Case Study On Staffing At Community Hospital

Background Statement

The case study is about a health facility that offers different outpatient and inpatient services. River Oaks Community Hospital (ROCH) has a bed capacity of 70 and has been in offering mental and drug or alcohol abuse treatment. Most of its competitors offering similar services are located within 2-50 miles from ROCH’s location. ROCH offers services to youths and adults in inpatient services while children between ages 3 to 17 are offered outpatient and partial programs of treatment. In addition to offering treatment services, the facility also offers education services. The facility has 100 employees working three shifts every week of the year. The executive management is comprised of the CEO, directors of nursing, finance, marketing, outpatients and Debbie in charge of Operations (Sheldon, 2005).
The proximity of several private for profit facilities offering similar services whether outpatient or inpatients is causing a strain and a decrease in the number of patients coming to facility for different treatment and rehabilitative services. As a result, there has been a decrease in patient influx resulting in reduction of 25% inpatient occupancy, 50% decrease in community central occupancy and a decrease of outpatient clients’ from 40 to 15 per week. As a result of this reduction in the number of clients, the company CEO gave a directive for all department directors to make a list of recommendation on staff to be cut off. According to the CEO’s orders, the directors have to analyze their staff and decide on who will have to leave the organization. However, most of the staff has been cut off previously, and as a result those who are still working with the facility are worried that their days with the organization is limited due to the frequent cutoffs. As the director of operations, Debbie is worried about the amount of work load facing the departments under her directive. Her staff had already expressed concern about the work load and made a request to have additional temporary staff to help them as there was only 16 staff working under the departments under her management in addition to the quality and risk departments that had no staff (Oetjen, Richardson & Slovensky, n.d.).

Major problems and secondary issues

ROCH has many problems that are escalating to become major issues that result in the continuing decrease in the number of clients visiting the facility. The first major problem in this facility is the increasing competition from other private and state owned health facilities. The competition is tough and with the increasing facilities offering similar services, then patients have different choices to select from when it comes to deciding which facility they want to go for treatment. Competition is always a threat to the survival of a business and in this case, ROCH lacks a competitive advantage over its clients; hence, the increasing decline in its clients. The CEO is failing to address the root cause of the problem that might help the organization gain a competitive edge over its competitors. The effects of competition on the organization are that it reduces the number of clients coming to the facility.
Secondly, the organization has a big issue in regards to staffing. The cause of this problem is in the lack of proper decision making measures in the organization as well as lack of good and futuristic plans. The organization does not have value for employee loyalty; hence, their ease of letting go of employees and re-hiring new one. Some of the effects of staffing is on the quality of work that is probably declining leading to the continual decrease in the number of client. It is evident that all the departments in the facility are seriously understaffed. Each department is struggling to keep up with the workload as well as ensure they offer quality services. However, how can this happen when the staff feels threatened because of the staff reductions that keep happening. There is a need for the organization to address staffing issues if it hopes to have an increase in the number of clients in the near future.
The other major problem facing the organization is lack of a proper integration plan. Changes made by the changes in reimbursement where insures were adapting to a shorter period of stay and treatment than it was before. Lack of plans to cope with this problem led to the numerous problems the facility is facing. Had the organization has a good plan to deal with the change in the insurance changes, then this change would not have has the impact felt by the organization. The organization lacks a strategic plan that would have otherwise helped the facility deal with these issues and resort to staff cuts as a last resort.
Some of the secondary issues facing the organization include lack of proper communication in the executive management team. The CEO makes decision without consulting with the other directors and gives them no chance to express some of their concerns in regards to the situation facing the facility. Considering that the decision the CEO makes affects the various departments and the directors in charge, there is need for the top management to come up with better decision making strategies that will take into considerations different organization aspects. Over time, this issue will become a major problem breaking down all communication procedures in the organization. Everyone will start making their decisions without bothering to consult about the views of opinions of others whom the decisions may impact. In the long run, the organization will not be properly functional as there will lack of proper communication channels between different departments. This will impair the overall function in the organization. Therefore, there should be a development of a proper communication and decision-making culture where each staff member feels that they are part of organization (Ployhart & Schneider, 2006).
As a senior manager for the organization, I can address the major problem in the organization. The reason for choosing the role of a senior manager is because I have some power to make some of the changes required to change and solve the main problem in the organization. Change can only be made from the inside, and being a senior manager is a good way to ensure that I am successful in implementing the change. When trying to instill a new culture in the organization, there is bound to be a lot of resistance, however, with a repetitive process, then this will be the case. Therefore, as a senior manager, I will be a position to ensure a repetitive culture is created where creativity is a priority. This way the employees will come up with ideas that will give the organizational competitive edge over its competitors. However, there are disadvantages in playing this role. As a senior manager, I would have been in the organization for a while, therefore; coming up one day with a change plan will be a problem. This is more so when it comes to convincing the CEO of the need for a change in tactic. The CEO does not seem to take advice from the staff or ask for their opinion regarding some of the changes to be made in the organization. Therefore, it will be a major problem convincing him that firing staff is not a necessary move, but changes in culture can solve the problems.
The other disadvantage of the role of a senior manager is the need to change the culture and dealing with the stress of the work environment. The staff working in the organization is already straining to keep up with the workload. The roles of a senior manager are increasing and taking on the role of changing the organization will be an added workload. Thirdly, this role may also cause problems between the other managers and I. there is bound to be issues with the other managers. Initiating change starts from the top, and most managers do not like be told to change their mode of working (Sheldon, 2005).

