The Changing Dynamics of the Workforce and its Impact on Organizational Effectiveness

Drivers of Changing Workforce Dynamics

Understanding the Generations

Integrating the Workforce

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Road Map

1 U.S. Population Demographics

2 Change of Guard Conflicts

3 Shortage of Skilled Workforce

Changing Dynamics of the Workforce The Three Big Drivers

35% 32%

31%

2%

Millennials (Age 18 – 34) Generation X (Age 35 – 50) Baby Boomers (Age 51 – 69) Traditionalists (Age 70+)

U.S. Population Demographics Four Generations at Work

Total Employees (as of Jan 2015):

148,201,000

Source: Pew Research Center tabulations of U.S. Census Bureau population projections released December 2014; “The Employment Situation – January 2015”, Bureau of Labor Statistics, available at: http://www.bls.gov/news.release/archives/empsit_02062015.pdf, accessed February 13, 2015; “How to Tell If a ‘Fact’ About Millennials Isn’t Actually a Fact”, WSJ.com, available at http://blogs.wsj.com/economics/2014/11/27/how-to-tell-if-a-fact-about-millennials-isnt-actually-a-fact; “Do 10,000 baby boomers retire every day?”, Fact Checker, The Washington Post, available at http://www.washingtonpost.com/blogs/fact-checker/wp/2014/07/24/do-10000-baby-boomers-retire-every-day/.

Number of baby boomers retiring each day

10,000

The Workforce in 2015 In millions Projected Size of U.S. labor force for 2015 Projected Population by Generation

Driver #1

Change of Guard Issues The Talent Pipeline Problem

Driver #2

Traditionalists Baby Boomers Millennials / Gen Y-ers Gen X Entering the workforce Advancing their

careers Retiring or delaying

retirement 95% are retired

Hey CIO! Can I Get a Ride?! I’m not Old Enough to Rent a Car…

Source: Artist’s illustration of situation narrated by Vince Cioti on HIStalk webinar “Cerner Takeover of Siemens – Are you Ready?”, November 14, 2014, available at https://www.youtube.com/watch?v=KTq5JaJAVWo, accessed February 14, 2015.

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Shifting Position on Retirement Gen X Hitting the Gray Ceiling

1985 2011

Source: “State of the American Workplace,” Gallup, available at: http://www.gallup.com/strategicconsulting/163007/state-american-workplace.aspx, accessed February 13, 2014; The Advisory Board Company Talent Development research and analysis.

20% of Workforce Ages 65 – 69

32% of Workforce Ages 65 – 69

• 1 in 4 Baby Boomers will never retire

• 26% of all Americans 46 to 64 years old have no personal savings

• In 2020, there will be five generations at work

Skilled Labor Market Continues to Tighten Health IT Staffing Shortages Complicate Matters Further

Driver #3

19%

6%

29%

71%

21%

40%

50%

69%

Other

Hiringvendors/consultants is

too expensive

Our hires are takenaway by more

lucrative offers fromother organizations

Lack of qualifiedtalent pool in our area

Provider (N = 119) Vendor (N = 52)

Barriers Organizations Face to Fully Staffing Environments 2014 Health IT Staffing Outlook

Provider organizations had to place at least one IT initiative on hold

35%

Provider organizations had to scale back at least one IT project

38%

CIOs say their organization has experienced higher staff turnover in the past 12 months than in previous years

31%

Projected growth in health IT jobs between 2012 and 2022—much faster than the average for all occupations.

22%

Source: 2014 HIMSS Workforce Survey, available at http://www.himssanalytics.org/research/AssetDetail.aspx?pubid=82173&tid=127; October 2014 healthsystemCIO.com Snap Survey, available at http://healthsystemcio.com/2014/10/22/survey-finds-staff-turnover-isnt-money/; U.S. Bureau of Labor Statistics, Employment Projections program, available at http://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm#tab-6, accessed February 14, 2015.

Beyond the 3 Drivers Changing Times Bring a Bigger, Broader Shift…

The 9 to 5 schedule was developed around sunlight. Workers could arrive in the light and return home before dark. People walked to work. Life was based in the neighborhood. Businesses controlled when customers bought goods and sought services. That world is history.”

Ira S Wolfe, Geeks, Geezers, and Googlization

We‘ve moved from an economy built on people's backs to an economy built on people’s left brains to what is emerging today: an economy and society built more and more on people’s right brains.”

