INCENTIVES, MOTIVATION & RETENTION HEALTH WORKER. Oleh: Dwi Handono Sulistyo

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1 INCENTIVES, MOTIVATION & RETENTION HEALTH WORKER Oleh: Dwi Handono Sulistyo 1

2 HRH PROBLEMS SHORTAGE WASTAGE LOW MOTIVATION O OUTDATED SKILL LOW PRODUCTIVITY MIGRATION/MALDISTRIBUTION Report of the Working Group on Demand (2004), P. 10 2

3 Does a well designed PAY SYSTEM MOTIVATE employees to perform better? Or does it create greater SATISFACTION? Does perception of PAY SYSTEM SATISFACTION related to RETENTION? 3

4 JAWABANNYA BUKAN HANYA YA ATAU TIDAK * PENJELASANNYA: TERGANTUNG TEORI APA YANG DIGUNAKAN 4

5 BASIC CONCEPTS COMPENSATION (PAY; INCENTIVES) MOTIVATION 5

6 Compensation System Direct Indirect Base Pay Incentive Pay Legally Required Optional -Bonus -Commission -Profit sharing -Stock options -Social Security -Unemployment Compensation Insurance -Worker s Compensation -Family & Medical leave -Paid time off (holidays, vacation, sick days, etc) -Health insurance -Retirement/ Pension plans -Disability insurance -Life insurance -Tuition reimbursement -Dependent care -Flexible work schedules (telecommuting, flex time, Compressed work week, etc) 6 From: Mello (2006), p. 494

7 A Simple Model of Motivation NEED Creates desire to fulfill needs (money, friendship, recognition, achievement) BEHAVIOR Result in actions to fulfill needs REWARDS Satisfy needs: intrinsic or extrinsic rewards FEEDBACK Reward informs person whether behavior was appropriate and should be used again From: Daft (2005), p

8 Motivation Theories & Workplace Outcomes: A Contingency Approach Source: Kreitner & Kinicki (1998; p. 192) Outcome of Interest Choice to pursue a course of action Effort Performance Satisfaction Absenteeism Turnover Need Reinforcement MOTIVATION THEORIES Equity Expectancy X Goal Setting Job Characteristic X X X X X X X X X X X X X X X X X X X X 8

9 NEED THEORIES OF MOTIVATION Maslow s Need Hierarchy Theory Two Factor Theory (Herzberg) Acquired Needs Theory (McClelland) 9

10 MASLOW S HIERARCHY OF NEEDS Self Actualization Needs Esteem Needs Belongingness/Love Needs Compensation (Pay; Incentives) Safety Needs Physiological i l Needs 10

11 MENURUT MASLOW KOMPENSASI (GAJI, INSENTIF KEUANGAN) BERADA DI LEVEL TERBAWAH DARI HIERARKI JADI TIDAK MEMPENGARUHI MOTIVASI BERSIFAT EXTRINSIKS 11

12 NEW MODEL OF MASLOW S HIERARCHY OF NEEDS Tran scendence Self Actualization Aesthetic Needs Need to Know & Understand Esteem Needs Belongingness/Love Needs Safety Needs Physiological Needs 12

13 HERZBERG S TWO-FACTOR THEORY Highly Satisfied MOTIVATORS Neither Satisfied nor dissatisfied Highly AREA OF SATISFACTION AREA OF DIS- SATISFACTION Achievement Recognition Responsibility Work Itself Personal Growth HYGIENE FACTORS Working conditions Pay & security Company policies Supervisors Interpersonal relationships Dissatisfied 13 Motivators Influence level Of satisfaction Hygiene factors Influence level of dissatisfaction

14 MENURUT HERZBERG GAJI ATAU KENAIKAN GAJI TIDAK AKAN MENINGKATKAN MOTIVASI TAPI, JIKA GAJI TIDAK CUKUP (TIDAK SESUAI DENGAN HARAPAN), AKAN MENIMBULKAN KETIDAKPUASAN GAJI CUKUP = Neither Satisfied nor dissatisfiedi d 14

