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Killer Culture???

23 Mar

Could the organizational culture of a hospital impact patient health? Put more bluntly, can a poor culture kill patients? According to recent research, reported by the Wall Street Journal Health Blog, the answer is yes.

Researchers from Yale studied the top 5% of hospitals whose patients were still alive 30 days after a heart attack, and compared those results to the bottom 5% of hospitals. Their findings, published in the Annals of Internal Medicine conclude:

Hospitals in the high-performing and low-performing groups differed substantially in the domains of organizational values and goals, senior management involvement, broad staff presence and expertise in AMI (acute myocardial infarction) care, communication and coordination among groups, and problem solving and learning.

What does a “healthy” hospital culture look like? The researchers report on a number of factors, including how mistakes are viewed and the regard given all hospital employees. From the Wall Street Journal blog, citing Leslie Curry, one of the Yale researchers:

Using mistakes as learning experiences as opposed to reasons for punishment was another characteristic of top performers, Curry says. And views of nurses, pharmacists, technicians and even housekeeping staff were highly valued in the team approach used at the best hospitals, she added.

A few years ago I conducted a study of employee engagement at twenty U.S. hospitals. They were the top and bottom ten in employee engagement rankings from a national sample, provided to me by the research firm Quantum Workplace

What differentiated the top 10 hospitals from the bottom 10? My analysis revealed that employees at the highest-scoring hospitals are more likely to have:

  • A strong feeling that the senior leadership of the hospital is committed to making it a great place to work and truly values employees as their most important resource,
  • Confidence in the organization’s future success and an understanding of how the employees contribute to that success,
  • Open and honest communication between employees and managers,
  • A sense that the hospital is committed to investing in employees, an investment that will help them develop their careers,
  • Opportunities for employees to be recognized when they contribute to the organization’s success,
  • Fair pay for their contributions, and
  • Benefits that are not perceived as typical of other organizations.

An employee at a bottom ten hospital summarized how she believes the culture where she works impacts the health and safety of patients:

Employee morale is reflected daily in patient care. I work on a unit where our director does not know our names, or interact with us. Although she is a nice person, her personality comes off as uncaring. This creates anger and frustration on the unit with the staff which creates less caring behavior for our patients. If the hospital wants its retention rate to increase or stabilize, they need to take the time to ensure that employees are well taken care of, and that their needs are being met.

These studies point to the same challenge-the culture of a hospital can impact patient mortality. Having honest discussions about hospital culture needs to occur more frequently and steps should be taken to build a more engaging, healthier culture.

Patient lives depend on it.

On Employee Engagement and the C-Suite, by Leigh Branham

10 Mar

I hope you enjoy this post, written by my colleague and good friend Leigh Branham:

I encourage anyone interested in employee engagement to read a report recently released by The The Economist (co-sponsored by The Hay Group), titled “Re-engaging with engagement: Views from the boardroom on employee engagement” .  The report is based on a survey of 331 C-suite executives or senior directors from 19 industries in Europe and the Middle East.  I would be interested in hearing from readers in the U.S. (and internationally) about whether you believe the findings also apply to senior executives in your country, or in your company.

The Survey Findings:

The most disturbing findings were these:

  • 84% of survey respondents say that “disengaged employees” are one of the three biggest threats facing their business.  Yet, only 12% report that their companies “regularly and often” confront staff with “continually low engagement.”  C-suite executives themselves admit that employee engagement is discussed “occasionally”, “rarely,” or “never” at board level in 43% of companies.
  • More than one in five in the C-suite believe that employees are “much more engaged” than those in rival firms, compared with only 7% of respondents outside the C-suite.
  • 47% of C-suite executives believe that they themselves “have determined the levels of employee engagement” in their companies, a view shared by only 16% of senior directors outside the C-suite.  Only 13% of C-suite executives believe that line managers and middle managers are “chiefly responsible” for staff engagement.

