MARTINI CREATE A SENSE OF
URGENCY?
Creating a sense of urgency from the top down: a case study at the
Martini Hospital
Master thesis, MSc BA, specialization Change Management University of Groningen, Faculty of Economics and Business
November, 30th 2010 LEONIE DUNNING Studentnumber: 1802771 Billitonstraat 10a 9715 ES Groningen Phone: +31 (0) 638 750 575 E-mail: l.dunning@student.rug.nl
First supervisor/university Second supervisor/university
Leen de Waal MSc. Dr. C. Reezigt
Supervisor/field of study Drs. Ing. Laurence Hovenkamp
Acknowledgments: I would like to thank Leen de Waal MSc. for giving me tremendous support and providing
CAN THE MANAGEMENT OF THE
MARTINI CREATE A SENSE OF
URGENCY?
ABSTRACT
The central research question that was investigated is: To what extent can a sense of urgency be created through a process directed top down? A sense of urgency of urgency depicts out two elements that were included, (1) discrepancy and (2) time pressure. Literature research made clear both of these elements show links to the motivation of an employee which can either be intrinsic or extrinsic. Organizational culture was used to generically determine the type of motivation. A literature study and interviews were performed in order to investigate the influence of management on the link between motivation and a sense of urgency. Results show the current culture at Radiology can be typified as ‘Hierarchical’, which was coupled to extrinsic motivation. The research further revealed only radiologists and the manager perceive a real sense of urgency and the sense of urgency declines when looked lower in the hierarchy. It was shown that the perceptions of management and employees lie far apart which makes it difficult for management to influence employees in the right manner. It was suggested that they should empathize with the type of motivation of the employees in order to create a sense of urgency.
Keywords: Change Readiness, Discrepancy, Employee Motivation, Organizational Change, Organizational Culture, Sense of Urgency, Time Pressure.
Supervisor Martini: Drs. Ing. L. Hovenkamp
Supervisor University: L. de Waal, MSc.
TABLE OF CONTENTS
1. INTRODUCTION... 1 2. LITERATURE ... 4 2.1 Sense of urgency ... 4 2.1.1 Discrepancy ... 5 2.1.2 Time pressure ... 7 2.2 Motivation ... 10 2.2.1 Extrinsic motivation ... 11 2.2.2 Intrinsic motivation ... 112.3 Linking a sense of urgency and motivation... 13
2.3.1 Discrepancy and motivation ... 13
2.3.2 Time pressure and motivation ... 14
2.4 Linking it together ... 15 2.5 Culture ... 18 2.5 Conceptual model... 23 3. METHOD... 25 3.1 Research approach... 26 3.2 Field study ... 26 3.3 Interview questions... 28 3.3 The OCAI ... 30 4. RESULTS... 31 4.1 Readiness to change ... 31 4.2 Motivation ... 34 4.3 Management ... 37 4.4 Culture ... 41 4.4.1 OCAI results... 41
4.4.2 Links between culture and motivation... 43
5.1 Culture and motivation ... 47
5.2 Motivation and sense of urgency... 47
5.3 Management and the influence on motivation and a sense of urgency ... 49
5.4 Urgency and readiness... 50
5.5 Recommendations ... 52
5.6 Limitations and further research... 53
REFERENCES... 56
APPENDIX A ... 61
Versie 1 – Medewerkers en teamleiders... 61
Versie 2 – Teamleiders en manager ... 63
Versie 3 – Radiologen ... 65
1.
INTRODUCTION
Within the department Radiology of the Martini Hospital Groningen the management wants to implement changes at the department in order to fulfill wishes of the board to become a hospital that works at the ‘highest quality of care, safety and hospitality.’ In order to do that, the management wants to fulfill a planned change initiative at the department. When within this thesis change at the department is mentioned, planned change will be meant.
Planned organizational change has been viewed as a complex social process, with many interacting elements (Lewin, 1951; Coch & French, 1948). The social process of planned change leads to the importance of employees within planned change, because managing organizational change is about managing the ‘people’ aspects of that process (Smith, 2005). Foster (2010) beliefs that employee responses to changes ultimately determine whether the change efforts succeed or fail. This means that within a planned change, things will be easier when employees are willing to change, because otherwise resistance can arise. Resistance can seriously threaten the successful outcome of a change. Schein argued ‘..the reason so many change efforts run into resistance or outright failure is usually directly traceable to their not providing for an effective unfreezing process before attempting a change induction.’ (in: Armenakis & Harris, 1993). Schein assumes readiness needs to be created before change can ensue.
Readiness to change is defined as ‘the degree to which those involved are individually and collectively primed, motivated, and technically capable of executing the change.’(Holt, Helfrich, Hall, & Weiner, 2009). This means that whenever resistance occurs, people affected by the change will do everything within their power to remain the current situation. Armenakis & Harris (1993), do not focus on signs of resistance within the organization, instead, they pay attention to the change agents and tactics and strategies used to create readiness, which is seen as the other side of resistance. ‘Readiness … is reflected in members’ believes, attitudes and intentions regarding the extent to which changes are needed.’ (Dent & Galloway Goldberg, 1999). So, it is the state of feelings of members before either change is resisted or supported.
agrees with this, by stating that creating readiness is important to avoid resistance in a later stadium. In many change models, creating readiness is one of the first steps in changing an organization and since it is believed that changing becomes easier when employees are ready for change, it is seen as an important step to fulfill changes. Besides that, it is argued to be one of the many factors contributing to change effectiveness, since it is seen as a precursor to the behaviors of resistance to, or support for a change effort. Literature shows us that changes will go easier when there is readiness -or support- for change (Armenakis & Harris, 1993; Bernerth, 2004; Madsen, Miller & John, 2005; Rowden, 2001; Smith, 2005) and this assumption is adapted within this thesis, which will not be investigated as such, as many authors have already argued in favor of this matter.
Therefore, in thesis readiness for change with all parties involved will be considered an important prerequisite for the planned change processes. To create this readiness for change, one step to be taken is to make people aware of the pressures for change through creating a sense of urgency or a feeling of dissatisfaction with the present. The focus in this thesis lies on this instrumental part of readiness for change: a sense of urgency. Armenakis & Harris 1993, as well as Metselaar & Cozijnsen (1997) both argue that ‘sense of urgency’ or discrepancy is part of a bigger picture, that leads to readiness to change. Smith (2005) states that creating a sense of need is a key step to accomplish change readiness. Palmer (2004) states that making people aware of the shortcomings of the current situation, creating a sense of urgency, is important to create readiness: ‘people are likely to react negatively to change when they feel that there is no need for change’. Kotter (1996) also states that creating a sense of urgency and a need for change is the vital first step towards achieving successful organizational change.
