Practice Assignment: Problem Statement: How good is it?

Chapter 1: Introduction

Hospitals and other health care organizations have a responsibility to the communities they serve to provide safe, reliable, quality patient care, despite an environment challenged by decreasing reimbursements, increasing costs, and regulatory requirements. These changes are complex and require a more collaborative relationship within and between hospitals, physicians, insurers, unions, and vendors(HealthLeaders Media, 2014). Health care services, including hospitals, physician practices, long-term care skilled facilities, rehabilitation centers, and outpatient services are facing rapid changes while moving from a volume-based, fee-for-service reimbursement system to a value-based purchasing model.

The Centers for Medicare and Medicaid Services (CMS) is experimenting with various programs to evolve the health care payment and delivery model. The most ambitious reform model is the accountable care organization (ACO)(Goldsmith, 2011). In the ACO model, CMS will reward providers economically if the providers reduce Medicare's cost growth within their communities. The performance of ACOs to date indicates that this model may not be able to achieve the desired cost reduction goals under health care reform (Goldsmith, 2011).

Health care spending increased 40.97% between 2002 and 2013 and represented 9.8% of the 2013 federal budget (Boccia, Fraser, & Goff, 2013). In addition, health care's share of the gross domestic product is estimated to grow from 17.9% in 2010 to 19.6% in 2021 (Keehan et al., 2012). As a result, health insurers and providers need to conduct business with each other differently to slow the rising costs of health care (Goldsmith, 2011). In addition, as the cost of doing business increases, health care administrators must be concerned with the loss of reimbursement due to the Affordable Care Act (Keehan et al., 2012). The 2014 HealthLeaders Industry Survey, Forging Healthcare's New Financial Foundation, points out that 91% of senior leaders responding to the survey cited reduced reimbursement as their organizations' number one concern. As a result, health care administrators, physicians, labor leaders, employees, insurers, and vendors must improve their collaborative relationships to transform their organizations to meet the new health care paradigm.

Problem Statement

Communities depend on their local hospital(s) to be available whenever needed, whether it be a planned clinical intervention, such as a surgical procedure, or emergent intervention requiring immediate medical attention. No matter what the community or individual patient need may be, the hospital must be prepared and able to deliver it in a safe, reliable way.

Under the Center for Medicare and Medicaid Services (CMS) federal regulations, hospitals serving Medicare patients must meet the Conditions of Participation (CFR Public Health, 2015). These conditions require hospitals and other health care organizations to serve all who seek services regardless of ability to pay, and to do so in a way that respects the individual's beliefs and needs. Though hospitals are committed to serving their communities, the challenge is to do so in a sustainable way that is clinically appropriate, cost effective, and without harm.

With the complexity of daily operations, the long-standing relationship between physicians and hospitals, and the challenges presented by health care reform, health care leaders must influence many different constituents to achieve operational performance at the lowest cost and highest quality (Feeley, 2013). The employee staff represents a significant constituency for health care leaders. Without them, it would be very challenging to make the needed changes to work or clinical processes. Bringing work groups together as teams to focus on work process improvements provide a distinct advantage to organizations dealing with rapid change (Appelbaum, 1997;Patnayakuni & Ruppel, 2010).Therefore, the research problem addressed is to what degree does the level of frontline managerial emotional intelligence relate to employee engagement?

Theoretical Rationale

Two theories were explored to understand the interaction between emotional intelligence (EI) of frontline managers and employee engagement within a health care setting. Emotional intelligence, as a construct, adds insight into the potential influence the various emotional intelligence competencies have on work performance and organizational performance (Boyatzis, 2009). The second construct, employee engagement, brings forth the influence of cognitive, emotional, and behavioral components into the work place (Truss, Delbridge, Alfes, Shantz, & Soane, 2014). Understanding both brings the importance of emotion into the workplace from a leadership perspective and employee staff contribution to organizational performance.

Emotional intelligence. A review of the various contexts within which emotional intelligence has emerged will help set the stage for understanding the theory. Initial research focused on the cognitive aspects of intelligence, but today psychologists and business researchers have begun to understand that the non-cognitive aspects of intelligence are also important (Cherniss, 2000). This new form of intelligence has emerged over the past decade in discussions among business leaders, industrial psychologists, social scientists, and others (Cote & Miners, 2006).

