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8.5 steps to employee retention.

8-1/2 steps to employee retention

Retaining competent laboratorians is the lab's major management challenge today. Job opportunities are numerous; applicants, few. Those who stay work under constant pressure and become increasingly frustrated. Study after study reports inadequate job satisfaction, motivation, and rewards in the lab.

Although a major offensive is under way to increase the personnel pool, such efforts take time. Lab managers will find it hard even to maintain the status quo unless they follow effective employee retention programs.

A survey of 651 managers in 10 firms by Caleb Atwood at ERIQ Inc., Houston, found that many managers don't do what the experts say they should. [1] Nearly half of the managers surveyed did not understand that rewarding behavior causes it to be repeated. More than 60 per cent thought it improper to brag about their staffs' accomplishments. Nearly 70 per cent avoided problem-solving strategies that entailed reaching a mutually satisfactory conclusion. And almost 50 per cent failed to recognize that cost goes down as quality goes up.

Developing a good motivational program is the key to employee satisfaction and managerial success. We have all heard the word "motivation" so often that we tend to forget it is still the basic element of all management principles. Managers cannot achieve departmental and organizational goals without staff support and cooperation. It definitely helps the cause when employees have a vested interest in seeing their own goals achieved when the organization succeeds.

Motivation is the major catalyst for employee behavior and performance. A highly motivated work force is self-directed and requires less supervision than a less motivated one. It experiences less absenteeism, produces more work, and enjoys greater job satisfaction. Unfortunately, today's laboratorians feel that they lack control over their jobs. They become frustrated and bored.

To develop a successful job enrichment program, lab managers should remember that they are dealing with professionals--and that professionals demand a challenging work environment. Before initiating appropriate motivational programs, however, managers must understand that success begins with determining the needs and wants of individual employees.

Two research projects in the early 1980s identified 12 key factors that influence the attitudes and job satisfaction of health care workers. [2] The findings, summarized in Figure I, still apply.

Managers can successfully address the concerns listed in Figure I--with the exception of the pay factor--by using a strong employee-focused motivational program adapted from Frederick Herzberg's seven steps to job enrichment. [3] Although this approach will not solve the parity problem, a highly motivated, professionally committed, patient-oriented work force could gain salary increases based on superior performance. Here is the Herzberg program:

Step 1: Give recognition. People respond to the positive reinforcement of having good performance recognized consistently. Giving positive strokes requires little effort yet yields multiple benefits. Time spent counseling or helping an employee improve can be considered a positive stroke; it tells employees that you care about them and their career development.

In contrast, negative strokes, such as critical punitive comments delivered in anger or in public, can permanently destroy employee motivation. A lab manager who is sincere and honest in giving both praise and criticism will see performance improve when staff members are praised or corrected. When employees feel unappreciated, they work less hard and may eventually leave, believing that their manager doesn't care.

Step 2: Encourage achievement. When employees have a sense of achievement--and see their goals being met--they try harder. Most laboratorians are proud of their work and start out as self-motivated professionals. This attitude fades fast when there is little or no opportunity to use their knowledge and skills fully. Opportunities for growth and development--and expanded roles and responsibilities--enhance the sense of personal and professional achievement.

Laboratory managers must be innovative, actively stimulating and encouraging employees to grow. Effective managers are not afraid of competition. Emphasizing cross-training and interdepartmental liaison teams (particularly with the nursing department) enhances an employee's sense of accomplishment.

Step 3: Remove day-to-day controls. This is the most difficult step for most managers. Employees who are competent professionals do not require constant supervision by an eagle-eyed boss. With basic policies and procedures in place and resource parameters established, why not forgo the minute detailed instructions and simply allow employees to do their jobs? If competency-based position descriptions state specific performance standards and objectives, employees know what is expected of them and what they are accountable for.

Far too many section supervisors spend valuable time checking every test result before it leaves the department. A competent and trusted staff should be supervised by exception. Employees should be expected merely to give supervisors results that fall outside stated parameters. Developing broad management operational and system policies encourages employees to use their knowledge and skills at the workbench.

Step 4: Share responsibility. This step goes beyond merely granting appropriate responsibility. It involves recognizing the need for strong employee input into decision making and problem solving and for special work assignments that draw on an individual employee's skills.

Resistance gives way to acceptance when an employee comes up with an idea. By "owning" that idea, he or she is committed to its success and will do everything possible to make it work. On the other hand, when change is forced, resistance or even sabotage may occur. It makes sense to involve staff members from the beginning in any plan they will ultimately implement. Employees who enjoy day-to-day contact with the job at hand also have the opportunity to solve many of the problems as they arise.

Quality management--that highly touted approach to cost containment--reflects this theory. It is not a new concept; lack of participation has long been documented as a major factor in organizational stress and burnout. Arthur Deming promulgated the theory many years ago. [4] This management philosophy, now known as Theory Z, holds that problems are best solved by those who experience them. Employee involvement and commitment to correcting errors and system improvement reduce costly repeats and consumables, thus enhancing quality. Japan in particular has embraced the theory and applied it widely in business.

One need not implement the formal quality circles that Theory Z describes. Setting up special project teams or task forces works just as well. The important thing to remember is that a teamwork approach to decision making and problem solving can result in:

* Improved morale and increased loyalty;

* Improved productivity and quality;

* Reduced grievances;

* Reduced absenteeism, lost time, accidents, tardiness, and attrition;

* Improved efficiency and cost effectiveness; and

* Enhanced teamwork.

