Introduction to the organization
The organization that I have chosen for the purposes of the final project is the Medical University of South Carolina (MUSC). MUSC is the only comprehensive academic health science center in South Carolina (MUSC). The mission statement of MUSC is concerned with preservation and optimization of human life in South Carolina and beyond it. The main activities, conducted by the Medical University of South Carolina, include education of healthcare professionals and biomedical scientists; research in healthcare sphere, as well as provision of comprehensive healthcare services (MUSC).
Principles that are used by the University to govern its activities include commitment to excellence, measurement of important targets, creating specific culture around the services, being provided by MUSC, creating and developing leaders, focusing on employee satisfaction, building individual accountability, aligning behaviors with goals as values, communicating at all levels, as well as recognizing and rewarding success. These principles serve as the basics for both functioning of all the units of MUSC and designing the relationships between individuals, concerned with the implementation of MUSC functions at all levels.
The Medical University of South Carolina has served the South Carolina citizens since 1824. It has started its activities as a small private college for the training of physicians and managed to expand to the level of state university, including an innovative medical center and six colleges. In 2013, the number of people, working for MUSC, was 1,400 staff members. The University is currently experiencing a steady growth in the number of enrollments, available study programs, as well as patient services. Variety of buildings was established to modernize the University campus over the period from the 1990s to 2014. Particular attention is being paid to continuous development of the MUSC Medical Center. Nowadays, the important parts of the Medical Center include MUSC Children’s Hospital, MUSC Heart and Vascular Center, Hollincs Cancer Center, as well as a specific branch, whose work concentrates on neurosciences. Apart from provision of healthcare services, above-mentioned centers are also involved in research work.
MUSC aims at further development as a leading and transformation healthcare center. Its strategic objectives include promotion of interprofessional and interdisciplinary integration both in terms of MUSC itself and through partnerships with other institutions. Among them one can also mention advancement of healthcare, education and research in MUSC; stimulation of the spirit of entrepreneurialism and the organization of infrastructure that supports coordination, collaboration and commitment to sustainable action (MUSC).
Organizational structure of MUSC can be characterized as vertical. New President and new Chief Executive Officer for the organization were elected in 2013. Despite the fact that both managers and staff of MUSC associated their election with conducting a quality change in the organization (that had been considered since 2011 and continuously postponed), no considerable improvements have been introduced since that time. Therefore, functioning of the organization is currently aggravated with significant management-related concerns that require implementation of changes, especially related to human resource management practices. Nowadays, a significant threat of the University’s being unable to function in accordance with its key principles exists.
Considerable difficulties concern the implementation of such principles of MUSC functioning as commitment to excellence and focusing on employee satisfaction. The lack of change that leads to the breach of above-mentioned principles is likely to exert intermediary impact on the company behavior’s alignment to its goals and values. After the brief introduction of the organization, let me proceed with an analysis of the issues that have negative influence upon the development of MUSC in the lights of its mission statement, principles and strategic goals.
As an interim Nurse Manager for Ambulatory Services, I have managed six different units within the organization under study, namely holding unit (the one, where patients get prepared for surgery), intraoperative unit (where patients are actually having surgery), post-anesthesia care unit (where patients recover after having surgery), preoperative clinic (where patients are being screened before surgery) and the ambulatory procedure center. Recently I have started experiencing management issues that became more evident after the election of new President and CEO for the organization. The one that is most challenging to deal with is the lack of employees’ satisfaction, called forth by the senior management’s aiming at cutting costs, associated with running the organization. The scores of employees’ satisfaction have become significantly lower over the period from 2011 to 2014.
The major reasons for the lack of employees’ satisfaction at MUSC are associated with the management’s reluctance to implement changes that have been planned since 2011; continuous decrease of the amount and quality of employees’ benefits, as well as the lack of chances for professional growth. The reason for the low employees’ satisfaction scores can be also associated with the high level of job stress that is not being compensated. Furthermore, it is worth remembering that MUSC employees communicate with colleagues from other healthcare education and research centers, and compare job conditions and benefits, offered by MUSC and other centers of healthcare education and research in the U.S. and worldwide.
The lack of change can be considered the primary issue to be dealt with in the light of considering the state of employee satisfaction within the organization under study. If at least some changes were introduced in the organization, the level of employee satisfaction would likely be less threatening, than at the moment. Combined with the lack of opportunities for professional growth and development, non-introduction of changes creates the impression of being stuck at a particular level with no opportunity for changing something. This effect is aggravated by the fact that the University has a vertical organizational chart, and employees do not have enough chances to participate in decision-making process within the organization, influencing their position and roadmaps for future development. The employees’ frustration that appears due to the lack of any kind of changes within the organization and being deprived of an opportunity to facilitate changes themselves is significantly influenced by the University’s current management’s focus on cost-effectiveness of policies, instead of the emphasis on the satisfaction and wellbeing of employees, as highlighted in the principles of the MUSC activities. While externally it may seem that the MUSC enjoys active development, an insight into the way it is being managed shows that current issues may exert considerable impact on the future of the organization.
