essential skill for a supervisor (huc6j)

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Course Learning Outcomes for Unit VI Upon completion of this unit, students should be able to:

6. Examine personnel management strategies needed to lead a well-functioning health unit. 6.1 Connect the importance of delegation to a properly functioning and efficient health unit. 6.2 Explore the importance of motivation and the supervisor’s role in creating a culture of self-

motivated employees. 6.3 Articulate strategies to manage difficult employees. 6.4 Create a plan to collaborate with the human resources department. 6.5 Assess common overarching challenges encountered in leadership.

Course/Unit Learning Outcomes

Learning Activity

6.1 Unit Lesson Chapter 5 Unit VI Proposal

6.2 Unit Lesson Chapter 11 Unit VI Proposal

6.3 Unit Lesson Chapter 14 Unit VI Proposal

6.4 Unit Lesson Chapter 15 Unit VI Proposal

6.5 Unit Lesson Unit VI Proposal

Required Unit Resources Chapter 5: Delegation and Empowerment: Forming Some Good Habits Chapter 11: Motivation: Intangible Forces and Slippery Rules Chapter 14: The Problem Employee and Employee Problems Chapter 15: The Supervisor and the Human Resource Department

Unit Lesson Managing one’s employees may be the single most important, rewarding, and difficult function of leadership. Being a successful leader of people requires skill, engagement, compassion and empathy, structure, and sometimes the ability to discipline as we learned in the last lesson. Understanding common challenges and pitfalls, how to properly manage even the most difficult employees, and what resources are available to assist a supervisor in managing their staff is vital. Also, two very important skills, delegation and motivation, are essential and arguably quite difficult for a health care leader to master. In this unit, we will explore each of these topics and more to prepare the next generation of leaders to successfully navigate managing a health care team during challenging times.

UNIT VI STUDY GUIDE

Managing Employees on a Health Unit

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Overarching Challenges in Leading People

Myrtle (2018) indicates a simplistic view of the role of a leader includes understanding what must be accomplished and developing the implementation plan. Challenges encountered in leading people can be categorized into five domains, including vision, alignment, empowerment, motivation, and learning. Understanding these key areas is essential for bringing about the most in the people a leader influences and are important areas for a leader to consider when honing their leadership style. Failing to address these areas for staff often yields a work environment lacking in productivity, inspiration, and satisfaction. In the health care sector, when a leader fails to properly address each of these areas, not only are employees negatively impacted, but the experience and safety of patients is also at stake. Creating Vision Probably the most important function of a leader is to create a true vision for the future. Myrtle (2018) explains that research has shown that employees are most engaged and satisfied when they understand and believe in what they are working toward. Not only must leaders be creative thinkers and planners for the future, but they must also have sufficient communication abilities to convey their vision to each employee on their team. So, how does a new leader get started in creating vision? It is key to point out that a strong leader does not create vision in a vacuum but considers the strengths, desires, and experiences of their staff whenever possible when formulating future plans. Myrtle encourages using the organization’s vision statement as a starting point and cascading down from there to the unit level. When a leader’s vision is clear and well communicated, staff understand the goals of the unit; the importance of the work they are asked to perform; and ideally, they experience excitement for the future, which serves to build momentum and engagement that becomes contagious across the team and throughout time. Alignment A very common pitfall for leaders is failing to align their staff with the vision. Put simply, it is vital that employees’ actions contribute to achieving the overall goals. However, research tells us most staff do not understand how what they do contributes to the overall goals. To maximize staff’s input, a leader must carefully and consistently align the work their staff is expected to perform with the goals of the team and institution. They must communicate ideas and goals regularly to inspire staff. Contemporary evidence suggests that the true key to success in implementing strategy and achieving goals is gained through behavior modification of the team responsible for the goals (Myrtle, 2018). Said another way, it is not enough to tell employees what to do, it is essential to teach staff the why behind their actions and how to do their job and complete their tasks in a manner that best supports the goals. Empowerment and Motivation In many ways, empowerment and motivation go together when thinking about how best to manage employees. Creating work environments conducive to employee success requires focus on the unit’s culture, management style, supportive team relationships, and removal of barriers, when possible, for staff to complete their work (Myrtle, 2018). Research shows that most workers crave a certain level of autonomy to do their job, but at the same time require support, resources, and regular review and acknowledgement for their actions and successes. A successful leader understands that employees need the right environment to do their best work (culture, resources, equipment, etc.), opportunities to improve and build on their existing knowledge and skills, as well as consistent feedback and gratitude for their hard work. This is a delicate balance for a leader to achieve, but often results in a team that feels empowered and motivated to do their best work. The Learning Challenge Myrtle (2018) stresses the importance of a leader’s role in spreading knowledge and creating a culture of learning for one’s team. Probably in no other industry is this more important than the health care sector. Given the rapid pace of change in medicine and health care, keeping one’s staff educated, knowledgeable, and practicing within evidence-based standards is a key area of focus for a leader. As discussed above, providing a constant means to learn and grow also plays into empowering and motivating an employee as well. Research has shown repeatedly that most staff need to feel challenged and want to know what is going on,

