Absence Management Change Management

ABSENCE MANAGEMENT: MY PERSPECTIVE

Absence Management: My Perspective

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Table of Contents

The Problem ...................................................................................................................... 3

Vision and Desired Outcome ............................................................................................. 5

Barriers to Success ............................................................................................................. 8

Recommendations: Short-Term .......................................................................................... 9

Recommendations: Long-Term & Sustainability ............................................................... 10

Effect of the Changes ............................................................................................. 10

Sustaining Progress ................................................................................................ 11

Anchoring Change as Part of the Culture ............................................................... 11

Evaluation Tool ...................................................................................................... 12

Success Stories ....................................................................................................... 12

References ........................................................................................................................... 13

Absence Management: My Perspective

The Problem

In any organizational setting, the relevance of human resources cannot be overstated. It therefore follows that for an organization to accomplish its objectives and fulfill its mandate, it should have a skilled, committed, and effective workforce. There are a wide range of personnel-related factors that affect the effective delivery of various services in healthcare institutions. One such factor happens to be personnel absenteeism. The problem the researcher identified in the selected FQHC relates to a high rate of absenteeism – with the facility having to grapple with, amongst other things, unscheduled absences of staff. This effectively gets in the way of effective delivery of various services and results in longer patient wait times, a higher than desired rate of patient readmissions, and loss of revenue. Towards this end, the need to rein in the high rate of absenteeism at the facility has been identified. The causes of the high absenteeism rate were identified via the development and dissemination of an employee absenteeism questionnaire. To be more specific, the said questionnaire sought to establish the reasons employees cite for failure to report to their workstations for periods of time deemed beyond the acceptable time span. The key cause of personnel absenteeism was in this case identified as low employee morale. The other less prominent reasons cited on this front were sickness and familial commitments.

To determine the absence rate in the facility, the researcher made use of the formula;

Employee absenteeism rate (%) = (Number of days absent/Total working days) * 100

Data from the most quarter was utilized – more specifically for the months of July, August and September. During the said period, it was established that the facility had an absenteeism rate of 18%. If it is to continue being effective in the delivery of its mandate to those it serves, the facility ought to ensure that the rate of employee absenteeism is reduced. This is more so the case given that in comparison to the industry average, the current absenteeism rate happens to be rather high. Available data from the U.S. Bureau of Labor and Statistics (BLS) indicates that as of the year 2022, the absence rate in the healthcare practitioners and technical occupations among fulltime wage and salary workers stood at 4.1% (BLS, 2023). This is a much lower rate than that which the facility registers at present. With a reduction in employee absence rates, the facility is likely to witness positive outcomes on these fronts: decreased patient wait times, decreased rate of patient readmissions, and increased revenue.

One of the steps to successful change identified by Kotter and Whitehead (2010) happens to be increasing urgency. According to the authors, this has got to do with the identification of a big opportunity by a large number of persons – who then become highly motivated to embrace the said opportunity. In the present scenario, the goal will be to get the ball rolling by commencing dialogue about the present state of affairs and the need to institute measures aimed at reducing the rate of absenteeism. This helps ensure that all those involved ‘own’ the process and possess an intrinsic motivation to see the change through. According to Boyatzis, Smith, and Oosten (2019), research indicates that one way of ensuring that change is permanent is by ensuring that in addition to being intentional, it is also motivated internally. Towards this end, the facility’s key stakeholders will be provided with the data gathered from the computation of the employee absenteeism rate and employee absenteeism questionnaires. Next, the impact of such a high absenteeism rate will be highlighted – with specific references in this case being made to the impact the concern has had on the facility, i.e. with regard to longer patient wait times, a higher than desired rate of patient readmissions, and loss of revenue. The researcher will proceed to develop scenarios indicating what could happen in the future if the problem is not addressed, and the benefits that the facility stands to reap if the problem is addressed. There may also be need to ensure that the interests of all key stakeholders are understood, with an intention of demonstrating how these interests will be advanced or curtailed by the choice of action embraced. Interests mapping is of great relevance in efforts to bring the said stakeholders, and has been identified by Lax and Sebenius (2007) as a tool of effective negotiation. More specifically, in the words of the authors, “since your counterparts will say yes for their reasons, not yours, you need the maximum insight possible into how well their interests would be met by a deal versus their best no-deal option” (Lax and Sebenius, 2007, p. 3).

Available evidence indicates that employee absenteeism does indeed have a negative impact on healthcare organizations. As Cole and Kelly (2020) point out, workers left to cover for absent employees often end up being overworked, which results in burnout and ultimately, decreased employee morale. In their study on workload and burnout among those working in the healthcare realm, Portoghese, Galletta, Coppola, Finco, and Campagna (2014) make a finding to the effect that “burnout among health care workers is associated with high turnover rates and absenteeism due to sickness, relative ineffectiveness in the workplace, as well as low job satisfaction” (153). It therefore follows that, as has been indicated elsewhere in this text, unscheduled absenteeism at the facility gets in the way of effective delivery of various services, and results in loss in revenue, high staff turnover rate, and low morale. There is, thus, urgent need to rein in the problem of absenteeism at the facility.

