# Presentation: 854260

## Hard Facts About The “Soft Stuff”

**Hard Facts About The “Soft Stuff”**

**The Business Case for Taking**
**Action on Stress and Aggression**

**Partially funded by a grant from the**
**National Science Foundation**

- August 2002

## VA Facilities Participating

**SITES**

**VAMROC**
**Fargo**

**VHA**
**Minneapolis**
**MC**

**VHA**
**Black Hills**

**VHA**
**St Cloud**
**MC**

**VAMROC**
**Sioux**
** ****Falls**

**Fort**
**Meade**
**MC**

**Hot**
**Springs**
**MC**

**VBA**
**Des Moines**
**RO**

**VBA**
** ****St. Paul**
**RO**

**VBA**
**Chicago**
**RO**

**VBA**
**Milwaukee**
**RO**

**VBA**
**Phoenix**
**RO**

**NCA**
**Houston**

**VA Facilities Participating**

**Veterans Benefits Administration (VBA)**
**Veterans Health Administration (VHA)**
**VBA+VHA = VA Medical/Regional Office Center (VAMROC)**
**National Cemetery Administration (NCA)**

**15 COMPARISON **
**SITES**

**NCA**
**San Juaquin**

**NCA**
**Massachusetts**

**VAMROC**
**White River**
**Junction**

**VBA**
**Montgomery**
**RO**

**VAMROC**
**Togus**

**VBA**
**Portland**
**RO**

**VBA**
**Louisville**
**RO**

**VBA**
**Pittsburgh**
**RO**

**VBA**
**Manches****ter**
**RO**

**VBA**
**Decatur RO**

**VBA**
**Boise RO**

**VBA**
**Detroit  RO**

**VHA**
**Spokane**
**MC**

**VHA**
**Coatesville**
**MC**

**PROJECT****TEAM**

**VAMROC**
**Wilmington**

**Notes:**
VA facilities participating include
VHA facilities in the old Network 13
Regional Offices in VBA’s SDN 6
Phoenix Regional Office, and the
Houston National Cemetery 

The Project team includes
Academics from 4 universities and 
VA employees from a number of organizations

Fifteen additional VA sites were surveyed for the purpose of data 
comparison

## Data Collection

_**Workplace Aggression Questionnaire**_
**Measures the nature (form) and relative frequency (duration & persistence) of aggression**
**Identifies the source of aggression (i.e., supervisor, co-worker, subordinate, customer-client, other)**
**Assesses perceptions of the causes of aggression**
**Measures the degree of harm inflicted **
**Identifies individual responses to aggression**
_**Employee Satisfaction Survey**_
**96 Question Extracted From the 1997 One VA Survey**
**Key questions selected from larger survey**
**We now believe that approximately 60 questions would provide the same data**

**Notes:**
Our survey included over 180 questions
96 questions were from the 1997 One VA employee survey

Response rate to the survey ranged from
35% at the largest facility
50 – 92 % at smaller facilities

## Source of Aggression: All Facilities

**Source of Aggression: All Facilities**

- n = 4,790

## Who are the Aggressors?

**Who are the Aggressors**?

## Bullying: Persistent Patterns of Aggression within VA

## Frequency of Aggression:Pilot vs. Comparison Sites

- Bullied

## Reporting Behaviors to Supervisor or Union Official as a Function of Persistence of Aggression

- Frequency of Aggression

- Reported to
- Supervisor or Union

## Confronting the Person(s) Involved as a Function of Persistence of Aggression

**Confronting the Person(s) Involved ****as a Function of Persistence of Aggression**

- Frequency of Aggression

- Confronted
- Person

## Filing Formal Grievance/Complaint as a Function of Persistence of Aggression

**Filing Formal Grievance/Complaint as a Function of Persistence of Aggression**

- Frequency of Aggression

- Filed Formal
- Complaint/Grievance

**NOTE:**
**Seldom do**
**people file**
**formal **
**complaints**

**EVEN**
**WHEN**
**BEHAVIORS**
**OCCUR**
**OFTEN**
**& PERSIST**
**OVER TIME **

## Intentions to Quit and AgeQ91 – I am considering leaving this organization

**Intentions to Quit and Age****Q91 – I am considering leaving this organization**

- 				          		          Strongly
- _# Respond._	_Age_		_Agree_	          	_Agree_	           _Total_
-        151	**20-29**		**22.5%****	****	****15.9%****	****	****38.4%**
**  **
-        540	**30-39**		**23.1%****	****	****10.4%****	****	****33.5%**
**     **1409	40-49		20.2%		8.8%		29%**	**