The goal of the thesis is to find out if management can create a sense of urgency among employees from the top down to create readiness for the changes they are planning to implement. Since creating a sense of urgency deals with the feelings of organizational members and their beliefs and intentions, and these are personal attributes, it does not seem logical to create this top down. Therefore, in this thesis there will be looked for methods that can help with creating a sense of urgency.
department Radiology).
The department can be typified as a mini professional bureaucracy within the hospital, with a clear hierarchical structure, detailed rules and regulations, and a distinct separation of members’ organizational and personal lives (Burnes, 2004).
From a managerial point of view, the department forms a difficult department in the sense that radiologists form their own, separate partnership. They offer their services to the hospital and its patients but are not on the hospitals payroll. This means that they operate independently and management does have no authority over them. This means that lab personnel, which offers support to the radiologists, reports to the organizational manager; not to the radiologists. The organizational manager has formal authority over everyone at the department, except for the radiologists.
Furthermore it can be argued that there is a large distance between radiologists and their patients, since the department does not have its own patients. The patients are referred to the radiology department by the physician in attendance. Besides that they do not have their ‘own’ patients, they hardly have any direct contact with the patient, since most of the time they are working on reports and are analyzing pictures made by lab personnel.
After this short description of the department as well as the circumstances leading to this research, it can be concluded that the management of the department Radiology wants to implement a planned change, but they have the feeling employees and radiologists do not see the need to change and are not ready to change. At the beginning of this chapter, it was stated that changes shall be implemented more easily when readiness for change is present. One instrumental part of readiness for change is creating a sense of urgency among organizational members. Within this research, creating a sense of urgency at the department Radiology will be the focus. The goal is to give the management recommendations on how to create a sense of urgency among employees and radiologists in order to let the contemplated change be implemented successfully, the goal is to provide management with a collective instrument in order to steer in the group and not each individual. The research question that will be investigated is:
2.
LITERATURE
In order to find out if management can create a sense of urgency top down, the first step is to establish what a sense of urgency is, i.e. what are the constituting elements. The next step is to determine to what extent these constituting elements can be influenced by management to generate a sense of urgency within the relevant aspects of the organizational context.
2.1 Sense of urgency
At first the link between a sense of urgency and readiness for change will be described, after that the term ‘sense of urgency’ will be elaborated upon. Besides this, the constituting elements that can be influenced by management will be described.
A sense of urgency is perceived as an instrumental part of readiness for change. In this thesis the assumption is adopted readiness will lead to more effective changes and therefore a sense of urgency is needed. Smith (2005) believes a sense of urgency is needed in order to create readiness for change by stating that ‘change readiness can be accomplished by creating a sense of need and urgency for change’. Further Metselaar & Cozijnsen (1997) also refer to the need of a sense of urgency in order to get employees ready for change. It appears a sense of urgency has an influence on readiness for change.
Kotter (2008) argues creating a sense of urgency is the most important part of change. A sense of urgency is described by Metselaar & Cozijnsen (1997) as ‘the extent an employee experiences the need for change through explanation of rational arguments and social pressure expressed by colleagues, management and directors’.
In order to create a sense of urgency, it is important to make employees aware of the shortcomings of their current situation. Employees need to have the feeling it is better to change, rather than continuing to work under the current situation, or as Dess, Picken & Lyon (1998) state, a ‘fear of not changing’ should be created. This leads to one element of a sense
SUB-QUESTION ONE:
of urgency, namely discrepancy. In order for employees to change, they need to perceive a discrepancy between the current situation and the preferred situation. Another element of a sense of urgency appears to be time pressure. Urgency refers to something that is a necessity; something should change as soon as possible, in order to realize the internal or external mainsprings of employees. Employees need to become aware of the effect action is needed now.
In the following paragraphs first discrepancy will be addressed, since discrepancy defines the content of the planned change. Elaboration on this element of a sense of urgency should give more insight on the influence of management on this topic. Once this has been established, the timing aspects will be elaborated, since the content of the planned change defines the timing aspect; it depicts how much time is needed to fulfill a change. Furthermore, the influence of management on this topic and the creation of a sense of urgency will be discussed.
2.1.1 Discrepancy
In order to create a sense of urgency, employees need to become aware of the shortcomings of their current situation. Employees need to gain a belief change is needed. This refers to the need of information about how the current performance differs from the desired performance, as referred to by Katz & Kahn (1978). The idea that informing employees about the gap as ascertained by the management of the organization is enough to create a sense of urgency among employees seems very limited, since the desired end-state for the management of the organization may not be the desired end-state for the employee. They may perceive a different discrepancy (between the actual and desired end-state) than management. Bandura (1969) argues that everyone cares in a given situation what’s in it for themselves. He basically argues that people change when they perceive change will be beneficial to them. So why should employees contribute in a change that offers no benefits to them? It seems quite straightforward that if a person does not understand and can accept a recommended or announced change, or if he or she does not think there is a need for the change, the person probably will not get very enthusiastic about making the change, neither individually nor organizationally. Managers therefore need to find out what the benefit for the employees is in the planned change, or focus on elements that will convince employees to change.
discrepancy between the current and the preferred situation in order to change. It should become clear to them what the benefits of the change are. Not only should the desired end state be explained, but also why that state is appropriate (Armenakis & Harris, 1993). In order to move, employees should feel an unfulfilled need or desire which the change can solve. Self-discrepancy theory explains this by stating that we are motivated to reach ‘a condition where our self-concept matches our personally relevant self-guides’ (Higgins, 1987).
In order for employees to accept the discrepancy of the management of the organization as their own, it should become clear to employees how the desired end-states helps their own desires or needs. In order to get more insight in what is needed for an employee to change, insight into behavior is needed.
There are two theories that explain behavior. The ‘value-attitude-behavior hierarchy model’ and the ‘Theory of Planned Behavior’, further TPB (Johnson, 2003; Ajzen, 1991). The ‘value-attitude-behavior hierarchy model’ reasons a connection exists between values and behavior, through intermediary attitudes. This research is often used in consumer research and leaves environmental factors out of the scope. The ‘theory of planned behavior’ (shown in Figure 1), includes this environmental factors.
