Behind the Scenes of Health Care

Motivation and Commitment of Health Care Employees

Hesston L. Johnson

• Publisher: Business Expert Press
• Year: 2020
• ISBN:
  9781951527396
• Topic: Business
• Subtopic: Pharmaceutical, Biotechnology & Healthcare Industry
• Index: Business

Behind the Scenes of Health Care presents an extensive review of motivation and commitment among health care workers in support and bedside care roles.

The publication includes two research studies: (1) motivation and commitment of support services employees in a health care environment and (2) the correlation between patient experience feedback and nurs­ing motivation and engagement. Additionally, the publication includes two case studies: (1) cultural disruption in a health care system and (2) a service organization review of turnover.

Lastly, and most significantly, the publication provides a framework and model, The Tri-Factor Model, to assess and measure workplace dynamics of motivation, commitment, and culture that is also applicable to turnover analyses. Readers of Behind the Scenes of Health Care are provided tools to understand motivation, commitment, and cultural components in the contemporary workplace that may be applied to any organization.

CHAPTER 1

Culture and Employment

The time an individual stays with his or her employer is increasingly becoming more about elements of organizational culture, motivation, and outcomes driving individual organizational commitment. Organizational culture is composed of norms within an organization that impresses upon employees workplace experiences, expectations, organizational philosophy, and acceptable behaviors. Culture is also composed of shared beliefs, attitudes, and relationships indicating expected group behaviors.

When considering culture, motivation, and turnover, the phenomenon of an endless existence of turnover challenges has, as of late, been further complicated by the improvement and stabilization of unemployment rates in the United States. At the present time (June, 2019), the overall unemployment rate for the United States is 3.6 percent and has been on an improving trend over the past 12 months (Bureau of Labor Statistics n.d.-a). To remain culturally competitive, more than 75 percent of organizations have committed to creating an enhanced employment culture to boost employee engagement and organizational performance (Paterson 2014), while 65 percent of the world’s leading employers have acknowledged cultural programs focused on workplace relationships, employee well-being and work–life balance are central to attracting and retaining employees (Paterson 2014). The drivers behind developing cultures focusing on well-being are associated with stress levels, organizational leadership, and coworker relations. Employers, including health care organizations, are attacking these concerns through branding programs and initiatives to strategically enhance culture, incorporating programs focused on more paid time off, more frequent breaks, safety, and flexible work options, as well as incorporating training and development opportunities (Paterson 2014). Other efforts associated with well-being and developing cultures indicate the shift in focus on the human element; 81 percent of employers aspire to develop and cultivate a culture to support productivity, employee satisfaction, and employee retention (International Council on Active Aging 2018). In 2018, 40 percent of organizations, collectively employing over five million employees, identified the significance of cultural development; up from 33 percent in 2016 (International Council on Active Aging 2018).

For health care leaders, industry employment has underscored the demand to develop strong cultures led by individuals focusing on motivation and commitment. To illustrate, within the health care services employment sector, the unemployment rate has decreased from 2.7 percent (641,000 individuals) to 2.6 percent (648,000 individuals) in the past 12 months (Bureau of Labor Statistics n.d.-a; 2018–2019) while the health care industry added approximately 368,000 jobs during the same window of time (Bureau of Labor Statistics n.d.-b). Given industry growth, the few vacancies existing in health care are in a mix of fierce competition among employers when the prior year increase in jobs has exceeded 50 percent of individuals unemployed. For health care jobs, a 2.6 percent unemployment rate accounts for 0.003 percent of unemployed health care employees and professionals (Bureau of Labor Statistics n.d.-a). In the growing health care industry, organizations are not just competing for talent, but they are competing for just over one-tenth of a percent of the unemployed industry workforce.

I say all of this to illustrate the significance of employment competition. With so much domestic competition for hiring skilled employees in not only health care, but in all industries, organizations are pressed to seek innovative approaches and strategies to ensure their employees are motivated, committed, and engaged. This includes how the employer influences organizational commitment and motivation to build a connection with employees so they stay. The difficulty in recruitment, retention, and performance places the subsequent demand on organizational culture competition.

Though commitment will be thoroughly explored later, the bottom line is that many employed individuals are passively or actively seeking alternative employment to a different organization motivated by culture, motivation, and commitment. In a study examining poorly performing cultures, approximately 75 percent of employees have identified they would leave their current organization for the “right opportunity” (Dunn 2016) It is important to understand what “right opportunity” means; it may be related to the leader, peers, benefits, or opportunities for advancement. In a 2018 study examining health care employees, the greatest employee motivators were use of personal abilities, job security, role fulfillment, and meaningful work. While motivation factors will also be discussed later, it is important to keep in mind that culture and stay intention is associated with workplace motivation. Motivation factors and culture does not completely exist in a silo, but rather as a complex and integrated force within organizations. Additionally, what motivates the sample of my studies does not necessarily mean it is congruent with all organizations. It is all about leadership focus on culture and motivation factors.

