Existing models of motivation are different in their focus and effectiveness. The results of the study of motivation models do not allow, from a psychological point of view, to clearly determine what motivates a person to work. The study of a person and his behavior in the process of work provides only some general explanations of motivation, but even they allow the development of pragmatic models of employee motivation in a particular workplace.

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INTRODUCTION…………………………………………………………………..	3
Chapter 1 . STAFF MOTIVATION AS A FACTOR OF INCREASING PRODUCTION EFFICIENCY……..	5
1.1 The role and importance of staff motivation …………………………….	5
1.2 Methods of staff incentives ………………………………..	7
Chapter 2 THEORIES OF MOTIVATION ………………………………………..	9
2.1 Content theories of motivation…………………………………	9
2.1.1 Theory of needs A. Maslow…………………………………	9
2.1.2 Theory of Needs by D. Mack Clelland………………………	12
2.1.3 Two-factor theory of F. Herzberg……………………………..	13
2.1.4 The theory of existence, connection and growth of K. Alderfer…………..	14
Chapter 3 WAYS OF MOTIVATION…………………………………….	16
Chapter. 4. MOTIVATION OF THE EMPLOYEES OF MBUZ “CITY POLYCLINIC LGO”……………………………………………………….	20
4.1 general characteristics MBUZ "City Polyclinic LGO"…….	20
4.2 The structure of the administrative apparatus of the MBUZ "City Clinic of LGO"…………………………………………………………….	21
4.3 Methods of motivating the staff of MBUZ "City Clinic of LGO"………………………………………………………………………….....	22
4.4 Proposals to encourage employees of MBUZ "City Polyclinic"……………………………………………………………….	24
CONCLUSION………………………………………………………………	26
LIST OF USED SOURCES……………………...	29
APPS	31

INTRODUCTION

Management activities includes many components. Among them:

personnel policy, relationships in the team, socio-psychological aspects of management. The key place is occupied by the definition of ways to increase productivity, ways of increasing creative initiative, as well as stimulating and motivating employees.

Motivation - is a set of internal and external driving forces that encourage a person to activity, set the boundaries and forms of this activity and give it an orientation focused on achieving certain goals.

No management system will function effectively if an effective model of motivation is not developed, since motivation stimulates a particular individual and the team as a whole to achieve personal and collective goals.

The evolution of the use of various motivation models has shown both positive and negative aspects of their application, and this is a natural process, since in the theory and practice of management there is no ideal incentive model that would meet various requirements.

Existing models of motivation are different in their focus and effectiveness. The results of the study of motivation models do not allow, from a psychological point of view, to clearly determine what motivates a person to work. The study of a person and his behavior in the process of work provides only some general explanations of motivation, but even they allow the development of pragmatic models of employee motivation in a particular workplace.

In Russia, there are many problems associated with motivational policy: the problem of relationships with management, dissatisfaction with the size of wages, living and working conditions in general at the enterprise. The main obstacle to resolving these issues is the unwillingness of management personnel to think about the living and working conditions of people who directly create profit. In market conditions, one should pay Special attention non-financial incentives, creating a flexible

employee benefit system.

Subject term paper : Theories of motivation by A. Maslow, D. McKpelland, F. Herzberg, K. Alderfer.

The relevance of the chosen topic lies in the fact thatthat not only the increase in the social and creative activity of a particular employee (manager, worker), but also the final results of the activities of enterprises of various organizational and legal forms of ownership, production and non-production areas of activity depend on the clear development of an effective motivation system.

The purpose of the course workstudy the theories of motivation by A. Maslow, D. McKpelland, F. Herzberg, K. Aldefer, to analyze the motivation of employees of MBUZ "City Clinic of LGO".

To achieve the goal, the following tasks were set:

1. Define the concept of motivation.

2. Consider theories of motivation

3. To study the influence of motivating factors on the work of the staff of the MBUZ "City Polyclinic of LGO"

4. Determine possible ways increasing the motivation of employees of MBUZ "City Polyclinic of LGO".

CHAPTER 1

STAFF MOTIVATION AS A FACTOR OF INCREASING PRODUCTION EFFICIENCY

1.1 The role and importance of staff motivation

The main feature of personnel management in the transition to the market is the increasing role of the employee's personality. The current situation in our country carries both great opportunities and great threats for each individual in terms of the sustainability of his existence. That is, now there is an extremely high degree of uncertainty in the life of every person. Therefore, it is necessary to develop a new approach to personnel management. This approach is as follows:

1) creating a philosophy of personnel management.

2) creation of perfect personnel management services.

3) application of new technologies in personnel management.

4) creation and development of shared values, social norms,

attitudes that regulate the behavior of an individual.

Philosophy of personnel managementthis is the formation of the behavior of individual employees in relation to the goals of the development of the enterprise. Under these conditions, motivation labor activity employees of the company becomes especially important. In order for a person to perform the work entrusted to him conscientiously and efficiently, he must be interested in this or, in other words, motivated.

In personnel management, motivation is seen as a process

activation of employees' motives ( intrinsic motivation) and creating incentives (external motivation) to encourage them to work effectively.

The purpose of motivation is the formation of a set of conditions that encourage a person to take actions aimed at achieving the goal with maximum effect.

Over time, various psychological theories of motivation have appeared, trying to consider the determining factors and structure of the motivational process from different positions. As a result, the so-called "carrot and stick" policy was replaced by the development of more complex systems for stimulating the motivation of workers to work, based on the results of its theoretical study.

Modern theoretical approaches to motivation are based on

ideas formulated by psychological science that investigates the causes and mechanisms of purposeful human behavior. From these positions, motivation is defined as the driving force of human behavior, which is based on the relationship of needs, motives and goals of a person.

