Friday, July 25, 2008

Front line managers are the key

Let me share with you the results of a piece of management research conducted in 2007 amongst health providers in the USA. View summary and white paper here.

The research was conducted over five years and involved 500 healthcare organisations and 200,000 healthcare professionals. The study aimed to study, job satisfaction, organisational loyalty and degree of professional engagement.

What was the main finding? Here it is. Leadership capability at the front-line level influences overall performance more than any other contributing factor. Rankings of leadership capability showed positive correlations with -

  • Job Satisfaction
  • Organisational Loyalty
  • Professional Engagement
  • Willingness to continue employment
  • Voluntary Turnover
  • Patient Satisfaction
  • Performance to projected budget
  • Employee productivity
  • Financial success (profitability)

I welcome feedback on this topic. Why not share your stories of how your organisation has utilised the strengths of its front line managers and supervisors?

Ageing population in Australia

Australian Federal Minister of Ageing, Justine Elliott, recently provided an insight into the growth of the aged population in Australia over the next two generations. Click here to view media release.

Australia has the second longest life expectancy rate in the world, with only Japan having a longer life expectancy. By 2060 it is expected the average life expectancy of women will be 88 years and for men the average life expectancy will be 84 years.

By 2021 it is expected that 18% of the Australian population will be aged 65 years plus, and by 2051 it is expected 26% percent of the population will be aged greater than 65 years. By 2025 Australia expects the number of people aged greater than 80 to double and by 2055 some 78,000 people will be aged greater than 100 years. These figures are generally consistent with projections for aged populations in developed nations worldwide.

How are we going to care for these people? Leaving aside any scientific breakthroughs for halting degenerative body processes, and the assumption that if they existed, they would be affordable to people on pensions, one thing is certain, it doesn't matter what age we live to be, in general, our bodies degenerate at around the same time. They simply wear out. Possibly a combination of healthier living and medical technology may combine to forestall the inevitable however the reality is that between 2025 and 2050 the Australian nation will need to provide:

  • Residential care for around 350,000 - 400,000 people
  • The majority of those will require high care
  • Community care of some nature for between 4m - 5M aged living in the community
  • A pension process that enables increasing numbers of aged to live in rental accommodation in the community
  • Affordable, subsidised rental accommodation
  • Meals on wheels for a large group of people
  • A significant investment in Government infrastructure to meet the information needs of the elderly
  • A more equitable funding process for aged services, designed to meet the needs of the elderly, rather than the budgeting needs of Federal Government
  • An investment in training and development of aged care workers and community care providers
Aged care providers and retirement village operators will face increasing costs as the demand for services increases on one side and the demand for workers, across all sectors, increases on the other side. Workers employed in aged care, with the exception of Registered Nurses, have traditionally ranked amongst the lowest paid groups. The continuing demand for workers throughout Australia, and globally, over the next thirty years, will drive wages up and draw workers away from low paid roles. This will increase labour costs to aged care providers and increase their reliance upon the use of technology. Either way the cost of providing aged care will fall onto a diminishing group of workers as taxes are used to provide funding for aged care services. Those that are working today need to increase their superannuation savings and invest in other forms of investments so as to minimise their hardship when they retire. The Federal Governement in Australia in 2040 is unlikely to have the working base to extract sufficient taxation from to meet all the needs of an ageing population. Increasingly aged services, beyond basic services, will be available only to those able to pay for them from their own means.

Governments need to change the rules related to superannuation, investments during retirement and working later in life. They need to remove blockages that discourage additional saving, even reward saving earlier in life. They need to remove restrictions on how superannuation funds may be accessed or utilised. They need to remove restrictions on working and investing. In short, Governments need to do everything they can over the next thirty years to encourage those now in their 30's and 40's to become as self sufficient as possible.

One way Governments can assist at an early stage is to mount an educational program on retirement implications and options. A sustained public awareness program over an entire generation would change attitudes and behaviors, just as has occured for smoking and drink driving. For many people aged under 50 years, the subject of retirement is taboo. They don't believe they will ever grow old and they don't want to consider the possiblity, therefore they don't plan for the future. This needs to change.

Aged are providers and retirement village operators need to be planning for the future - a long way into the future. This doesn't mean 50-year strategic plans, it does mean 3-year plans, updated every three years. What is required is for the boards of aged care organisations to be thinking some 30 years ahead. Boards need to proactively recruit younger people. This will shift their focus forward from tomorrow to the future. Boards should be obtaining a constant flow of information about future population projects and building their planning around that information. Aged care management teams need to be looking long term at their staff needs. How many people will be required, where will they come from, what skills will be needed and how to create a competency pathway that provides interest and acts as an incentive to people to enter and remain in the industry. The future will be very different to the present, so don't plan for now, plan for the year 2050.