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Navigating the Changing Dynamics of the Intergenerational Workforce
Staffing Strategies for the Highly Productive Health Care Organization
Dr. Jean Ann Larson, FACHE, LFHIMSS, FIISE
Santosh Mohan, MMCi, CPHIMS
April 29, 2016
Acknowledgements
Advisory Board Company
Washington, DC
Jim Adams
Alicia Dick
Ernie Hood
Rachel Keller
Ken Kleinberg
Ed Marx
Brendan McGinty
Kate Vonderhaar
Change Gang, LLC
Blaine, WA
Dave Garets
Claire McCarthy
HIMSS
Chicago, IL
JoAnn W. Klinedinst
Rod Piechowski
Magdalene Van Vossen
Jason Keller
Boston, MA
2
Pam Foyster
Family Health West
Fruita, CO
Stanford Health Care
Palo Alto, CA
Yael Markley
Eric Tancongco
Drivers of Changing Workforce Dynamics
Understanding the Generations
Integrating the Workforce
1
2
3
Agenda
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• Formulate an effective approach for integrating the multigenerational workforce
• Recognize the impact of mass boomer retirements and encourage the transfer of
critical institutional knowledge and experience to younger staff
• Create staff engagement through shared accountability and individual commitment
for organizational success in the new economy
Learning Objectives
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Drivers of Changing Workforce Dynamics
Understanding the Generations
Integrating the Workforce
1
2
3
Road Map
Agenda
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1 U.S. Population
Demographics
2 Change of Guard
Conflicts
3 Shortage of
Skilled Workforce
Changing Dynamics of the Workforce The Three Big Drivers
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Instant Poll #1
a) Silent (Born before 1945)
b) Baby Boomer (1946 – 1964)
c) Gen X (Born 1965 – 1980)
d) Gen Y (Born 1981 – 1997)
What Generation Are YOU?
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34% 34%
29%
2%
1%
Millennials (Age 18 – 34) Generation X (Age 35 – 50)
Baby Boomers (Age 51 – 69) Traditionalists (Age 70 – 87)
Post-Millenials
U.S. Population Demographics Four Generations at Work
Total Employees
(as of Dec 2015):
149,929,000
Source: Pew Research Center tabulations of U.S. Census Bureau population projections released December 2014 ; “The Employment Situation – December 2015”, Bureau of Labor Statistics, available at: http://www.bls.gov/news.release/pdf/empsit.pdf, accessed January 10, 2016; “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/; “Millennials surpass Gen Xers as the largest generation in U.S. labor force”, Pew Research Center, available at http://www.pewresearch.org/fact-tank/2015/05/11/millennials-surpass-gen-xers-as-the-largest-generation-in-u-s-labor-force/.
Number of baby boomers
retiring each day
10,000
The Workforce in 2015
In millions U.S. Labor Force Composition by Generation
Projected Population by Generation
Driver #1
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Change of Guard Issues The Talent Pipeline Problem
Traditionalists Baby Boomers Millennials / Gen Y-ers Gen X
Entering the workforce Advancing their careers
Retiring or delaying retirement
95% are retired
Driver #2
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Hey CEO! 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 industry webinar, accessed February 14, 2015.
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Shifting Position on Retirement A Ticking Time Bomb
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
• Gen X is hitting the
‘Gray Ceiling’
• In 2020, there will be
five generations at
work
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2015 State of Staffing Shortages
Provider organizations had to
scale back or place at least one IT initiative on hold
Driver #3
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6.5%
19.8%
All Industries Health Care andSocial Assistance
Source: “Employment Projections 2014-2024,” Bureau of Labor Statistics, December 8, 2015, http://www.bls.gov/news.rel ease/pdf/ecopro.pdf; “Industry-occupation matrix data, by industry, Table 1.9 2014-24,” Bureau
of Labor Statistics, 2015, http://www.bls.gov/emp/ep_table_109.htm; 2015 National Healthcare Retention & RN Staffing
Report, NSI Nursing Solutions, Inc., available at http://www.nsinursingsol utions.com/fil es/assets/librar y/retention-institute/NationalHealthcareRNRetentionReport2015.pdf; The Advisory Board Company research and analysis.
