l have been working in local public health for some time now.
And throughout these months, I have seen a plethora of organizational issues, hindering the efficiency of our organization and lowering morale of staff.
Many of these issues are thoroughly covered in business literature. That is, these are not new, affect plenty of other organizations and, most importantly, can be overcomed.
After plenty of conversations and much sharing with other members, I felt compelled to summarize my observations to further share and, hopefully, empower staff to find solutions.
My premise is this: kinder, more purposeful work is possible. And it can be achieved by loosening up the tight organizational rules that govern us. The way I see it, all of these organizational issues refer to flexibility. And yes, government can be more flexible. We have to start by acknowledging.
The Public Health Workforce Interests and Needs Survey (PH WINS) is the most complete scan of the US Public Health workforce. They see some of the pain points I have seen. I recommend checking their work.
Let’s get right into it. I see three major organizational issues.
We are bureaucratic. Our roles are strict. And work gets crazy.
Bureaucratic, because we have to get through many approval layers when we are pushing for projects. These approval layers slow down projects and do not necessarily increase the quality of our product. Strict roles, because our roles tightly define what we are to do and who we are to communicate with. And crazy, because we can multi-task, feel tired, or feel lost.
Out of these large problems I see other smaller problems sprout.
Some lack work. There are plenty of development pathways in undeveloped Public Health organizations. Plenty to do. But work is so cumbersome and restricted that there are few routes to create and deprecate work. Automatization is hard to pull-off. And people defend with teeth and nails the little work they own. There is a tight ownership grip.
Bureaucracy is alive and kicking. We have to go through a multitude of approvals to push for projects. Plenty of sign-offs, good-to-go’s, and thumbs up, no matter how small the project is. The more people involved in approval, the better. Witnesses are higly considered.
We have decision bottlenecks. The people who must approve projects are overwhelmed, thus working as bottlenecks that delay projects.
It’s crazy sometimes. Some working long hours. Constantly running. Eyes red due to being tired. Bad moods. Many multitasking, putting out fires in many places at the same time. Many answering to the latest, most recent thread, leaving little time for long term objectives. Lots of ASAPs.
Death by power-point. We often want detailed requirements and documentation; detailed meeting notes, email threads, and workflows; proofs of conversations and decisions. These are important we are told. Yet, there is little discussion on why such thoroughness is required, or who the audience reading these documents is.
Culture of silence. It is highly regarded to not stir the pot. As long as you stay in your lane, you won’t get in trouble. Try not to question commands. The rule of fist works. So if I outrank you, it is better for you to follow the orders.
Status quo. Plenty look to lay low, stay out of trouble, and clock out as soon as possible. There is resistance to new, different, tasks. If you are an executive, you might face staff saying no to your requests. There is little room for staff to find ways to improve processes, and creativity is not highly considered.
Role stiffness. You were hired to do one job, and one job you will probably do. It’s hard to push for a better fit.
Little trust. Executives and managers want to be present in most if not all decisions. Not fully trusting the decision making of staff. If staff gets in trouble, they will too. Communication outside the organization must be careful and approved first. When you come with a question or a new idea, you might raise eyebrows.
There is little discussion on how success looks like. We tend to invest little time on strategy and vision. Good work is not much discussed.
Watch who you talk to. Heads tend to talk to heads, and staff tends to talk to staff. Vertical communication is discouraged. If you want to have a conversation with other departments, make sure to follow proper communication channels.
Inter-departmental data collaboration is cumbersome. Data sharing between bureaus requires data agreements and involvement of heads. Shared contracts are cumbersome too, specially when bureaus manage their own money.
Meetings oh meetings. There are plenty of them and they can feel unproductive.
No intrapreneurs. As far as I have been at Public health, I haven’t heard the word intrapreneur being mentioned. That is, there is little room for high risk high reward projects led by an internal visionary. Intrapreneurs are necessary for organizations that want to innovate.
Closing remarks: the good.
Public health is honorable. The staff is clearly driven by a spirit of sociability. Members want to do public good, a great force that provides plenty of energy.
Public health must reduce burnout. It’s killing us. It is up to us to find the incentives that will reduce our burnout. And implement them. I recognize we will become more flexible as we implement burnout-reducing strategies happens.
I say we start by addressing the lingering issues I mention. Having honest, open discussions about our organizational practices. Identifying practices that are hurtful, and setting behavior expectations. At the same time, develop a better understanding of what good work means, empower the right staff, discourage bureaucratic behaviors, and request more out of the workforce.
