Presenteeism - Overworked businessman taking a break from work and napping on his desk.

target readers - strategic manager

By Dr John Briffa BSc,MB BS

Presenteeism – people putting in the hours without the productivity to match – represents a major cost for organisations. But strategic investment can turn that cost into a competitive advantage.

People problems such as stress and burnout cost organisations via three major factors: presenteeism, absenteeism, and staff turnover.

Deloitte research reveals that, of the three, presenteeism is by far the biggest contributor, accounting for almost half of total costs. However, the same research finds that, on average, wellbeing interventions return €4.70 for each €1.00 spent, making them a compelling area for investment for organisations seeking to cut costs and boost productivity.

Whatever their precise nature, resolving wellbeing and performance challenges almost always comes from attending to and correcting key areas that I call the Four Fundamentals.

1. Emotional Regulation

How people respond to stress and challenge, and their ability to keep their emotions in check, is critical to success in work and life. However, work pressures are common at all levels of business, and so are domestic challenges in one form or another.

A sense of ‘threat’ will typically trigger activity in the ‘stress centre’ of the brain called the ‘amygdala’. In turn, this can downregulate activity in the ‘prefrontal cortex’ – the part of the brain we rely on for keeping calm, thinking under pressure, and coming up with creative solutions to problems.

One key to unlocking our inner resourcefulness is understanding that events and circumstances are not the true cause of stress, but our perspective on them is. The ability to see challenges through a different lens – what psychologists term ‘cognitive reappraisal’ – is associated with greater personal resilience. Interventions that equip individuals with real-world psychological skills don’t just help them manage stress more effectively, but also support clarity, decision-making and overall performance.

2. Energy

Abundant, reliable energy is essential for leading an engaged, fulfilled, and productive life in and out of the workplace. Several factors influence vitality and endurance, with the key ones being diet, exercise and sleep.

  • Diet

Diet is a large and complex topic, but a lot of benefit is to be had by ensuring levels of sugar in the bloodstream remain relatively stable. This helps provide consistent, dependable energy for the body and brain, and is something that can usually be ensured by eating a diet based on natural, unprocessed foods.

  • Exercise

Exercise plays an obvious role in wellbeing and resilience. But when work is all-consuming, some people will find it difficult to ‘fit exercise in’ on a consistent basis. There is good evidence, though, that the fitness and health benefits of longer-duration exercise can be had in a fraction of the time via ‘high-intensity intermittent exercise’ (HIIT). Time-efficient exercise, like HIIT, can help ensure consistency with exercise, preventing the weeks- or months-long periods of inactivity some people fall into when work gets busy.

  • Sleep

Sleep is key for recovery and performance but, in my experience, very few people get the sleep they really need.

Sleep requirements vary from person to person, and from time to time, and are therefore best gauged from symptoms. Two questions I like to ask here are: how many hours of sleep does someone need to feel their best, and how many hours do they actually get on average during the working week? I find, more often than not, the second number is about an hour lower than the first.

Because sleep looks like unproductive time, it’s easy to see how it gets squeezed. However, many people find that when they get more sleep, they see a significant uptick in their performance and productivity.

While I don’t think the standard advice to ‘schedule sleep’ is particularly realistic for busy professionals with what can be unpredictable and shifting schedules, What I do find works is for individuals to go to bed earlier when their schedule allows. Doing this – even semi-consistently – is often all it takes for someone to feel better and function more effectively, quite quickly.

3. Environmental Design

Beyond ergonomics, our immediate working environment gets scant attention. However, other factors in our close proximity that can be engineered to enhance our comfort, performance and output include light, sound and air quality.

These factors can have a profound effect. For example, research shows that as carbon dioxide (CO2) levels rise in the air we breathe, brainpower can fall precipitously. One study found that, compared with CO2 levels of 600 parts per million (ppm) in the air, concentrations of 1,400 ppm caused overall cognitive function to halve.

A CO2 monitor will reveal that sitting in a closed room at home can quickly allow CO2 to build up to levels well over 2,000 ppm. The same is true for the bedroom, where high CO2 levels have been found to impair sleep quality and next-day performance.

Adequate ventilation is essential to keep CO2 levels down, ideally with two openings that allow air to flow into and out of the room (e.g., a window and a door, even slightly ajar, on opposite sides of the room).

4. Execution

Of the thousands of business professionals I have advised, the great majority have complained of feeling overwhelmed much of the time. One common issue is that a move to hybrid working has brought with it a newfound ability to communicate online. As a result, it’s easy for the day to be consumed by an endless stream of meetings and calls. This is compounded by synchronous communication stealing time and attention.

All of this counts as work, of course, but the problem is that no real work is getting done. Almost inevitably, essential tasks get shunted late into the day and possibly a ‘second shift’ after dinner. Other than an overly long workday, this risks a delayed bedtime and insufficient sleep.

Also, many people find their minds are preoccupied with work, even during what should be leisure time. This is connected to a phenomenon known as the ‘Zeigarnik effect’ – tasks yet to be done tend to intrude on our thinking until resolved. This is why some people find it hard to stick to the task at work, and may even drift off mentally while they’re in conversation with their partner or child.

One way to get something off our mind is to do it, of course. However, when is there ever nothing left to do? It’s a rhetorical question, of course. Fortunately, research shows that planning and scheduling tasks can prevent these intrusive thoughts and help us be much more present and focused while executing tasks and talking with others.

My advice is to preserve time in the working day for prioritised tasks. A genuine emergency can, of course, take precedence. That said, giving ourselves time in the workday to get things done, and scheduling remaining tasks into the next day’s calendar, is a winning formula. People who use these tactics usually benefit in terms of a calmer, less cluttered mind and, critically, greater effectiveness and productivity.

Soft Skills can bring Hard Returns for Businesses

The Deloitte research referenced above that calculated an average ROI from wellbeing interventions of 4.7-fold, also found that this can be as high as 11-fold. Preventive interventions promise the highest ROI, and those broadly applied across the workforce also typically yield higher ROIs.

While presenteeism is a major drain on organisations, providing evidence-based, actionable advice and training on the full range of factors relevant to performance can bring considerable cost savings and tangible benefits in effectiveness and productivity. The Four Fundamentals are typically thought of as ‘soft skills’, but the results they deliver are hard.

About the Author

Dr John Briffa BSc,MB BSDr John Briffa BSc,MB BS (Lond) is a medical doctor, speaker, facilitator and coach who partners with organisations to support sustainable high performance. Clients include multinational companies in the professional services, finance, legal, banking and private equity sectors. He is the author of 10 books, including The Performance Prescription: The Science of Sustainable Success (Pinnacle Press – 2026). www.drjohnbriffa.com

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