PEOPLE WILL TALK-AND TALK, AND TALK
Groups of employees, as well as individual employees, can be dramatically different from each other. For example, whereas one manager complained of how her employees talk, talk, talk instead of working, another manager asked how she could get her employees to be more open and assertive with each other. Several of her employees apparently felt that 2 or 3 others were not doing their fair share of the work, yet none would say a word to these people directly-instead they complained to "anyone else who would listen."
In a work group of any appreciable size, some employees are sure to feel that certain others are not doing their fair share of the work, and these employees will frequently share their complaints with all people except the ones they should really talk with. This condition may exist despite everything the manager does. The problem is partly a function of the personalities involved and partly a function of peoples' perceptions. Not all employees agree on what constitutes one's "fair share of the work," and although most may see themselves as performing an appropriate amount of work, the perceptions of other people may suggest otherwise.
The fundamental need may not necessarily be to get all employees to be more open and assertive with each other. One might rather wish to achieve thorough, open, honest communication in which everyone in the department, including you, the manager, participates on an equal footing. Openness is certainly desired; however, assertiveness-at best a hazy concept-is far too easily confused with forcefulness or aggressiveness to be readily addressed. What one party may regard as assertive behavior, another may see as aggressive behavior; one party may feel that "I'm simply standing up for my rights," but others may see this as attempting to impose one's will on other people.
When communication problems occur in a group of employees, one can usually find a number of sides to every story or issue. And there certainly will be multiple perceptions as to how much constitutes "one's fair share of the work." In brief, unless there are some fairly specific measures of output available, there can be no absolute certainty as to a "fair share."
There is one message that should be communicated to these employees diplomatically, but in no uncertain terms: they are wrong in simply complaining to "anyone who will listen." We know of course that people talk with each other all of the time and that some are going to use third parties-persons who are not present to defend themselves-as subjects of their complaints. However, the fact that this happens does not make it appropriate or acceptable. Complaints, whether about coworkers or other subjects, should be reported at the proper points in the organization. When simply passed around the work group, complaints take on the general character of rumors-generally, grapevine transmissions-and they disrupt work, spread discontent, and sometimes tend to divide the staff into factions. Rather, discontented employees should talk directly with the manager-you-and leave it to you to investigate their complaints. It may then be necessary for you to hold private discussions with each complaining employee to bring out specific information.
Discussions with employees should not initially focus on what an employee's fair share may be, but rather on what the manager regards as the fair share of each employee. In other words, have in mind some kind of productivity standard or other measure of an individual's work. This standard-which should be your consistently applied expectation of employee performance-should be known by each employee; that is, all employees should know at all times what is expected of them. For your part, in dealing with employees, you should be taking action based on whether the standard of performance has been attained.
This kind of problem calls for a great deal of emphasis on group communication processes. Matters of productivity and concerns with measures of output can, in many respects, be topics of concern to all members of the group. Some staff meetings dealing with these common topics may be in order, and such sessions can give you the opportunity to help foster the concept of your department as a team-a group that exists for a common purpose-rather than a collection of individuals all doing their own work. Even if some staff meetings turn into gripe sessions, they may still be helpful in bringing the problems out in the open where they can be dealt with by all. In brief, a group problem-solving approach is called for in which all can properly consider the same question: How can we work together to better accomplish the work of the department?
This issue of The Health Care Manager (30:3, July-September 2011) offers the following articles for the reader's consideration.
* "Internal Marketing: Creating Quality Employee Experiences in Health Care Organizations" stresses the importance of internal marketing of a department's services as a means of supporting employee empowerment and increasing employee motivation, satisfaction, and productivity.
* "A Framework for Cultural Competence in Health Care Organizations" addresses the need for health organizations to focus on establishing culturally competent strategies and implementing best practices to improve quality of care and achieve improved health outcomes for growing minority populations.
* "Advanced Practice Nursing, Health Care Teams and Perceptions of Team Effectiveness" summarizes the results of an extensive review of organizational and health care literature of advanced practice nursing roles, health care teams, and perceptions of team effectiveness, addressing some concepts that have not been extensively studies previously.
* "International Classification of Diseases, 10th Revision: It's Coming, Ready or Not" strongly suggests that planning should begin now for the projected October 2013 implementation of International Classification of Diseases, 10th Revision, Clinical Modification, Procedure Classification System, the replacement for International Classification of Diseases, Ninth Revision, Clinical Modification, the diagnostic and inpatient procedure coding system that has been in use in the United States since 1979.
* "Using Monitoring and Controlling in an Electronic Health Record Module Upgrade: A Case Study" addresses the application of the monitoring and controlling portions of the general project management system (initiating, planning, executing, monitoring, and controlling) to the upgrade of an electronic health record system.
* "An Evidence-Based Case for the Value of Social Workers in Efficient Hospital Discharge" reports on a study that was undertaken to make an evidence-based case for the value of social workers in efficient discharge of patients from acute care hospitals and to assist managers in making informed staffing decisions.
* Case in Health Care Management: "Delegation: Researching the Records" asks the reader to consider the pros and cons of several possible approaches the problems of extracting useful information from an accumulation of maintenance records.
* "The Use of Governance Tools in Promotion of Health Care Information Technology Adoption by Physicians" addresses in detail some of the governance tools that can be used to alleviate the financial concerns of third-party payers and others, suggesting that the use of some available options can make it easier for some physicians to adopt electronic health record technology.
* "Sustainability and the Health Care Manager, Part II" continues the examination of sustainability begun in the previous issue (HCM 30:2), suggesting that health care managers can make use of an assessment framework to determine whether they are ready to achieve health care sustainability.
* "A Primer for Health Care Managers: Data Sanitization, Equipment Disposal, and Electronic Waste" addresses the safe and economical disposal of e-waste, produced when electronic media is disposed of and potentially to human health and the environment.
* "Addressing Employee Turnover and Retention: Keeping Your Valued Performers" addresses the inseparable concepts of employee turnover and employee retention, suggesting that one of the best means of enhancing retention is to conscientiously control turnover to the maximum possible extent.