Behavior in the Workplace Evidence-Based Leadership Practices for Creating a Positive Workplace Jo Manion PhD RN CNAA FAAN 1/8/07 NCSBN.

Behavior in the Workplace

Evidence-Based Leadership Practices for Creating a Positive

WorkplaceJo Manion PhD RN CNAA FAAN

1/8/07NCSBN

“Never before have organizations paid more attention to talent …

Keeping it. Stealing it. Developing it. Engaging it. Talent is no

longer just a numbers game; it’s about survival.”

Kaye & Jordan-Evans, 2002

--Bowles, 1991

The Plan Cost of Turnover What is Being Done The Study Design What Managers Actually Do Ramifications for Individuals & Organizations

Cost of Turnover

$$$$

Gelinas & Bohlen, VHA Tomorrow’s Work Force, 2002

Replacement costs as % of total payroll

base compensation22 %

Average replacement cost per skilled

employee$28,877.08

Reduce overall turnover from 31 –

25%, the replacement costs savings

$814,045 per year

Reduce overall turnover from 31 –

20%, the replacement costs savings

$1,424,578 per year

Economic Benefits of Retention

Cost of Turnover

$$$$ Damages the Brand

Loss of Experience, Knowledge & Connections Felt Rejection

“Resignation is not just a

behavioral act; it is also a state of

being.” Manion, Health Forum

Journal, Sept., 2000

Recruitment is a key strategy for the current

workforce shortages, but isn’t enough. It does no good to recruit and

select the right people if you can’t keep ‘em.

Manion, Health Forum

Journal, Sept., 2000

What kept you?

1. 2. 3. 4.

What Kept You?

• Exciting work, challenge• Career growth, learning &

development• Great people• Fair pay & benefits• Good boss• Pride in organization,

mission, product• Great work environment,

culture• Recognition, valued,

respect• Meaningful work, making

a contribution

• Autonomy, creativity, sense of control

• Flexibility: work hours, dress, etc.

• Security• Location• Diverse, changing work• Fun• Responsibility• Being part of a team• Work/life balance• Loyalty & commitment• Comfort on the job

89% of all managers STILL

believe it is about $$$$$

Why do people work?

Kaye & Jordan-Evans, 2002

Intrinsic Motivation

Meaningful Meaningful WorkWork

Positive Positive RelationshiRelationshi

psps

ChoicesChoicesCompetenCompeten

cece

Progress

Strategies

Inspire for Inspire for Meaningful Meaningful

WorkWork

Build Build Healthy Healthy RelationshiRelationshipsps

Create ChoicesCreate ChoicesCoach for Coach for CompetenCompeten

cece

Cheerlead for

Progress

1.What does a culture of retention mean to you?

2.What characteristics do you think of when you think of a culture of retention?

What do leaders do to create a culture

of retention in their area of

responsibility?

The Participants Current managers with direct

reports Recommended by others as an

individual who has successfully created a culture of retention

Combination of low turnover rates, waiting list of interested staff, positive patient or service outcomes, healthy employee relationships, high employee and physician satisfaction levels

The Study Design

Telephone & face-to-face interviews with 32 managers

Face-to-face interviews with 3 of the people to whom they report

3 focus groups of their employees

Nurse managers, directors of pharmacy, imaging, PT, RT & Business Office

Analyzing the Data

Used a categorical-content analysis approach

Let the themes emerge from the participant’s stories & examples

Code the interviews to determine most common strategies or interventions

Defining a Culture of Retention

It’s creating an environment where people want to stay.

It means that people enjoy their work so much and the people they work with that they want to stick around and get involved. Everybody is trying to make it a great place to work.

It’s an environment that meets people’s needs.

Defining a Culture of Retention

It’s a culture where employees know they are valued.

When they come to work, they enjoy being here, they feel good about being here. They feel safe. They can trust each other that the job will be done and done well.

They wake up in the morning and want to come to work. They are interested and want to be here.

It’s more than a culture of

retention, it’s a culture of engagement & contribution. Because that will lead to a

culture of retention. It’s not enough that you stayed for 30 years. It’s what are you

giving? How are you contributing?

