Nearly 40 years ago in the Harvard Business Review, Frederick Herzberg addressed ideas about how to motivate employees.1 In this review, Herzberg identified motivating factors imperative in the work environment: achievement, recognition for achievement, actual work, responsibility, and growth or advancement. A survey presented in Herzberg’s publication of over 1600 employees from various backgrounds including hospital personnel and nurses revealed that job satisfaction is more likely to result from these motivating factors as opposed to dissatisfaction-avoidance factors like salary, working conditions, and interpersonal relationships.1 Specifically, Herzberg’s reported survey identified that achievement and recognition had the largest impact on job satisfaction and may have long-term effects on employees and their attitudes toward work.
A more recent survey performed in 2014 by researchers with the Nursing Executive Center2 identified that an area for improvement in staff engagement among nurses was in the provision of recognition related to achievements and contributions to care. This survey was completed by more than 340000 employees within 575 health organizations. Assessment of the survey results revealed that meaningful recognition provided in a timely fashion can lead to an engaged workforce. Providing effective recognition for employees is possible by linking recognition to specific accomplishments, allowing recognition to be delivered by a person who possesses professional importance, and delivering recognition in a timely fashion.3
Overall, recognition of employee achievements and activities provides a positive environment in addition to motivating employees and improving their overall moods.4 While well studied throughout the last decades and despite well-documented assessments in the fields of nursing and health care, there is minimal information published regarding the process of rewards and recognition within departments of pharmacy. This commentary seeks to identify and describe some current processes of recognition and rewards for pharmacy staff.
An exploratory survey was sent through the Vizient list-serve to identify novel practices related to pharmacy staff recognition and rewards. Institutions were asked to share meaningful ways that pharmacy team members are being recognized for their outstanding work on a daily basis. The following information was requested from participating institutions: name, institution, job title, e-mail, and brief description of the “best practice” method used to reward/recognize pharmacy team members for their efforts. Nineteen institutions participated in the survey and shared numerous initiatives utilized for staff. Three program types were noted by more than one institution: criteria-based awards, thank you notes, and public recognition.
Criteria-Based Awards
Several institutions have established award programs that recognize staff for a variety of contributions. A “good catch” award was utilized at 5 of the responding institutions to promote a culture of safety and recognize employees who identify medication errors throughout the medication-use process. Most nomination processes included simple and convenient steps for employees to nominate themselves or a peer such as having small collection boxes for nominations in the pharmacy or on patient-care units. In most cases, nominations for the award could be submitted by individuals from any discipline involved in the patient-care process. Winners and nominees were described as being recognized publically through avenues including e-mail, during a standing department or medication safety meeting, in a designated location (eg, a bulletin board or flier), or in multiple venues. Information included in the public recognition often included proposed resolutions or the resulting intervention.
Additional criteria-based awards have been created at institutions to recognize all levels of employees within the Pharmacy Department. Examples included preceptor of the year, employee of the month, etc. Certificates, trophies, and/or small monetary incentives were commonly associated with the awards to provide additional extrinsic employee motivation. After assessment of reported awards, award criteria should distinguish an employee whose behaviors and efforts go above and beyond their expected job functions and responsibilities. To maintain the impact of the award on staff morale, a mixture of monthly, quarterly, and annual awards should be utilized based on the selected criteria. A combination of peer- and management-nominated awards can maximize the benefit as recognition from both groups is important for employee satisfaction.
Thank You Notes
Handwritten thank you notes from department leadership can be an effective recognition tool. Two institutions noted regularly utilizing this tool in an organized format. The frequency varied from daily to biweekly based on available information on extraordinary employee efforts. Information to write the notes often comes from fellow employees. Prior to this type of recognition, department leadership should ensure the information provided is sufficient to write a personal thank you note that specifically identifies the employee’s unique behavior(s). Ideally, the behavior being recognized can be clearly tied to the department or organization’s mission and vision. One survey participant noted that a majority of employees who receive a thank you note personally or via e-mail provide her with positive feedback for the gesture. Some key components to consider in utilizing this tool are inclusion of a personal, specific message, writing style (handwritten or typed), and delivery method (personal, e-mail, home/office, etc).
Public Recognition
Similar to the strategies mentioned above, an important element of most recognition tools is the public nature of recognition efforts. Some examples include in-person feedback, verbal recognition in front of the team, articles in a department newsletter, or posts on a department or institutional bulletin board. All methods can be effective in communicating achievements and the identified behaviors or attitudes of extraordinary employees. Public recognition should be given to staff at all levels and services, including both technicians and pharmacists. This tool can also be utilized to highlight actions of other health care professionals that support the pharmacy department’s patient-care efforts.
Considerations for Recognition Programs
A recognition or reward program should be aimed at identifying desirable behavior and performance, then capitalizing on personal intrinsic and extrinsic motivators to achieve excellence. Survey results revealed great examples of recognition that utilized money, certificates, and public and personal appreciation. Some items to consider when designing and implementing a recognition program include the process of identifying behavior/performance (peer/supervisor nomination, electronic tracking, etc), timing of the reward (on the spot, monthly, quarterly, etc), and creating awareness of the program and its criteria. The tools and items above should be considered in designing recognition programs with the goal of encouraging desired behavior and high performance. To do this, it is important to have an understanding of which rewards are valued by team members and their perception of how likely it is that their actions will result in a reward.
