Ashley, Sheimeita- Nurs 613-Organizational Analysis-2

7/30/2019 Ashley, Sheimeita- Nurs 613-Organizational Analysis-2

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Running head: ORGANIZATIONAL ANALYSIS

Sheimeita Ashley

Organizational Analysis

University of South Alabama


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ORGANIZATIONAL ANALYSIS 2

Organizational Analysis

Introduction

The concept of Hospice originated in originally in London in 1963 by Dr. Cicely

Saunders (National Hospice, 2013). In 1974, the first American Hospice was opened and

founded in Brandford, Connecticut. Hospice is intended to provide skilled respectful care to

people that are dealing with a life limiting condition and involves a team approach in order to

manage care. This essay will analyze Gentiva Hospicesinterdisciplinary teams organizational

framework, as well as analyze the organizational culture and learning environment, as well as

address the organizations readiness for change.

Hospice as an Organization

Gentiva Hospice of Douglasville strives to improve quality of life by providing

compassionate care to those who are suffering from life limiting injuries and illnesses (Vistacare

Hospice, 2013). The hospice philosophy advocates palliative care versus curative care. In

addition to palliative care, hospice promotes patient autonomy and encourages the patient and

family to guide their treatment. Gentiva Hospice values treating patients and their families with

dignity, and providing respectful care at the end of life. The overall goal of hospice is to ensure

that the patients quality of life is sustained, the patient and the family have autonomy and is

included in making treatment decisions, and that the patient dies a peaceful and dignified death

(Wright, 1999).

Leadership and Culture

A hierarchical leadership structure exists within the company. On the local level there is a

leadership team as well as an interdisciplinary team. The interdisciplinary team consists of the

medical director, patient care manager, the nurse case manager, the social worker, and the


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chaplain. The local leadership team includes the executive director, the patient care manager, the

office manager, the quality improvement manager, as well as the administrative support staff. If

an issue arises it must first follow the chain of command starting with the direct patient care

manger. If the issue remains unresolved then it continues to move up to the chain.

During an interview with the Executive Director (ED) on March, 11, 2013, she stated that

she uses the participative leadership style. Participative leaders acknowledge issues and involve

the staff in finding a solution (Blaylock, 2011). This style is effective when staff members have

high levels of autonomy and have a sense of empowerment. Issues are usually addressed during

staff meetings. One example would be the on call schedule. The case managers have to come up

with this schedule amongst themselves. Another example would be chart audits. Case managers

are required to perform monthly chart audits. This makes the staff member aware of topics that

are not being addressed and need correcting. By redirecting problems back to the staff this

increases awareness and can help resolve problems (Blaylock, 2011).

Organizational Culture

Cultural understanding and consensus amongst the team is necessary for leaders to be

effective and to develop and direct their followers. According to Edgar Schein (1991),

organizational culture is defined as assumptions that a unit has learned from past experiences that

effectively resolve issues and are passed on as the appropriate way to respond to problems. Each

member must know their role, the tasks that they need to complete, as well as the objectives that

need to be met. A strong leader must be in place to guide the group. The interdisciplinary team is

required to address the physical, social, and spiritual factors that impact patients and their

families. Staff members all have a certain degree of autonomy and responsibility to patient care.


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Each individual must uphold their responsibilities to ensure that patients needs are met.

Conflicts are openly acknowledged and addressed.

One the local level, open and effective communication is imperative to solving problems

and addressing change within the team. Plan of care meetings can be arranged to resolve issues

with patients care in order to come up with an effective intervention. Staff meetings are

arranged to address new changes and updates to policy. Regional leadership teams make

quarterly visits to assist with developing the staff. Team members must also stay current with

education and new medications and treatments that are introduced into patient care (Vistacare

Hospice, 2013). Change is a constant factor in health care, including hospice. The organization is

able to prepare, accept, and adapt to change effectively.

Schein describes artifact as being easily observed and visible behaviors, patterns, things,

as well as technology. Team members are expected to maintain a professional appearance and

demeanor. Within the hospice interdisciplinary team, team members professionally respond to

patient needs in a timely manner. Members use cell phones to communicate with each other and

patients. Members use computers for documentation purposes as well as learning purposes.

