Even before Covid-19, rates of behavioral health illness were on the rise. In the third year of the pandemic, mental health has accelerated into a crisis, with health care workers in particular facing high levels of stress and burnout. Although mask mandates have been lifted and restrictions have been eased in many areas, caregivers are still in the throes of treating infected patients, while also coping with the fallout of the past two years. This convergence of factors has led to an uptick in mental health issues among health care workers, many of whom report experiencing record-high rates of anxiety and depression compared to the general population.
Previously, designing clinical spaces for well-being was focused primarily on the patient. Now, taking care of patients is table stakes; caring for the people who serve them is crucial to creating and maintaining a high-performing hospital system.
Designing buildings for the well-being of health care staff is not just necessary to curb the mental health crisis among the profession. It’s also critical to buttress the financial fallout that ensues with high turnover, preventing additional strain on a system already taxed from financial losses due to differed treatment during the pandemic.
During Covid, hospitals have seen increased rates of turnover among employees, which is both costly to morale and the bottom line. According to Becker’s Hospital Review, in 2020, the turnover rate for registered nurses increased 2.8 percentage points to 18.7% industry-wide. Each percentage point change translates to approximately $270,000 lost or saved per hospital.
These numbers have prompted hospitals to rethink their approach to the physical environment and incorporate research-based design strategies that improve well-being for both patients and the staff guiding their recovery. Below, we outline three lessons for designing hospitals and clinics based on current projects NBBJ is working on with Massachusetts General Hospital, Atrium Health, Loma Linda University Medical Center, and Montage Health.
Lesson 1: Employee mental health can be part of a building’s identity.
Massachusetts General Hospital (MGH) in Boston is currently building a 482-bed expansion called Cambridge Street that focuses on staff and patient satisfaction, operational efficiency, and environmental stewardship. Several years ago, NBBJ also oversaw the creation of MGH’s 150-bed Lunder Building. Both facilities offer key insights into how seemingly simple design interventions can have a significant impact on the mental well-being of staff members.
It’s important to note that what we recommend are not amenities, even if some may call them that. Rather than focusing on the “nice to have” perks found in tech company headquarters, many of the spaces in MGH’s facility are “must haves” given the fact lives are on the line: stairwells flooded with light, deliberately quiet patient floors, and safer working conditions, for example.
The Lunder building offers plentiful access to daylight through a glass-encased stairwell used only by staff, who have adopted the corridor as a de facto meeting space (nicknamed the “stair conference room”). Staff also use this stairwell as a place to “be alone together” and report that they find comfort watching employees traverse the stairwell while they use the space to think and decompress.
The building further expands staff’s exposure to daylight — which impacts work-related stress and job satisfaction and is found to affect clinician burnout — through corridors that allow staff to access rooms from an exterior wall. Since less noise can reduce stress among caregivers and also help patients recover from illness, the Lunder building uses a variety of sound-absorbing materials and techniques to make the patient floors 35% quieter than typical health care buildings. Other features designed to minimize noise include sliding doors, distributing work zones for clinical staff across the floor rather than in a single location, and elevators and visitor waiting areas located away from patient rooms.
Finally, staff safety is perhaps the most critical “amenity” of all. For example, overexertion — in the form of repetitive routine physical tasks such as bending, stretching, and standing — account for 45.6% of all injuries occurring to nurses, according to a 2018 article published by the U.S. Bureau of Labor Statistics. These injuries can result in musculoskeletal disorders such as sprains and strains that accounted for 8,730 days away from work among nurses in the private industry in 2016. Features such as motorized overhead patient ceiling lifts or full-height glass doors that provide greater situational awareness can help reduce injuries.
Designing buildings in this fashion makes a difference. For example, post-occupancy data from new inpatient units and staff work areas NBBJ designed for Atrium Health indicates that vast majority of employees feel safer and more at ease in the workplace. In the same post-occupancy evaluation, employees mentioned “the collaborative nature of the research floor,” “increased interaction with colleagues,” and “improved team collaboration” as positive aspects of the new building, further illustrating that opportunities for collaboration and interaction improve employee satisfaction.
Lesson 2: Design features can reduce stress in core working spaces.
Many hospitals are embracing support spaces that enable people to choose how they spend their precious break times. These spaces, both “offstage” (where staff can gather or be alone) and “onstage” (where caregivers see patients), allow staff to spend less time navigating a building and more time recharging.