Novel Recognition Programs
Pharmacy leadership at Rush University sought a new way to recognize employees within the department over the past year. New pharmacy achievement awards were implemented to embody organizational goals and Rush’s core values of innovation, collaboration, accountability, respect, and excellence. Prior to developing a new set of awards, the only award was The Preceptor of Year award. With a staff of over 30 preceptors and 40 clinical staff pharmacists, the leadership team wanted to expand ways to identify admirable work. The selection process includes nomination from the leadership team based on concrete and objective criteria developed for each award. In addition to recognizing pharmacists within the department, certain awards recognize pharmacy technicians as well. The consortium of awards includes The Preceptor of the Year (contributed most to the development of the residents), The Innovator of the Year (recognizes creative solution to common challenges within the department), The MVP Award (excellence in their work and their personal integrity), The Einstein Award for Scholarship (generation of new knowledge from research, reviews, or platform presentations), Clinical Service Award (excellence in patient care, teaching, and mentoring), and the I-CARE Award (sought out a diversity of opinions to assure delivery of optimal pharmacy services). Because the awards span different areas of practice, pharmacists and technicians with different strengths have an opportunity to be recognized. The awards are presented annually at the resident commencement ceremony to which all staff, residents, and family are invited.
Hershey Medical Center has an innovative program to recognize staff members. In lieu of their slogan “Inspired Together,” peers are asked to recognize fellow employees who have been an inspiration at the beginning of all meetings. The leadership team then takes the time at their weekly meeting to sign and send a card to every staff member that was recognized. About 10 individuals are recognized each week with no maximum in the number of recognitions that could be potentially given. The biggest hurdle is deciding what is noteworthy and inspiring rather than meeting baseline job expectations. In either direction, staff members appreciate being recognized for the work they do. In addition to recognizing staff through peer nomination, a birthday card is sent to every staff member and Hershey provides biannual retreats to all employees focusing on the company’s mission of being inspired together.
At Denver Health, pharmacy management was interested in showcasing the work done internally within the Department of Pharmacy. Most importantly, the management team wanted to highlight pharmacy accomplishments to senior-level executives within the organization. Pharmacy managers planned a Pharmacy Summit where pharmacists could highlight posters, publications, presentations, and projects worked on over the course of the past year. Invitations were extended to all employees with a manager title or above. The department used a hallway within the pharmacy as a location to showcase posters. The viewing event was 1-hour long, with refreshments served. In a conference room at the end of the hall, pharmacists and interns were available to speak with guests about the various posters, publications, and initiatives. There were roughly 15 posters presented in addition to several publications, and more than 25 people attended the event. One of the unexpected benefits of the event was the positive feedback related to getting to see the pharmacy firsthand, as the pharmacy is typically a highly restricted area. The Department of Pharmacy intends to make this an annual event as leadership was encouraged by the success of the program.
The Dartmouth-Hitchcock Medical Center implemented an award called Positive Recognition of Patient Safety (PROPS) which encourages front line staff members to identify processes that are error-prone or inefficient and propose solutions. Operational leaders then work with the staff member to fully develop solutions and submit proposals for review by the pharmacy management team. Awardees receive a card and “Safety through Teamwork” pin to recognize their efforts. Awardees are also recognized in e-mails, staff huddles, and/or a departmental meeting. To encourage participation, staff is intermittently reminded of this program in departmental newsletters and e-mails.
Conclusion
As noted by the survey and by those institutions who shared their specific recognition programs, it is clear that there are a variety of mechanisms which can be utilized to recognize employees at all levels. That recognition can also act to showcase efforts to other leaders in the organization and highlight the role of pharmacy in patient care. It is important to develop a recognition program that is consistent with the culture of the pharmacy department and the organization. What may be well received at one organization may not work at another due to organizational and individual differences. For example, some individuals are not as receptive to public recognition during large meetings or group settings but are comfortable with public recognition through a newsletter or a bulletin board.
In addition, it is important to create a program that allows recognition at all levels from support staff to technical staff to pharmacists. A program should be inclusive so that all staff members feel valuable. As the recognition program is created, clear criteria should be created and shared with staff. Staff should also be educated about how to use the program to recognize peers. The ease of being able to nominate someone for recognition is a vital variable in creating a successful program. One of the biggest challenges may be to determine what is considered “above and beyond” behavior for recognition versus what is considered to be a part of the defined job duties. Providing explicit criteria will aid in ensuring recognition opportunities can be consistently applied.
Overall, those organizations whom have implemented pharmacy staff recognition programs have found them to be highly accepted by staff. Recognition of staff is an important piece to job satisfaction whether directly or indirectly to the staff member. Once implemented, it is important to evaluate the program’s success and make modifications as needed to ensure the program supports current culture and staff needs.
References
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