FIGURE 1
Theory of Planned Behavior
Source: Ajzen, 1991
The model describes three independent determinants of these motivational factors1. The more favorable the attitude and subjective norm and the greater the perceived behavioral control, the stronger should be an individual’s intention to perform the behavior. It does not fall within the scope of this research to fully address this topic, but it can be seen management can influence the determinants (by e.g. providing information about the discrepancy, or increasing the social pressure) which influences the motivation of an employee to behave in a certain way. When management focuses on the motivation of employees, they may see what is needed for employees to see the need for change and can steer on this and in that way stimulate employees to act, since according to Amar (2004) ‘Motivation is associated with the forces acting on a person causing him to act in a certain way’.
This sub-paragraph made clear discrepancy is the perceived difference between the current and the preferred situation. The discrepancy of the management of the organization is not per se the same discrepancy the employee perceives. Employees may be perfectly pleased with the current situation and because of this do not see the need for change and do not perceive a sense of urgency. In other words, discrepancy is a matter of interpretation. In order for employees to accept the discrepancy it should become clear to them how the desired end-state helps their own desires or needs. When an employee perceives an unfilled need or desire they will be more motivated to change. The TPB (Ajzen, 1991) shows this by stating that members should have an intention before they show certain behavior. Management can steer on this intention/motivation and in that way stimulate employees to accept the discrepancy and act.
Now the first part of a sense of urgency is elaborated upon, the second aspect will be discussed; time pressure.
2.1.2 Time pressure
The second element of a sense of urgency is time pressure. The discrepancy aspect makes clear how large a planned change is (difference between preferred and present state) and depicts the time necessary to fulfill a change. The element time pressure is useful within a planned change in which it is clear how long a certain change will take, depending on one’s capabilities. In order to use time pressure it should be possible to rationally determine the time
1
needed for a change. Therefore the second element of a sense of urgency that will be discussed is time pressure.
An important part of a sense of urgency is the feeling that something should change,
now (Kotter, 2008). This raises the attention on time. According to Gersick, Gladstein and
Seers & Woodruff several studies demonstrated that groups increase their activity when they begin to feel time pressure because of an approaching deadline (in: Gevers, van Eerde & Rutte, 2001). According to Gevers et.al. (2001) this points attention to the belief that there appears to be a relationship between the awareness time is running out and making progress. This implies that in order for employees to ‘feel’, or enhance a sense of urgency, they need to have the feeling that time is running out. As said before, this can only occur when employees are able to determine the time needed for a task or change, as within planned change.
Within an organization, employees have certain tasks which lead to goals that need to be achieved. These activities and tasks normally have a certain timeframe. The existence of a deadline normally motivates employees to work on a task. According to Nordqvist, Hovmark & Zika-Victorsson (2002: 464) ‘motivation intensifies as the deadline approaches… activity will be increased when they feel the time pressure because of the forthcoming deadline’. This corresponds with the TPB of Ajzen (1991) in that in that the existence of a deadline influences the determinants of motivational factors. This means that employees need to feel time pressure in order to act.
However, high levels of time pressure can ‘engender a loss of enthusiasm and an inability to act’ (Nordqvist et.al. 2002:464). Gevers et.al. (2001) agree with this, by stating that the best performances are achieved under an intermediate time pressure: too little time pressure leads to boredom and too high time pressure leads to stress, resulting in procrastination. Within most tasks the relationship between time pressure and performance is curvilinear (Gevers et.al. 2001), see Figure 2. Perception plays a central role in the experience of time pressure. This makes it difficult for management to steer on, since it is hard to determine what is ‘too much’ for someone. Gevers et.al. (2001) state stress negatively influences performance. Therefore, stress should be avoided. It is important to find an optimum amount of stress, with intermediate time pressure. As Kotter (2008) says, it is important to act with a sense of urgency but to have a realistic view of time.
the contrary, is perceived by employees if they have the feeling they are confronted with a situation which they cannot handle.
When a sense of urgency should be created it is preferable to do this with the use of positive stress –situated within the optimum stress in Figure 2- since employees than deliver the best performances. Management can steer on the amount of stress employees perceive by choosing a rather pragmatic approach. When management notices employees get stressed and anxious management should correct the time pressure put on employees and when employees get bored and relaxed also adaptations in time pressure are needed. However, when management is unable to create positive stress, negative stress or high levels of stress may be useful (although this can lead to negative consequences), since in the end no stress leads to no action.
It can be concluded that depending on the type of stress perceived by employees, time pressure can either motivate or discourage a sense of urgency to happen. An optimum amount of stress, leads to motivation to start acting.
.
Source: Hellriegel & Slocum, 2007
Now both elements of a sense of urgency are elaborated upon. Both the discrepancy and the time pressure element of a sense of urgency have links with the motivation of employees: It was shown that the discrepancy the management of the organization perceives is not per se the same discrepancy the employee perceives. In short, discrepancy is a matter of interpretation, which is based on beliefs and desires. These beliefs and desires should lead to intention which in turn leads to behavior (Ajzen, 1991). It can be concluded management can
FIGURE 2
influence this difference in perceived discrepancy by focusing on the intention/motivation of employees. Finding out what motivates employees and how they perceive the discrepancy can help in creating a sense of urgency since management than knows where to steer on.
When employees feel a deadline is approaching, they will be motivated to work or act, as shown by e.g. Nordqvist et.al.(2002). Therefore it can be concluded time pressure can be used to motivate employees to act. Time pressure creates stress, which can either be positive or negative. This means time pressure can either motivate or discourage a sense of urgency to happen. Management should try to let employees feel an optimum amount of the right type of stress, which leads to motivation to start acting. This can be done with influencing the determinants of motivational factors (Ajzen, 1991). The optimum amount of stress should be found by experimentation in which management clearly monitors the reactions of their employees to time pressure. In every situation no stress should be avoided, since with no stress nothing will happen. It should be pointed out again that time pressure is especially useful within planned change and that employees should be able to rationally determine the time needed to fulfill the changes, which points to the need of first determining the discrepancy aspect.