A general characteristic of the motivation process can be represented if

define the concepts used to explain it: needs, motives, goals.

Needs is the state of a person who needs an object necessary for his existence. Needs are the source of human activity, the cause of his purposeful actions.

motives these are human motivations for action, aimed at the result (goal).

Goals is the desired object or its state, which a person aspires to possess.

The motives driving a person are extremely complex, subject to frequent changes and are formed under the influence of a whole complex of external and internal factors - abilities, education, social

position, material well-being, public opinion, etc. Therefore, predicting the behavior of team members in response to different systems of motivation is very difficult.

Motivation as a control function is implemented through a system of incentives, i.e. any actions of a subordinate must have positive or negative consequences for him. negative consequences in terms of meeting his needs or achieving his goals. The study of the team can allow the leader to create a motivational structure with which he will carry out the education of the team in the right direction.

1. Staff incentive methods

Methods of staff incentives can be very diverse and depend on the development of the incentive system at the enterprise, the general management system and the characteristics of the enterprise itself.

Depending on the orientation to the impact on certain needs, management methods are divided into:

1. Economic methods of management, due to economic incentives. They involve material motivation, that is, an orientation towards the fulfillment of certain indicators or tasks, and the implementation of economic rewards for the results of work after their fulfillment.
2. Organizational and administrative methods based on directive instructions. These methods are based on imperious motivation, based on obedience to the law, the rule of law, senior officials, etc., and based on the possibility of coercion. They cover organizational planning, organizational regulation, instruction, direction, control.
3. Social psychological methods used to increase the social activity of employees. With the help of these methods, they influence mainly the consciousness of workers, the social, aesthetic, religious and other interests of people and carry out social stimulation of labor activity.

In management practice, various methods and their combinations are simultaneously used. For effective management motivation it is necessary to use all three groups of methods in enterprise management. Thus, the use of only power and material motivations does not allow mobilizing the creative activity of staff to achieve the goals of the organization. To achieve maximum effectiveness, it is necessary to apply spiritual motivation.

CHAPTER 2

THEORIES OF MOTIVATION

The most widely known theories of motivation are:

• Maslow's theory of needs;

• Alderfer's theory of existence, connection and growth;

• McClelland's theory of acquired needs;

• Herzberg's theory of two factors.

2.1.1 Maslow's theory of needs

Abraham Maslow is one of the leading scientists in the field of motivation and psychology.

Maslow's needs theory is one of the most famous theories of motivation.

The essence of the theory is reduced to the study of human needs. This is an older theory. Its supporters, including Abraham Maslow, believed that the subject of psychology is behavior, not human consciousness. Behavior is based on human needs, which can be divided into five groups:

1. Physiological needs.

This group includes the needs for food, water, air, shelter. These are the needs that a person must satisfy in order to survive, in order to keep the body in a vital state. People who work primarily to meet the needs of this group have little interest in the content of the work. To manage such people, a minimum wage was necessary to ensure their survival, and the working conditions did not burden their existence too much.

2. The need for security.

The needs of this group are related to the desire of people for stability and security: to have good housing, to be protected from pain, disease and other suffering. For a person influenced by these needs, job security, pensions, and health insurance are important. To manage such people, it is necessary to create a reliable system of social insurance, apply fair rules for regulating their activities.

3. The need to belong to social group . A person seeks participation in joint actions, he seeks friendship, love, membership in certain group people who want to participate in social events. Good results can be achieved with a brigade form labor organization, using group activities that go beyond work, as well as reminding employees of how much they are valued by colleagues at work.

4. Needs for recognition and respect. This group of needs reflects the desire of people to feel competent, self-confident, strong. People exposed strong influence of this need, strive for a leadership position or for a position of recognized authority in solving problems. When managing such people, you need to use various forms moral encouragement, expressions of recognition of their merits. For this, the following can be used: assignment of titles and titles, publications in the press and mention by the management in public speeches of their merits, presentation of honorary awards.

5. Needs of self-expression. This group combines the needs expressed in the desire of a person to use his knowledge, abilities and skills for self-affirmation in business and management. People with this need are open to the perception of themselves and the environment, creative and independent. When managing such people, it is necessary to realize their abilities to the maximum, strive to give them original tasks, provide greater freedom in choosing means and involve them in work.

All these needs can be arranged in a strict hierarchical sequence in the form of a pyramid, at the base of which are primary needs, and the top is secondary.

Pyramid A. Maslow

The meaning of the hierarchical construction lies in the fact that the needs of lower levels are priority for a person, and this affects his motivation. In other words, in human behavior, the satisfaction of needs at first low levels is more decisive, and then, as these needs are satisfied, the needs of higher levels become a stimulating factor.

The highest need - the need for self-expression and growth of a person as a person - can never be fully satisfied, so the process of motivating a person through needs is endless.

The duty of the manager is to carefully observe his subordinates, find out in a timely manner what active needs drive each of them, and make decisions on their implementation in order to increase the efficiency of employees.

2.1.2 Theory of needs D. Poppy Clelland

Emphasizes the needs of higher levels.

D. McClelland believed that people have three needs:

• power,
• success,
• involvement.

The need for power is expressed as a desire to influence other people. People with a need for power are not necessarily power-hungry careerists in the negative and most commonly used sense of these words. When people need power in its purest form, according to this theory, there is no inclination to adventurism, the main thing is the need to manifest one's influence.

The need for success is not satisfied by proclaiming that person's success, but by the process of bringing the work to a successful conclusion. People with a highly developed need for success like situations in which they can take responsibility for finding a solution to a problem, and they want to be rewarded for their results in a very specific way. To motivate people with a need for success, you should set them tasks with a moderate degree of risk or the possibility of failure, delegate them enough authority to unleash their initiative, regularly and specifically reward them in accordance with the results achieved.

