The June 24 issue of The Wall Street Journal carried a front-page article introducing readers to the radical idea that a nursing home could be a place where you or a loved one might want to live, not just a place in which to die. The story followed one of the industry pioneers, physician Bill Thomas, who developed an elder care model called Green Houses. Step into a Green House and you step into a small, tight knit community of 10 to 12 residents and their caregivers, where people live together in a ranch-style home in an atmosphere that’s more like a family than a facility.

What the Journal article did not mention was that not only are Green Houses improving the lives of the elderly who live there, but they also are transforming the workplace of the aides who care for the residents. For the workforce management perspective on nursing homes, I turned to Beth Baker’s Old Age in a New Age: The Promise of Transformative Nursing Homes, an engaging, compassionate and well-researched book that anyone who plans to live beyond 80 would benefit from reading. The book landed in my inbox a day before the Journal article, so I welcomed the chance to offer a workforce management response to a promising development in the $122 billion nursing home industry.

Baker’s book includes a chapter on the dire workforce shortages, high turnover and poor working conditions of nursing homes, all of which have contributed to their reputation as destinations of last resort. Most HR executives know well enough our nation’s shortage of nurses. And many know of a similarly looming shortage of nursing home aides, a crisis that is expected to grow as baby boomers age. With the help of hard stats and previous research, Baker frames this issue in no uncertain terms. Turnover among aides—the people who are the homes’ frontline workers—is 70 percent nationally and 100 percent in 10 states. Annually, staff turnover costs the average nursing home $150,000, while absenteeism adds another $75,000, Baker writes. Nationally this waste in the system totals an estimated $4.1 billion, of which $2.5 billion is paid by taxpayers through Medicare and Medicaid.

Nursing home aides have said in previous studies that the working conditions that are most important to them are having enough staff to care for residents, being treated with respect, working as a team and having a good relationship with supervisors. For reasons that have to do with regulation, economics and entrenched interests, nursing homes have been slow to change, let alone transform themselves. But, as Baker writes, it is transformation that is necessary if nursing homes are to attract and retain workers who, in turn, feel empowered to care for and contribute to the lives of residents.

Enter the Green House. In 2004, Baker visited a transformational nursing home, one of Bill Thomas’ Green Houses, in Tupelo, Mississippi. Here nursing aides are called shahbazim. Thomas borrowed the word from the Farsi word shahbaz, meaning “royal falcon,” an image that evokes courage, loyalty and strength. He likens them to “midwives of elderhood.”

Interestingly, the word shahbaz, however foreign, has helped give new life to the job. Baker wrote to me in an e-mail: “When the first Green House opened in Tupelo, they ran an ad for a CNA [aide] to work in an innovative setting. They got 2 responses. When they ran an ad for a Shahbaz they got 70 responses. Such is the power of language!”

Rather than being the bottom rung in a hierarchy, shahbazim are in put in charge to “protect, sustain and nurture” the elders for whom they care. They are the head of a household of 10 to 12 residents, far fewer than the 20 or more residents nursing aides normally care for. They are trained to be both caregivers who help residents dress and wash and homemakers. The shahbazim cook three meals a day for the residents and deal with their everyday needs, desires and problems. For their domestic efforts, the aides are paid more. They have more responsibility and feel better about themselves and their employer, Baker writes. Nurses, doctors, therapists and social workers make house calls, and in doing so, they become members of a team who bring their services to people, rather than being the top of a social hierarchy in which nursing aides are at the bottom. Baker describes meeting one shahbaz, Rena, an 11-year veteran of nursing homes:

“As we talked, she puttered around the kitchen with a proprietary air. On the counter were bowls of fruit, chips, a layer cake, and a cookie jar. Part of her training includes cooking; many of the young women grew up on fast food and had few culinary skills before becoming shahbazim. Rena kept a watchful eye on Mrs. Adams, who was finishing her meal at her own slow pace.”

Baker shows other examples of nursing homes combating turnover by giving workers career advancement opportunities, a strategy similar to Workforce Management Optimas Award winner Sun Healthcare.

But the transformation of work and place is most evident in Thomas’ Green Houses. The power to make decisions and to care for residents is in the hands of aides who no longer feel mistreated, disrespected or unable to do their job.

