PRINCIPLES OF HOSPITAL MANAGEMENT

BY – HARI SHANKAR NAUTIYAL MHA 1ST SEMESTER

ASSIGNMENT ON MOTIVATION

MOTIVATION

Motivation is the reason for people’s actions, desires, and needs. Motivation is also one’s direction to behavior, or what causes a person to want to repeat a behavior. A motive is what prompts the person to act in a certain way, or at least develop an inclination for specific behavior.

DEFINITION OF MOTIVATION

The process of arousing the action sustaining the activity in the process and regulating the pattern of activity

Early Theories of Motivation

Hierarchy of Needs (a.k.a. Maslow’s Pyramid)

  • Physiological
  • includes hunger, thirst, shelter, sex and other bodily needs
  • Safety
  • includes security and protection from physical and emotional harm
  • Social
  • includes affection, belongingness acceptance, and friendship
  • Esteem
  • includes internal esteem factors such as self-respect, autonomy, and achievement; and external esteem factors such as status, recognition, and attention
  • Self-actualization
  • the drive to become what one is capable of becoming; includes growth, achieving one’s potential, and self-fulfillment

Note:  An individual moves “up the steps” of the hierarchy.  “Lower order” needs are satisfied externally (i.e. physiological and safety) while “higher order” needs are satisfied internally (i.e. social, esteem, and self-actualization).

Theory X and Theory Y

Douglas McGregor proposed two distinct views of human beings: one basically

Negative, labeled Theory X, and the other basically positive, labeled Theory Y.

Theory X

  • The assumption  that employees dislike work, are lazy, dislike responsibility, and must be coerced to perform. (Lower order needs dominate)

Theory Y

  • The assumption that employees like work, are creative, seek responsibility, and can exercise self-direction. (Higher order needs dominate)

McGregor believed Theory Y assumptions were more valid than Theory X and proposed such ideas as participative decision making, responsible and challenging jobs, and good group relations as approaches that would maximize an employee’s motivation.

**Question = what type of manager will you be (or are you)? One who believes in Theory X or Theory Y? Be honest! Do you think this is important? Why? Why not?

Two-Factor Theory

  • Intrinsic factors are related to job satisfaction, while extrinsic factors are related to job dissatisfaction.
  • Hygiene factors = when these are adequate, workers “feel OK” (i.e. they are NOT dissatisfied). Examples include quality of supervision, company policies and administration.
  • Motivators = examines factors contributing to job satisfaction. Thus there are factors which lead to job satisfaction and things that don’t (i.e. notice there is a difference between “non-satisfying” and “dissatisfying factors”) 

Contemporary Theories

McClelland’s Theory of Needs

  • The Need for Achievement: the drive to excel, achieve in relation to a set of standards, strive to succeed.
  • The Need for Power: The need to make others behave in a way that they would not have behaved otherwise.
  • The Need for Affiliation: The desire for friendly and close interpersonal relationships.

Question: What can we do with this information? Answer: Match people to jobs!

Those high on “achievement” tend to prefer jobs with personal responsibility, feedback and moderate risks. They DO NOT always care about motivating others!

In general, individuals high on the need for “Power” and low on the need for “Affiliation” tend to perform better in managerial roles.

Cognitive Evaluation Theory

  • Allocating extrinsic rewards for behavior that had been previously intrinsically rewarding tends to decrease the overall level of motivation.

Goal -Setting Theory

  • The theory that specific and difficult goals lead to higher performance.
  • Goals tell an employee what needs to be done and how much effort will need to be expended.
  • Specific goals increase performance; that difficult goals, when accepted, result in higher performance than do easy goals; and that feedback leads to higher performance than does non-feedback.
  • Specific hard goals produce a higher level of output than does the generalized goal of “do your best.”
    • The specificity of the goal itself acts as an internal stimulus.
  • Be sure to note the importance of goal commitment, self-efficacy, task characteristics, and national culture on goal-setting theory.

Management by Objectives (“MBO”)

This approach puts goal setting to work.

It is a program that encompasses:

  • specific goals (tangible, verifiable, measurable)
  • participative set
  • for an explicit time period
  • with performance feedback on goal progress

MBO operationalizes the concept of objectives by devising a process by which objectives cascade down through the organization.

The result is a hierarchy of objectives that links objectives at one level to those at the next level.

For the individual employee, MBO provides specific personal performance objectives.

Self-Efficacy Theory

Self-efficacy refers to an individual’s belief that he or she is capable of performing a task.  The higher your self-efficacy, the more confidence you have in your ability to succeed in a task.