For example, when an employee is capable of leaving—or actively seeking to leave—your organization, the result may be that either the culture within is inadequate or leadership is perceived to not value culture and individual motivation factors (Dunn 2016). If motivation factors are not sufficiently understood, counterbalanced, and addressed with competing motivation factors, turnover will perpetuate because the motivation factor is inadequately satisfied. In an effort to understand turnover through motivation, internal leaders, such as our human resources professionals, seek to understand how their organizational culture is different from that of others (Dunn 2016). This includes how the organization differentiates itself in recruitment and retention activities when those efforts seem to fail (Dunn 2016). High performing leaders develop high performing cultures through understanding their culture, the motivation of their staff, and the efforts required to improve the workplace environment.

How does the organization retain and develop a team from scratch that will be successful when the employer is the independent variable in the relationship? What puts the organization above the rest in order to retain and attract the best talent and experience in the field? Simply put, a culture focused on motivation is the key to developing high performing groups. And, culture is not as simple as implementing improved programs in paid time off, work flexibility, and healthy well-being programs. Rather, a culture focused on motivation is more specific to each individual in your workforce and collective teams as many motivational factors include team related behavioral factors. It is also critically important to understand and accept the fact that turnover is not an industry phenomenon.

For health care leaders in operations, it is clear that motivation, satisfaction, and cultural development are central to employment and recruitment efforts and competition. It is essential to understand the factors associated with employees that remain with the organization and what the “right opportunity” is for those that are passively seeking alternative organizations. It is also the key to understand what organizational efforts to develop employee-centric programs look like. Is your organization developing and practicing contemporary employee engagement practices associated with flexibility and well-being programs while differentiating efforts from the competitive health care employers in the market? Is the “right opportunity” gap understood? Do leaders understand what that “right opportunity” is? What is the differentiator?

There are a multitude of motivation factors leading employees to connect or disconnect from their current employer. In an analysis of motivation factors among point-of-contact employees initiating connection with patients and customers, leading factors of motivation are outlined later. As a health care leader, how do you measure and understand the influence of motivation factors on business outcomes? The Tri-Factor Model analysis of motivation, satisfaction, and commitment, presented later, provides a foundation for identifying the weight of motivation, commitment, and satisfaction factors; all essential to understanding what leads employees to remain with an organization, as well as what draws them out to seek employment with other organizations when their needs are not met. At this early point, leaders should be prepared to evaluate and understand what motivates employees, why they stay, and what factors need to be present to drive workplace satisfaction.

Health Care Leadership Takeaways

As discussed, employee retention in modern workplace environments is driven by developing cultures focusing on motivation factors to strengthen organizational commitment. The strong unemployment rate has created a competitive landscape where health care worker unemployment is less than one-tenth of a percent.

To develop cultures, health care leaders must understand why employees stay with their organization. This includes understanding differentiating workplace benefits and programs among health care organizations and how leaders develop and commit to employee-centric environments. For employees, leaders must understand what “the right opportunity” looks like to anticipate the passive job seekers on work teams.

CHAPTER 2

Motivation

How do leaders retain and develop teams from scratch that will be successful? What positions an organization to be able to retain and attract the greatest talent? At this point, it should be clear that understanding motivation factors are the key to understanding work groups.

Workplace motivation is the force in the workplace that drives all employee behaviors and responses. Employees are motivated in different ways, requiring a comprehensive understanding of relationships in order to identify motivational needs. There should also be a level of analysis on how to counterbalance needs if they cannot be directly addressed. When employees are motivated, they exert greater levels of effort, time, and persistence to meet organizational goals. When rewards, recognition, and retention strategies do not match the workforce, the effort to address opportunities and improve focus on the human element of business fades into the background of daily busyness of management. In a health care setting, considering the fierce competition and favorable unemployment, health care leaders should understand competing components of turnover and retention.

In a case study conducted within a private sector services employer, turnover rates exceeded 50 percent. Annual turnover averaged 13.7 employees per day. Exit interviews indicated that the organization was considered a favorable employer among 72.3 percent of participants. Of these participants, 57 percent were employed less than 2 years, 40 percent were employed two to five years, and 3 percent were employed for greater than 5 years. Of the respondents, 82 percent reported strong teamwork, 42 percent left the employer due to higher paying employment, 38 percent left for “something else,” 12 percent left because of poor management, and 8 percent left because of physical demands. Results are presented in Figures 2.1 and 2.2.

Figure 2.1 Private sector service organizational duration of employment

Figure 2.2 Private sector service organization—reason for leaving the organization

In examining motivation factors, pay and salary generally surfaces from health care leaders as a leading factor, though data and evidence of this is often lacking. Understanding the counterbalance of factors is essential to address such factors and consideration of pay as a factor. Pay is an extrinsic motivation factor while peer interactions and relationships are intrinsic motivation factors. The organization in the case study primarily has driven employee engagement in intrinsic factors of role fulfillment, advancement, development, and a culture of caring. These factors are important and effective components of culture and motivation. However, the organization in the case study miserably failed to address or counterbalance compensation-related motivational factors evidenced by the analysis. The identification of factors and motivators suggests...