How to do this Annotated Bibliography on Multi-generational Families

Terrence F. Cahill, EdD, FACHE, and Mona Sedrak, PhD, PA • 3

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Terrence F. cahill, edd, Fache, and Mona Sedrak, Phd, Pa

Su m m a r y • over the past several years, leaders in healthcare have noticed an increase in generational tension among employees, most often focused on the attitudes and behaviors of the arriving millennials (generation Y). While these employee relations issues were a nuisance, they rarely rose to the level of a priority demanding leadership intervention. Some leaders, in fact, hoped that the issues would resolve themselves as these young employees settled in and learned that they had to demonstrate new behaviors to be successful in the workplace. Most organizations adopted this wait-and-see attitude.

not so today. as the boomer generation has begun its exodus from the workplace, organizations are increasingly looking at the millennials as not a problem but a solution to the workplace manpower transition that is under way. our problem is that we don’t yet know how best to lead such a diverse, multigenerational workforce.

this article examines the generational topic and provides advice concern- ing a variety of changes that leaders may implement to advance their organiza- tion’s ability to attract and to retain the millennials.

Leading a Multigenerational Workforce: Strategies for Attracting and Retaining Millennials

Terrence F. Cahill, EdD, FACHE, is chair and associate professor in the department of graduate programs in health sciences in the School of Health and Medical Sciences at Seton Hall Uni- versity in South Orange, New Jersey. Mona Sedrak, PhD, PA, is associate dean of the division of health sciences in the School of Health and Medical Sciences at Seton Hall University.

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4 • f r o n t i e r s o f h e a l t h s e r v i c e s m a n a g e m e n t 2 9 : 1

senior healthcare leaders. for example, if you are one of those older leaders, did you ever get a trophy for just showing up to play or to participate in an activity as a child? our millennial employees did. is it any wonder that they arrive at our work- places with high expectations for positive feedback? early life experiences contribute to generational differences that are deeply imprinted in individuals’ beliefs, values, preferences, and behaviors and are not easily changed.

During the last decade, consulting organizations, professional and industry associations, and the academic com- munity published reports that drew our attention to the issue of generations in the workplace. the Society for Human resource Management published Gen- erational Differences: Survey Report (Burke 2004), in which they presented the results of a survey that explored what human resource professionals observed as advantages and disadvantages of an intergenerational workforce. Deloitte Development llc published Decoding Generational Differences (Smith 2008), a report of several years of research on the topic. Pew research produced Millenni- als: A Portrait of Generation Next (taylor and Keeter 2010) to compare the values, attitudes, and behaviors of millennials with those of older adults. integrated Healthcare Strategies (2007), in col- laboration with the american Society for Healthcare Human resources adminis- tration of the american Hospital associ- ation (aHa), published The Multigenera- tional Workplace: Strategies and Solutions for Healthcare Employers to report on emerging trends on the topic.

While these and similar publications provide excellent information on the increasingly important topic of leading

Introduction in Good to Great (2001), collins reports that leaders who take their companies from good to great first pay attention to who is on their bus, who is working in their organiza- tion. Have you noticed that the people on your bus are changing? We are referring to the retirement of the baby boomer genera- tion while increasing numbers of millen- nials (generation Y)—those in their twen- ties—are arriving in the workplace.

for the past several years, we have been studying generational issues in the health-

care workplace. What we have found is that while leaders are aware that the boomers are approaching retirement and may have been advised of tensions among employees result- ing from generational differences, most leaders have made generational issues a low priority.

this is understandable given the many pressing demands on leaders of healthcare organizations during the past decade. However, we also found that this lack of attention to generational ten- sions was deliberate in some cases. We heard senior healthcare leaders express the opinion that these tensions would naturally resolve themselves as millen- nials matured and realized that they had to change their behaviors if they wanted to be successful in their jobs. “after all,” those leaders argued, “weren’t we like that too? and we learned.”

Unfortunately, the evidence so far does not support this wait-and-see approach concerning generational tensions. the millennial employees grew up with very different family, school, and environ- mental influences compared with today’s

Today’s workplace requires

a new human relations

guide referred to as the

platinum rule—“Do unto

others as they prefer to be

treated.”

