Management and Motivation

1. Management and Motivation BUS443 Dr. Abad Alzuman

2. Learning Objectives • Understanding the concept of motivation, particularly who and what motivates employees. • Offer insights into reason why motivation is important. • Provide an overview of the different theories of motivation. • Identify extrinsic and intrinsic factors that impact motivation. • Assess misconceptions about motivation • Suggest strategies to enhance employee motivation.

3. Defining Motivation-The Concept Motivationis defined as “the act or process of motivating.” The definition raised a coupe of questions: • What are rewards? • Who motivates employees? • Is everyone motivated?

4. Defining Motivation-The Concept What are rewards? Rewards can take two forms. They can be either: • Intrinsic/Internal rewards: are driven from within the individual. For a healthcare employee, this could mean taking pride and feeling good about a job well done (e.g. providing excellent patient care) • Extrinsic/External rewards: refers to those reinforcements that are given by another person (e.g. a healthcare organization giving bonuses to exceptional workers)

5. Defining Motivation-The Concept • Who motivates employees? Managers do exert as motivators providing various types of incentives ,but the real motivation to act comes from within the individual. • Is everyone motivated? It is critical to understand that not all employees are motivated.

6. Why Motivation Matters • Healthcare organizations face pressure externally and internally. External challenges such as aging population, increases in market competition, and increases in the cost of providing care. Internally, healthcare system faces challenges such as shortage of healthcare workers, increasing accreditation requirements, and insuring patient safety.

7. Why Motivation Matters • These pressures can lead employees to feel burned out, frustrated, and overworked. • Healthcare managers must create a work environment in which employees are happy at their job and motivated. • Therefore, motivation matters because: • Employees who are motivated are happier, work harder, and more productive.

8. Why Motivation Matter 2. Managers who understand employees’ needs experience a higher level of motivated behavior from their employees. 3. Once a need is satisfied, its impact as a motivator lessens. 4. Motivated and engaged employees experiences better outcomes and provide the organization with competitive advantage.

9. History of Motivation Motivation is not a new concept Theories of Motivation Motivational theories include theories that focus on motivation being a function of:

10. Theories of Motivation • Employee needs of various types (Needs-based theories of motivation) • Extrinsicfactors (Extrinsic factor theories of motivation) • Intrinsic factors (Intrinsic factor theories of motivation) • Management (Management theories of motivation)

11. Needs-Based Theories of Motivation • Maslow's Hierarchy of needs: Malsow (1954) proposed a “hierarchy of needs” that progresses from the lowest level needs to the highest level of self-awareness and actualization. • Once each level has been met, the theory is that an individual will be motivated by and strive to progress to satisfy the next higher level of need. • The five levels in Maslow's hierarchy are: • Physiological needs (including food and water), • safety needs (including shelter and safe environment),

12. Needs-Based Theories of Motivation • Belonging needs (including desire for social interaction and friendship), • Self-esteem needs (including status and recognition), and • Self-actualization needs (including the desire for achievement, personal growth and development). • The movement from one level to the next was termed “satisfaction progression” by Maslow, and it was assumed over time that individuals were motivated to continuously progress upward through these levels. However, most individuals don’t view their needs in this way, making this approach to motivation a bit unrealistic.

13. Needs-Based Theories of Motivation • Alderfer’s ERG Theory: The three components identified by Alderfer (1972) in his ERG theory drew upon Maslow's theory but also suggested that individuals were motivated to move forward and backward through the levels in terms of motivators.He reduced Maslow's levels from 5 to the following 3: • Existence: which related to Maslow's first two needs, thus combining the physiological and safety needs into one level • Relatedness: which addressed the belonging needs and, • Growth: which related to the last two needs, therefore, combining self-esteem and self-actualization. • Alderfer also added his frustration-regression principle postulated that individuals would move in and out of the various levels • This theory is suggested to be more logical to many individuals.

14. Needs-Based Theories of Motivation • Herzberg’s Two-Factor Theory • Herzberg (2003) further modified Maslow’s needs theory and narrowed it down to two areas of needs that motivated employees. These were termed: • Hygienes: There emphasized lower-level motivators such as working conditions, salary, status, and security. • Motivators: These emphasized higher-level factors such as achievement, recognition, and growth. • Herzberg’s is easily understood theory that suggests the individuals have desires beyond the hygiene.

