastically promote it to others, a number far better than industry peers. Blue Care’s residential EBITDA, or earnings before interest, taxes, depreciation and amortization, tripled over three years.
These results do not prove that one activity caused every change. They show what Blue Care reported after connecting its care model, staff engagement work and leadership practices. Blue Care is one of many organizations whose results with the FISH! Philosophy have been documented.
As Robyn Batten, Executive Director, and Cathy Thomas, Director Services South East, said:
“FISH! teaches us that the power is in our hands; that by choosing a positive attitude, having fun, and being truly attentive to our customers, we can not only radically change the way we view our jobs, we can vastly improve customer service.”
What can another care organization try first?
Start with a conversation rather than a campaign slogan. Ask employees where a routine task could become a more meaningful moment for a client, resident or colleague. Invite people to test one small idea, then ask what they noticed.
From there, help managers practice leader rounding and listening. Recognize specific actions, not only large outcomes.
Learn enough about the people receiving care to understand their preferences and history. Give teams safe boundaries for creative approaches, and return to the conversation through follow-up sessions.
The four FISH! practices work together. Choose Your Attitude helps people decide how they want to show up. Be There keeps attention on the person in front of them.
Make Their Day turns that attention into a meaningful act. Play brings curiosity and creativity to the work. Together, they offer a simple way to ask a useful question: Who do we want to be while we do what we do?
Try the FISH! Philosophy with your team
If you want to connect employee engagement ideas to everyday service, try the FISH! Philosophy upgraded trial with your team. It gives your team 30 days of access to the FISH! film and its digital guides, so you can explore the practices, start useful conversations and put the ideas into practice together.
Frequently Asked Questions
What is the difference between employee engagement and employee satisfaction?
Employee satisfaction often describes whether people are content with parts of their job, such as schedule or pay. Employee engagement goes further by asking whether people feel psychologically connected to their work, team and employer, and whether they bring energy and commitment to it.
How can a small team measure engagement without a large survey?
Use a short, repeated pulse survey with a few clear questions, then pair it with listening conversations. The important step is to share what you heard and explain what the team will do next, because asking for feedback without responding can reduce trust.
What are practical employee engagement strategies for home care teams?
Home care teams can focus on reliable communication, specific recognition, manager check-ins and flexible ways for staff to share what they learn about each client. A shared language such as Be There can also help teams discuss presence and handoffs without turning every conversation into a performance review.
How can recognition avoid feeling forced?
Keep it timely, specific and sincere. Recognition should name what the person did and why it mattered, and it should fit the person’s preferences; some employees value public praise while others prefer a private thank-you.
What should leaders do when an engagement idea loses momentum?
Return to listening before adding another activity. Ask employees what helped, what felt artificial and what support is missing, then use their answers to shape the next step rather than treating a stalled idea as a reason to mandate more participation.