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munication patterns, hospitals need to orient young workers to the expectation of patients and staff from the traditional, baby boomer, and X generations, as well as differences in expectation by gender, race, and ethnicity.

these prescriptions call for a twofold response to problems related to genera- tional issues. first, programmatic changes related to generational issues are needed. in this article we discuss changes that are recommended by generation for benefits, work structure, training, and commu- nication, with particular attention to the millennials. Second, the aHa recommen- dations accentuate the need for healthcare leaders who know how to lead a multigen- erational workforce.

Unfortunately, because we are all new to these challenges, we are all still in a learn- ing process. for example, the golden rule, “Do unto others as you would have them do unto you,” has been a guiding principle in human relations throughout the twentieth century. However, when generational dif- ferences are considered, the rule no longer works. take the issue of feedback. research says that millennials demand constant feedback and interpret silence as negative. in contrast, older employees prefer to just do their jobs and are content to receive little feedback. What happens when either the millennial or the older employee is the manager and applies the golden rule? employee relations become tense. today’s workplace requires a new human relations guide referred to as the platinum rule—“Do unto others as they prefer to be treated” (alessandra 1994).

to address these individual and rela- tionship issues, we discuss a variety of actions that organizations are taking to sensitize their employees to generational

multigenerational organizations, the aHa issued a call to action of much greater urgency with its report Workforce 2015: Strategy Trumps Shortages (2010). accord- ing to the report, generational issues were no longer merely an employee relations matter. rather, the retirement of the baby boomer generation from the workplace is becoming a real threat to the ability of healthcare organizations to ensure ad- equate staff, and the arrival of the mil- lennials is our primary hope. across the United States, 10,000 baby boomers are retiring daily, and this pattern is predicted to continue for the next several years (Meister and Willyerd 2010). the employ- ment forecast for this period is that these retirements will result in over 15 million job openings, but only 12 million new individuals (i.e., millennials, immigrants) will be available to fill those jobs. as a result of this dire forecast, the aHa (2010) recommends the following:

• In identifying, developing, and appoint- ing managers, hospitals need to give increased attention to the employee’s understanding of, appreciation for, and effectiveness working with the multiple workforce generations.

• To accommodate the preferences of the multiple workforce generations, hospi- tals need to replace traditional human resources policies that were applied uniformly to all workers with policies and programs that include flexibility and choices.

• Hospitals need to work with employees approaching retirement age to iden- tify attractive options regarding roles, schedules, and benefits for continuing to work full- or part-time.

• Given the generational differences in dress, cosmetics, body art, and com-

Terrence F. Cahill, EdD, FACHE, and Mona Sedrak, PhD, PA • 5

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6 • f r o n t i e r s o f h e a l t h s e r v i c e s m a n a g e m e n t 2 9 : 1

growing up at the same time and being exposed to similar stimuli, a group of children tend to develop similar world- views, beliefs, attitudes, values, and behaviors. However, while acknowledg- ing this process as the basis for viewing generational similarities, stereotyping and failure to recognize individual dif- ferences are obvious dangers. genera- tional theory acknowledges heterogene- ity within groups by identifying cuspers, individuals who are born near the end of one generation or the beginning of the next generation. these cuspers often have characteristics associated with both generations (Mcarthur 2009). With the cautionary note concerning the risk of stereotyping in mind, there is much we can learn by understanding characteris- tics associated with each of the four gen- erations represented in our workplace.

The Generations americans are living longer and work- ing longer than at any other time in our nation’s history. as a result, four distinct generations are currently in the workplace (exhibit 1). each of these generations brings its own set of values, beliefs, life experiences, and attitudes.

Traditionalists: Loyalists traditionalists grew up in difficult times, experiencing both the Depression and World War ii. to survive, they saved for a rainy day. in battle, they followed orders. and in times of challenge, they main- tained an immense faith in and loyalty to their institutions. While a small number of traditionalists remain employed, in hos- pitals this population is more often found in our volunteer services and, of course, in our hospital beds—our Medicare patients.

differences. We begin by discussing the concept of generational theory and identi- fying the generations and their workplace characteristics.

What Makes a Generation? Most of us first encounter the concept of generational differences in our early family experiences. remember when a holiday celebration was approaching and all the thoughtfulness that went into ac- commodating different family members’ needs, wants, and values? What will we serve? When will we eat? Who will sit

where at the table? What will we wear? consider- able effort was made to appreciate individual differences to avoid indi- vidual disappointments and unnecessary tensions and make it an enjoyable event for all. While this is a simple metaphor, it cap-

tures the type of sensitivity and proactive planning that is necessary to become a successful leader of a multigenerational workforce. leaders who understand the concept of generation and how it contrib- utes to individual values, preferences, and habits will be better prepared to rec- ognize and address the needs of today’s workforce.

a generation is “the average span of time from the birth of parents to that of their offspring” (Merriam-Webster 2011). in general, this is approximately 20 to 22 years. children are born into a particular era, and they are influenced not only by the values and attitudes of their family, friends, and communities, such as schools, but also by significant world events, social trends, and environ- mental factors occurring at that time.