According to Schein (1991), values are determined by the environment as well as a social

consensus and are exemplified through behavior . The staff shares similar values that are well

known throughout the organization. The main goal of the interdisciplinary team is to provide

high quality and respectful care to the patients. This is done by ensuring that messages are

communicated effectively and in a timely manner and maintaining the patientsplan of care.

Hospice team members consider themselves valuable assets of the team. Team members are

open to change in order to improve patient care and maintain functionality.


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According to Peter Senge, a learning organization is one that functions as a team and

promotes a learning environment (Kurpius, 1993). Gentiva values education and learning. They

use the systems thinking approach. Problems are addressed from within and pointing blame is

avoided. Team meetings are conducted to resolve issues and develop solutions. In addition to

using the systems thinking approach, the company also offers frequent in-services for staff, along

with continuing education hours. Gentiva also has a thorough orientation program for new hires.

New employees are expected to complete didactic as well as practical training in the field. New

employees are assigned a preceptor to guide them through the orientation process and to help

them adapt to their new environment.

Framework

According to Jim Collins Good to Great (2001), there is a hierarchy of leadership that

determines the level of competence of the organizations leader. The executive director of the

organization exemplifies the qualities of a level three leader. A level three leader is a competent

manager, one that is capable of organizing its members and driving them towards their common

objectives. The current executive director is relatively new to the position and is still developing

leadership skills. While the director is able to direct the members towards a common goal and

has humility, her demeanor is not assertive and at times she has problems upholding certain

rules. This is problematic because tension arises at times, and at times she has difficulty

resolving the issues. According to Collins, it is necessary to have the right people in place on the

team prior to starting a journey towards ones goals.. In health care this can be a challenging

concept, and hospice is not exempt. Often there is a high turnover rate which makes it difficult to

sustain an effective team. Currently the company is going through a transition where new


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management and staff (nurses) have been put into place. The team knows where they want to go,

but are still in the process of attaining an effective crew.

Stage two of Collins framework requires that leaders and members be determined, yet

recognize and confront abounding issues. The ED and the patient care manager must be in synch

with the goals and happenings of the office. Being aware of conflicts and appropriately

addressing these issues helps to avoid unnecessary collapses in the system. Whether its patient

or family dissatisfaction or a disgruntled employee, all issues need to be tackled and resolved.

The hedgehog concepts involves three intertwined concepts that include: addressing what

one can be the best at, acknowledging what drives your profitability, and finally identifying what

one is passionate about (Collins, 2001). Team members share common goals and realize their

strengths. Gentivas culture of discipline has a high level of greatness. There is a great deal of

autonomy and responsibility that the team members must uphold in order to keep the business

running. Each member is self-disciplined and capable of managing themselves. Collins states

that a culture of discipline is necessary to make a company successful (Collins, 2007).

Gentiva will soon be implementing an electronic documentation. This technology will be

beneficial to the company as a whole by allowing documentation to be more accessible and

completed in a timely manner. While the company is not yet at this point, it is making great

strides to work toward this technological advancement. While Gentiva as a whole is a successful

company, there are still changes that could be put into place to make it a great company,

especially on the local level. In order to achieve a high level of greatness, Gentiva of

Douglasville needs to build an effective and team whom recognizes and strives towards it goals.

Seeing as how hospice is a saturated and competitive market, the company needs to successfully

market and promote its brand in the community.


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Readiness for Change

Gentiva as a whole is prepared for change and striving towards greatness. Gentiva

recently purchased Odyessy Hospice and Vistacare Hospice and continues to demonstrate

impeccable growth (Zigmond, 2010). Not only is Gentiva changing on the national level, but as

well as on the local level. The team welcomes beneficial change and works as a group to adapt to

new concepts in order to improve patient care. Personally one can be involved during board and

staff meetings where changes are often introduced. As a nurse practitioner or doctorate of

nursing, one could conduct research and ensure that best practice measures are being introduced.