15. Needs-Based Theories of Motivation • McClelland’s Acquired Needs Theory: The idea here is that needs are acquired throughout life. That is, needs are learned or developed as a result of one’s experiences (McClelland, 1985) • This theory focuses on three types of needs: Need for achievement: which focuses on the desires for success, mastering tasks, and achieving goals. Need for affiliation: which focuses on the desire for relationships and associations with others. Need for power: which focuses on the desires for responsibility for, control of, and authority over others. • All four of these theories are helpful in understanding employee motivation on the basis of needs. However, other theories of motivation also require consideration.

16. Extrinsic Factor Theories of Motivation • Theories that are based on extrinsic factors focus on external factors and their role in understanding employee motivation. • Reinforcement Theory:Skinner (1953) studied human behavior and proposed that individuals are motivated when their behaviors reinforced. His theory is comprised of four types of reinforcement. The first two are related to achieving desirable behaviors, while the last two are related to undesirable behavior:

17. Extrinsic Factor Theories of Motivation • Positive reinforcement: relates to taking actions that rewards positive behaviors; • Avoidance learning: occurs when actions are taken to reward behaviors that avoid undesirable or negative behaviors (referred to as negative reinforcement); • Punishment: relates to actions designed to reduce undesirable behaviors by creating negative consequences for the individual; and • Extinction: includes the removal of positive rewards for undesirable behaviors Criticism: the reinforcement theory fails to account for employees’ abilities to think critically and reason, both of which important aspects of human motivation. It doesn’t account for the higher level of cognition that occurs in humans

18. Intrinsic Factor Theories of Motivation • Theories that are based on intrinsic factors focus on internal thought processes and perceptions about motivation. • Some of these theories are: • Adam’s Equity Theory: which proposes that individuals are motivated when they perceive that they are treated equitably in comparison with others within the organization (Adams, 1963). • Vroom’s Expectancy Theory: which addresses the expectations of individuals and hypothesizes that they are motivated by performance and the expected outcomes of their behaviors (Vroom, 1964). • Locke’s Goal-setting Theory: which proposes that by establishing goals individuals are motivated to take actions to achieve those goals (Locke & Latham, 1990). Criticism: While each of these intrinsic factor theories deals with a particular aspect of motivation, it seems unrealistic to address them in isolation, since these factors are important to employee motivation at one time or another.

19. Management Theories of Motivation • Other approaches to motivation are driven by aspects of management. Most famous theories are the following: • Scientific Management Theory: Frederick Taylor focused on studying job processes, determining the most efficient ways of performing them, and in turn rewarding employees for their productivity and hard work. This theory assumes that people are motivated and employee pay should be based on the amount and quality of work performed. • Criticism: This approach is limited by the capacity of employees to continue to increase the quantity of work without sacrificing the quality.

20. Management Theories of Motivation • McGregor’s Theory X and Theory Y: this approach draws on the work of Herzberg and develops human resources management approach to motivation. The theory first classifies managers into two groups: Theory X managers view employees as unmotivated and disliking work. The manager’s role is to focus on the hygiene and to control and direct employees. It assumes that employees are mainly concerned with safety. In contrast, Theory y managers focus on Herzberg motivators and work to assist employees in achieving these higher levels. • Criticism: researchers have found that approaching motivation from this either/or perspective is short-sighted.

21. Management Theories of Motivation • Ouchi’s Theory Z: This theory is rooted in the idea that employees who are involved in and committed to the organization will be motivated to increase productivity. Theory Z managers provide rewards, such as long term employment, promotion, and other techniques to motivate employees (Ouchi, 1981). • While all these theories are important in understanding management and motivation, most managers use a combination of needs, extrinsic, intrinsic, and management factors to help motivate employees to achieve effectiveness within the organization.

22. A Bit More about Incentives and Rewards • Extrinsic rewards include: • Money • Benefits (e.g. health insurance ) • Flexible schedules • Job responsibilities and duties • Promotions • Change in status • Supervision of others • A good boss • A strong leader • Other inspirational people • A nurturing organizational culture

23. A Bit More about Incentives and Rewards • There are five types of intrinsic rewards summarized by (Manion, 2005) include: • Healthy relationships: in which employees are able to develop a sense of connection with others in the workplace. • Meaningful work: where healthcare employees feel they make a difference in people’s lives. Making their jobs more interesting. • Competence: where employees are encouraged to develop skills that enable them to perform at or above standards. • Choice:where employees are encouraged to participate in the organization in various ways such as expressing their opinions and sharing in decision making. • Progress: where managers find ways to hold employees accountable, facilitate their ability to complete their assigned tasks, and celebrate when progress is made toward completing important milestones within a project.

