by Nicole Gravina, Ph.D. and Lisa Kazbour, M.S.
The human resources literature is replete with advice for designing attendance policies. When companies first began establishing attendance policies, they were created as a cost-control measure. Employers posited that absences resulted in lost productivity and other costs to businesses, and therefore, designed policies to encourage attendance.
The recent COVID-19 pandemic has exposed a glaring problem with this approach– when people attend work sick, they spread illness and cost the organization money. A study by the Institute for Women’s Policy Research in 2010 indicated that 7 million of the 60 million H1N1 infections in the United States were contracted at work. Researchers also estimate that 15-20% of flu cases are spread at work (Ahmed et al., 2018; Edwards et al., 2016). When employees come to work sick, they increase the risk of spreading illness to their coworkers, thereby making more people sick, increasing absences, and decreasing productivity.
Therefore, we need to acknowledge that some level of absence is expected and even desired. Within the behavior analysis literature, attendance studies have focused on eliminating absences with little consideration for health or other factors. It is time for attendance policies and practices to evolve and organizational behavior management can help.
Organizations need employees to come to work healthy and stay home when they are sick. So how can we promote those behaviors? Below are several strategies for encouraging healthy attendance at work, while striving to maintain good work ethic.
Avoid Incentivizing Attending Work Sick
- Avoid perfect attendance awards and other incentives for attendance. One problem with incentives is that they work! Perfect attendance awards and other attendance incentive systems reward employees who come to work sick. Instead, recognize employees who follow work policies like calling their supervisor with sufficient notice when ill, taking steps to find coverage, etc.
- Avoid sick pay cash outs. Sick pay cash outs also reward employees who come to work sick. Cash outs are also unfair to parents and others with caregiving responsibilities, who will be less likely to get cash outs if they used sick time to care for family. Instead, encourage employees to use their sick pay throughout the year. Some organizations have a use-it-or-lose-it approach to sick pay, which encourages employees to take the time they need. If your organization takes this approach, it is important to have the reset deadline fall during a slow time, because employees with unused sick time may use it just before the deadline.]
Reduce Barriers to Staying Home/Alternative Work Arrangements
- Offer sick pay. Offering sick pay gives people leeway to put their health ahead of work. Research shows that offering sick pay decreases absences in the workplace because people stay home when they are sick and do not spread illness among their coworkers (Ahmed et al., 2020; Gould & Schieder, 2017; Piper et al., 2017). Lack of sick pay is an issue that disproportionately affects women and people of color in the United States. The data show that the cost of offering sick pay is neutralized by having a healthier workforce.
- Offer alternative work arrangements. Allowing employees to work remotely or choose a less populated work setting (e.g., stock room instead of cash register) when they are sick but healthy enough to work, enables them to earn their paycheck and simultaneously avoid spreading illness to others. This, in turn, reduces sick contacts among employees. The current pandemic has resulted in many workplaces learning to create alternative work arrangements, and we hope that many will choose to continue making these options available when the pandemic subsides.
- Cross-train and design systems to reduce coverage issues. Some employees report that they do not call in sick to work because there is no one available to cover their shifts. If the workplace cannot sustain a few absences, it is time to redesign the system. It is unfair to employees and clients/patients/customers to have such lean staffing that one absence causes substantial issues. Cross-training employees and designing systems to allow for flexibility with coverage may improve outcomes (Olivella & Nembhard, 2016).
- Model staying home when sick. Research shows that leaders who stay home when they are sick are more likely to have employees who stay home when they are sick. (Deitz, et al. 2019) This is also true for accessing employee assistance and wellness programs. When leaders model taking care of their health, they give their employees permission to do the same.
Create Healthy Work Environments
- Improve cleaning and hand hygiene. Research in schools and hospitals shows that improved cleaning practices can reduce employee and student absences by 20-25% (Azor-Martinez et al., 2014; Bowen et al., 2007). If many employees are getting sick, employers may opt to enact more preventative strategies at work. For example, staff can be trained to follow cleaning procedures and provided checklists and sufficient time to complete the task. Hand washing or sanitizing can be chained into the work routine at specified times like the start of shift and before and after lunch. Employees might also do a better job of preventing the spread of illness if materials are readily accessible. See this blog for more ideas.
- Offer employee assistance and wellness programs. Research has demonstrated that when employees access assistance and wellness programs, they are absent less often (Truman, 2003). Employee assistance and wellness programs aim to reduce stressors and promote wellness. For example, many parents find themselves saving sick days for times when their children are at home sick, and parents have to come to work sick. Offering emergency childcare services, as one type of employee assistance program, can help parents care for their kids and continue to work. Other assistance and wellness programs include mental health services, legal services, smoking cessation programs, financial planning services, and fitness center discounts, among others.
- Improve leadership practices. Research shows that too much stress in the workplace leads to both presenteeism and increased absences and that having a supportive supervisor can attenuate the effects of stress (Gosselin et al., 2013). By improving leader practices and workplace culture, employees may not need as many personal days to recover from work stress.
Gather and Use Data to Make Informed Decisions
- Follow the data. If poor attendance is an issue in your organization, look at the data and find trends. I (Nicole) once worked with an organization that sought to improve attendance. After looking at the frequency data on absences, I found that most absences occurred on Fridays. Further evaluation uncovered that the organization sometimes denied vacation day requests for Fridays. Therefore, instead of requesting vacation time, employees called out sick. The company also staffed the lowest number of employees on Fridays, to give more people the day off, which made coverage more difficult, Thus, Fridays had the fewest staff members available, and the most callouts. By increasing staffing on Fridays, it became more manageable for them to accommodate vacation requests on Fridays, resulting in fewer call outs and making it easier to cover work when employees did call out.
- Gather feedback. Ask employees (anonymously) for feedback on current attendance policies. What would make them come to work sick? Is presenteeism a problem? Why do people call out? Is it burnout? Illness? Kids? What would they like to see in terms of policy changes? For many clients I (Lisa) have worked with, simply gathering feedback helps shape attendance policies to better support employee attendance and performance. For example, one organization made accommodations for the opening day of hunting season to prevent call outs. Asking for feedback is a great way to increase engagement and implement positive changes in policies where appropriate.
- Shift focus from presenteeism to outcome-focused metrics. If being present during specified hours is not a requirement of the job, employers can offer flexibility with scheduling and work hours. Many company cultures thrive on the appearance of being busy rather than measuring work completed. It takes time to shift the culture toward an emphasis on efficiency and productivity but can be done with focused leadership. Instead of attendance being part of annual reviews, focus on output, giving appropriate notice for sick days, and other outcome measures that support the organization’s mission.
OBM has a lot to offer to encourage employees to attend work when they are healthy, and stay home when they are sick. Using the strategies listed above, leaders can create healthy and productive workplaces during the pandemic and beyond.
*Lisa Kazbour is a Director at Harkera, a behavioral consultancy.
**The authors would like to thank Drs. Katie Nicholson and Celeste Harvey for comments on earlier versions of this blog.
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