At what point do we stop

viewing the millennials as

joining our organizations

and accept the reality

that our organizations

have become their

organizations?

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themselves. resourceful and independent, Xers adopted a “show me the money,” short- term orientation. Highly educated, they favor pay-for-performance over tenure as the basis for rewards.

Millennial Generation: "Trophy Kids" the newest generation to enter the work- place, the millennials, is the largest age co- hort. in addition to being called millenni- als, they are also referred to as generation Y, nexters, and trophy kids. in 2010 they represented only 27 percent of the work- force, but with the escalating retirements of boomers and the continuing influx of millennials, they are predicted to represent 48 percent of the workforce in 2014 (Meis- ter and Willyerd 2010). this projected change raises the question: at what point do we stop viewing the millennials as join- ing our organizations and accept the reality that our organizations have become their organizations?

the millennials have been a sheltered group since their births; think of the countless minivans with “baby on board” signs. their parents are very protective, particularly of their children’s self-image. they have provided continual reminders to their millennial children that they are “special.” for example, to prevent their children’s disappointment, parents made

Baby Boomers: Me Generation Baby boomers grew up in a thriving, post- war economy characterized by optimism and a can-do attitude. they inherited their parents’ hard work ethic and are known for their long work hours and willingness to sacrifice personal and family matters for their careers. Yet, the boomers were also very much into themselves, leading to their other name: the me generation. through the 1960s boomers aspired to fix society’s ills through various movements (e.g., the peace movement, civil rights, feminism). Boomers are a competitive generation, as their large numbers re- quired that they strategize and struggle to succeed in their careers. Boomers favor relationships, loyalty, and teamwork in their approach to success.

Generation X: Skeptics gen Xers grew up as the first latch-key gen- eration because their boomer parents were out working. they grew up in a time of in- creasing unsettledness in society character- ized by high divorce rates, an unstable econ- omy, and high crime rates. Xers watched as organizations downsized, merged, and went out of business, often resulting in hardships for their parents and families. as a result of those experiences, Xers grew skeptical of institutions and learned to rely more on

Terrence F. Cahill, EdD, FACHE, and Mona Sedrak, PhD, PA • 7

Exhibit 1 The Generations

Traditionalist Baby Boomer Gen X Millennial

Date of birth Before 1945 1946–1964 1965–1978 1979–2002

Age 67 and older 48–66 34–47 10–33

Current cohort size 27 million 76 million 60 million 88 million

Generation

Used with permission. © American Hospital Association. Workforce 2015: Strategy Trumps Shortage, 2010. Accessible at http://www.aha.org/advocacy-issues/workforce/workforce2015.shtml

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8 • f r o n t i e r s o f h e a l t h s e r v i c e s m a n a g e m e n t 2 9 : 1

they also want work–life balance. to the dismay of their supervisors, they will consis- tently choose personal obligations over work responsibilities. a related characteristic is their internal clock. Millennials operate in a 24/7 virtual world that has almost unlimited access to information. While historically the distinction between work time and non– work time has been clear, millennials are less oriented to the scheduled work hours and more to the work itself. as long as the work gets done, why does it matter where or when it gets done? for healthcare organiza- tions that have traditionally been oriented to the acute care model, this millennial characteristic is a challenge. However, it may become a significant asset as healthcare becomes less institution based and more community/wellness oriented.