Motivation based on the need for belonging determines the interest of people in the company of acquaintances, establishing friendships, helping others. People with a developed need for belonging will be attracted to work that will give them ample opportunities. social communication. The leader can also ensure that their needs are met by devoting more time to them and periodically bringing such people into separate groups.

2.1.3 Herzberg's two-factor theory

This theory appeared in connection with the growing need to find out the influence of material and non-material factors on human motivation.

Frederik Herzberg created a two-factor model that shows

job satisfaction.

Factors affecting job satisfaction

hygiene factors	Motivation
Company policy and administration	Success
Working conditions	Career advancement
earnings	Recognition and approval of the result
Interpersonal relationships	High degree of responsibility

Hygiene factors are associated with environment where the work is being done. The absence or insufficiency of hygiene factors causes a person to be dissatisfied with work. But the sufficiency of these factors in itself does not cause job satisfaction and cannot motivate a person to do anything. These factors include earnings, working conditions, administration policy, degree of control, relationships with colleagues and supervisors, subordinates.

The applicability of Herzberg's theory in practice has been tested in many organizations. The results of the experiments showed that in order to effectively use Herzberg's theory, it is necessary to compile a list of hygiene and especially motivating factors and give employees the opportunity to determine and indicate what they prefer.

2.1.4 Alderfer's theory of existence, connection and growth

K. Alderfer believes that human needs can be combined into separate groups. However, unlike Maslow's pyramid of needs, he believes that there are only three such groups of needs:

• the needs of existence;
• communication needs;
• growth needs.

Needs of Existenceaccording to Alderfer include two groups of needs of Maslow's pyramid: the need for security and physiological needs.

The need for communicationaccording to Alderfer, it includes the social nature of a person, the desire of a person to be a member of a family, a team, to have friends, enemies, bosses and subordinates. Therefore, this group should include the needs to belong to a social group, recognition and respect, which are associated with a person’s desire to occupy a certain position in the world around him, as well as that part of the security needs of Maslow’s pyramid that is associated with group security.

Growth Needsare similar to the needs of self-expression in Maslow and also include those needs of the recognition and self-affirmation group that are associated with a person’s desire to develop confidence, to self-improvement.

These three groups of needs, as well as in Maslow's theory, are arranged hierarchically. However, there is one fundamental difference between the theories of Maslow and Alderfer. According to Maslow, there is a movement from need to need only from the bottom up: only when the needs of the lower level are satisfied, the person moves to the need of a higher level. Alderfer believes that the movement goes both ways: up if the need of the lower level is not satisfied, and down if the need of the higher level is not satisfied. At the same time, Alderfer thinks that in case of dissatisfaction of the need of the upper level, the degree of impact of the need of the lower level increases, which switches the person's attention to this level. For example, if a person has not been able to satisfy the needs of career growth, his communication needs are again "turned on".

Alderfer's theory reflects a hierarchy of needs in the direction from more specific to less specific needs. He believes that every time a need is not satisfied at the top level, there is a switch to a more specific need at the bottom level, which determines the reverse movement from top to bottom.

So, the effectiveness or viability of a particular model can only be verified by testing them in practice, taking into account the environment where they will be implemented. One thing is certain, that the lack of motivational models at our enterprises will reduce the effectiveness of existing management systems and the socio-economic activity of labor collectives.

CHAPTER 3

WAYS OF MOTIVATION

The strategic theories of human resource management discussed above are adapted by each organization to the specific features of its functioning. Whether the subordinates will strive to work well or simply serve their attendance hours depends on the success of solving this issue.

Ways to improve labor motivation.

They combine into five relatively independent directions:

• financial incentive,
• quality improvement work force,
• improvement of the organization of work,
• involvement of personnel in the management process,
• non-monetary incentives.

Material incentives reflect the role of the motivational mechanism of remuneration in the system of increasing labor productivity. It includes as elements the improvement of the wage system, the provision of opportunities for staff to participate in the property and profits of the enterprise.

Of course, the motivational mechanism of remuneration plays a large role, but a constant increase in the level of remuneration does not contribute to both maintaining labor activity at the proper level and increasing labor productivity. The application of this method can be useful for achieving short-term increases in labor productivity. In the end, there is a certain imposition or addiction to this type of exposure. Unilateral influence on workers only by monetary methods cannot lead to a lasting rise in labor productivity.

Next direction improving motivation - improving the organization of work - contains setting goals, expanding labor functions, enrichment of labor, production rotation, the use of flexible schedules, improving working conditions.

The expansion of labor functions implies the introduction of diversity into the work of personnel, that is, an increase in the number of operations performed by one employee. As a result, the work cycle for each employee is lengthened, and the intensity of labor is growing. The use of this method is advisable in case of underloaded workers and own desire them to expand the range of their activities, otherwise this may lead to strong resistance from workers.

The enrichment of labor implies the provision of such work to a person that would enable growth, creativity, responsibility, self-actualization, inclusion in his duties of some functions of planning and quality control of the main, and sometimes related products. This method it is expedient to apply in the field of work of engineering and technical workers.

Improving working conditions is the most acute problem of today. At the stage of transition to the market, the importance of working conditions as one of the most important human needs increases. The new level of social maturity of the individual denies adverse conditions working environment. Working conditions, acting not only as a need, but also as a motive that encourages work with a certain return, can be both a factor and a consequence of a certain labor productivity and its efficiency.

