Management of Health Care Organizations: Assignment Week 4

Chapter 11: Motivating for Improvement

Objectives

• Understand intrinsic and extrinsic motivation

• Recognize content theories and process theories of motivation

• Be able to apply motivation theory when designing jobs and incentives

Outline

• Theories of Motivation

– Intrinsic vs. Extrinsic Motivators

– Content Theories of Motivation

– Process Theories of Motivation

• Motivating for Improvement

Theories of Motivation

Classified into two main categories

• Content – seeks to identify drivers internal to individuals.

• Process – focus on activities or forces external to individuals. Can be altered to induce or affect more commitment.

Theories of Motivation

Content Theories

• Maslow’s hierarchy

• Existence, Relatedness, Growth (ERG) theory

• McClelland’s learned needs theory

• Herzberg’s hygiene factors theory

• Job enrichment theory

Process Theories

• Expectancy theory

• Goal setting theory

• Equity theory

Intrinsic vs. Extrinsic Motivation

• Intrinsic – sources of motivation that come from within an individual (examples: honor, idealism, status).

• Extrinsic – sources of motivation that are derived from outside an individual (examples: compensation, recognition, punishment).

Content and Process theories both contain concepts of intrinsic and extrinsic motivation.

Content Theories

Maslow’s Hierarchy

• Universal internal drivers of human behavior, ordered from most basic:

1. Physiological

2. Safety and security

3. Love and belonging

4. Self-esteem

5. Self-actualization

Maslow’s Hierarchy

• Represents an oversimplification, but has high face validity (people find it intuitively true)

• Does not capture the fact that needs can change over time

ERG Theory

There are 3 categories of needs:

1) Existence

2) Relatedness

3) Growth

• Congruent with Maslow’s five categories

• Distinct from Maslow in that ERG recognizes humans cycle through priority of needs rather than ascending a fixed hierarchy

McClelland’s Learned Needs Theory

• Key needs motivating individuals can be learned and are not necessarily genetic

• These needs are:

1) Achievement

2) Affiliation

3) Power

• Suggests that these needs can be instilled in employees through coaching, and conversely unlearned through habit

Herzberg’s Hygiene Factors Theory

Rewards that motivate come in two forms: 1) Hygiene factors • Rewards that encourage sufficient performance.

Do not motivate extra effort or guarantee improved outcomes (examples: job security, salary, organizational policies).

2) Satisfiers • Rewards that encourage improved performance.

Positively associated with effort (examples: advancement, recognition, personal growth).

Herzberg’s Hygiene Factors Theory (continued)

• Hygiene factors and satisfiers can be influenced by an organization and its managers.

• How these motivators are designed influence employees’ performances.

• A system design with more satisfiers should yield higher performance.

Job Enrichment Theory

• Most jobs can be enriched so that they come closer to meeting the human needs already expressed by expanding the nature of the tasks an individual performs.

• Job characteristics amenable to enrichment:

1) Skill variety (number of skills used in performing a task)

2) Task identity (portion of a whole task performed by an individual)

3) Task significance (importance to an organization)

4) Autonomy (freedom to choose how a task is performed)

5) Feedback (information about the quality and outcomes of a task)

Job Enrichment Theory (continued)

• Can provide increased employee satisfaction due to expanding responsibility and control over tasks.

• Some job enrichment strategies include: 1) Combining tasks so that employees can see the

entire process 2) Rotating employees through different

assignments 3) Delegating tasks typically assigned to those

higher in the organizational hierarchy

Process Theories

Expectancy Theory

• Proposes a relationship between (1) efforts of employees, (2) quality of their performance, and (3) level of recognition by organization.

• If the employee perceives the level of recognition (3) is in line with the amount of effort dispensed (1), than the employee feels motivated.

Expectancy Theory (continued)

• A manager should seek to understand the degree to which different employees value different rewards (recognition).

• Management can positively affect employee motivation by ensuring: (1) employee time is well-spent, (2) effort increases performance, and (3) performance is appropriately recognized.

Goal Setting Theory

• Establishing appropriate goals for employees is motivating.

• Goals should be: (1) established jointly between employee and manager and (2) be challenging.

• Goals that are too easy, or impossible, are not effective.

• Regular feedback on progress is necessary to stress the goal’s importance and to permit adjustments.

Equity Theory • Employees are motivated when their effort is

rewarded in a manner that is equitable with how others are rewarded.

• Issues of equity and fairness can be raised by: 1) Salary and perks

2) Office space

3) Work assignments

• Managers should have a reasonable and publicly defensible reason for treating employees differently.

Motivating for Improvment

• Screening of new hires should include a discussion about commitment to customer service and continuous improvement – helps determine level of intrinsic motivation.

• Design and implement policies that encourage employee engagement and reinforce high motivation like sharing information widely and investing in learning opportunities.

• Understand that there is variation in motivating drivers for individual employees.

Motivating for Improvement (continued)

• Be creative and take risks/experiment.

• Look for opportunities to praise.

• Draw on the intrinsic motivations inherent in health work.