A central challenge facing CEOs and other C-suite leaders today is how to reinvent their organizations to address employees’ changing needs and expectations.
Current State
The healthcare industry is experiencing a workforce renaissance, as employees’ desires may not be aligned with employers’ traditional offerings. In 2023, the top two reasons causing employees to change jobs or to actively seek new opportunities were better compensation and improved work-life balance, according to the “State of Hybrid Work 2023” study from
Owl Labs. From a clinical perspective, the hospital setting has been transformed due to the implementation of strategies on the payer side seeking to move healthier patients to outpatient settings and to consolidate the sickest, most complex patients in one care venue. This has resulted in longer, more onerous and unpredictable workdays for clinical and support staff.
In addition, the administrative demands on clinical staff are increasing, especially with the advent of technology. Technology has facilitated the spread of one’s work beyond the physical workplace, which can propel the rate of burnout if “online” expectations are not managed.
Ideal Future State:
Workforce Venn of Zen
The foundational premises of the theoretical model called the Workforce Venn of Zen is that having flexibility and autonomy on the job—plus commensurate compensation at market rates—creates an intrinsic harmony within the employee that will lead to increased morale and productivity. This increases overall employee well-being within the institution, ultimately achieving the organization’s set mission and creating a healthy organizational culture (see graphic below).
The Workforce Venn of Zen
To test consumer perspectives on the Workforce Venn of Zen model’s features, Johns Hopkins conducted a focused quantitative study in February 2024. There were 127 participants, with 42% from clinical areas and 58% from nonclinical areas. Administrative staff (55%), followed by attending physicians (21%) and advanced clinical practitioners (13%), were the highest participating job categories. Most participants (94%) indicated that remote work should become an accepted norm within healthcare when suitable and possible. One hundred percent of participants agreed that autonomy was between very important and somewhat important to how they perform their jobs.
The majority (87%) of participants agreed with aligning compensation to productivity. Most respondents (86%) also indicated risk aversion to having two-sided risk, where there would be a reduction in salary if performance measures were not met, even if there was no cap to the increase in salary. Seventy-five percent of participants said they would choose competitive cash compensation plus average benefits over an average cash compensation with attractive and useful benefits.
Implementing Workforce Venn of Zen
The responses from the focused survey provided insights and considerations on how organizations can implement the Venn of Zen model:
Time: Flexibility With When and Where Employees Work
The pandemic provided experiential evidence that remote work is viable within healthcare when appropriate, and that it will not jeopardize the standard of care delivery once there is a critical mass on-site to provide in-person services. The Owl Labs study indicated that flexibility in remote work is better for employees’ mental health. There is also no discrediting the value of face-to-face interactions: The key here is to offer work schedule flexibility.
Autonomy: How Employees Work
Leaders should communicate clear expectations, provide employees with the psychological support and physical resources to get the job done, and provide space and degrees of freedom for employees to execute their work. This approach favors a results-and-outcome orientation rather than a process orientation.
Commensurate Compensation: Base Pay, Benefits and Performance Incentive
To attract talent, the base pay offering should be the competitive market value for the role and should increase annually in alignment with inflation. Risk-sharing compensation models should be carefully designed with employee feedback at the center, as most healthcare workers are risk averse when it comes to their salary.
Morale and Productivity: Increasing Performance and Job Satisfaction
When commensurate compensation and flexibility on the job are combined, improved employee morale and productivity are inevitable. Productivity, however, should be well-defined, metric measured and dashboard accessible, and involve a performance feedback loop with the employee. It also should be tied to the job role and to individual metrics and be within the employee’s sphere of control, especially when the productivity metrics relate to compensation. When performance incentives are well-designed, they can be powerful tools to increase morale and productivity.
Employee Well-Being: Patient Care Requires Employee Care
Employee well-being is the equilibrium achieved when the employee experiences self-actualization, work-life harmony and a sense of belonging on the job. At work, it includes supportive relationships with managers and colleagues, feeling valued and a balanced expectation of productivity. With the increased prevalence of mental health issues in the present day, leaders should protect their human capital by prioritizing employee well-being through supportive services and offerings that help employees achieve this well-being equilibrium.
Organizational Mission and Culture: The Employee Experience
Culture can be the biggest adversary to mission realization. When employees are in a state of optimal well-being, the organization’s mission will be fulfilled, and there will be a cultural transformation. Leaders should consider conducting an assessment of their business culture to understand its distinctiveness, identify the traits individuals associate with it and recognize the habitual behaviors followed by people internally. Encouraged by PwC in its Global Workforce Hopes and Fears Survey, and pulse surveys among employees, combined with external social listening and online monitoring of employee review websites and social media platforms, organizations have the potential to bring attention to cultural issues that employees may not be openly discussing with leaders.
In a Transformative Period, Focus on Employees’ Needs
The healthcare sector is experiencing a transformative period characterized by unprecedented turnover rates and driven by shifts in healthcare professionals’ preferences. The responses from a majority of our survey respondents indicating remote work should become an accepted norm within healthcare reflect a departure from traditional, labor intensive work structures to a more integrated approach that incorporates work-life balance.
Leaders grapple with the challenge of attracting and retaining top performers in a highly competitive market to fulfill their missions, all while managing and controlling labor costs. Backed by survey data, the Workforce Venn of Zen framework can help leaders tackle workforce shortage concerns through redesigning job offerings and placing central emphasis on employees’ experiences and needs.
Mira Yaache is administrator, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Bayview Medical Center, Baltimore (mking54@jhmi.edu) and an ACHE Member. Yvonne Mitchell is vice president, talent acquisition, Johns Hopkins Talent Acquisition Center of Excellence, Baltimore (ymitche5@jhmi.edu). Tangwan Azefor, MB, is an assistant professor and division chief for the Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Bayview Medical Center, Baltimore (tazefor1@jhmi.edu).