In management, 6 methods of non-monetary incentives are used:

1. Approval.

Approval is an even more powerful form of reward than money, which of course will always mean a lot. Almost all people respond positively if they feel valued and respected. There are following rules for managers:

"praise immediately"

"praise the man's work"

“say that you are satisfied and you are pleased that the employee did this

after that, you should not stand over the soul of the worker, therefore, having completed your mission, leave."

2. Action . Employees who purchase shares and become co-owners behave like owners. But in order to use this method of remuneration, the enterprise must use group acceptance management decision, instead of authoritarian and produce a competitive product.

3. free time reward. This will help keep employees from forming the habit of wasting time and will allow the employee to spend more time on himself and his family if he completes work ahead of schedule. This method is suitable for people with a free schedule. Otherwise, management will be tempted to increase the volume of work.

4. Mutual understanding and interest in the employee. The method of remuneration is most significant for effective professional employees. For them, intrinsic rewards carry a lot of weight. This approach requires managers to have good informal contact with their subordinates, as well as knowledge of what excites and interests them.

5 Career advancement. This method of remuneration requires a significant financial outlay for senior management.

6 Independence in your favorite work. This method is especially good when employees aspire to become professionals, but feel the pressure of control over themselves or feel that they would do other work much more professionally, with more dedication and better results. Here, the manager's art lies in the ability to identify such an employee, which can be difficult to accept these actions as another control event. Very often, such people could work effectively without supervision from above, but lack of some courage does not allow them to turn to management about this.

7. Profit sharing.

The most common form of collective reward is the so-called “system” PARTICIPATION IN PROFIT". The essence of the system “ participation in profits” lies in the fact that at the expense of a predetermined share of profits, a bonus fund is formed, from which employees receive regular payments. The amount of payments is made dependent on the level of profit, the overall results of production and commercial activities enterprises. Payments to workers and employees (including representatives of the highest administration) in the order " participation in profits” are not taxed. Thus, entrepreneurs are encouraged by the state to spread this system. In many cases " participation in profits” provides for the payment of all or part of the premium in the form of shares.

In the “participation” system in profits” bonuses are accrued for achieving specific results of the production activities of enterprises: increasing labor productivity and reducing production costs. Bonuses are accrued, as a rule, in proportion to the salary of each employee, taking into account the personal and labor characteristics of the performer: work experience, absence of delays and absenteeism, rationalization activities, as well as a tendency to cooperate, loyalty to the company, etc.

This system is good for large firms.

CHAPTER 4

STAFF MOTIVATION

MBUZ "CITY POLYCLINIC"

4.1. General characteristics of MBUZ "City Polyclinic"

Municipal state-financed organization of health care "City polyclinic", abbreviated name MBUZ "City polyclinic" is a medical and preventive, specialized health care institution designed to implement a set of preventive measures to improve and prevent diseases and provide medical care to the adult population. The clinic is located at:

The polyclinic is organized according to the precinct-territorial principle in the prescribed manner in municipality"Lysvensky urban district". The clinic has necessary details for its activities and is an independent healthcare institution with the right of a legal entity.

In its work, MBUZ "City Polyclinic" is guided by the current legislation, orders and instructions of the Ministry of Health of Russia, this regulation and other regulatory documents.

4.2. The structure of the administrative apparatus

MBUZ "City Polyclinic"

1. Staff motivation methods

MBUZ "City Polyclinic"

In MBUZ "City Polyclinic" non-economic and psychological methods of motivation are used, but the economic method prevails, i.e. material incentives.

Based on the program for the modernization of healthcare in a constituent entity of the Russian Federation, developed in 2011, the purpose of which was to improve the quality and ensure accessibility medical care population in the regions wage and the working conditions of medical personnel have improved significantly. Thus, a doctor with a narrow focus with 10 years of experience received an average of 8,500 rubles, and after the implementation of the program, the salary increased to 25,000 rubles. The nurse initially had a salary of 3,800 rubles to 4,480 rubles, but as a result of payments for modernization, the salary increased to 13,000 rubles. Payments were made on the basis of the reports of the heads of departments, where the responsible person evaluated the work of subordinates according to the criteria.

But unfortunately the modernization program was introduced temporarily, its deadline is 07/01/2013, these dates are indicated for the completion of repairs, construction and procurement medical equipment. With regard to wages, from 01.04.2013 wages medical workers will be charged from the funds of Compulsory Medical Insurance. In the clinic, such an innovation as "Fund holding" was introduced. This means that funding will be per capita.

The goal of the project is to encourage primary care physicians to focus more on preventive work, reduction in hospitalization, reduction in the number of ambulance calls. If positive results are achieved, the polyclinic will receive additional funds from the hospital fund. This is the meaning of fundraising.

The employees of the polyclinic have already felt the changes in funding.

If we return to the payment for the modernization of a doctor of a narrow specialty of 25,000 rubles, then in April 2013, according to the new payment scheme, the doctor received 21,000 rubles. Nurses have a reduction in salaries by an average of 2,000 rubles.

The pay cut is obvious.

What caused the decline?

On this moment the clinic fund contains about 4.5 million rubles, according to the calculations for payment utility bills, analyzes for patients, salaries of employees, purchases medicines for day hospitals and injection rooms, as well as daily expenses for gasoline and expenses for household needs, 6 million rubles are needed. Where to get the missing funds?

Here, the administration comes to the aid of total savings on: stationery, for the payment of bonuses to personnel, for staff reductions, etc.

But in any case, the innovation in the clinic is not a personal desire of the administration, but an order "from above" that must be followed.

In 2012, cosmetic repairs were made in the branches of the polyclinic, equipment was purchased for 6.5 million rubles, computers were installed in the offices of general practitioners and specialized doctors to facilitate documentation.