Both elements of a sense of urgency showed their links to motivation of an employee. Therefore, in the next paragraph the topic motivation will be further elaborated upon. After that, the links of motivation with discrepancy and time pressure will be further described.
2.2 Motivation
Both elements of a sense of urgency -the discrepancy aspect as well as the time pressure aspect- refer to the necessity to make employees aware of the need for change in order to make them act and create a sense of urgency. Motivation can be a powerful instrument to create or enhance a sense of urgency, since both elements of a sense of urgency, time pressure and discrepancy showed links to the motivation of employees. Therefore, in this paragraph motivation will be discussed, as it is considered a key principle in the instrumental approach towards creating urgency in a planned change context. To best comprehend the full scope of the instrument motivation the research in this paragraph will include the various types of motivation that can be found.
to behave in a way of which they think it will lead to the achievement of a certain goal’ (in: Bredenhoff, 2009). The term motivation is distracted from the Latin word ‘movere’, which means ‘to move’ (Steers & Porter, 1991). To motivate someone, means to encourage an individual to behave (or move) in a certain way.
According to Ryan & Deci (2000), people not only have different amounts, but also different types of motivation. This means not only the level of motivation but also the orientation of that motivation varies. Vinke (2000) refers to this orientation of motivation, he says motivation can come from within, ‘intrinsic motivation’, but can also be steered on from the outside, ‘extrinsic motivation’. The subject motivation -extrinsic and intrinsic- has been researched extensively. In the next subparagraphs extrinsic and intrinsic motivation will be discussed in more detail.
2.2.1 Extrinsic motivation
Extrinsic motivation pertains to a wide variety of behaviors where the goals of action extend beyond those inherent in the activity itself (Deci & Ryan, 1985). According to Burnes (2004:599) extrinsic rewards come from material rewards, such as money and promotion, provided by others.
Extrinsic motivation is characterized by (Quinn, Faerman, Thompson & McGrath.,2008): - employees act because they are turned to this by others
- the source of action lies in factors outside of the employee; - employees are motivated from the outside.
When someone is extrinsically motivated, they will work on a task even when they have little interest in it because of the anticipated reward or punishment they will receive at the end. Extrinsic motivation is regulated by rewards or in order to avoid negative consequences (Guay, Vallerand & Blanchard, 2000). It does not mean a person will not get any pleasure from working on or completing a task, but it means the pleasure they anticipate from some external reward will continue to be a motivator even when the task to be done holds little or no interest.
2.2.2 Intrinsic motivation
(2004: 600) intrinsic rewards come from non-material rewards, such as praise, satisfaction and recognition which are internal to the individual.
Intrinsic motivation is characterized by (Quinn et al. (2008): - employees work from internal needs;
- employees deal without interference of other persons and factors; - employees are stimulated from the inside.
For a long time it was believed extrinsic rewards could motivate every type of employee and much research has been done on the effect of extrinsic rewards on intrinsic motivation (e.g. Cameron & Pierce, 1994). According to many, financial rewards are the most important rewards to perform better, although more recent research shows financial rewards do not lead to better performances when the task becomes harder (Pink, 2010). Rewarding people may decrease interest by weakening competency drives or by ‘shifting causal attributions for performance from internal motivators to external rewards’ (Bandura, 1982). Pink (2010) says that as long as the task only involves mechanical skill, bonuses work as expected; higher pay leads to better performances. However when the task asked for rudimentary cognitive skill, higher rewards let to lower performances. When intrinsic motivation is important, there are three factors that lead to better performances and personal satisfaction (Pink, 2010):
- Autonomy: desire to be self-directed. Management is great if you want compliance, but if you want engagement, self-direction is better.
- Mastery: urge to get better. It’s about challenge, mastery and making a contribution - Purpose: when the profit motive gets unmoored from the purpose motive, bad things
happen.
Therefore, it is important to find out what type of motivation drives employees, because when the wrong kinds of rewards are used they can discourage employees. When employees are intrinsically motivated, extrinsic rewards can discourage employees and therefore they should be intrinsically rewarded, which means by non-material rewards, or focus on autonomy, mastery and/or purpose.
When the ideas of Quinn et.al. (2008) and Ajzen (1991) are linked, it can be concluded that intentions/motivational factors can arise intrinsically or extrinsically, therefore, in the next paragraph the link between a sense of urgency and motivation will be elaborated upon. The focus in this will lie on the two aspects of a sense of urgency (discrepancy and time pressure) and the two sorts of motivation (extrinsic and intrinsic).
2.3 Linking a sense of urgency and motivation
In the previous paragraphs, both a sense of urgency and motivation were elaborated upon. Both elements of a sense of urgency showed links to the motivation of employees. Therefore in the previous paragraph the motivation subject was elaborated. This revealed two types of motivation, extrinsic and intrinsic. In this paragraph the two subjects (sense of urgency and motivation) will be linked together, and the role of management becomes clear. 2.3.1 Discrepancy and motivation
Employees can be either intrinsically or extrinsically motivated. This has an influence on the perceived discrepancy and the role of management. Extrinsically motivated employees will only change their behavior when this will either have positive or negative consequences. This requires explanation about the discrepancy and the effect on the employee. Although they might not agree with the explanation, the prospect of positive or negative consequences may be enough to overcome the discrepancy between the different end-states and start to move, as Guay et al. (2000) mention.
On the other hand, when employees are intrinsically motivated the discrepancy itself may be enough motivation to change, intrinsically motivated employees do not need positive or negative consequences in order to act since they might perceive the discrepancy as well and change because of their inner needs/desires. As Quinn et. al. (2008) argue in § 2.2, employees with intrinsic motivation deal without interference of other persons and factors, they are stimulated from the inside. Pink (2010) showed that the use of consequences might even lead to resistance and therefore management should use different tools. The easiest way for management to deal with intrinsically motivated employees is letting employees see how they can serve their own needs synchronous to that of the management of the organization, to make sure employees will start to move.
extrinsically motivated extra rewards, aimed at satisfying their extrinsic motivations, may be enough to make employees act, but when employees are intrinsically motivated, other behavioral techniques seem appropriate. De Young (1993) differentiates between two groups of change techniques, either antecedent interventions (e.g., prompting, education, and modeling) or consequence interventions (e.g., reinforcement, punishment). When looking at the different types of motivation, consequence interventions match with extrinsic motivation since consequences are needed in order for an extrinsic motivated employee to act. On the other hand, antecedent interventions matches with intrinsic motivation, since what is needed in order to make intrinsic motivated employees act is explanation about how the preferred situation for the management matches their own inner needs and desires. As said before the use of consequences may be misplaced and can lead to resistance.