Based upon this system analysis, one would keep in mind that this organization functions best as

an open team. Introducing new concepts to the group as a whole is important. As mentioned

previously, soon Gentiva will abolish paper charting and implement electronic documentation.

Being experienced in electronic documentation, one would be involved in helping the leaders

develop a training course that would be effective in training the new staff on the use of the

system. One would also work closely with the technology department to ensure that the charting

is clinically practical and makes data accessible.

Conclusion

Gentiva is a company that continues to thrive locally and nationally. Even with its present

achievements, the company continues to grow and accept change. Having a positive

organizational culture as well as an effective leader is necessary to promote change and drive the

company. Gentiva of Douglasville has a strong team in place, with proper guidance and training

all members will develop into effective members and promote a thriving organizational culture.


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References

Blaylock, B. (2002). Supportive leadership behavior. [PowerPoint slides]. Retrieved from:

http://www.radford.edu/~bblayloc/Homepage/Powerpoint/Leadership/

Collins, J. C. (2001). Good to great: Why some companies make the leap--and others don't. New

York, NY: HarperBusiness.

Collins, J. C. (2007). Jim Collins: taking health care from good to great.Healthcare Financial

Management: Journal of the Healthcare Financial Management Association, 61(8), 50-

54.

Kurpius, D. (1993). The Fifth Discipline: The Art and Practice of the Learning Organization.

Consulting Psychology Journal. Fall 1993.

National Hospice and Palliative Care Organization. (2012). History of Hospice Care.

Retrieved from: http://www.nhpco.org/history-hospice-care.

Schein, E.(1991). Defining Organizational Culture Chapter One Organizational Culture and

Leadership Second Edition,

Vistacare Hospice. (2013). Vistacare Hospice: A Gentiva Company. Retrieved from:

http://www.vistacare.com/?utm_source=google&utm_medium=local&utm_content=161

&utm_campaign=localmaps

Wright, P. (1999). Expanding the role of the home health nurse: Recognizing the hospice-eligible

patient.Journal of Hospice and Palliative Nursing, 1(4), 135-140.
http://www.radford.edu/~bblayloc/Homepage/Powerpoint/Leadership/http://www.nhpco.org/history-hospice-carehttp://www.vistacare.com/http://www.vistacare.com/?utm_source=google&utm_medium=local&utm_content=161&utm_campaign=localmapshttp://www.vistacare.com/?utm_source=google&utm_medium=local&utm_content=161&utm_campaign=localmapshttp://www.vistacare.com/?utm_source=google&utm_medium=local&utm_content=161&utm_campaign=localmapshttp://www.vistacare.com/?utm_source=google&utm_medium=local&utm_content=161&utm_campaign=localmapshttp://www.vistacare.com/http://www.nhpco.org/history-hospice-carehttp://www.radford.edu/~bblayloc/Homepage/Powerpoint/Leadership/


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Zigmond, J. (2010). Hospice hot spot: Gentiva-Odyssey pairing banks on inevitability of aging

population.Modern Healthcare, 40(22), 6.


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Organizational analysisby Sheimeita Ashley

WORD COUNT 1996

CHARACTER COUNT 11063

TIME SUBMITTED 18-MAR-2013 09:30PM

PAPER ID 313281452


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11 %SIMILARITY INDEX

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6 %PUBLICATIONS

8 %STUDENT PAPERS

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Organizational analysisORIGINALITY REPORT

PRIMARY SOURCES

Submitted to University of South AlabamaStudent Paper

Hale, Beth Ann. "Hospice interdisciplinary team processes and effectiveness ",Publication

Bicehouse, Vaughn L. "The multicolored patchwork portraiture of an effective vPublication

Submitted to Bridgepoint EducationStudent Paper

Submitted to DeVry University OnllineStudent Paper

www.hospiceofwf.orgInternet Source

indianapolis.reporter-times.comInternet Source

www.uvm.eduInternet Source

www.hospiceofthecomforter.orgInternet Source

pptfile.infoInternet Source

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Ashley, Sheimeita- Nurs 613-Organizational Analysis-2