Volume 11 Number 3 THE MANAGER - MSH

1 MANAGERMANAGEMENT STRATEGIES FOR IMPROVING HEALTH SERVICES2002 Volume 11 Number 3 THEC reating a Work Climate ThatMotivates Staff and ImprovesPerformanceIn This IssueEditors NoteHEALTH MANAGERS ARE UNDER PRESSURE to achieve sustainableresults. To meet this challenge, managers must develop high-performingwork groups and cultivate a positive work climate that fosters staffmotivation. A positive work climate encourages and sustains staff motiva-tion. In fact, experience in industry has shown that a positive workclimate can account for nearly 30 percent of improvements in financialresults. How can the findings in industry be used to improve employeemotivation and organizational results in the health sector?Managers can often sense when the work climate is affecting staff sperformance. Absenteeism, unmet performance objectives, lack ofinitiative, and reduced interest in their work or organization are signsthat a work climate may be less than optimal and that staff may beholding back the discretionary, or extra, effort they could bring to theirjobs.

2 Managers can often turn their work groups around by applyingleadership and management practices that promote on-the-job clarity,support, and ISSUE OF THE MANAGER outlines the connections between workclimate, employee motivation, and performance. It describes how manag-ers can assess the climate in their work group and shows how they canuse the results to make changes in leadership and management prac-tices that will motivate their group to do the best work possible andimprove results. Recognizing the Impact of Climate onMotivation and 2 What Experts Have Discovered aboutWork 3 Understanding the MANAGER s Role inInfluencing Work 3 Factors Influencing Work 4 Understanding What 5 External and Internal 5 Focusing on Developing a MotivatingWork 6 Research Findings on the Effects ofEngaged Work 6 Improving Climate in Your Work Groupthrough Good Leadership 7 Indications of Low Motivation 7 Understanding Three KeyDimensions of 8 Working Solutions 9 Assessing Work Group 10 How the Work GroupClimate 10 The Work Group Climate 12 Analyzing the 13 Taking Action to Improve Your WorkGroup s 14 Leadership and Management Practicesfor Improving Work 15 Working Solutions 18 Case StudyThe NGO Healthy Families Improves ItsWork ClimateMANAGERVol.

3 11, No. 3, 2002 THE2 Editorial Review BoardDr. Alfredo Ari ez, JHPIEGO, BoliviaDr. Med Bouzidi, International PlannedParenthood Federation, LondonDr. Borbala K , SECS, RomaniaAbu Sayeed, TAI, BangladeshCelicia Serenata, Department of Health,South AfricaDr. Enrique Su rez, The Mexican Federation ofPrivate Health and Community DevelopmentAssociationsDr. A. B. Sulaiman, Planned ParenthoodFederation of NigeriaSixte Zigirumugabe, USAID, MaliField Advisor Dr. El onore Rabelahasa, PRISM, GuineaSubscriptions to The MANAGER are $15 per yearin North America, Western Europe, Japan, andAustralia; in all other areas the publication isdistributed free of charge. Postmaster: Sendaddress changes to: 165 Allandale Road, Boston,MA 02130-3400 DirectorFounding EditorJanice MillerJanice MillerJanice MillerJanice MillerJanice MillerJamesJamesJamesJamesJames WolffWolffWolffWolffWolffEditorConsultin g EditorsClaireClaireClaireClaireClaire BahamonBahamonBahamonBahamonBahamonSusan na BinzenSusanna BinzenSusanna BinzenSusanna BinzenSusanna BinzenAnn BuxbaumAnn BuxbaumAnn BuxbaumAnn BuxbaumAnn BuxbaumSaulSaulSaulSaulSaulHelfenbeinHel fenbeinHelfenbeinHelfenbeinHelfenbeinCas e StudiesDesktop PublishingLaura LorenzLaura LorenzLaura LorenzLaura LorenzLaura LorenzCeallaigh ReddyCeallaigh ReddyCeallaigh ReddyCeallaigh ReddyCeallaigh ReddyWeb EditionsDistributionAlex BermudezAlex BermudezAlex BermudezAlex BermudezAlex BermudezSherrySherrySherrySherrySherry CotacoCotacoCotacoCotacoCotacoLuc-Bernar dLuc-BernardLuc-BernardLuc-BernardLuc-Be rnard ValValValValValThe MANAGER (ISSN 1060-9172)

4 Is publishedquarterly by Management Sciences for publication does not represent officialstatements of policy by MSH or its donors. 2002 Management Sciences for rights citation: Management Sciencesfor Health. creating a Climate that MotivatesStaff and Improves Performance The MANAGER (Boston), vol. 11, no. 3 (2002): pp. 1 PublicationsManagement Sciences for Health165 Allandale RoadBoston, Massachusetts 02130-3400 issue was published withsupport from the US Agency forInternational Development throughthe Management and LeadershipProgram under cooperativeagreement the Impact of Climate on Motivationand PerformanceHealth managers at all organizational levels are responsible for producingsustainable results strengthening institutional capacity, expanding accessto health care, and improving the quality of services. They are asked to en-hance organizational, programmatic, and financial sustainability. They striveto reduce health risks, morbidity, and mortality in their communities.