It is reasonable to assume the best policy for management therefore is to adapt their influencing intervention based on their perception of the relevant type of motivation that drives employees attitude toward the planned change. Finding the right perception is very important for management, since using the wrong intervention may lead to resistance. Therefore, management should put effort in finding the right perception.
2.3.2 Time pressure and motivation
As well as with discrepancy, the sort of motivation that drives employees (extrinsic/intrinsic) is believed to influence the importance of time pressure; time pressure appears to be of no importance when someone is intrinsically motivated, since when someone is intrinsically motivated, they will be eager to change to overcome the discrepancy and serve their (inner) needs, so this aspect of a sense of urgency is perceived to play a minor role when creating a sense of urgency. This matches the ideas of Hellriegel & Slocum (2007) who talk about positive stress. Whenever an employee perceives positive stress, they will feel an urgency to act. So, whenever an employee is intrinsically motivated, their motivation comes from the inside and there is no need for management to focus on the time pressure aspect of a sense of urgency, because they perceive this urgency or positive stress by nature.
of stress depends on the available time, as well as the capabilities of the employees (Anderson, Hellriegel & Slocum 1977), and as said in § 2.1.1 should be created by management by means of experimentation. When employees perceive there is just enough time available and they have the proper capabilities, they will perceive positive stress and start to act. As said before, when time is limited even negative stress can be used, since no stress leads to no action.
Again, it is reasonable to assume management should adapt the effort they give on the timing aspect based on their perception of the relevant type of motivation that drives employees’ attitude towards planned change; with little effort on time pressure when someone is intrinsically motivated and much effort when someone is extrinsically motivated.
In this paragraph it became clear that the type of motivation influences the discrepancy or time pressure perceived. In the next paragraph the found ideas will be combined in order to find out the best intervention method for management.
2.4 Linking it together
When combining the ideas of the previous paragraphs, the type of motivation of an employee can be used by management to find the focus point (either the discrepancy aspect or the timing aspect) when creating a sense of urgency. A matrix can be set up (Table 1), which summarizes the findings from the previous paragraphs.
On the other hand, when someone is intrinsically motivated, time pressure does not seem to be very important since the employee will be eager to change, to fulfill their needs. Within this situation the discrepancy aspect is important to focus on, because in order for employees to move, it needs to become clear how they can serve their own needs synchronously to that of the management of the organization. Explanation and information therefore seem the most important tools for management.
TABLE 1
Focus point of management
Discrepancy Time pressure
Extrinsic motivation
Rational explanation, influenced by consequence interventions
Influence by creating preferably possible stress
Intrinsic motivation
Explanation and information provision, influenced by antecedent interventions
No action, intrinsic motivation leads to eagerness to change
Both intrinsic and extrinsic motivation appear to have an influence on how discrepancy or time pressure are perceived; the elements/characteristics of a sense of urgency. Both discrepancy and time pressure can be influenced by management but it appears that the kind of influence should be adapted to meet the needs of the relevant type of motivation of employees, which occurs in the specific planned change program. Therefore, the following sub-questions will be investigated:
When motivation needs to be dealt with, it is hard to focus on the individual. Bandura (1982) states it is important to not focus too much on individuals when motivating them, since
SUB-QUESTION THREE:
To what extent can management influence the motivation of employees to create a sense of urgency?
SUB-QUESTION TWO:
people do not live their lives as social isolates. Many of the challenges and difficulties they face reflect group problems, requiring sustained collective effort to produce any significant change (Bandura, 1982). This reasoning regarding group behavior implies that management will more likely make an efficient use of their energy involved in planned change processes if they adapt one singular mode of action, specifically aimed at the collective motivations of the relevant group, rather than focusing on every single individual’s motivation. Besides this, it is hardly possible for management to ‘focus’ on every individual during a collective planned change effort and therefore, management is more likely to achieve the desired results when they focus on group-wide motivations.
As said in §2.1 in order to create planned organizational change, employees need to change their behavior. This behavior is guided by several factors, as shown by the TPB (Ajzen, 1991). According to the TPB the determinants of motivational factors (intention) come forth out of certain beliefs. These certain beliefs are in essence is the same as the underlying assumptions within organizational cultures, as can be seen in Figure 3.
Every organization has an organizational culture and as can be seen in Figure 3, this culture consists of artifacts, shared values and assumptions. The interaction of groups within an organization creates culture (Johnson, 2003). Since cultures consist of artifacts, shared values and assumptions, the existence of a culture implies that groups share some assumptions, which is the inner layer of culture as described by Schein (1999). The motivation of employees is driven by certain beliefs or assumptions and since shared assumptions influence motivation, it can be concluded that the organizational culture is a possible predictor of the generic type of motivation (intrinsic or extrinsic) present among employees.
.
Source: Johnsen, S.E., 2003
2.5 Culture
It was already mentioned that management cannot guide each individual; it was concluded management should aim at the collective motivation of the relevant group, rather than focusing on individuals. As concluded in the previous paragraph, the predominant motivation of employees comes forth out of the organizational culture. Therefore, in this paragraph the topic culture will be elaborated upon - in order to find out which culture type leads to which type of motivation.
As discussed in § 2.4, the culture of an organization consist of artifacts, shared values and assumptions. Within organizations, the interactions of people create culture which implies that groups share some assumptions, the inner layer of culture as discussed by Schein (1999). Further it was argued that shared assumptions are needed to manage motivation at the department and that therefore culture is used to generically determine the type of motivation.
In order to typify possible cultures within organizations, Cameron & Quinn (2006) developed the ‘Competing Values Framework’, further CVF (Figure 4). In order to
FIGURE 3
investigate motivation and the role of management, a model of organizational and individual values was required that (1) could be applied to a wide range of organizations and (2) included values that seemed especially germane to organizational functioning and behavior. The CVF is used within this research because it is widely used and matches an instrumental approach of change. It offers an instrumental view on culture which matches this research, since an instrumental part of readiness for change –a sense of urgency- is researched.