24. Misconceptions about Motivation and Employee Satisfaction • Managers tend to have many misconceptions about motivation: • Although I’m not motivated by extrinsic rewards, others are. • All motivation is intrinsic • Some people just are not motivated • People are motivated by money • Motivation is manipulation • One-size-fits-all reward and recognition programs motivate staff • Motivational people are born, not made • There is one kind of employee satisfaction

25. Motivational Strategies • There are wide array of strategies for managers to use to help motivate employees: • Expect the best: people live to the expectations they and other s have of them. • Reward the desired behavior: make sure that rewards are not given for undesirable behaviors and be sure to use many different types of rewards to achieve the desired outcomes (e.g. thank you note) • Create a “FUN (Focused, Unexpected, and Novel) approach”: using money for a variety of creative employee rewards (e.g. gift certificates). • Reward employees in ways that enhance performance and motivate them: money is better spent on true rewards for specific types of performance. • Tailor rewards: finding more creative ways to reward employees.

26. Motivational Strategies • Focus on revitalizing (energizing) employees: motivation is diminished when employees are working on overload schedules. Managers can help to motivate employees by encouraging them to eat right and take real vacations and slow down. • Find creative ways to obtain information and recognize excellence in employees: recognition can be provided to individual employees who provide excellent services (e.g. through patient satisfaction surveys) • Get subordinates to take responsibility for their own motivation: this can be achieved by managers taking steps to deal with problem employees. • Play to employees’ strength, promote high performance, and focus on how they learn: this requires managers to know their employees’ strengths and weaknesses and find ways to capitalize on the ways those employees learn.

27. Case Study • It is Sunday night in Labor and Delivery. An obviously pregnant full-term mother, Mrs. Ford, presents herself, saying her doctor, Dr. Jones, told her to come to the hospital to deliver her baby. The mother tells Ms. Smith, the nurse manager of L& D, that the doctor has informed her that the baby has anencephaly, and she understands that the baby will not be expected to live very long after delivery. Ms. Smith is very concerned, since the unit did not receive any prior word about Mrs. Ford coming to the hospital, nor did the unit receive the prenatal record, which is required to be submitted by the 36 th week of pregnancy per hospital policy. Ms. Smith proceeds to call Dr. Jones to ask for orders and to get more information regarding Mrs. Ford's condition.

28. Dr. Jones gets very upset with the phone call, says that he just completed a delivery and was trying to get a couple hours of sleep before he came to the hospital to deliver Mrs. Ford's anencephalic baby. He yells that he will be there shortly now that she has woken him and tells her to start prepping for a C-section and hangs up. Ms. Smith realizes the survivability of the baby is not possible and that no measure will be able to save the life of the baby once delivered. Ms. Smith understands that in these cases, it is the nurses' job to use whatever measures necessary to make the baby and mother as comfortable as possible so the baby can have a dignified death. Ms. Smith is agitated at Dr. Jones's response. First, he was obviously in the wrong in not notifying the hospital about Mrs. Ford coming in, let alone not sending in the prenatal record. When Dr. Jones enters the unit, he is obviously upset but gets even more upset when Ms. Smith questions why he intends to do a C-section. Ms. Smith could tell that Mrs. Ford was not expecting a C-section based on her comments to her. Dr. Jones dismisses Ms. Smith's comments about

29. doing a vaginal delivery and begrudgingly he does do a vaginal birth, complaining during it about how he will now have to reschedule his whole day, since it will take much longer than a C-section. The baby is delivered. It is clear that the baby is anencephalic and has very poor circulation. The nurses wrap the baby in blankets and hand the baby to Mrs. Ford for her to view. Dr. Jones says there is no reason to call in a neonatologist and that this baby will obviously only live a few hours at most. Mrs. Ford requests to have her baby fed. Dr. Jones says it is okay to do that and requests the baby be put on a cardio-respiratory monitor with an IV tube for feeding. Ms. Smith is concerned about this, since she knows it will prolong the life of the child, and this would be considered futile care. She wonders how to handle this concern since she realizes Dr. Jones will probably yell at her if she is to question his orders again.

30. What is your opinion of Dr. Jones's emotional intelligence (EI)? Based on a scale of 1-10, with 1 being lowest, how would you rate Dr. Jones? Why? • Repeat this process for Ms. Smith, the nurse manager. • Do you think there should be any consequences for Dr. Jones as a result of his behavior? What can be done? • Should Ms. Smith question Dr. Jones's orders for feeding the terminal baby? How would she do this? • What about the patient, Mrs. Ford? What is her stake in all this? Should she get involved in the obvious conflict occurring around her? • What should the hospital do to try to educate the staff about emotional intelligence? Explain your answer.