Daniel Pink, An Emerging Mind

Definition of work is changing

Economy is shifting

Technology is reshaping every aspect of our life and work

People no longer have to follow the leaders and do what they’re told. Now they can organize themselves, publish themselves, inform themselves, and share with their friends – without waiting for an authority to instruct them.”

Dan Tapscott, Grown Up Digital

Drivers of Changing Workforce Dynamics

Understanding the Generations

Integrating the Workforce

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3

Road Map

Historical Events

Environment

Race and Ethnicity

Disability

Religion

Education

Level

Age

Generations

Political

Gender

Socio-economic

status

Factors of Diversity

“Just when we thought we were getting used to managing gender and ethnic diversity in the workplace, we are faced with addressing age diversity.” Ira S Wolfe in Geeks, Geezers, and Googlization

And their Influence on Characteristics and Attitudes of Individuals

Source: “Managing an Intergenerational Workforce: Strategies for Health Care Transformation”, American Hospital Association, January 2014, available at http://www.aha.org/about/cpi/managing-intergenerational-workforce.shtml, accessed January 19, 2015.

Traditionalists AKA: Veterans, Silents, WWII Generation

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Born: 1922‒1945

Generation in Brief: Traditionalists

• Grew up during wartime and postwar periods; lived in and adapted to an environment of scarcity

• Key messages from formative years:

– Make do or do without

– Stay in line; stay loyal

– Duty before pleasure

– Consider the common good

• Popular technology of the era: Radio

• Currently semi-retired or fully retired; many are grandparents, and some are great-grandparents

The Baby Boom Generation AKA: Boomers, Vietnam Generation, ‘Me’ Generation

Born: 1946‒1964

Generation in Brief: Baby Boomers

• Grew up in an era of global rebuilding and recovering economies— optimistic about the future

• Key messages from formative years:

– Be anything you want to be

– Work really hard

– Live up to expectation

– Change the world

• Popular technology of the era: Television

• Currently hold senior-level positions and are approaching retirement; many becoming grand-parents and empty-nesters.

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Generation X AKA: Baby Busters, 20-somethings, Latch-key Generation

Generation in Brief: Gen X

• Grew up in two-income households; often described as the ‘latchkey kids’ and free agents

• Key messages from formative years:

– Don’t count on it; keep options open

– Take care of yourself

– Do it your way; balance work/life

– Always ask “why?”

• Popular technology of the era: Personal Computer

Born: 1965‒1981

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The Millennial Generation AKA: Gen Y, Gen WHY, Nexters, Digital Generation

Generation in Brief: Millennials

• Grew up in a modern society—characterized as technologically savvy multi-taskers

• Key messages from formative years:

– You are special

– Stay connected 24/7

– Achieve now!

– Everyone wins; leave no one behind

• Popular technology of the era: Internet

Born: 1982‒1997

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Since we are all “immigrants” to three other generations, we might as well not be jerks about it. Hadyn Shaw in Sticking Points

Generational Differences

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Understanding the Gap Words of Wisdom from Sun Tzu

So it is said that if you know your enemies and know yourself, you will win hundred times in hundred battles. If you only know yourself, but not your opponent, you win one and lose the next. If you do not know yourself or your enemy, you will always lose.”

Sun Tzu, “The Art of War”

Understanding the Gap Common Flashpoints of Generational Differences

Communication Learning and Diversity Work Expectations

• Career, retirement outlook • Loyalty; job security • Work styles and ethics • Rewards and recognition

• Use of technology • Management style • View of authority • Team relationships

• Learning needs • Training styles • Attitude toward diversity • Comfort with change

I’ll put in the effort, but I want work-life balance

too.

I’m connected 24/7. How does

it matter if I leave at 5?

Work Hours

How do I work?

Gen X-ers

Traditionalists

Baby Boomers

Millennials

I work 9 to 5, plus overtime.

That’s what I’ve always done.

“

It takes hard work to get ahead. I work

8 to 6 and take work home.

“ “

“

They don’t work as hard as I did when I was their age.”

“ They’re inefficient. “ They are never on time, and they’re

always stuck to their phones.” “ They are stuck to their calendars. Why should

we all meet in the same place anyway?” “

Example #1

Interaction Styles

I send txts w/ lots of abbrevs. Gchat works too. Twitter maybe? #Whynot

What are memos? I send an email or IM, and I

prefer to meet virtually.

