| Published: | August 25, 2010 |
| Paper Released: | July 2010 |
| Authors: | Julia Rose Adler-Milstein, Sara J. Singer, and Michael W. Toffel |
Executive Summary:
How can front-line workers be encouraged to speak up when they know how to improve an organization's operation processes? This question is particularly urgent in the U.S. health-care industry, where problems occur often and consequences range from minor inconveniences to serious patient harm. In this paper, HBS doctoral student Julia Adler-Milstein, Harvard School of Public Health professor Sara Singer, and HBS professor Michael W. Toffel examine the effectiveness of organizational information campaigns and managerial role modeling in encouraging hospital staff to speak up when they encounter operational problems and, when speaking up, to propose solutions to hospital management. The researchers find that both mechanisms can lead employees to report problems and propose solutions, and that information campaigns are particularly effective in departments whose managers are less engaged in problem solving. Key concepts include:
- Front-line workers offer more solutions to operational problems in departments whose managers are more engaged in problem solving.
- Information campaigns that promote process improvement generate more solutions from front-line workers, especially from workers whose managers are less routinely engaged in problem solving.
- Efforts at the organizational level can compensate for managers who cannot or do not create an environment that inspires front-line workers to speak up.
Abstract
Ideas that could enable organizations to improve their operating processes often come from front-line workers who voice concerns and share ideas about how to solve problems. Our study is among the first to develop and empirically test theory about how specific management practices can encourage employees to speak up about problems and to offer suggestions for solving them. We hypothesize that employees are more likely to speak up and offer solutions when organizations launch information campaigns to promote process improvement and when managers engage in process-improvement activities themselves. We test our hypotheses in the health-care context, in which problems are frequent and many organizations use incident-reporting systems to encourage employees to communicate about the operational problems they witness. Using data on nearly 7,500 reported incidents, we find that information campaigns encouraging process improvement promote both speaking up and offering solutions, while managerial engagement in process improvement promotes the latter. Our findings suggest that particular management practices can influence front-line workers' decisions about whether to speak up and that direct managerial engagement can result in their doing so constructively. 42 pages
Paper Information
- Full Working Paper Text
![]()
- Working Paper Publication Date: July 2010
- HBS Working Paper Number: 11-005
- Faculty Unit: Technology and Operations Management
![]()
