NICHOLAS H. APOSTOLERIS, PHD MBA

HEALTH CENTER DIRECTOR ACTION HEALTH SERVICES

VP OF BEHAVIORAL HEALTH SERVICESCOMMUNITY HEALTH CONNECTIONS, INC.

ASSISTANT PROFESSORDEPARTMENT OF FAMILY MEDICINE AND

COMMUNITY HEALTHUMASS MEDICAL SCHOOL

Work Environments and Morale: Setting Up Your Program For

Success

Work Environments and Morale: Goals

Participants will:Share experiences from their programs

regarding morale challengesShare experiences regarding successful

approaches to improving moraleLearn the principles of Self Determination

Theory as they apply to the work place environment

Learn how to change workplace environments to improve employee satisfaction

Work Environments and Morale

Is morale an important issue for your program?

What does high morale look like?

When have you had times of high morale?

What brings down morale?

Morale Challenges

Mission-related When personnel feel they are not adhering to the

mission

Personnel-related In all positions

Personality Non-work stressors Others?

Resource-related On mission, but insufficient resources to do the job

right

Morale improvement successes

Any common themes from your experiences?

Could they work without additional resources?

Where did the good ideas come from?

Who was listening for these ideas?

Self Determination Theory

Developed at the University of Rochester in the past 30 years

Focuses on better understanding why we do what we do and on how to improve social environments

When people are self-determined, they experience the satisfaction of doing something that is important to them

To feel self-determined, fundamental psychological needs must be met

Motivation and Morale

Self Determination Theory poses that people have three fundamental psychological needs Autonomy Competence Relatedness

Environments can be supportive or unsupportive of the fulfillment of these needs

Environments supportive of the person fulfilling these needs will result in more intrinsically motivated action

Fundamental Psychological Needs

Autonomy The perception that we have choices and can act on

those choicesCompetence

The perception that we can function in the world, doing what we need to do to survive and succeed

Relatedness The perception that we are related to others and

ourselves in a positive way

Motivation Orientation

External Act to avoid punishment Act to get an external reward

Internal/Extrinsic Act to avoid negative self-evaluation Act to obtain a positive self-evaluation

Intrinsic Act for the love of the act Immersed in the act – sense of time can be lost

Enhancing Intrinsic Motivation

Potential negative effects from tangible rewards Intrinsically motivated behaviors become extrinsically

motivated A lowering of intrinsic motivation for the activity

How to avoid the negative effects of rewards Detach from a specific task request Make the tangible reward unexpected Verbal recognition rather than tangible rewards

Controlling Environments

Work environments, especially when stressed, tend to adopt a bottom-line approach

Workplace well-being issues can be framed exclusively in dollar terms, which can make for poor work environments

Recruitment, retention, productivity all are related to work environment

Tendency is to just push harder and to value compliance and obedience of employees

Vertical hierarchies can be efficient – but at a cost

Controlling Environments

“Control” in this context is not goodAttempting to control the actions of others

rather than setting up the situation so that the actions are self-determined Feeling ‘controlled’ versus feeling ‘self-determined’ or

‘autonomous’Negative consequences of controlling

environments When people feel controlled, they act in a more

oppositional, even anti-social way

Environments that Support Basic Needs

Fulfillment of each of the basic needs can be supported or damaged by the nature of the environment

Autonomy-supportive environments

Competence-supportive environments

Relatedness-supportive environments

Autonomy-Supportive Environments

When a person perceives that they have meaningful choices, that is autonomy-supportive

When a person’s point of view is valued and brought into consideration in decision-making, that is autonomy-supportive

Autonomy-supportive environments tend to produce more proactive and engaged people

Competence-Supportive Environments

Determine areas where people perceive their own competence to be high

Be careful about moving people into areas where they will have a sharp drop off in perceived competence

Provide trainings with adequate time to assimilate information Trainings that overload with too much information too

fast are not helpful

Relatedness-Supportive Environments

Relatedness is to one’s self and to others

Relatedness to self Realistic expectations Limiting negative self-talk Valuing self-care

Relatedness to others Positive, appropriate connections to others Respect for personal boundaries Warmth and good will

Where does personality fit in?

Causality Orientations Autonomy Orientation

Some people will perceive environments as being more autonomy-supportive than will other people

Organize life around personally meaningful goals Control Orientation

Some people will perceive environments as being more controlling than will other people

Lots of ‘shoulds’ Seek/need deadlines

Impersonal Orientation Things happen for reasons out of our control Do what has been done – no ability to do things differently Depressed about present, anxious about future

What can we do to improve our workplace?

Suggestions for increasing Autonomy Supportiveness and reducing how controlling our workplace can feel?

Suggestions for increasing Competence Supportiveness?

Suggestions for increasing Relatedness-supportiveness?

Valuing our Colleagues

Well-being of the person as an end value Not solely as a means to an end

Higher productivity Lower recruitment costs

Colleagues are not machines and are not disposable They stay or go back to the community Improved or harmed by their work experiences

Strengthening communities by strengthening and elevating our workforce

References

Self Determination Theory http://www.psych.rochester.edu/SDT/

Interpersonal control, dehumanization, and violence. Moller & Deci. Group Processes and Intergroup Relations, 13, 41-53. http://www.psych.rochester.edu/SDT/documents/2010_MollerDeci_GPIR.pd

f

Intrinsic Need Satisfaction. Baard, Deci & Ryan Journal of Applied Social Psychology, 34, 2045-2068 http://www.psych.rochester.edu/SDT/documents/2004_BaardDeciRyan.pdf

Self determination theory and work motivation. Gagne & Deci. Journal of Organizational Behavior, 26, 331-362 http://www.psych.rochester.edu/SDT/documents/2005_GagneDeci_JOB_SD

Ttheory.pdf

Contact Information

Nicholas H. Apostoleris, Ph.D.ACTION Health ServicesCommunity Health Connections, Inc.Fitchburg Family Medicine Residency ProgramUMass Medical School275 Nichols Road, Fitchburg, MA 01420

nhaphd@gmail.com