Maintaining Morale in the Face of Change



Can you offer some guidance on how to motivate and maintain morale in these times of healthcare change?

Answers from Scott MacLean:

Encourage emplyee engagement

Having engaged employees is perhaps the most critical element to the success of any organization.  As Fred Reichheld describes in his 2006 book The Ultimate Question, employee engagement is tied to customer satisfaction, which in turn produces desirable business outcomes.  In our case, that means our clinicians and researchers have the information they need because our information systems are usable and reliable.

Many who are more expert than I have penned volumes on strategic initiatives for organizational development and tactics for improving morale.  One counter-intuitive thought is that maybe motivating and maintaining morale in times of healthcare change is the wrong question.  Maybe the question is, "do I have the right leaders and staff in my organization, do they understand the mission and are they committed to it?"

The StuderGroup ( has compelling research suggesting that one of the biggest reasons organizations don't achieve their goals is an unwillingness to deal with low-performing employees.  The best tool we have for retaining high-performing talent is to set expectations and hold people accountable, and then dismiss those who can't or won't meet organizational standards.  This is particularly true in not-for-profit or low-margin entities in the healthcare space. 

After college, I entered one of GE's entry-level training programs.  At that time, Jack Welch had started his transformation of the company, focusing on talent acquisition and retention, training and getting the most productivity out of human capital.  I also recommend Welch's books such as Winningfor an overall picture of how to attract and retain highly motivated employees.

Day-to-day morale boosters

With these principles as a foundation, I find the following day-to-day behaviors to be helpful for maintaining and motivating the people we want to keep:

  1. Walk around and be present with leaders and staff as much as possible.  While doing this, listen three times as much as you speak.  Ask questions like, "What is going well?  Do you have everything you need to get your job done?  What ideas do you have for improvement?"  Then listen and follow up and complete any items you promise.
  2. For high and solid performers, give nine praises for every one criticism.  If something goes well, give credit to those below you.  If something goes poorly, take responsibility, then work with staff to increase accountability.
  3. Say thank you and smile – a lot.  Use whatever reward and recognition tools your organization might have for high and solid performers, but regular thank yous are your easiest and most available recognition tools.  My department has pre-printed thank you notes with our corporate logo, which I will send regularly to people's homes.
  4. Don't be afraid to push back on low performers.  Again, these folks are used to sucking up your time and making everyone around them miserable.  Refusing to play that game makes it less fun for them and your high performers will take note.

Remember, it's futile to try to maintain morale with people who don't even want to be part of your mission.  While it's very difficult at first, dealing with low performers will pave the way to put your energy into the people who want to be with you.  Your hard work in holding low performers accountable will pay great dividends on motivation and morale for the rest.

Answers from Rick Lang:

With shorter planning cycles, unprecedented demand for services, and dwindling resources, healthcare IT leaders face a daunting challenge — developing an IT organization that will support the organization's ephemeral goals and objectives.

Lead by creating leaders

The modern healthcare CIO must cultivate a cadre of organizational leaders throughout the entire chain of command. Leading by creating more leaders is a timeless and universal motivation and morale building strategy. Show them how to lead and then get out of their way.  High morale will be prevalent when your staff has control of their professional destiny.  Grant them the gift of power, freedom, and responsibility -- that comes with leading mission critical assignments.

Personal example: (people want to solve their own problems – they just don't know it): A while back, I had the opportunity to form a team responsible for solving the organization's deplorable IT support function. Along with this challenge came the decree that there would be no additional FTEs or budget increase to support any proposed solution. The department was fraught with disintegration, teamwork was nonexistent, and morale was low. Recognizing these limitations, I challenged the team to propose an unorthodox, budget-neutral solution.  Their recommendation: make the support function everyone's responsibility by establishing a mandatory and regular rotation on the help desk for each and every IT staff member.

Result: in the short term, there was "grief and woe of biblical proportion." After a while, the factions disappeared, the support function dramatically improved (with problem resolution rates well above industry standard), and incredulously, the staff looked out for one another by accepting ownership, accountability, and responsibility for the support function as a whole.  Moral of the story: collaboration occurs naturally when all stakeholders share a common misery. Wacky idea transformed into acceptable norm. Leaders changing their world together resulting in an immeasurable morale boost.

Creativity is essential

Finally, leaders must be creative thinkers. Great leaders must establish a genuine presence with the people they lead.  Some of the best leaders I have known have had a strong sense of the human condition. Their staff worked hard for them, not out of fear, but because they didn't want to disappoint them. These leaders demonstrated a number of natural qualities that contributed to their success. They command respect because they build trust and are beyond reproach. But most of all they are human and they are not afraid to show it. Never let your authority encumber your ability to lead.  And never let your position or pride prevent you from developing your future leaders. 

July 2012