HR executives and other business-minded readers, of course, want to know the return on such an investment. Does it reduce turnover and eliminate wasteful costs? Baker reports that turnover at the Green House in Tupelo dropped by 10 percent. Another nursing home in Rochester, New York, saved $4 million a year in temporary worker costs by including certain principles advocated by Thomas. A shortage of extensive data on Green Houses should change. As The Wall Street Journal reported, Thomas recently received a $15 million investment from the Robert Wood Johnson Foundation to build Green Houses throughout the country and study their impact. Perhaps only then will we know whether these nursing homes are as transformational as they seem.

One of last year’s winners in the Optimas Awards, which Workforce Management gives for excellence in workforce management practices, was Best Buy and CultureRx, a subsidiary company that Best Buy launched. The radical notion put forth by Best Buy and the founders of CultureRx, Cali Ressler and Jody Thompson, was that the only thing that should matter about work is that it gets done. When and where it gets done and how many hours someone puts into it are not relevant. Results are the only thing that matter. They call this approach the Results-Only Work Environment, or ROWE for short. The program was also profiled in a Workforce Management feature story in 2006.

Now Ressler and Thompson have laid out the argument in support of the result-only workplace in Why Work Sucks and How to Fix It: No Schedules, No Meetings, No Joke—the Simple Change That Can Make Your Job Terrific. According to the authors, virtually all of Best Buy’s 3,000 corporate headquarters employees are now working in a results-only environment. No one keeps track of when they start working or when they stop. No one expects to see them at a desk at a certain time. Every meeting is optional.

According to the book, ROWE has real cost impacts. For instance, lower turnover among three work teams at Best Buy—just 377 employees—has saved the company nearly $7 million in voluntary turnover costs. Productivity is up, the authors say.

The book is peppered with first-person accounts of Best Buy employees talking about how ROWE has improved their working lives—and their personal lives too. One employee, an e-learning specialist whose work is fairly self-contained, talks about how ROWE enabled him to spend 19 days in Europe following the Dave Matthews Band on tour.

“I basically do what I want, when I want, all the time. I do my work, for the most part, when it is convenient for me. Since I always get my work done, I can enjoy life to the fullest while working for a great company.”

That sounds pretty much like paradise—and to some people, paradise can only be achieved after death. Ressler and Thompson argue on virtually every page of the book that we don’t have to wait that long.

To a certain degree, I think Ressler and Thompson are right. Some work can be done differently than the way it is now. Technology, in the form of cell phones, the Internet and wireless connections, lets some people do work wherever and whenever they want. That’s very often how we do work at Workforce Management. Our reporters and editors mostly work in offices, but sometimes we work at home because that beats the time (and cost) of commuting, or because we have dentist appointments, kids’ school events, yoga class. You know—life.

Ressler and Thompson know that there are plenty of naysayers out there in workland, so the book has lots of sidebars headlined “Yeah, But …”. These anticipate common objections to ROWE. And the authors’ answers are good ones, as far as they go. Any HR reader, however, is bound to start asking, “But what about hourly employees? What about vacation time and PTO? What about staffing the shop floor?”

Why Work Sucks and How to Fix It does point out that there are hourly workers at Best Buy’s headquarters who work in a results-only fashion but must track their time because of federal wage and hour laws. “We think this is stupid and outdated,” the authors write. “Having to track your time even when you’re delivering results makes people feel like second-class citizens. … We believe that eventually the Department of Labor is going to have to change its laws to catch up with the new realities of the global economy.” They also question, rather blithely, whether FMLA would be necessary if companies would just adopt ROWE.

Maybe they’re right, and ROWE is the answer to all our workplace woes. But given the glacial pace of change at the Labor Department and battleground that is wage and hour law and employee leave law, I don’t think we should hold our breath. In fact, I think the authors might be a little naive about how fiercely some constituencies will fight to retain such things as nonexempt job status and disability leaves. “As ROWE spreads, these are issues that we’ll have to work together to resolve.” Work together? I don’t think they’ve met Andy Stern and the Service Employees International Union.

At the risk of sounding like a “Yeah, but …” type myself, ROWE really is designed for knowledge workers, and there are certainly plenty of those trapped in old-fashioned work environments. There are also thousands of companies and millions of workers for whom the full-on ROWE concept is not possible, including schools and their teachers, hospitals and their nurses, stores and their clerks, manufacturing facilities and their line workers. Even Best Buy hasn’t converted its stores to ROWE, although Ressler and Thompson have said that’s being contemplated.

