The conclusions that can be drawn from this research are the following: 1. Health productivity management is a viable strategy and innovation that organisations need to consider, so as to effectively maximise their human capital. 2. This research clearly supports the assertion that factors such as employee health status and functional level, should be included in an organisation’s productivity strategy.
To effectively cascade the health productivity strategy, from the operational, tactical to strategic organization levels, business leaders need to develop their own health productivity scorecard, aligned with the uniqueness of their corporate culture, politics, organisation design, and processes. In the development of health productivity scorecard there are specific physiological and psychosocial indicators (that are statistically significantly) that should be included within the perspectives.
When developing a balance scorecard, it is essential to understand the cause and effect relationships between each perspective, through applying strategy maps, that insures the success during the implementation phase. 3. The consistency of these results aligns with current management theories of causality, systems thinking, learning organization and strategic mapping, within the context of priority reasoning. 6. 2. Implications 6. 2. 1. Towards a New View
The results of this research provide new insights, and suggest new theories based on health productivity management scorecard integration, which presents an opportunity for future research. This insight provides the foundation to challenge the strategy proposition. The strategy proposition being the connectedness between the theory of linear causation, balance scorecard perspectives and the organisation dimensions. The integrated model suggests a systematic approach in the successful integration of causation, the four perspectives (sub-systems) and the overall organisational strategy, within the four frame organisational dimensions.
This proposition is a transition from a linear causal relationship to a systematic integrative connection, so as to assist business leaders in the development and implementation of a successful balance scorecard. This proposition requires further research and development. 6. 2. 2. Practical Implications The practical implications of this research highligh the importance of health productivity management as a viable management tool. The health productivity management scorecard connects the medical science and management science paradigms. 6. 2. 3.
Other Questions from the Current Research Question one: Balance scorecards have been criticised for having a unidirectional causal chain, without any feedback loops, and without a systematic approach. A successful scorecard must also demonstrate causal relationships aligned with the dimensions of the organisation including culture, design, process, and politics. It is important to integrate systems thinking. This also explores the concept of cascading and integrating strategy throughout the long-term, tactical and operational levels of the organisation.
Question two: Organisations often have unsuccessful scorecards because they do not establish a correct causal hierarchy in their strategy maps. Philosophers state that causal relationships should address the question “how things happened”, instead of “why things happened. ” The correct order of causes should be: final >efficient > material > formal. This will be a point of further research. Question three: A noted weakness of the balance scorecard relates to the time dimension of the balance scorecard as there does not seem to be a time lag between the stages in the causal chain between the perspectives.
Hierarchy and temporal relationships will also need further researching. For example within an organisation, and across the functional units that are involved with HPM, how often, should specific key performance indicators be reported? Question four: If a health and productivity scorecard is developed, what would a dashboard look like? A dashboard would be a summary of key performance indicators that would be presented monthly to support and facilitate management decisions. 6. 3. Recommendation
The author will continue collating data in case study four to include a study population of four thousand. This will support the causality theory and strengthen existing correlations between the impact of high health risks, poor functionality and poor health on productivity. This research suggests further work that is required in other areas of health productivity management such as evaluating the balance scorecard as a successful management tool, that will insure the success of the health productivity strategy throughout the operational, tactical and strategic levels of the organisation.
Other researchers could improve on this work by utilising the newly developed health productivity scorecard as a longitudinal study, with a variety of industrial settings, countries, and occupations. 7. 0 Insights & Reflections When re-examining the assumptions of this research, there are specific questions that have contributed towards examining the given premises. An example is the new knowledge on connectedness and integration of cause and effect hypothesis with the scorecard perspectives and organisational dimensions.
This integration contributes towards a new strategy map which explores systematic relationships. This provides the platform for future research. The researcher will continue to develop and investigate the new knowledge contribution of the health and productivity systematic matrix within the context of a philosophical inquiry using Aristotle’s question “why? ”. Further investigations into Aristotle’s final cause aligned with the BSC financial perspectives asking the query “how do we look to shareholders?
”, in correlation with the organisational political dimensions, questioning “why a design or decision should be adopted that merely serve the interest of the dominant group? ” and within the ecological hierarchy of the distal leverage point, a query on the multidimensional factors that pervade all levels and shape behavior. Aristotle’s efficient cause aligned with the BSC internal customer value, asking “how do customers see us? ”, in correlation with the organisational design dimensions, asking “how can we achieve an effective organisation?
” and within the ecological hierarchy of the proximal leverage point, a query on structures and features that affect the microenvironment for individuals. Aristotle’s material cause, aligned with the BSC internal process perspective, asking “what must we excel at? ” in correlation with the process organisational dimension asking “how can we design the most efficient organisation processes, and arrange their implementation? ” and within the ecological hierarchy of the enablers of choice a query on behavioral setting, which is the situational context with a behavior takes place.
Aristotle’s formal cause aligned with the BSC learning and growth perspective, asking “how can we continue to improve and create value? “ in correlation with the culture organisational dimension asking “What options should we decide upon that debate technical and human issues that charaterise organisational activity and lead to decisions on what to do with them? ” and within the ecological hierarchy of lifestyle a query on the visible choices people make in terms of specific behavior.
Most important is Aristotle’s theoretical base of “priority reasoning” which provided the epistemological discourse throughout this thesis. The author recognises that the current research could have been completed differently due to certain limitations. Case study one could have been continued as a longitudinal study with a six month and twelve month follow up. The study population group should also have included more males in the study group and include a control group that did not receive the intervention.
Case studies one, two and three should have included other occupational groups from the demand/risk continuum, various industries and countries so as to provide a more representational study. Another confounding factor to consider is to differentiate between employee desire to work (internal and external motivation) as compared with employee functional level and health status, and the effect that these factors have independently on productivity. These results support the importance of health productivity management to organisations in all management levels.
Future research could involve validation studies of the new health and productivity equations at both microeconomic and macroeconomic perspectives as well as creating health risk and disease scales and functional scores to provide numerical values to the new equations. Building from the conceptual framework of the effective workforce, EWF = f( OS + OL) f(BS + BL) x f( WHL + WFL), and the production function Y = AL? / HR X (PFxK? ) ), further validation studies could further support numerical values at various systems levels. Additional research could follow the logical theory of priority reasoning of which this current research is grounded.