Loma Linda University Medical Center’s expansion in Southern California boasts an open-core design. It features wide corridors, access to daylight, and the distribution of patient and supply rooms along the wings, which allows staff to connect better with each other and patients. In open-core hospitals, major support functions such as staff lockers, break rooms, and conference rooms are in a centralized hub that connects to patient wings along the exterior. This layout reduces the need for staff to travel between patient and supply rooms, the type of inefficient and repetitive physical tasks that can lead to burnout.
In addition to open-core designs, collaborative clinician rooms — such as the new examination rooms at MGH’s Cambridge Street project, which are sized to allow for multidisciplinary consults — reflect the evolving nature of medicine. Collaborative clinician spaces decrease the load on caregivers and their teams while also providing patients with a new, more effective way to navigate their medical journey.
In the future, these recharging spaces could take different forms, which would acknowledge that everyone refuels in a different way. For instance, because the availability of private spaces has been shown to reduce caregiver stress some hospitals are exploring restorative zones with nap areas for their staff that would be located close to the patient unit for ease of use.
Lesson 3: Good design is ultimately good for business.
Health systems such as Montage Health on the Monterey Peninsula are taking advantage of their less-densely-populated location by incorporating nature into the design of their buildings. For example, Montage’s Ohana Center’s garden-like environment and private patios for staff are designed to lower levels of arousal fatigue — the psychological exhaustion that results from sustained stimulation without breaks. Arousal fatigue is one of the key factors contributing to burnout among behavioral health caregivers, who have an annual turnover rate of 40%.
Other organizations are exploring solutions such as satellite food lockers, mobile ordering apps, and meal programs that offer discounts for nutritious food options. These types of design interventions are investments in staff longevity; they help to reduce stress and encourage positive lifestyle choices, ultimately supporting the mental and physical well-being of the people charged with helping others recuperate.
Behavioral health challenges existed before the pandemic and will persist after it’s over. Consequently, as health care systems navigate the lingering impacts of the pandemic, it’s more important than ever that they shift towards a more caregiver-centric mindset. Only by creating spaces and implementing solutions that promote staff well-being and patient healing at the same time can they effectively retain and recruit staff and reduce the financial impact of burnout and turnover. Designing buildings to enhance employees’ well-being will help keep them satisfied and productive.
Four Effective Tips to Improve Labor Management in Companies
Businesses worldwide are always on the hunt for ways to improve their processes and add more efficiency to day-to-day functions. Of course, labor management is one of the major aspects of every company that demands continuous attention and improvement.
Every business understands that effective labor management is essential when it comes to increasing the productivity, safety, and efficiency of every project. The managers bear all burden to ensure that the labor is working effectively to meet the needs of supply and demand chains.
Here are some effective ways to improve labor management in your company for the best of your business.
1. Use Standardized KPIs
It can be hard to hold someone accountable for their performance when there is no evidence to back up the claims. In such circumstances, the labor deserving of praise may be left out, and those who need improvement may continue to waste company time and resources. Of course, such practices can cost you a lot of time and money in the long run.
Hence, smart companies worldwide are using Key Performance Indicators (KPIs) as a tool for worker motivation and accountability. These indicators help them better understand why certain standardized goals exist and their role in making the company succeed.
2. Incorporate a Software
Managers have a lot on their shoulders in addition to managing the workforce. A few people cannot keep an eye on everyone throughout the day. They need Kaizen Software to find the best solution for labor management. This way, the managers can find time to pay attention to many more important matters.
Efficient management software is being used worldwide due to its countless benefits. They offer security, better communication, and enhanced tracking to make your business more efficient. Hence, your business will have a better opportunity to grow and bloom.
3. Ensure Safety at the Workplace
Every workspace has its own challenges. However, everyone can agree that industrial workers have more challenges when it comes to safety. After all, they are surrounded by heavy machinery and face increased chances of accidents, injuries, and even fatalities. Hence, it must be a top priority to make your workplace safer.
You can start by looking into the hazards in your workspace and minimizing them one by one. In addition, it is also important to ensure that all your workers have access to safety gear at all times. Caution can save more lives than building an elaborate regime to care for injured workers.