5 Whilethey face multiple challenges to producing results, they cannot adequatelyface these challenges and achieve results by themselves. They must rely onthe efforts of their staff and colleagues, day in and day managers who have achieved results recognize how much theirachievements are due to a group effort involving staff members. Perhapsthese staff members contributed to a particular project or to a communityfaced with overwhelming social and economic needs. Perhaps they gener-ated new ideas or helped to improve a management system. Maybe theysimply stayed committed to their work under difficult performance is apt to be strong and sustained when both man-agers and staff are motivated. They are committed to the mission of theirorganization and work energetically to carry it out. They show up, take re-sponsibility, cooperate with others, and follow through. Highly motivatedemployees willingly address challenges, innovate, take risks to make thingshappen, and achieve results.

6 In contrast, unmotivated employees often donot appear at work, fail to reach performance targets, and may even offendclients. They may be uninterested in or opposed to new ideas or processes,engage in staff conflicts, and communicate poorly with others at the motivation to perform well is influenced by many factors, includ-ing the climate in an organization. People think of climate as related toweather conditions that affect their outdoor activities, but they may nothave considered the climate of their workplace and its effect on climateork climateork climateork climateork climate is the prevailing workplace atmosphere asexperienced by employees. It is what it feels like to work in a place. Leadership and management practices that provide clarity, support,and challenge contribute to a positive work climate. A positive work climate increases the discretionary effort, or level ofextra effort, that employees exert above and beyond job expectations.

7 A positive work climate leads to and sustains employee motivation andhigh has shown that work climate significantly affects employees de-sire to learn and apply material, and ultimately affects results. For this rea-son, it is critical that managers learn ways to improve a less than optimalwork climate. Improving the work climate is the responsibility of healthmanagers at all levels who oversee employees on a day-to-day basis, fromthe executive director of an organization or program to the leader of a teamCreating a Work Climate That Motivates Staff and Improves Performance3 What Experts Have Discovered about Work Climateof providers in a small clinic. All managers, even thoseworking in extremely resource-poor environments andin large, demoralized organizations can produce betterresults if they strive to improve the work issue of The MANAGER can help managers whosupervise groups of employees to increase motivationand performance by improving the work climate intheir group.

8 It presents a way to assess work climateand offers leadership and management practices thatmanagers can use on a daily basis to improve climatesthat demotivate employees. These practices focus on keyfactors clarity, support, and challenge that create amotivating work issue was written by Sarah Johnson and GregRodway of the Management and Leadership (M&L)Program of Management Sciences for Health (MSH).Sarah Johnson, a Senior Program Associate, has imple-mented leadership development programs that focuson improving work climate and organizational Rodway, a Senior Program Officer, has used hisyears of experience in management assessment to de-velop and fieldtest the Work Group Climate Assessment. When we looked at the impact of climate onfinancial results such as return on sales, revenuegrowth, efficiency, and profitability we found a direct correlation between the is not to say that organizational climate is the only driver of performance.

9 Eco-nomic conditions and competitive dynamics matter enormously. But our analysissuggests that climate accounts for nearly a third of the results. And that is simply toomuch of an impact to ignore. (Goleman 2000, p. 82) An analysis of data on 3,781 executives, correlated with data from climate surveysfilled out by those who worked for them, suggests that 50 to 70 percent of employ-ees perception of working climate is linked to the characteristics of the leader. (Goleman 2001, p. 42) What the boss of a work group does is the most important determinant of boss s behavior drives climate, which arouses motivation. And aroused motivationis a major driver of bottom-line performance. (Stringer 2002, p. 99) Leaders can sustain performance improvements by creating a climate that motivates,develops, and retains talented people. (Watkins 2000, p. 13)CLIMATE AFFECTSPERFORMANCEMANAGERSINFLUENCECLIMA TEU nderstanding the MANAGER s Role inInfluencing Work ClimateAn organization s work climate is affected by many fac-tors inside and outside an organization: theorganization s history, culture, management strategiesand structures, and external environment, as well as in-ternal leadership and management practices.

10 As themanager of a group of employees, you can control someof these factors (such as your own management andleadership practices), but not others. The following dia-gram can help you understand those factors that youcan influence. The left column at the bottom of the boxindicates the factors over which all managers have somecontrol. The right column lists factors that may beyonda MANAGER s influence unless he or she holds a very in-fluential example, management systems are one of the fac-tors that managers have some control over. Managersneed to pay attention to systems, processes, and policiesthat facilitate work getting done in the organization. Ifsystems are overly bureaucratic and inefficient, bothmanagers and end-users need to periodically evaluatethem to see how they can make them effective, helpful,and easy for staff to 11, No. 3, 2002 THE4 Factors Influencing Work ClimateLeadership practicesLeadership practicesLeadership practicesLeadership practicesLeadership practices providing vision, living organizational values knowing staff aspirations, skills, and interests focusing staff attention on critical challenges aligning work with skills and interests, motivating teamwork recognizing accomplishments.