Change That Motivates
Let us start with the premise that for positive change to take place in any organization, managers have to become leaders. A commonsense definition of leadership in a healthcare setting is the ability of one person to influence many in a way that benefits patients (Pine & Galloway, 2011). So the first best organizational change to make would be to invest in training designed to develop leadership skills in Managers.
Manager’s focus on processes and are consumed with building a better mouse trap (Peter Drucker, 1954); (Pine & Galloway, 2011). What they fail to understand is that unless they can motivate employees to engage in their processes, the trap never gets set properly and the desired change never occurs. Leaders on the other hand focus on people, have followers and can inspire others to change their behavior in a meaningful way (Drucker, 1954), (Pine & Galloway, 2011).
Let’s explore why this happens. To be effective, leaders need only have four qualities i.e. intelligence, trustworthiness, humanity and moral courage (Pine & Galloway, 2011). A leader can have more than four but that is sauce for the goose. They only need four to motivate and inspire others. Let us examine why these qualities produce results. First, intelligence has nothing to do with being book smart and everything to do with critical thinking. Critical thinking requires common sense and the ability to make and change plans based on the needs of any given situation. Nurses begin this process in nursing school and later master it on the job. To be a leader is also to be a tactician who understands prior planning prevents poor performance. Flexibility in the planning process guarantees the highest possible degree of success. Trust on the other hand, is the wellspring from which all leadership flows. You cannot lead or motivate anyone who doesn’t trust you (Colquitt, Scott, and LePine, 2007). The good news is that this is the easiest of the four qualities to acquire. To be considered trustworthy, you only have to be as good as your word and all the time. In short, if you promise your people ice cream and there are three feet of snow on the ground outside, then you had better get a shovel and dig a path to the supermarket because they must have ice cream. In addition, leaders share information in real time with employees because they trust them enough to do that (Finkelstein, Marvin; Harrick, Edward; Sultan & Paul, 1991). According to Yan Carlzon, CEO Scandinavian Air, “A person without information cannot take responsibility for anything. A person with information cannot help but take responsibility for everything.” Trust is the gasoline that fuels engagement. Over the course of an employee’s entire work history, how many of their mangers do you think they consider trustworthy?
We said earlier, leaders have followers (Drucker, 1954). The ability to build trust relationships with staff is one of the main reasons why. Humanity embraces the concept of fairness. It requires a leader to ensure everyone receives equitable treatment across the board (Harrington, 2010). Doing so eliminates any perception of favoritism on the part of the employees and has a positive impact on motivation and productivity. A leader does this by focusing on employee behavior rather than on the employee (Pine & Galloway, 2011). Doing so eliminates the possibility of age, ethnicity and gender as a potential source of bias. Behavior either meets or exceeds departmental standards or it does not. Departmental policies are the measuring stick used to assess behavior. So we can say without fear of contradiction that when behavior does not meet the standard, employees can be held accountable because they violated a hospital policy. The real problem then becomes the behavior, not the employee and is easily dealt with. The only caveat I would add is the purpose of accountability should be to elicit a positive change in employee behavior. Any coaching session should raise the employee’s awareness around the issues, retain a positive focus and demonstrate commitment on the part of the manager to the employee’s success (Pine & Galloway, 2011). Over the course of a lifetime, how many coaching sessions have you been involved in where a manager has done that? Managers don’t because they focus on processes. Leaders do because they focus on people Drucker, (1954). In this way, when an employee leaves the session, there is no negative impact on performance and in a hospital that could prove dangerous. What happens if you lack humanity? Employees will undergo a withdrawal reaction from work obligations for any perceived inequities on the part of the manager (Banks, Patel and Moolah, 2012).
Moral Courage means doing the right thing because it is the right thing to do. Managers will always assign blame. It is never quite their fault and always someone else’s failure. A leader takes the heat for bad decisions and passes on the credit for good ones. Doing the right thing solely because it’s the right thing to do builds trust and cements positive relationships between leaders and staff (Sharpe, 2011). Each one of these four qualities builds upon the others. If you can’t plan you can’t succeed. Without trust, no one will follow you. Without humanity productivity suffers and without moral courage, you stand alone. With these four qualities, a leader can build relationships based on trust and engage employees to step up even if they must make a personal sacrifice to do so. Investing in leadership training is the single most important change an individual or an organization can make.
The second organizational change should be to implement a reward and recognition program designed to help employees reach departmental goals. Reward and recognition is the most powerful tool in any leader’s toolkit (Pine & Galloway, 2011). In addition, there is a direct correlation between the level of employee commitment and the effectiveness of a company’s reward and recognition program (Andrew & Kent, 2004). A leader must reward and recognize every behavior that moves the individual or the department forward or he/she will sit back and watch that behavior become extinct (Pine & Galloway, 2011).
If our plan was to raise the clinical bar in a nursing department, we must reward behaviors that help the employee achieve that goal Moskowitz, Levering & Tkaczyk, (2011). Nothing gets the motivation level of a group up faster than public recognition. Have a 3 or 4 minute meeting at the beginning of each shift i.e. an energizer. This meeting will serve two purposes, first it allows a manager to set the priorities of the group for the shift. Second it is the perfect platform to raise the enthusiasm levels of the group before you send them out to meet the demands of the day. Reward and recognition programs do three things well. First they optimize the performance of the group. Second they have a positive impact on morale, job satisfaction and turnover. Third they generate increased profits which are vital to the organizations long term success Deeprose, (2006).
The only problem we have yet to solve is communication. The goal is to select the correct medium so as to reach as many members in both groups in the shortest possible period of time Barry and Smithey-Fulmer, (2004). Here is the plan. Today is Monday. HR will send an email to all staff by close of business today. Managers will schedule a meeting with charge nurses for 8 am tomorrow morning to discuss the reward and recognition program. Each charge nurse will then go over the program at an energizer at 7:15 am and pm for the next several days. They will also put out that the manager will schedule a staff meeting for 8 am Monday morning to discuss the program in detail and to answer questions. Managers will also receive a corporate email about leadership training today as well. The Chief Nurse will send each manager a calendar e-vite for 10am Tuesday of next week. Questions to be answered at that time. The invitation will contain a message requesting anyone scheduled to be off on Tuesday to reschedule with the Chief Nurse via her cell phone.
In conclusion, we now know that leadership qualities have a positive impact on employee motivation and engagement. Reward and recognition on the other hand is a system that directs that motivation toward reaching specific goals and generating long term profits. Both will ensure the viability of an organization however without communication nothing happens. Getting the message to the people who need it is just as important as the message itself.
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