My Take:

I was not surprised by the first two findings.  My experience has led me to agree with the report’s conclusion that “a sizeable discrepancy exists between what companies say about the perils of disengagement and how far they will actually go to confront the problem.”  This describes most companies, but not the minority whose CEOs are committed to building best-place-to-work cultures–CEOs like Jim Sinegal at Costco, Kip Tindell at The Container Store, Vineet Nayar of HCL Technologies, Tony Hsieh at, Howard Schultz at Starbucks, Dr. Kim Hoogeveen at Quality Living, Inc., or Graham Weston at Rackspace Hosting (these last two are profiled in our new book, Re-Engage: How America’s Best Places to Work Inspire Extra Effort in Extraordinary Times, co-authored with Mark Hirschfeld).  The business success of these companies speaks for itself that employee engagement works.

Now that “employee engagement” has reached true fad/buzzword status, many CEOs have pretended to embrace it by jumping on the engagement survey bandwagon.  But alas, many have not followed through by acting on employee ideas and feedback.  I think most CEOs no longer need convincing that employee engagement is vital to business success, though some, incredibly, still express doubt. The main reason most CEOs don’t aggressively tackle the employee disengagement issue, I believe, is that it appears “soft” and overwhelmingly difficult (soft = hard) to do so.  After all, in many cases it would mean a complete overhauling of the culture.  Most CEOs, especially at public companies, would much rather, in their boardroom discussions, deal with the nearer-term topic of how to increase quarterly profits.  The irony is, of course, that the surest way to increase profits is to build a culture where engaged employees consistently exceed customer expectations.

The finding that many CEOs are more optimistic than their subordinates about how engaged their employees are compared to rival firms is not surprising considering that most CEOs are generally optimistic and take seriously their role as cheerleader.  The cause for concern lies in the fact that they may be isolated from the reality that those one level down can see more clearly.

Good News, Bad News

What I did not expect to see in the survey was the degree of responsibility that CEOs take for controlling levels of employee engagement in their companies.  This should be good news.  But, if almost half of CEOs believe they are the prime mover of employee engagement in their companies, why are so many not doing more to drive it?  Our analysis of 2.1 million employee engagement surveys from 10,000 employers (in partnership with Quantum Workplace) does indeed show that senior leaders influence employee engagement slightly more than direct managers in that they do set the tone, embody the values, and convey the culture.  But it would be a mistake for CEOs not to hold middle managers equally responsible for driving up levels of employee engagement, just as it would be a mistake to not hold all employees responsible for keeping themselves engaged.  The fact that only 16% of those who report to CEOs agree that CEOs are the primary drivers of engagement suggests that lower-level leaders are more than ready to share the responsibility.

“People Leave Managers, Not Companies”…Up to a Point

I  have facilitated too many post-survey action planning sessions in which middle managers, after identifying the corrective steps they can and must take, come to the inevitable point where they say “we can only do so much.”  Some things, they correctly point out, only CEOs, their boards, and more senior leaders control and decide–things like clarification of company direction, overall staffing/workload levels, work/life policies, general pay/benefits, recognition budgets, and many other vital levers of employee engagement.  It’s up to those of us in HR-related roles to help them see the connections and trust us to advise them on the truest path to engaging leadership.

So, What Do You Think?

I welcome your responses to these questions:

  • Who truly influences levels of employee engagement more in your company–senior leaders or direct managers?
  • What actions should HR leaders take to help C-suite leaders sort out which employee engagement initiatives to take?

A New Low

7 Jan

The Conference Board has released a new study, which I picked up via National Public Radio, that employee satisfaction (as the Board measures it) is at an all-time low. They report that “just 45 percent of people surveyed said they were satisfied with their jobs. That number fell from more than 61 percent who said they were satisfied in 1987, the first year the survey was conducted.”


The report continues:

Even more troubling, says Lynn Franco, Conference Board spokeswoman, is the satisfaction rate of young workers, less than 36 percent.”Generally the longer you are in the workforce the more your satisfaction seems to deteriorate. So these new young entrants with such a low level of satisfaction, the outlook is not very promising there. It’s something employers need to address very quickly.”

These findings are generally in keeping with the survey results we see from our partners at Quantum Workplace. How many companies have reacted to the economic conditions and their approach to leading their employees through this mess has not helped the cause– we’ve generally blown it when it comes to maintaining and highly engaged place to work.

For some managers the response will be a shrug and feeling that nothing can be done. For others this can be a rallying cry in to increase efforts at re-engaging those with whom they work. (“re-engage”, kind of a catchy name!). Here’s hoping you are one who is ready to lift up employees and renew engagement at work.

