There is no magic. Adapting the workplace to the modern enterprise requires experimentation.

By Jack Cumming

Whenever Steve Moran throws out a crazy idea, I pause and think whether it might work. Then I hope that someone will try it out, at least as a pilot, and let us all know whether it turns out to be practical.

Unitizing Work

Lately, I’ve been pondering Marion McGovern’s book, Thriving in the Gig Economy: How to Capitalize and Compete in the New World of Work. The idea is a simple one: move much of a business’s project work out of the employment structure by assigning projects to carefully selected independent contractors on a case-by-case, project-by-project basis. It’s an intriguing concept and one which Ms. McGovern has found to be practical both as a business venture and as a personal solution for herself. The trend to outsource project work, as described by Ms. McGovern, however, has applied principally to skilled professionals.  

Workforce Challenge

Senior living, in contrast to project-oriented industries, has a large dependence on low paid workers with a modicum of rudimentary training. Certified Nurse Assistants, for instance, according to Glassdoor, can expect to be paid little more than the minimum wage. Even so, with the Centers for Medicare and Medicaid (CMS) putting downward pressure on reimbursement rates and with affordability a big challenge for seniors, it’s increasingly difficult for providers to cover their costs. Higher wages is not the answer to a tight labor market.

This may be the tightest labor market since World War II armaments production pulled the nation out of the Great Depression. The implications of that increasingly competitive labor market for senior housing intrigue me. It’s a challenge that cannot be deferred. One response lies in technology. The automation of recordkeeping; rapid advances in exoskeletons; and increasingly sophisticated patient monitoring tools all offer promises. Countering that are laws that specify staffing ratios without regard to what technology can offer to better serve patients.  

A secondary response is to offer work advantages beyond money wages. The tying of fringe benefits – health insurance and pensions – to employment began during that earlier tight labor market, the World War II labor shortage when wages were frozen by the Wage Stabilization Act of 1942. The nonmonetary incentives for today’s workers will differ dramatically from those 1942 social benefits.

What Might Work?

Modern workers crave flexibility to balance life, work, play, and responsibility. Ms. McGovern’s ideas of flexible employment for workers and adaptable staffing for employers is consistent with that balancing. To extend Ms. McGovern’s concept of contracting to shift work requires that employees commit to covering a shift whether it’s by themselves or by an equally qualified fellow employee. The key is that commitment, the acceptance by the employees of an irrefutable responsibility to ensure that what they are employed for is covered. Workers can trade shifts but one worker, the owner of a shift, must take responsibility to ensure that the shift is covered. That applies regardless of whether it’s 2 hours, 4 hours, 8 hours, or some other time commitment.

A simple scheduling app such as Shiftboard – or others – can be deployed to ensure that all shifts are covered. Failing to show up for a committed shift is grounds for immediate termination since acceptance of individual responsibility in return for individual flexibility has to be the sine qua non of the system. There is no magic. Adapting the workplace to the modern enterprise requires experimentation. Any change should first be tested as a pilot. The popularity of flextime during the 1980s did not prove out. Still, new ideas, once tested and proven, will lead the way into the new work era. Flexible work is a crazy idea. Let’s call it Flex-Shifts.

Positive Madness

Many of history’s great advances have seemed crazy at the time. There were those who thought it crazy to give women the vote. That worked out. Then, there are those who are crazy with prescience. They are the disrupters . . . those entrepreneurs who leapfrog conventionality to remake an entire industry. It seemed mad for Jeff Bezos to give up a rewarding job to found Amazon, foregoing his annual bonus in the process. It’s madness for Elon Musk to think that he can change the automotive world.

Such forward thinking people seem crazy at the outset, but in the end, it’s those who are slow to adapt who prove to be crazy. Maybe now is the time for senior housing to try crazy ideas like reversing the hierarchical structure that puts those who directly interact with patients and customers at the bottom of the heap. Encouraging bottom-up initiative, even in Flex-Shift scheduling, may leapfrog innovation into a new reality.

Senior housing is a people business. People helping people requires shift commitments; they can be Flex-Shifts. It’s people – those who are aging and those who seek to meet their needs – who will create the industry for the coming decades. Some may even seem crazy and some will be crazy right.