How do you build a high performing team? Ask Helen Bevan, a self-described radical and heretic. Bevan is also director of service transformation of the National Health Service (NHS) Institute for Innovation and Improvement in England. The NHS provides 57 million Britons with cradle-to-grave health care, employs 1.3 million people, and has dramatically improved quality and service in recent years.

Bevan draws inspiration from the world’s movements for social change when looking for ways to improve health care. These movements, she says, connect to people’s hopes and aspirations in order to bring about change—and that approach can be used to inspire caregivers to go the extra mile for their patients.

“If you want to energize staff more you have to find ways to connect the work to what is important to them,” Bevan said. “An organization must live its values.”

Bevan distinguishes between “work,” the contractual agreement to show up and do a job, and “discretionary effort,” the extra energy people bring to their jobs out of personal commitment. In fact, engaged workgroups have an average 30% higher productivity rate, are more profitable and have higher retention and better safety, according to the Harvard Business Review (2005).

Measuring organizational energy to create change

To better understand what motivates discretionary effort, Bevan and her colleagues used the Stanton Marris Organizational Energy Index, developed in Australia. The index identifies four sources of organizational energy:

Organizational energy source	Defined as degree to which:
Connection	People see and feel a link between what matters to them and what matters to the organization
Content	The actual tasks people do are enjoyable and challenging
Climate	“The way we do things around here” encourages people to give their best
Context	The organization’s operations and work environment make people feel supported.

Bevan’s team found that the most important source of energy for NHS employees is their sense of “connection”—a motivator often overlooked by managers. On the other hand, the biggest barrier to performance is a lack of “context”—that is, a poor work environment.

If you want to energize staff more you have to find ways to connect the work to what is important to them.

Employees were proud of the work they did and wanted to be proud of the NHS, but were disappointed and frustrated when the organization did not live up to its ideals. Today, performance improvement efforts at the NHS tap into workers’ aspirations for providing better patient care and engage them in day-to-day problem solving. That’s also the principal behind unit-based teams at KP, which are engaging employees to improve service, quality, affordability and the workplace.

Health care organizations are not faced with an “either/or” choice between programmatic change with top-down goals and metrics or a more grassroots approach. Instead, both strategies are needed, Bevan says.