I wonder if it would be preferable for the aged care sector in Australia to operate as a for profit sector. By this I mean the funding for aged care infrastructure is provided by investors while the funding for residential care is provided by the Commonwealth. Accreditation standards and classification standards could remain in place as process of quality assurance. Instead of the Commonwealth issuing 'bed licences' it could instead offer a 'operator licence'. This licence would be dependent upon the operator meeting the minimum standards of operation and care and being subject to visits from accreditation agencies.
No doubt many could think of reasons why this shouldn't happen. There may be some good arguments in favour and maybe the time has arrived for the discussion and the debate. Clearly it is not something that is going to occur overnight. It may be possible to implement a dual process and let market forces sort out the final result.
Would smaller non profit providers be the losers? Undoubtedly. Market force feeds on scale of economy, systems and processes and the ability to share costs over a wide base. Many, larger, non profits have already moved in this direction. It may be that over the next twenty years the majority of smaller non-profit aged care operators in Australia will have been acquired and merged into larger groups anyway.
The age care sector requires a massive investment towards infrastructure over the next three decades, in addition to simply maintaining wages levels in line with cost of living increases. This is a significant drain on Commonwealth taxes. Why not transfer that cost and risk to institutional investors?
Would the consumer be disadvantaged? Those opposed to this concept will raise this scenario immediately, yet it may not be the case. Look around you. Even today, with vastly improved acceditation standards and continuous improvement processes in place over the past decade, still the papers are full of stories of aged care operators who have a complete disregard for the resident. These breaches continue to occur for a number of reasons, including; poorly trained managers and staff, inadequate enforcement of standards, low levels of funding for staff, resources, equipment and infrastructure and last but not least an inherent belief that you have to literally kill someone before you lose your operating licence. Even if that were to occur the financial cost is viewed differently by the facility operator. Private investors would not tolerate losing their licence to generate revenue and would likely be equally or more diligent in meeting the required legislative requirements.
Just a thought . . . .
John Coxon
Taking You From Frontline Manager to CEO
Saturday, November 22, 2008
Friday, November 21, 2008
Boring, boring, boring
This blog is boring. Well that is not actually true. I just wanted to draw your attention to the fantastic offer I am about to make.
Would you like to participate in free management coaching? It’s an easy question to answer. Yes or No. If yes please read on.
Throughout 2009 I will be delivering a series of management workshops throughout Australia and New Zealand. At each event, on either the evening prior or the evening after I will be holding court in a lounge at the venue. I will be providing free, no obligation, coaching to those in attendance. I will help you solve management issues, develop competencies, reduce stress and enjoy your work more. It’s free, no cost, no obligation, no books, no CD’s, no hidden agenda’s or products and definitely no hard sell. If you are there you benefit from the combined knowledge of all in attendance. If you are not there then you miss out. Whether 5, 50 or 500 turn up I will find a place for us to work together. If need be we will move out into the street and work there.
Why am I making this offer? I operate a successful consultancy working with managers in the health, aged care and not for profit sector. The work I do allows me to travel throughout the two best countries in the world. It allows me to spend time with my wife, Liz, to enjoy holidays together and it allows me to spend time with my children, Tara and Byron. I do what I love and I love doing it. I also like to give back as much as I get. Most management advice is freely available. If you had the time you could read all the books, articles, blogs, research reports, white papers I do. After many years as a management coach I have learned one irrefutable fact. Most people can access information. What they need me to do is help them develop and implement the action plans that convert knowledge into results. By coming along, meeting me, letting me meet you, it means that when you do call me seeking my help we already have had contact. You are comfortable with and we spend less time becoming comfortable and move quickly to help you reduce stress and enjoy your work.
How do you register for these events? You don’t. Just turn up. If you wish you may SMS me a message on +61427390376 the day prior, regardless I will be there.
How do you find out about dates and times? Firstly, go our either of our websites, www.johncoxon.com.au or www.johncoxon.co.nz and follow the link to services and to workshops. Here you will find details of cities, venues and dates. Court will be in session from 5.30-7.00pm.
