Case Study on Managing Organizations and People

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Managing Organizations and People

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08-Nov-14


Section A: Case Study
The case in reference is an insight on the operations of King Edgar Hospital and the problems related to authority, quality of service, rigidity in systems, and steps leading to change in systems and the after-effects of the change in systems of the hospital in reference to the underlying problems. There is a huge amount of focus on characters and entities and their reactions to leading organizational changes and the steps they take in the development stage and the eradication stage of the problem.
The problem that persists in the operations of the hospital is that the level of management in the hospital has deteriorated to the point where the hospital has difficulty in starting the treatment of new patients, the medically fit patients are not being discharged due to lack of initiative by the physicians, increasing number of complaints from the patients and a bad reputation in dealing with the social services department. This led to a 1 star rating for the hospital which was considered poor and suggestive of the fact that there was need for organizational change in the hospital. The level of concern surrounding this problem was raised by the fact that there was immense pressure by the government to improve their standards. This leads us to examine the protagonists of this case, their reaction on the case, the steps taken by them to solve the problems and the implementation of leadership concepts of power. (Wilson, 2001)
The problem described in the case is a corroding problem which contains issues with the workforce where the different departments do not coordinate that well in work and there is a general sense of lethargy in some aspects of the work being done in the hospital which is the reason behind the problems of waiting times that stretch for hours. Another problem is that the duties assigned to people cannot be don’t by them at times but if the people of other departments are willing to do the same work then they try to become a hindrance by displaying non-compliance in their behavior. There is also a problem persisting in the hospital where people are not being accountable or answerable due to their own mishaps but when they are enquired about the problems they point the finger at other people which is not the sign of a mature and well managed organization. A bunch of these problems together has led to the 1 star rating of the hospital which goes further down by the end of the case.
Tracey Burns

Ms. Tracey Burns was the Executive Director of Nursing, the position entrusted to her by the chief executive Mr. Rodgers. Her work involves dealing with an array of functions as nursing doesn’t just involve caretaking. She is of a responsible demeanor and she remains concerned about the condition of the hospital and has an input regarding the problems going on in the hospital.
She is a woman who takes initiative regarding the problems of the hospital and it suggests the notion that she either feels responsible for or is passionate about her work at the hospital. She is clear about her duties and her powers as the director of nursing and is skillful about managing her resources which are the nurses. She knows that the problems the hospital is going through can be solved by restructuring the processes of the hospital as an organization.
She is analytical about the processes of the hospital which gives her a deeper insight about the situation. After the drop of the ratings the hospital doesn’t receive as much funding as before and that leaves few options open about solving the situation of the hospital and the resources that the hospital is left with are the people that work for the hospital and the nurses form a majority of that.
When the chief executive provided everybody with their objectives, she took charge and utilized her power as the director of nursing and worked on formulating a pledge which would make sure that the duty of discharging the patients is bestowed upon the nurses. As she had powers assigned to her by the senior management, she hosted a workshop for improvising the process of discharging the patients. The other departments were excited about the suggestion due to the fact that it would increase their workload.
There were still persisting problems about the waiting times of the patients which needed to be dealt with which came out during the session hosted by Ms. Burns. By the end of the session, she got a lot of people convinced about the decision but she also knew that a lot of effort was required by her staff to make things work.
Ms Tracey Burns uses legitimate power according to the bases of power. Specifically, she uses legitimate position power as she has been assigned some powers but to get work done, she needs to use the powers to get approvals of people who wouldn’t have generally approved of something.
Although she made sure the decision regarding the nurses discharging the patients got through, it wasn’t well received by certain physicians didn’t approve of the decision and totally disregard the rule. Meanwhile, Ms Burns was active in other roles like initiating talks with social services and health department. When it was found that situations regarding the nurse’s discharges are going haywire, it would still be the best thing that the decision stays.
She also declared in a statement that it was wise to keep the decision due to the fact that there were some dinosaurs in the organization and that they were primitive in their ideas and made it hard for things to change. She used her expert power here, by determining the processes and their long term effects and how they would affect the processes of the organization.
Also during the time when single assessment processes were getting implemented, she used her legitimate power of position to delay its implementation. The purpose of the process was to reduce duplication during the step of information gathering among the patients.
As a collective and calculated approach by her, her action of supporting the nurse’s discharge decision during the session in which the group of executive directors and presenting a robust action plan regarding her decision which led to its approval. This feat of intellect was a display of expert power which played in her favor of her later stages as the Director of Nursing. (Pfeffer)
Ms Tracey Burns had good managerial and decision making skills which were demonstrated in her ideas and her work. She envisions the changes in the organizational structure and its culture. By the steps she takes for solving the problems in the hospital, she also hopes to unite various different groups of the staff. She had the potential to change the landscape of the hospitals of the trust but the incompetency of the people of different departments caused the final loss of the only star they had in their ratings.