15 Acquired Needs Theory (McClelland) 3 needs can be acquired: Need for Achievement Need for Affiliation i Need for Power Diskusi: TIDAK TERKAIT LANGSUNG DENGAN HUBUNGAN KOMPENSASI MOTIVASI 15

17 REINFORCEMENT THEORY Skinners Looks at the relationship between BEHAVIOR & its CONSEQUENCES by changing or modifying follower s on the job behavior through the appropriate use of immediate REWARDS or PUNISHMENTS BEHAVIOR MODIFICATION: the law of effect 4 Cara: Positive & Negative Reinforcement; Punishment; Extinction Diskusi: HUBUNGAN KOMPENSASI MOTIVASI 17

18 ADAM S EQUITY THEORY OF MOTIVATION A Model of Motivation that explains how people p strive for FAIRNESS & JUSTICE in social exchanges or give and take relationship Employee Employer Employer exchange components: INPUTS & OUTCOMES INPUTS: Time, education/training, experience, skills, creativity, it seniority, it loyalty, lt age, personality traits, effort expanded, personal appearance OUTCOMES: pay/bonuses, py/ fringe benefits, challenging assignments, job security, career advancements/promotions, status symbols, recognition, etc 18

19 ADAM S EQUITY THEORY OF MOTIVATION Self Other Self Other An Equitable Situation EQUITY = RATIO OF OUTCOMES TO INPUTS Self Other Negative Inequity Positive Inequity 19

20 Expanded the Concept of Equity Distributive Justice Procedural Justice External Equity (pekerjaan A vs pekerjaan A di organisasi lain) Internal Equity (pekerjaan A vs pekerjaan B dalam satu organisasi) Individual Equity y(pekerjaan A vs pekerjaan A dalam satu organisasi) Diskusi: HUBUNGAN KOMPENSASI MOTIVASI & KEPUASAN 20

22 VROOM S EXPECTANCY THEORY E P expectancy Effort Performance Will putting effort into The task lead to the Desired performance? P O expectancy Performance Outcomes Will high performance Lead to the desired Outcome? Valence Value of outcomes (pay, recognition, other rewards) Are the available outcomes Highly valued? MOTIVATION 22

23 PORTER LAWLER S EXPECTANCY MODEL 1 Nilai penghargaan 4 8 Kemampuan Penghargaan dan bakat yang dirasa pantas Usaha Kinerja Penghargaan Kepuasan 2 5 Kemungkinan Persepsi kinerja akan diberi terhadap penghargaan peran 23

24 EXPECTANCY THEORY DISKUSI: HUBUNGAN KOMPENSASI MOTIVASI & KEPUASAN Contoh: Jika bekerja 5 tahun mendapat cuti 10 hari/5 tahun; Jika bekerja 10 tahun akan mendapat tambahan cuti 5 hari/tahun, plus: status senior, tunjangan dan gaji tambahan, dll. 24

26 THE JOB CHARACTERISTIC MODEL Core job characteristics Critical Psychological states Outcomes Skill variety Task identity Task significance Autonomy Feedback from job Experienced meaningfulness of the work Experienced responsibility for outcomes of the work Knowledge of the actual results of the work activities iti High internal Work motivation High growth Satisfaction High general Job satisfaction High work effectiveness Moderators: 1.Knowledge and skill 2.Growth need strength 3. Context satisfactions 26

27 Locke s Model of Goal Setting Directing one s attention Goals motivate the individual id by Regulating one s effort Increasing one s persistence Task performance Encouraging the development of goal-attainment strategies or action plans 27

28 DISKUSI KEDUA MODEL TERAKHIR, TIDAK ADA HUBUNGANNYA/TAK BISA MENJELASKAN HUBUNGAN KOMPENSASI MOTIVASI & KEPUASAN 28

29 RANGKUMAN HUBUNGAN ANTARA KOMPENSASI DENGAN MOTIVASI DALAM 2 KONTEKS KHUSUS: KEPUASAN PEGAWAI & PRODUKTIVITAS BOCORAN UJIAN: HUBUNGAN PAY and EMPLOYEES SATISFACTION HUBUNGAN PAY and EMPLOYEES PRODUCTIVITY 29

