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Employee Engagement: The Role of Leaders and Managers Connie Yoon, PharmD, BCPS1, Amy Ryzenga2, and Hal Chappelear2 1. University of Maryland School of Pharmacy 2. Internasource LLC In the 2013 Gallup report, “State of the American Workplace” it is stated that only 30% of today’s workers are engaged in their jobs based on a 12-question survey (Figure 1).1 Twenty percent are disengaged and walk the halls of our institutions discouraging others. The remaining 50% are simply not engaged. The most costly portion of any institution is the employee; yet, 70% of employees are disengaged in their jobs. Gallup estimates a loss of $450 billion to $550 billion in productivity within the United States annually from unengaged employees. While disengagement is slightly lower among healthcare professionals compared to other professionals, the healthcare industry is not immune to disengagement. With the increase in cost and loss of productivity associated with unengaged employees, employee engagement should be a focus of all leaders within the healthcare system. What is employee engagement? What really motivates us? According to Daniel Pink’s book, Drive: The Surprising Truth About What Motivates Us, it is not the practice of “reward the behavior you seek and punish the behavior you discourage,” but it is what he discovered to be the “Third Drive.”2 There are two biological drives, which include first, hunger, thirst and sex, and second, the reward and punishment phenomenon. Pink proposes a new “Theory of Motivation,” termed the “Third Drive.” He asserts that businesses should adopt a revised approach to motivation, one that is based on the “self-determination theory” (SDT). He suggests that “rewards by their very nature, narrow our focus.” SDT, on the other hand suggests human beings have an innate drive to be autonomous, self determined and connected to one another. When this drive is satisfied, people achieve more and live richer lives. Organizations should focus on this drive when creating settings for their employees. They should focus on our innate need to direct our own lives (autonomy), learn and create new things (mastery) as well as contribute to a cause that is greater and more enduring than ourselves (purpose). Autonomy provides independence over some or all of the four main aspects of work: when they do it (time), how they do it (technique), with whom they do it (team), and what they do it (task). Mastery allows employees to extend themselves, develop their skills further and perform tasks better. Purpose allows employees to fulfill their natural desire to make a contribution to the “greater good,” especially of the organization to which they belong.

Pink’s theory on motivation, how it applies to the world of business and how an organization can update their “human capital” practices will result in the most motivated, productive and engaged employee. Now, what does the above have to do with leadership or management? In Gallup’s report, one of the most significant findings was that managers and leaders play a critical role in the engagement of an employee. By focusing on the employee’s strengths, management can practically eliminate disengagement altogether. An engaged employee leads a healthier life, thus contributing to higher productivity, fewer sick days, less chronic health disorders (i.e. hypertension, obesity, depression) and health-related costs.1 How employees are managed and the environment created by leaders and managers contribute significantly to the employees’ well-being. Managers who inspire and invest in the overall lives of their employees, focusing on the whole person, positively influence worker performance. Knowing the significant impact managers and leaders have on employee engagement and productivity, it is important to distinguish between a leader and a manager to better understand their roles. In many for-profit and not-for-profit institutions today, we are given the impression that there is a choice between management and leadership. In some cases, they are considered one and the same, just different titles. On the other hand, we are given the impression that somehow the application of management and leadership processes are mutually exclusive. We suggest that management is an integral part of leadership. In the early years of management literature we read about the management pyramid. At the base of this pyramid is: plan, organize, direct and control. Many managers stop at this base. Plans and organization of the group are often done by the “manager” and passed on to the team where its members are directed to get the work done.3 The final step is control. Some feel it is essential that the manager be able to control the team’s activities. Peter Drucker, gave birth to the concept known as management by objectives (MBO).4 MBO is a process of defining objectives within the institution so that management and employees agree to the objectives and understand what they need to do in the organization in order to achieve them. Behind the principle of MBO is for employees to have a clear understanding of the roles and responsibilities expected of them. Then, they can understand how their activities relate to the achievement of the organization's goal. This approach also places importance on fulfilling the personal goals of each employee. Drucker presents a very nice segue to leadership when he suggests that “management is doing the right things” where “leadership is doing things right.” And, there appears to be a direct relationship between employee engagement and “doing things right.”

We define leadership as a transforming relationship of influence that results from one or more persons engaging with others for the purpose of sharing a vision, values and beliefs. The purpose of leadership is to accomplish the organization’s mission.5 To take it a step further, successful leadership is evident when the vision is implemented, continually refined and leaders and followers raise one another to higher levels of morality, motivation and achievement. In the end, the leader and the led reap mutual benefit from the relationship while pursuing the vision. To be sure, leadership requires that one master many of the principles of management as advanced by Drucker and others. Additionally, the leader must be aware of the need to serve others, as leadership is not a rank but a responsibility.5 To that end, the leader must know the follower(s) and understand their needs. While followers’ needs vary somewhat, research clearly shows that they include: Trust – the follower needs to rely on the leader’s integrity, i.e. actions match words Compassion – followers needs to know that the leader is fully aware of the follower’s challenges (personal and professional) and always stands by to help Stability – the follower needs to know that the leader behaves in such a way that the “job” will always be there… there will always be a payday Hope – the follower needs something to look forward to with expectation of its fulfillment While the roles of leaders and managers are at times different, their responsibilities are closely intertwined. Both leaders and managers are responsible for employee engagement and to that end, must recognize the follower’s/employee’s needs. Apply the leadership process as herein defined and give it time – you will be amazed at the positive results.

Figure 1. Gallup’s Q12 Survey to Measure Employee Engagement. Adapted from Gallup’s State of the American Workplace Report 2013. References 1. Gallup. State of the American workplace report 2013: employee engagement insights for U.S. business leaders. Washington, D.C.: Gallup, Inc; 2013; [cited 2014 Apr 25]. Available from: 2. Pink DH. Drive: the surprising truth about what motivates us. New York: Penguin Group; 2009. 272 p. 3. The Wall Street Journal. What is the difference between management and leadership? The Wall Street Journal (U.S. Ed.) [Internet]. 2009 Apr 7 [cited 2014 Apr 25]. Available from: 4. Drucker PF. The practice of management. New York: Harper & Row, Publishers, Inc.: 1986. 416 p. 5. Garner D. CE: Effective leadership: the pharmacist’s role and responsibility. Drug Topics 2002;18:76.

Mshp management article edited