Every year, on the day of the medical worker, the administration of the polyclinic honors the most responsible and conscientious physicians by presenting them with a cash prize and certificates of gratitude.

Leisure activities are held.

Employees are provided with vouchers for sanatorium treatment.

4.4 Employee incentive offers

MBUZ "City Polyclinic"

If we take into account the fact that labor activity occupies a significant place in the life of almost every person, then medical workers are engaged in their activities after the working day, advising neighbors, relatives and providing assistance in force majeure circumstances. Therefore, the constant experience of negative emotions, dissatisfaction with one's occupation, working conditions have significant implications for human health and general well-being.

Accordingly, if you properly motivate a person, create comfortable working conditions for him, the efficiency of the staff will increase significantly.

In MBUZ "City Polyclinic", doctors and nurses would work much better in clean, renovated rooms, where there would be comfortable furniture swivel chairs and new tables, as well as full provision of stationery with what is currently a tense situation.

Wish there were fun activities for the kids

after the birth of a child, women would be presented with a small present from the administration, as well as a timely application to the kindergarten.

There is a catastrophic shortage of young specialists doctors in the polyclinic.

But they do not go, because the salary does not suit the novice doctor. Attracting young people is a very important goal.

Therefore, specialists need to create conditions for work, provide housing, guarantee a place in kindergarten for their children, etc.

When studying the enterprise, it turned out that the average age of doctors is 48 years old, the average age of nurses is 36 years old, which means that the team is qualified and works smoothly, so it is not desirable to allow “churn” and the solution to this may be an increase in wages.

It is also necessary to train personnel in working with a computer and programs, in connection with the transfer of all reporting and document management to an electronic version.

I would also like to note thatThere are absolutely no rest areas for staff.

I would like to fix this.

CONCLUSION

The real effectiveness of any economic measures is determined by their impact on the attitude of people to work. It is impossible to change this attitude legislatively, since this is a long evolutionary process, but it can be accelerated if a specific situation is soberly assessed and the reasons that gave rise to it are taken into account.

Unfortunately, managers rarely take into account social consequences decisions, and the decisions themselves are often not complex, but purely economic or technical in nature.

Any leader is always aware that it is necessary to encourage people to work for the organization, but at the same time believes that a simple material reward is enough for this. Sometimes such a policy is successful, although, in essence, it is wrong.

The main conclusions on the theoretical part:

Labor motivation, despite the difference in approaches, is one of the fundamental methods of personnel management, encouraging employees to achieve the goals set for them and the organization. Development market relations makes leaders change existing methods and forms of management in all spheres of modern management, and primarily in the management of staff motivation. These changes must be based on the existing needs of workers who, despite the difficult economic situation, are not limited only to the material component, but are presented in all their diversity. Therefore, leaders who want to achieve effective work of their employees, apply not only the methods of economic incentives and administrative influence, but also pay great attention to socio-psychological methods.

To create a positive socio-psychological climate in any team, it is necessary to study the characterological features of employees (typology of characters). The effectiveness of the work performed by the staff largely depends on this. Such studies should be carried out using a variety of tests already at the time of employment (Appendix 1). In addition, it is necessary to take into account the factors of motivation identified as a result of diagnostics. Such factors are, first of all, the feeling of envy of some workers towards others who receive more remuneration for similar work, and an overestimated self-esteem by workers of the results of their work. This requires either the psychological assistance of specialists, or explanatory work of the direct management, which implements this or that policy of differentiated stimulation.

In case of ineffectiveness of the methods of motivation used, it is necessary to change the approaches to the implementation of the motivational policy, based on the needs, interests and desires of employees. However, relying entirely on calculated indicators is wrong. In personnel management, as well as in other areas of management, a situational approach is needed to determine the effectiveness of the policy being pursued based on the specific state of affairs in the organization.

The main conclusions on the practical part and recommendations:

The situation in the team is quite favorable. The performance is at a decent level, as shown by the latest audit of the CHI Fund.

The main attention of management should be paid to the fair remuneration of employees according to their contribution to the collective labor process. The greatest value for employees is material incentives - salary increases, as well as working conditions.

Management should take some psychological work in the team, given that the value is not only external material reward, but also internal satisfaction, as well as skillfully combine economic incentives with moral encouragement.

List of used literature

1. Vikhansky O.S., Naumov A.I. Management, - M.: Gardarika, 1998.

2. Burmistrov A., Gazenko N., What methods of increasing staff motivation are the most effective? Personnel management - 2002.- No. 7.

3. Tsvetaev V.M. Personnel Management. St. Petersburg: Piter, 2002. S. 127.

4. Bogdanov Yu. N., Zorin Yu. V., Shmonin D. A., Yarygin V. T. Personnel motivation Methods of quality management. - 2001. - No. 11.

5. Shepelya V. "Labor stimulation" - "Archimedes lever" 1999

6. M.Kh. Mescon, M. Albert, F. Hedouri. "Fundamentals of Management", M.: Delo, 1992

7. Campbell R. McConnell, Stanley L. Brew - "Economics", 2 vols., M.: Respublika, 1992.

8. Blinov A. Motivation of personnel of corporate structures Marketing. - 2001.

9.Agaptsov, S.A. Motivation of labor as a factor in improving the efficiency of production and economic activity of the enterprise: textbook. manual for universities - M.: Misanta, 2003.