Forge Strong

Connections

Focus on

Results

Partner with

the Staff

Coach for & ExpectCompetence

Put the

Staff First Creating a Culture of Retention

Put Staff First “My staff comes first, not the patient

comes first. Because if I make my staff feel valued and respected and good about what they do, then they’re going to give the best care in the world.”

“I know that if I’m looking out for them, they will look out for the department. They know when they need me I will be there for them.”

“If the staff is going to put service first, I have to put them first. They have to feel that you have their interests at heart. That they are important and not being used & abused.”

Put Staff First

Caring for them as people

Caring for Them

“It’s caring about people and not just their work.”

“I don’t allow staff to be dumped on. By anyone!”

“They know I love them. I have fallen in love with my staff.”

“We are re-focusing on the deep longings we have for community, meaning, dignity, purpose, and

love in our organizational lives. We are beginning to look at the strong emotions of being human, rather

than segmenting ourselves by believing that love doesn’t belong

at work, or that feelings are irrelevant in the organization.”

Margaret Wheatley, 1999

--Bowles, 1991

“The caring part of empathy, especially for the people with

whom you work, is what inspires people to stay with a leader when the going gets rough. The mere fact that

someone cares is more often than not rewarded with

loyalty.” James Champy, 2003

--Bowles, 1991

Put Staff First

Caring for them as people

Treating others with respect

Treating Them with Respect

“They have the right to challenge me on any decision. I’m open to that. If I say something wrong, they will come and tell me.”

“I always respect their opinions and I don’t judge them. I listen to what they are telling me.”

“I treat them with respect in all situations. I never speak badly of anyone in front of others.”

“I am just in awe of what they do, I am just stunned by it. Their hearts are so big! They amaze me every day.”

“I trust that they are honorable people, if they tell me they need something, I believe

it.”

Put Staff First

Caring for them as people Treating others with respect Using appreciation & recognition

liberally

Appreciation & Recognition

Getting people’s accomplishments in a newsletter

Bulletin boards to share the thank yous Recognition “tool kits” … give aways Events during recognition weeks Displaying evidence of accomplishments Clinical advancement programs Taking people’s pictures & posting them Thank you notes & special occasion

cards Acknowledgement in front of others

Put Staff First

Caring for them as people Treating others with respect Using appreciation &

recognition liberallyMeet their needs

“Getting involved in the everyday problems of your people may violate the HR rule-book, but it’s also the single best way to build an emotional bond with your employees.”

Katzenbach, Why Pride MattersMore Than Money, 2003

--Bowles, 1991

Put Staff First

Caring for them as people Treating others with respect Using appreciation &

recognition liberallyMeet their needsListen & respond

Put Staff First

What took too long today? What is just plain silly? What is holding you back from doing your best work? What keeps you up at night?

Ask questions & listen to the answers:

Listen & Respond

“They are the ones with the gems. They will come to you with their problems. You’ll know what needs to be fixed, ‘cause they’ll tell you what’s broken.”

“I address issues they have brought up, it surprises them sometimes.”

“I may not have the answer right away because I like to go back and process things, but I always get back to people and they really appreciate that.”

“Listening is probably one of the most important things I do. I repeat what they said and then I get back to them on it.”

Put Staff First

Caring for them as people Treating others with respect Using appreciation &

recognition liberally Recognize & appreciate

diversity Meet their needs Listen & respondSupport

Forge Strong

Connections

Put the

Staff First Creating a Culture of Retention

Forge Strong Connections

Connect with people, as people

Get to know them

Get to Know Them “It’s understanding what’s important

to them outside the institution. That they’re human, that they have important lives and need to feel valued.”

“I know all of them. I know their names, their families, their dogs, what they like to do.”

“I don’t do it as a strategy. I do it from my heart, but I know it makes a huge impact on them. Because I remember.”

Forge Strong Connections

Connect with people, as people Get to know them

Create a sense of communityHire the right people

Hire the Right People “I look for people who are passionate around

their work.” “I’m very selective. I know that if people

want to learn the job, they will. I’m looking at attitudes and behaviors, enthusiasm.”

