Running head: ORGANIZATION AND LEADER ANALYSIS 1

Organization and Leader Analysis

YOUR NAME HERE

Managing Organizations and Leading People

GR, C200, BIP Task 1

Western Governors University

ORGANIZATION AND LEADER ANALYSIS 2

Organizational and Leader Analysis

Organization Description

A1. Describe the organization and its objective(s)

Acme Healthcare System (AHS) is a not-for-profit health care organization based in

Anytown Virginia. Boasting a staff of over 12,000 employees, a large network of hospitals,

primary and specialty physician practices and other complementary services, AHS provides

healthcare services to approximately 1 million residents in its region, regardless of their ability to

pay. AHS also provides medical education and research opportunities through a medical school

formed in partnership with a large, nationally known university.

 Vision statement: “We are committed to a common purpose of better patient care,

better community health and lower cost.”

 Mission statement: “Improving the health of the communities we serve.”

ACH has grown significantly from its humble beginnings as a local, single hospital

formed over 100 years ago by leaders in the community. As one would expect, a healthcare

organization of its current magnitude would require a robust risk management initiative. This

document will deal specifically with this department and its leadership.

The ACH Clinical Advancement and Patient Safety Department (CAPS) is responsible

for addressing all issues of clinical risk management as well as quality and patient safety

improvement initiatives. It consists of the following positions:

 Vice President (VP)

 Senior Director of Clinical Risk Management (SDCRM)

 Clinical Risk Manager (CRM)

 Ambulatory Clinical Risk Manager (ACRM)

ORGANIZATION AND LEADER ANALYSIS 3

 Clinical Safety Systems Manager (CSSM)

 Clinical Risk Investigation Facilitator (CRIF)

 Clinical Risk Management Coordinator (CRMC)

 2 Patient Safety Systems Specialists (PSS)

 4 Patient Advocates (PT ADV)

 2 Administrative Assistants (AA)

A2. Describe at least three leadership practices of the primary leader

The VP of CAPS displays the personal traits of high energy and positive attitude. These

are infectious and have enabled her to quickly engage with her peers and the CEO in a positive

way. Upon acceptance of the position of VP, she quickly developed steering committees,

involving key stakeholders in her expansion plans. These committees report up through the board

of directors, allowing her to interact with our most senior leadership on a regular basis keeping

our department visible and relevant. She is a transactional leader in that she exhibits concern for

the social needs of the staff, but she is very clear in her specific assignments at times, leaving

very little in the way for staff initiative. She conducts monthly one-on-one meetings with, not

only her direct subordinate, the SDCRM, but with those of us in managerial roles that report to

the SDCRM. During these meetings, we are asked to report on our project progress and given

new assignments and directives on how to achieve the goals she has set. Of the leadership styles

listed in our text (Daft, 2014), the VP is, like most leaders I have encountered, a melding of

styles. Most noticeably, as seen above, she exhibits Directing style. It is possible that this is due,

in part, to the leadership style of her direct subordinate, the SDCRM. He is a very charismatic

leader. He is empowering of his staff in his large vision and allows us to personally create the
ORGANIZATION AND LEADER ANALYSIS 4

necessary results. His leadership style is purely the Entrusting style. His staff is comprised of

seasoned employees who have proven themselves and need little oversight. Hopefully, as the VP

becomes more familiar with the staff, she will see that they do not require micromanagement to

be successful. Both the VP and SDCRM meet the needs of the organization by supporting the

staff through own style. The VP understands the leadership culture within our organization. Our

board of directors prefers a very high-level view of the happenings within our organization and

often times smaller departments can be overlooked. The VP has maintained their interest in and

appreciation for our work through her regular reporting to and engagement with the members of

the board. Our SDCRM supports the needs of the organization by maintaining a highly effective

staff and buffering as much as possible the demands of the VP on us as individuals. It is a

delicate balance, but it works.

A3. Discuss how the current leadership has affected the organizational culture

Our VP regularly expresses her concern for the patient first. As a registered nurse, she

comes from a background in direct care and she has brought those values to her role as VP.

AHS’s migration to a clinic-model healthcare organization required the transition from

leadership by those with strictly traditional business background to one lead by those with a

combination of both clinical and business expertise.