Reinforcement Theory

  • A counterpoint to the goal-setting theory.
  • In reinforcement theory, a behaviorist approach, which argues that reinforcement  conditions behavior.
  • Reinforcement theorists see behavior as being behaviorally caused.
  • Reinforcement theory ignores the inner state of the individual and concentrates solely on what happens to a person when he or she takes some action.
  • Because it does not concern itself with what initiates behavior, it is not, strictly speaking, a theory of motivation.
  • It does however provide a powerful means of analysis of what controls behavior.

Equity Theory

  • Individuals compare their job inputs and outcomes with those of others and then respond so as to eliminate any inequities.
  • Equity theory recognizes that individuals are concerned not only with the absolute amount of rewards for their efforts, but also with the relationship of this amount to what others receive.
  • Historically, equity theory focused on:

distributive justice or the perceived fairness of the amount and allocation of rewards among individuals. However, equity should also consider procedural justice or the perceived fairness of the process used to determine the distribution of rewards. Interactional justice is also important.

*Question: So, what happens when your pay is “inequitable”?

Expectancy Theory

  • The strength of a tendency to act in a certain way depends on the strength of an expectation that the act will be followed by a given outcome and on the attractiveness of that outcome to the individual. The theory focuses on three relationships:
  • Effort-performance relationship or the probability perceived by the individual that exerting a given amount of effort will lead to performance.
  • Performance-reward relationship or the degree to which the individual believes that performing at a particular level will lead to the attainment of a desired outcome.
  • Rewards-personal goals relationship or the degree to which organizational rewards satisfy an individual’s personal goals or needs and the attractiveness of those potential rewards for the individual.

Don’t Forget Ability and Opportunity

Performance = f (Ability X Motivation X Opportunity)

Question: Think about how the fundamental attribution error can lead you astray in terms of “understanding” others’ behavior in the workplace.  How do ability, motivation, and opportunity influence YOUR perceptions of workplace behavior?)

Integrating Contemporary Theories of Motivation

  • First, consider employees’ opportunity, ability and the “purpose” or objectives of the current performance evaluation system in which they work. Then, consider the link between individual effort – individual performance – organizational rewards and personal goals. Each link can be influenced by a variety of factors (i.e. needs, reinforcement, equity)

Motivation Theories are Culture Bound

  • Note that most theories were developed in the US. Many theories do not always work around the world (e.g., equity theory).  However, many do (e.g., having interesting work).

Summary and Implications for Managers

Need Theories

–     Maslow’s hierarchy, Two factor, ERG, & McClelland’s

Goal Setting Theory

–     Clear and difficult goals often lead to higher levels of employee productivity.

Reinforcement Theory

–     Good predictor of quality and quantity of work, persistence of effort, absenteeism, tardiness, and accident rates.

Equity Theory

–     Strongest when predicting absence and turnover behaviors.

–     Weakest when predicting differences in employee productivity.

Expectancy Theory

– Focus on performance variables

– It is a “rational” model so be careful when using it

– This theory may be better applied to employees with greater discretion in their jobs (i.e., as opposed to semi-skilled positions)

Incentive theories: intrinsic and extrinsic motivation

Motivation can be divided into two different theories known as intrinsic (internal or inherent) motivation and extrinsic (external) motivation.

Intrinsic motivation

Intrinsic motivation has been studied since the early 1970s. Intrinsic motivation is the self-desire to seek out new things and new challenges, to analyze one’s capacity, to observe and to gain knowledge. It is driven by an interest or enjoyment in the task itself, and exists within the individual rather than relying on external pressures or a desire for consideration. The phenomenon of intrinsic motivation was first acknowledged within experimental studies of animal behavior. In these studies, it was evident that the organisms would engage in playful and curiosity driven behaviors in the absence of reward. Intrinsic motivation is a natural motivational tendency and is a critical element in cognitive, social, and physical development. Students who are intrinsically motivated are more likely to engage in the task willingly as well as work to improve their skills, which will increase their capabilities. Students are likely to be intrinsically motivated if they:

  • attribute their educational results to factors under their own control, also known as autonomy or locus of control
  • believe they have the skills to be effective agents in reaching their desired goals, also known as self-efficacy beliefs
  • are interested in mastering a topic, not just in achieving good grades

An example of intrinsic motivation is when an employee becomes an IT professional because he or she wants to learn about how computer users interact with computer networks. The employee has the intrinsic motivation to gain more knowledge .Art for art’s sake is an example of intrinsic motivation in the domain of art.

Traditionally, researchers thought of motivations to use computer systems to be primarily driven by extrinsic purposes; however, many modern systems have their use driven primarily by intrinsic motivations. Examples of such systems used primarily to fulfil users’ intrinsic motivations, include on-line gaming, virtual worlds, online shopping, learning/education, online dating, digital music repositories, social networking, online pornography, gamified systems, and general gamification. Even traditional management information systems (e.g., ERP, CRM) are being ‘gamified’ such that both extrinsic and intrinsic motivations must increasingly be considered.