Millennials have never known a time without sophisticated technology. as such, they are the most tech-savvy generation. Having trouble with a technology issue? give it to a millennial and he or she will figure it out. While older generations use technology as a tool to accomplish a task, millennials view technology as a way of life, a part of who they are. as healthcare pursues the adoption of more technology, organizations will benefit from having millennials on their bus.

a related issue is that technology has brought with it the expectation for instant solutions. accustomed to microwaves, internet, text messaging, and cell phones, millennials are impatient with delays. if we asked you how long you were prepared to wait for a response to an application for a job, what would you say? Whatever you answered, that is too long for a millennial. organizations targeting the recruitment of millennials have figured out ways to provide not only the instant e-mail acknowledgment of the application but also a call-back within 24 hours and a decision within days.

sure that everyone involved in recreational sports received a trophy for just showing up, regardless of achievement. Millennials have been continually praised throughout their developmental years, and as a result organizations are finding their demands for feedback surprising and frustrating. if millennials do not receive feedback, they interpret it as an indication that they did something wrong. With their parents hov- ering so closely overhead to protect them, the term helicopter parents was coined to

describe how they swoop in whenever their children are threatened. teachers all the way up to college and even graduate school report parents of millenni- als scheduling meetings to discuss why their child did not get a better grade.

Millennials have grown up working in teams. their schooling gets the credit for instilling good teamwork skills, as most school assignments were done collaboratively. in today’s healthcare environ- ment, very little can be accomplished alone. therefore, the millennials’ teamwork and collaboration skills should be considered valuable contributions to our healthcare organizations.

Millennials pursue a very busy sched- ule, having juggled multiple activities from very young ages. in learning how to navigate these matters, millennials de- velop very good multitasking skills. How- ever, some have questioned whether this routine leads the millennials to be satis- fied with superficial skills. additionally, as a result of their busy schedules, they grow accustomed to having very little downtime, with the result that when they are not busy, they get bored very quickly.

While the millennials are known for working hard to achieve their objectives,

While historically the

distinction between work

time and non–work time

has been clear, millennials

are less oriented to the

scheduled work hours and

more to the work itself.

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bility. for healthcare organizations this should be a good thing, as we are a mis- sion-driven industry.

With this general understanding of the four generations, we next identify work- place characteristics associated with each generation.

Generational Workplace Characteristics in viewing workplace characteristics (ex- hibit 2), a generational lens reveals a new level of diversity in the workforce.

By itself, each of these generational characteristics is neither positive nor nega- tive. However, when the preferences of each generation are considered in relation to the preferences of other generations, sources of tension become evident.

Millennials see themselves as custom- ers, even in their employment relationship. they grew up in a customer-centric world in which retail organizations, recognizing that millennials commanded significant purchasing power, catered to them. as mil- lennials enter the workforce they continue to expect that their organizations want them there and that their leaders are interested in their ideas. When we present to millen- nial audiences, we hear that this expectation results in the biggest culture shock as they enter the workforce. often, millennials re- port that no one listens to them. this leads us to our last millennial characteristic.

Millennials want to do meaningful work. they are attracted to mission-driven organizations and organizations that are committed to corporate social responsi-

Terrence F. Cahill, EdD, FACHE, and Mona Sedrak, PhD, PA • 9

Exhibit 2 The Generational Workforce Characteristics

Used with permission. © American Hospital Association. Workforce 2015: Strategy Trumps Shortage, 2010. Accessible at http://www.aha.org/advocacy-issues/workforce/workforce2015.shtml

Traditionalist Baby Boomer Gen X Millennial

Respectful of authority Values individuality Self-reliant Image conscious

Values duty and sacrifice Driven by goals for success Highly educated Need for feedback and reinforcement

Values accountability Work ethic = hours worked and monetary rewards

Questioning Values instant gratification

Values practical experience Believes in teamwork Most loyal employees Idealist

Work ethic = timeliness and productivity

Emphasizes relationship building

Wants open communication Team-oriented

Strong interpersonal skills Expects loyalty from coworkers Respects production over tenure

Wants open communication

Promotions and recognition come with job tenure

Career = identity Values control of his or her time

Searches for others who will help him or her achieve his or her goals

Values academic credentials Wants work-life balance Invests loyalty in a person, not in an organization

Wants job that is personal fulfillment

Accepts limited resources Risk averse Searches for ways to shed stress in his or her life

Loyal to employer; expects loyalty in return

Racial and ethnic identification less important

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10 • f r o n t i e r s o f h e a l t h s e r v i c e s m a n a g e m e n t 2 9 : 1

to lead in a multigenerational environment, the more successful we and our organiza- tion will become. Second, failure to learn how to lead a multigenerational workforce will result in career derailment for aspiring leaders. the aHa (2010) report foreshad- ows this fact. third, for organizations, the payoff for addressing generational issues is improved organizational effectiveness. We need all employees to be energized and cre- ative in doing their work. Particularly as we continue to squeeze costs out of the system, we cannot afford clash points that distract our attention and drain additional resources.

