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Healthcare Organizations, Research Paper Example

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Research Paper
  1. Introduction

Management of health care organizations has been the subject of an extensive research in the past decades. Health planning and management are essential for managing performance, resources and quality of service. The below review and research of the St Joseph’s Hospital’s ambulatory surgery center would provide an overview based on how the organization implements effective and supportive management and leadership into its organizational structure and what impact it has on resource management, staffing, patient outcomes and quality of care.

            Thesis statement: The St Joseph’s Hospital’s ambulatory surgery center effectively handles organizational change, and the leadership structure of the organization, as well as the unit enables the health care provider to maximize patient benefits and increase staff retention.

  1. The Organization

Using the concepts of health care management, different areas of the organization will be examined; using Collins’ Good-to-Great diagnostic tool. (2006) Inspecting the input principles and output results within t Joseph’s Hospital’s ambulatory surgery center would provide the current research with the information needed for thorough leadership and leadership structure.

Stage One: Disciplined People. Leadership within the examined organization is displaying personal humility and continuous assessments of staff ensures that the right people are selected and those who are unable to meet the guidelines are removed.

Stage Two: Disciplined Thought. The leadership of the unit focuses on a series of strategical decisions, instead of making all the outcomes depend on one major decision. The culture of the company promotes the idea that people have “responsibilities” instead of “jobs”. (Collins, 2005)

Stage Three. Disciplined Action. The organization operates freely within the framework of responsibilities. The disciplined action is based on a “Flywheel”; a process, rather than a single step for change or improvement.

Stage Four. Building Greatness that Lasts. The organization is not built around one single leader, and this is valid for both the large hospital organization and the health care unit examined during this assessment. Core values, for example process improvement and commitment to patient outcomes are constantly reinforced and kept communicated.

The main core values of the organization are integrity, excellence and compassion. These are communicated through internal communication, meetings and training for staff.

  1. Organizational Structure

The organization is governed by a board of directors, consisting of eleven members. The CEO is Scott Schmidly, supported by a chief financial officer, two vice presidents, a chief mission services officer and a chief medical officer. The Chief of Staff, Paul J. Scheinberg, MD has recently earned an award for his commitment for patients. (St Joseph’s Media Room, 2013) Further, encouraging staff to take part in collaboration and community projects enables the organization to create an effective and easy to manage structure of management based on units of health care teams. Leaders are assigned responsibilities, not jobs.

  1. Strategic Plan and The Organization as a System in the 21st Century

According to Collins (1999), the clear definition of the “inside” and “outside” of the organization is the first step towards creating a strategic plan. Next, leadership needs to create commitment and connection based on the freedom of choice. The third step would be to realize that exercising power is not increasing true leadership involvement. The final step is to realize that the traditional walls between the organization and stakeholders are breaking down continuously. This, according to Collins (2001) is the way organizations in the 21st Century should be managed and structured. Deming’s principles of transforming organizations says that the system should be built upon relationships and not its flowchart. Openness, flexibility and acceptance of change is needed for implementing the change and innovation within the organization. Within St Joseph’s, the communication and openness creates a stronger relationship between departments and teams than hierarchy would. It also supports the removal of barriers in innovation, developing rewards, recognition and a unified vision. (Drucker, 1988, Greenhalgh, 2001)

  1. Change and Innovation

St Joseph’s Medical Group, of which St Joseph’s Atlanta Hospital is a member of, is one of the leaders in innovation. According to the company’s mission statement, they are promoting equality in health care, providing affordable health care solutions for “the poor and vulnerable”. The organization is maintaining excellent relationship with research centers, local communities and participates in various health related awareness campaigns. Their publications within their press room indicate that the organization is working on fulfilling their mission on every level; informing patients about the different innovative treatments available, teach basic health skills and have developed a patient safety and quality guideline that protects stakeholders.