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which is often at the epicenter of employee satisfaction. Because of this, leaders must integrate into practice such things as learning, employee communications, and their vision for the future. Putting It All Together Let’s examine the following scenario as it pertains to the five domains explained above. If a leader of a health unit has a vision of improving patient experience scores, the leader’s goal might be to focus on improving call bell response times. It would not be enough for a leader to instruct staff to answer all patient call bells as quickly as possible. In order to align their staff’s work with contributing to the goal, a leader should communicate and teach their employees about how prompt responses to patient needs makes the patients feel cared about, prevents safety events, and contributes to patient experience scores that include timely response to call bells and staff communication metrics. In learning the why behind certain actions, the staff begins to understand better their role in achieving the goal. When leaders include staff education on how hourly rounding cuts down on call bell usage by patients, thereby decreasing the number of call bells to answer, the leader has empowered the staff to use their work to contribute to the goal. Further, if a leader teaches employees that educating their patients about when to use their call bell, such as acute pain versus needs that can be managed during hourly rounds, such as refilling a water pitcher, staff will be motivated to apply their work in a manner that maximizes effectiveness and supports the goal of improving call response times. Lastly, the leader should regularly share data related to call bell response trends with staff over time in order to communicate performance, celebrate successes, and identify areas for ongoing improvement.

The Art of Delegation

In the last unit, organizing was discussed as a primary function of leadership, with delegation following under this domain. Ultimately, no leader can do it all themselves. Further, McConnell (2019) describes delegation as a synonym of empowerment. We have learned that it is vital for a leader to empower their employee, just as it is necessary for a leader to learn to delegate certain tasks to others. McConnell says, “regardless of which term is used, the result should be the placement of a task or activity with an employee along with the responsibility, authority, and command of resources necessary to independently achieve the desired result” (p. 76). This can be where leaders go wrong. It is not uncommon for a leader to request an employee complete a certain task but fail to ensure proper resources or allow for the proper decision-making abilities be bestowed on the employee, thereby failing to delegate correctly. This failure leads to uncertainty, frustration, and often a failure of results. McConnell explains the propensity to delegate incorrectly often stems from the leader failing to consider the viewpoint of the employee. McConnell (2019) cites a failure to delegate consistently or appropriately is a failure of leadership and a common reason why some leaders fail to promote to higher level positions. A key role of the leader is to teach employees, provide professional development, and develop a succession plan. Delegation guarantees that others are given the opportunity to grow and are equipped to handle some of the leader’s responsibilities. This becomes important when the leader is unable to be at work because of illness or vacation. It may prevent burnout common to many health care leaders. Also, McConnell stresses that when a leader is freed from completing some necessary but more basic tasks, time can be allocated for some of the higher functions and vital duties of leadership such as strategic planning. McConnell (2019) points out the most common reason for a leader to fail to delegate is simply out of habit of failing to delegate. Being aware of this pattern is the first step in a leader increasing both their ability and comfort with delegation. Next, leaders are often hesitant to share responsibilities with employees for fear they may not be ready. The best way to alleviate this concern is to prioritize professional development of one’s team, thereby ensuring they are ready for the added responsibility or skill. Another major barrier to delegation is time. It is a significant commitment to allocate enough time for the development of staff. However, as we have seen, prioritizing learning and growth is vital for the success of an employee and a team. A leader does not have to be solely responsible for professional development and therefore has the time it takes available to develop employees. Many organizations have educators and leadership training available to staff. Often, just encouraging an employee to further their formal education gives them the inspiration necessary to become ready for higher-level responsibilities. Also, leaders should be aware of some less-than-desirable motivations for failing to delegate, such as not receiving the recognition for the achievement or fear of losing one’s job to the employee. Personal barriers such as these are toxic and should be avoided at all costs.