Generational Clash Points the values and perspectives of each gen- eration often conflict with the values and perspectives of other generations, result- ing in multiple clash points. in exhibit 3 we summarize generational characteristics identified by many researchers as contrib- uting to clash points.

recognizing and addressing generational clash points in the workplace will benefit organizations in several ways. first and foremost, the multigenerational workplace is not going away. this is not an “it too will pass” phenomenon. the faster we learn how

Exhibit 3 Generational Clash Points in the Workplace

Clash Point Traditionalist Baby Boomer Gen X Millennial

Outlook Practical Optimistic Skeptical Hopeful

Work definition

Work ethic Committed Ambitious Balanced Determined

Work/career goal What will I leave behind?

Accomplishing bigger things

Building my skill set

So many interest- ing things to do

Organizations Believe in them Change them Doubt them Judge them

View of authority Deferential Love/hate Uninterested Civil

Reward system Doing good work Tangibles; corner office, title

Independence Meaningful work

Feedback No news is good news

Occasionally is fine

Regular feed- back, please

Constant feed- back or else

Changing jobs Bad Only to move ahead

A must Routine expectation

Learning “I learned it the hard way; you can

too.”

“Train ’em too much and they

will leave.”

Motivates me to stay

I expect it

A place you go Anytime, anyplace

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organizational culture that recognizes and addresses generational differences.

Developing Emotional Intelligence leaders and employees need to be emo- tionally intelligent (goleman 2006) in respect to generational diversity issues. emotional intelligence entails understand- ing one’s own generational personality and biases, as well as learning about dif- ferences among other employees that are based on generational issues. the desired outcome is an appreciation that, due to generational differences, there are few one-size-fits-all solutions for addressing employee issues. We are living in the age of the platinum rule and must treat others as they wish to be treated.

organizations that are leading the way in building strong, effective multigen- erational workforces invest in a variety of educational activities. intergenerational workshops that introduce employees to different generational preferences are common. Mutual understanding is fos- tered in an attempt to reduce misunder- standing and miscommunication. Because different generations prefer different teaching styles and formats, these pro- grams include a creative mix of tactics. for example, baby boomers are used to having PowerPoint slides, but millennials prefer a more interactive approach to learning. therefore, using a variety of educational formats is common in generationally sensitive organizations. to accommodate the millennials’ 24/7 virtual orientation, e- learning courses are being developed that employees may take at a time and location of their choice. Speaker series is another alternative for providing groups with ac- cess to generational information. Which- ever educational formats are utilized to address this topic, employees and leaders

Leading a Multigenerational Workforce We repeat collins’s (2001) question, “Who is on the bus?” the starting point in developing your organization’s mul- tigenerational workforce is for you to understand your current workforce in respect to their generations. conduct an audit and analyze the results to deter- mine the generational composition of your workforce. explore whether there is a higher attrition rate for particular gen- erations. identify generational tensions in particular areas of the organization or concerning particular issues. this information provides several benefits. first, it allows you to determine if you have greater staffing risks in certain departments due to approaching retire- ments. Second, with your understanding of each generation’s needs, you can bet- ter craft a workforce plan that addresses employees’ needs. third, you can use this generational information to iden- tify beneficial organizational changes in areas such as benefits planning, continu- ing education programs, and employee relations planning.

in addition to this baseline audit, we agree with and expand upon the twofold strategy recommended by the aHa (2010) report. first, to success- fully lead a multigenerational workforce, healthcare organizations need to adopt organizational policies, procedures, and structures that fit the needs and interests of their generationally diverse employ- ees. Second, we need to develop not only leaders but also employees who are generationally sensitive and competent in their business exchanges. While both are necessary, we suggest that organiza- tions begin with the latter action, as this contributes to establishing an inclusive

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12 • f r o n t i e r s o f h e a l t h s e r v i c e s m a n a g e m e n t 2 9 : 1

A key retention strategy is

to provide the opportunity

for lateral moves within

your organization when

a millennial is anxious for

new learning.

body art such as tattoos and piercings are much more prevalent among millennials than they are with older employees. While organizations historically “just said no” to drastically changing dress code standards, more organizations are now willing to negotiate dress code rules to arrive at a solution that works for both the hospital’s patients and its employees.