Organizational strengths and weaknesses

The organization is facing many challenges at the moment; however, it has strengths and weaknesses that make the situation worse that it has been over the years. The strengths of the organization includes presence of staff whose performance appraisal results shows are all performing well. Therefore, the organization has room for a change in culture. The directors and managers only have to work together to ensure that the staff are well motivated to tackle their day to day activities. This can be done by coming up with a reward system or overtime payment that will give the employees a reason to work hard to wards changing the organization culture and steering it to gain competitive advantage in the highly competitive market.
The other strength the organization has is its strategic location; hence it can attract more customers if measures are put in place to regain customer trust. One way the organization can do this is through intensive marketing and advertising that will catch the interest of the potential customers. The position of the organization offers it a strategic advantage. It is located in a growing urban center where there is an increasing population and there is presence of malls and neighborhoods surround it. Therefore, the organization can use their position to attract more customers than it is receiving at the moment. Therefore, in the departmental level, actions should be focused on ensuring that the reputation of the facility is changed to give the potential customers a feel of the new approach to services in the organization (Oetjen, Richardson & Slovensky, n.d.).
Some of the weaknesses the facility has include understaffing. In order for the organization to create a new perception and way of operations, there is need for enough staff members who will perform their duties well. The organization keeps on resorting to staff cuts in a bid to deal with the current reduction of customers coming to the clinic. Therefore, in order to change the current issue of understaffing and eventually change the continuing reduction of clients, the organization should work on ensuring that it is well staffed. The staff in different departments will then produce quality work that will end up giving the organization a competitive edge over its competitors. Therefore, the organization should be willing to accept to incur increased expenses in regards to staff.

Alternatives and recommended solutions

One of the alternative solutions for this problem can be rebranding in an effort to recreate interest in the organization. This can be done through marketing where a new improved imaged is created through the public’s eye. People always run for something new and this will give them a feel of something new or different. The advantage of rebranding is that people will want to get a feel of what the new facility is offering. However, this will not address the key issues affecting the organization. The other solution can be external funds to help the organization pay for all the changes that needs to be done as well as increase the number of staff working for the organization. This can be done by borrowing a loan to help fund the expenses needed to make the necessary changes. This will give the3 organization a chance to start over and rectify some of the issues facing them. However, paying off the loan can be an issue if the expected changes do not occur (Sears, 2003).

Evaluation

The goals that will help in measuring the outcomes of the solutions will include income in terms of money. An increase in the amount of money will show a change in the situation. The other measurable goal will be the number of new clients coming in for services. This goal will be assessed weekly by checking records created in the medical records department. A continuous increase in the number of new clients will show an improvement in the situation facing the facility. The old clients will also provide a measure of their satisfaction with the new way of doing things.

References

Oetjen, D. M., Richardson, W. D., & Slovensky, D. J. (n.d.). Staffing at River Oaks Community
Hospital: Measure Twice, Cut Once. 424-428.
Ployhart, R., & Schneider, B. (2006). Staffing organizations: Contemporary practice and theory
(3rd ed.). Mahwah, N.J.: Lawrence Erlbaum Associates.
Sears, D. (2003). Successful talent strategies achieving superior business results through market-
focused staffing. New York: AMACOM.
Sheldon, A. (2005). Organizational issues in health care management. New York: SP Books
Division of Spectrum Publications; distributed by Halsted Press.