4. Keep Workers Posted
Whether a construction site or a chemical industry, there can be new hazards and precautions for workers every day. A little negligence in the workplace can lead to a regrettable accident. Hence, it is always a good idea to keep your workers informed about current events.
Knowledge about company procedures and safety rules can reduce insecurity among workers and increase their efficiency. It is best to let your workers know that all their questions will be answered. This way, they can feel more comfortable seeking your guidance instead of finding out by trial and error.
10 Key Strategies for Managing and Engaging your Employees
Effective employee management and engagement are crucial for small businesses to foster a positive work environment, maximize productivity, and retain top talent. Small business owners need to prioritize their employees’ well-being, provide growth opportunities, and create a culture that promotes engagement and collaboration.
Here, we will explore ten strategies and practices for employee management and engagement in small businesses.
1. Clear Communication and Expectations
Clear communication is vital to set expectations and ensure alignment between the business and its employees. Regularly communicate goals, priorities, and performance expectations to your team. Provide feedback and recognition for their achievements and address any concerns or issues promptly. Encourage an open-door policy and create channels for open dialogue and feedback.
2. Training and Development Opportunities
Investing in training and development opportunities for your employees demonstrates your commitment to their growth and success. Identify areas where employees can benefit from additional skills or knowledge and provide relevant training programs. This can include workshops, conferences, online courses, or mentoring programs. Encourage a culture of continuous learning and support employees’ professional development.
3. Employee Recognition and Rewards
Recognizing and rewarding employee contributions is essential for fostering motivation and engagement. Implement a recognition program that acknowledges outstanding performance, teamwork, and achievements. This can include verbal praise, written appreciation, or tangible rewards such as bonuses or incentives. Regularly celebrate milestones and accomplishments to show appreciation for your employees’ hard work.
4. Work-Life Balance and Well-being
Promote a healthy work-life balance and prioritize employee well-being. Offer flexible work arrangements when possible, such as remote work options or flexible scheduling. Encourage breaks and time off to prevent burnout. Provide resources and support for physical and mental well-being, such as access to wellness programs or employee assistance programs. Show genuine care and support for your employees’ overall well-being.
5. Foster a Collaborative and Inclusive Culture
Create a collaborative and inclusive culture that values diversity and fosters teamwork. Encourage open communication, idea sharing, and collaboration among employees. Foster an environment where everyone feels valued, respected, and included. Embrace diverse perspectives and leverage the unique strengths of your team members to drive innovation and growth.
6. Performance Management and Feedback
Establish a robust performance management system to set clear goals, provide regular feedback, and evaluate employee performance. Implement regular performance reviews to discuss progress, identify development areas, and set new objectives. Provide constructive feedback that focuses on both strengths and areas for improvement to support employee growth.
7. Empowerment and Autonomy
Encourage autonomy and empower employees to take ownership of their work. Delegate responsibilities and provide them with the necessary resources and authority to make decisions. Encourage innovation and creativity by allowing employees to explore new ideas and approaches. Trust their expertise and provide guidance when needed.
8. Career Growth and Advancement
Support your employees’ career growth and advancement within the organization. Provide opportunities for skill development, such as stretch assignments or cross-functional projects. Offer mentorship programs or coaching to help employees navigate their career paths. Create a clear path for advancement and communicate the potential growth opportunities available to them.
9. Team Building and Social Activities
Organize team-building activities and social events to foster strong relationships among your employees. This can include off-site retreats, team lunches, or recreational activities. Encourage team bonding and camaraderie to enhance collaboration and create a positive work culture.
10. Continuous Improvement
Establish a culture of continuous feedback and improvement. Encourage regular check-ins between managers and employees to discuss progress, challenges, and goals. Solicit feedback from employees on processes, policies, and workplace initiatives. Actively listen to their suggestions and make necessary improvements to enhance the work environment.
Effective employee management and engagement are critical for small businesses to thrive. By prioritizing clear communication, providing training and development opportunities, recognizing and rewarding employee contributions, promoting work-life balance and well-being, fostering a collaborative and inclusive culture, and implementing additional strategies such as performance management, empowerment, career growth, team building, and continuous feedback, small business owners can create a positive and engaging work environment.
Investing in your employees’ success and happiness not only benefits them individually but also contributes to the overall success and growth of your small business.