I’m sure there is some kind of modified ROWE that would work in some organizations. Hospitals, for example, are increasingly using software that lets nurses and other medical professionals pick their own schedules. Manufacturing probably could come up with its own version of voluntary scheduling. But I think it will be a very long time before Taco Bell or J.C. Penney let their employees do their work when it’s convenient for them.

I will say this for Why Work Sucks and How to Fix It: It made me think about my relationship to time and my notions of when I’m “on the clock” or not. It made me pay attention to the damage I could be doing to co-workers if I imply, even with a joke, that their working at home, or their time of arrival or departure, is in any way related to how well they’re doing their work. The authors call that kind of time-slave backbiting “sludge,” and say that it poisons the workplace. I think they’re right. If the only thing that Why Work Sucks and How to Fix It accomplishes is getting managers to stop watching clocks and start measuring results, they’ll have done all of us a favor.

There are certain things that employers can control during an economic downturn, and some  things they cannot. In her book One Foot Out the Door, Judith Bardwick discusses them both.

On the one hand, I’m not sure that companies can really do a lot about reforming our country’s health care or Social Security systems, which Bardwick writes about in Chapter 12. While the chapter’s discussion about the need for a national safety net for workers is interesting on a philosophical level, it doesn’t give employers anything practical to work with.

But the main premise of the book deals with an issue that all employers, and particularly their HR executives, can and should address—and that is what she calls “the psychological recession” that is plaguing our country’s workforce.

Bardwick, a management consultant and a former clinical professor of psychiatry, defines a psychological recession as “an emotional state in which people feel extremely vulnerable and afraid for their futures.”

Americans today feel this way for a number of reasons, according to Bardwick. First of all, the media is constantly playing a gloom-and-doom scenario, which is hard to ignore. Also, after the last market dip in 2001, many very bright, educated and experienced workers found themselves out of work and unable to find a new job. This phenomenon is particularly significant because in the U.S. there is the widely held idea that education leads to job security.

“After the 1990s bust, many of our best educated and highly skilled people could not find jobs for as long as five years,” Bardwick notes.

As a result, today’s workers are not only burdened with concerns about job security, but they’re also not particularly motivated to work hard. They no longer believe that if they are good at what they do, they will be guaranteed job security. At the same time, corporate leaders are taking fewer risks because of the economic downturn. These two factors result in U.S. companies becoming less competitive than their counterparts around the globe, Bardwick says.

“Mostly I worry because psychological insecurity has replaced psychological security for too many people,” she writes. “The American Dream, that uniquely American source of optimism, is in jeopardy.”

To address this deteriorating condition of the country’s workforce, employers need to step up their efforts to engage employees. Rather than just offering cookie-cutter menus of benefits to employees, Bardwick suggests that companies really get to know the people who work for them and ask them what their priorities are.

Bardwick provides readers with a list of priorities that organizations can provide employees to choose from, such as assignments that develop interpersonal skills, advanced professional education and access to career counselors.

Similarly, she suggests that companies figure out what kinds of rewards and recognitions their employees appreciate and make sure they comply when appropriate.

One of the most crucial ways that companies can make sure their employees are engaged and committed, however, is by hiring the right people, Bardwick says.

And to do this, companies need to look beyond candidates’ skills and experience, she says. “Regardless of education nor experience, ultimately it’s personality, values and attitudes that will determine whether or not someone will succeed,” she writes.

By focusing more on who the candidate is and not on what a candidate can do, Bardwick believes companies can make better hires who ultimately will be more committed workers.

While I agree with Bardwick that today’s workers in general don’t have the same level of trust that employees may have had 50 years ago, I am not sure that they’re so demoralized that they are jeopardizing the performance of their companies. While I am all in favor of yet one more argument to create a workplace that engages employees, I’m just not sure the situation is as dire as Bardwick contends.

Still, Bardwick’s statistics and research do indicate that companies with more engaged workers perform better than others. The problem is that anyone picking up this book probably is already in favor of that notion. It’s those executives who have little interest in the psychological state of their employees who need to read One Foot Out the Door.