Therefore, taking into account the Learning Organizations Theory of Senge (1990), it is important to note that the culture of the hospital encourages collective and collaborative learning in order to improve performance, fulfill the mission of the organization and maximize the benefits for stakeholders. According to Roger’s diffusion model (Quoted in: Daly et al., 2004) the diffusion of innovation is originated by the leadership; invention of change is present. Next, diffusion (communication) of the information regarding the change takes place and finally the consequences follow; adoption or rejection of the change. The more committed and involved the members of the organization are the more positive the consequences of innovative change initiatives will be. Taking into consideration the chaos theory, the constant changes within the organization can have long term permanent effects. (butterfly effect). Therefore, instead of fixed term targets and goals, the communication of boundaries, policies and vision has proven to be more effective within St Joseph’s Atlanta Hospital.

  1. Sustaining Readiness for Change

The changes in the requirements, management and teams create challenges for the organization. Reviewing the structure of the group and my own unit, it is important to maintain readiness for change, collaboration, democracy and shared vision. Complex adaptive system development is the most successful method to sustain readiness for change. As a leader, me personally and the APN/DNP -s within the hospital need to work on recognizing the problem caused by change and communicate the vision with team members during meetings in order to maintain openness and respond after reading the signposts, translating the roadmap, informing colleagues on the journey, discussion with stakeholders and formal response to the challenges before taking action. (Porter-O-Grady & Malloch, 2002) This would engage commitment within the team and increase the team’s readiness for change. One of the major challenges the hospital faces is the structure of teams and limited funds. Therefore, reconstruction, moving people around teams and changes to staffing, shift allocation is necessary to improve patient outcomes. (Quantum Leader characteristics) The above described strategy is suitable for implementing these changes and reducing resistance.

  1. Leadership Style

There are different levels of leadership associated with nursing management. Collins’ leadership levels (2001) are related to behavior and style. Effective managers perform five essential functions; planning, organizing, directing, controlling and decision-making. Within the St Joseph’s Medical Group, the author of the current study has observed consultative leadership. The flow of information from the upper management about strategies and concepts within the group is clear and constant. The management is aiming for increasing the organization’s overall knowledge levels, The promotion of knowledge is a part of the organization’s culture.

One of the strengths of the organization observed by the author is effective communication with stakeholders. Throughout online publications and the supporting of health awareness campaigns, the hospital is maintaining a close relationship with the public, communities, research community and manages change within the organization. This increases the credibility of the hospital, engages discourse between stakeholders.

  1. The Learning Organization – Culture

Senge (1990, p. 3.) states that a learning organization enables all people within to expand their knowledge as a team. Therefore, learning organizations have collective development goals. As mentioned before during the study, changes and goals on an organizational level are effectively communicated. This enables the organization to maintain a high level of commitment on every level. Within the  St Joseph’s Atlanta Hospital, nurses and medical team members feel connected, working towards the same goal; excellence. The main competent technologies of the hospital group support the group in becoming innovative learning organization. The five different disciplines are built within the mission statement and the vision of the group. These are systems thinking, personal mastery, mental models, the building of a shared vision and team learning. (Senge, 1990)

            According to Schein (2002), the problems caused by internal integration and external adaptation (culture, community, group environment and mission of the hospital) can be overcome by shared basic assumptions and vision, promoting the correct way of thinking across the organization. When workload increases, teams think together to act in the best interest of the community, avoid unnecessary visits by educating the public about common causes of condition and the way to prevent them. Staffing is reviewed and collaboration based on shared vision of providing excellence is achieved within nursing teams.