Secondly, sign into www.twitter.com and follow john_coxon, here you will see announcements of dates and venues also. You could also return to this blog in one week and you will see a list dates on here.
Are you in? What have you got to lose? Absolutely nothing. What value on the stuff you learn? Priceless.
Let me help you reduce stress and enjoy your work as a manager.
John Coxon
Thursday, October 9, 2008
Staff retention
Health providers in Australia and New Zealand, along with health providers in every developed and developing nation, are facing the impending impact of labour shortages. News media worldwide carries stories daily of the shortage of qualified medical staff at every level. Baby boomer, leaving aside current financial blues, are leaving the workplace to retire or work part time and that trend will continue to many, many years.
The healthcare sector embraces the extremes of earning capacities from highly paid specialists at one end of the scale to personal care attendents in aged care at the other end of the scale; in the middle are corps of nurses and medical staff. The majority of those employed in the health sector earn an average salary, the same as other people do in other industry sectors.
For the past five years Western Australia has dragged people away from other states to feed the mining sectors insatiable need for staff. There is no end in sight to that trend. The Western Australian situation does provide an insight into the problems a nationwide labour shortage may create.
The reality is that no single organisation, or industry sector, can prevent a shortage of labour. The shortage is being driven by shifting demographics as 20-30% of the population moves into retirement age. Health providers cannot afford the luxury of focussing on how they attract people to work for them; they must, instead, focus on how to prevent people leaving their organisations. If there was ever a time to be recognised as an employer of choice then that time is now.
The best people are attracted to the best employers. It doesn't take a Government funded research project to understand that. Good people do not tolerate mediocrity for long and when the shortage of labour drives up the price of labour; they dont tolerate mediocrity at all. Many, many employers will discover this for themselves over the next decade or two.
There is a number of things a health provider can do to improve its staff retention rate. Firstly, choose the right people to be managers and provide them with an appropriate level of professional development, coaching and mentoring. Secondly choose the right people full stop. Regardless of who you are hiring, hire them for their competencies and their demonstrated ability to do the required job, not for their technical knowledge or diplomas.
The younger generation of workers bring a far greater level of diversity to any organisation than at any time in the past. As much as you spend time and money on cultural diversity, spend more money on learning about and understanding how generational diversity can work effectively together.
A labour shortage will reverse one of the more insidious trends of the past two decades; that being to condemn mature workers to the scrap heap. It is possible employers will come to realise the inherent benefits in retaining knowledge and passing that knowledge on by mixing the old with the young. Mature workers, like younger generations, have their own needs and wants. As an employer you will need to retain mature workers for as long as possible - and you compete with their desire to spend the kids inheritance.
There is more, much more. Learn about various employer of choice programs and awards and put yourself on display. Even if you dont win you will serve notice to your employees that you wish them to remain on board.
Whatever you do, the solution does not rest with increased remuneration. You will never be able to compete with those driven only by the need for more money. Don't waste time on them, instead focus on the majority of your employees who simply want you to operate in a sustainable manner for the long term, be paid a level of salary that doesnt create stress, be treated with dignity and respect and be valued for their contribution - regardless of their age or position.
The healthcare sector embraces the extremes of earning capacities from highly paid specialists at one end of the scale to personal care attendents in aged care at the other end of the scale; in the middle are corps of nurses and medical staff. The majority of those employed in the health sector earn an average salary, the same as other people do in other industry sectors.
For the past five years Western Australia has dragged people away from other states to feed the mining sectors insatiable need for staff. There is no end in sight to that trend. The Western Australian situation does provide an insight into the problems a nationwide labour shortage may create.
The reality is that no single organisation, or industry sector, can prevent a shortage of labour. The shortage is being driven by shifting demographics as 20-30% of the population moves into retirement age. Health providers cannot afford the luxury of focussing on how they attract people to work for them; they must, instead, focus on how to prevent people leaving their organisations. If there was ever a time to be recognised as an employer of choice then that time is now.
The best people are attracted to the best employers. It doesn't take a Government funded research project to understand that. Good people do not tolerate mediocrity for long and when the shortage of labour drives up the price of labour; they dont tolerate mediocrity at all. Many, many employers will discover this for themselves over the next decade or two.
