HCA 301 Leadership and Management in Healthcare Setting - Motivation and Development PDF

HCA 301 Leadership and management in healthcare setting CHAPTER 8 MOTIVATING AND DEVELOPING OTHERS Resource: Sullivan, E.J. & Garland, G. (2013), 2nd Edition. Practical Leadership & Management in Healthcare for Nurses and Allied Health Professionals. UK: Pearson HCA 301, CHSS, AHD, SEMESTER II-2023-...

HCA 301 Leadership and management in healthcare setting CHAPTER 8 MOTIVATING AND DEVELOPING OTHERS Resource: Sullivan, E.J. & Garland, G. (2013), 2nd Edition. Practical Leadership & Management in Healthcare for Nurses and Allied Health Professionals. UK: Pearson HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 1 Learning Outcomes 1. Understand the role of motivation in determining employee performance.. 2. Apply motivation theories to analyze performance problems 3. Suggest practical ways of influencing employees to accomplish organisational objectives. 4. Explain the importance of staff development programs. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 2 Introduction The performance of individuals within an organisation determines how successfully an organisation operates. Important factors influencing performance are The skill and knowledge of the staff (ability) The commitment to the work to be done (motivation) Motivation derived from the Latin word “mover” which means “ to move.” Motivation is an important consideration for those who lead and manage. Why? Motivated people are more likely to be productive than are unmotivated workers HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 3 Introduction Historically, motivational theories were concerned with three things: what mobilises or energises human behaviour what directs behaviour towards the accomplishment of some objective how such behaviour is sustained overtime HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 4 Motivational Theories Content theories Emphasize individual needs or rewards that may satisfy those needs ◦ Marslow’s hierarchy ◦ Alderfer’s ERG ◦ Herzberg’s two factor ◦ McClelland’s needs Process theories Emphasize how motivation works to direct staff's performance ◦ Reinforcement ◦ Expectancy ◦ Equity ◦ Goal-setting HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 5 HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 6 Hierarchy of needs theory ▪Developed by Abraham Maslow. ▪Lower-order and higher-order needs affect workplace behavior and attitudes. Lower-order needs: ▪Physiological, safety, and social needs. ▪Desires for physical and social well being. Higher-order needs: ▪Esteem and self-actualization needs. ▪Desire for psychological growth and development. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 7 Hierarchy of needs theory HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 8 Hierarchy of needs theory HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 9 ERG theory Developed by Clayton Alderfer in 1971 Simplifies human needs into three essential categories: ◦ Existence needs — desires for physiological and material well-being. ◦ Relatedness needs — desires for satisfying interpersonal relationships. ◦ Growth needs — desires for continued psychological growth and development. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 10 ERG theory ▪Individuals can focus on multiple needs at the same time. For instance, a person might be motivated by their growth and relatedness needs simultaneously, without having their basic existence needs fully met Frustration-regression principle. ▪An already satisfied lower-level need becomes reactivated when a higher-level need is frustrated. Imagine an employee who is not given the chance to advance or grow in their job. According to ERG Theory, this person might start prioritizing their social relationships at work as a substitute. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 11 HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 12 Herzberg’s two-factor theory ◦ Developed by Frederick Herzberg. ◦ Hygiene factors: ◦ Elements of the job context. ◦ Sources of job dissatisfaction. ◦ Satisfier factors: ◦ Elements of the job content. ◦ Sources of job satisfaction and motivation. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 13 Herzberg’s two-factor theory HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 14 Herzberg’s two factor theory HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 15 Acquired needs theory Developed by David McClelland. ◦ People acquire needs through their life experiences. ◦ Need for Achievement (nAch) ◦ Need for Power (nPower) ◦ Need for Affiliation (nAff) HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 16 Acquired needs theory ◦ Need for Achievement (nAch) ◦ Desire to do something better or more efficiently, to solve problems, or to master complex tasks. ◦ People high in (nAch) prefer work that: ◦ Involves individual responsibility for results. ◦ Involves achievable but challenging goals. ◦ Provides feedback on performance. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 17 Acquired needs theory ◦ Need for Power (nPower) ◦ Desire to control other persons, to influence their behavior, or to be responsible for other people. ◦ Personal power versus social power. ◦ People high in (nPower) prefer work that: ◦ Involves control over other persons. ◦ Has an impact on people and events. ◦ Brings public recognition and attention. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 18 Acquired needs theory ◦ Need for Affiliation (nAff) ◦ Desire to establish and maintain friendly and warm relations with other persons. ◦ People high in (nAff) prefer work that: ◦ Involves interpersonal relationships. ◦ Provides for companionship ◦ Brings social approval. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 19 Comparison of Maslow’s, Alderfer’s, Herzberg’s, and McClelland’s motivation theories. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 20 Process theories of motivation Why & How motivation occurs? Emphasize how the motivation process works to direct a staff's effort into performance How people make choices to work hard or not. Choices are based on: ◦ Individual preferences. ◦ Available rewards. ◦ Possible work outcomes. Types of process theories: Equity theory. Expectancy theory. Goal-setting theory. Reinforcement theory HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 21 Equity theory ◦ Developed by J. Stacy Adams. ◦ Suggests a person perceives that one’s contribution to the job is rewarded in the same proportion that another person’s contribution is rewarded ◦ When people believe that they have been treated unfairly in comparison to others, they try to eliminate the discomfort and restore a perceived sense of equity to the situation. Perceived inequity. Perceived equity. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 22 HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 23 HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 24 Equity theory People respond to perceived negative inequity by changing … ◦ Work inputs. ◦ Rewards received. ◦ Comparison points. ◦ Situation. Managerial implications of equity theory ◦ Underpaid people experience anger. ◦ Overpaid people experience guilt. ◦ Perceptions of rewards determine motivational outcomes. ◦ Negative consequences of equity comparisons should be minimized, if not eliminated. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 25 Expectancy theory Developed by Victor H Vroom in 1964 According to the theory the behaviour we choose will always be the one that maximizes our pleasure and minimizes our pain ◦ Emphasizes the role of rewards and their relationship to the performance of desired behaviors ◦ Regards people as reacting deliberately and actively to their environment Individuals have different sets of goals and can be motivated if they believe: There is a positive correlation between efforts and performance. Favourable performance will result in a desirable reward. The reward will satisfy an important need. The desire to satisfy the need is strong enough to make the effort worthwhile. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 26 Expectancy theory Vroom suggests that three factors interact to create motivation. Expectancy is the perception of capability, or confidence in one's ability to do the work. Instrumentality is the belief that the consequences will actually materialise. Will the promotion happen? Valence is the perceived value (attractiveness or unattractiveness) of the consequence on offer (Money, status, promotion) A manager aiming to motivate an individual must first determine an individual's beliefs regarding their ability to carry out the task (expectancy), that their efforts will achieve the expected reward (instrumentality), and that the reward has value (valence). HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 27 Expectancy theory Motivation (M), expectancy (E), instrumentality (I), and valence (V) are related to one another in a multiplicative fashion: M=ExIxV If either E, I, or V is low, motivation will be low. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 28 Managerial implications of expectancy theory HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 29 Goal-setting theory ◦ Developed by Edwin Locke. ◦ Suggests it is not the rewards or outcomes of task performance that cause a person to expend effort but, rather, the goal itself. ◦ Properly set and well-managed task goals can be highly motivating. ◦ Motivational effects of task goals: ◦ Provide direction to people in their work. ◦ Clarify performance expectations. ◦ Establish a frame of reference for feedback. ◦ Provide a foundation for behavioral self-management. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 30 Goal-setting theory Key principles in the goal-setting process: ◦ Set specific goals. ◦ Set challenging goals. ◦ Build goal acceptance and commitment. ◦ Clarify goal priorities. ◦ Provide feedback on goal accomplishment. ◦ Reward goal accomplishment. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 31 Reinforcement theory Fundamentals of reinforcement theory ◦ Reinforcement theory focuses on the impact of external environmental consequences on behavior. ◦ Law of effect — impact of type of consequence on future behavior. ◦ Operant conditioning: ◦ Developed by B.F. Skinner. ◦ Applies law of effect to control behavior by manipulating its consequences. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 32 Operant conditioning HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 33 Reinforcement theory ◦ ◦ ◦ ◦ Behavior modification Behavior is learned through a process called operant conditioning. Behavior becomes associated with a particular consequence. Negative reinforcers are used to inhibit an undesired behavior. ◦ Punishment is a common technique. ◦ Extinction is another technique used to eliminate negative behavior. ◦ By removing a positive reinforcer, undesired behavior is extinguished. Shaping ◦ Involves selectively reinforcing behaviors that are successively closer approximations to the desired behavior Behavior modification works quite well. ◦ Provided rewards can be found that employees see as positive reinforcers, provided that such rewards are contingent on performance HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 34 Reinforcement theory Operant conditioning strategies: ◦ Positive reinforcement ◦ Increases the frequency of a behavior through the contingent presentation of a pleasant consequence. ◦ Negative reinforcement ◦ Increases the frequency of a behavior through the contingent removal of an unpleasant consequence. ◦ Punishment ◦ Decreases the frequency of a behavior through the contingent presentation of an unpleasant consequence. ◦ Extinction ◦ Decreases the frequency of a behavior through the contingent removal of an pleasant consequence HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 35 HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 36 Reinforcement theory Successful implementation of positive reinforcement is based on ◦ Law of contingent reinforcement ◦ Reward delivered only if desired behavior is exhibited. ◦ Law of immediate reinforcement ◦ More immediate the delivery of a reward, the more reinforcement value it has. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 37 Reinforcement theory Guidelines for using positive reinforcement: ◦ Clearly identify desired work behaviors. ◦ Maintain a diverse inventory of rewards. ◦ Inform everyone about what must be done to get rewards. ◦ Recognize individual differences when allocating rewards. ◦ Follow the laws of immediate and contingent reinforcement. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 38 Reinforcement theory HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 39 Role of reinforcement in motivation Schedules of reinforcement: ◦ Continuous reinforcement administers a reward each time a desired behavior occurs. ◦ Intermittent reinforcement rewards behavior only periodically. ◦ Acquisition of behavior is quicker with continuous reinforcement. ◦ Behavior acquired under an intermittent schedule is more permanent. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 40 Reinforcement theory Guidelines for using punishment: ◦ Tell the person what is being done wrong. ◦ Tell the person what is being done right. ◦ Match the punishment to the behavior. ◦ Administer punishment in private. ◦ Follow laws of immediate and contingent reinforcement. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 41 Integrated model of motivation ◦ Motivation leads to work effort that, when combined with appropriate individual abilities and organizational support, leads to performance accomplishment. ◦ The motivational impact of any rewards received for this performance accomplishment depends on equity and reinforcement considerations. ◦ Ultimately, satisfaction with rewards should lead to increased motivation to work hard in the future. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 42 Integrated model of motivation Managers who are effective leaders draw from their knowledge of various motivational theories to create the environment in which their staff derive satisfaction from the work itself. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 43 Staff development ◦ Every individual is unique and therefore will have different skills, ability and experience, and will come with a different educational background. ◦ Some people will not have developed all of the skills and knowledge necessary to perform at the expected level in the job. ◦ Even when competence is achieved in one setting' maintaining capability throughout one's career requires continuing education and staff development ◦ One of the ward manager or team leader's important responsibilities is to identify staff development needs and enable staff to learn throughout their careers. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 44 Staff development Life-long learning ◦ We live in a period of knowledge explosion, in which cultural and technological change is rapid (training may become out of date) ◦ The implications of this are twofold. First, learning must be viewed as lifelong learning, a continuous process. Second, learning must become a partnership between the learner and others so that learning occurs every day in an unstructured manner. ◦ The manager; identifies development needs and ensures that development and training are provided. ◦ The leader; responsible to ensure that what is learned is applied, and that standards and practices in work reflect best practice. ◦ Effective staff development usually results in higher productivity, fewer accidents or mistakes, better morale, greater pride in work, and better, safer patient care. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 45 Staff development Training and development needs assessment oIs the first step in achieving full capability for staff The ultimate purpose of staff development is to change practices and behaviours in clinical settings and are appropriate for staff development that; ◦ can be made more effective and efficient (e.g. a different way of managing patient appointments, a revised clinical procedure); ◦ need maintenance usually because they are not done very often in the normal course of work but are essential to be done well when called upon to do so (e.g. health and safety updates, cardiopulmonary resuscitation, hazardous materials and infection control); HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 46 Staff development Training and development needs assessment ◦ new employees need to learn (e.g. department-specific practices and standards); ◦ employees who are new to a role need to learn (e.g. a staff member who transfers to an out patient setting after working in the acute setting); ◦ are needed as a result of new knowledge or new technology (e.g. a new piece of equipment); ◦ have been identified as a result of information gathered from complaints, clinical incidents, audits and patient surveys. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 47 Staff development programs Induction ◦ A well-planned induction program reduces the anxiety that new employees feel when beginning the job. ◦ Supports consistency in practice and standards of care by imparting vital information to the new person about 'the way we do things here’. ◦ Provides social integration of the new person into the existing team, promoting effective team working, good communication and cooperation. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 48 Staff development programs Preceptor model for induction Preceptors ◦ should be selected based on their clinical competence, organisational skills, ability to work with others, good communication skills and interest in the success of others. ◦ The primary goal is to assist newly qualified staff to acquire the necessary knowledge and skills so that they can function effectively on the job. ◦ Teaches and supervises the new person to gain competence in any unfamiliar procedures and helps the new person to develop any necessary skills. ◦ Acts as a resource person on routine matters as well as policies and procedures HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 49 Professional development Professional development programmes come in many varieties, including workshops, university courses, conferences and online development. For effective adult education, the learner needs, at a minimum: information to be presented practice using the new knowledge and/or skill feedback about performance HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 50 Evaluation of staff development Is an investigative process to determine whether the education was cost-effective, the objective was achieved and learning was applied to the job. The purpose is to determine whether the educational program has a positive effect on job performance and to identify elements of the program that need improvement. Four evaluation criteria should be used: learner reaction; questionnaire completed at the end of a program (usefulness of the program's content, the effectiveness of the learning facilitator and the methods used) learning acquired; Knowledge is typically measured by paper-and-pencil/ computer-based tests Learning skills for the job assessed by return demonstration — can the learner demonstrate proper use of new equipment or accurately follow the steps in a procedure? behaviour change; Transfer from the classroom to the job is critical to the success of the educational programme. organisational impact. The objective can be expressed in terms of organisational impact, such as improved quality of care, a better health and safety record, a reduction in clinical incidents, and better patient and staff satisfaction at work HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 51 Ponder points ◦ Performance is determined by motivation and ability ◦ Motivational theories are classified as content theories or process theories. Content theories emphasise individual needs or the rewards that may satisfy those needs. Process theories emphasise how the motivation process itself directs individual performance. ◦ Staff development is intended to enhance specific job skills and knowledge, through methods such as induction, training, workshops and on-the-job instruction. ◦ The most important role of staff development is transferring knowledge in order to change work behaviour. ◦ Staff development programmes should enhance the organisation's effectiveness. HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 52 Useful links Maslow's Hierarchy of Needs in the Workplace https://www.youtube.com/watch?v=nASV5I_WG3k Herzberg Theory of Motivation https://www.youtube.com/watch?v=hSA7wQ5BgAQ Alderfer's ERG Theory https://www.youtube.com/watch?v=CuJmyPUtuGg McClelland - Theory of Needs https://www.youtube.com/watch?v=0Tie4rJmNFQ Expectancy Theory of Motivation https://www.youtube.com/watch?v=GIXUg6N-eOs&t=253s HCA 301, CHSS, AHD, SEMESTER II-2023- 2024 53