Your High Potentials May Be On Their Way Out The Door

30 Aug


From Talent Management, a study that reports high potential employees may still change jobs in spite of the recession:

High-potential employees aren’t afraid to strike out for greater opportunities despite the continuing recession, according to a study of how the best and brightest of high-potential talent have weathered the global recession over the past 18 months. The report released by Catalyst, “Opportunity or Setback? High Potential Women and Men During Economic Crisis,” offers an overview of the current workplace and recommends that even during international economic instability, employee retention must remain a foremost concern for businesses.

The article continues:

Overall, this study demonstrated that high potential women and men are successfully working through the recession with continued choices in employment and prospects for growth. Talent managers who view the economy as an opportunity to scale down on retention efforts should seriously reconsider in light of these surprising findings.

Our research confirms this point. We see many talented employees who are “sullen and near mutinous”, who are not being led in a way that gives them confidence in their current employer. Many are willing to take the calculated risk to find a place where they can grow and be recognized for contributing to a business that won’t ignore them.

A fews years from now we will fondly remember some businesses who hit the scrap heap and say “too bad they couldn’t hang on to their best and brightest– it might have made a difference.

After The RIF, Don’t Panic

29 Aug


Excellent advice from India’s Express Computer Online if you going through a downsizing.

If your organization has undergone trauma in the form of layoffs as a result of economic conditions or other reasons (e.g. M&A-induced redundancies), what should HR practitioners and organizational managers and leaders do? The WorkTrends results suggest a number of important steps that can be taken to enhance future levels of engagement and mitigate the potential of regrettable turnover. 

  • Confidence is key—Perhaps one of the most important first steps in any post-layoff environment is to regain employees’ confidence in the organization and particularly the future role that they play. While this may seem obvious, a crisis situation may cloud that. Confidence can be instilled in a variety of ways, but organizational leaders should communicate the strategy going forward, translate the strategy into what it means for workgroups, listen to employee concerns, and make clear how the future will be bright for individual employees. Give them a ‘light at the end of the tunnel.’
  • Recognition and opportunity—In the midst of crisis, individuals still make their way the best they can. Life goes on, despite the turmoil. Managers need to consider this while the organization struggles; employees need to know that they are doing their job well and that there will be again opportunities from them at the organization, especially in times after crisis. In other words, give them a reason to hang in there.
  • Turn ‘me’ into ‘we’—In a post layoff environment, employees may turn inward and worry more about matters that are personally relevant or give them a sense of security. Naturally, in times of uncertainty, employees and managers will be more concerned with their own work and livelihood. This tendency towards protectionism can threaten to break down the social ties that bind an organization together. Reinforcing messages such as ‘We are all in this together,’ and reiterating that group is stronger than individuals will encourage employees to bond together and increase organizational loyalty.
  • Prepare for the rebound—Finally, while there are things that can and should be done now for your layoff survivors, it is also important to take a long-term perspective. The economy will eventually rebound, customers will return, and hopefully your company will return to its upward path to prosperity. How your layoff survivors are treated will become part of the organization’s history. If it is done well, that can help attract and retain new employees. If it is done poorly, it will have the opposite effect.

I recently assisted an organization that had to go through a downsizing. The leaders acted in a professional and dignfied manner. The reduction certainly had an impact– they always do– but that impact can be managed by effective leadership.

Good Bosses Gain Employee Loyalty

20 Aug


This Associated Press article features Leigh Branham, my co-author, talking about the importance of employee retention for small businesses:

Many employees of small businesses are grateful to have a job, even as salaries are frozen or cut and they’re asked to take on more responsibility. Company owners shouldn’t take those good attitudes for granted — they need to show workers some loyalty so staffers don’t jump ship when the economy gets stronger.

“This is a crucial time,” said Leigh Branham, owner of Keeping The People, a human resources consulting firm in Overland Park, Kan. “Employees are testing you to see how loyal you are to them, to decide if they’re going to stay.”

The article presents several excellent ideas for keeping employees in these more difficult times.

Hopefully, you’ll read the article, manage accordingly, and “pass the test”.

Is Your RIF Leaving Staff “Punch Drunk”?