There is a number of things a health provider can do to improve its staff retention rate. Firstly, choose the right people to be managers and provide them with an appropriate level of professional development, coaching and mentoring. Secondly choose the right people full stop. Regardless of who you are hiring, hire them for their competencies and their demonstrated ability to do the required job, not for their technical knowledge or diplomas.
The younger generation of workers bring a far greater level of diversity to any organisation than at any time in the past. As much as you spend time and money on cultural diversity, spend more money on learning about and understanding how generational diversity can work effectively together.
A labour shortage will reverse one of the more insidious trends of the past two decades; that being to condemn mature workers to the scrap heap. It is possible employers will come to realise the inherent benefits in retaining knowledge and passing that knowledge on by mixing the old with the young. Mature workers, like younger generations, have their own needs and wants. As an employer you will need to retain mature workers for as long as possible - and you compete with their desire to spend the kids inheritance.
There is more, much more. Learn about various employer of choice programs and awards and put yourself on display. Even if you dont win you will serve notice to your employees that you wish them to remain on board.
Whatever you do, the solution does not rest with increased remuneration. You will never be able to compete with those driven only by the need for more money. Don't waste time on them, instead focus on the majority of your employees who simply want you to operate in a sustainable manner for the long term, be paid a level of salary that doesnt create stress, be treated with dignity and respect and be valued for their contribution - regardless of their age or position.
Monday, August 4, 2008
The Age of Collaboration
John Chambers, CEO of Cisco, recently contributed an article to the CEOFORUM GROUP website title The Power of Collaboration. In his article Chambers discusses how corporations and the business sector will learn how to combine technology, such as web 2.0 tools with the human ability to communicate to create the ultimate forms of workplace collaboration.
You may read the article yourself by selecting the link above. Obviously I am delighted to share John's insight with you as he mirrors everything I believe in - that the best outcomes in any workplace are achieved through collaboration.
For those unable to get to John's article, I will an insight here with you. John states "encouraging this collaborative behavior will also require us to teach students and employees how to work well together and to make good collective decisions". Oh, I can see the rednecks and those that fear the onslaught of the 'comrades' turning in their collective graves!
Go read, its is a short article. Afterwards I would be keen to hear from you as to how you believe technology might contribute to greater workplace collaboration.
You may read the article yourself by selecting the link above. Obviously I am delighted to share John's insight with you as he mirrors everything I believe in - that the best outcomes in any workplace are achieved through collaboration.
For those unable to get to John's article, I will an insight here with you. John states "encouraging this collaborative behavior will also require us to teach students and employees how to work well together and to make good collective decisions". Oh, I can see the rednecks and those that fear the onslaught of the 'comrades' turning in their collective graves!
Go read, its is a short article. Afterwards I would be keen to hear from you as to how you believe technology might contribute to greater workplace collaboration.
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 -
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:
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.
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
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.
Friday, June 20, 2008
Enter the new executive
Over the past few months I have been helping two clients who have experienced issues with the introduction of new executive manager. The first is an organisation that hired its first ever CEO, after many decades of growth and management by committee. The second is a hospital that has recruited a replacement Director of Nursing, replacing an incumbent that had been in place for many, many years.
In both instances, the organisation experienced unrest and discontent as a result of the new appointments. This is not entirely unexpected. Whenever a new person arrives it creates a discord. Different experiences create different perspectives which lead to different management practices. Everyone involved is forced to adapt somehow.
Just because the discontent is unexpected does not mean it cannot be managed and the disruption minimised. In both instances the disruption in each of these organisations could have been minimised through better communication with stakeholders, in particular the existing management team. In both instances the repair work was as a result of improved communication. It's a funny word communication it just keeps cropping up!
In the instance of a new CEO being introduced, especially when there hasn't been a CEO in the past, everyone will be impacted upon. The collegial management style of the past will likely change. Decisions may be made faster. Due to the decisionmaking being delegated to a single individual there may appear to be less consultation, though the reality may be different to the perception. The Board has a role to play here, ensuring all stakeholders are advised of the appointment, of the strengths and experiences the incoming CEO will bring, expectations of the Board and some indication of the immediate direction and management plans. Secrecy does not aid integration, it actually hinders the incoming CEO as he or she seeks to implement change. Secrecy or a lack of information leads to rumour, innuendo and stalling behavior, all which results in the organisation becoming distracted from its strategy.
