Appendix A: Matrix of Theoretical Models
Erica Creighton
HCS/587
November 20, 2013
Karissa Steward

Managers need to understand employees and what motivates them; this can prove to be a challenge because they are composed of a diverse group of people. Process theories of motivation can assist them in how to predict and influence behaviors. In this paper will cover three of the five process theories which are Vroom’s Expectancy Theory, Adams’ Equity Theory, and Locke’s Goal-Setting Theory.
Theoretical Model: Vroom’s Expectancy Theory
Description of Theoretical Model: This theory states that a person will choose to act or behave a certain way depending on if he or she perceives the reward as good or bad for that particular behavior. This theory explains that every individual has a different set of goals and can be motivated if there is a positive correlation between efforts and performance. This model is based on three beliefs valence, expectancy, and instrumentality. Valence is how an individual perceives or values the reward that is offered as good or bad. For example, some may value job promotion as a positive reward because of their need for achievement, although others may have a negative view of the advancement because it will require more time commitment. Expectancy believes that one’s hard work will result in a specific outcome. Instrumentality is the belief that if a person meets performance expectation he or she will receive a reward. Managers can use the expectancy theory to help them understand an employee’s behavior. If the employees lack motivation, the manager needs to discover what their employees’ value, what resources or training their staff may be in need of. Most important managers must be sure that the promises for rewards are fulfilled (Borkowksi, 2005).
Type of health care change situation where model best applies: This theory would be idealistic for managers that are looking for ways to motivate employees because it emphasizes expectations, perception, and the value of appropriate payoffs. Majority of individuals are taught to believe that there should be a strong correlation between performance and incentives. Supervisors must be aware that this theory does have its limitation as a reward system. In the hospital setting there are many parameters to achieving a certain reward, these parameters include position, responsibility, and education. In order, for a manager to apply this theory appropriately he or she must make sure the staff can achieve the intended performance level and reward the employees once an exceptional performance has been met. Administrators must ensure that the reward system is fair and just and must continually monitor the employee’s motivational level. The most important part of this theory is the belief if employees perform well then there will be a valid outcome. Some important questions nursing supervisor should ask themselves when applying this theory are is the nursing staff efforts being recognized in performance appraisals? To what extent does the staff believe that a good performance appraisal will lead to a reward? What is the appeal of the potential reward to the nursing staff? For this theory to work properly managers need to make sure that the payoffs are deserved and wanted by workers (Borkowksi, 2005).
Theoretical Model: Adam’s Equity Theory
Description of Theoretical Model: Adams’ Equity theory is based on inputs and outputs. This theory states that individuals may evaluate his or her input and outcomes by comparing them to those of others. Inputs can be defined as what a person can contribute to an exchange such as skill, hard work, and education. Outputs can be defined as the result of an exchange such as a promotion, salary, and recognition. According to this theory if an employee perceives treatment to be fair the manager can expect to see positive outcomes and high levels of motivations from his or her employees. This model proposes that if input and output become out of balance not only will some employees become less motivated while others may seek to bring balance by seeking more compensation/recognition, or seeking employment elsewhere or even becoming disgruntled (Borkowksi, 2005). The thought behind this is theory is to maintain an equally reasonable balance between production and contributions. This model explains that if an imbalance is noted supervisors must try to seek equilibrium concerning the employee inputs given and the outputs received (“Adams’ Equity Theory”, (n.d.). Managers should also be aware of how inequities may be perceived by employees in the work environment. If workers believe that they are not being treated fairly, it may become difficult to motivate them (Borkowksi, 2005).
Type of health care change situation where model best applies: This model would best apply in a hospital setting if the organization is looking to improve effort-reward imbalance and reduce nurse burnout. Nurses work in a very stressful environment because of the constant requirement to manage and help people during a stressful time in their lives. Much of the nurses’ motivation and reward comes from the act/feelings they get from helping others. When nurses are repeatedly confronted with difficult or demanding patients lacking in showing appreciation of the efforts made to assist them, this can cause a disequilibrium causing nurses to put more into the relationships with their patients than they receive back in return, causing exhaustion and burnout to set in. As a response to this feeling of inequity, nurses may respond to their patients in a depersonalized manner. Managers can help to restore the balance between nurses’ efforts and rewards by providing emotional and instrumental support and by giving adequate feedback (this will help to increase the nurses’ self-esteem reward). Hospital administrators can also consider establishing nurse to patient staffing ratio to limit the amount of patient a nurse can care for. Such interventions may help to restore the effort and rewards balance while reducing burnout among nurses (Bakker, Killmer, Johannes & Schaufeli, 2000).