Gen X-ers

Traditionalists

Baby Boomers

Millennials

I write memos, or meet face-to-face. I think in-

person meetings are the best way to work things

out..

“

I use the phone to set up meetings, and I also send memos out to my group.

“ “

“

How do I interact?

I don’t need a Gen Y-er texting instead of building business relationships. They run the risk of eroding what we’ve been doing to build a relationship of

trust between the business and IT.”

“ They spend too much time in meetings. They don’t use technology to make their life and interactions

easier and more effective.”

“

Their communication skills are awful.” “ Their communication skills are awful” “

Example #2

Source: Gelston, S.,“Gen Y, Gen X and the Baby Boomers: Workplace Generation Wars”, CIO.com, available at http://www.cio.com/article/2437236/staff-management/gen-y--gen-x-and-the-baby-boomers--workplace-generation-wars.html; Geeks, Geezers, and Googlization.

— Mark Cummuta, CIO.com

Rethinking the Gap … From a Parking Garage in Calgary

Source: Shaw.H, “How to Get the Generations Working Together,” American Management Association; Sticking Points; McCarthy, C. (2015, February 06), Telephone interview; Garets, D. (2015, January 23), Telephone interview.

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Shared Values and Commonalities Top Five Expectations of Employees

Baby Boomers, Gen X, and Millennials share the same top 5 expectations of their employers:

1 2 3 4 5 To Work on Challenging

Projects

Competitive Compensation

Opportunity for Advancement and Learning

To be Fairly Treated

Work-Life Balance; Flexibility

Having continuous employment and chances to do engaging work

Being well-compensated for the contributions made

Feeling successful in careers and having opportunities for promotion and knowledge enhancement

Viewed as competent, knowledgeable workers and to be treated with respect for contributions

Having a balance of social and work lives; respect for individual preferences

Source: “Rethinking Generation Gaps in the Workplace: Focus on Shared Values,” UNC Kenan-Flagler Insights, available at http://www.kenan-flagler.unc.edu/executive-development/about/~/media/C8FC09AEF03743BE91112418FEE286D0.ashx, accessed January 26, 2015.

Drivers of Changing Workforce Dynamics

Understanding the Generations

Integrating the Workforce

1 2

3

Road Map

Integrating the Generations Two Standard Approaches

Maximizing Differences Minimizing Differences

Create level playing field by neutralizing existing differences and focusing on similarities

Focus on ways in which differences can be emphasized and leveraged for organizational gain

Source: The Advisory Board Company Talent Development research and analysis.

Minimizing Differences New Policy Brings New Tensions

Source: Putre. L. “Generations in the Workplace,” Hospitals and Health Networks, available at http://www.hhnmag.com; The Advisory Board Company Talent Development research and analysis.

M T W Th F

12:00 12:00 12:00 12:00 12:00

8:00 8:00

12:00 12:00 12:00

4:00 4:00

M T W Th F

12:00 12:00 12:00 12:00 12:00

12:00 12:00 12:00 12:00 12:00

Young nurses frustrated by less flexible shifts

Older nurses frustrated by longer hours per shift

Nursing unit at 250-bed hospital in Toledo, OH converted eight-hour shifts to twelve-hour shifts

Change

Maximizing Differences Well-intended, but Ineffective

Forum unnecessarily calls attention to differences

Misjudgments erode morale Tone is not focused on learning opportunities

Generation Sensation

Case in Brief

• 160-bed hospital in Michigan with mid-size intergenerational staff • After noting tensions around age-related differences, decides to host

monthly “Generation Sensation” forum for staff • During monthly forum, staff discuss varying viewpoints on other generations;

though well-meaning the initiative can draw negative attention to the differences among generational cohorts

Source: Putre. L. “Generations in the Workplace,” Hospitals and Health Networks, available at http://www.hhnmag.com; The Advisory Board Company Talent Development research and analysis.

Pitfalls of Standard Approaches Good Intentions are Not Enough

Source: The Advisory Board Company Talent Development research and analysis.