  1. The Image of the Organization

Wheatley (1992) concludes that every organization needs to have a mission that is widely publicized and effectively communicated throughout the groups of stakeholders. This creates an image of the system within the community, workers and those involved. This practice also allows workers and managers to empower individuals and through people the whole system. Porter-o-Grady &Malloch (2002) talk about the re-engineering of the way individuals in the organization think. This is also a tool for empowering people and gaining a higher level of commitment from nursing teams, leaders and health care staff. Self-governance of individuals is an empowering emerging leadership method built upon vision, encouragement, appreciation, trust, recognition and celebration of individual achievement. (Porter-O-Grady &Malloch, 2002) Taking into consideration the framework of effective organizations in the 21st Century (Barker, 2009, p. 284.) the steps to take are clearly outlined by the St Joseph’s Atlanta Hospital. These are:

a, mission, vision and outcome

b, structure (network and communication links)

c, processes (challenges of change and corrections)

d, culture (technological drivers, communication structure and environment, access and recognition)

This method is clearly visible within the organization examined. During the interviews and discussions with nursing team leaders, the importance of engagement, caring and individual performance, achievement was emphasized. Reviewing the user rating of the hospital and patient feedback, the image drawn about the organization by the public matches the vision and mission initially examined during the research. Patients state that nursing and medical staff is competent, experienced and they felt safe. The hospital’s patient safety and satisfaction guidelines are clearly followed, and this is based on collaborative learning, shared vision and individual commitment. The high standards of quality and professionalism as one of the main core values of the hospital are communicated by the leaders at every level. Nurses share the vision of compassion, helping communities and excellence. The innovation and change is effectively communicated; one of the examples for improvement efforts is the appointment of David Markham, MD, MSc as the head of heart failure services. The new leader is committed to getting involved with the Advanced Heart Failure Network collaboration program to provide and share expertise amongst specialists in the field.

  1. Conclusion

After the careful review of St Joseph’s Atlanta Hospital’s systems, change management policies and leadership style, the authors would like to conclude that the consultative leadership style, supporting the learning organization and shared values are helping the health care providers operate based on 21st Century level, using the advanced approaches and strategies needed for managing fast-paced change. One of the main strengths of the leadership identified by the study is innovation and vision related to change. Commitment is gained by communicating values and empowering people within the organization to share the company’s goals.(Daniels, 2003)  Achievement is recognized on a structural and individual level, and employees strive to achieve professional excellence. Reviewing the customer feedback comments of the hospital and publications of articles reporting awards and national recognition achieved by health care professionals, it is evident that the organization’s consultative leadership approach creates long term positive results for all stakeholders. Staff retention rates were analyzed, as well as change management patterns, and the initial thesis statement has been confirmed. Through consultative leadership, the management of change and innovation is handled effectively by the organization, individual health care professionals and the leaders.

References

Barker, A. (2009) Advanced Practice Nursing: Essential Knowledge for the Profession. Jones & Bartlett Learning.

Collins, J. (1999) And the Walls Came Tumbling Down. In: Leading Beyond the Walls, Drucker Foundation on Non-Profit Management Jossey-Bass books, 1999

Collins, J. C. (2001). Good to great. New York, NY: Harper Collins Publishers.

Collins, J. (2005). Good to great and the social sectors. Boulder, CO: Jim Collins Publisher.

Collins, J. (2006) Where Are You On Your Journey From Good To Great? Good to Great. Diagnostic Tool Individual Worksheet Packet Release Version 1.00

Daly, J., Speedy, S., Jackson, D. (2004) Nursing Leadership (Google eBook). Elsevier Health Sciences,

Daniels, R. (ed.) (2003) Nursing Fundamentals: Caring and Clinical Decision-Making. Cengage Learning.

Drucker, P. (1988)  The Coming of the New Organization. Harvard Business Review. January-February, 1988

Greenhalgh, L. (2001) Managing Strategic Relationships: The Key to Business Success. Simon and Schuster

Porter-O-Grady & Malloch, K. (2002) Quantum Leadership: A Textbook of New Leadership. Aspen. Gatesburgh.

Schein, E. (2002) Organizational Culture and Leadership. John Wiley & Sons,

Senge, P. (1990) The Fifth Discipline: The Art & Practice of The Learning Organization. Crown Publishing Group

St Joseph’s Media Room. Web. <http://www.sjmediaroom.com>

Wheatley, M. (1992) Leadership and the New Science: Learning about Organization from an Orderly Universe. Berrett-Koehler Publishers

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