The CVF quickly became a device for mapping organization’s value profiles and conducting comparative analyses on them (Quinn and Cameron, 1983). Quinn and Kimberly (1984) argued for the model’s ability to ‘explore the deep structure of organizational culture, the basic assumptions made about such things as the means in compliance, motives, leadership, decision making, effectiveness values and organizational forms’.
The CVF has four quadrants, situated in a matrix of two continuums. One continuum distinguishes effectiveness criteria that emphasize ‘flexibility, discretion and dynamism’ from criteria that emphasize ‘stability, order and control’. The other continuum distinguishes effectiveness criteria that emphasize an ‘internal orientation, integration and unity’ from criteria that emphasize an ‘external orientation, differentiation and rivalry’. Together the four quadrants are formed, each representing a distinct set of organizational effectiveness indicators or culture types: clan, adhocracy, market and hierarchy.
The organization that has a culture which is typified as a clan culture values flexibility and has an internal focus. Emphasis within this culture lies on commitment, cohesion and morale. It is typified as an organization that is a friendly place to work and where people share a lot of themselves: it is like an extended family. The organization is held together by loyalty and tradition: commitment is high.
Second, an adhocracy culture type values flexibility and has an external focus. It tries to dominate its environment (Mallak, Lyth, Olson, Ulshafer & Sardone 2003). The organization can be seen as a dynamic, entrepreneurial, and creative workplace. There is commitment to experimentation and innovation.
Third, a so called market culture values stability and has an external focus. This culture type typifies a results-oriented workplace and emphasizes winning. Market share and market penetration are key measures of success (Mallak et.al. 2003).
This short introduction about definitions and typologies of culture and the approach of Cameron & Quinn in the CVF is not exhaustive but it highlights the most important bases and aspects regarding this research. Within this research the goal is to find out to what extent management can create a sense of urgency among employees. Since the top-down creation by management of a sense of urgency with employees in this research is considered to be instrumentally driven by employees’ motivations, ways of influencing and/or using these motivations need to be investigated. As it is next to impossible for management to have a ‘differentiated focus’ on each individuals motivations, this research will try to distinguish a common instrumental denominator for collective motivations through the various cultural archetypes as defined by Cameron & Quinn (2006). The goal is to find a collective instrument instead which requires less managerial input but still realizing most of the effects of using individual motivational steering.
FIGURE 4
The next table (Table 2), couples the motivation of employees within the different culture typologies and the role of managers in that case.
TABLE 2
Culture and motivation Type of
culture
Motivation of employees by:
Managers need to be: Managers role:
Clan The concern shown by their manager.
Focused on their staff and their needs/desires
- mentor - facilitator Adhocracy Common vision, excitement
of the change and risk taking
Externally focused - innovator - broker Hierarchy Certainty and predictability Internally focused - monitor
- coordinator Market Desire to complete the task
at hand
Focused on the demands of the task and getting the work done
- producer - director
Source: based on Vilkinas & Cartan, 2006
Until now, the different concepts of a sense of urgency and motivation were defined and coupled to the role of managers. Both elements of a sense of urgency (discrepancy and time pressure) showed links to the motivation (extrinsic or intrinsic) of employees. In order to let employees overcome discrepancy they should be motivated to do so. This can either be done by information and explanation, or by using consequence interventions. Time pressure also showed links to motivation, since employees should experience a certain level of stress in order to be motivated to move. It was argued the focus of management on time pressure should depend on the type of motivation. Management can influence both elements, but it was concluded it is not preferable that managers steer on individual motivation; therefore, they should steer on groups (Bandura, 1982). Culture is used to define group motivation, since it was argued that culture depicts the generic type of motivation of its employees.
Comparison of the characteristics of the different models (Rhineland versus Anglo-Saxon) and the different types of culture of Cameron & Quinn (2006) showed a link between the Rhineland model and the flexibility focused cultures of Cameron & Quinn in that it focuses on individuals, recognizes the importance of different stakeholders and working together (Cameron & Quinn, 2006; Goodijk, 2008, Wondergem, 2008) and a link between the Anglo-Saxon model and stability focused cultures of Cameron & Quinn in that they focus on goals and rules, steady relationships and focus on control. (Cameron & Quinn, 2006; Goodijk, 2008; Wondergem, 2008).
When looking closer at the different culture types of Cameron & Quinn this same links can be found. It can be argued that stability focused cultures show links to extrinsic motivation. Stability focused cultures have an emphasis on reputation and success; stability is important and the emphasis lies on low cost (Cameron & Quinn, 2006). Within extrinsic motivation, reputation is seen as an extrinsic motivator (Burnes, 2004) and the importance of stability shows members are not invited to show much initiative and employees act because they are turned to this by others, which is a characteristic of extrinsic motivation as described by Quinn et.al. (2008).
The link between flexibility focused cultures and intrinsic motivation can also be found. Flexibility focused culture are characterized by high commitment, the importance of human resource development, innovators, and individual initiative (Cameron & Quinn, 2006). This links to intrinsic motivation since the importance of human resource development refers to the importance of growing and developing an individual, stimulating an employee from the inside (characteristic of intrinsic motivation by Quinn et.al. 2008), the presence of individual initiative shows employees deal without interference of other persons or factors (characteristic of intrinsic motivation by Quinn et.al. 2008) and the presence of innovators which shows employees are stimulated from the inside (characteristic of intrinsic motivation by Quinn
et.al. 2008)
The literature study led to certain findings and research foci. In the next paragraph these will be combined into the conceptual model that is on the basis of this research.
2.5 Conceptual model
In the previous paragraphs literature on a sense of urgency was discussed. A sense of urgency is perceived as an instrumental part of readiness for change. In this thesis the assumption is adopted that readiness for planned change will lead to more effective changes and therefore a sense of urgency is needed. A sense of urgency consists of two elements, discrepancy and time pressure. Discrepancy is defined as the difference between the current and the preferred end-state. The discrepancy aspect makes clear how large a planned change is and depicts the time necessary to fulfill a change. In order to show certain behavior employees need to perceive a certain amount of time pressure. Time pressure motivates an employee to act. Both characteristics of a sense of urgency showed employees need to get motivated in order to act. It was shown that motivation can either be intrinsic or extrinsic and the best policy for management is to adapt their influencing intervention on the discrepancy or time pressure element, based on the perceived type of motivation that drives employees’ attitude toward the planned change.
