Joy at work? You can’t be serious…

Who are the most important people for your organisation?

According to Johann Krieger, the general manager of the Gaylord hotel in Orlando it’s not the’s the staff. Maybe surprising, but he knows all too well that in a service industry, that they are the key to success.

I helped to man the desk at the IHI staff retreat yesterday. (Hey, it was only next door to the office but you did get breakfast, lunch and tea). It was Jeff Selbergs last day. He is the COO and moving  to a new job in New York. It got pretty emotional – in a fun way plus the odd staff shed a tear.  Standing ovation, HUGE cake, Red Sox shirt (which should ensure he is beaten up on the NY tube), life size poster and a few personal jokes. Hey – he only did 3 years! Maybe this guy was just amazing, maybe it’s just American’s but it felt like the right thing to do and it made you proud to share in the success. Time was set aside to facilitate people in forming their personal goals (from spiritual to loved ones, physical fitness, professional etc) and your 4Es to discuss with your manager for this year: What do you want to achieve regarding experience, exposure, . At the end of the day there was some compulsory dancing to loosen up which developed into a conga, all of which seemed perfectly natural of course. IHI give each employee $750 in professional development AND $750 for personal development. It still requires a signature but gym membership counts. Then there’s the ‘ministry of fun’, a wellbeing blog, sponsored health checks. One starts to realise that investment in staff isn’t just a random occurrence.


The guys at EA sports also seem to be onto something – gyms at work, chill zones…and yet when staff are required to put in the 14 hour day there’s no come back. Sure, there are times that they will shoot a few baskets at lunch but making the next FIFA 2014 for X-box doesn’t happen by just fiddling your thumbs (or maybe it does, I’m not a big gamer anyhow).

Richard Sheridan takes it one step further. Joy, Inc.: How We Built a Workplace People Love is getting quite a bit of attention. Sheridan runs Menlo innovations – a software company in Michigan, which to me is a flat, cold and therefore non-joyful place.

To be fair, (at least at some point) he had his feet firmly on the ground:

“Joy is a pie-in-the-sky, cymbals-clanging,music-playing, radical dream. Joy is a word that carries connotations of love, happiness, health, purpose, and values. Joy might work at home, or at church, or with a hobby – but not at the office. It’s a concept that has no place in the corporate world. It certainly does not sound profitable.

BUT Deep down you know that there is a better way to run a business, a team, a company, a department. You’ve always known it…” (of if you don’t you would like to work there anyway)

Menlo has tripled in size three times. Maybe they just are competitive, but there must be some reason why thousands of people, (who have no interest in software) go and visit each year. “Sheridan and his team changed everything about how the company was run. They established a shared belief system that supports working in pairs and embraces making mistakes, all while fostering dignity for the team”.

joy inc

Well, you know, it’s okay for these namby pamby companies who don’t have a ‘serious’ job to do – but real healthcare? No – it’s just not possible. I mean, the hours, the suffering, the complexity, the political pressures. Plus in a National Health Service, we are servants of the state, we are accountable for every penny.

For some reason though things haven’t turned out quite they way they should. It’s got to a point now where we give students in healthcare courses in resilience before they graduate (seriously, I’ve run one). Wouldn’t it be a better idea to train them at least how to improve the system, increase efficiency and gain time to at least do a thorough job?

You know, sometimes I wonder what has caused a system designed to help people enjoy life, lead to so much burnout, low morale, moaning and perpetual grind. So for the purpose of ‘reality’ let’s down grade our expectations to mere ‘staff satisfaction’.

And yet here is the crux…the public (via politicians) do not support rewarding hard working NHS staff with little more than a Christmas letter of thanks from the Health Minister. Celebrating success? It’s just not on the contract.


(surely this guy must be posing, bit harsh of his mate to take a shot on the iphone)

A typical article: “NHS managers spend £100,000 on staff events”. Of course, this was the sum of Primary Care Trust events across the entire country. The biggest culprit was Berkshire Primary Care Trust who lashed an incredible £8 ($13) per staff over a whole year on thanking them for their hard work and celebrating success. Wow, I estimate that’s 0.03% or less of the staff operating budget. (In the name of transparency, could the telegraph please publish how much it spent on staff per head – oh, and please include free coffees and tea over the last financial year too please, given that is also considered wasting tax payers money and beyond the NHS budget)

Rant over – but is it possible?

Take a look at the the CareerBliss 2013 Top 50 companies in the US. This survey is in it’s third year and assesses 100,000 independent employers.

The first observation is that there is no, one sector, industry or company type. The second observation is that Kaiser Permanente, a health system covering 8 million Americans, is in the top 20 for two years running. Sure, it’s not hard to find a review of someone who thinks there issues but surely making the top 0.02% isn’t to bad? Of interest KP are adding another 1 million Americans this year without any expansion in infrastrusture, such has been the ‘space created’ by good practice. So maybe it is possible for a health system with salaried staff that covers all areas of care and drives a tough improvement agenda to actually have happy staff?

The business case for this is pretty clear.

Staff satisfaction is inversely proportional to sick leave and staff turnover – two very expensive measures every organization should be tracking.

  • Staff are a healthcare systems most expensive asset
  • The UK NHS spends 2.5 billion GPB on agency staff (on top of the staff who are not there doing the job anyway)
  • On average 4% of staff are off at any one time (highest in support, ambulance and nursing staff)
  • Staff turnover varies between 4-18% of total staff a year between NHS trusts, a greater than 4 fold variation. Each post involves cost on advertisement, interviewing, recruitment and often a gap between filling the post
  • And the cost of a staff appreciation program? Back fill for one nurse for a month

I sure felt like going the extra mile when I worked at places where the boss took the effort to thank you (and generally out of their own pocket): Wine at Christmas from Dr Rodrigues for all at Aintree cardiology, registrars meal with partners at St Georges Medical Centre, Clive Shaw picking up the tab on a work night out (hey if I didn’t thank you back, please accept my humblest electronic cheers).

Now, before hiring your local foot massager, it’s important to take in a few principles.

  1. It doesn’t happen by itself: All the organisations mentioned above have a strategy to increase staff engagement and support staff actively in a positive way (as opposed to waiting until an issue occurs).
  2. It doesn’t have to be costly to create a culture of gratitude, but it does need to be regular: Words don’t cost anything and a few hundred quid a year to gain appreciated staff just requires the addition of creativity and fun.
  3. As with everything, leaders need to lead by example: Leaders shape culture, for good or bad, knowingly or not knowingly.
  4. When it comes down to money, its still worth it: Locum fees are 50-100% more than regular salaried staff costs. Loss of organizational memory can be crippling and people who don’t want to be there are less likely to put the required effort in to see the organisation succeed.
  5. A culture of psychological safety is a key building block: Few fancy touches won’t cut it if staff don’t feel comfortable to speak up in a trusted environment
  6. It’s likely going to require changes in team structure and function for a sustainable difference

So, what’s your next step to retaining your best employees, reducing stress related time off and the agency staff bill? Probably go and have a chat and find out how things really are underneath the employee bonnet – because joy at work may by more than a pipe dream.


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