Build a Strong Learning Culture on Your Team
When Kendra Grant’s team was charged with designing and delivering learning experiences for 90,000 Walmart Canada associates, she knew as a senior learning-and-design director that the landscape of corporate learning needs was constantly changing. “Over time,” says Grant, now the principal of her own L&D practice, “we acknowledged that many of the problems we saw such as lack of engagement and lack of retention were a result of the design process and not the fault of the learners.”
If you are in a leadership role in your organization, you more than likely share this problem. Technology and society are driving changes faster than your people can adapt. According to the OECD, 1.1 billion jobs will be disrupted in the next five years. Employees the world over require upskilling (learning to improve current work) and reskilling (learning to do new types of work). Some organizations are heeding the signs and investing heavily in learning and development: Walmart, for example, is investing $1 billion into reskilling its workforce, and McDonald’s has spent $165 million over the past eight years to prepare 72,000 employees for upward mobility. The Association for Talent Development’s most recent study found the average organization spends almost $1,300 per employee on professional learning. Microsoft’s CEO, Satya Nadella, exhorts everyone to be a “learn-it-all.”
Workers of today need to prepare for what they’ll be doing tomorrow. But how can they adapt effectively if their work is changing in real time? What skills can they learn now that will support them in the face of a volatile and ambiguous future? And how can their employers support them?
There’s a simple but not easy answer to all of these questions. Employers have to help employees become expert learners — people with the will to learn, the skill to do it effectively, and the ability to apply that learning in ways that positively impact their performance and that of their teams.
Still Wearing Blinders
Traditionally, learning within organizations has been driven by a single department. In a general attempt to motivate and support employee development, the learning-and-development team — which sometimes consists of just one person — acts as an order filler for operations managers and leadership, providing formal learning support, such as classroom training and online modules. Frequently, these efforts are augmented by tuition assistance for degree and certificate programs at institutes of higher education. In recent years, companies have created digital “learning-management systems” or “learning-experience platforms” that offer a Netflix-style menu of learning content that employees can access on-demand and at their own pace.
Unfortunately, however, these approaches to employee learning are not up today’s challenge, for a few reasons:
A day late and a dollar short. Content creation lags significantly behind the need for that content, making the content available less relevant to current needs. Also, when an employee needs new knowledge and skills now, a course next month isn’t helpful.
One-size-fits-none. Every learner is unique, with varied strengths, experiences, and challenges. Every learner works in different contexts, thus requiring greater personalization to support meaningful learning and improvement.
A lack of support for application. Pushing out content can impart new information, but developing effective skills requires coaching, reinforcement, and opportunities for safe, authentic practice.
A cultural disconnect. Leaders can say they value learning, but according to Deloitte, workers actually have less than 1% of their time available for learning. Further, learning can be messy, because it requires that people try new things and make mistakes. If an organization punishes people for those mistakes, as some do, people will shy away from learning.
Learner experience and identity. Not everyone thinks of themselves as a lifelong learner, nor do they all have the skills to learn and apply learning effectively. Further, biases in development programs may reinforce the notion that only some people are capable of learning and therefore worth the investment. This bias is communicated to workers.
There Is a Solution
We need to address these barriers to learning in order to meet the challenges of today and the future. Learning, after all, is what enables people to adapt to change and even become drivers of change. But, as Matthew Daniel has recently noted on the Chief Learning Officer website, even if people want to learn they may not know what to learn — or how to learn.
Expert learning requires two key conditions. The first is context. People need the time and space to learn. They need timely, actionable feedback; opportunities for collaboration; and just-in-time support to convert new knowledge and skills into measurable performance improvement. Then there’s capacity. Each person has talents, strengths, interests, challenges, and experiences that influence how they engage with, make sense of, and apply new knowledge and skills. We can’t assume everyone has developed the requisite learning skills and behaviors, and we can’t effectively gauge learning capacity in advance. However, we can help all people become expert learners, by providing them with options to learn and apply key learning behaviors rooted in a framework known as the Universal Design for Learning.
UDL, as it’s often called, was first devised in the 1990s by researchers and clinicians at the nonprofit learning organization CAST, Inc., under the direction of the neuropsychologist David Rose, of the Harvard Graduate School of Education. Today it’s endorsed in federal education legislation as a means for supporting inclusive, impactful learning for all learners. That includes workforce preparation and training. In essence, UDL helps us embrace the differences between learners — their variability in strengths, interests, attitudes, cultures, and more — by setting firm, challenging goals and allowing for flexible pathways to meet those goals.