Since we want to prevent steering on individuals, the type of culture was used to define generic motivation within an organization. It was expected –based on literature- that different cultural archetypes (clan, hierarchy, market, adhocracy) point to different types of motivation (intrinsic and extrinsic). Literature also showed management can have an influence on the motivation of employees. The findings of the literature study led to the following summarizing model (Figure 5).
SUB-QUESTION FOUR:
3
FIGURE 5 Summarizing model
In order to test if the links found in literature are correct, a conceptual model is set up which will test the summarizing model. The focus will lie on the relationship between the factors described (culture with type of motivation, type of motivation with elements of sense of
urgency) and the influence of management on these aspects. The found links lead to the
following conceptual model (Figure 6) that will be tested.
FIGURE 6 Conceptual model
Summarizing this, first it was found a sense of urgency was part of change readiness. After that it was concluded a sense of urgency depicts out of two elements, discrepancy and time
pressure, which are influenced by the type of motivation (extrinsic or intrinsic) that drives an
employee. The conclusion could also be drawn that management has an influence on this Flexibility focused culture type Intrinsic motivation Extrinsic motivation Sense of urgency Intrinsic ‘rewards’ Extrinsic rewards Management role Stability focused culture type
relationship and should adapt their influence techniques depending on the type of motivation which drives an employee. Since it is hardly possible for management to ‘focus’ on every individual, group-wide motivation (extrinsic or intrinsic) should be used, which was shown to be based on the cultural archetype present within an organization. The goal is to individually create a sense of urgency among employees. In order to do this, group motivation is used, which is based on the cultural archetype. Therefore, the goal is to use collective motivation to create individually experienced urgency which should lead to individual behavior.
The literature study and the conceptual model led to sub-questions that will be investigated in this specific case:
Sub-question (1): To what extent does a sense of urgency lead to readiness to
change?
Sub-question (2): Does the type of motivation influence the characteristics of a
sense of urgency?
Sub-question (3): To what extent can management influence the motivation of employees to create a sense of urgency?
Sub-question (4): To what extent does the type of culture influence the type of
motivation?
3. METHOD
3.1 Research approach
Baarda & de Goede (2006) describe two sorts of research approaches, qualitative and quantitative approaches. The purpose of qualitative research is to gain a deeper understanding and description of a problem through gathering and analysis of detailed data of ideas, feeling and attitudes or can be used when a topic is relatively unexplored. The empirical data received is not easy to transform into numbers, and is best described in words. The purpose of quantitative data is to gather, analyze and measure statistical data. The findings can be presented in numbers.
This research is about the creation of a sense of urgency, a topic which is not widely discussed or researched and literature about the creation of a sense of urgency is limited. Therefore, an exploratory study will be conducted in order to test if the links between the elements of a sense of urgency and group motivation (which will be tested with the use of culture) can be found in practice as well. Another reason to use a qualitative approach is the fact that the influence of management on a sense of urgency will be researched. Insight into feelings about management and how they threat employees’ motivation is important, since it is assumed that a relationship exists between culture, motivation and the sense of urgency. This makes it important to collect opinions, and in this way, get a deeper understanding.
3.2 Field study
To test the sub-questions set up in the literature section, semi structured interviews were held. The choice for semi-structured interviews was made because the purpose of these interviews was to learn the interviewees’ viewpoints regarding situations relevant to the research question and the sub-questions. These semi-structured interviews were set-up based on the theory findings from the previous chapter, and were conducted in Dutch. Before the interviews were actually conducted, the interview scheme was checked by the supervisor of the university. With the use of open questions, employees were invited to speak freely and openly about their opinions.
asking the employees for the interviews the research was introduced in the newsletter of the department in which it was announced some employees could be approached by the researcher for giving an interview. When asking the employees to participate in the research a reference was made to this publication.
TABLE 3
Staff structure Radiology
In order to test opinions of the entire department, it was important to involve at least one person from every department. Therefore a stratified random sample was drawn (Baarda, de Goede & Teunissen, 1997). After the selection was made, the actual employees that were to be interviewed were chosen based on a random sample out of relevant available employees, due to the nature of their work. After a short introduction they were asked if they would like to contribute to this research. All eleven selected interviewees were willing to participate.
TABLE 4 List of interviewees
Function
Manager Radiology Lab worker echography
Team leader nuclear Radio diagnostic lab worker Team leader conventional radiology Employee business support
Lab worker roentgen
Recent medical manager (radiologist) Radio diagnostic lab worker Future medical manager (radiologist) Medical nuclear lab worker
From the interviewees, five were women and six were man. The number of years Department Number of employees
Ultrasound 10
interviewees worked for the Martini hospital range from one year to 32 years, with an average of 13,59 years. The average of working years at the Martini among radiologists is 10 years, among other employees 13,83 years and among team leaders / manager 23,5 years. All of the team leaders already worked in the hospital before they were pointed out to become team leader. On average, they work as a team leader for four years.
During the interviews names and other information that could have leaded to specific interviewees were not mentioned, which guaranteed anonymity to prevent bias from socially applicable answers as much as possible.
The semi structured interviews can be found in Appendix A, and are conducted in different variants. The first variant was conducted among lab personnel, the employee of business support and the team leaders. The second variant was conducted among the manager and the team leaders. This variant included questions about them in their role as management. The third variant was conducted among the radiologists. This approach was chosen since questions in the interview related to management and its capacities. This means the team leaders answered two kinds of questions; those involving themselves as management as well as questions about the organizational manager, their manager. The interviews conducted with the radiologist were a combination of the two others, since the radiologists work in a partnership, and do not fall under direct authority of the management.
The interviews were topic-guided, so questions were formulated before the interviews, and acted as a guideline for the interview. Furthermore, follow-up questions were asked whenever suitable, to gain more insight in the motives and underlying thoughts behind the answers.
The interviews started by providing some information about the background of the interview: the topic goal, the duration and the role of the interviewee, the reasons why the employee was asked to participate, and what was expected from the employee. After the research introduction, some introduction questions about his/her position in the organization and personal background were asked.
3.3 Interview questions
In order to test the sub-questions different interview questions were asked. In order to test the first sub-question (To what extent does a sense of urgency lead to readiness to
were directly asked if they felt a sense of urgency, but also questions referring to discrepancy and time pressure were asked in order to test the correctness of their answer. Discrepancy was tested asking questions about the performance and if they thought improvements should be made, since discrepancy deals with a difference between the current state and the preferred end-state. Time pressure was tested asking employees to indicate when changes were needed.
