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Common Sense and the Workforce Shortage

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By Jack Cumming

A recent survey by the Senior Living Innovation Forum revealed technology and the “workforce challenge” to be the most pressing C-Suite concerns. This will be a focus for a conference later this month. Simple logic suggests that the solution for the staffing challenge is easily stated, though more difficult to implement. Here’s the logic:

  1. Increase staff productivity, i.e. get more done with less staff, and

  2. Compete for staff with attractions beyond money.

When there’s a workforce shortage, employers have to learn to manage with fewer workers. That requires rethinking the business model from top to bottom.

Technology is Central

Moreover, the technology challenge is intrinsically related to staffing since technology, after a learning period, is a painless path toward increased productivity. The increasing cost of staffing, in wages and related expenses, incentivizes a growing investment in technology. Vendors are starting to respond as senior housing executives show more enthusiasm for automation.

The mindset of senior housing leaders inclines increasingly toward technological innovation, and as a result, more comprehensive, integrated solutions are beginning to emerge. Evolving technology ranges from point-of-service monitoring to exoskeletal solutions to physical tasks. The senior housing acceptance of technology may have begun with comfort toys, but its best rationale is as an engine for efficiency. If the workforce shortage continues to tighten labor acquisition, technology will increasingly respond as part of the solution.

Organizational Innovation

Other current trends can also help, and these are primarily organizational. It’s been nearly fifty years since Robert Townsend’s seminal book, Up the Organization, proposed a bottom-up approach. The book was highly popular as a response to William H. Whyte’s, The Organization Man, which had called into question concepts of "commitment" and "loyalty" within corporations. Townsend called for balancing individuality and collective effort.

Business historically followed the military, top-down, chain-of-command model. Townsend called for commonsense melding of management by supervision, rewards, and penalties with an increased emphasis on job satisfaction allowing workers to approach tasks without direct supervision. His conclusion was that wise managers strike the right balance between the two approaches.

Empowerment Organization

The modern and still evolving Empowerment Organization is a direct result. It’s technology dependent. The key manifestation is a flattening of the traditionally multi-layered hierarchical organization. This calls for the recruitment of highly qualified individuals for the first level of customer interaction; giving them considerable responsibility and decision authority, but holding them accountable with clearly articulated and understood consequences for success or failure. It takes talented people, and supportive corporate resources, to foster such first-line independence.

The Empowerment model requires a technological capability to measure all events at the transaction level and to bring them together into continuous performance evaluation. A restaurateur does not wait six months for performance evaluation; restaurants watch their daily sales. The same should be true of senior housing.

The corporate savings can be immense as the bloat of outdated span-of-control notions gives way to an organization that is fleet of foot, able to respond actively to market developments. In short, you can’t manage what you don’t measure, so pervasive measurement is the key to corporate performance.

Workforce Savings

How does this address the workforce challenge? First, it results in immediate oversight savings to offset escalating labor costs. Second, it allows lower level jobs to be more satisfying as employees are given more freedom coupled with clear-cut performance standards and consequences. Third, it doesn’t allow an underperforming employee to hide behind the efforts of others. Fourth, it allows local managers to respond to local needs for flexibility, adaptability, and work-life balance among their workers. That can lead to lower turnover with dramatic drops in the costs of recruiting, training, and monitoring new hires.

Embracing A Cause

The Empowerment Organization also brings workers into the service of a cause. This is particularly attractive for senior housing in which service for hapless elders becomes a calling that invites employee loyalty. Even when upper management missteps or acts insensitively, cause-based organizations can retain staff, allowing time for the board or other overseers to restore a vision-oriented, motivating leadership.  

By putting cause and mission first, Empowerment Organizations excel over others that may be viewed as no more than waystations, e.g. dining room wait staff looking for other opportunities, or career organizations that spawn a politics of ambition over customer service. This is not to mention those avarice-driven entities that put money before customer and employee interests. Empowerment Organizations improve customer value and attract committed, loyal employees.

Change Means Challenges

Compliance can become a challenge. Technology – exoskeletons, for instance – may reduce staffing needs, say, in a skilled nursing setting. But, legislated staffing ratios preclude such an advance. That is the task of trade associations, i.e., to persuade the legislature to allow waivers of counterproductive regulations when an enterprise is able to demonstrate an improvement in quality and performance. By presenting proactively the need for change, trade associations can perform a more positive function than a predominantly reactive approach.

No one wants to be a human resource. Every person, no matter how lowly their position, wants to be valued as an individual and to feel that they are able to meet their personal needs while bringing value to others. Their need may be childcare; they will be loyal to enterprises that help them meet that need. Their need may be time; they will be loyal to organizations that meet that need while sparing them the uncertainties of the gig economy. Executives who can value their employees to that degree emerge as the natural leaders of the Empowerment Organization. This is the path toward success in our age of labor scarcity coupled with high business opportunity.

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