10. Dryakhlov, N.I. Staff motivation systems in Western Europe and USA. St. Petersburg: Peter 2003

11. Maslow, A. Motivation and personality textbook, St. Petersburg: Peter 2002

12. Meskon, M. Kh., Fundamentals of Management, textbook M. Albert, F. Hedouri. Per. from English. M.: Delo, 2002

13. Utkin, E.A. Motivational management, textbook - M.: TANDEM: EKMOS, 1999.

14. Khoroshiltseva, N.A. Study of the structure of motivation of specialists in the construction of a wage system - Corporate management http://cfin.ru

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Annex 1

Test

In order to determine the level of satisfaction with the work of employees at the enterprise MBUZ "City Polyclinic of LGO", a survey of employees is conducted. Please answer the test questions as truthfully as possible.

1.Your age ____________

2. Work experience in this organization ___________

3.Education ____________

Please indicate to what extent you are satisfied with the following aspects of your work (write the appropriate number next to the question using the scale):

5 quite satisfying

4 more satisfying than not

3 can't tell if it's satisfying or not

2 rather unsatisfactory

1 Totally unsatisfactory

1. Salary
2. The work process itself
3. Prospects for professional and career growth
4. Relationship with immediate supervisor
5. The importance and responsibility of the work performed
6. Working conditions (noise, lighting, temperature, cleanliness, etc.)
7. The reliability of the place of work, giving confidence in tomorrow
8. Opportunity to perform a job respected by a wide range of people
9. How effectively the work is organized in general
10. Relationships with work colleagues
11. Opportunities for independence and initiative in work
12. Working mode
13. Work matching your abilities
14. Work as a means to success in life

If possible, indicate your wishes and suggestions on the listed issues ________________________________________________________________________________________________________________________________________________

Thank you for your help with the research!

I therapeutic department

II therapeutic department

Narrow specialists:

ENT, Oculist,

Dermatologist

Neurologist,

Surgeon, Venereologist

Traumatologist,

Endocrinologist,

Urologist,

Physiotherapist.

Physiotherapy department

Women's consultation

Clinical laboratory

x-ray

Registry

Electronic registry

older sisters

Accounting

Human Resources Department

Department of Statistics

CHIEF DOCTOR

deputy chief economics doctor

Deputy head business doctor

Chief Accountant

Deputy head medical doctor

Ch. nurse

Economists

Operators

Sisters are housewives

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7. Vikhansky O.S., Naumov A.I. Management: A textbook for universities. 3rd ed. M.: Gardariki, 2001.

8. Volosskiy A. A., Motivation and stimulation of labor. M.: "Technosphere", 2007

9. Gazheva A.V. The state of nursing in Russian Federation[Electronic resource] // All-Russian conference " Organizational Foundations personnel policy in health care of the Russian Federation” May 19 - 20, 2010 URL: // http://www.mednet.ru/ (date of access: 11.09.2012).

10. Dvoinikov S.I. Management in nursing. - Rostov n / a.: Phoenix, 2006

11. Dvoinikov S.I., Lapik S.V., Pavlov Yu.I. Management and leadership in nursing: Textbook / ed. I.N.Denisova. - M.: GOU VUNMTS, 2005.- 464s

12. Drozdova G.Yu. Problems of motivation of labor activity of nurses [Text] // Chief Nurse. - 2007. - No. 1. - S. 54 - 62.

13. Egorshin A.P. Personnel management: Textbook for universities. - Nizhny Novgorod: NIMB, 2001. - 720 p.

14. Egorshin A. P. Motivation of labor activity: tutorial. N. Novgorod: NIMB, 2003

15. E.P. Zhavoronkov, Yu.O. Kim, T.G. Nikolaeva, N.V. Kulikova Factors of motivation of work of nurses in health care facilities Science Magazine SBEI HPE "Novosibirsk State Medical University" of the Ministry of Health and Social Development of Russia (Novosibirsk) No. 2 - 2012

16. Zhavoronkov E.P. Management of organizational culture: textbook / E. P. Zhavoronkov. - Novosibirsk: Sibmedizdat NSMU, 2009. - 154 p.

17. Zagorodnova G.A., Pavlov Yu.I. Characteristics of job satisfaction and production motivation of nurses // Chief Nurse. - 2008. - No. 3.

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19. Kamynina N.N. Management and leadership: a textbook for students of institutions of higher prof. education / N.N. Kamynina, I.V. Ostrovskaya, A.V. Pyanykh and others - M .: GEOTAR-Media, 2009. - 528 p.

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23. Mishurova I. V., Kutelev P. V. Management of personnel motivation. M .: ICC "MarT", 2003. - 224s

24. Mukhin Yu.I. The science of managing people: a presentation for everyone. - M.: Folium, 2003, 312 p.

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The study of the work motivation of nurses is becoming an urgent topic in connection with the tasks that are set for the domestic health care. The "Concept for the development of the healthcare system in the Russian Federation until 2020" states that one of the main areas of reforming the industry is to address issues related to its staffing. Nursing staff bears the bulk of the burden of patient care, treatment, diagnostic and preventive measures, and the number of nurses is more than 2 times higher than the number of doctors. In the structure of assessing the quality of medical care, as studies show, the professional activity of nursing staff ranks third after the performance indicators of doctors and the effectiveness of therapeutic measures. At the same time, the key to improving the efficiency of the quality of medical care to the population is the creation of conditions for motivated work of medical personnel. Meanwhile, the number of works that consider the work motivation of Russian medical personnel is very limited (V.V. Madyanova, V.A. Mansurov, O.V. Yurchenko, M.A. Tatarnikov, N.V. Kungurov, N. V. Zilberberg, D.I. Prisyazhnyuk, S.V. Shishkin, A.L. Temnitsky, A.E. Chirikova, etc.), and there are practically no studies of the motivation of work of nurses.