AHS places the mission and vision above all else in all decisions. It is clearly displayed

in all areas of all facilities, including patient care areas and staff offices. Staff are regularly

challenged by senior leaders to maintain our focus on the mission in our conduct with each other,

our patients, and in our project planning through execution. AHS encourages a collaborative

process and publically recognizes interdepartmental projects. We have established a Human

ORGANIZATION AND LEADER ANALYSIS 5

Factors Department and frequently work in multidisciplinary teams to ensure that organizational

changes will have a positive impact on the whole and not be beneficial to only a specific silo.

Our organization is hierarchical and job titles are important, however, most of our leaders

work hard to avoid “pulling rank” when engaging collaboratively with staff. That said, there is a

bit of social segregation between the clinical staff and non-clinical staff and between

management and support staff, such as front desk, food services, and housekeeping. Although

these positions are crucial, they are seen as somewhat “less than.” This can be very disheartening

to observe.

Quality patient care and patient satisfaction are the forces that drive the organization. It is

understood and regularly stressed to staff that the organization supports healthy work/life balance

for staff, but due to the staffing shortages being experienced nationwide, our staff often work

longer shifts than what is beneficial to them or to the patients. As a member of the Risk

Management Department, I am privy to the details of all the medical misadventures which take

place in our organization. We frequently anonymize these and use them as lessons for staff in our

ongoing efforts of continuous improvement. Although the work is hard and the hours can be

long, our staff is committed to the mission and vision of the organization and to providing the

community in which they live with quality patient care.

SWOT Analysis

B1. Evaluate at least two strengths of the organization

1. Staff commitment to the mission and vision

AHS employs over 12,000 people within our region. In an annual voluntary anonymous survey

of employee engagement, over 75% of employees participated. From that number, over 80%
ORGANIZATION AND LEADER ANALYSIS 6

indicated that they felt the leadership of organization were true to the mission and supportive of

front line staff. These figures have not changes significantly (although there has been slight

improvement) over several years. This commitment from the leadership has had an impact on the

staff and on the organization’s reputation in the community. As one of the largest employers and

providers of healthcare in Anytown, Virginia, AHS has a strong presence in the area. While not

all patients are satisfied with their experience, patient satisfaction survey data is also positive.

These indicators reflect the commitment of the organization to the mission.

2. User-friendly, robust event reporting system

AHS recently worked with a nationally known company to build a customized patient event

and patient feedback reporting system. Events can now be entered by anyone in any AHS facility

and is fielded by a Patient Safety Specialist in real time. This allows the Risk Manager to be

notified immediately of any risk management issues. If needed, patient advocates are dispatched

to work with the patient/family and offer early resolution. This has resulted in a significant

reduction in claims and, thusly, a reduction in malpractice premiums.

B2. Evaluate at least two weaknesses of the organization

1. Shortage of primary care practices in rural areas of the region

In addition to the six hospitals run by AHS, there is also a network of family practices scattered

throughout the region. Due to the rural nature of the region, many of these areas a far removed

from cities or metropolitan areas. This creates an undesirable life/work location for many young

professionals which make recruiting of family medicine practitioners extremely difficult. As a

result, patients in these areas either do not seek/receive care for chronic issues until they become

life-threatening, or they use the closest community hospital emergency department for care of
ORGANIZATION AND LEADER ANALYSIS 7

non-emergent, chronic issues. Since AHS is the only healthcare organization that provides

charity care, both of these scenarios are detrimental to the success of the organization. Providing

relatively inexpensive regular care for chronic issues in a family practice setting would be

preferable in both cost and patient outcomes. Not having patients overuse the emergency

departments would also reduce cost and improve response/care for true emergent patients.

2. Large number of retirees from leadership

AHS has 14 staff members in key senior leadership positions planning on retiring in the next

3 years. In addition, our CEO has accepted a position as the chair of a national healthcare

organization. Currently, there are not succession plans in place for all. While AHS has over

12,000 employees and operates a healthcare occupations college, there has not been a graduate

component until recently. Within the next 4-5 years, the college will be producing students with

a post-graduate degree, however, these students will not necessarily have the management

experience needed to take on senior leadership roles.

