The latest headlines from the world of health care can be depressing.  Increases in morbid obesity amongst our children, adult onset diabetes, lung cancer and asthma are on the rise along with a ballooning, aging population.

Headlines decrying drastic cuts to public health services and Medicare and Social Security funds blare at us.

Here’s something really scary: predictions of decreases in numbers of skilled health care workers are already coming to pass. We are seeing fewer and fewer medical students picking primary care as their field of choice. The RN shortage may last the next fifteen to twenty years.

Is there any way to counteract this dire news?  We think there is.

Discretionary effort

Helen Bevan, the director of service transformation at the British National Health Service’s Institute for Innovation and Improvement, teaches us about “discretionary effort.” It’s “…the degree to which individuals are personally committed to helping the organization by putting in more effort than is actually required to do the job.  It is what we are willing to work at because we want to,” she says.  Work is contractual, effort is personal.

Being excited about going to work everyday and wanting to make a difference is part of discretionary effort. We all know people who don’t feel engaged with their team and go through the motions, doing just enough to get by.  We also all know people who are passionate about their work and are very engaged with their team. People Pulse, KP’s employee satisfaction survey, tells us that people who are engaged with UBTs and the Labor Management Partnership are happier in their jobs. That’s also discretionary effort.

“Discretionary effort is linked to level of engagement.  Engagement implies ownership of the change process by everyone affected by the change,” says Bevan.

Good for business, good for employees

In Great Britain, the Health Accreditation Programme compared workplaces that had a leadership style that encouraged discretionary effort with offices that did not. They found that the workplaces with discretionary effort generated 43 percent more income.

“Discretionary effort represents a range of performance 20 to 40 percent above that which is typically realized by an organization,” according to Bevan. 

Is discretionary effort the answer to all of the vast problems facing the world of health care? Maybe. At least it’s something to give serious consideration. Are you a top down, my-way-or–the-highway type of supervisor? Are you a union member at work just to get a paycheck? Are you a physician that doesn’t have time to really talk to your team? Discretionary effort. Give it a try.