While the lack of employees’ satisfaction may seem an insignificant issue to deal with, one needs to remember that it is closely related to a wide range of other issues, including the quality and productiveness of their performance, employee loyalty to the organization, as well as their readiness to support ambitious change-related plans in the organization. Continuous lack of job satisfaction is likely to lead to higher stress levels among employees, preventing them from performing effectively in terms of MUSC and making them look forward to finding jobs in other organizations that will most likely be MUSC’s competitors. Furthermore, as MUSC has ambitious strategic development objectives, it is important for it to develop employee loyalty to the organization, so that they are not only prevented from opposition to change, but become its immediate agents.
The results of empirical research suggest that there is a clear link between the degree of employees’ satisfaction and business results (Topolosky, 2000, p.64). Specific studies, aimed to address the link between hospital employee satisfaction and the patients’ satisfaction with the quality of care, being provided at hospitals, show the same results as the general ones. The study by Atkins, Marshall and Javalgi (1996) shows that healthcare institutions’ employee dissatisfaction can negatively affect the quality of care and have adverse impact upon the patient’s readiness to address the organization once more and, thus, profitability of a healthcare institution. Therefore, it is recommended that healthcare managers and marketers regularly apply efforts to measuring employee satisfaction as one of the ways to monitor the quality of healthcare services, being provided by the healthcare institution. Having briefly described the scope of the management problem at MUSC, I would like to continue with the description of preliminary solutions to a current situation.
The assignment under study is concerned with changing the organization, so that the management problem that currently affects its activities is eliminated. Providing preliminary solutions for change requires getting an insight into organizational behavior, as well as organizational change and development. The classical textbook by Robbins&Judge (2012) is designed to provide undergraduate and graduate students with the basic understanding of key concepts related to organizational behavior. The content of the book reflects most recent developments in the field of organizational behavior theory and practice. As the assignment is practice-oriented, I paid specific attention to practical examples, contained in the textbook on organizational behavior.
I also used the textbook on organizational change by Senior&Swailes (2010) to learn what organizational change is, how it is connected with organizational development and the ways the change can be facilitated. This book provides a perspective on organizations and their changing environments, the nature and organizational change, organizational structure design and change, culture and change, as well as the relation between leadership and change. Having got an understanding of basic types of changes and learnt the examples of successful changes, I managed to elaborate on preliminary solutions to the problem under study.
The research by Topolosky (2000) is concerned with finding a link between employee satisfaction and business results. Apart from highlighting this link, the book also contains valuable information on different understandings of the concept of employee satisfaction and its application in business studies. This book was useful in terms of defining the issue under study and substantiating its importance for the organization’s development. The study, conducted by Atkins, Marschall& Javalgi (1996) is a more specific one by comparison with the research work by Topolosky (2000), because it is designed to consider the link between employee satisfaction and customer satisfaction in terms of healthcare business. The results of the study showed that there was an evident link between employee satisfaction and patient loyalty. While patient loyalty exerts significant impact upon business results, the study manages to substantiate the link between employee satisfaction and business results through patient loyalty. Similar research was conducted by May (2007), who studied the impact of employee satisfaction on patient safety in the light of medical errors’ occurrence frequency. Research works by Topolosky (2000), Atkins, Marschall& Javalgi (1996) and May (2007) helped me to get more aware about the possible implications of the issue I chose for studying.
One of the management concepts that was of significant importance for work was the concept of organizational culture. The classical book by Hofstede (2010) provides an insight into the impact of culture upon business that needs to be taken into account, whenever the change takes place. Finally, the work by Waisfisz (2012) represents the development of Hofstede’s ideas and their application to the field of business.
Analysis of basic concepts
This project proposal includes such notions and concepts as organizational change, employees’ satisfaction, employees’ loyalty to an organization and organizational culture.
Organizational change is a process that is concerned with organization’s adaptation to changes in external and internal environments of its operation. According to Weick& Quinn (1999), the study of organizational change is concerned with such issues as the tempo of change, as well as the mode of episodic change being introduced to the operation of the organization (p. 361). Major triggers for change include globalization, deregulation of markets, changing market demands, as well as ever increasing competition rates. Determinative factors that are to be taken into account in the process of change management include elaborating on the levels, goals and strategies; measurement system; sequence of steps and the basic design of change’s implementation process. In other words, the process of change in the organization can be described as being comprised of three basic steps, namely getting an insight into current scenario of the organization’s functioning; the elaboration of the preferred scenario of the way the organization will develop in the future and designing the mode of organization’s transfer from its current state to the preferred one.