Suppressing or emphasizing differences leaves some feeling out-of-touch and disengaged with work

Ignoring differences or focusing too much attention on them causes staff to feel misunderstood and valued for the wrong reasons

Minimizing or maximizing differences can cause myopia as staff become fixated on the differences among them; staff struggle to see the whole picture

Insecurity Alienation Myopia

Supporting a Diverse Workplace Identifying Macro- and Micro-level Strategies

Incentives Intrinsics Morale Motivation

Acknowledge the uniqueness of staff members by uncovering their individual motivators

Motivate the Individuals Create a workplace that accommodates all groups and generations

Create an Accommodating Culture

Source: The Advisory Board Company Talent Development research and analysis.

Creating an Accommodating Culture Designing a High-Performance IT Department

Tailoring Organizational Processes and Management Strategies Talent Management

• Leadership Style • Work Design • Workplace Policies • Organizational Structure

• Attract: Hiring, onboarding, and retention

• Develop: Training and succession planning

• Inspire: Engagement and recognition

• Mentorship

Imperative #1

Tailoring for Success Organizational Processes and Management Strategies

• Encourage openness and curiosity • Set and communicate vision • Stay culturally relevant and be transparent

• Create workplace choices • Clarify expectations and set metrics • Balance high-tech with high-touch

• Set behavioral standards • Consider how policies affect generations • Instill discipline to adhere to organizational values

Leadership Style

Work Design

Policies

Tool to Consider: Skills Matrix

• Develop a skills matrix for each team

• Establish criteria to rate each individual’s skill level across different functions of the job as novice, intermediate, and advanced

• Be clear about what each criteria means and how it is rated

• Rate each team member and publish the matrix to the team

• Approach most often results in everyone wanting to master all the skills, getting the whole team up to performance

• More experienced staff automatically tend to mentor the less senior members

Talent Management Checklist for IT Workforce Development

• Be creative with hiring.

“If they’re talented, they’re teachable.”

• Take time to onboard people effectively based on who they are.

• Retain your staff. Don’t overlook the value and knowledge of older IT staff.

Attract

1

• Set reasonable expectations about training. Consider rotations outside IT to broaden skills.

• Give younger staff freedom to explore areas of interest. Create ‘career paths’ to accommodate preferences.

• Promote from within and have succession planning in place. Offer clear guidance on how to succeed and advance.

Develop

2

• Paint a broad vision that has the patient at the center of every decision.

• Create shared experiences and rituals to come together. Be sure to offer challenging work.

• Tell your stars how bright they shine. Reward them and show them that you want to invest in their future.

Engage and Inspire

3

Source: “IT Staffing Strategic Outlook”, Health Care IT Advisor research and analysis, available at http://www.advisory.com/research/health-care-it-advisor/studies/2013/it-staffing-strategic-outlook; Marx. E, “Culturally Relevant Leadership”, HIStalk CIO Unplugged, Published 4/15/08, available at http://histalk2.com/2008/04/15/cio-unplugged-41508.

Build a 2-Way Street for Mentoring Transfer Experience Across Generations to Increase Impact

Source: Marx. E, “The Lost Art of Mentoring”, HIStalk CIO Unplugged, Published 2/2/11, available at http://histalk2.com/2011/02/02/cio-unplugged-2211; Marx, E. (2015, January 23). Telephone interview.

Mentoring Contract Please see appendix for a formal mentoring contract that you can customize and use as a tool to facilitate mentoring relationships. Compliments of Ed Marx, Senior VP and CIO, Texas Health Resources.

Restoring the Lost Art

“On even years, I mentor someone; on odd years, I am mentored. I require each of my direct reports to do the same.”

Ed Marx, SVP and CIO, Texas Health Resources.

Make it Socially Acceptable

Make it Relevant

Make it Formal

• Get everyone to do it! Create a culture that encourages role-modeling • Get younger staff to refine management skills by supervising interns • Encourage experienced staff to have ‘advisory groups’ of bright, young individuals

• Seek broader health care experience, organizational perspective, and new skills • Consider finding a mentor outside IT. Match up with a clinician or a administrator. • Leverage opportunities to become ‘business ready’

• The framework needs to be at least partly formal • Both parties have to be clear that their relationship is a two-way street • Agree on ground rules: expectations, confidentiality, communication etc.

Supporting a Diverse Workplace Identifying Macro- and Micro-level Strategies

Incentives Intrinsics Morale Motivation

Acknowledge the uniqueness of staff members by uncovering their individual motivators

Motivate the Individuals

Create a workplace that accommodates all groups and generations

Create a culture that accommodates all groups and generations

Source: The Advisory Board Company Talent Development research and analysis.

