servant leadership, psychosocial work environment and performance

Servant leadership, Psychosocial work environment and performance

Kasper Edwards, Technical University of Denmark

*DTU Management, Danmarks Tekniske Universitet

AgendaPerformance

Psychosocial work environment

Servant leadership

Combine it all in a single model


Performance / Performance managementThe basic ideaMeasure how an organization is performingTo get best possible performance

Performance is many thingsRevenue Financial targetsEmployee turnoverAbsenteeism Number of patients treated Patient lead time


Performance / Performance managementThe indicatorsKPIs key performance indicators the few important onesRIs result indicatorPIs performance indicators

Leading or laggingLeading indicate future performanceLagging measure result

Proces 1Proces 2LeadingLagging


Performance / Performance managementThe assumptionA relation between the overall goal and the KPIs

Two approachesThe logic breakdown from organization goal to activitiesThe heuristic: We think this will lead to good performance

What we knowYou get what you measure but do you want what you get?

The bankManagement logic: High number of sales = make lots of money Employee: Number of sales = sell cheap productsResult: lots of sales, negative contribution to profit


Performance management systemsCombinePerformance measurementPerformance management Reward and corrective action

The consultant sales pitchImproved Productivity -- Improvement in both the way people work and the outcomes they produce.Improved Employee Morale -- Resulting from on-time performance appraisals and rewards commensurate with employee contributions.Retention of Top Performers Employees who feel accomplished in their work become loyal employees.Increased Profitability Loyal employees deliver higher levels of service that result in customer loyalty.


The balanced scorecard and others

Hard and soft dimensions

But always numbers

Detached from actual work

Performance management systems


Performance management systemsBasic ideaReward induce certain behaviorsManagement and monetary instruments

Organization level determine degree of freedomIndividual DepartmentCompany

Powerful motivational systemsChange behaviorMore stick than carrot

But, motivation is driven byAutonomyMastery Purpose


Lean performance through processesA production system developed by ToyotaOriginally called the Toyota Production System

Draws on the ideas of Taylor, Ford, Deeming etc.

A set of principles and tools5S, VSM, Kaizen, Vaste, pull etc.

Primary benefitsShorter lead timeHigher qualityLess inventory


Lean principles

Specify value from a customer perspective

Identify value adding steps Remove non-value adding

Create flow


Lean principles

Let demand pull goods through production

Strive for perfection


Lean is not a one shot wonderLean do make rapid improvements

The long run is important

Continous improvement KaizenContinous improvementBack sliding


Lean processes improvementFocus on lead time and efficiencyLean has industry track record for solving such problems

One, but not uncommon, exampleLead time average: 25 daysProcess time average: 81 minutesHuge potential for improvement


Pen and paper approach


76 Activities


Future state Gynacology ward17 Activities

Henvisning, visitation og indkaldelseUndersgelse og behandlingPatient- administrationAfslut patientAlle henvisninger modtages elektronisk inkl. billedmateriale. Henvisning visiteres hver morgen.

1 lge | 5 min.Ankomstregistrering med sygesikringskort. Pt. Indtaster hjde, vgt, anamnese i OPUS p PC ventevrelse. Evt hjlp fra lgesekr.1 patient /1 lgesekr. | 5 minJournal skrives og registrering foretages samme dag eller indenfor 24 timer.

Sekretr | 5-20 min Tastning af diverse skemaer (DUGA-base etc. Indenfor URO)

1Sgpl./l.sekr.| 30m/sk.Patient modtages p henvisning, brev til patient om at ringe

1 sekretr. | 5 minPatient kaldes til stue via nummervisning.

1 sygeplejerske | 5 sek.Henvisning til andre funktioner

Sekretr | 5 min Patient ringer selv og booker tid. Alle forventede undersgelser bookes.

1 sekretr | 5 minAnamneseoptagelse pba. patientens indberetning. Tilrettes direkte p skrm.(1. patient p dagen: Samtidig klargring til GU, prvetagning + instrumenter.) 1 lge + (1 sgpl).: 10 minJournal til lge nr svar er kommet

Sekretr | 2 min Patienter mailer evt. sprgsml og fr elektronisk svar

1 sygeplejerske | 5 minAssistere patient med tj og lejring.

1 sygeplejerske | 3-5 minSignering af svar elektronisk lgge recept p EPM-server+ ringe, skrive til pt. Og journalnotat

1 lge | 15 minSMS til patient med reminder om tid.(Evt. automatisk)

1 sekretr. | 5 minGU + UL og prvetagning. Information til patienten plan for videre forlb. Booking af resterende tider.