Vision and Desired Outcome

To achieve the vision, the researcher identifies the need to boost employee morale. This is more so the case given that the employee absenteeism questionnaire, as has been indicated elsewhere in this text, has identified low morale as the key cause of personnel absenteeism at the facility. Towards this end, there will be need to apply methods and approaches that have been proven effective in diverse contexts in efforts to boost employee morale. The proposed approaches in this case are: promotion of a life-work balance among workers, embrace of a culture of teamwork within the facility, deployment of skill-enhancement training, and improved communication between those in positions of authority and workers at the facility.

Those who will act as guides for the proposed change will be carefully selected. This group, according to Kotter and Whitehead (2010), could comprise of “some people who have credibility with others, or have connections to the various parts of the organization, or leadership skills, or formal authority...” (182). Several key stakeholders will be invited, engaged and involved in the framing of the problem and possible solutions. These are inclusive of: facility management; staff i.e. healthcare providers including physicians, nurses, caregivers, etc.; federal and state government; and representatives from the underserved community/population. The members identified above were selected based on a wide array of considerations. To begin with, facility management was selected owing to the fact that it is a key custodian of the facility resources and is actively involved in planning and decision-making efforts. Given that members of staff are the ones to be impacted most by the proposed changes meant to stem absenteeism, there will be need to take into consideration their insights about the issue, i.e. with regard to the key contributors to the high rate of absenteeism. Involving staff members will also help stem resistance to change during the implementation of proposed solutions. Representatives from the underserved community would in this case help in the shaping of solutions as they possess key insights about the impact that health worker or caregiver unavailability has on the effective delivery of the various health services. The federal and state governments could also be deemed key external stakeholders owing to the fact that the facility receives state and federal grants. They could, thus, be deemed a crucial change guide.

According to Kotter and Whitehead (2010), it is the guiding coalition, such as the one that has been identified above, that comes in handy in efforts to not only create a change vision, but also adapt or modify strategies. In developing the vision, there will be need to first outline the core values that deemed crucial to the proposed change. These have been identified as inclusion/inclusivity, effective communication, and teamwork. Next will be highlighting the desired state of the facility following the implementation of change. With a reduction in employee absence rates, the facility is likely to witness improvements and positive outcomes on multiple fronts including; decreased patient wait times, decreased rate of patient readmissions, and increased revenue. Third, in seeking to execute the vision, a strategy will be formulated. It is important to note that for successful execution, the change coalition needs to familiarize itself with the vision.

Kotter and Whitehead (2010) indicate that to ensure that nobody is left behind by the change wagon, there is need for the coalition to communicate the vision in an effective format. Thomas and Inkson (2009) refer to communication as an essential social experience building block and restates its relevance on multiple engagements such as teamwork and negotiations. Some of the effective formats of communication that have been identified by Kotter and Whitehead (2010) are inclusive of; posters, one-on-one conversations, e-mail, etc. As Philips and Klein (2022) point out, how viable a strategic vision is depends on not only how effectively it was developed, but also on whether it is communicated in a constructive manner. In the words of the authors, communication has got to do with “the process of sharing your vision with your team and stakeholders, explaining its rationale, benefits, and expectations” (Philips and Klein, 2022, p. 190). In this context, the following approaches will be embraced in communicating the vision: group presentations, team meetings, and notice boards.

Barriers to Success

Kotter and Whitehead (2010) point out that obstacles are largely inevitable in efforts to bring about change. As the authors further indicate, these barriers could take various forms. According to the authors, the guiding coalition must ensure that these barriers are eliminated. A number of barriers have been identified by the researcher as having the highest potential of inhibiting the successful attainment of the outcome desired. The first barrier identified is managerial attitudes. It was discovered that those charged with decision making at the facility often formulate and implement initiatives without the insight and/or input of subordinate staff. This could be seen as lack of empathy, which has been described by Goleman (1998) as one of the key characteristics of good leadership, on the part of management. Seeking the insights of all those involved in this undertaking is crucial in efforts to ensure that the vision and desired outcomes are achieved. This is more so the case given that concerns and reservations can be addressed – hence ensuring that everyone involved is fully involved and committed. This also helps ensure that resistance to change is eliminated or minimized. To eliminate this barrier, communication lines between management and subordinates will be opened and the need for regular communication restated. This could be achieved by implementing weekly meetings between subordinate staff and departmental heads. A robust feedback mechanism that favors a two-way approach to communication can also be implemented in this case. In an organizational setting, all kinds of feedback (positive or negative) should be embraced (Forbes Coaches Council, 2021).