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The key to successful delegation is quite simple. First, the leader must choose and plan what to organize. Next, and perhaps the most important part of the process, is selecting the best person to delegate a particular task to based upon their skillset, willingness, and availability. After selection, the leader must initiate the request to complete the task to the employee and provide purpose. Establishing a well-communicated deadline for completion of the task as well as being available for further direction or questions should they arise are crucial steps in the process. Lastly, as discussed above, the leader must relinquish the authority and resources necessary for the employee to complete the task at hand. Finally, once a leader has become comfortable with delegation, it is imperative that the leader teach other members of team the importance of delegation, depending on the makeup of one’s team. For example, the leader of a health unit must ensure that registered nurses understand the importance of delegating to support staff such as certified nursing assistants. Failure of nurses to delegate and to delegate appropriately can lead to patient safety events, burnout of nurses who feel overwhelmed, and discontentment amongst the team (Wagner, 2018).

Motivating Employees Motivating employees is a crucial skill for a great leader to master. Motivated employees usually equate to more efficient operations, better outcomes, and more satisfied customers and employees. According to McConnell (2019), “the sources of motivation are the opportunities to

• achieve,

• learn and acquire new knowledge,

• perform interesting and challenging work,

• do meaningful work,

• assume responsibility,

• become involved in determining how the work is done” (p. 201) McConnell (2019) further indicates the following are vital to the motivation and overall satisfaction of employees:

• communication about performance, the organization’s happenings, and so forth

• professional development and opportunity for advancement

• culture of how employees are treated including acknowledgment

• wages and benefits

• working conditions As a leader, it is important to recognize what motivates an individual employee in order to meet employees where they are. Doing so creates an individualized relationship with each employee and allows the leader to focus on those specific motivations. This becomes exponential and leads to the best performance possible from an employee. Alternatively, it is equally important for a leader to understand their own span of control and focus on improving motivating factors that they can influence. For example, some leaders may have little to no say in wages and benefits within their organization. As such, spending a lot of time dwelling on these areas may be futile and may even be counterproductive for the leader whose employee may become frustrated by the perceived lack of change. McConnell (2019) provides some ground rules for leaders in terms of motivation of employees that are key to successful motivation. First, it is essential to acknowledge a job well done. Gratitude and reward are very motivating; failing to recognize performance consistently will surely have a negative impact. Next, acknowledgement must be timely and delivered frequently. Saving it for a formal expression such as the employee’s yearly evaluation will fail to motivate the employee throughout the year. Third, positive reinforcement is much more motivating than negative reinforcement. Individualized acknowledgement is valuable, as one employee may be motivated or inspired by one type of feedback while another may place less value on it. Understanding what each employee wants and values makes a good leader great!

Managing Difficult Employees

Managing employees is one of the most challenging aspects of leadership. McConnell (2019) cautions a leader from labeling an employee as difficult or challenging, because doing so can often perpetuate the

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undesirable traits of the employee because the label affects how you, the leader, approach the employee and manage their behavior. However, eventually all leaders will have an employee who is difficult to connect with, or who does not behave in a manner that one would hope. McConnell stresses empathy as the key to successful management of all employees, but especially the most challenging. Trying to understand the root cause of the undesirable behavior goes a long way in navigating a better connection between the supervisor and difficult employee. Further, many times employees are problematic or upsetting when they are not adequately stimulated, given enough to do, or are otherwise bored with their job. Sometimes taking a counterintuitive approach to an unruly employee, giving them more responsibility instead of discipline, is a successful strategy. McConnell (2019) gives seven strategies to manage employees:

• listening empathetically

• display fairness and consistency across all employees (decision-making, discipline, etc.)