A new senior executive joining the ranks of an existing team has to deal with ingrained management behavior. Again change is inevitable. It is rare for an new senior executive to be hired for the purposes of maintaining the status quo. The situation lends itself to introducing change. When a new executive manager is introduced there is a fear factor amongst all existing staff. Some will fear being caught short as their competencies and work practices are challenged. Peers will resent any attempts to move in on their patch. Poor understanding of the role and expectations of the incoming executive may lead to suspicion and blocking behaviour. On the other hand the incoming executive will have their own fears. Depending upon their past experiences they to may fear being found short on experience and knowledge by peers or direct reports. They may feel obliged to meet seemingly unreasonable expectations by the CEO or may not even fully understand what is expected of them. They may face the challenge of having to make unpopular decisions before they have had an opportunity to become known and accepted.
The CEO has a role to play in helping to integrate an incoming executive manager. Again communication is the key. It is important to bring the management group together as a team. The CEO should communicate to the group collectively so that all hear the same message and any assumptions can be challenged. Ensure the entire management group understands why the new manager was hired and what is expected of this person. Discuss and confirm the roles, expecially any changes to the status quo. It doesn't hurt to discuss as a group any shortcomings the new manager may have (and they all have some) so that the group can work together to minimise any impact of those shortcomings. Hiding shortcomings does not help the organisation in any way.
In both instances, the organisation experienced unrest and discontent as a result of the new appointments. This is not entirely unexpected. Whenever a new person arrives it creates a discord. Different experiences create different perspectives which lead to different management practices. Everyone involved is forced to adapt somehow.
Just because the discontent is unexpected does not mean it cannot be managed and the disruption minimised. In both instances the disruption in each of these organisations could have been minimised through better communication with stakeholders, in particular the existing management team. In both instances the repair work was as a result of improved communication. It's a funny word communication it just keeps cropping up!
In the instance of a new CEO being introduced, especially when there hasn't been a CEO in the past, everyone will be impacted upon. The collegial management style of the past will likely change. Decisions may be made faster. Due to the decisionmaking being delegated to a single individual there may appear to be less consultation, though the reality may be different to the perception. The Board has a role to play here, ensuring all stakeholders are advised of the appointment, of the strengths and experiences the incoming CEO will bring, expectations of the Board and some indication of the immediate direction and management plans. Secrecy does not aid integration, it actually hinders the incoming CEO as he or she seeks to implement change. Secrecy or a lack of information leads to rumour, innuendo and stalling behavior, all which results in the organisation becoming distracted from its strategy.
A new senior executive joining the ranks of an existing team has to deal with ingrained management behavior. Again change is inevitable. It is rare for an new senior executive to be hired for the purposes of maintaining the status quo. The situation lends itself to introducing change. When a new executive manager is introduced there is a fear factor amongst all existing staff. Some will fear being caught short as their competencies and work practices are challenged. Peers will resent any attempts to move in on their patch. Poor understanding of the role and expectations of the incoming executive may lead to suspicion and blocking behaviour. On the other hand the incoming executive will have their own fears. Depending upon their past experiences they to may fear being found short on experience and knowledge by peers or direct reports. They may feel obliged to meet seemingly unreasonable expectations by the CEO or may not even fully understand what is expected of them. They may face the challenge of having to make unpopular decisions before they have had an opportunity to become known and accepted.
The CEO has a role to play in helping to integrate an incoming executive manager. Again communication is the key. It is important to bring the management group together as a team. The CEO should communicate to the group collectively so that all hear the same message and any assumptions can be challenged. Ensure the entire management group understands why the new manager was hired and what is expected of this person. Discuss and confirm the roles, expecially any changes to the status quo. It doesn't hurt to discuss as a group any shortcomings the new manager may have (and they all have some) so that the group can work together to minimise any impact of those shortcomings. Hiding shortcomings does not help the organisation in any way.
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