The second sub-question (Does the type of motivation influence the characteristics of a sense of urgency?) was not tested using measurement that would define the individual intrinsic or extrinsic motivation, since it was the goal to avoid individual steering. Furthermore, no questions were asked that directly linked to the type of motivation of an employee, in order to prevent bias from socially applicable answers. Instead, questions were asked about certain elements as being characteristics of motivation. These elements are a feeling of ownership, taking responsibility and self-discipline. These elements are perceived to say something about the type of motivation, as they can be linked to the characteristics Quinn et.al. (2008) give to the different types of motivation:
• It can be argued that someone with a high feeling of ownership will act out of inner motivation, they deal without interference of other persons or factors (characteristic of intrinsic motivation, Quinn et.al. 2008) and someone with a low feeling of ownership will act because they are turned to this by others, they are motivated from the outside (characteristic of extrinsic motivation, Quinn et.al. 2008).
• Someone who takes many responsibility probably is stimulated from the inside and works from internal needs (characteristic of intrinsic motivation, Quinn et.al. 2008) and someone who does not take much responsibility act because they are turned to this by others and is motivated from the outside (characteristic of extrinsic motivation, Quinn et.al. 2008).
• Someone who shows high-levels of self-discipline works from internal needs and without interference of other persons and factors, they are stimulated from the inside (characteristic of intrinsic motivation, Quinn et.al. 2008) and someone who shows low levels of self-discipline acts because they are turned to this by others and they are motivated from the outside (characteristic of extrinsic motivation, Quinn et.al. 2008). Since the elements can be coupled to the characteristics of the type of motivation, these elements are used to gain insight into the type of motivation of employees.
employees and management influence on employees. Further employees were asked about previous changes, the role of their managers in that and the belief they have management is capable of fulfilling changes.
The fourth sub-question (To what extent does the type of culture influence the type of
motivation?) was answered combining the answers of employees referring to the type of
motivation present and the OCAI (Organizational Culture Assessment Instrument) test, which was used to determine the generic type of culture. The OCAI test will be further explained in the next paragraph.
3.3 The OCAI
The CVF set up by Cameron & Quinn (2006) was used to typify the culture of the department Radiology of the Martini. The OCAI measures the organizational culture and the underlying aspects of this organizational culture (Cameron & Quinn, 2006). The measurement tool exists of six questions and each question includes four options. The OCAI test was held under eight employees (a different sample than used for the interviews); two team leaders, two secretaries, two lab workers, one radiologist and one manager. Participants were asked to divide one hundred points among these four options depending on the extent each option is similar to the department Radiology of the Martini.
The question list used can be found in Appendix B. Any needed explanation to questions was given in order to prevent wrong interpretations. The model of Cameron & Quinn (2006) has been used in more than thousand organizations and therefore there is sufficient measurement data for comparisons. As said in chapter 2, the model is used within this research because it is widely used and matches an instrumental approach of changes. It offers an instrumental view on culture which matches this research, since an instrumental part of readiness for change a sense of urgency is researched.
4.
RESULTS
In the theory chapter the conceptual model was presented which formed the basis of this case study research. In order to investigate the current culture of Radiology, eight employees completed the OCAI test developed by Cameron & Quinn (2006). In order to further test the conceptual model, eleven semi-structured interviews were performed. The results of these OCAI tests and the interviews are described in this section. This will be done in the line of reasoning of the research questions described in chapter two.
In chapter three it was described that three different groups can be distinguished at the department and also the interviews were set up in three different variants. Therefore, within this chapter the answers of these three different groups will be separated to find any differences or similarities. So, the answers of the employees, radiologists and team leaders/manager are analyzed separately. The interviews were conducted among two radiologists, two team leaders, one manager and six other employees. When referred to an employee in this chapter, one of the six other interviewed employees is intended.
The line of reasoning of the research questions will be followed since the first goal is to gain insight into the perspectives of the employees on the sub-questions. After that culture will be reviewed and the combination of the answers on the sub-questions and the culture test make it possible to test the assumption if it possible to determine the type of motivation based on the type of culture as mentioned by Cameron & Quinn (2006).
4.1 Readiness to change
In order to answer the first sub-question (To what extent does a sense of urgency lead to readiness to change?), it is essential to gain insight in the sense of urgency members currently perceive and/or if they are ready to change.
Out of the eleven interviewed employees, five employees said they do not feel a sense of urgency and six employees answered confirming, they feel a sense of urgency (see Figure 7) although some employees rate their sense of urgency higher than others.
Both radiologists had a high sense of urgency; one of
FIGURE 7
them admitted this is primarily driven by some inspections planned later that year. This refers to the existence of extrinsic motivation.
The manager also said he has a high sense of urgency; this comes forth out of the assignment he was given by the Board of Directors. He says this assignment came forth out of cost-consciousness, and therefore can be considered extrinsic. But he also states he wants to do it better, he talks about ‘I always will have a desire to do it even better’, which can be considered something intrinsic. One of the team leaders does not perceive a sense of urgency on her own sub-department but admits the entire department can improve a lot and a sense of urgency for the department as a whole is present. The other team leader has a real high sense of urgency, and grades it with a nine, but refers to not having enough time and financial resources.
The other employees reacted very differently, four of them had a feeling of urgency and two of them did not. They did not gave clear indications why they had a sense of urgency or why this was missing. Most said a lot of improvement possible were possible, but when asked what could be improved they could not mention any clear improvement points.
In § 2.1 it was argued that a sense of urgency consists of two elements, discrepancy and time pressure. At first discrepancy was tested, since it was argued that discrepancy depicts how much time is needed. The first question asked based on discrepancy was if employees had the feeling there was room for improvement or if they thought currently everything is all right.
Both radiologists felt there is room for improvement. Both team leaders and the manager also said improvement was possible in many aspects. Of the other employees the four that perceived a sense of urgency also had the feeling there was room for improvement, the other two thought the situation was fine as
it is.
After that, discrepancy was tested asking questions about the current performance (see Figure 8, in which the number of employees giving a certain answer are schematically presented) and their feeling that something needs to change, that a different performance was necessary.
FIGURE 8
