The Problem
America, as well as many other countries in the world, is at an important crossroad. While many large companies are reporting near record profits, employees are experiencing near epidemic levels of stress, anxiety and depression often created by 24/7 responsibilities, depleted workforces and toxic work environments and cultures.
The mid- and long-term impact on company and employee performance and quality of life are immense. In addition, healthcare costs in America remain out of control with no obvious improvements in health outcomes. While our current medical, wellness and well-being solutions are absolutely necessary treatments, they are not sufficient to bring America back to a thriving, high-performing standard at which citizens can claim high qualities of life and levels happiness.
The course is not sustainable - something has to change. The good news is that Positive Organizational Health is the solution.If we continue to wait for defects and then try to fix them. We will never address the fundamental problem! Employers have now been adopting prevention, wellness and well-being solutions based on the medical model view of health for five decades.
Most wellness and well-being efforts to date have focused on programs designed to get employees to change the risky behaviors that lead to clinical health risks and disease. The results have been marginal at best. As Albert Einstein and others have said:
"We cannot solve our problems with the same level of thinking that created them.""It is time to see and do things differently -- it is time for a new level of thinking."
Health and well-being are multi-dimensional and influenced by many factors including social, emotional, environmental and cultural. Some are known. Some are yet to be discovered. Poor employee health and well-being is either a complex or wicked problem. A wicked problem is social or cultural and difficult or impossible to solve for many reasons including:
- Incomplete or contradictory knowledge
- Number of people and opinions involved
- Large economic or social burden
- Interconnected nature of these problems with others.
A better understanding of the multidimensional nature of health as well as its positive outer limits (positive outliers) is required to most effectively impact employee health and well-being in the broadest sense. As a field, a considerable amount of time and energy has been spent on understanding and changing negative outer boundaries of health (negative outliers i.e., excessive risks and disease) relative to a better understanding of the impact of concepts on the far positive end of health dimensions.
A better understanding of the influences of the complex social systems, environments and cultures in which people work and live must also be sought.
"Perhaps we should begin to seek out the creativity and innovation killers in our organizations instead of trying to fix the people within?"
- Abraham H. Maslow.
New Solutions
Wicked problems are socially complex; however, typical employee wellness and well-being programs are relatively straightforward or tame solutions. Relying on a few brilliant people to lead the effort or the latest new wellness or well-being solution is no longer sufficient.
Systematic and systemic approaches that involve all stakeholders in an organization, and using principles from systems and design thinking to improve support of workplace employee health and well-being is recommended.
Systems thinking allows for a broader lens to understand the whole system-level impact on health and to map and understand connections and relationships between parts of the whole. Design and systems thinking provides tools and processes that can help realize courageous and creative solutions to address the "wickedness" of poor health and well-being.
"The fundamental rationale [of systems thinking] is - to understand how it is that the problems that are the most vexing, and difficult and intransigent, come about, and to get a perspective on those problems that gives us some leverage - some insight as to what we might do differently." -Peter Singe
A form of systems thinking was used to write "Zero Trends: Health as a Serious Economic Strategy." A five-pillar approach with a Strategic, Systematic, Systemic and Sustainable system to implement the initiative was then applied. This approach also helped to recognize the "bigger picture" of workplace and workforce impact on the health of employees and the health of the organization.
Since "Zero Trends" was published in 2009, considerable research has been performed and experiences gained to expand the original five fundamental pillars in service of helping organizations develop healthy, high-performing, thriving and sustainable workplaces and workforces.
Visible and Thriving Senior Leadership
Leaders must have "a very deep and persistent commitment to real learning." They must be prepared to be wrong, and ready to acknowledge where they may be part of the problem. They must be willing to "triangulate" by bringing people together from different parts of the system and with different points of view.
They must champion the creation of a truly shared vision of a thriving workplace and workforce culture. For a leader who subscribes to systems thinking, focus needs to shift from wanting to control everything to wanting to leverage every relationship.
Committed and courageous leaders are critical to a thriving work culture and environment. Everyone in the organization should be considered a leader in this process including all employees, managers and senior leaders.
Positive Organizational Health
Individuals responsible for creating environmental and operational transformation need to realize the shared values, shared results and shared vision, and must share a commitment to deep learning. This includes people who represent both internal and external partners. Collaboration among all partners is critical, as is:
- Shared understanding about the problem
- Shared commitment to possible solutions
- Intelligent dialogue about the different interpretations of the problem
- Collective intelligence about how to solve the issue.