11 Aug


Yet another survey, this time from People Management, points to how badly most employers go about force reductions:

As half of UK businesses consider making redundancies within months, the damaging effect on morale has been highlighted by a CIPD survey of 3,000 employees. The YouGov survey found that 70 per cent of employees said redundancies had damaged morale, with 22 per cent so unhappy about how redundancies were being handled that they were looking to change jobs as soon as the labour market improved. Just over a quarter said they were less motivated as a result of redundancies.
Some 81 per cent believed senior managers needed to restore or improve trust in their leadership, as only a quarter said that they were consulted on important decisions. Just over half of employees said frequent and honest communications would have the greatest impact on improving trust. Public outrage at “rewards for failure” was also reflected in the survey, as 29 per cent said not rewarding failing senior managers was key to rebuilding trust.
Ben Willmott, CIPD senior adviser, public policy, said: “Survivors of redundancy programmes left ‘punch drunk’ by the process may not have the levels of motivation and commitment needed for their employers to capitalise on any recovery. Many disillusioned employees will vote with their feet and leave as soon as the labour market picks up.

Terribly sad, really. By leaving employees “sucker punched”, leaders risk losing those employees who survive the layoff. In the employee engagement surveys we’ve analyzed for our book Re-Engage!, we see many employees who are, to coin a phrase, “sullen and near mutinous.

Peter Drucker on Change Leadership

7 Aug


From The Daily Drucker, by Peter Drucker and Joseph Maciarello:

One cannot manage change. One can only be ahead of it. In a period of upheavels, such as the one were living in, change is the norm. To be sure, it is painful and risky, and above all it requires a great deal of very hard work. But unless it is seen as the task of the organization to lead change, the organization will not survive. In a period of rapid structural change, the only ones who survive are the change leaders. A change leader sees change as an opportunity. A change leader looks for change, know how to find the right changes, and know how to make them effective both outside the organization and inside it. To make the future is highly risky. It is less risky, howeve, than not to try to make it. A goodly proportion of those attempting to will not succeed. But predictably, no one else will.

Questions to consider:

  • Are you change leader?
  • If not, what can you do to become one?
  • How can you get your manager/your organization to embrace needed changes?
  • What changes do you need to make in order to be more effective?

In A Recession, Bad Managers Make Things Even Worse

3 Aug


I recently analyzed employee engagement surveys for two different employers. In both cases I found a group of employees who had significantly lower results than the rest of the company. As I dug deeper into the results, including the anecdotal comments, the same problem in both employers become clear:

Bad, rogue management.

What sickened me most was what these rogue managers were doing to “motivate” employees in the midst of this economic crisis. In both cases they were telling employees:

 “you better keep your nose to the grindstone, because if you don’t I can hire a dozen others just like you who don’t have a job. And don’t making any demands, because I’m in charge here.”

Could someone please tell me why ANYONE would think this strategy is going to make sense for these businesses now or, importantly, in the future?


Our research tells us there are other employers who are not subscribing to this kind of fear mongering and are, in fact, managing in a more engaging manner and, in doing so, achieving outstanding results.

The “you-bet-your-job” attitude on the part of some so-called leaders isn’t the cure to our economic woes.

For more information on what some outstanding employers are doing to engage employee in difficult economic times please read Beating the Bear Market with Engaged Employees

Recession or No, Invest In Your People

3 Aug

Very good article today at  about taking care of employees through the transition period to economic recovery. The article states:

And even though it could take up to two years for a real labour market revival, it would be a mistake for companies to assume they have the upper hand over their staff. In fact, businesses should be taking action now to ensure their best workers remain engaged, says Terry Power, president of staffing firm Randstad Canada.

“When you’re in a recession, the trend typically becomes one of `do more with less.’ And inevitably that means a little more stress on your people,” Power said.

“The people in those situations that tend to step up and do the most for you … are your best people. And often times, though, that gets kind of taken for granted.”

That means managers should not simply assume their star employees are coping well with weighty issues such as heavier workloads or the loss of colleagues through layoffs. Although many businesses are squeezing their staff through painful cost controls right now, good quality companies will also take the initiative to provide some sort of longer-term payoff – even if it is not a cash-based reward.

This is the time to invest in your people. I know the economy is a challenge for many businesses, but there are creative ways we can help our associates grow and know they are valued. The employers that engage their employees now will have a much better chance of coming out of this recession with those valued employee still on board instead of working for the competition.