## 1-5 Aggressive Events Weekly/Daily Plotted Against Respondents’ Age

**1-5 Aggressive Events Weekly/Daily Plotted Against Respondents’ Age**

- Age Groups
- Experiencing
- The Most
- Aggression in
- The 1-5 Events
- Weekly/Daily
- Category

## Incidents Reported in 

**Incidents Reported in **
**Project Survey vs. **
**OWC P  Violence**
** ****Claims Filed**

## Aggression & Stress Learning Window

**   ****What We Know**
**Non-physical/emotional forms of aggression occur frequently in work settings**
**Unjust, disrespectful/rude behavior is strongly linked to aggression**
**Employees overestimate the personal causes of aggression and underestimate the social and situational causes**

**Notes:**
From our survey data, interviews and analysis, we are convinced
that low level aggression and stress in the workplace have a number
of measurable negative effects

The more significant include

Respondents reporting higher levels of overall aggression:
are less satisfied on the job
report higher levels of perceived injustice
experience greater levels of stress
are more likely to feel bothered by such behavior 
report greater intentions to quit

## Aggression & Stress Learning Window

**   ****What We Know**
**Respondents reporting higher levels of overall aggression:**
**are less satisfied on the job**
**report higher levels of perceived injustice**
**experience greater levels of stress**
**are more likely to feel bothered by such behavior **
**report greater intentions to quit**

**Notes:**
From our survey data, interviews and analysis, we are convinced
that low level aggression and stress in the workplace have a number
of measurable negative effects

The more significant include

Respondents reporting higher levels of overall aggression:
are less satisfied on the job
report higher levels of perceived injustice
experience greater levels of stress
are more likely to feel bothered by such behavior 
report greater intentions to quit

## Aggression & Stress Learning Window

**   ****What We Know**
**Persistent patterns of workplace aggression have an adverse impact on employee and organizational performance, are associated with EEO & OWCP claims, and are associated with employee withdrawal behavior (i.e. absence, lateness, turnover****)**

**Notes:**
From our survey data, interviews and analysis, we are convinced
that low level aggression and stress in the workplace have a number
of measurable negative effects

The more significant include

Respondents reporting higher levels of overall aggression:
are less satisfied on the job
report higher levels of perceived injustice
experience greater levels of stress
are more likely to feel bothered by such behavior 
report greater intentions to quit

## What We Know About Aggression & Stress in the Workplace & Employee Satisfaction

**High-involvement, “empowered” work climate is strongly associated with lower stress and aggression and higher employee satisfaction**
**A major portion of the impact of the work climate cluster on employee satisfaction acts through perceptions of fairness and workload obstacles **
**Increased employee satisfaction improves business results**

**Notes:**
We know that involving employees does matter

(Pause a few seconds for the viewers to read the slide)

## The Power of Work Climate

***increase in Satisfaction***

**WORK-DESIGN/ CLIMATE**

- INFORMATION & COMMUNICATION

**WORKLOAD & STRUCTURAL FACTORS**

**INVOLVMENT & INFLUENCE**

- GOAL ALIGNMENT

**RESPECT & FAIRNESS**

- DEVELOPMENT

- SUPERVISORY SUPPORTIVENESS

- CREATIVITY & IMPROVEMENT

**PERCEIVED**** ****QUALITY**

**PAY**

**EMPLOYEE SATISFACTION**

**The Power of Work Climate**

**. ****24**

**. ****21**

***. ******55***

**Notes:**
Based on our survey data and analysis, we believe that perceptions
on a cluster of approximately 35 question drive a large percentage
of employee satisfaction.  We named that cluster, Work Design & 
Climate

This path diagram displays the relationship

Pay and perceptions of the quality of service provided to veterans
by the facility also significantly influence employee satisfaction

## WHAT IS WORK CLIMATE? Derived From Analysis of 1997, 1999 & 2000 Employee Survey Data

| First-Order Factor/Scale |  | Central item(s) to scale |
| --- | --- | --- |
| INVOLVEMENT & INFLUENCE |  | Efforts to get opinions; Employees involved in improvement |
| CREATIVITY & IMPROVEMENT |  | New ways encouraged: Sup open to change |
| GOAL ALIGNMENT |  | Mgrs let employees know how their work contributes to org goals |
| INFORMATION & COMMUNICATION |  | Kept informed about job and about organization |
| SUPERVISORY TRUST & SUPPORTIVENESS |  | Trust between employees and supervisors; Supervisors help and support employees |
| SKILL DEVELOPMENT |  | Get training to enhance performance and career opportunities |
| WORKLOAD & STRUCTURAL FACTORS |  | Workload is reasonable; Minimum interruptions and “red tape” |
| FAIRNESS |  | Disciplinary actions and disputes are handled fairly |

