LEARNING CORNER WITH JEFFREY PFEFFER: HOW TO REDESIGN JOBS TO IMPROVE EMPLOYEE HEALTH & COMPANY PERFORMANCE

Employers today face an epidemic of workplace stress and depression that takes an enormous toll on employees and company performance. In late 2019, the American Institute of Stress pulled together “42 Worrying Workplace Stress Statistics” from a variety of sources, including Gallup, Korn Ferry and the American Psychological Association. Some of the most troubling revelations:
  • 83% of U.S. workers suffer from work-related stress
  • In 2018, a third of US-based respondents visited a doctor for something stress-related
  • 16% of workers have quit their jobs due to stress
And then there’s depression: The American Psychiatric Association reported that depression “significantly impacts productivity” (along with stress, it also leads to absenteeism, presenteeism and turnover), and the World Health Organization noted that it’s one of the leading causes of disability. But that’s not all: Numerous studies show that depression has physiological repercussions and can increase the risk of heart disease, insomnia, weight gain and other unexplained aches or pains. No wonder employers are placing more focus on employees’ mental and physical health.
But to make a difference, they—and we—need to acknowledge the causes. Research has uncovered some principal sources of workplace-induced stress, anxiety and depression: job strain resulting from a combination of high job demands and low job control, long work hours, economic insecurity due to job loss and scheduling uncertainty, low wages that produce economic insecurity, work-family conflict, workplace bullying and harassment, perceived unfairness or a sense of injustice and a lack of social support. So how do we go about fixing these issues?

Redesigning Jobs and Work Environments to Fix the Problem

Many of the factors causing stress and burnout can be at least partly remedied if companies stop taking existing jobs and organizational arrangements as sacrosanct and engage in serious redesign initiatives. Below are two examples of businesses doing just that:
Removing Unnecessary Distractions
When I wrote a case on SAS, the largest privately owned software company in the world, I interviewed co-founder and CEO Jim Goodnight about the company’s 35-hour workweek and what made it possible. Goodnight, his VP of HR and many other SAS employees all had the same response: Few people work 35 productive hours in a week. 
SAS successfully reduced distractions that wasted time by providing employees with high-quality help for their life issues. This included on-site childcare, assistance with elder care, a chief medical officer to help choose the best health providers and select health plans that didn’t bog people down with paperwork and adoption assistance.
An emphasis on employee trust and the decentralization of decision-making also eliminated endless “check-in meetings” and the need to get approval from layers of management—processes that unnecessarily consume much of people’s time. 
Using Automation to Relieve Burdens
Recently, I met with the CEO of a company that is redesigning the primary care experience for both patients and providers. To be successful, he needs to reduce physician turnover and burnout (a massive problem within the industry) and to provide an outstanding patient experience by increasing doctors’ level of engagement. Doing so requires addressing a dramatic rise in bureaucratic tasks, too many hours spent at work, and the increasing computerization of practice—what some people call desktop medicine
The company is doing something that any organization can do to reduce the wasted effort that makes long hours necessary and work stressful. I describe it as “user-centered work design.” User-centered product design, which was more or less pioneered by IDEO, has become de rigueur and typically includes an almost anthropological observation of people’s product experiences.
User-centered work design takes the same form. The company has hired more than 100 software engineers—and does not use off-the-shelf software. Instead, the engineers engage with physicians to figure out what tasks can be automated to reduce doctors’ workloads and to provide doctors with software designed to be easy to use and helpful. Groups of people from all jobs and levels at the company now meet regularly to determine how to allocate work in ways that reduce stress. This helps the employees figure out what practices, tasks and operations can be eliminated without any adverse consequences. 

Making a Real Commitment to Change

The number of unnecessary work tasks performed in a given day is pretty astounding. Many activities are simply leftovers from long-established policies that no longer serve a purpose. Certain processes, including some owned by human resources—think job requisitions and the now-disappearing annual performance review—do not add significant economic value. And many companies take current job designs and work arrangements for granted, thereby foregoing opportunities to seriously reduce workplace stress.
Some of my colleagues from Stanford’s School of Medicine and I conducted more than 20 interviews with supposedly leading-edge companies that have embraced a holistic definition of health and well-being and claim to understand the connections between health and economic performance. We found that most organizations consider their work environments and habits necessary and never question what they are doing or how they are doing it. For instance, one financial services firm never even considered the idea that its 100 hour work-weeks were neither mandated by law nor useful in attracting or retaining talent. No wonder workplace stress is not only high, it’s on the rise.
Job redesign to reduce stress—and thereby increase health and productivity—is not a formulaic activity. Just like product design, it requires observation, employee interactions to ascertain how to remove unnecessary tasks and consultation with the people who do the work every day. 
Mostly, it requires people who refuse to accept workplace stress and depression as unchangeable and who don’t apply Band-Aids like yoga classes and stress-reduction workshops to the problem. Any organization can accomplish this if, and maybe only if, it’s willing to place employees at the center of the job redesign process.