Professor Michael West. Healthcare People Management Association Conference

Transcription

1 Resilient Individuals Resilient Organisations Professor Michael West Aston Organisation Development and Lancaster University Management School Healthcare People Management Association Conference

2 Content Resilient individuals and organisations depend on distributed leadership ensuring: > Patient focus > Clear aligned goals and objectives at every level > Good people management > Positive emotional environments and relationships > Employee engagement > Real team working > Values based leadership

3 Leading for resilience Searching for new ways to meet patients /clients needs and ensure quality and safety Leadership is upbeat and self confident. There s no problem that can t be solved, no status quo that can t be bettered Listening to clients/patients... Leadership is about doing the difficult not managing the inevitable

4 The HR system variable explains 16.9% of the variance in subsequent mortality (p <.01) Mortality Below average Average Above average Even taking prior mortality into account, the HR systems variable explains a further 7.8% on top of this (p <.01)

5 Implications 25% more appraisers trained, associated with a reduction of 12.3% of the number of deaths after hip fracture 25% more staff working in teams associated with 275 fewer deaths per 100,000 following emergency surgery or 7.1% of the total number of deaths following emergency surgery West et al, 2001 International Journal of HRM West, Guthrie, Dawson, 2006 Journal of Organizational Behavior

6 Boorman Report - Absenteeism 10.3 million working days per year 45,000 whole time equvalents (WTEs) 4.5% of workforce; 1.75 billion BT and Royal Mail achieved 30-40% reductions saving 555 million

7 NHS stress, health and well-being > Presenteeism Pressure to attend when unwell 22% > NHS as exemplar e.g., smoking, drinking, diet > Bullying and harassment (14% report bullying by managers and colleagues in 2010) > A move from average to good staff health well being would save 840,000 staff days per year ( 13.7 million) > Use of agency staff to cover absence costs 1.45 billion; recruitment costs to cover turnover 4.5k; ill health retirement 150 million

8 Resilience through Engagement Performance Appraisal Team Working Job Design Supervisors Support Work Pressure Having an interesting job Feeling valued by colleagues Overall Engagement Advocacy Intrinsic Engagement Involvement Employee Reactions Health and Well-being Stress Presenteeism Hospital Performance Quality of Services Financial Performance Absenteeism Patient Mortality Rate client Satisfaction

9 Positivity builds resilience > Barbara Fredrickson > Positivity ratio > 3:1; Maximum 11>1 Fredrickson & Losada, American Psychologist (2005) 60, > (... and negativity is necessary)

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11 Resilience is undermined by chronic conflict... > Relationships are one of the most potent sources of human misery > Chronic conflict and hostility damage the immune system > Modelling positive relationships in health care organisations > Feedback is key Reis and Gable, 2003

12 Resilience in NHS organisations > Positive organisational climates linked to high staff satisfaction and low levels of stress and injury > Support for work life balance linked to staff satisfaction, low pressure and staff intention to stay > Well designed jobs linked to satisfaction, lower intention to leave, pressure, injury, harassment, bullying and violence > Supervisory support is associated with staff satisfaction

13 What else enables resilience and engagement? Employees have: > the information they need to do their jobs well > learning opportunities > feedback which builds confidence > support and safety to innovate > leaders who value, respect and support them > trust in their leaders

14 A culture and all leaders focused on quality and safety > A culture of trust - in leaders, managers and system > What leaders pay attention to, monitor, model and resource > The criteria for recruitment, selection, promotion and disciplinary action > Flat hierarchies, rituals and rites; celebrations of accomplishment and innovation > The focus of the organisation s systems and procedures is on quality and safety of health care

15 Impact of Appraisal in Healthcare Lower Patient Mortality Higher Job Satisfaction Lower Intention to Leave Lower Stress Lower levels of Bullying CQC ratings MHT Lower pressure and fewer errors Well-structured > none > poor appraisal.

16 Well-structured appraisal Agree objectives Clear Challenging Measurable Agreed Conversation helps me to do my job better Conversation makes me feel valued and respected by my employer

17 Appraisal in English NHS Organisations (2010) % appraised % well-structured Acute Trusts PCTs Mental Health Trusts Ambulance Trusts 68 19

18 Appraisals/Personal Development Reviews Clear, challenging objectives (5 or 6) Barriers and supports to effectiveness over previous year Training needs Career plans Appraiser helps and hindrances Actions by appraiser Actions by appraisee Appreciation and recognition of contribution Review after 3 months

19 Team working in health care promotes resilience, innovation, quality and safety

20 Working in Teams in the NHS Do you work in a team? If yes >Does your team have clear objectives? >Do you have to work closely together to achieve these objectives? >Do you meet regularly to review your team effectiveness and how it could be improved?

21 Staff absenteeism 5% more staff working in real teams associated with 0.27% in overall absenteeism rate (p <.001) For an average acute hospital, this represents a potential estimated saving of over 1 million per year in direct salary alone Absenteeism (%) Low (< 35%) Moderate (35-40%) High (> 40%) Extent of real team working

22 Patient mortality 5% more staff working in real teams associated with 3.3% drop in mortality rate (p =.006) For an average acute hospital, this represents around 40 deaths per year Mortality ratio Low (< 35%) Moderate (35-40%) High (> 40%) Extent of real team working

23 Mortality

24 Organisational resilience key principles > Patient focus > Clear aligned goals and objectives at every level > Good people management > Positive emotional environments and relationships > Employee engagement > Real team working > Values based leadership

25 Resilience is gained from value congruence

26 Wisdom and Knowledge > Curiosity, interest > Love of learning > Judgement, critical thinking, openmindedness > Practical intelligence, creativity, originality, ingenuity > A broad and long perspective How can we promote these values and virtues in the organization?

27 > Valour of a vision Courage > Industry, perseverance to carry it through > Integrity, authenticity, honesty > Zest, enthusiasm vs cynicism How can we promote these values and virtues in the organization?

28 Humanity > Reciprocal attachment > Kindness, generosity, nurturance > Social intelligence, emotional intelligence How can we promote these values and virtues in the organization?

29 Justice > Citizenship, duty, loyalty, teamwork > Equity, fairness > Leadership How can we promote these values and virtues in the organization?

30 Temperance > Forgiveness, mercy > Modesty, humility > Prudence, caution > Self-control, self-regulation How can we promote these values and virtues in the organization?

31 Spirituality and Gratitude > Wonder, delight, appreciation of excellence and beauty > Gratitude > Hope, optimism, future mindedness > Humour > Sense of deeper purpose or contribution How can we promote these values and virtues in the organization?