The Prevailing Problems Forwarded by the Hospital Employees - Case Study Example

Unravelling Group Development Within One Successful Meeting The group meeting I attended was one in a hospital setting where the hospital administrator/manager called all heads of departments to attend. The type of meeting was an administrative one and the purpose of which is to address the prevailing problems forwarded by the hospital employees and staff. There were about 25 attendees in the meeting comprising of the administrative heads, department heads and representatives of the various disciplines from the multi-disciplinary team of specialists employed by the hospital - doctors, nurses, physiotherapists, psychologists, occupational and speech therapists, social workers and even special resettlement officers. These individuals only get to meet quarterly, as they are all busy in their own departments and specific jobs in the hospital. They know each other as mere acquaintances except for those whose encounters are more frequent as dictated by the medical cases they handle. There was an air of professionalism that prevailed, and some feel of indifference towards each other. The meeting was set at 9:00 AM, but attendees came in trickles. Only a handful were there on time, and the ones that intermittently come in reasoned they had come from important shifts that they could not easily abandon. The meeting officially started twenty minutes later. The person who presided the meeting was the hospital manager assisted by the head of personnel. The manager presented the agenda for the meeting and then gave the floor to the personnel head who shared with the group the common gripes of the hospital employees and staff that they, as leaders needed to address in order for the hospital to run more efficiently. These issues included a lingering communication problem within the staff of the hospital,; transfer of information from one staff group to another regarding the patients’ cases making the workers unable to contribute productively to the staff meetings; and finally, the high stress level in the work environment which may be the reason for the quick turnover of staff over a short period of time. The announcement of the issues aimed to be resolved in the meeting at hand elicited various reactions from the attendees. Some agreed, and some vehemently disagreed claiming their departments were running very smoothly and none of the problems mentioned existed there. There was a lot of blame assignment and murmurs of discontent heard all around the room. The manager had a difficult time quieting the attendees down and had to raise his voice just so they would return their attention to him. The group seemed to be in the “Storming” stage of Tucker’s model and Wheelan’s Counterdependency and Fight stage where the members tended to express their own individual opinions whether it agrees with the group’s or not. The manager explained to the group the actual situation in the hospital. The intensive and multi-disciplinary approach in the treatment of patients necessitates that each professional worker be aware of their patients’ cases including the treatment being done by other professionals on the case. However, due to the high stress level in the hospital environment where pain and agony abound from the patients, workers are usually left with no choice but to concentrate on their own discipline in providing therapy, care or help for their patients. Add to that, the obligatory meetings set up by management to ensure that things are flowing smoothly, create resistance among the staff, as they are anxious to be questioned about their cases in detail. Such a scenario prevents effective communication to flow within the workers, staff and management of the hospital. This is a cause for concern, as the situation may bring about more problems that can affect the quality of treatment afforded to the patients that has gained recognition for the hospital. Hence, the meeting was called to solicit the support of the head of the departments and all the other attendees to: study the current organizational situation of the hospital to identify the roots of a possible proliferation of communication problems among hospital staff and management. encourage staff groups to be diligent in communicating to other groups what they do with their patients to achieve a more holistic therapy for the patients. Come up with an effective strategy to lessen the stress in the workplace At this point, the members seemed humbled by the administration’s realizations of their own weaknesses in sustaining the workers’ motivation, and their expression that they are in dire need of members’ help and support seem to have struck home. The manager of the hospital made it clear that the meeting was not called to reprimand them or to make them accountable for such problems but to work together in coming up with solutions for the benefit of all concerned. His speech seemed to have moved the members into positive action and into the Norming stage of Tucker’s model and the Trust and Structure phase of Wheelan’s Integrated model of group development. I was amazed to witness such flow of events within an hour, thanks to the approach that the leader of the meeting used. One by one the members began coming up with their ideas. To organize it, the personnel head tried to limit the issue to one at a time. First discussed was the communication problem. Richmond & McCroskey (2005) defines organizational communication as “the process by which individuals stimulate meaning in the minds of other individuals by means of verbal or nonverbal messages in the context of a formal organization.” Apparently, this was becoming a source of conflict within the employees