Theoretical Model: Locke’s Goal-Setting Theory
Description of Theoretical Model: This study shows that a relationship exists between how difficult and specific goal is in relation to a person performance. The theory states that if a person is given a challenging yet specific goal he or she will outperform those who were given an easy or vague goal. For example, asking someone to “bet your last score” is more effective than telling someone to “do your best.” Hard goals are more motivating than easy goals; it is much more of a payoff when someone realizes they have accomplished something that they have to work for. Managers must be aware of the employees’ abilities and skills for this theory to be in order for this theory to be effective. This model consists of three phases: setting the goal, obtaining goal commitment, and providing support elements. Setting the goal should be specific and challenging yet attainable. To ensure that goal setting is successful, the manager will need to make sure that staff members accept and stay committed to the goals, offering rewards will ensure that this will happen. Rewards should be increased for more difficult tasks. If employees believe that they will be well compensated for achieving a challenging goal, this will boost their motivation and enthusiasm to get it the task completed which will reinforce acceptance of future goals (Borkowksi, 2005).
Type of health care change situation where model best applies: In a health care organization this model can be used to help with inadequate preceptor feedback and to increase graduate nurse retention. “New nurse graduates turnover rates of roughly 30% in the first year of practice and as much as 57% in the second year. At a cost of $82,000 or more per nurse” (Twibell, St. Pierre, Johnson, Barton, Davis, Kid, & Rook, 2013). New graduates nurses want to perform at his or hers best for their patients and they will need help and support in learning how to create healing relationships with their patients, managing their time, prioritizing patients’ demands and recognizing circumstances that may require additional resources to provide safe and effective care. Nursing administrators can support the integration of new nurses by providing the new graduates with training, direction, and feedback to guarantee safe practices. The preceptor along with the new nurse can use Locke's Goal-Setting Theory to defined clear goals and provide accurate feedback. Some goal setting options that preceptors can establish with the new nurses are reviewing medications commonly used, reviewing the most common diagnose, slowly increasing the workload and acuity of patients, and by giving and receiving constant feedback. These goals can assist the new graduates in their roles by fostering a sense of security and achievement in their work. This goal setting steps will help decrease new graduate nurse turnover, increase preceptor satisfaction, and reduce overall turnover costs (Bullock, Paris, Terhaar, 2011).
Workplace development can bring changes such as new policies, new systems, causing roles and responsibilities needing to be adapted and revised. These changes will call for managers and employees to learn a new set of behaviors or to establish patterns of behavior, which may be needed to adapt successfully and transform to organizational change. Applying these motivation models managers can create an environment in which employees, feel secure, valued and are more productive.

References
Adams’ Equity Theory. (n.d.). Mindtools.com. Retrieved November 15 , 2013, from Google.
Baaker, A. B., Killmer, C. H., Siegrist, J., & Schaufeli, W. B. (1999, August 25). Effort-reward imbalance and burnout among nurses. Journal of Advanced Nursing, 31(4), 884-891. Retrieved November 15, 2013, from Google.
Borkowski, N. (2005). Organizational behavior in health care. Sudbury, MA. Jones and Bartlett. Retrieved from http://ecampus.phoenix.edu
Bullock, L. M., Paris, L. G., & Terhaar, M. (2011, December). Designing an Outcome-Focused Model for Orienting New Graduate Nurses. Journal for Nurses in Professional Development, 27(6), 252-258. Retrieved November 15, 2013, from nursingcenter.com.
Twibell, R., St. Pierre, J., Johnson, D., Barton, D., Davis, C., Kid, M., & Rook, G. (2012, July 6). Why New Nurses Don't Stay and What the Evidence Says We Can Do About It. Medscape. Retrieved November 15, 2013, from Google.