The concept of organizational change is associated with the notion of organizational development, because change is frequently viewed as an important aspect of organizational development. Organizational development can be defined as the field that studies change and the ways it influences the organizations and the individuals within these organizations. Organizational development is usually based on humanistic values, such as viewing people as human beings, rather than resources in productive process; providing each of organization members with the opportunity to develop his/her own potential, along with the development of organization’s potential; looking forward to increase effectiveness of the organization’s functioning in all the dimensions; providing people in organizations with the opportunity to take an active part in decision0making processes and considering employees’ needs in a complex way. Employee or job satisfaction rate represents the degree to which employees are satisfied with their jobs. Employee satisfaction influences employee loyalty and business results. In terms of healthcare sphere of business, employee satisfaction also influences the way patients perceive the quality of care they get and patient loyalty. Employee satisfaction in healthcare is also associated with the attitudes towards patients that dominate in medical units (patient-centered vs not patient-centered care) and the possibility of medical errors’ occurrence (May, 2007, p. 9-10)
Employee loyalty needs to be considered in terms of employee loyalty towards and organization and his/her loyalty to an employer (Robbins&Judge, 2012, p.87). Loyalty is associated with such feelings as inclusion, bonding, care and responsibility. While loyalty to an employer is likely to characterize personal relationship towards him/her, loyalty to an organization is concerned with an employee readiness and willingness to make a contribution into the development of the organization. The degree of employee loyalty is to great extent determined by the leadership style, employed by management.
The paper also mentions the concept of patient loyalty. Patient loyalty is directly associated with customer loyalty, because patients play the role of customers in healthcare. There are many definitions of customer loyalty in management, marketing and psychology. Customer loyalty is most frequently viewed as a result of positive emotional experience that has been acquired in the process of obtaining services from the service provider. Customer loyalty can be built through a variety of values, such as physical and emotional ones. The importance of measuring, analyzing and enhancing customer loyalty is concerned with the fact that customer loyalty determines customers’ readiness to use the services of particular healthcare providers and, thus, profitability of the healthcare institution and its capability of surviving, despite highly competitive industry environment.
Organizational culture delineates and distinguishes one grouping of employees from other groupings and represents a range of assumptions and beliefs that are shared by the company’s employees. Organizational culture change is one of important branches of change within general organizational change (Senior&Swailes, 2010, p.129). It is important to treat organizational culture both in broad and narrow terms. In broad terms, organizational culture can be considered with respect to the culture of particular state and cultural background of employees. In narrow terms, organizational culture can be distinguished from both the culture of the state(s), where the company functions, and cultural backgrounds of the employees. Let us consider both aspects of organizational culture. Significant volume of scientific literature in the field of cross-cultural management and organizational behavior is dedicated to finding out the degree to which culture is capable of influencing business behavior.
The most wide-spread model of explaining above-mentioned influence was developed by Hofstede (2010). This classical model of organizational culture suggests considering five basic dimensions of culture that are most likely to affect business behavior. They are power distance, uncertainty avoidance, the interrelation between individualism and collectivism in society, the interrelation between masculinity and femininity, as well as long- or short-term orientation.
The term “power distance” characterizes the relationships between a boss and a subordinate that are peculiar to a particular culture. High power distance-related score suggests that people approve of significant inequalities that exist between bosses and subordinates, sometimes willing to enlarge the distance that may already exist. On the other hand, low score means that the representatives of a particular culture are inclined to building relationships between bosses and subordinates (e.g., management and staff of an organization) on equal basis. Uncertainty avoidance relates to coping with the uncertainty about the future through different means, such as usage of technologies, law, religious rituals, etc. The interrelation between individualism and collectivism in culture exerts significant influence upon the way its members’ function in business sphere. While employee, belonging to cultures that value collectivism, can work in teams effectively and make best use of synergy effects, the ones from states with individualism-centered countries frequently need specific training to be engaged into teamwork. This characteristic needs to be taken into account, when trying to enhance employee satisfaction with communication at the workplace. Femininity vs masculinity interrelation is concerned with cultural values that dominate in the society, typical gender roles, characteristic for it, as well as the influence of masculinity and femininity debate on the power relations. The long-term orientation is concerned with society’s search for values, while short-term orientation is being described by the society’s looking for absolute truth. Society’s long- or short-term orientation influences many aspects of societal life and predispositions of its members, such as the respect for traditions, being ready to innovative change and risk.
