While many employers are focused on combatting absenteeism, they really should be looking at a major factor behind low productivity: Presenteeism.
That’s according to a report from Global Corporate Challenge (GCC) that found employees are absent from work an average of four days per year, but they are unproductive for almost three months — 57.5 days — in that year.
“Businesses use absenteeism rates as an indicator of engagement and productivity because it’s easy to quantify. If your employee is at their desk or on the work site, you can tick a box,” said GCC Insights data scientist and report co-author Olivia Sackett, who is based in Melbourne, Australia.
“But… businesses are focused on the wrong measure of productivity; absenteeism is not a major culprit… For every one day off sick, employees waste 10 more doing very little.”
It’s time to change the conversation and start prioritizing under-performance instead of absenteeism, said David Batman, GCC’s chief medical officer in York, U.K., and co-author of the report, based on a study of 1,872 employees.
“We need to stop talking about how many sick days people are taking and focus our energy on what they’re doing when they’re actually at work.”
Presenteeism is when a person is physically at work but not performing at his best due to a physical or psychological issue, said Sackett. Any issue that prevents a person from performing at his best contributes to presenteeism, she said.
Presenteeism used to be defined strictly as somebody who was sick but came into work anyway and was not able to function as well as he could, said Paula Allen, vice-president of research and integrative solutions at Morneau Shepell in Toronto. But that definition has broadened.
“It’s basically people at work but not really working to their full capacity, so they’re capable of it, they have the skills but they’re not working to full capacity so that could be because they’re distracted.”
But Gary Johns, professor emeritus of management at the John Molson School of Business at Concordia University in Montreal, defines presenteeism as going to work when you’re ill, period.
It’s an old-fashioned view, he said.
“In most cases, I think professional people and academia either define it as going to work ill or define it as productivity loss going to work ill, those are the two kind of major definitions.”
There are all kinds of things that can detract from a person’s work, said Dave Gallson, associate national executive director of the Mood Disorders Society of Canada.
“Their life isn’t just from eight to four, they have a home life and when you carry that stuff in from your home life, then it affects your work productivity, your safety… how you get along with your co-workers, your customers, all of that stuff,” he said.
“Sometimes, being wired and being connected to the Internet or your cellphone or texting and all that can also reduce the person’s ability to take a clean break mentally from work.”
Many workplaces are demanding 110 per cent from people, in terms of working extra hours, higher levels of customer service and higher levels of innovation or problem-solving, said Allen.
“Whereas you could be functioning at 80 per cent, 60 per cent and it not have an impact on the workplace before because the standard was... a little bit lower, its more noticeable now.”
There’s more of a focus on presenteeism as employers attempt to keep employees engaged and recognize that physical health doesn’t stop on the doorstep of the organization, said Johns.
“I don’t think people are any sicker but I think organizations are realizing they may have some vested interest in paying attention to something that at one time was considered to be private, secret and confidential — employee health.”
And with a weaker economy and higher job insecurity, people are more likely to go to work when they’re ill, he said.
“People might be also stuck in jobs that are less fulfilling but don’t see any options to move at any given time.”
Identifying, measuring presenteeism
To identify presenteeism, it’s about noticing change within employees, said Gallson, such as lower productivity, tardiness, longer lunch breaks or crankiness.
“All of those things are slight signs that there’s something amiss, and it’s at those times when it’s so important to have your manager trained on identifying these issues, and it’s important to have your managers trained on how to approach the employee the right way.”
Presenteeism should also be tracked over time, he said.
“There’s only, I think, about 15 per cent of Canadian organizations who actually have a plan in place to track presenteeism, so 85 per cent of the employers out there really don’t have a good understanding of how presenteeism impacts their business.”
It’s about using a definition that’s narrow enough for it to be managed, just like absenteeism, said Johns. But the problem is identifying the behaviour.
“It’s relatively easy to measure absenteeism, it’s much more difficult to measure presenteeism because it’s something that, to some extent, is hidden.”
One way is to ask people for a self-report, he said.
“The one that’s most comparable to absenteeism data is to simply ask people in some kind of an HR audit: “In the past six months, how many days (did you go) to work ill when you probably should have stayed home?’”
Research has shown that self-reported presenteeism, collected through a validated tool such as the World Health Organization Workplace Health and Productivity Questionnaire (WHO-HPQ), is a strong indicator of the costs associated with presenteeism, said Sackett.
