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HomemibusinessThe Hawthorne Effect: Watch It Get Better!

The Hawthorne Effect: Watch It Get Better!

Sometimes, what you know to be a problem in one setting, can be a very handy thing in another. Take the ‘Hawthorne’ effect for example. As scientists, we recognise it as a rather unwanted research bias that can be hard to control. But management practitioners see it quite differently.

Let’s start by going back in time. The name ‘Hawthorne’ is not the surname of a researcher who discovered the phenomenon of the Hawthorne Effect, but rather, the name of the place where the effect was first noticed.

Over a period of time, between 1924 and 1932, an Australian psychologist and management theorist named George Elton Mayo conducted studies at the Hawthorne Works at Cicero Illinois USA. This factory was part of the Western Electric Company and they produced the central component of electric motors. One of the main functions was winding the copper wire onto the stator core. A very labour intensive and taxing job at that time.

Mayo’s team carried out a number of ‘experiments’ to look at ways to improve productivity. The research involved manipulating length of rest and lunch periods and piecework payment plans, as well as environmental factors such as lighting. Mayo concluded that productivity partly depended on the informal social patterns of interaction in the work group.

Know what you want to know before you start measuring things. Sometimes reports are a dumping ground for all the data that’s available, whether it’s useful or not

Mayo found that none of the variables made huge differences to productivity, but changing a variable, such as lighting, did usually increase productivity.

In 1955, the researcher, Henry A. Landsberger performed a follow-up study and analysis of data from experiments undertaken by Elton Mayo. He noticed that productivity improved when any variable was changed, and concluded that the workers felt important because they were pleased to be singled out, and increased productivity was the result.

The workers increased output simply because they were aware that they were under observation from researchers and supervisors.

An Irritating Bias

The Hawthorne Effect is recognised as a common and difficult-to-control bias in any research that uses human subjects. It is accepted that this problem needs to be considered when presenting the results of research, and is often used as a criticism by those who disagree with the conclusions.

Simply being a part of an experiment is likely to cause behaviour modification and this is extremely difficult to quantify. All that a researcher can do is attempt to factor the effect into the research design, a tough proposition, and one that complicates research studies involving people.

What is Watched Gets Done

There is quite a bit of debate about the origin of this little statement. The Renaissance astronomer Rhaticus suggested that if you can measure something, then you have some control over it, and the Hawthorne Effect is a great example of this principle in action.

For most health care providers and optometry practices in particular, this idea presents some opportunities, challenges, and risks.

Firstly, in almost every practice the staff are committed and keen to ensure that the business does well. However, in our experience, and if Henry Landsberger is right, we have an opportunity to get some additional runs on the board for a small investment of time and effort.

In optometry in particular, the watcher is quite often missing. Clearly optometrists have to see patients, but that job effectively takes them out of their own business for large parts of the day. Occasionally between patients and for short breaks (if you are lucky) it might be possible in amongst the phone calls and emails, to get some time to see what the staff are doing. If you are big enough you might have a Practice Manager, and that’s very beneficial, but not many have this option.

We might also be concerned about the message that watching the staff sends. Are we micro-managing? Do they think they are not trusted? Surely as professionals they should be responsible for their own performance? All these are valid concerns and are going to be issues if we get the process wrong.

Getting it Right

There are many options for ensuring that effective measures and supervision is in place in our practices.

First there are some basic principles to get right:

Set Up the Basics

You must have a business plan and budget. Without the simple and clear statement of goals and objectives you’ll have no idea of why you are observing and where you would like to be.

You must also have good information systems. Your practice software will tell you everything you need to know, but only if you put the right information in to it. Garbage in, garbage out – or ‘GIGO’ definitely applies here. Empty data fields and inaccurate entry are going to sink the ship quickly.

Know the difference between a measure and a metric. A measure is one quantitative number that counts something, for example; “We made AUS$100,000 sales last quarter”. A metric gives you more information because it compares the measure to some other baseline, for example; “We made $100,000 sales last quarter, $50,000 more than the same quarter last year”. It is also important to look at trends over time. Benchmarks can also be helpful, particularly when discussing differences. A ‘busy’ practice with $500k of sales and four staff, might want to think about the $1.5 million sales practice with five staff.

Understand the difference between an outcome metric and a performance metric. An outcome metric tells you the result of something compared to the past. A performance metric tells you how well the activities are performing that have been determined as future targets.

Know what you want to know before you start measuring things. Sometimes reports are a dumping ground for all the data that’s available, whether it’s useful or not. The information must mean something and lead to a change in actions, tactics or behaviours.

Set Targets

Nobody will achieve their objectives if they have no idea what they are. Staff need to know what their daily, weekly and overall targets are for sales, break-even and the reportable KPIs. They also need feedback. We also need to give them knowledge, resources and support to get there. This is really important.

Ways to Watch

Team Meetings

Even very small practices need a team meeting. A properly managed meeting is a way to ensure responsibilities and outcomes are planned, delegated and followed up. Everyone knows what they have to do, and also knows that the results and accountability will be a topic of the next meeting.

A 10 minute ‘toolbox’ meeting at the start of each day can be very empowering. Keep it short, tight and focussed. What happened yesterday? Does anything need to be followed up? What’s on for today? Who’s coming in for appointments? Any tricky problems? Anything to refer to the end of month meeting?

Report Key Performance Indicators

Selected performance information can be a powerful motivator and feedback system. Practices rarely give their staff meaningful information about the practice performance. We don’t need a flood of information, but a good idea of the important measures will really help. Make sure there are trend measures included such as the average month sales for last year, and a moving average. Consider reporting conversion, average sales per patient, patient/consultation numbers, as well as basic sales. Also report specific measures for marketing targets such as patient take-up of transitions lenses.

Simple graphs on the wall of the staff room and discussion at meetings will keep everyone interested get up to speed.

Give Regular Feedback and Performance Appraisals

This is harder to do, but is very valuable. Mostly, it’s just letting staff know you are there and you are interested in what they are doing, and have noted the good and the bad. It doesn’t have to be big or complicated. A simple acknowledgement of a phone call well done, or a bin not emptied, can have a disproportionate effect on performance.

The positive effect of a well-done performance appraisal can last for months. This is a complicated area of management and is one of the most challenging tasks for any manager. Get in touch if you need more information or support.

Spend Time in the Practice

When you do have a cancelled appointment, make sure that sometimes you go out of the consulting room and get involved with the rest of the practice. Do it with purpose. Reinforce objectives and standards, give feedback, observe performance, engage and seek views and opinions. The phone calls and emails might just have to wait a bit longer.

Not Easy but Worth It

All of this creates additional work and effort, but if it were easy everyone would have it sorted!

The challenge, as with all changes to practices, is making this stuff stick and become a part of the way you do things. It’s as much about your own behaviour as it is about your staff. There can be some significant obstacles, stiff resistance and systems to fix, but the best practices get this done.

Mark Overton has science and business qualifications and, for over 30 years, has consulted to or worked with major public hospitals, federal government, small and medium private businesses, medical research institutions, professional associations and small businesses. Mark is the CEO of Ideology Consulting and, on occasion, lectures at universities.