another benefit that is particularly popular with millennials is the opportu- nity for work release to engage in commu- nity volunteer activity. Millennials expect their work to be meaningful, and they are attracted to employers who want to make a difference in the world (i.e., corporate social responsibility). Some organizations offer employees the opportunity for paid leave to volunteer in a community project.

in addition to benefits, organizations are negotiating work structures to accom- modate employees’ needs and interests, and for the millennials this often has to do with work–life balance issues. What nurs- ing departments have done for years to accommodate employees’ diverse schedul- ing needs is now expanding across health- care organizations. Job sharing, flexible or remote work arrangements, special term appointments, even seasonal months-off programs are examples of the willingness of organizations to customize their em- ployees’ employment arrangements.

for millennials, this customization also applies to career development. While millennials are anxious to advance their careers and eager to learn new things, the population shift that is occurring due to the boomers’ retirements means organizations need to prepare millenni- als to assume supervisory responsibility earlier in their careers than was the case with previous generations. Mentoring programs (reverse, two-way, clinical),

must learn about their generational biases, others’ preferences, and how to address generational clash points.

Implementing Programmatic Changes to engage employees of different genera- tions, organizations are adopting human resources (Hr) policies and programs that offer flexibility and choices. for example, while cafeteria-style benefits programs have historically provided choices, organi- zations are now packaging their benefits in ways that are attractive to employees

with varying life stage needs or interests. Scripps Health has adopted this life stage benefits approach with offerings such as training, mentoring, and career advancement op- portunities that are popu- lar among millennials and

gen Xers. an assortment of work–life and wellness programs is offered in response to the interests of different generations. flexible work schedules, job sharing, and telecommuting arrangements respond to work–life balance interests, a subject that is particularly attractive to millennials but also increasingly popular across the gen- erations (aarP 2007).

caregiver benefits for elder and family care issues are another example of orga- nizations responding to their employees’ generational needs. While boomer and gen X employees are dealing with the chal- lenge of caring for their parents or grand- parents, millennials and gen Xers run into child care issues that distract them from their work responsibilities. also, the never-ending dress code issue takes on new generational overtones as the mil- lennials arrive in the workplace with very informal dress code practices. in addition,

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promotional, move. therefore, a key reten- tion strategy is to provide the opportunity for lateral moves within your organiza- tion when a millennial is anxious for new learning. also, millennials are attracted to fast-moving, technology-based envi- ronments. remember, they grew up on technology that produced instant results, and they were multitaskers from an early age. as revolutionary changes concerning the introduction of new technologies occur in the healthcare industry, we should be very attractive in the eyes of millennials. However, change comes slowly, particu- larly in certain departments and positions, and the enthusiasm and energy that a mil- lennial brings to our organizations can be quickly drained if management does not nurture it.

as we recognize the challenge of gen- erational differences, managers will need to address these new issues. learning how to manage a multigenerational workforce is minimally, if at all, addressed in current educational programs. therefore, managers need on-the-job training and self-learning to be able to recognize and respond to the different needs and interests of today’s multigenerational workforce. Perhaps the most basic issue concerns communica- tion. communication is often taken for granted if the other individual looks like you and talks like you. However, different generations use language differently. they may look like you, talk like you, and sound like you, but their meaning can be very dif- ferent. as managers, we need to appreciate how individuals use the english language differently and facilitate conversations that build collaborative engagement and action to achieve our organizational objectives. think of the word work. Work means dif- ferent things to different people. addi- tionally, millennials frequently use a very

internships, rotational training, and other fast-track-to-management programs are examples of actions that organizations are taking to prepare millennials for career advancement.

in addition to these selective career advancement programs, organizations are responding to millennials’ general need for social support as they transition from school to workplace by providing social networking forums. Young pro- fessional networks, regional millennial councils, emerging leaders organiza- tions, and cross-generational councils are examples of forums that provide young employees with the opportunity not only to collectively support each other but also to engage in fun activities, which is another millennial expectation. in- novation groups are another idea that some organizations have introduced to engage millennials in meaningful work that capitalizes on their new energy and their entrepreneurial spirit. a caution- ary note, however, is that millennials expect that organizations are interested in their ideas, so if you invite millennials to speak, be sure to listen to them or risk increasing millennial turnover.

