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On July 4, 2018, Chalchisa commented on Blending cultures for excellence :

Hey David:
Hopefully you are checking this! I would love to check out the BART model you referenced.

On May 11, 2018, Chalchisa commented on Absenteeism :

Be cautious re rewarding perfect attendance. you work in healthcare, so do you really want people coming to work sick?
The best way to reduce absenteeism is to create an environment in which people are happy and want to come to work. A sense of community, where they are supported to be the best professional they can be. Focus on what matters to your people – find out from them first (which is really really hard to do reliably and well) – then work on the things that negatively impact them and on the areas where you can do more to positively incentivize (which may not be dollars).
Look at it this way – if the people are calling in sick because they really are sick then there isn’t much you can do. If the people are calling in sick when they aren’t you can begin to get control of that when you understand what is influencing them to do that and fix it. And for those who are diehard abusers you need to effectively risk-manage their removal from employment as quickly as you can – which in a unionized setting takes time and commitment; and also requires that you have well structured and fully aligned policies, supports, protocols, and most importantly leadership expectations.

1. Set a plan to get your people and culture where you want them. bear in mind that culture is a combination of a bunch of things that you can lever and control – leadership, recognition, reward, etc. – but will take time to get where you want it. you need to understand where you are, and what levers you can/should adjust first to get better cultural outcomes.
2. Create a plan for the board to demonstrate how you will begin to work towards your targets – you’ll likely need at least a quick win or two; ideally things that specific influential board members have been pushing for – with the culture/people plan as a key enabler to getting things done.
3. If there are big disruptive things you may need to do, to get the business and operations parts right, do those straight away. Buys you time with the board in the form of action, and you’ll need that all squared away before you can really implement your people plan

Assuming you are unionized you need to sit down with your unions and change your collective agreement language to enable what you want to accomplish. I would suggest an ‘interest-based’ approach to this, perhaps with all your unions versus each individually. This would be where you come to them and say, “here is the problem we want to solve” and discuss it with them versus giving them paper at bargaining and setting up a positional discussion. They may have a better solution to the issue than you have come up, or they may agree with you and find a way to help you make it happen.
normally when you change out of one model to another you will need to be prepared to pay more in either the last or the first year so there is an overlap and you don’t end up with disengaged staff. You have to be super clear with your change-plan and communications though (especially ensuring front-line leaders understand what you are doing and how things will change), because if you aren’t you’ll have paid more and still end up with the disengaged people.
Lastly, does $500 really add up to enough to incentivize behavior or performance? would/could the money be spent differently in order to increase morale and satisfaction and therefore achieve the outcomes you are looking for? Do you reall yknow what your people want and what will incentivize/motivate them? Often we don’t because its hard to figure out – but if you can do that you can get to something that will make a difference.

I like it. Agree with above that the social determinants of health also need to be considered and worked on, in order to really focus on prevention, education, promotion, etc. We also need to understand the impact of stigma and societal pressures on mental health and the impacts that have on the mind and the body. An investment in our socio-economic infrastructure that supports everyone – perhaps not equally, but based on what they need, will pay dividends in reducing health treatment expenditures – shift to keeping people healthy versus just treating illness.

In most instances performance expectations can be set, and should be set. And in most, if not all, global environments if measurable and reasonable performance requirements are unmet they can and should be dealt with. Often perception is that they cannot, or the perceived volume of work associated with dealing with them prevents it from happening, but it can be done. It starts with clear expectations that can either quantitatively or qualitatively be measured. From there, if there is a gap you need to determine if the gap is culpable or non-culpable. Non-culpable would be (typically) and education/training/clarity gap that can be rectified with clear expectations or with a training plan of some sort; OR disability-related. any other reason for the gap is culpable and should be dealt with through clear performance management.
If your HR department can’t help you work through how to deal with this, then your issue may be there. Ofcourse, it could also be that your performance expectations are too high and maybe they are performing to an acceptable level (in which case, you shouldn’t change – keep those standards high! BUT bear in mind that not everyone performs to the same high standard. Again, HR should be able to help you with this – its one of the things they are there for.

On May 11, 2018, Chalchisa commented on Hiring for skills or organizational fit? :

I would agree with Bidur – a coach can be a wonderful help. Often/especially when combined with a 360 assessment and/or psychometric testing and compared against the competencies/capabilities for the role (which likely identify technical AND non-technical requirements because BOTH are crucial to a person’s success).
Dual reporting is usually a problem – should be remedied. Very hard to fix a behavioural issue when different messages can/are sent by two different leaders with (likely) two different views of what success looks like.
Lastly, from your description there is an accountability issue on the part of the employee. in such instances the coaching approach is not usually the right one, at least on its own. This is where a direct performance management conversation should take place with clear expectations set.