Tasks performed cooperatively (not competitively) are accomplished more efficiently and leave employees more motivated and satisfied. Indeed, many managers and supervisors assume they are hired to make decisions. They are not paid to make all the decisions themselves, but to see that decisions are made. Management should make sure that those affected by a decision will participate in identifying the causes of the problem and in reaching a solution to it.

Step 5: Introduce more challenging tasks. Managers promote professional growth and development by assigning more challenging and rewarding work. It may take creativity to recognize individual expertise. When managers may choose between assigning work to a more experienced technologist and to a bench beginner, it often pays to take a chance on the newcomer. The rewards are twofold: Experienced laboratorians remain available for advanced projects while novices get a chance to learn new tasks and broaden their knowledge, skills, and growth potential.

There is no substitute for rotating job duties and responsibilities. Even limited cross-training helps employees master new skills. Doing so gives them the feeling of being needed and of conquering a task previously handled by someone else. Identifying "experts" or resource personnel for certain instruments or complex test procedures signals a lab manager's recognition of employees' ability. Laboratory managers can foster the satisfaction of a feeling of expertise among their staffs by delegating certain management tasks, such as purchasing, nursing liaison, and safety.

In assigning new challenges, laboratory managers should follow three rules:

1. Give the employee permission to make mistakes or even to fail. Failure is a valuable learning experience.

2. Grant sufficient authority to carry out the task. Delegation without responsibility is merely a task assignment.

3. Allow employees to disagree with you. Differences of opinion, handled fairly, can contribute to organizational success.

Step 6: Redesign your work groups. Changing the way laboratory services are provided is no longer a matter of "should"; the pivotal word is "how." Hospitals are overhauling the basic organizational structure by eliminating parts of all management layers. Inside the laboratory, technologic advancements also dictate the way labs operate. Sharp alterations in the health care system in general have strongly influenced where testing is performed.

Creating a dual career ladder within the laboratory involves establishing the job category of the technical specialist. The abilities of most laboratory supervisors do not meet the strict definitions of their job titles. Technical specialist positions would acknowledge the true expertise of the traditional (but unrealistic) supervisory designation.

There are many ways to redesign work groups. One might try cross-training, interdepartmental liaisons, or emphasizing the interpretation and correlation of laboratory data. Other options include expanding lab involvement in patient outcome-oriented quality assurance and recognizing the laboratory's participation in bedside testing.

Step 7: Strive for more direct communication. Sharing information as quickly as possible enhances employees' motivation and morale. Few management actions are more apt to make an employee feel a part of the organization than simply knowing what is going on and being on the inside track. Managers who remain married to memos lose the advantage of obtaining immediate feedback and may actually cause confusion, frustration, and errors due to their staffs' misinterpretation of the written word.

Weekly management meetings and monthly or more frequent staff meetings are a must. Include all employees--support staff as well as technical personnel. Enhance communication further by providing ongoing recognition and counseling programs that acknowledge above-average performance and address below-par performance.

A competency-based performance review system should focus on growth and development and reflect objective-oriented position descriptions with measurable performance standards. The annual review should be used to set goals and objectives for the coming year. It can provide an overview of an employee's contributions to the organization and of successful attempts to strengthen any weaknesses. It is the laboratory manager's responsibility to keep employees up to date on institutional policies and problems, financial status, and future plans as well as on concerns specific to the laboratory. The more informed employees are, the greater their ability to help maintain a cost-effective and efficient operation.

Step 8: Develop a leadership style. Herzberg's seven basic steps to job enrichment presume that those doing the implementing have solid management skills. Productive managers encourage teamwork, think positively, and deal honestly with their employees. They take charge and help employees fulfill both their own goals and those of the organization. Good managers are empathetic and keep the lines of communication open--both up and down.

Successful managers realize that a strong staff points to a strong leader. They do not feel threatened when their employees express the desire to grow and to assume additional responsibility. Managers who respect their employees as equals see themselves as the equals of their own superiors. A participative, communicative, and goal-oriented leadership style restores employees' faith in the manager's ability. For many laboratory managers, adopting such a leadership style requires major changes in their behavior and attitudes.

Step 8-1/2: Take risks. The transformation from an authority-obedience supervisory style to one of involvement, participation, and commitment may well involve risk taking. Risk may lead to such negative consequences as failure and rejection; so, however, may failure to take risks.

A good risk taker inspires other employees to do the same. Staff members understand when their manager will tolerate the mistakes that often accompany risk and will allow them to profit from the errors they make.

Managerial success reflects the strengths not only of the manager but also of his or her superiors, peers, and--of greatest importance--staff. In a direct application of the theory of self-fulfilling prophecy, managers who expect superior performance are likely to get it; managers who expect inadequate performance will almost surely get it.

Authority and power do not come with the title. Employees grant them to managers who respond to their needs, allow them a voice in decision making, and offer them opportunities to learn management techniques.

Developing and using these supervisory skills foster a motivational climate that can help boost employee retention even when little or nothing can be done to improve their salaries.

[1] What managers don't know may hurt them. Behav. Sci. Newsletter 20: 1, Oct. 24, 1988.

[2] Fitzgerald, P.E. Jr. Worker perceptions: The key to motivation. Health Care Supv. 3(1): 13-18, October 1984.

[3] Herzberg, F. "Work and the Nature of Man." Cleveland, World, 1966.

[4] Walton, M. "The Deming Management Method." New York, Putnam, 1986.

Annamarie Barros is a management consultant and educator; director of Health Management Analysts, Los Gatos, Calif.; and laboratory operations adviser, Ernst & Young, Great Lakes Region, Cleveland.
COPYRIGHT 1990 Nelson Publishing
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Author:Barros, Annamarie
Publication:Medical Laboratory Observer
Date:Aug 1, 1990
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