The Return of the Smiley Face

Kathy S. Douglas MHA, RN

Abstract and Introduction

Introduction

Most of us remember the big yellow smiley face that seemed to be just about everywhere in the late 1960s and into the '70s. The endearing character reminded us to be happy. Looking at the smiley face one would be hard pressed to not respond with a smile. But more than a smile, this simple yet powerful drawing represented something so much bigger. In a time when our country was weary of war, a time of restlessness when calls for peace and equal rights were permeating even the most remote parts of our being, the smiley face offered relief. It represented happiness that could be taken in and felt deeply, even if only for a moment.
The first happy face symbol was seen in the film Hamastad with Ingmar Bergman in 1948. The yellow iconic version, which we have all come to know and love, was designed by commercial artist Harvey Ball in 1963 (Wikipedia, 2012). In the '70s the yellow smiley face seemed to be everywhere, becoming a symbol of a generation. Paired with the phrase "Have a Happy Day" and later songs like Bobby McFerrin's "Don't Worry Be Happy," the power of the smile was popularized. Today we are in a much different world, one in which the understanding of the value of happiness can seem distant.

The Business of Happiness

Much like running into an old friend you had not seen in years, there was instant recognition and a wave of joy when, during a recent stroll through the airport bookstore, a giant yellow smiley face filled the entire cover of a magazine. The surprise grew exponentially when, on closer examination, it was revealed that the prominent new home of the beloved character was the cover of the Harvard Business Review accompanied by the title "The Value Happiness."
If recollection serves, the period during which yellow smiley faces were so pervasive was linked to what they represented, a rebellion against the establishment and the promotion of freedom and joy. Much has changed in the world since and it is now unusual to see the smiley face character, although on occasion :-) accompanies an e-mail or text. Enter 2012 and the Harvard Business Review devoting an entire issue (January/February 2012) to the business case for happiness. For those of us who have been calling for a closer look at the health and well-being of our health care workforce, this is very exciting.
It could very well be the beginning of relabeling and newly embracing the "soft stuff" that so many business leaders have tended to shun. Sadly true even in health care, where we are suppose to be ever mindful of people's well-being, talking about "feelings" does not go over well in the board room, in setting workforce management strategies, or in budget discussions. Well, that could all be changing. With such a well-respected journal taking a stand on happiness, we may finally be getting the attention of leadership on this long neglected and important topic.
There is no question that measuring factors such as how people are feeling is difficult. Applying that to business strategies is even more challenging. After all, we are very focused on data and "hard numbers" to inform our decisions and guide our constant hunger for improved performance and better margins.

The Implications of Unhappiness

Even if we do not have confidence in the growing body of research and understanding that is inspiring such work as represented in the Harvard Business Review, there is always logic to consider. Even without any data to turn to, it makes a lot of sense that when people are happy, well rested, and inspired, they will perform better work. Yet, there are many signs that we do not understand or accept this in health care.
When we calculate hours of care needed for patients and then translate that into how many nurses are needed, we may capture additional time needed for care coordination, but where do we capture and then calculate into our hours the needs of the nurse? How many more errors do we need to have before we realize that noticing and managing things like fatigue can have big financial returns? And what about attitude? If caregivers are experiencing compassion fatigue, often rightfully so, what impact is that going to have on the patient experience, resulting reimbursement implications, and personnel outcomes like sick calls or turnover? How many qualified nurses do we lose to other career choices because we do not attend to their needs? The cost and quality implications of an unhappy workforce seem immense, yet we don't look there to save money.
The pressures to improve performance and reduce costs are not going away. We have a choice; we can keep trying to squeeze more out of our health care workforce or we can invest in their well-being and get more out of them. I, for one, say to our old friend Smiley Face, welcome back! You are very much needed!

Sidebar

Executive Summary

The iconic, ubiquitous smiley face of the 1960s and '70s represented happiness that could be taken in and felt deeply, even if only for a moment.
Today we are in a much different world, one in which the understanding of the value of happiness can seem distant.
Talking about "feelings" does not go over well in the board room, in setting workforce management strategies, or in budget discussions.
That could all be changing and we may finally be getting the attention of leadership on this long neglected and important topic.
The cost and quality implications of an unhappy workforce seem immense.
We can keep trying to squeeze more out of our health care workforce or we can invest in their wellbeing and get more out of them.

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References

Wikipedia. (2012). Harvey Ball. Retrieved from http://en.wikipedia.org/wiki/Harvey_Ball

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Wednesday, July 4, 2012