Sue Green

Sue Green is the key character during the tide of changes that were going to come upon the hospital. She was one of the three assistant nursing director applicants. She was privy to the knowledge that there was going to be a new policy in the hospital and she was going to be a part of that process in organization. Ms. Green got handed the job and started working to the realization that the attitude of the people inside the hospital was ridden with fatigue and people ran away from taking responsibilities. It was a disappointment to her as one of the primary reasons why she was hired was that she had good experience in dealing with people in multiple organizations that she had worked with in the past.
When Ms. Burns initiated the workshop, she was the principle character in helping her out through the workshop. The workshop saw most of the invited people and further formalities and steps went on. Ms. Green also helped out Burns in extracting the preliminary findings of their workshop. The task was a bed occupancy exercise which consisted of nurse identifying the patients who needed be discharged.
The preliminary findings suggested that almost 17% were supposed to be discharged as soon as possible. It was green who applied the methodology to figure out the conundrum in this situation by utilizing her experience. She utilized her expert power in this scenario. She became one of the driving factors of change for the hospital which was in grave need for some motivational changes in the organization. This is an example of the expert power being applied by Ms Green where she performs good and in a practical manner according to situation which should be a mandatory quality for a person handling a workforce in any organiation.
Ms. Green administered the change that the date of discharge should be hinted in the admission papers so that a track record of the process of discharge should be maintained. She encouraged daily updates on this process.
Due to her caliber of taking initiative and the can-do attitude, Ms. Green was chosen to chair the steering group which was handed the task to oversee the initiative of handing over the discharge duties to the nurses. As both of them worked previously at the clover hospital, she accompanied Burns into interactive sessions at both formal and informal levels. When the session for improving the discharge processes were going on, her primary task was to support the matrons for improving the processes further.
Ms. Green took some big steps to improve the hospital processes. She took initiative of talking to the general manager for initiative some changes and providing her some more time with the matrons so she can organize the session properly. She also trained nurses well regarding what kind of demeanor to have with the patients and their family, how to determine the stability of the patients, handling the discharge plans and taking proper care of the patient. When finally there was the stage when the chief executive assigned the :golden bullets”, promoting the projects seemed challenging due to the facts that the coordination of the nurses and the physicians wasn’t as good as required for a two-way helpful bond.
After the session ended, Ms. Green was keen to welcome external agencies and set a connection with them in order to build a good image and for future assistance. She was disappointed at the adverse condition of the Bronte hospital as it was dragging down the image of the trust. When enquired about the reason of that condition they said that Ms. Green hadn’t been visiting Bronte at all and had her sole focus on Clover.
Sue Green during the initial processes of training nurses on discharging, she made efforts to remove the insufficiencies of the system by formulating a new metric which she called point prevalence. The steps she took when she was taking charge of the responsibilities and approached the general manager to ask for his help on assigning more time for handling the matrons. Ms. Green had no real power of position but she utilized her referent powers to convince the general manager to give her what she wanted which was keeping the matrons free for training exercises.
The people she had authority on was the nurses, she handled them well, guided them and supervised them to check over the patients and she displayed a fair use of her legitimate power to efficiently control the nurses.
It was notable how Ms Sue Green brought a new organizational culture into her work and was proactive in her role. She brought forward a wave of change and she was also a woman of initiative judging by her initiative to go and talk to the general manager if she wasn’t getting what she wanted. By her traits, she can be a lot more successful and it seems that she can be promoted as she handles authority and power well enough.