It’s important for managers to be aware of behavioural changes, said Allen.
“Managers typically know, they’ll see a little bit of behaviour change, somebody is being a little bit sluggish, the work has some errors. Another way to actually pay attention to what’s going on is if there are more accidents and incidents, especially.”
There are also validated scales that can be embedded in engagement surveys or health-risk assessments that can measure for presenteeism, along with self-reports, she said.
“Organizations should pay attention to it and should measure it because it is costing more,” she said.
“If you have high presenteeism, you don’t have the level of customer service you should, you don’t have the quality of work that you should, you don’t have the innovation and creativity that you should. You also have a high risk of disengaging people even if they are a source of presenteeism, so if you yourself are in a work environment where there’s a fair bit of partial work by your co-workers, you’re not going to be feeling great about that, either your work is going to go down, or you’re going to feel that you’re not going to be the one who pulls all the weight or you’re going to feel that you don’t fit and you leave.”
The cost of this presenteeism is 10 times higher than absenteeism, said the GCC report, citing research by Gallup-Healthways, PwC and Direct Health Solutions in the United States. Absent workers cost employers about US$150 billion per year but those who come to work and are not fully productive cost US$1,500 billion per year.
“If your employees are at work but performing at a low level of productivity, you’re essentially going to need more people to get the same job done. This is a major expense for organizations,” said Sackett.
“High levels of presenteeism are predictive of increased absenteeism later on. That means if your employee comes to work sick, they are more likely to need extra days off down the track. Perhaps presenteeism is such a big issue because of a social perception that taking personal leave is a bad thing? Anecdotal evidence suggests this may be the case.”
Presenteeism happens more often than absenteeism and can be more disruptive as it leads to missed deadlines, errors, extra work and potential accidents, said Allen.
“It’s a much bigger issue than absenteeism and it’s actually a bit of a predictor for absenteeism as well, so when you have groups with high presenteeism, you also have groups with high absenteeism, and individuals, when they show signs of presenteeism, are more likely to take time off work or to go on disability leave.”
Very few organizations have presenteeism policies and that’s a good place to start, along with boosting the dialogue around the need to perhaps disclose hidden ailments that might be accommodated, said Johns.
“Involving at that level the direct managers is very important because they’re the people that are most likely to know about and spot these kinds of things and be able to accommodate them.”
The larger issue has to do with defining this behaviour, developing a policy, showing concern about the issue and then using good common sense management to deal with it, he said.
Lunch and learns are also important as they encourage people to share their experiences, said Gallson.
“Then you start learning, ‘OK, well I didn’t know that the person at the next desk to me has an elderly parent and they’re going through a bad time right now,’ and you start understanding each other a little bit better.”
EAP contact information should also be posted throughout the workplace, he said, though this is not a failsafe solution.
“There’s still a certain number of employees who do not feel they can fully confide in an EAP provider because they don’t understand about the confidentiality requirements EAP providers have, and they still have a fear... that ‘If I disclose I have a mental illness to my EAP provider, it will get back to my partner or my employer, and I’m going to be restricted moving forward, so to speak.’”
HR should be encouraging employees to look after their physical and psychological well-being, said Sackett.
“I’ve heard anecdotal evidence that some organizations have stopped tracking sick leave. This may seem radical but perhaps they’ve already worked out that a few extra days off generates a higher rate of performance when employees are on the job. Alternatively, this move may simply send a strong message that taking personal leave is a good thing to do, empowering employees to take time off when they need to.”
If the cause of presenteeism is cultural, then working toward changing the culture is a good idea, she said.
“Make sure that people feel comfortable taking personal leave. Make sure that excessive overtime is not encouraged.”
GCC encourages a “whole-of-person” approach, said Sackett.
“Personal and professional lives interact and can both lead to presenteeism. Nurturing employees by empowering them to look after their health and well-being through exercise, sleep and nutrition will pay dividends for an organization.”
That kind of approach makes sense, said Allen.
“When you think about the sources, there’s personal distraction, then you can help with resources and coping skills to help deal with personal issues and personal stressors. There’s the physical health component of it… so the more physically fit and well you are, the less likely that you will have those energy trains, the less likely that you will be overwhelmed and you feel pain if you have pain.
“And from a mental health point of view, there’s no question about it, depression, anxieties, anything unmanaged in terms of a mental health issue also impacts presenteeism, so helping people with skills to manage both their physical and mental health are important.”
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