• build individualized relationships with employees

• decide to never argue

• allow latitude, when possible, to allow employees to contribute to workflows and such

• prioritize relationships with chronic complainers to get to the bottom of their issues

• provide consistent, true acknowledgment when appropriate Absenteeism A specific issue most if not all leaders has to deal with at one time or another is absenteeism. McConnell (2019) reports that worker absenteeism costs institutions in excess of $10 billion annually in the United States. When employees are absent from work, the whole department suffers, and leaders are required to spend precious time revising assignments and covering tasks. It is essential that a leader addresses absenteeism on both an individual and departmental/unit level. Having regular conversations with staff regarding not abusing one’s sick time benefits is crucial, as is having frequent discussions regarding the importance of regular attendance and the stress absences cause in the whole department. Leaders must be diligent in tracking and trending employees’ absences. Further, any unusual trends or patterns must be promptly discussed with the employee. McConnell encourages leaders to have department rules in place to mitigate patterns of weekend and/or holiday call-offs, such as automatically assigning someone to work the following weekend or holiday. Finally, using incentives and positive reinforcements to discourage employees from excessive absenteeism is another successful means of managing one’s team.

Understanding the Human Resources Department

The human resources (HR) department is a vital resource for leaders when managing their teams. This department typically performs many tasks and services to support the organization, its people, and the leaders. Usually, the HR department reports to either the chief executive or chief operating officer of the organization (McConnell, 2019). Key attributes of the HR department include impartiality, which exists only when the reporting structure of the department avoids a certain division head or another. By reporting to the top executive, each department/division can receive fair representation. According to McConnell (2019), the HR department’s overarching responsibilities include the following:

• recruiting

• compensation and benefits management

• employee relations

• employee health

• training and education

• payroll

• in some institutions, security, public safety, and parking Leaders and HR should have a symbiotic relationship. HR should assist leaders with finding and hiring staff, changing or adding job descriptions, disciplining employees, providing specific policies and forms to assist the leader in managing employees, and conducting staff and leadership training and development (McConnell, 2019). Leaders assist HR by providing information such as changing needs of the organization in terms of

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potentially outdated policies, employee opinions regarding salaries and other perks, employee concerns/complaints, and changes to the market that may affect recruiting. Presently, labor laws and employee relation regulations are more abundant and convoluted than ever. The human resource department serves as a guide to the leader to ensure that the leader maintains compliance with these rules and avoids common pitfalls. Examples include discrimination based upon gender, disability status, race, or sexual orientation; workplace violence; negligent hiring; and union practices (Hall, 2009). As such, a health care leader should regularly collaborate with their human resource department regarding policy, handling of employee concerns, and when any other unusual or unfamiliar situation arises.

Conclusion

Managing people is an awesome responsibility. There are many skills, barriers, as well as rewards the health care leader will encounter when leading one’s team. Understanding how to inspire, motivate, empower, and delegate are essential skills for a leader that are important to the staff the leader influences, the department’s outcomes, and patient safety. Moreover, being able to pivot between getting the best out of your top performers and managing a challenging employee is necessary for a health care leader. This agility and flexibility are learned over time, but learning the foundational skills is important for the start of one’s leadership journey. Finally, developing a regular, collaborative relationship with the organization’s human resource department is vital, as this serves as a key relationship for the leader.

References

Hall, A. T. (2009). Legal issues in human resources management. Society for Human Resource Management. https://shrm.org/certification/educators/Documents/09-0185-LegalIssuesinHRM-IM-FNL.pdf

McConnell, C. R. (2019). The effective health care supervisor (9th ed.). Jones & Bartlett Learning. Myrtle, R. C. (2018, April/June). The challenges of leadership. The Health Care Manager, 37(2), 158–163.

https://doi.org/10.1097/hcm.0000000000000215 Wagner, E. A. (2018, April/June). Improving patient care outcomes through better delegation—

Communication between nurses and assistive personnel. Journal of Nursing Care Quality, 33(2), 187–193. https://doi.org/10.1097/ncq.0000000000000282