B3.Evaluate at least two opportunities of the organization

1. Expand the organization’s college and medical school

AHS currently owns a college of health sciences and is partner in a medical school. If these

were expanded to accommodate a greater number of graduates while incentivizing them to

remain in the area as employed staff, it could help with staff shortages. Tuition could be reduced

or waived in exchange for contractual agreements of a period of service. This would allow the

organization to employ staff already aware of the structure and culture of the organization and

provide better trained staff from the first day. It would also provide staffing for the rural areas
ORGANIZATION AND LEADER ANALYSIS 8

with difficult to fill positions. Both of these would go a long way toward fulfilling the

organization’s mission of improving the health of the communities it serves.

2. Create a “fast-track” or non-emergent area within the emergency departments of rural

hospitals

This would allow dedicated emergency room staff to deal with true emergent patients while

those with non-emergent issues could be handled in a designated area by separate staff. Non-

emergent patients would receive care and flow back out of the facility with a lower, more

predictable wait time while emergent patients could be triaged and handled without the pressure

of a full waiting room of non-emergent patients. It would also reduce the spread of infection by

reducing the wait time of contagious patients in the waiting area. This would support the

organization’s mission, reduce staff stress and work load, and improve patient

satisfaction/outcome.

B4. Evaluate at least two threats of the organization

1. Large number of uninsured or underinsured patients

In 2015, AHS provided over $116 million in uncompensated care. As a not-for-profit

healthcare organization, AHS is committed to providing care to patients regardless of their

ability to pay. If this figure continues to rise and income does not increase at a matching rate,

AHS could be forced to reevaluate its policies as they relate to charity care. This could also result

in the need to close some of the rural hospitals in order to maintain the main facility which

houses the region’s only Level I Trauma Unit and neonatal intensive care unit (NICU).
ORGANIZATION AND LEADER ANALYSIS 9

2. Inadequate number of staff

AHS faces a challenge that is shared by many healthcare organizations across the country.

Due to an aging population of baby boomers employed as nurses, fewer young people entering

the profession, and more nurses who leave the profession within the first year, there is a national

shortage of nurses. This is threatening to the organization’s ability to provide quality patient care

due to overwork of the available staff, causing mistakes or to increasing patient load for each

nurse leaving the door open to unnoticed patient decline. If not managed correctly, this can lead

to staff turnover, further exaggerating the already existing shortage.

Leadership Evaluation

C1. Evaluate at least three strengths of your chosen leader

1. Well-defined and clearly articulated expectations

Our VP is very clear in her expectations and meets regularly with staff individually to assess

progress and obtain reports. During these conversations, she makes sure that staff members are

aware of the objective(s) and on track to meet established goals. This type pf leadership can be

very beneficial in certain work environments such as military, police departments, and

emergency medical staff (Spahr, 2016). It works well within a healthcare setting to maintain a

very clear cut set of expectations.

2. Clear reward and punishment structure

There is no doubt among the employees in our department when there has been a success or a

failure of the team. While the fear of failure and punishment is present, there is an equal

parceling of reward for a job well-done. Because our team is very driven and high-functioning,
ORGANIZATION AND LEADER ANALYSIS 10

this form of leadership is not detrimental, but rather feeds our already present commitment to the

success of our projects (Sultana, Darun & Yao, 2015).

3. Strong performing department

Transactional leaders often have departments that perform well in the areas of quality and

customer service. They are also skilled in maintaining reduced costs and increased production

(McClesky, 2014). This is especially favorable in a healthcare environment where trends are

moving toward hospitals and providers being paid based on patient satisfiers and improved

patient outcomes.

C2. Evaluate at least three weaknesses of your chosen leader

1. Innovation delays

While the transactional leadership model has worked for our VP throughout her career, new

technology and innovative ways of doing things are difficult for her to embrace. This has

occasionally led to delays in moving forward with projects because, although some of the staff

member was well-versed in the new technology, the VP was not and was reluctant to accept that

a subordinate held information that she did not.

2. Team creativity is thwarted

Employees of our department are not regularly encouraged to think for themselves. Our VP

prefers to develop the ideas herself and mandate to the staff how to make her ideas a reality.

This does not leave room for individual creativity or problem solving (Benjamin, 2011).