30 KEMBALI KE COMPENSATION 30

31 COMPENSATION DECISIONS PAY FOR PARTICULAR POSITION IS SET RELATIVE TO 3 GROUPS (remember: EQUITY THEORY): Employees working on similar jobs in other organizations (based on: EXTERNAL EQUITY PAY LEVEL DECISION) Employees working on different jobs within the organization (based on: INTERNAL EQUITY PAY STRUCTURE DECISION) Employees working on the same job within the organization (based on: INDIVIDUAL EQUITY INDIVIDUAL PAY DETERMINATION) 31

32 COMPENSATION DECISIONS PAY LEVEL DECISION EXTERNAL EQUITY INTERNAL EQUITY PAY-STRUCTURE DECISION INDIVIDUAL EQUITY INDIVIDUAL PAY DETERMINATION 32

33 PAY LEVEL DECISION BASED ON: PAY SURVEYS 3 PAY LEVEL STRATEGY: HIGH PAY STRATEGY LOW PAY STRATEGY COMPARABLE PAY STRATEGY 33

34 THE PAY STRUCTURE DECISION TOOL: JOB EVALUATION A systematic comparison of the worth of one job with that of another job, results in the creation of wage or salary hierarchy Case: Strategic HRM: A position ii versus B or C position (Jobs/work); A player versus B or C players 34

35 Comparison of Job Evaluation Systems COMPARISON BASIS NON- QUANTITATIVE COMPARISON (Job as Whole) QUANTITATIVE COMPARISON (Parts of Factors of Jobs) JOB versus JOB JOB RANKING FACTOR COMPARISON JOB versus SCALE JOB GRADING or CLASSIFICATION POINT SYSTEM 35 Source: Ivancevich (2007; p. 312)

36 The Individual Pay Decision Two issues: 1. the same pay? 2. make the distinction? i i Based on what? Individual differences in experience, skills, & performance? Expectations that seniority, higher performance, or both thdeserve higher h pay? 36

37 Methods of Payment Flat Rates Payment for Time Worked Variable Pay: Incentive Compensation Any compensation plan that emphasizes a shared focus on organizational success, broadens opportunities for incentives to nontraditional groups, & operates outside the base pay increase system Gainsharing, winsharing, lump sum bonuses, individual variable pay, etc. Flexible, depend on organization profit 37

38 The Double Impact of Incentive Bonuses on Employee Motivation and Performance Identification of & solution to productivity it problems Bonus promised Participation Intrinsic motivation Effort Bonus Information sharing & employee empowerment From: Kreitner & Kinicki (1998), p

39 RETENTION Does perception of PAY SYSTEM SATISFACTION related to RETENTION? 39

40 3 Categories of factors affecting retention Personal Factors (age, gender, education, etc) Professional factors (specialization, working hours, incentives, etc) Contextual/environmental factors (community amenities, ii quality of life, population s educational level, etc) 40

41 5 Categories of Determinants that affect Geographical Distribution Individual Factors: social background, ethnicity, age, g, gender, education, values, beliefs, etc Organizational Environment: management style, incentives & career structures, salary scales, etc Health Care & Educational System Determinants: education & training process, health care system, HRH policy formulation process Institutional Environment: decentralization & civil service reform, Sociocultural Environment Source: Dussault & Francheschini (2006), p

42 Dokter di Bengkulu Penelitian: Bukit, Trisnantoro, Meliala (2002) Turn Over Rate tinggi Dokter hanya betah bthbertahan selama 2 th tahun Insentif kehadiran up to Rp 5 juta Fasilitas bekerja dan perumahan disediakan Pelayanan kepada pasien di RS buruk Source: Meliala (2007) 42

43 Dokter di Papua Penelitian Napitupulu, Meiyanto & Meliala (2005) Turn Over Rate tinggi Dokter hanya betah bertahan selama 3 tahun Hanya menyelesaikan kontrak Insentif kehadiran Rp 7.5 juta Penghasilan Rp. 20 juta Fasilitasbekerja dan perumahan disediakan Pelayanan kepada pasien di RS buruk Source: Meliala (2007) 43

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