After having developed general cultural dimensions model that can be applicable to organizational culture, Hofstede’s Center elaborated on the model of organizational culture that includes eight basic dimensions. They include means-oriented vs. goal-oriented, internally driven-externally driven, local vs. professional, open system vs. close system, employee-oriented vs. work-oriented, as well as the degree of leadership style’s acceptance and degree to which employees and management identify themselves with the organization they work in (Waisfisz, 2012). All the above-mentioned dimensions are closely concerned with the effectiveness of the organizations’ functioning and the degree to which companies are ready to build efficient mutually beneficial relationships with other companies. Awareness of the peculiarities of organizational culture, inherent for particular organizations, can be applied in order to achieving measurable success in mergers and acquisitions; creating an engaging organizational culture that will help both managers and staff perceive organization’s objectives effectively and efficiently and making best use of culture as a tool of organizational change.
Both the characteristics of culture that can be located with the help of classical theory of culture and specific characteristics, peculiar to business environment are important to be considered in the process of changes, aimed at improving employee satisfaction and exert intermediary impact upon the degree to which patients are satisfied with the quality of care that they get at MUSC Medical Center.
A number of solutions to the problem of the lack of employees’ satisfaction can be singled out. In practice, it is possible to implement either one of them or elaborate on the combination of solutions. Usage of the combination of solutions can be considered more effective because it can quicker provide employees with a feeling of change, and make them inspired by its prospects. However, if no significant changes are planned afterwards, it seems more reasonable to implement the planned change step-by-step so that the sense of change can be preserved for a longer period of time. Furthermore, it is worth taking into account that the employee satisfaction is multi-aspect construct that includes satisfaction, coming from various sources. Among the aspects of employee satisfaction one can single out being satisfied with the type of work that he/she conducts in the organization; the management of the organization; the ways administrative and financial issues are being tackled in the company, as well as the relationships with other staff members. The degree to which an employee is satisfied with all above-mentioned aspects of the organization’s climate influences complex level of employee satisfaction. The preliminary ways that can be used to solve the management problem under study include the following ones:
- Enhancing employees’ satisfaction is concerned with providing them with greater self-control powers so that they can exercise some control over their working schedules. While it may be hard to widen the space for self-control for healthcare professionals, this solution can be used to increase satisfaction of employees, busy with research work. The way that can be used to enhance job satisfaction of all kinds of employees is providing them with the opportunities to customize their working environments. If there are opportunities to invest into new equipment, it is worth providing staff with the opportunity to participate in the selection of the items that will be purchased.
- Decreasing of job-related stress. Numerous ways of reaching this aim can be designed. For instance, it may be concerned with the decrease in workload; review of work times, as well as providing staff members with telecommuting options. Decrease in employees’ stress can be also achieved through changing the mode of communication between managers and staff, making it less formal. The design of special organization-wide communication system can help reduce stress, associated with the need for face-to-face communication with managers, and provide employees with greater interprofessional integration opportunities. Another way to help employees become more satisfied with their jobs includes promoting positive lifestyle changes, such as regular sports and healthy eating.
- Development of a comprehensive human resources development strategy that will provide all the members to MUSC team with an opportunity to enhance his/her knowledge and chances to be promoted. In-house trainings and educational programs can become not only the means of stimulating professional growth of MUSC employees, but the space for communication and teambuilding. These events can become the basis for the development of specific organizational culture.
- Employees’ benefits and considering chances for enhancing them. Partnerships can be made with other organizations, so that their employees and the ones of MUSC are provided with benefits on the mutual basis.
- Making the activities of the MUSC clinics more patient-centered. It is known that the work environment variables exert significant impact upon both the healthcare professionals and patient outcomes. The results of the empirical research work by May (2007) suggest that the medical units that were based on patient-centered care tended to have employees, more satisfied by their job, than the ones, who perceived their units as less patient-centered. Patient-centered care is likely to be associated with the specific climate that exerts highly positive impact upon both patient safety and avoidance of medical errors and cases of malpractice (May, 2007, p. 9-10). Thus, it is proposed to define the most important elements of patient-centered climate and elaborate on their introduction into the functioning of the organization.
The practice-oriented assignment under study is of significant importance for getting an insight into the work of change manager. It allows students to practice identifying management issues; exploring their links with other issues; making assumptions concerning their possible implications on the activities of an organization, as well as applying management concepts to elaborating on preliminary solutions to the issues. The assignment is helpful in theoretical terms, because a careful analysis of used concepts is required. However, its major value is concerned with practical aspect, because students are required to analyze situations that tend to happen in practice. Furthermore, completing the assignment is concerned with significant degree of creativity, when discovering the ways to solve the problem under study.
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