“We look for people that really have the energy and the sort of sense of humor that fits with our group.”

“I want someone who has the heart and the caring and this is of interest to them.”

“We want someone who is going to contribute, participate on committees, be a part of what’s going on.”

Forge Strong Connections

Connect with people, as people Get to know them Create a sense of community Hire the right people

Have fun together

Have Fun Together “We try to keep it lighthearted. I have a good

sense of humor. They see that and it sets the tone for the department.”

“I use humor and fun to emphasize the things I think are important. For example, we always celebrate the end of orientation. I take the orientees out to breakfast … and the preceptors out to dinner.”

“We have so much fun at our parties, we started having these little cookouts every month or so. One of staff brings his grill & we’ll do hamburgers & hotdogs around 6 pm so oncoming and off going staff can have some. We invite everyone.”

Forge Strong

Connections

Coach for & ExpectCompetence

Put the

Staff First Creating a Culture of Retention

Coach for & Expect Competence

Sets high standards & expectations

Sets High Standards “My leadership team and I actually look for

and create new goals every year so that people are always feeling challenged. So we’re always on the cutting edge. You cannot be satisfied with what you did last year.”

“I have very high expectations, I expect them to participate in PI efforts, to attend the committee meetings that they are on, to practice their profession in a quality way.”

“I don’t expect anything of them I wouldn’t do myself.”

“I have high standards, but I’m a soft touch person. There are a core set of rules, like patient safety. We don’t bend rules there.”

Coach for & Expect Competence

Sets high standards & expectations

Coaches for development

Coaches for Development “I am very well known for developing my

staff. I have given birth to 10 managers here”

“I look for opportunities for them.” “I get them involved in things. I ask them,

what do you want to do?” “Each employee has special strengths and it

means recognizing those and asking people where they would like to develop. They may like teaching others, or improving their clinical skills, maybe they want to be a manager or a case coordinator. So what kinds of experiences would be beneficial to help them prepare for that role?”

Coach for & Expect Competence

Sets high standards & expectations

Coaches for development

Models behavior

Models Behavior “I have faced many situations that

would get most people down, but I don’t let it. I’m choosing my attitude every day.”

“You have to lead by example. We have to help each other. This job is difficult enough as it is. We just need to be supportive of each other. If you see that someone is sinking and having a really tough day, help them out.”

“I try to model the behavior I think employees want … they want honesty, they want fairness, and they want to see that I treat everyone the same.”

Coach for & Expect Competence

Sets high standards & expectations

Coaches for development

Models behavior

Manages performance

Manages Performance

“You have to deal with problems head on and not let them fester.”

“I hold people accountable for their behaviors. We follow a process, it’s time-consuming, but you know what? They either comply or they move on.”

“Here’s the bar. It’s set right here and if you don’t get up to that bar, then there are consequences. Too many people are afraid to discipline, afraid to counsel, because of workforce shortages. But the reality is, you can’t keep bad apples. You really dilute the quality of service and the morale.”

Manages Performance

“You know, it takes a lot of time and energy, but you have to.”

“In my most difficult conflict times over the years in management, I never ran away from it. I knew I was going to be in the hotseat, but I will not let that stop me from doing what I needed to do.”

“When employees bring these problems, they want to see that they are taken care of.”

“They want to know, to trust that something will happen.”

Forge Strong

Connections

Focus on

Results

Coach for & ExpectCompetence

Put the

Staff First Creating a Culture of Retention

Focus on Results

Solve problems

Solve Problems

“I try and deal with whatever they need in a very timely manner. I try and be very responsive to them. They don’t have to come back to me again and say ‘whatever happened with?’”

“People know they’ve been heard when the problem is solved.”

“Taking action very quickly is crucial. Delay, delay, delay will kill them and the manager’s reputation & credibility. If they bring something forward or you see something wrong, take care of it now.”

Focus on Results

Solve problemsEmpower & involve employees

Empower & Involve Staff “A big role of the leader in this

environment of retention is that you start giving up as much power as possible. I measure my success by how little they need me anymore!’”