Advantages: Intrinsic motivation can be long-lasting and self-sustaining. Efforts to build this kind of motivation are also typically efforts at promoting student learning. Such efforts often focus on the subject rather than rewards or punishments.

Disadvantages: Efforts at fostering intrinsic motivation can be slow to affect behavior and can require special and lengthy preparation. Students are individuals, so a variety of approaches may be needed to motivate different students. It is often helpful to know what interests one’s students in order to connect these interests with the subject matter. This requires getting to know one’s students. Also, it helps if the instructor is interested in the subject.

Extrinsic motivation

Extrinsic motivation refers to the performance of an activity in order to attain a desired outcome and it is the opposite of intrinsic motivation. Extrinsic motivation comes from influences outside of the individual. In extrinsic motivation, the harder question to answer is where do people get the motivation to carry out and continue to push with persistence. Usually extrinsic motivation is used to attain outcomes that a person wouldn’t get from intrinsic motivation. Common extrinsic motivations are rewards (for example money or grades) for showing the desired behavior, and the threat of punishment following misbehavior. Competition is an extrinsic motivator because it encourages the performer to win and to beat others, not simply to enjoy the intrinsic rewards of the activity. A cheering crowd and the desire to win a trophy are also extrinsic incentives.

Social psychological research has indicated that extrinsic rewards can lead to overjustification and a subsequent reduction in intrinsic motivation. In one study demonstrating this effect, children who expected to be (and were) rewarded with a ribbon and a gold star for drawing pictures spent less time playing with the drawing materials in subsequent observations than children who were assigned to an unexpected reward condition. However, another study showed that third graders who were rewarded with a book showed more reading behavior in the future, implying that some rewards do not undermine intrinsic motivation. While the provision of extrinsic rewards might reduce the desirability of an activity, the use of extrinsic constraints, such as the threat of punishment, against performing an activity has actually been found to increase one’s intrinsic interest in that activity. In one study, when children were given mild threats against playing with an attractive toy, it was found that the threat actually served to increase the child’s interest in the toy, which was previously undesirable to the child in the absence of threat.

Behaviorist theories

While many theories on motivation have a centralistic perspective, behaviorists focus only on observable behavior and theories founded on experimental evidence. In the view of behaviorism, motivation is understood as a question about what factors cause, prevent, or withhold various behaviors, while the question of, for instance, conscious motives would be ignored. Where others would speculate about such things as values, drives, or needs, that may not be observed directly, behaviorists are interested in the observable variables that affect the type, intensity, frequency and duration of observable behavior. Through the basic research of such scientists as Pavlov, Watson and Skinner, several basic mechanisms that govern behavior have been identified. The most important of these are classical conditioning and operant conditioning.

Classical and operant conditioning

In classical (or respondent) conditioning, behavior is understood as responses triggered by certain environmental or physical stimuli. They can be unconditioned, such as in-born reflexes, or learned through the pairing of an unconditioned stimulus with a different stimulus, which then becomes a conditioned stimulus. In relation to motivation, classical conditioning might be seen as one explanation as to why an individual performs certain responses and behaviors in certain situations. For instance, a dentist might wonder why a patient does not seem motivated to show up for an appointment, with the explanation being that the patient has associated the dentist (conditioned stimulus) with the pain (unconditioned stimulus) that elicits a fear response (conditioned response), leading to the patient being reluctant to visit the dentist.

In operant conditioning, the type and frequency of behavior is determined mainly by its consequences. If a certain behavior, in the presence of a certain stimulus, is followed by a desirable consequence (a reinforcer), the emitted behavior will increase in frequency in the future, in the presence of the stimulus that preceded the behavior (or a similar one). Conversely, if the behavior is followed by something undesirable (a punisher), the behavior is less likely to occur in the presence of the stimulus. In a similar manner, removal of a stimulus directly following the behavior might either increase or decrease the frequency of that behavior in the future (negative reinforcement or punishment).[For instance, a student that gained praise and a good grade after turning in a paper, might seem more motivated in writing papers in the future (positive reinforcement); if the same student put in a lot of work on a task without getting any praise for it, he or she might seem less motivated to do school work in the future (negative punishment). If a student starts to cause trouble in class gets punished with something he or she dislikes, such as detention (positive punishment), that behavior would decrease in the future. The student might seem more motivated to behave in class, presumably in order to avoid further detention (negative reinforcement).

The strength of reinforcement or punishment is dependent on schedule and timing. A reinforcer or punisher affects the future frequency of a behavior most strongly if it occurs within seconds of the behavior. A behavior that is reinforced intermittently, at unpredictable intervals, will be more robust and persistent, compared to one that is reinforced every time the behavior is performance. For example, if the misbehaving student in the above example was punished a week after the troublesome behavior, that might not affect future behavior.