The second barrier is insufficient resources. As is the case with various organizational initiatives, the implementation of the vision at the facility is likely be a resource-intensive initiative. At present, the facility has other initiatives competing for the very same resources. To address this challenge, the facility will reach out to donors and funding sources in the private sector.

The third barrier is poor cross-functional teamwork. The facility grapples with poor cross-functional teamwork. This is more so the case when it comes to effective collaboration between physicians, nursing teams, and caregivers. This is not a problem unique to this facility alone. Crocker, Cross, and Gardner (2020) point out that “most organizations don’t manage internal collaborations productively” (44). Philips and Klein (2022) are categorical that lack of collaboration and team spirit could get in the way of the successful attainment of desired outcomes in any change initiative. With this in mind, deliberate measures will in this case be taken to improve cross-functional teamwork. This could be achieved by identifying and addressing factors and get in the way of the entrenchment of a collaborative culture, and rewarding collaboration. The creation of a trusting environment, as Crocker, Cross, and Gardner (2020) observe could also help in the advancement of collaboration within an organization.

Recommendations: Short-Term

Recommendations

In the words of Kotter and Whitehead (2020), “empowered people, feeling a sense of urgency and guided by the vision and strategies, focus their actions on achieving a continuing series of visible and unambiguous successes, starting as quickly as possible” (184). To a large extent, the relevance of these short-term wins cannot be overstated. This is more so the case given that as Kotter and Whitehead (2010) indicate, they come in handy in efforts to gain momentum. There are two short-term wins that have been identified in this case. These are expected to be realized within a span of one year.

The first win relates to an increase in employee engagement levels. This has got to do with the extent to which workers at the facility feel emotionally and mentally connected to the organization as a whole and to the tasks they are mandated to perform on a regular basis. The measure of success will in this case be an increase in the extent to which the said workers feel involved and valued. This could be gleaned from the results of surveys that can be undertaken on a quarterly basis. The second win will be in relation to enhanced teamwork. Here, workers at the facility will be able to work seamlessly with others in the facility’s various departments and leverage each other’s skills and competencies to better serve the needs of patients. Success could in this case be assessed by evaluating the ability of teams to accomplish set goals in an efficient and timely manner.

Recommendations: Long-Term & Sustainability

Effect of the Changes

The proposed change initiative will be expected to benefit the facility on multiple fronts in the long-term, i.e. beyond one year. One effect of the changes will be decreased rate of employee absenteeism. Thus, it is expected that the employee absenteeism rate will decrease following the implementation of the change initiative. The goal in this case is to attain a rate below the industry (healthcare practitioners and technical occupations) average of 4.1%. Another effect will be improved performance. There are a wide range of indicators that could be used to measure performance on this front. In the present scenario, the performance measures that have been deemed to be of great relevance, as they have been negatively impacted by the significant rate of absenteeism are: patient wait times, rate of patient readmissions, and revenue. Thus, it is expected that the changes instituted will have a positive impact in terms of decreased patient wait times, reduced rate of patient readmissions, and increased revenue.

Sustaining Progress

Kotter and Whitehead (2010) are categorical that there is an ever-looming danger of complacency with every success – especially early success. This, according to the author, should be avoided. With this in mind, there will be need to ensure that victory is not declared prematurely in the present undertaking. Following each win will be an assessment of what went according to plan and what could be learnt from the same to improve chances of future successes. There will also be need to assess what went wrong at every stage so as to establish what needs to be adapted and/or improved. The concept of kaizen will also be embraced so as to sustain momentum.

Anchoring Change as Part of the Culture

Kotter and Whitehead (2010) observe that at first, a new way of doing things happens to be rather fragile. This, according to the authors, is more so the case given that what has been done repeatedly for a long time could have taken root and, thus, is likely to pull an organization back to ‘default.’ It is for this reason that there is need to ensure that change is in this case anchored as part of the culture. In the words of Kotter and Whitehead (2010), “when a changed culture emerges, it provides the ultimate glue... stability is achieved, and even the gale winds of tradition do not overturn the new organizational behavior” (185). With this in mind, there will be need to repeatedly engage all stakeholders on the progress made on a constant basis. Further, new hires will be oriented towards the new ideals from the onset. This could be done by way of coaching which Boyatiz, Smith and Oosten (2019) note is short-term oriented, and mentoring which the authors further indicate is long-term oriented. There may also be need to ensure that the contributions made by members of the change coalition is ‘immortalized’, i.e. by awarding them officially for their efforts. By ensuring that every person remembers their efforts, the change agenda will remain to be part of the overall organizational identity. The change vision will also be constantly communicated going forward, i.e. in the relevant facility briefings and get-togethers. Cole and Kelly (2020) observe that “constant communication of the change vision is imperative in ingraining change in the culture of an organization” (174).