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Introduction
There is a morale problem among staff members in Smiley Hospital that stems from incongruence in its jobs organization and performance evaluation system. Various aspects of management will be examined to find out what decisions and actions can be done to resolve the situation. They are goal setting, planning, motivation, mentoring, directing, leading and decision-making.
Managing in a Hospital
Because of the urgency of its mission, a hospital has one of the most stressful environments. Management’s role is to organize and supervise staff so that they can handle stress and perform effectively. High quality of service is required in spite of the common problem of manpower shortages (Freel, 2012). It is also an environment that is dominated by knowledge workers in he medical field. Management must be able to harness the wide and varied collection of expertise into coherent efforts. Huge amounts of data are also produced which require management also by itself.
Management must be systems and technologically inclined to keep up with the many processes and data required, often in real-time demand. Systems must be efficient and well organized so operations can run smoothly and reduce stress. Managers must have the highest qualifications possible to gain the respect of subordinates. The management approach must be customer-centric because the hospital is a services business whose customers are usually highly anxious and prone to negative behavior. The sense of customer service must be of the highest priority.
Managerial Goals
There is an existing widespread morale problem and the urgent goal is to create contingency plans for sudden resignations of staff. Staffing agencies need to be identified and notified. Job ads need to be prepared in advance. Skeleton forces need to be designed for affected departments.
The general goal for the hospital at the moment is to restore the high morale of the staff. They have specific complaints that must be addressed as soon as possible. One objective is to determine why performance evaluations are not referring to their actual responsibilities. The most likely situation is that additional responsibilities are being added that are not in the official job description. Accomplishments then are not being recognized. This possibility must be confirmed. Overworked staff is a common complaint in hospitals (How hospitals are boosting staff morale, 2013).
Another objective is to validate complaints about job assignments that are outside of staff’s capabilities. This situation will surely result in poor performance ratings and low morale. Definitely, this is a matter that management must clarify with HRM and the operational managers. An expected result is the revision of performance evaluation procedures that will accommodate any necessary changes in responsibilities that can be demanded by day-to-day operational requirements.
The criteria for assigning importance to goals are financial impact, operational impact and marketing impact. For Smiley which is a small hospital with limited resources, the contingency goal has the most operational impact as failure to quickly replenish staff would lower the quality of services. Serious mistakes by temporary staff can result in harm to patients which can cause costly lawsuits. If they become public, the marketing and sales will be affected too.
The procedures revision goal will have an operational impact by improving the morale of staff that would be more productive because of higher morale. This can enhance the reputation of the hospital and improve sales.
One alternative is to outsource some of the work that is not in the current job responsibilities. The objective is not to overload the current staff with work that is below their expertise. Another alternative is to hire an HR consultant who can recommend organizational changes that will handle dynamic assignment of responsibilities.
Motivation
Management can complement its morale-boosting goal setting with motivational tools. The tool with the most impact would be additional pay in the form of salary increases and bonuses (Nornberg, 2014). If additional work across patient groups would have proper approvals and if performed well, these would be considered as “going for the extra mile” and would entitle merits for salary increase computations. Based on the equity and expectancy theories of motivation, employees would be more motivated knowing that whatever extra efforts they exert has a commensurate future reward. Exceptional performance beyond expectations can be rewarded by spot bonuses to be announced publicly. Compared to salary increases, these are instantly gratifying and more dramatic which can spur more energy and productivity. This is also on line with the path-goal theory of leadership where you clarify goals and rewards and enable your subordinates to achieve them.
Learning structures can also be posed as a non-financial motivation. Cross-training can be implemented wherein briefing sessions can be held based on new experiences or insights on the job that can be applicable to other groups. Being assigned to different patient groups can be a rich source of new learning. It is as if employees are on the on-the-job program again.
Managers can refer to the path-goal theory to show leadership behavior. Directive behaviors pertain to the goal-setting, organizing, policy and rule setting and training. Supportive and achievement-oriented behaviors are the personal interactions managers make with subordinates to show concern and encouragement in the new tasks and patient groups they are assigned to. Participative behaviors will allow staff to provide input and suggestions on the formation of policies regarding inter-group responsibilities.
