(National Healthcare Journal, Sep/Oct 2007)
"If you're a leader, you need everything around you to support you rather than to create resistance."
"Healthy Organisations Optimize Healthy Outcomes"
The health of individuals is profoundly affected by the culture of a community in which they live” (Rose, 1992). This is as true for the aged as it is for the people serving the aged. Think about caring for people with dementia. Staff work mostly with clients who are challenging to connect with, who can become isolated and isolating towards others, and whose family relationships range from helpful to harmful.
If you are a leader, you need to be dedicated to these people and the challenges they have. You need everything around you to support you in this work rather than to create resistance. Healthy organizations arise from healthy individuals who practice healthy ways of working. If the board doesn’t genuinely understand and respect how their decisions affect staff, the effects can be quite dramatic.
Equally importantly, if managers don’t work in partnership with the staff, staff will resist them. If the frontline staff don’t take good care of themselves, breakdowns will occur. Healthy organizations are designed to enable the people working within them to realize the purpose of the organization in the most effective way. This means they need to be structured to support people doing their work.
Healthy economics within the organization are critical to this support. In the aged care sector this is even more important with exponentially increasing numbers of clients needing care combined with plateauing numbers of available staff and careers. This causes a gap that can only be filled with leveraged performance achieved by effective leadership that liberates creativity, collaboration, commitment, and productivity. That gap demands that organizations are good at attracting and retaining people of ‘good fit’, releasing people of ‘poor fit’ and developing people with good potential. This requires sound recruiting practices, well designed and executed performance monitoring, development and discipline. Without these things, the gap will widen, because if you lose good people the stress on the organization increases exponentially.
If you want to have good retention and levels of engagement, you need to ensure the people from the board to the bedside have a healthy Psychological Contract (PC) with the organization. The health of this contract determines people’s levels of commitment, job satisfaction and desire to stay with the organization. This has a direct impact on how much they will give to their work.
The Psychological Contract includes both the expressed and unexpressed expectations people have when they come to work. Four categories of expectations include reward and recognition, safety and security, career growth and the social support within the organization. They may have realistic expectations or unrealistic expectations, and these may be managed or not.
The health of the PC is determined by perceptions of how the organization delivers on the person’s expectations and a sense of trust and fairness within the organization. This is determined by the person’s perceptions, not the leaders’ perceptions. If the person’s perceptions are negative, initially they may respond by holding back their contribution. Later, they may leave, or worse, stay but be completely disengaged. If too many people are resistant, a negative spiral begins for the organization, as good people leave in greater numbers and many disengaged people stay.
Optimising performance and productivity comes from effective leadership. People have three basic requirements which leaders need to ensure are present:
- Clarity – any initiative must make sense to them, they need to be clear on what the outcome looks like and how to achieve it;
- Capability – skills and resources required;
- Commitment – the values, desire and motivation to do it.
Leaders need the appropriate skills to do this effectively. They need to be good at relating with all types of people, self-aware, authentic, system aware and good at achieving. The evidence of leadership effectiveness is in the business results achieved. If the results are not being achieved, the system needs to be examined to discover where the development needs to occur to ensure the capability that is required.
If everyone has a healthy psychological contract and is enabled by the effectiveness of the leaders then people can create healthy organizations together.