“Micromanaging kills you. You’ve got to let go. You think you’re going to do it all, but you can’t. It will kill you. You’ve got to have everyone helping you.”

“I want to create more leaders on my unit, people that can just take the ball and run with it instead of always feeling like they have to come to me. And my goal is to get them so self-sustaining that they don’t need me anymore.”

Focus on Results

Solve problems Empower & involve staffResponsiveness to staffProvide adequate resourcesCreate a pleasing physical environment

Forge Strong

Connections

Focus on

Results

Partner with

the Staff

Coach for & ExpectCompetence

Put the

Staff First Creating a Culture of Retention

Partner with the staff

Works interdependently

Partners with Staff “My job is to facilitate their work. I

make a joke about it, but really the truth is that I work for them. They don’t work for me … I work for them.”

“All of these things create a sense that I’m working for them, and it creates an environment where there’s mutual respect between us.”

“It’s understanding that it’s never about me …it’s about we. I’m not retaining people, we are.”

“My job, and I can never forget this, my job is to provide service to those employees. That’s my job, I’m working for them.”

Partner with the staff

Works interdependently

Visibility

Visibility “I just make a point of getting out at

least once a day, making rounds and seeing everyone.”

“Where ever I can just jump in and help out … that’s a good opportunity to be with that employee.”

“I’m here in the morning to see the night shift, and then in the afternoon to see the evening shift.”

“I spend time out at the desk … I take as much of my work out there that I can. Just to be around people.”

“I block time out on my calendar to make rounds.”

Partner with the staff

Works interdependently VisibilityAccessibility

Accessibility “I’m out there with them. I tell them, I’m

available … this is what I’m here for. If you need me or need to talk about something, I’m here.”

“Things like where your office is is important. What you wear to work. If you come in dressed to work or you are in business attire. Wearing the proper clothing that sends the message, ‘if you need my help, I’m ready.’”

“I post my schedule on the my door so people will know where I am at all times. If they want to talk to me and don’t know where I am or when I am coming it, it creates a lot of frustration. This way they know.”

Partner with the staff

Works interdependently Visibility Accessibility

Establishes clear boundaries Communication is open & honest

Open Communication “I am very honest with them and tell

them: ‘I will tell you the way it is, whether you like it or not …I’m going to tell you. It’s going to come from me. The good and the bad, you will hear it from me. If you hear it elsewhere, it’s gossip.’”

“I don’t hide anything from my employees that they need to know.”

“I am very up front with them. The previous leader lost their trust because of misinformation given. I expect the same from them that they expect from me.”

“I try and approach things from a ‘no surprise’ perspective.”

Forge Strong

Connections

Focus on

Results

Partner with

the Staff

Coach for & ExpectCompetence

Put the

Staff First Creating a Culture of Retention

“The people in the good-to-great companies did things that

seemed so incredibly obvious, straightforward, simple… the

comparison companies may have been very smart people, brilliant, but they saw things as complex,

and they had elaborate plans and complicated strategies.”

Jim Collins,in HealthForum Journal,2002

--Bowles, 1991

Action Plan

What should I start doing? What should I stop doing? What should I keep doing? What are 3 action steps to

which I will commit?

Ramifications/Individual

Do an honest self-appraisal--- “How do I measure up against these five principles?”

Look for opportunities to apply these 5 principles

Seek out other supportive managers Incorporate self-care into daily

routine Find your voice, speak up & speak

out Use evidence-based leadership

practices

Ramifications/Organization Know what makes the difference, expect

evidence-based leadership practice Provide necessary resources, not just lip

service Leaders need authority to solve problems

and change what needs to be changed Provide support for dealing with

polarities & managing boundaries Recognize & reward those who are

effective rather than letting them be penalized in the system

Strengthen the working effectiveness between HR and operational managers

Creating a culture of

engagement is hard work, but, it isn’t rocket science and it doesn’t cost a lot of money. Developing such a

culture requires being authentic, caring about

people and making yours a good place to come to

work.

. . . it is far too late and things are far too bad for pessimism.

In such times as these, it is no failure

to fall short of realizing all that we might dream; the failure is

to fall short of dreaming all that we might realize.

Dee Hock, 1999