1970s cubicle-style office space featured privacy over interaction. Organizations, write Jaason Geerts and Verna Yiu, need to avoid imposing top-down, one-size-fits-all work arrangements, and instead allow leaders to work with their teams to sort out what works best for each staff member.Glenn Lowson/The Globe and Mail
Dr. Jaason Geerts is the director of research and leadership development at the Canadian College of Health Leaders and an honorary visiting fellow at University of London’s Bayes Business School. Dr. Verna Yiu is the past president and CEO of Alberta Health Services.
The landscape of work has changed, expedited by the COVID-19 crisis, and there’s no going back now.
Across sectors, including health care, we broke the workplace mould during the pandemic, proving that we can adapt quickly and work effectively in non-traditional ways. In the process, many employees have enjoyed extraordinary flexibility and autonomy to achieve their targets, with more management support and less oversight. Many have also defined non-negotiable professional limits, either because they want more cherished family or personal time, or because of excessive stress, burnout or mental-health consequences.
Some organizations have successfully embraced these work force trends and are thriving as a result. But others have seen “quiet quitting” (people intentionally limiting their effort to the bare minimum), languishing (staff experiencing prolonged and unexplained dips in productivity) or large-scale turnover, whether due to early or delayed retirements, or people willing to ditch their jobs without another lined up. Many workplaces struggled to replenish their numbers quickly enough to replace departures, which is costly, counterproductive and unsettling.
Historically, employees left because of bad bosses, and management too often dismissed requests for greater balance as laziness or merely the “pie-in-the-sky” naiveté of younger generations. But now, it seems that workers of all ages are refusing to tolerate toxic cultures, excessive workloads and inflexible arrangements more broadly. Rigid, traditional approaches are simply not going to cut it any more and even companies that have expanded their rosters through the pandemic are aware that coasting can quickly invite irrelevance.
Normally, organizations maintain a business-as-usual approach and it often takes a crisis before they seriously evaluate how they could and should do things differently. But even in such a crisis, reinforcements can only address frenetic short-term problems; until there is systemic change, the bleeding will continue.
Health care workers have borne the brunt of the pandemic – and continue to do so – which has contributed to the worst health HR crisis of our generation. This has had severe ramifications for Canadians, including emergency room closings, record wait times and unprecedented surgical and service backlogs. The strain on the people and system caused by droves of staff (including perpetually underappreciated nurses) leaving their respective professions altogether, and by sector-wide burnout and mental-health effects of the COVID-19 response, is crippling our ability to provide the best possible care.
And yet, during this difficult time, health care leaders have also learned valuable insights that can transcend sectors.
To better understand these insights, we undertook a nationwide survey of top engagement and retention strategies of nearly 40 chief executives of health care organizations. The results informed a novel leadership approach that we call the Great Optimization: a system-wide process of engaging leaders, staff and key stakeholders in discussing and experimenting with approaches to work to optimize people’s contributions, and thereby maximize organizational performance, regardless of the industry.
This is important, especially as many companies navigate the early stages of returning to the office. The current revolution in work force expectations has orchestrated a perfect storm in which we can optimize performance – but only if we get the people strategy right. Here is what many of those health care leaders told us in our survey.
The Great Optimization centres on workplaces engaging their people. Increasing staff engagement heightens job satisfaction, motivation, creativity, innovation, performance and retention. Conversely, when staff feel leaders are detached, don’t listen, don’t care or ignore their suggestions, they start to look elsewhere for the respect they feel they deserve.
Leaders should engage people first by updating staff of recent developments and “by gathering feedback via multiple channels and visiting the front lines regularly,” suggests Dr. Tim Rutledge, president and CEO of Unity Health. This enables leaders to stay in touch, understand pain points and resource needs, listen with empathy, and witness the effects of their decisions. It requires cultivating psychologically safe forums, such as town halls, where people can ask questions, raise concerns and propose improvements, without fear of negative repercussions.
Outstanding leaders routinely praise people’s contributions and make them feel essential to advancing the organization’s overarching purpose: the mission, vision and values that unite them and define their collective identity. This includes “expressing all they have sacrificed for exceptional patient care,” affirms Sarah Downey, the president and CEO of the Centre for Addiction and Mental Health. Public recognition should enhance organizational efforts to prioritize diversity, accessibility, equity and inclusion.