According to classical theory A. Maslow, the behavior of the individual is directed by the need that is actualized at the moment. At the same time, scarce needs, which are needs of a lower hierarchical level, stimulate human activity until they are saturated. On the contrary, needs related to a higher level, when they are actualized, are capable of further growth. The development of this theory is contained in I.G. Kokurina; she notes that in labor activity each motive has two semantic orientations: procedural and resulting. Procedural semantic orientation means that a person's activity is limited by the given scope of activity. The resulting semantic orientation is a higher level of activity; it makes a person go beyond the limits of activity prescribed for him.

The motives of employees that encourage them to engage in work activities can vary significantly. At the same time, it is possible to single out certain types of labor motivation. IN AND. Gerchikov proposes to use a typological model of labor motivation, which is built on the intersection of two differently directed axes: “achievement or avoidance motivation” and “active and constructive or passive and destructive labor behavior”. The author identifies four basic types of achievement motivation: instrumental, professional, patriotic, mastery and one opposite type - avoidant.

The basis of psychological analysis professional activity nurse is the fundamental methodological principle of the unity of consciousness and activity, which is most fully implemented from the standpoint of a system-structural approach. Based on this approach, in the process of performing the professional activities of a nurse, a self-forming and self-developing system of mental regulation of activity is formed, which affects all structures and formations of activity, affects all areas of mental activity. When studying the professional activity of a nurse from the standpoint of a system-structural approach, her activity should be considered as a socio-psychological system "nurse - team - patient". The functional elements of this socio-psychological system determine the achievement of the goal, which is a system-forming factor.

The purpose of the professional activity of a nurse is defined as the provision of qualified medical care to the population in accordance with the requirements of the State Educational Standard for the relevant medical specialty. In accordance with code of ethics nurse in Russia, the most important tasks of the professional activities of a nurse are: comprehensive comprehensive care for patients and alleviate their suffering; health recovery and rehabilitation; promotion of health and disease prevention. The profession of a nurse refers to professions of the “person-to-person” type, where work is combined with increased moral responsibility for the mental and physical condition of the patient. In the specialty "nursing" the main form of activity is the nursing process - a method of organizing and providing nursing care, which includes the patient and the sister as interacting persons.

The features of the professional activity of a nurse place significant demands on the psychological characteristics of a specialist. To obtain initial data on psychological factors that ensure the effectiveness of the professional activities of a nurse, the method of peer review is of undoubted value. This method makes it possible to explore the representation of the subject of labor about the significance of certain psychological characteristics for the successful implementation of their professional activities. In the course of generalizing and systematizing the data, the following areas were identified: cognitive, motivational, communicative, characterological, emotional and volitional.

Among the cognitive characteristics required for successful work, experts identified the following: professional erudition, observation, creative mindset, memory, attentiveness. In the motivational sphere, the experts identified the following characteristics: the desire to help people, the desire to improve one's personality, the desire to achieve the heights of mastery. In the communicative sphere, experts noted sociability, openness, listening skills, and sociability. In the characterological sphere, the experts noted the following psychological characteristics: goodwill, honesty, self-confidence, optimism, accuracy, punctuality, politeness, tact, conscientiousness, selflessness. In the emotional realm during expert analysis the following characteristics were revealed: resistance to stress, endurance, compassion. In the volitional sphere, experts have identified: discipline, determination, diligence, organization, independence, perseverance, diligence, consistency, vigor, initiative.

The high efficiency of the professional activity of a nurse is possible only with optimal labor motivation in combination with professionally important qualities identified in the course of an expert assessment.

In the context of globalization, there is a need to increase the competitiveness and efficiency of the functioning of domestic organizations, regardless of the scale and profile of their activities. And this competitive opportunity (especially in social objects man-man to which they belong medical institutions) to a large extent depends on the efficiency of the work of the staff, which in turn is determined by the quality of the motivation of employees for useful work.

There is a need to consider in more detail possible ways to improve the material system that is currently operating in domestic practice, first of all (in conditions of limited economic resources) and non-material motivation which would bring the interests of employees closer to the interests of the organization.

The problem of effective motivation of employees of medical institutions is of particular importance, since, firstly, the financial resources of these institutions are limited, and secondly, the average age of medical personnel exceeds 45 years. Motivation to work in the middle of a service career is significantly reduced, and this fact requires close attention and special approaches. In addition, not all tools that allow highly effective management of the behavior of employees of commercial companies are also acceptable to medical personnel. This has a number of explanations.

The work of a medical worker in the current conditions is increasingly motivated by internal factors, many external factors, with the exception of the social significance of his professional activities, do not work enough. There is an exploitation of such personal qualities of physicians as responsibility, a sense of duty, fidelity to the medical oath, love for one's work, while external stimulation from the state is insufficient. If the older generation of healthcare workers has this internal motivation formed and is quite stable, then the younger generation needs external support for the determination to engage in the difficult profession of a doctor, and this support must be accompanied by a fair material assessment of his work.

According to research, the main motives for the labor behavior of medical workers begin to form from the moment they choose a profession. It was revealed that for the majority of medical workers, when choosing their profession, the motive is the interest in this activity (54.1%). The second most important motive is the desire to benefit society (29.3%). 13.4% of medical workers choose this profession due to the formed family tradition. At the same time, the percentage of people who randomly choose this profession is low (2%). This indicates that people become medical workers consciously, long before they start working, having decided who they will work in the future.

In the process of labor activity, the main motivating factors for medical workers are: a sense of the usefulness and importance of work (thus, they are aware of the social significance of their work in society); a sense of moral pleasure (the ability to do what you love, a good socio-psychological climate in the team); various forms of incentives (first of all, medical workers allocate an assessment by the management of their professionalism at meetings, a cash bonus, honoring in connection with a significant event in his life, presenting a memorable gift, and also declaring gratitude to the head physician); advanced training and study (the profession of a medical worker belongs to the category that needs to constantly improve its professional level, keep abreast of innovations in the field of medical science; in certain cases, this requirement can be vital).

