Engagement: The Key to a Culture of Well-Being

Rosie Ward, Ph.D., MPH, CHESCertified Intrinsic Coach®

Health Management Services ManagerRJF Agencies, Inc.

Health Promotion LIVE July 8, 2010

Health / Well-Being SafetyEngagement

Intrinsic Values / Intrinsic Capacity

Culture & Environment

Moving from Good to Great• “A good hockey player

skates to where the puck is. A greathockey player plays where the puck is going to be.” ~Wayne Gretsky

What We Perceive as “Wellness”

Healthy WeightEating Fruits

Normal Blood Pressure Non-SmokerNormal Glucose

Normal Cholesterol

Eating Vegetables

Physically ActiveGetting Enough

Sleep

Low Fat, High Fiber Diet Wear SeatbeltsUse Sunscreen

Use alcohol in moderation Manage Stress

Regular Preventive CareLow Number of Sick Days

When EEs Feel “Unwell”

Company Doesn’t Care

Too much to do Co-workers Don’t Care

No time for me

Don’t like what I’m doing

OVERWHELMED

Unrealistic Company Demands

Pulled in too many directions at

work & home

Feel Trapped in my job

Worried about layoffs

All work and no play

Not enough resources

Issues with Traditional Health Promotion

• Focused on behavioral management and “getting”people to change.

• Little evidence that short-term changes in attitudes and behaviors resulting from traditional HP programs lasts after the program ends.

• Stand-alone behavior change programs have proved to be relatively ineffective.

Sources: Jon Robison, Ph.D. (2009); O’Donnell, AJHP (1997); Edington, Zero Trends (2009)

Focus on Culture

• Current and desiredculture must be defined.

• OCAI (Organizational Culture Assessment Instrument)

• What to:– do more of– start & stop doing

“A Culture of Health”

“The set of shared attitudes, values, goals, and practices that characterize an institution, organization or group; and that members use to cope with their world and with one another.”(Webster’s Dictionary)

• Is NOT simply a checklist of health-focused activities or health-conducive facilities a company has.

• Culture is more about the meaning of what people do than about the doing.

What is Being Assessed?1) Would you describe your work as monotonous?

2) How satisfied are you with your job?

3) How tense or anxious have you been in the past week?

These three questions are part of a screening that is more than 80% accurate at predicting what?

It’s BIGGER Than Health!A Complete Picture of What Impacts

Organizational Effectiveness

What Interferes with Productivity?

31%

28%

26%

19%

18%

18%

15%

12%

9%

10%

7%

6%

5%

5%

4%

3%

5%

3%

2%

2%

2%

0% 10% 20% 30% 40% 50%

Low motivation

Poor communication

Low morale in co-workers

Not enough training

Personal Issues

Personal Health Problems

Family Issues

Sometimes Frequently All the Time

Source: Human Capital, Motivation, & Productivity, Health as Human Capital Survey (2007)

47%

25%

3 Companies, 3 Medical Cost StoriesPredicted Medical Costs

$3,536

$2,705

$4,981

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

Company #1 Company #2 Company #3

Most Wellness

Healthiest

Source: Wendy Lynch, PhD., HCMS Group (2007)

Employees See Through Gimmicks

Individual Well-Being

5 Universal, Interconnected Elements:

• Career Well-Being• Social Well-Being• Financial Well-Being• Physical Well-Being• Community Well-Being

• 25-year strategic partnership to measure Americans’well-being– 1,000 surveys completed per day– Create the “Dow Jones Industrial Average” for well-being– Over 709,000 completed as of 12/31/2009

• Gallup = communities, states, countries• Healthways = health plan and employers

Impact of Negative Work Environment

Source: Gallup-Healthways Well-Being Index – Oct. 2008 Results

• Elements of negative work environment:– Dissatisfaction with job– Authoritative rather than collaborative leadership– Lack of trust and openness at work – Lack of focus on individual strengths

• Having any one of these four negative factors present drains well-being– Employers eliminating these negative factors will see one

of the greatest improvement in well-being scores and return on employee investment

Impact of Work Environment & Health

Source: Gallup-Healthways Well-Being Index (Oct. 2009)

Days Unable to Perform Usual Work Activities Per Yearby Number of Disease Conditions for Each Individual by

Type of Work Environment (Positive/Neutral or Negative)

13.520.1

52.7

68.9

0

20

40

60

80

1-3 conditions 4+ conditions

Positive/Neutral Negative

↑ 6.6 Days/yr↑ 16.2 Days/yr

Work and Well-Being• “U.S. workers hit a record low of well-being on the

job in October of last year. In 2009, on average, only 49 percent of all Americans provided positive responses in the four categories of work environment that we measure. These categories include job satisfaction, a trusting work environment, collaborative supervision and an opportunity to use their strengths each day.”