## -

**-**

***WORKLOAD & STRUCTURAL FACTORS***

**STRESS**

**-**

***24% ******of****** ******variance****** ******explained****** ***

***RESPECT & FAIRNESS***

**EMPLOYEE SATISFACTION**

**-**

**-**

***53% ******explained****** ***

**WORK-CLIMATE**

**INFORMATION & COMMUNICATION**

***INVOLVMENT & INFLUENCE***

**GOAL ALIGNMENT**

**DEVELOPMENT**

**SUPERVISORY SUPPORTIVENESS**

**CREATIVITY & IMPROVEMENT**

**Work Climate Effects on Aggression, Stress & Satisfaction**

**AGGRESSION**

**-**

**-**

***33% ******explained****** ***

**Notes:**
Improving the perceptions on the work climate cluster also reduces
 Stress and Aggression

(Pause a few seconds for viewers to look at the slide)

## Does Employee Satisfaction Matter?

**WORK CLIMATE**
**from a mean  of 2.89 to 3.02**

**= increase  in **
**EMPLOYEE**
**SATISFACTION**
**from mean 3.24 to 3.36**

**= -.23 STD REDUCTION IN **
** ****COST**
**or**
**- $128.38**
**Per Unique Patient **
**or**
** ****-$400,300,000**
**Across VHA**

**.77**

**-.30**

**Does Employee Satisfaction Matter?**

**Notes:**
Does employee satisfaction matter?

We think that if you improve employee perceptions on the 35 question work climate cluster, you can squeeze $400 million in costs out of the system

## What We Know About Aggression and Stress in the Workplace and Employee Satisfaction

**High-involvement, “empowered” work climate is strongly associated with lower stress and aggression and higher employee satisfaction**
**A major portion of the impact of the work climate cluster on employee satisfaction acts through perceptions of fairness and workload obstacles **
**Increased employee satisfaction improves business results**

**Notes:**
We know that involving employees does matter

(Pause a few seconds for the viewers to read the slide)

## Using Local Teams To Act on Survey Data

**Using Local Teams To Act on Survey Data**

**VAMROC**
**Fargo**

**VHA**
**Minneapolis**
**MC**

**VHA**
**Black Hills**

**VHA**
**St Cloud**
**MC**

**VAMROC**
**Sioux**
** ****Falls**

**Fort**
**Meade**
**MC**

**Hot**
**Springs**
**MC**

**VBA**
**Des Moines**
**RO**

**VBA**
** ****St. Paul**
**RO**

**VBA**
**Chicago**
**RO**

**VBA**
**Milwaukee**
**RO**

**VBA**
**Phoenix**
**RO**

**NCA**
**Houston**

**Partially funded by a grant from the**
**National Science Foundation**

**Notes:**
(NOTE: Script includes text to read.  Include additional time
for viewers to read the slide on those slides where the note
says:
Pause a few seconds for viewers to look at the slide.)

The Project is answering four questions:
How does workplace aggression and stress affect
	employee satisfaction? 
	the quality and costs of services in VA? 
	the veterans’ satisfaction? 
How does our collaborative action inquiry process
encourage and bring about learning and change in VA?

The Project is partially funded by a grant from the
National Science Foundation

**1.  Facilities volunteered to join the project after the Project Team briefed them on  the project’s objectives. **
**Both management and the union had to agree.  **
**Either party can withdraw the facility from the project.**
**2.****	****Management and the Union jointly selected Action Team Members using the following  criteria:**

**Credibility with employees and leadership**
**High potential for success**
**Action-orientation**

**Varied backgrounds**
**Committed to learning**
**Good communication skills**

**Selecting Action Team Members**

**Notes:**
We believe that our process was important in achieving our results
 to date.

Joint process with labor partners based on selection criteria.

We would now probably add some data sense making skills and 
change management competencies.

## Just-In-Time Training and Initial Actions

**3.****	****The Project Team trained the Action Teams on:**
**The way to ask questions about the data they would receive, and**
**Learning practices that would help them work and learn together****.**** ****(KEY)**
**4.**** ****Each team had a team leader and a learning coach . **
**5. The Action Teams provided the Project Team with  input into the original survey.**
**6. The Action Teams prepared the facility for the taking the survey by briefing employees on project goals and survey process****.**** ****(KEY)**

**Notes:**
Learning practices and employee involvement seem to have made
a difference

The learning practices and conversation with the entire workforce
 seemed to make a difference. 