Occasionally this has resulted in a member of the staff having an excellent solution that was not

given consideration because it did not come directly from the VP.
ORGANIZATION AND LEADER ANALYSIS 11

3. No sharing of a high-level view

One of the challenges faced under a transactional leader is the lack of employee involvement

in developing goals on an organizational level. While staff are expected to meet the project

deadlines and lower level goals designed to help the organization reach its goals, staff are not

engaged in the early (or any) conversations on how they should be reached. This is a satisfactory

situation for staff members who want to meet status quo, but can be challenging to employees

who would prefer to participate in big picture planning. Fortunately, our SDCRM is a different

breed and does involve staff members in strategic planning whenever possible.

C3. Recommend three theory-based practices to maximize the success of the leader

Transactional leaders require a strong hierarchy in order to function. There must be a clear

delineation between managers and workers. This is typical in healthcare organizations and likely

is a holdover from the historical relationship between doctors and nurses. Because our VP comes

from a nursing background and AHS has a firmly established hierarchical system in place, our

VP is comfortable in this environment, has risen through the ranks, and will likely continue to do

so. That said, the department and organization could benefit if she was able to transition into a

more transformational style

1. Deepen relationships with staff (Institute of Medicine, 2004)

Although the staff members currently in the department are all self-starters and highly

motivated by reward, there are deeper needs of the individuals not currently being met. If the VP

were to get to know more about the individuals and what motivates them (aside from salary), she

would see that there is the desire to make a difference in the lives of the patients and a desire to

participate in decision making. Many of our staff members have strong leadership capabilities
ORGANIZATION AND LEADER ANALYSIS 12

and the department, as well as the organization, could benefit from the development of these

talents. Identifying and allowing these staff members to try these skills on and grow them would

be an excellent place to start. This could be accomplished within the structure of her existing

practice of one-on-one meetings.

2. Sharing the “big picture” (Anthony & Swartz, 2017)

The staff members are hard-working people and routinely meet goals and complete tasks on

time. Unfortunately, staff members are not typically made aware of how the individual project

fits into the big picture needs of the organization. This could result in “shallow” deliverables that

could have been much more robust if the staff member had been read-in on the larger initiative

driving the project. While not every employee needs to know all the details of the C-suite, being

empowered to think more globally could produce a much more diverse idea pool and generate

solutions not previously considered.

3. Expand training opportunities (Hayati, Charkhabi, & Naami, 2014)

Staff members are currently encouraged to obtain certifications directly related to their

specific roles, but there is little encouragement to attend classes outside those roles. Even cross

training of staff members so that there is support for vacations and absences is not actively

promoted. Allowing and encouraging staff to explore other areas of the organization would

broaden the knowledge and experience that individuals could bring to their existing roles as well

as identify previously undeveloped strengths that could be of benefit to the department and

organization.
ORGANIZATION AND LEADER ANALYSIS 13

References

Anthony, S., & Swartz, E. I. (2017). What the best transformational leaders do. Harvard Business

Review. Retrieved from https://hbr.org/2017/05/what-the-best-transformational-leaders-

do

Benjamin, T. (2011, December 10). Transactional leadership limitations. Retrieved from

http://smallbusiness.chron.com/transactional-leadership-limitations-35903.html

Daft, R. (2014). Management [11th Edition]. Retrieved from http://ng.cengage.com

Hayati, D., Charkhabi, M., & Naami, A. Z. (2014). The relationship between transformational

leadership and work engagement in governmental hospitals nurses: a survey study

(PMC3895439). Retrieved from US National Library of Medicine, National Institutes of

Health website: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3895439/

Institute of Medicine. (2004). The Richard and Hinda Rosenthal lectures 2003: Keeping patients

safe - transforming the work environment of nurses.

McClesky, J. A. (2014). Situational, transformational, and transactional leadership and

leadership development. Journal of Business Studies Quarterly, 5(4). Retrieved from

http://jbsq.org

Spahr, P. (2016, October 19). What is transactional leadership? How structure leads to results.

Retrieved from https://online.stu.edu/transactional-leadership/

Sultana, U. S., Darun, M. R., & Yao, L. (2015). Transactional or transformational leadership:

Which works best for now? International Journal of Industrial Management. Retrieved

from http://ijim.ump.edu.my/images/pdf/4.pdf