Source: John Harris, Chief Wellness Officer, Healthways

Life Evaluation & Well-Being• Significant contributors to well-being in workers

– Learned or did something interesting yesterday– Laughed a lot yesterday– Satisfaction with job– Social time with family and friends– Exercised 30 minutes each day in past week

• Significant detractors from well-being in workers– Lower health function than others of similar age– 2+ days in past 30 when illness prevented usual activities– Experienced anger yesterday

Source: Gallup-Healthways Well-Being Index – Oct. 2008 Results

The Missing Component…

• Employee Engagement!– Positive employee engagement is the key to successfully

reducing or at least stabilizing health care costs.

– Engagement is NOT telling people what to do.

• Engaged employees are more productive, profitable, safer, create stronger customer relationships, and stay longer with their company than less engaged employees.

Engagement Defined• Engaged: work with passion and feel a profound

connection to their company. They drive innovation and move the organization forward.

• Not Engaged: essentially “checked out”; are sleepwalking through their workday, putting time – but not energy or passion – into their work.

• Disengaged: actively act out their unhappiness and undermine what their engaged coworkers accomplish every day.

Source: The Gallup Organization (2006)

Organizational Well-Being

• Productivity, profitability, retention and satisfaction all linked to Engagement.

• Engagement occurs when EEsknow what’s expected of them, feel valued, get to leverage their strengths, and have quality relationships at work.

Employee Engagement & Workplace Injuries

• Workgroups in bottom 25% of engagement average 62% more accidents than workgroups in top 25% of engagement.

• Building on employee strengths and improving engagement substantially impacts productivity, employee retention and safety, and customer experiences.

Source: Gallup Consulting (2007)

Giving <100% Effort at Work

50%

38%

25%

19%

13%

13%

0% 10% 20% 30% 40% 50% 60%

Negative Work Environment

Personal Values not Supported

Lack of Interest in Certain Job Functions

Feeling Sick

Stress in Personal Life

Work-Related Fatigue

Source: Rosalind Ward, Ph.D. (2008)

Under what conditions do you give less than 100% at work?

Giving >100% Effort at Work

75%

69%

38%

31%

25%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Personal Interest/Enjoyment in Work

Positive Work Environment

Personal Values are Supported

Commitment to Clients/Co-workers

Meeting a Short-Term Need

Source: Rosalind Ward, Ph.D. (2008)

Under what conditions do you give more than 100% at work?

Engagement & Physical Health

Source: Crabtree, Gallup Management Journal (2005)

Engaged Not Engaged Actively Disengaged

Effect of Work Life on Health

62%39% 22%

30% 54%

12%62%

12%

30%23%

25%

2% 1% 1%

Disengagement & Mental Well-Being

4.6%

6.4% 6%7.6%

8.8%10.4%

Engaged Not Engaged Actively Disengaged

% Dx with Depression Over the Next Year

% Dx with Anxiety Over the Next Year

Source: Robison, Gallup Management Journal (2010)

1.7x Increase for Disengaged EEscompared to Engaged EEs

Engagement & the Recession• Employee engagement dropped 9 percent overall.

• Engagement dropped 25 percent among top performers.

Source: Watson Wyatt Worldwide (2009)

When Engagement Occurs

• Emotionally connected to others• Cognitively stimulated• Know what is expected of them• Have what they need to do their work• Perceive they are part of something significant with

co-workers they trust• Have chances to improve and develop

Source: Harter, Schmidt & Hayes, Journal of Applied Psychology (2002)

Take Home Message:

If the nature of the work at your company is not fulfilling for most people, provide opportunities to find meaning and connection to their work with what is important in their lives outside of work.

How People Make Behavior Changes

Changing the Change Paradigm

Brain: Friend or Foe?

Prefrontal Cortex Basal

Ganglia

Cognitive Challenges with Change

• Change itself amplifies stress & discomfort.

• Carrot & Stick don’t succeed in the long run.

• Brains = pattern-making organs with innate desire to create meaningful connections.

• People can detect the difference between authentic inquiry and persuasion efforts.

• Change requires changing mental maps through creating moments of insight.

Source: Rock & Schwartz, “The Neuroscience of Leadership”, Strategy + Business (2009)

Sustained Behavior ChangeCognitive Coaching Research (Stanford)

Instruction Only

Add Demonstration

Add Practice

Add Feedback

Add Coaching

New Knowledge

New Skill Developed

New Behavior at Work

90%

90%

90%

90%

90-100%

25%

50%

90-95%

90-95%

90-100%

5%

5%

5%

5%

95%

Types of Motivation• Intrinsic Motivation:

– “People doing an activity because they find it interesting and derive spontaneous satisfaction from the activity itself.” (Gagne & Deci, 2005)

• Extrinsic Motivation:– People are driven to do something due to pressure

or tangible rewards rather than for the fun or interest of it.” (Petri, 1991)

Extrinsic MotivationDo Extrinsic Rewards

Undermine Intrinsic Motivation?