Competing Values Framework

Competing value framework is an extremely useful for properly setting and understanding various organizational phenomena. These competing values are very useful for understanding the significant approaches to the design of the organizations, aspects of the development of the cycle, quality of any organization, effectiveness and the theories, role of leaders in market, managerial skillas well as the management skills and leadership roles of the managers at human resource department. (Cameron, Quinn, DeGraff, & Thakor, 2014)
The objective of using the competing values framework is to study and provide the conversion in the organization and its culture for betterment
The Competing Values Framework has four sub models. They are as follows: (COMPETING VALUES FRAMEWORK, 2014)
• Internal process model – The internal process model is very useful in bringing control and management stability. Each and every process can be efficiently done when every individual understands his / her part of the work and there is no limited time factor. The main aspects of the model are documentation, information and management, hierarchy and focus on the measurement
• Open system model – The open system model is very useful in bringing innovativeness and creativity. This model states that the employees are always inspired and never controlled. The main aspects of the open system models are growth, readiness, external support, adaptability and sustainability, organic system and resource acquisition.
• Rational goal model – The rational goal model assumes that the planning setting and goal setting directly affects the productivity and the effectiveness. The rational model assigns tasks to every employees working and the objectives are created and the task is carried out then. The main aspect of these models is focus on rational model and the profit.
• Human Relations Model – In this model, individuals are seen as cooperating members who works together and form part of a social system that is common. This theory is completely based on the moral of focus on the training of the individuals and the human resources.
There are four quadrats that form the competing value framework. Each and every market and companies have different strategies and different beliefs. Sometimes they have to just adopt the policy that is most success in that particular area. (Cameron, An Introduction to the Competing Values Framework, 2014)o
Some industries believe that the manager and the employees need to be changing and adaptable to succeed ahead. They are made ready for the changes and the transformation. The more flexible, the team members, the more the company could succeed in the market. While some company believes that the manager and other employees at any level should be focused on one definite goal and u der one definite principles. They should be stubborn on their mottos and should not be open to the changes in their principles. Now in the competing values framework, as shown in the diagram below, flexibility as well as the focus is mentioned in the diagram. We can see that the top part of the circle has flexibility and the bottom part has focused. (Cameron & Quinn, Diagnosing and Changing Organizational Culture, 2014)
Both of this completely opposite and contrasting to each other, yet they are good policies and both are success. It is dependent on the company that which type of policies it wants to adopted. Some companies believe that the environment inside the company should be peaceful and harmonious. All the members should help each other and there should be complete peace. This is the way the company can grow. While some companies or organization believes that the departments among the company should try successfully competing with each other. This way they will always try competing with each other to prove, that particular department is better than the other. And so they can continuous be better. Just like flexible and focused theory, here both of the theories are globally acclaimed and successful. It is organization or manager who has to decide which strategy to choose. (Cameron & Quinn, Diagnosing and Changing Organizational Culture, 2014)
Now these are the end points of the quadrants, we need to now find what is inside the quadrant. All four quadrants are filled with such values that are set in it. Now if we observe the first quadrant that is between the flexible and the internal is the Collaborate. It indicates the collective and collaborate work done among the team members. Now the quadrant opposite to this is Compete. It stands for speeding up the work, doing it fast and efficient. Now the quadrant that is between the flexible and external is the Create. It stands for creating the things, making plans and strategies. While, the quadrant that is opposite to it is for control. It stands for controlling the tings, having flow of control over capital and all