The staff can be empowered with extra duties by programmed OJT with supervisors and senior staff. To be fair, performance evaluation should not apply when a staff is in OJT status for a particular task. Preparatory training with certificates can also be conducted on weekends.
Mentorship
Supervisors can guide the staff on the new performance evaluation system by positive modeling which is a form of mentoring (Lewis, n.d.). To be evaluated fairly, it is important that staff should report difficulties which are beyond their control. Correct reporting of issues is an important input to management and performance evaluation. Supervisors and senior staff can show that they practice this. They can show their reports during their meetings and narrate how they were received by their own management.
An alternative to modeling would be group discussion of difficult situations encountered by staff. Moderated by supervisors, teams can jointly discover solutions to these situations. The model is the solution that was agreed upon by the group.
Mentorship can be established as a standard practice wherein each staff will always have a senior as a mentor and this includes supervisors and managers to play the role as well. This will assure that everybody has at least two sources of support, the manager and mentor.
Achieving Goals
Transparent and clear communication is the best means to counter resistance from staff. Firstly, it must be made clear how all their efforts will now be tied to performance evaluation and commensurate benefits. They may still be pessimistic but management should be persuasive to assure them that all will be accounted for. Secondly, there also must be assurance that managerial support will always be available when staff encounters work that he can’t handle. Thirdly, training should be planned in anticipation of challenging tasks. Lastly, all of the above must be executed for trust to be maintained. (Johnson, n.d)
Ethical Considerations
The management can revise the performance evaluation system to address the complaints of staff but ethical leadership calls for an apology for negligence and a show of close attention that the corrections are thorough and complete. Genuine concern for the staff can also involve them in the drafting of improvements. Ample time for training or mentor support should also be provided for new tasks. Managers have a right to make staff to carry out any task but it is unethical if they are put in a position to fail.
Management Decisions
This grievance from staff can lead to further decisions. One is in the area of work where it should be examined if staff needs to be given different responsibilities if they are in different floors. There may be a scheme where they can have work that can focus only on a few skills of which they are most qualified. Productivity in terms of efficiency and quality of service can be observed by managers. Completion times can be taken and patient surveys should reflect quality as well.
Assuming fair performance evaluation has been achieved, the next decisions can be about a holistic training program that can make broaden staff skills to make them versatile. This will empower them to handle the dynamic and challenging tasks that are usual in the hospital. Through the input of the managers in operations, the HR can design and propose training schemes that will have the most impact. Effectiveness of training can be measured by identifying ad-hoc tasks, the staff assigned, the training received and the ensuing performance.
Conclusion
The complaints of staff regarding skewed performance evaluations are valid but can be corrected by proven managerial methods which will restore morale. Management can clarify goals, job structures and performance criteria. It can practice motivational techniques during these changes. Being a busy hospital with workload related problems is a good problem because business is thriving. This is also an opportunity to upgrade management practices to keep morale high at the same time.
References
Freel, M. (2012, January 26). 5 Challenges Hospital Administrators Must Overcome to Succeed in Today’s Rapidly Changing Industry. Becker's Hospital Review. Retrieved April 30, 2016 from http://www.beckershospitalreview.com/hospital-management-administration/5-challenges-hospital-administrators-must-overcome-to-succeed-in-todays-rapidly-changing-industry.html
How hospitals are boosting staff morale. (2013, July 16). The Daily Briefing, The Advisory Board Company. Retrieved April 30, 2016 from https://www.advisory.com/daily-briefing/2013/07/16/how-hospitals-are-boosting-staff-morale
Nornberg, V.M. (2014, March 17). The Annual Pay Raise Is Dead. Here's Why I'm Not Mourning. Inc. Retrieved April 30, 2016 from http://www.inc.com/vanessa-merit-nornberg/tips-for-paying-employees.html
Lewis, J. (n.d.). What Is Positive Modeling in the Workplace?. Demand Media. Retrieved April 30, 2016 from http://smallbusiness.chron.com/positive-modeling-workplace-35099.html
Johnson, S. (n.d.). How Can an Organization Overcome Employee Resistance to Change?. Demand Media. Retrieved April 30, 2016 from http://smallbusiness.chron.com/can-organization-overcome-employee-resistance-change-13216.html