Productive engagement strategies involve radically transparent decision-making, says Holland Bloorview Kids Rehabilitation Hospital president and CEO Julia Hanigsberg: “Explain what you are doing, why and seek advice from staff.” Successful leaders then commit to tangible deliverables and zealously avoid alienating staff with excuses, such as systemic issues, organizational problems and tight budgets. Instead, they flag challenges and devise solutions. Leaders also need to trust and support front-line staff to use their professional judgment with creative workarounds when needed, without bottlenecking the process by requiring excessive approval.
Two-way trust between leaders and their teams emerges “from an underlying culture of psychological safety, wellness, support and collaboration,” according to Paul Heinrich, president and CEO of the North Bay Regional Health Centre. This includes allowing time for people to recharge and disconnect from work, as well as for customization in their work arrangements, which offers balance and experimentation to optimize their creativity and performance.
In short, the key to workplace engagement is keeping alight the confidence “that we are contributing collaboratively and meaningfully to society, making a difference, and improving things for the future,” as summarized by Major-General Marc Bilodeau, Surgeon-General of the Canadian Armed Forces.
When staff are highly engaged and are united with their colleagues by a shared purpose, they flourish and generate creative ideas that can help their organizations optimize and evolve – provided that leaders care and have earned the trust that their suggestions will potentially be taken up.
Engaged staff are also more likely to stick around. In every industry, retaining great talent is essential to a sustainable future.
For Ray Racette, president and CEO of the Lake of the Woods District Hospital, that can start by “defining from the staff what would make their organization the choice employer” and then exploiting top features.
Above all, CEOs asserted that recognition and talent management, including continuing professional development and mentorship, are best strategies. A crucial feature is “reinforcing the differences staff make,” says Kathy MacNeil, president and CEO of Island Health, coupled with fair compensation and benefits packages.
To retain people, organizations must “embrace that many staff have re-evaluated personal and career priorities, and should maximize flexibility and autonomy to meet the need for work/life balance,” suggests David Diamond, the incoming president and CEO of Newfoundland’s provincial health authority. Dr. Sylvain Brousseau, the president of the Canadian Nurses Association, elaborates that this includes allowing employees to set their schedules in a co-ordinated way.
Flexibility requires that leaders hold people accountable for performance outcomes, including their impact on teamwork and organizational culture. That accountability requires “having the trust and agency to make decisions, experiment, and innovate, understanding that failures will occur,” says Caroline Lidstone-Jones, CEO of the Indigenous Primary Health Care Council.
Organizations and teams should commit to frank, data-informed metrics of success, which can inform decisions of which services and meetings to prioritize, discontinue or outsource. This kind of optimizing also involves simplifying and automating certain processes and re-evaluating work roles, accountabilities and arrangements. This process should involve “trying to marry past lessons with those from the pandemic to create a new way forward that incorporates the best of both,” says Dr. Lawrence Loh, CEO and executive director of the College of Family Physicians of Canada (CFPC).
To support this, leadership and leadership development should be distributed throughout the organization, as that would normalize leaders engaging staff at all levels and role-modelling supportive behaviours, rather than inappropriate parental ones.
Retention is further enhanced by a strong organization-wide people and wellness strategy that creates an environment in which staff feel safe, supported and cared for. Dr. Francine Lemire, former CEO of CFPC, highlights “celebrating the cultures and faiths represented among staff, patient, and community members.”
Finally, people stay when there is a shared overarching purpose. At the Ottawa Hospital, it’s “our commitment to community, to knowledge, and to excellent, truly compassionate care,” according to Cameron Love, its president and CEO.
Technology startups have been at the forefront of workplace innovations. But as Jaason Geerts and Verna Yiu write, we cannot unconditionally invest in an untested fad, "only to learn too late that for many people, this set-up actually decimated productivity."JASON HENRY/The New York Times News Service
Across sectors, the scene is set for large-scale transformation. This transcends merely dissuading staff from quitting, replacing them or persuading those who left to return; it’s about genuinely engaging the people who work there now to optimize their professional contributions for the better. The business of where, when and how we work is merely the start of the conversation for a new work force and leadership paradigm.
We cannot ignore this opportunity to optimize, or risk falling into another open-concept offices trap – that is, unconditionally investing in an untested fad, only to learn too late that for many people, this set-up actually decimated productivity. Organizations need to avoid imposing top-down, one-size-fits-all work arrangements, and instead allow leaders to work with their teams to sort out what works best for each staff member. They should also allow for enough flexibility to change course if performance outcomes suffer.
The pandemic isn’t over, and there are further challenges and opportunities to come: climate change, digitization, artificial intelligence and more. Getting the Great Optimization right will distinguish organizations that flourish from the redundant ones, and prepare us to envision a better future in all sectors.