Projected Increase in Employment,
2014-2024
Skilled Labor Market Continues to Tighten Health Care Staffing Shortages Complicate Matters Further
Projected number of new jobs in health
care and social assistance industry, 2014-2024
3.8 million
17.2%
Hospitals reporting a vacancy
rate of 10% or greater. RN Vacancy Rate is 7.2%,
with Recruitment Difficulty
Index averaging to 85 days.
24.2%
Hospital turnover rate in 2015
– up from 13.5% in 2011
38%
Organizations view retention
as a “key strategic imperative”, but 36.4% have a formal
retention strategy
89.1%
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
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Drivers of Changing Workforce Dynamics
Understanding the Generations
Integrating the Workforce
1
2
3
Road Map
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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.
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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
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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 Stick ing 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 a 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”
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a) Work Style
b) Communication
c) View of Authority
d) Employee Engagement
Instant Poll #2 Where Are You Seeing the Biggest Differences?
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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
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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
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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” “ 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
Example #2
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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.
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Drivers of Changing Workforce Dynamics
Understanding the Generations
Integrating the Workforce
1
2
3
Road Map
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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.
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Creating an Accommodating Culture Designing a High-Performance Working
Tailoring Organizational Processes
and Management Strategies Talent Management
• Leadership Style
• Work Design
• Workplace Policies
• Compensation Policies
• Organizational Structure
• Attract: Hiring, onboarding,
and retention
• Develop: Training and
succession planning
• Inspire: Engagement and
recognition
• Mentorship
Imperative #1
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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
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Talent Management Checklist for 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 staff.
Attract
1
• Set reasonable expectations
about training. Consider
rotations 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.
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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. 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.
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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.
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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
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Tools for Reimbursement Both the Carrot and the Stick
Source: The Advisory Board Company Talent Development research and analysis.
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
Incentives
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Inherently Inspirational Three Categories of Intrinsic Motivators
Source: The Advisory Board Company Talent Development research and analysis.
Sense
of Purpose
Satisfaction
of Accomplishment
Commitment
to Community
Intrinsics: Properties of the job itself that are valued and inspire action
“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”
Intrinsics
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Morale
Morale a Key Component of Engagement
If we are to attempt a fusion of morale and engagement, it is this:
engagement is a by-product of high morale, a result of it. When
workplace psychosocial and physical environmental factors are
perceived positively by the workforce, they experience a sense of
well-being which we call high morale. When that morale level is high enough, it triggers behaviors on the part of workers which
include advocacy, willingness to “go the extra mile”, commitment,
helping others, etc. and which we call “engagement”.
Engagement is therefore not possible without high morale;
and high morale usually results in engagement.”
David Bowles and Cary Cooper,
Employee Morale: Driving Performance in Challenging Times
Morale Particularly Crucial in Hospitals
Jeff Durr, Senior Managing Consultant, Gallup
We looked at engagement in hospitals and found that it is related to many important outcomes.
In a hospital with engaged staff, there are fewer infections, fewer slips and falls, as well as less turnover and higher productivity.”
Source: Bowles. D, “MORALE…OR ENGAGEMENT?,” Published 11/3/09, available at https://davidbowles.wordpress.com/2009/11/03/morale-or-engagement; Robison.J, “Leading the Way to Better Patient Care,” Published 11/20/12, available at http://www.gallup.com/businessjournal/158840/leading-better-patient-care.aspx
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
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Dr. Jean Ann Larson, FACHE, LFHIMSS, FIISE
Leadership Development Officer
University of Alabama at Birmingham Health System
and School of Medicine
LinkedIn: www.linkedin.com/in/jeanannlarson
Twitter: @jeanannlarson
Q&A and Contact Information
40
Santosh Mohan, MMCi, CPHIMS
Health Care IT Industry Analyst
LinkedIn: www.linkedin.com/in/santoshmohan
Twitter: @santoshSmohan
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.
Skill Analysis Design Code/
Configure Test Manage
Barry
James
Shelby
Linda
Tracking Staff Development with Skills Matrix Example from an IT Services Department
42
No
Experience Attended training;
understands
concepts
Applied the
concept
Demonstrated
consistent
application
Deep understanding
& consistent practice;
able to train
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.
Appendix II: Skills Matrix
Appendix III: Book Recommendations
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