and staff, perhaps due to the nature of its multidisciplinary approach in healing. Communication may be in the form of written or verbal. Employees are used to being the receiving end of downward communication, but usually struggle with initiating upward communication such as speaking up about one’s situation and need for consideration, request for an increase, complaints about a co-worker, etc. Upward communication can only be successful if those at the higher levels are willing to allow the communication to be effective. Horizontal communication is the more common, everyday kind that is transmitted from peer to peer. It usually focuses on how the work day goes, feelings about the organization or problems faced. In addition, horizontal communication promotes social interaction and increases one’s knowledge, communication skills and socialization skills that are necessary for survival in the organization. Outwardly, this already encourages the formation of cliques and subcultures within specific departments instead of fostering team spirit for the whole group. In relation to communication problems, the transfer of information from one worker of a particular discipline or work department to another from a different discipline or department is not very effective. This affects the performance of the whole multidisciplinary team. The whole group analyzed the actual scenario happening in the hospital, and it was very interesting to note that all members gave their full attention to the matter since they are all involved in this issue. It was acknowledged that indeed, information transfer is a challenge. Physiotherapists do their therapy with the patients not necessarily being aware of the psychological interventions or medication the patients are undergoing. Most of the time, it is deemed irrelevant since their concern is mostly to do the job they are called to do. However, holistic treatment is best for the patient, so it is essential that the workers are aware of the whole case to come up with the most appropriate therapy for each patient. “Motivational barriers to knowledge transfer included a lack of extrinsic rewards, stronger levels of group versus organizational identification, reciprocity norms, and the view of knowledge as a means of achieving upward organizational mobility.” (Burgess, 2005). Workers will be more encouraged to transfer knowledge to another professional from another discipline if this sort of behaviour is rewarded by management either by external means such as merit or salary increases or internal means to boost their self-esteem such as praise or simply appreciation. A sense of loyalty to the organization is also necessary for workers to be motivated to go beyond just doing their job. Mostly, it takes above average standards of personal and professional characteristics to uphold such company integrity. This is something to think about as a worker, and for management to evaluate the kind of worker they really want. “Because sharing knowledge can be a time-consuming task that leaves employees less time to pursue their own work, it is important that organizations send clear and consistent messages about the types of knowledge-exchange activities that they want to encourage, and provide adequate credit, recognition, and time for employees who engage in those activities.” (Burgess, 2005) In the hospital setting, it would help if the professionals have access to the patients’ history and medical chart which indicates all of the therapy treatment they are being provided. It would be upsetting to recommend a certain exercise that would strain injured muscles or prescribe medication that triggers allergies, but these may happen if information provided to the workers is not adequate enough. To monitor each patient’s case thoroughly, it is suggested that there is one chart per patient for diagnostic and treatment purpose, and all involved professionals write in their remarks on the chart. These charts of the patients’ cases shall be copied for all the professionals concerned for easy reference during case evaluation meetings and for their own files. Admittedly, the leader of the group shared that management must be consistent in communicating to each worker its philosophy of providing the best quality treatment through collaborative efforts of professionals from different disciplines. Each worker should be able to feel that he is part of a great team that sets high goals and successfully attains them. “Creating the conditions that engender knowledge transfer entails significant structural and cultural changes by top leadership, which will require leaders to be convinced that the benefits of knowledge transfer outweigh the costs. In the absence of this commitment, it is unlikely that attempts to increase knowledge flow will succeed. Leaders should be cautious about publicly touting the virtues of "knowledge sharing" without a substantive commitment to change, as this may result in the failure of well-intentioned knowledge transfer initiatives, bringing with it lowered employee morale and the potential for resistance against future knowledge-transfer initiatives.” (Burgess, 2005) Lastly, the group addressed the problem of high stress in the workplace. Hospitals are innately prone to stressful situations. The fact that patients are usually in pain and in need of immediate relief makes people around them anxious to help. Health care professionals are not immune to stress even if they face it everyday. Their practice requires that they are able to handle stress in order to lower its levels in the patients in their care. Hospital workers also need to contend with the demands of their jobs. They cannot escape paperwork, performance evaluations and a series of