Fig 1.1 showing the four quadrants of the Competing Values Framework
Critical report
If I had a chance to run and manage a XYZ hospital, then I think this competing value framework would be perfect for it. I can create management strategies and I can go through the competing value framework to analyze and study my progress.
As shown in the figure, in upper right most quadrants, we have to first make strategies. I have to first analyze the market, study the current market demands, and study the customer demands. I also have to know from where I can get best staff with highly qualified nurses and staffs, along with the highly experienced and qualified doctors. After I am done with these problems, now I have to deal with the capital management. I have to make strategies regarding the capital along with the structure of the capital flow in the market. I have to see from where I can get the huge capital amount and who will be ready to invest.
Secondly, as shown in bottom right quadrant, next step will be Compete. It means execution of the task and doing it fast. As soon as the marketing strategies are made and we are done through it and it is good to go, our next step is its execution. We know that strategies we made are excellent and it will work in market and will help in prosper, so the next step is its execution. I have to make time table and have to keep a track records of execution of each and every steps of my strategies.
Now my third step will be Control which is at the bottom left most quadrant of the circle. The main idea if the control is the controlled and efficient process which also has a complete effectiveness on the processes. As we saw in the second part that it was time for execution and on the completion of the process or quadrants, we started execution of the strategies. Now it is time to control those strategies that we made. There should be a proper control over the management or the policies or the strategies. Because without the control over the strategies it can change any time and fail us. We cannot then meetour target and then we have to make some other changes.
The fourth and last step for a complete competing values framework is Collaborate. It states various factors like there should be a human resource development sector that primarily works for betterment of the hospital. If the XYZ hospital is made better then it could serve patients more nicely. Another important that should be taught from Collaborate is group work. We should all group together or unite together and then work so that we can serve better.
I will try to make my working environment flexible out of flexible versus focused. Because just like the writer who made the Competing Values Framework, I also believe that for a company to grow better, the managers and the employees at all the levels should be flexible with the new changes. They should say no to changes, as the changes will always be welcomed in my hospital, only if the changes are better than before and it can help to progress the hospital.
For the internal versus the external, I believe external to be a better source of inspiration. They should always be competition for proving who is better. This is because anyone could work in coordinating and supporting environment. There is no fear of being better than what you current are. In this way there is always a need of competition. Once the competition ends, the department will underperform. And there will be no new things and innovation.
Apart from this strategic managements and strategies, there is also need for Human Resource department and recruitment process. The Human Resource Department is created at the fourth quadrant.
Culture change
To implement a better cultural change in my hospitals, I have made few steps that will help me in achieving my goals. I think I should follow these steps strictly and without any exception if I want a culture change in my company. These points are set priority wise. These points are as follows:
• Current evaluation and performance – I should first have a proper current analysis. In short, I should know where exactly I stand. This way I can know how much more ahead I need to go.i should always keep the current record whether it is good or bad.
• Clean initial vision – I should have proper initial cultural policies. I should know about my cultural advantages and disadvantages. I should also be aware about my strengths and weaknesses. This way I can make visions once I get to know about my strengths and weaknesses.
• Clear values and behavior expectation –I should clearly know what kind of behavior I am expecting from others whom I have to rely upon. If the person I am relying upon, fails to deliver the expected work in expected time than I can change the source and could ask help from some other individual.
• Clear strategy priorities – it is obvious that I will have various numerous policies or strategies. I should prioritize them in order that those which are in top should be executed first and those which are at the bottom can be delayed for few times.
• Team management and goals – I should have a proper control over my team. Apart from me, my team should also be clear about the goal of the hospitals so that they can also help to achieve it. Achieving goals are like team work. It could only be done if all the team starts to work on it.
• Good management systems with my goals and priorities – I should have proper management systems that records and maintains my hospital’s goals and my priorities of the policies as mentioned above. I should make different goals for different periods of time, goal A for first year, goal B for second year and so on.
• Managing communication habits – I should have a transparent and a proper genuine communication so that I can communicate with my employees about their performances and I can inform if they need to do well or not.
• Motivating the employees – I have to motivate them through the various processes. But for that the main factor is feedback and company recognition. Employees need continuous motivation and acclamation of their work
This ways I think it is possible that my hospital works better. If I succeed to follow this then I think I could achieve my targeted goals. My ultimate goal is to make my XYZ hospital not only famous across the United Arab Emirates, but it should earn name across the entire world.
Bibliography
Cameron, K. (2014, November 9). An Introduction to the Competing Values Framework. Hawort.
Cameron, K., & Quinn, R. (2014). Diagnosing and Changing Organizational Culture.
(2014). Competing-Values-Leadership-Excerpt. In K. Cameron, R. Quinn, J. DeGraff, & A. Thakor. http://competingvalues.com/competingvalues.com/wp-content/uploads/2009/07/Competing-Values-Leadership-Excerpt.pdf.
COMPETING VALUES FRAMEWORK. (2014). Retrieved November 9, 2014, from utwente.nl: http://www.utwente.nl/cw/theorieenoverzicht/Theory%20clusters/Organizational%20Communication/Competing_Values_Framework/
Pfeffer, J. Managing with power. Stanford: Stanford University.
Wilson, A. (2001). Understanding organisational Culture and the implications for corporate marketing. European Journal of Marketing , 353-367.

Skills

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March 7, 2018

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