When employing UDL in creating learning experiences, you’re encouraged to think of learning as a set of behaviors and skills that exist on a continuum from novice to expert. Novice learning is primarily guided by external forces: Novices learn what they’re told, when they’re told, for the reasons given to them. They are the type of learners whom top-down, one-size-fits-all training was meant to serve. A distinct step above the novice level is self-directed learning, where learners take the initiative for their own learning, making decisions about what, when, and how to learn.
Expert learning takes things to another level, by adding in specific learning skills and a focus on strategic performance improvement. Expert learners have the will and skill to learn, can identify ways to leverage that learning into impact, and are always looking for new challenges and ways to improve their skills. They are the learners best able to adapt to the rapidly changing modern workplace.
How Expert Learners Improve Outcomes
Building a strong learning culture that focuses on capacity and context can give companies a strategic advantage. Let’s consider why.
First, employees who are skilled learners can more readily innovate, for what is innovation if not the learning how to solve a problem in a new way? A person focused on continuous improvement rarely settles for “We’ve always done it this way.” Expert learners can identify emerging knowledge and skill needs and generate new knowledge to meet those needs.
Next, learning fuels employee engagement. Employer-supported learning is a key driver of retention, particularly when learning is visibly linked to employee development — that is, upward mobility. Creating a culture that supports people to learn and own their improvement makes improvement a common cause between the employees and the organization. Further, a visible emphasis on learning can be key to attracting new talent, with Gen Z and Millennial workers citing learning and upward mobility as key motivators in selecting job opportunities.
Finally, investing in learning is just that: an investment. According to Gallup, companies that invest in employee development increase profitability by 11%.
Building a Culture of Expert Learners
Building a culture of expert learning is a complex undertaking. There are, however, some foundational practices, aligned with UDL, that leaders and teams can engage in as they work to develop support an expert learning culture.
Adopt a learning philosophy and stick to it.
A learning philosophy is a codification of what the organization believes about learning, including its value, the responsibilities of each person related to learning, and the methods by which the organization will support its employees to learn and improve.
Consider the philosophy of the United States Marine Corps, where learning is literally a survival skill. In 2020, the USMC published Marine Corps Doctrinal Publication 7: Learning, or the MCDP 7, which tells all Marines, from the lowest-ranking enlisted member to the commandant, that they have a professional responsibility to learn. It also lays out the necessary conditions for learning, requiring each Marine to contribute to and leverage those conditions. All Marines are told they can’t rely on a training department of some sort but instead have to define and own their roles as learners. “Continuous learning is essential,” USMC Commandant Gen. D.H. Berger writes in the MCDP-7, “… because it enables Marines to quickly recognize changing conditions in the battlespace, adapt, and make timely decisions against a thinking enemy.”
Audit your culture for barriers to learning.
With your learning philosophy in place, make sure the collective behaviors, practices, and systems of your organization — and particularly the behaviors of your leaders — model and support the tenets of that philosophy. Examine what learning currently looks like in your organization and begin addressing common barriers. Provide time and resources for learning and regularly reinforcing the value of learning. Incentivize experimentation, collaboration, and knowledge-sharing. Promote team learning over individual knowledge-hoarding. Link learning to development by creating clear pathways for skill development and promotion. And enlist frontline employees and managers to more quickly identify learning needs and potential solutions.
To act like expert learners, particularly in selecting and strategically applying learning, people need flexibility in when and how they learn. New approaches, such as learner-cluster design and the modern-learning–ecosystem framework, acknowledge variability among learners, providing them options that best suit their learning needs, and close the gap between formal learning and where learning happens most — on the job.
* * *
Change is constant, and the need for adaptability extends beyond leaders to every level of the organization. When employees own their improvement, they can better anticipate, communicate, and meet their upskilling and reskilling needs. As Kendra Grant pointed out in describing her work with Walmart, many barriers to improvement that are thought to be internal to learners are really external — they’re flaws in the design. UDL helps us focus on what works for people rather than on what’s not working in them. By providing the right context and supporting capacity, we can make expert learning become the skill that fills the skills gap.
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