A generally accepted definition for emotional intelligence is the aptitude to manage one's own and other peoples' feelings and emotions; to distinguish between different emotions and label them accurately; and to use the emotional information assessed to guide thinking and actions (Cherniss, 2000; Kannannatt, 2008; Shooshtarian, Ameli, & Aminilari, 2013). Polychroniou (2009) describes emotional intelligence as being a combination of interpersonal intelligence and intrapersonal intelligence. Goleman (2005) submits that EI consists of the social competencies of empathy, motivation, and social skills.

Ioannidou and Konstantikaki (2008) point out that EI not only involves the ability to recognize, determine, and manage the emotions of one's self and others, but also includes managing the emotions of groups. Emotionally intelligent leaders use self-awareness and self-control to influence others by understanding how their behavior affects others (Goleman, 2005).

There are three major emotional intelligence theories (Webb, 2009), and they differ in how they delineate the critical factors that make up emotional intelligence; how they define EI; how EI works inter and intra personally; and the instruments they use to measure the concept(Codier,E., Kooker, B., & Shoultz, J., 2008). The first of the three major theories that have emerged from the research is the trait or personality model developed by Reuven Bar-On (1999). The theory focuses on the individual's skill to process emotional information and use it to interact within a social setting. Bar-On initially used the term emotional quotient to describe his model. He later abandoned the name and adopted emotional intelligence as the descriptor (Codier,E., Kooker, B., & Shoultz, J., 2008).

The trait model, developed within a clinical setting, was designed to measure personality qualities that enable a person to acclimatize emotionally (Cherniss, 2000). The model consists of five traits: intrapersonal, interpersonal, stress management, adaptability, and general mood. The model's assessment tool is a reliable evaluation of a person's ability to manage the pressures and demands of daily life (Webb, 2009).

Peter Salovey, David Caruso, and John Mayer developed the second theory in 1998. The theory is referred to as the Ability Model (Mayer, Salovey, & Caruso, 2004). It recognizes that individuals vary in their ability to assess emotion and appropriately navigate through social environments. Their EI theory views emotion as an important source of information that helps a leader understand the social aspects present in the workplace. Mayer et al. (2004) developed the Multifactor Emotional Intelligence Scale (MEIS). This tool, consisting of 141 questions, assesses an individual's ability to perceive emotions, use emotions, understand emotions, and manage emotions. The MEIS is considered one of the more reliable assessment tools for measuring emotional intelligence (Olatoye, Akintunde, & Yakasai, 2010; Webb, 2009).

Finally, Daniel Goleman developed the third theory, a set of skills and characteristics that drive leadership performance (Codier,E., Kooker, B., & Shoultz, J., 2008). His theory is considered a mixed model in that it is the combination of trait and EI ability. The model was developed in an organizational setting and is used to understand and measure the effectiveness of workplace relationships. The skill clusters in this model are divided into personal and social competencies (Goleman, 2005).

Employee engagement. Employee engagement has gained the interest of business organizations due to the current economic challenges they face, specifically doing more with fewer resources in an increasingly competitive environment (Albrecht, 2010). Organizations are also attracted to the dual goals employee engagement comprises. The importance from an organizational leadership perspective is that employee engagement offers strategies to enhance the contribution of the individual worker and the improvement of the organization's overall performance (Truss et al., 2014). First proposed by William Kahn in 1990, employee engagement research has experienced increased attention from scholars and practitioners (Kataria, Rastogi, & Garg, 2013).

Employee engagement is focused on understanding the degree to which employees commit to something or someone within their workplace, how hard they work, and how long they stay because of that commitment (Alvi, Haider, Haneef, & Ahmed, 2014). De Clercq, Bouckenooghe, Raja, and Matsyborska (2014) posit that employee engagement is a set of positive emotions that brings congruence and focus on goal alignment, resulting in the reduction of organizational nonconformity. A critical factor that influences goal congruence is the alignment of the employee-supervisor relationship. Earlier research has determined that this relationship may affect job satisfaction, organizational commitment, and intent to stay by the employee (De Clercq, Bouckenooghe, Raja, & Matsyborska, 2014).