To be an effective partner in this process, participants may be required to set aside a focus on goals of their individual areas (internal partners) or business model (external partners), and attune to a more holistic and synergistic process of serving the ultimate vision of the organization.
Self-leadership and other Precursors to Positive Organizational Health
There is a mounting evidence and growing recognition among employers that characteristics like resilience, optimism and well-being are important contributors to employee health and performance. There is also increasing acknowledgement by some of the more visionary employers that, in addition to supporting the physical health of employees and providing a safe work environment, they have an opportunity to create conditions that optimally promote and support meaningful work, respect, resilience, optimism and creativity.
Organizations that practice Shared Values -- Shared Results and help employees live in accordance with their values and realize their individual and organizational purpose will gain from significant competitive performance advantages in the 21st century.
By shared values - shared results, the ideal work culture and environment is one where employees and the company share core values (Shared Values), and what is good for employees is good for the company and vice versa (Shared Results).
Meaningful and Intrinsic Recognition
Although recognition of the importance of intrinsic motivation is increasing, current trends in the wellness and well-being industry favor approaches that use extrinsic motivators, such as financial incentives or premium reductions for program participation, biometric or behavior outcomes. The reliance on external motivators (monetary incentives and/or rewards) has been one of the most interesting and controversial techniques to affect engagement in wellness activities.
From 2009-2014, the average financial incentive per program participant increased to nearly $650 annually. How long can organizations continue at this rate (approximately $100 per year increase)? Research on self-determination theory has generated persuasive evidence that once basic human needs have been met (i.e., our physiological and safety needs a la Maslow's Hierarchy), tangible rewards including money or prizes can actually undermine intrinsic motivation.
Organizations are encouraged to develop an increased capacity for more organic forms of recognition. What could be more powerful than positive recognition from a parent, child, friend, spouse, teacher, student, co-worker, supervisor, or stranger? Positive recognition has to be one of the most universally valued signs of approval and motivation.
Align organizational environment, culture, programs, policies, and relationships to help self-leaders at all levels of the organization develop a greater capacity to support and encourage each other to engage in healthy activities that they find personally meaningful and rewarding.
This could include involvement in more customary wellness activities like healthier eating, increased activity, or engaging in less traditional approaches like meditation, yoga, more quality time spent with family and friends, volunteer work and service to others. One of the most intrinsically rewarding and healthy experiences in life is in heartfelt service to something greater than oneself.
"I slept and dreamt that life was joy. I awoke and saw that life was service. I acted and behold, service was joy."- Rabindranath Tagore
Measure what Matters
To help the field evolve, a new set of measures and metrics for success must be embraced, and new, more responsive methods for measuring impact applied. A shift in focus to Positive Organization Health requires an expanded set of success metrics.
Financial metrics will likely remain important although they will likely become less important as the workplace and workforce find ways to share values and share results through a shared vision. Measuring what matters demands respecting what is critical to the organization and to the employees.
The organization will continue to value production and performance and financial objectives among others while employees are likely to value recognition, respect, a productive work environment and culture; while acquiring reasonable work expectations and fair wages among others. Both the employer and the employee will want to see a difference in the workplace and workforce:
- Beyond outcome measures of healthcare and productivity costs to include the full value of happiness, engagement, loyalty, and being an employer of choice.
- Beyond productivity to the value of an investment in shared values, positive health and supportive environment and culture.
- Beyond physical health measures to measures of mental health, social-emotional workplace environment and culture, family/ friends and community.
Today, the world is more crowded, more interconnected, more interdependent, and more rapidly changing than ever. The world is at a critical pivot point where problems faced are more serious than in any other human era. Solutions and results must rise to the occasion.
While systems thinking and shared values may sound formidable, the alternative of continuing with business as usual with respect to health is far more daunting. However, strictly following systems thinking or design thinking process is less important than embracing new viewpoints, thinking bigger about health and well-being, and sharing values, results and new methods to help expand an understanding of the many factors that influence health and well-being.
About the Authors
Dee Edington, Ph.D., retired in 2013 from the University of Michigan where, in the course of 37 years, he served as a professor of kinesiology, administrator and director of the university's Health Management Research Center. The final 35 years of his university research was captured in his 2009 capstone book, "Zero Trends: Health as a Serious Economic Strategy."
Jennifer Pitts, Ph.D., has been exploring the health-related influence of social support, engagement in treatment decisions, and meaning in life and work for the past 25 years. Most recently, she has focused on the impact of positive organizational cultures on the ability of employees to thrive in their work and lives.