Motivating the Individuals Motivation Comprised of Multiple Factors

Instruments that incite action

Incentives Properties of the job itself that are valued and inspire action

Intrinsics A person’s emotional predisposition to act

Morale The combination of incentives, intrinsics, and morale that determine the degree of investment an individual will make

Motivation

Source: The Advisory Board Company Talent Development research and analysis.

Imperative #2

Demystifying Motivation Drilling Down to the Individual-level

Source: “Wellbeing: The Five Essential Elements,” Gallup, available at http://www.gallup.com/businessjournal/126884/five-essential-elements-wellbeing.aspx; The Advisory Board Company Talent Development research and analysis.

• Leader must have a one-on-one conversation with each member of staff to uncover his or her individual motivators

• Use behavioral analysis • Be sensitive to individual

needs and preferences • This can be time-consuming,

but needs to be done

Ask Questions that Relate to… ?

• Career Wellbeing: liking what they do every day

• Physical Wellbeing: having good health and enough energy to get things done on a daily basis

• Social Wellbeing: having strong relationships

• Financial Wellbeing: effectively managing their economic life

• Community Wellbeing: the sense of engagement they have in the area in which they live

Motivation

Tools for Reimbursement Both the Carrot and the Stick

Source: The Advisory Board Company Talent Development research and analysis.

Incentives

Incentives: Instruments that incite action

Rewards Consequences

• Money, flexibility, acknowledgement / appreciation.

• Is one better than the other? Or a combination?

• Incentives that cut across generations: Increasing autonomy, increase in mastery over skills, and purpose

• Probation, limited privileges • Negative feedback, constructive criticism • Tighter management

Inherently Inspirational Three Categories of Intrinsic Motivators

Source: The Advisory Board Company Talent Development research and analysis.

Intrinsics

Sense of Purpose

Satisfaction of Accomplishment

Commitment to Community

Intrinsics: Properties of the job itself that are valued and inspire action

• Provide opportunities to experience the clinical care setting and understand the critical intersection of IT and quality of patient care

“The job allows me to contribute to a purpose I support”

“The job enables me to get a sense of achievement”

“The job connects me to others whom I care about”

• Be sure to offer challenging work

• “If something in IT fails, it can be harmful to the patient.”

• Strengthen the social contribution that staff associate with health care

• Health care first, IT second

Snapshot of Satisfaction Morale as Past, Present, and Future

Morale

Source: The Advisory Board Company Talent Development research and analysis.

Morale: A person’s emotional predisposition to act

Prediction of future level of morale based on trust, confidence, and overall satisfaction; can impact current motivation

Time Past Future

Current

Determined by accrued levels of professional satisfaction, including past incentives and intrinsics

Morale

The Bigger Picture Understanding Your Workforce

“In case you’re worried about what’s going to become of the younger generation, it’s going to grow up and start worrying about the younger generation.”

Roger Allen

Source: “Rethinking Generation Gaps in the Workplace: Focus on Shared Values,” UNC Kenan-Flagler Insights, available at http://www.kenan-flagler.unc.edu/executive-development/about/~/media/C8FC09AEF03743BE91112418FEE286D0.ashx, accessed January 26, 2015.

Final Word

What type of assistance does the mentee want from the mentor?

What expectations does the mentor have of the mentee?

What expectations does the mentee have of the mentor?

How often will you meet?

When and where will you meet?

For how long will you meet?

Who will be responsible for scheduling the meetings?

What will be the ground rules for your discussions?

If problems arise how will they be resolved?

Any concerns the mentee wants discussed and resolved?

Any concerns the mentor wants discussed and resolved?

How will you know when the mentoring relationship has served its purpose/terminate?

We have agreed that our initial meetings will focus on these three topics:

1. 2. 3.

Any additional area/issues you want to discuss and agree to?

Partner Signature: Date

Mentor Signature: Date

Appendix I: Mentoring Contract

Source: Marx, E. (2015, January 23). Email interview.

Santosh Mohan, MMCi, CPHIMS Health Care IT Advisor Program Research and Insights The Advisory Board Company MohanS@advisory.com (650) 694-9197 www.linkedin.com/in/santoshmohan

Q&A and Contact Information