(Pause a few seconds for the viewers to read the slide)

## Reviewing Data and Feedback to Workforce

**7. The academic researchers received completed surveys and provided results to  the teams.**
**Conference with all action team members to release initial data and reinforce previously training**
**Action Teams received facility descriptive statistics for each survey question (means , frequency distribution and standard deviations), comparison data for the other pilot sites,  & some causal models (KEY)**
**Action Teams requested data analysis of facility level data from the academic partners**
**8.****	****Action Teams briefed employees on the survey results.**** ****(KEY)**

**Notes:**
Briefing and obtaining feedback from the workforce was important

(Leave a few seconds for the viewers to read the slide)

## Acting on Survey Results

**9.****	****Action teams examined and discussed the data and suggested possible areas of intervention**
**In some cases, the Project Team asked questions to test  the assumptions underlying the suggested intervention**
**10.****	****The Action Teams are in various stages of the analysis, identification, and implementation process.**
**11.****	****The Project and Action Teams will re-administer the survey in November 2002 to help evaluate results.**

**Notes:**
One team implemented a periodic meeting of randomly selected group of employees and the Associate Director (now the Director) to discuss work practices.  Initial results indicate that communication barriers are decreasing, employees are communicating across work units, and grievances and complaints decreased.

Another team is implementing a simple communication system that identifies employee disputes as they are beginning to emerge.  The previously high number of EEO complaints and grievances has fallen to zero.

## Variety of Learning Practices

**Notes:**
The Project Team trained the Action Team members in the use of a few simple inquiry and learning practices 

The practices are best taught as the team reviews data rather than in the classroom separated from work.  Integrating learning into work activities seemed to be helpful.

In addition, a number of participants are adapting the practices for use in other settings

A Learning Guide will be available shortly as will the Project Web Site

## Our Local Action Team Process Is an Important Product

**What We Know**
**Feedback to the workforce on the survey results is important**
**The Action Teams received survey data within 60 days following the survey **
**Face time is important – virtual interactions are insufficient **
**For many Action Teams, their use of the learning practices in meetings and activities created a special space that has had a positive impact on relationships **
**The process of creating this special reflective communicative space is critical to explaining the successes of project to date**
**Individual Action Team members are using some learning practices in other settings**

**Notes:**
The process is important

The Action Teams reported survey data back to the workforce 

Face time is important – virtual interactions are insufficient

(Pause a few seconds for the viewers to read the slide)

## Our Local Action Team Process Is an Important Product!

**What We Think We Know**
**The larger VA culture has trained employees not to act without permission**
**“****Do you see a number as an answer or as posing a question?” **
**The power in the data may lie in the conversation about the data rather than in the data itself**
**Mixing quantitative data with qualitative data, including stories about what is going on at a facility offers greater opportunities for action**
**Using the learning practices changes individual and group  behaviors**
**Integrating learning into work activities is critical to understanding the project dynamics and action team activities**

**Notes:**
Using the learning practices changes individual and group  behaviors

Mixing quantitative data with qualitative data, including stories about
what is going on at a facility offers greater opportunities for action

## What We Know About Aggression and Stress in the Workplace and Employee Satisfaction

**High-involvement, “empowered” work climate is strongly associated with lower stress and aggression and higher employee satisfaction**
**A major portion of the impact of the work climate cluster on employee satisfaction acts through perceptions of fairness and workload obstacles **
**Increased employee satisfaction improves business results**

**Notes:**
We know that involving employees does matter

(Pause a few seconds for the viewers to read the slide)

## Our Local Action Team Process is an Important Product

**What We Think We Know**
**The larger VA culture has trained employees not to act without permission**
**“****Do you see a number as an answer or as posing a question?” **
**The power in the data may lie in the conversation about the data rather than in the data itself**
**Mixing quantitative data with qualitative data, including stories about what is going on at a facility offers greater opportunities for action**
**Using the learning practices changes individual and group  behaviors**
**Integrating learning into work activities is critical to understanding the project dynamics and action team activities**

**Notes:**
Using the learning practices changes individual and group  behaviors

Mixing quantitative data with qualitative data, including stories about
what is going on at a facility offers greater opportunities for action

## Action Team - Examples of Interventions  

**Employee Briefings on the Survey **
**Flake-Off**
**The Rover**
**FISH**** **
**Newsletters**

**Notes:**
Using the learning practices changes individual and group  behaviors

Mixing quantitative data with qualitative data, including stories about
what is going on at a facility offers greater opportunities for action