turnover is already a concern with the millennial generation. in fact, a new term was created to describe this prob- lem: retention deficit disorder (Johnson and lopes 2008). While it is too early to identify definitively what might lead mil- lennials to remain at an organization, the organizational actions noted above are expected to contribute to better results. ad- ditionally, millennials like to continually learn. if they find another organization that offers them a better learning experi- ence, they are likely to leave your organiza- tion. interestingly, when these departures occur, they are typically a lateral, not a

Terrence F. Cahill, EdD, FACHE, and Mona Sedrak, PhD, PA • 13

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14 • f r o n t i e r s o f h e a l t h s e r v i c e s m a n a g e m e n t 2 9 : 1

Managers’ performance

management assessments

should include evaluation

of their talent management

skills, and appropriate

rewards or consequences

should be provided.

yet to arrive at a clear understanding of what it takes to be a successful leader in this new environment. We believe that due to generational differences, no single answer or approach will be successful, and we accept that this makes the job of managers more complex and challenging. While we have provided many examples of tactics that organizations are utilizing to address generational challenges, par- ticularly as related to millennials, there is no doubt that we have much to learn concerning this matter. We have focused on generational differences as the basis for learning how to be successful leaders of a multigenerational workforce. others argue that a better approach is to understand what we have in common, such as the need for respect and success (Deal 2007). We suspect that a combination of both lines of thinking will ultimately help us to better understand this subject.

in closing, we note that healthcare or- ganizations have adopted patient-centered care as the only way that care should be delivered. to support this philosophy, a complementary philosophy is necessary: an employee-centered framework. While this is not a new concept (remember the upside-down pyramid?), we offer a new lens, generational differences, as a means for noticing and addressing information that may help us become more employee centered and better leaders of a multigen- erational workforce.

References aarP. 2007. Leading a Multigenerational

Workforce. Washington, Dc: aarP. alessandra, t. 1994. “the Platinum rule.”

Leadership Excellence 11 (5): 12. american Hospital association’s 2009

long-range Policy committee. 2010. Workforce 2015: Strategy Trumps Shortages. chicago: american Hospital association.

informal communication style, and this can irritate others, resulting in employee tensions. Managers who are sensitive to this issue can help employees understand others’ communication styles and negoti- ate reasonable solutions to avoid tensions. in the process, managers help employees achieve a common understanding of the communication rules of the department or organization.

as noted earlier, the generations have different preferences concerning the frequency and style of feedback. Manag-

ers who understand these preferences will be more effective in engaging and guiding their employees in the accomplishment of their organization’s objectives.

While sensitivity to em- ployees’ needs is not a new concept, we believe it fair to say that historically this

was regarded as a soft objective and was too often passed over in favor of attending to more bottom-line results. However, in the current workforce transition, inatten- tion to millennials’ turnover represents a real threat to organizations. the predicted workforce shortages are considerably more threatening than the ones we have experi- enced in the past. for organizations to suc- ceed, managers must be accountable for maintaining and developing their employ- ees. Managers’ performance management assessments should include evaluation of their talent management skills, and ap- propriate rewards or consequences should be provided.

Conclusions We are living through the transition to a multigenerational workforce, and we have

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f e

a t

u r

e

Mcarthur, J. 2009. “gen Y Working Model.” Intheblack 79 (10): 52.

Meister, J. c., and K. Willyerd. 2010. The 2020 Workplace: How Innovative Compa- nies Attract, Develop, and Keep Tomorrow’s Employees Today. new York: Harper collins.

Merriam-Webster inc. 2011. Merriam-Web- ster’s Collegiate Dictionary, 11th edition. Springfield, Ma: Merriam-Webster inc.

Smith, S. 2008. Decoding Generational Differences: Fact, Fiction . . . or Should We Just Get Back to Work? new York: Deloitte Development llc.

taylor, P., and S. Keeter. 2010. Millennials: A Portrait of Generation Next. Washington, Dc: Pew research center.

Burke, M. e. 2004. Generational Differences: Survey Report. alexandria, va: Society for Human resource Management.

collins, J. 2001. Good to Great. new York: Harper Business.

Deal, J. J. 2007. Retiring the Generation Gap. San francisco: Jossey-Bass.

goleman, D. 2006. Emotional Intelligence. new York: Bantam Dell.

integrated Healthcare Strategies. 2007. The Multigenerational Workplace: Strategies and Solutions for Healthcare Employers. Minneapolis, Mn: integrated Healthcare Strategies.

Johnson, J., and J. lopes. 2008. “the intergenerational Workforce, revisited.” Organization Development Journal 26 (1): 31–36.

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