In addition to the influence of the employee-supervisor goal congruence, employee engagement is affected by the employee's feelings, ideas, and views about his or her job. Employee engagement leads to enthusiasm, passion for the work, and a sense of pride (Alvi et al., 2014).

The employee engagement construct has been challenging to develop due to numerous potential operational variations, such as job engagement, personal commitment, organizational involvement, staff engagement, and work engagement (Truss et al., 2014). It is believed that sufficient evidence now exists to suggest that employee engagement is a unique psychological state (Albrecht, 2010; Markos & Sridevi, 2010; Truss et al., 2014).

The employee-manager relationship plays a significant role in organizational performance, both on the individual level and the department level (Harter, Schmidt, & Hayes, 2002). The manager's role is significant in creating a workplace environment in which the employee determines the degree to which they are personally committed to the daily work and organizational goals (Markos & Sridevi, 2010). With this relationship, employees are more productive, innovative, and collaborative. As a result,employees who are actively engaged in their organizations are psychologically happy and emotionally attached to their job as well, as the organization, with great enthusiasm (Anandhi & Perumal, 2013).

Significant research has demonstrated that employee engagement leads to higher organizational performance. In fact, Rayton, Dodge, & D'Analeze (2012) highlight in their report, The Evidence, that the top 25% of employee engaged companies in the 2008 Kenexa research had twice the annual net income as compared to the bottom quartile companies. Also, they report that a Gallup study conducted in 2006 demonstrated that the organizations with the highest engagement scores averaged greater productivity by 18% when compared to the lower scored companies.

How do leaders take advantage of employee engagement to improve organizational performance? To what degree does manager or supervisor emotional intelligence groom employee engagement? There has been limited research, especially in health care, that links leader emotional intelligence as a statistically significant correlate to employee engagement. This study explores the possible link between emotionally intelligent leaders and the degree of employee engagement among their direct reports. If such a relationship exists between employee engagement and improved operational performance and between emotional intelligence and increased employee engagement, it can be concluded that emotionally intelligent frontline leaders may influence organizational performance.

Statement of Purpose

Health care organizations faced with economic and quality outcome demands may find an advantage in serving their communities through the deliberate application of emotional intelligence in daily operations. Understanding the stimulus of emotional intelligence on employee engagement can provide potential strategies and interventions to health care leaders and human resource practitioners to mobilize the workforce in a constructive and energized way.

Employee engagement has been identified as a critical approach to enhancing organizational performancethrough leadership direction (Nasomboon, 2014). With the rapid changes currently underway throughout the health care industry, leaders are faced with improving efficiency and effectiveness opportunities in their organizations (Keehan et al., 2012). As Humphreys, Brunsen, and Davis (2005) point out, employees may be the most important factor in improving organizational effectiveness. Moreover, employee commitment may be the only sustainable competitive advantage for health care organizations to address the challenges they face.

Recognizing the importance of employee engagement to improving organizational performance, the question for this research became: to what degree does the level of emotional intelligence influence employee engagement and, as a result, affect organizational effectiveness.

Research Questions

The purpose of the study is to affirm or deny the hypothesis that emotional intelligence is a statistically significant correlate to employee engagement for leaders in a private, not-for-profit tertiary care hospital located in Central New York.

The quantitative analytical study posed three research questions:

1. What is the level of employee engagement among those who participated in the study?
2. What is the level of emotional intelligence of the frontline managers and supervisors who participated in the study?
3. Using inferential statistics, is there a statistically significant correlation between emotional intelligence of frontline managers and supervisors and the employee engagement of their direct reports?

At a significance level of p< 0.05, the research hypothesis was:Within a tertiary care hospital setting there is a statistically significant correlation between the level of emotional intelligence of frontline managers and supervisors and their direct reports' degree of engagement within the workplace.

Questions

1. What is the problem statement?
2. Why is it important to address? If so, why? If not, why not?
3. How would you rewrite the Problem Statement to give it more purpose/importance?
4. What are the Research questions for this study?
5. Provide an additional possible research question.