The main demotivating factors in the professional activities of medical workers are low wages and unfavorable working conditions. Due to financial difficulties, many workers are forced to work part-time, sometimes far from direct professional activity, which negatively affects their medical qualifications.

However, according to sociological surveys, the majority of employees of medical centers would not want to change their place of work, despite partial satisfaction with working conditions. This, in turn, indicates that the majority of medical workers are characterized by devotion to their work, the constancy of the chosen place of work, a high level of social competence, which, of course, should be appreciated and encouraged by all available means.

In the current conditions, the most important type of material incentives are cash payments, the need to increase earnings is obvious, since wages in medicine are low. The starting point for the formation of wages is guaranteed constant wages. Variable - bonus payment provides for an additional bonus for an excess amount of work, combinations, length of service, and the like, that is, bonus payment should depend on objectively measurable results.

In this regard, a fairly relevant task is to develop an incentive system of remuneration based on the use of indicators that most fully reflect the labor contribution of a particular employee and the team as a whole. The variety of types of work in health care, the lack of clear criteria for labor productivity, an objective assessment of the quality of work, quantitative labor indicators - all this complicates the development of an incentive system of remuneration in medical institutions.

Until now, little attention has been paid to the formation of a permanent mechanism of continuous motivation, which would be based on the systematic monitoring of the motivational needs of employees and the degree of their satisfaction through the use of appropriate incentive packages for each employee. In foreign literature, the technology for identifying the motivational needs of employees is known as the Ritchie-Martin model, which interprets the results of such identification in the form of “Motivational Profile” histograms.

However, there is still no clear algorithm for introducing such a universal mechanism of goal-oriented personnel motivation in the health care industry, which necessitates its preparation.

Technologically, the formation of such a mechanism for motivating personnel to active work (to achieve the goals medical organization) is carried out in stages, starting with an analysis of the current employee incentive system. The latter also includes an assessment of the degree of staff satisfaction with this system.

The essence of this analysis lies in the primary identification of the current incentive bulletin in a particular healthcare organization and their division into incentives of a material, non-material and mixed nature. The assessment of the real impact of these incentives on medical personnel is carried out through a sociological survey of employees. Evaluation criteria are noted in the questionnaire, which lists the elements of the incentive bulletin (ie the incentives themselves) and five criteria: fully satisfied; more satisfied than dissatisfied; something in between; more dissatisfied than satisfied; completely satisfied.

In the qualimetric measurement, the first criterion is equated to an estimate of 1.0, the second - 0.8, the third - 5, the fourth - 0.3, the fifth - 0.0. This allows you to quite clearly identify the level of employee satisfaction with the existing incentive system, which will characterize the real motivational potential of the personnel of a particular organization. At the same time, it becomes personalized, since it starts with each individual and only then reaches the average indicators of categories of professions, groups of workers, etc. For example, the level of satisfaction with the incentive bulletin of one employee can be 0.38, the second - 0.25, the third - 0.30. This makes it possible to assess the real low motivational potential of individual workers, as well as the potential of departments or the motivational potential of the entire medical organization, having the corresponding average annual indicators. This completes the stage of formation of the mechanism of goal-oriented personnel motivation (MCMP) of a medical organization.

Stage II of the formation of the MCMP is characterized by the identification of the motivational needs of employees according to the Ritchie-Martin method and the selection of appropriate incentive bulletins that are designed to satisfy these needs.

The essence of the Richie-Martin technique lies in a kind of identification of the motivational needs of medical workers using tests of 12 factors (only one of which is purely material in nature) and the interpretation of the test processing results in the form of “Motivational Profile” histograms.

These 12 factors were substantiated by S. Ritchie and P. Martin as the most important of many other factors that influence the activation of the labor behavior of workers.

To identify the motivational needs of employees from these 12 factors, the Ritchie-Martin method proposed a text that contains 33 statements. Each of the statements has four answers. The worker needs to prioritize their priorities from these four answers using an 11-point scale so that the sum of the points for the answers equals 11 from each statement. Having received answers to all 33 statements, it becomes possible to build a scale of needs of each employee in the form of “motivational profile” histograms.

The next task of stage II is the formation of a bulletin (package) of incentives to intensify labor activity that would meet the personal motivational needs of employees (meaning that incentives that do not meet these personal needs are not able to provide motivation for labor activity). This will be a so-called personalized package of incentives, which must be put into operation through an appropriate organizational and economic mechanism.

This personalized incentive bulletin for six months (this period has been empirically confirmed in practice as optimal) influences the labor behavior of workers.

However, time passes, and the needs change: as some needs are satisfied, the employee's priorities may receive other needs (according to the law of increasing needs). In this regard, the 3rd stage of the consistent formation of the MCMP is carried out after 6 months and includes:

A quantitative assessment of the degree of satisfaction of the motivational needs of employees after the influence of a personalized incentive bulletin;

Identification of variable motivational needs of employees;

Selection of updated incentive bulletins that meet these needs;

Implementation of updated stimulus bulletins.

Thus, repeating every 6 months the quadra of the above-mentioned elements of the formation of goal-oriented motivation of the personnel of a medical organization, it becomes possible to establish effective motivational monitoring. It is this kind of monitoring that is the main tool of the permanent mechanism of motivation of employees associated with the satisfaction of their variable motivational needs. This is what ensures the continuous interest of the staff in achieving high results, bearing in mind that the application of the bulletin (package) of incentives to each employee separately depends on the quality of these results.

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