In addition to these basic principles, antecedent factors also affect behavior. Behavior is punished or reinforced in the context of whatever stimuli were present just before the behavior was performed, which means that a particular behavior might not be affected in every context, just because it was punished or reinforced in a particular one. A lack of praise for school-related behavior might, for instance, not decrease sports-related behavior usually reinforced by praise.

The various mechanisms of operant conditioning may be used to understand the motivation for various behaviors by examining what happens just after the behavior (the consequence), in what context the behavior is performed or not performed (the antecedent), and under what circumstances (motivating operators).

Incentive motivation

Incentive theory is a specific theory of motivation, derived partly from behaviorist principles of reinforcement, which concerns an incentive or motive to do something. The most common incentive would be compensation. Compensation can be tangible or intangible, It helps in motivating the employees in their corporate life, students in academics and inspire to do more and more to achieve profitability in every field. Studies show that if the person receives the reward immediately, the effect is greater, and decreases as delay lengthens. Repetitive action-reward combination can cause the action to become a habit.

“Reinforces and reinforcement principles of behavior differ from the hypothetical construct of reward.” A reinforcer is anything that follows an action, with the intentions that the action will now occur more frequently. From this perspective, the concept of distinguishing between intrinsic and extrinsic forces is irrelevant.

Incentive theory in psychology treats motivation and behavior of the individual as they are influenced by beliefs, such as engaging in activities that are expected to be profitable. Incentive theory is promoted by behavioral psychologists, such as B.F. Skinner. Incentive theory is especially supported by Skinner in his philosophy of Radical behaviorism, meaning that a person’s actions always have social ramifications: and if actions are positively received people are more likely to act in this manner, or if negatively received people are less likely to act in this manner.

Incentive theory distinguishes itself from other motivation theories, such as drive theory, in the direction of the motivation. In incentive theory, stimuli “attract” a person towards them, and push them towards the stimulus. In terms of behaviorism, incentive theory involves positive reinforcement: the reinforcing stimulus has been conditioned to make the person happier. As opposed to in drive theory, which involves negative reinforcement: a stimulus has been associated with the removal of the punishment—the lack of homeostasis in the body. For example, a person has come to know that if they eat when hungry, it will eliminate that negative feeling of hunger, or if they drink when thirsty, it will eliminate that negative feeling of thirst.

Motivating operations

Motivating operations, MOs, relate to the field of motivation in that they help improve understanding aspects of behavior that are not covered by operant conditioning. In operant conditioning, the function of the reinforcer is to influence future behavior. The presence of a stimulus believed to function as a reinforcer does not according to this terminology explain the current behavior of an organism – only previous instances of reinforcement of that behavior (in the same or similar situations) do. Through the behavior-altering effect of MOs, it is possible to affect current behavior of an individual, giving another piece of the puzzle of motivation.

Motivating operations are factors that affect learned behavior in a certain context. MOs have two effects: a value-altering effect, which increases or decreases the efficiency of a reinforcer, and a behavior-altering effect, which modifies learned behavior that has previously been punished or reinforced by a particular stimulus.

When a motivating operation causes an increase in the effectiveness of a reinforcer, or amplifies a learned behavior in some way (such as increasing frequency, intensity, duration or speed of the behavior), it functions as an establishing operation, EO. A common example of this would be food deprivation, which functions as an EO in relation to food: the food-deprived organism will perform behaviors previously related to the acquisition of food more intensely, frequently, longer, or faster in the presence of food, and those behaviors would be especially strongly reinforced.For instance, a fast-food worker earning minimal wage, forced to work more than one job to make ends meet, would be highly motivated by a pay raise, because of the current deprivation of money (a conditioned establishing operation). The worker would work hard to try to achieve the raise, and getting the raise would function as an especially strong reinforcer of work behavior.

Conversely, a motivating operation that causes a decrease in the effectiveness of a reinforcer, or diminishes a learned behavior related to the reinforcer, functions as an abolishing operation, AO. Again using the example of food, satiation of food prior to the presentation of a food stimulus would produce a decrease on food-related behaviors, and diminish or completely abolish the reinforcing effect of acquiring and ingesting the food.[20] Consider the board of a large investment bank, concerned with a too small profit margin, deciding to give the CEO a new incentive package in order to motivate him to increase firm profits. If the CEO already has a lot of money, the incentive package might not be a very good way to motivate him, because he would be satiated on money. Getting even more money wouldn’t be a strong reinforcer for profit-increasing behavior, and wouldn’t elicit increased intensity, frequency or duration of profit-increasing behavior.