We can’t motivate others; we can get compliance, but the desire has to come from within.

Businesses Ignore the Evidence

• Carrot & Stick (especially $$$) not only ineffective but HARMFUL

• True Motivation = Autonomy; Mastery; Purpose.

Results in higher EE satisfaction and stronger results

Baseline Rewards

• Baseline Rewards must be adequate & equitable.– Salary, contract payments, benefits, a few perks, etc.

• Without - focus will be on the unfairness of the situation and anxiety over the circumstance.– No motivation at all.

• Removing barriers increases actions.

Source: Drive, Daniel Pink (2009)

Escalating Zero Point2002 HA Participation:• $50 = 50-60%• $100 = 60-70%• $200 = 80%

2006 HA Participation:• $100 = 50-60%• $200 = 60-70%• $400 = 80%

Source: StayWell Health Management (2002, 2006)

Heavy Use of Extrinsic Incentives → It costs more over time to get the same result.

“Insanity: doing the same thing over and over again and expecting different results.”

~Albert Einstein

Values Thinking

• Hartman’s hierarchy of values:Intrinsic (I) – value for individual uniquenessExtrinsic (E) – strategy / expertiseSystemic (S) – it ought/should be this way

• I > E > S – people are more valued than things; things are more valued than mere ideas of things or people.

Sources: Hartman (1967) & Pomeroy (2005)

Proprietary & Confidential.© 2010, Rosalind Ward, Ph.D.

All rights reserved.

Values Thinking in LifeWorld / Work View:• (I) – people have value

independent of roles, accomplishments; people > tasks

• (E) – task-focused; people = means to get things done.

• (S) – idea-focused; people viewed in terms of our ideas of how they & they world SHOULD be.

Self-View:• (I) – I value my uniqueness;

clarity of self independent of roles, etc.

• (E) – I view myself in terms of my roles

• (S) – I view myself as a “cog in the wheel”

Sources: Hartman (1967) & Pomeroy (2005)

I,E,S in Organizations• Judgment Index™ (C. Stephen Byrum, Ph.D.)

– Uses HVP to measure strength of judgment, stress indicators, burnout indicators, hiring, morale/engagement, etc.

Vs.

www.judgmentindex.com

Outcomes

Part 1 –Work Side

Part 2 –Self Side

Outcomes

Part 1 –Work Side

Part 2 Self Side

Value of Increased Intrinsic Capacity• Builds RESILIENCY

– Stress / lack of coping and resiliency = #1 cause of poor judgment

• Self-side coping / resiliency significantly related to job satisfaction and affective commitment.

• Also strengthens internal systemic (clarity of life direction).

Sources: Byrum, Ph.D. (2009) & Ward, Ph.D. (2008)

Fostering Intrinsic Motivation• Having goals and rewards that are meaningful to

people.

• Having learning/activity that is important to people.

• When learning/activity helps people obtain valued accomplishments.

• When learning/activity helps people integratethemselves with the world, with others, and promotes self-awareness.

Sources: Brandt (1999) & Chance (1992)

Shifting Our ApproachYesterday’s Approach

HA

Biometric Screenings

Incent Behaviors

Limited in scope; lacking in sustainability

Biometrics Optional

Emotional Well-Being

Physical Health

Cognitive Stimulation

Increasing I>E>S

Work Environment

Ind. & Org. Assessment

Engagement & Sustainability

Today: Organizational Well-Being

Results Only Work Environment

• Teamwork, morale & engagement increase

• 35% avg. increase in productivity

• Up to a 90% decrease in voluntary turnover rates

• Healthier, less stressed employees

ROWE Considerations

• Trust – trust people to deliver results & hold accountable

• Empowerment – EEs manage work responsibilities & schedules

• Leadership – focus on results rather than how results are achieved

• Federal Government now piloting ROWE

A Culture of Engagement

• Truly engage people in the change process.

• Customize programs based on where the individual is and what is most important to him/her.

• Change requires leaders to recognize, encourage and deepen their team’s insights.

• Transform the culture through I>E>S!

Moving Upstream

Wellness

Behavior

Emotional State

Thinking Skills

Health / Well-Being SafetyEngagement

Intrinsic Values / Intrinsic Capacity

Culture & Environment

What new thinking have you had today that you want to apply at your organization?

Health Management Services Manager, RJF Agencies, Inc.www.rjfagencies.com; wardr@rjfagencies.com

Dr. Rosie Wardwww.DrRosieWard.com; rosie@drrosieward.com