1 lge+1 sgpl| 15 minLbende tastning af div. skemaer (DCBG etc.)

1 sekretr | 3 min/ skemaDiktering og klargring til GU, prvetagning + instrumenter mv (nste patient)..

1 lge + 1 sgpl. | 10 minProcestid: ca. 25 minGennemlbstid: 2,5 dageProcestid: 46 minGennemlbstid 1 dag (eksklusiv ventetid)Procestid: 20 - 35 MinGennemlbstid: 1-10 dag (afhnger af ventetid p svar)Procestid: 30 MinGennemlbstid: 0 dage


Many flavors of leanHard leanValuestream mappingTact timeTight planning Strict standardization

Works well in planned and predictable environments

Soft leanValuestream mappingCommon understanding of processes and activitiesIndividual understanding of role

Works well in unpredictable and reactive environments



Work environmentDifferentiate betweenPhysical Psychosocial

Physical work environmentSmoke, noise and dirt

Psychosocial work environmentSocial relationsMental wellbeingHow employees thrive at work


Good psychosocial work environment good for the organizationVountary employee turnoverVountary employee turnoverVountary employee turnoverVountary employee turnoverVoluntary employee turnoverSource: Better place to work


Good psychosocial work environment good for the organizationLess absenteeism

Higher productivity

Higher job satisfaction

Higher quality


Psychosocial work environment factorsThe six golden nuggets (job factors):InfluenceSocial supportRecognitionMeaningPredictabilityDemands

The three diamonds social capital (workplace)Trust JusticeCooperation


Social capital

Coordination

Social support

Spontaneous supportlend a hand

Does not create processes

Supports processes*


Social capital is not laissez-faire

Rules

Social norms

Structure

Common goals

A well run social system

-> Result of leadership

*


Social capital flows from the leaderThe leader sets norms and standards

Decides how the work is organizedTogether with employees

Social capital theory does not (yet) have a leadership theory

Social capital may depend on process performance


Leadership and sales performance (rank)Lower is better


Leadership and justiceSammenhng mellem ledelseskvalitet og retfrdighed. Kilde: Olesen et al. 2008, Virksomhedens sociale kapital Hvidbog, Arbejdsiljrdet og NFA.


Lean and work environment (stress)To typesChange induced stressWork induced stress

Change induced stressLean takes timeTension between lean and productionFrustration and stress reactions


Change induced stress can be avoided


Change induced stress can be avoidedTalk about the change processLet the frustration out

Reflection seminarGather all project membersIts NOT a project meetingDiscuss good and bad in the projectAll types of emotions are legitimate

(almost)


Work stressLean can lead toHigher paceSystematic removal of resourcesLong workdaysShortening of cycle times

In short: Work intensification


Lean standardization and transformation

Standardization TransformationRutinizationDevelopmentStandardized production Constant changing lean-initiativesMaintain the systemChange the systemFocus on toolsCreate a change-cultureAttention to detailConsidering the whole system


Lean and stressDegree of leanChange in stressPositive change


Lean and jobsatisfactionDegree of leanJobsatisfactionHigher is better


Overall change in work environment


Positive effects of leanGain control of the processes

Who does what and whyRemove daily frustrations

Improved layout

Team spirit

Transparency

No one wants to go back to the old days


Negative effects of leanChange is hard!

Many develop change induced stress

Too much focus on tools and too little on employees


Quick sum-upPerformance managementCentralization through measures and built-in management action

Lean Performance through process improvementNot evil

Social capital Employee well-being at the group levelAssociated with performance but does not create processesFlows from leader


Servant leadership EmpowermentAccountabilityStanding backHumilityAuthenticityCourageInterpersonal acceptanceStewardship


Putting it all together

ProcessesLean toolsPerformance measurementHumilityStewardshipAuthenticityInterpersonal acceptanceAccountabilityEmpowermentStanding backCourage


Servant leadership not always one personServant leadershipMany attributes in the same person

May not be tied to a person but a role or a team

Team of twoCare social Process - performance


ConclusionGood organizational performance is the sum of many parts

Performance measures must provide insight and allows maneuverability

Good processes that are continuously improved

Social capital to allow support and autonomous coordination

Servant leadership to tie it all together


The end


BackgroundThe Danish healthcare system is primarily a public healthcare system

Its ok we do get a bit healthcare for our tax $$$2009 OECD dataDK: health cost per person = $3,512 (100% covered)US: health cost per person = $7,290 (

servant leadership, psychosocial work environment and performance

Documents

dtu management

time performance appraisals

high number of sales

organization goal

performers employees

patient lead time

employee contributions

money employee