meetings. Living a life full of stress in a prolonged period may cause harm to one’s health. It can also dampen his motivation on what used to be something that impassioned him. This is called ‘burnout’. Burnout obviously affects a person’s productivity and quality of life. Losing the flame for something that used to excite and fulfill him may cause depleted physical energy, emotional exhaustion, lowered immunity to illness, less investment in interpersonal relationships, increasingly pessimistic outlook, increased absenteeism and inefficiency at work. (Scott, 2007). Burnout may also be the cause of the fast turnover of hospital staff. Management must be able to come up with ways to reduce it like arranging less demanding schedules. This may include less frequent but more thorough, well-planned meetings that meet its goals. The people in charge of facilitating meetings must draw up a written agenda and estimated time spent for each item. During the meeting each item must be thoroughly discussed and it should be made clear to everyone in the meeting. It would also help if workers are given adequate breaks within the work day for rest and rejuvenation. At this point of exchange of ideas and suggestions, it was evident that the meeting was becoming successful. The feeling of fulfilment at being productive was very palpable, and it egged on the group members to be very participative. It was such a powerful experience for me to be an observer in the meeting, as I actually saw the process of the group’s movement towards the Norming and Performing stage of Tucker’s model and its counterpart in Wheelan’s model, the Trust and Structure and finally Work stages, all in the span of one very fruitful meeting. The unravelling of events validated the theories proposed by both Tucker and Wheelan. Three hours into the meeting, resolutions and recommendations were already being inked by the group’s appointed secretary. They were as follows: 1. General Assembly for Revisiting Philosophy: A general assembly to reorient everyone about the philosophy, mission/vision and values of the hospital is scheduled the following week. It should be made clear to everyone what the hospital stands for and that their cooperation and support is essential in upholding its high standards. Workers are encouraged to reassess their values and level of commitment to the hospital. This general assembly also signals that changes in the system are to take place for the betterment of the hospital. 2. Surveys & Consistent Evaluation: A standard evaluation of communication survey within the hospital staff and management is to be designed and reviewed with everyone on an agreed schedule. Suggestions and resolutions are solicited from everyone concerned. These suggestions may be carried out and evaluated after a period of time. Resolutions are likewise evaluated after two weeks and on a regular basis after that. 3. Working with Team Leaders: Team leaders from each group may represent their group to work with the internal consultant. They are assigned responsibilities to keep their teams or units harmonized. Gaining their rapport and trust may in turn provide the consultant with their confidence in sharing their concerns and listening to suggestions to implement in their respective groups. The head of personnel will now take on the role as a conduit of communication that goes horizontally as well as vertically within the organization. 4. System of Information-Sharing: Since team leaders will be working very closely, transfer of knowledge from one discipline another will be much more manageable. For example, the team leader of the group of psychologists may share some psychological interventions they are implementing on certain patients and justify why such interventions were chosen over the others. This would entail discussing the symptoms and circumstances of the concerned patients. On the other hand, the team leader of the physiotherapists may explain certain therapy methods used on some of their patients. The team leader of nurses may share the medication being administered to said patients, and even the observed behaviors and personality quirks that the other professionals must be aware of. This information shared among the representatives of different disciplines may now be disseminated among their respective staff groups. This information may come in handy when case reviews of the patients are discussed. Concerned professionals from each group working on a particular patient may now be confident in writing their own remarks on the patient’s case chart so the other members of the team may be adequately informed too. 5. Trainings on Effective Communication: The hospital manager may bring in communication specialists to give seminars and workshops to the management and employees. These aim to develop skills in horizontal and vertical communication among the hospital management and staff and even among the workers and the patients. The success of these trainings will be manifested in practice. 6. Stress Management: Strategies to manage and minimize stress also need to be designed and implemented. Examples are organizing schedules of the staff to have more breaks, lessening time for redundant meetings, proper and equitable delegation of tasks, and time for non-work-related fellowship. Following the group’s recommendations to the letter will significantly increase work motivation and productivity in the hospital. Since effective communication is key to success in organizations, it is anticipated that workers will be more cooperative in attaining its goals. All in all, the whole meeting was deemed a success, thanks to the effective handling of the leaders who expressed their limitations and need for the support of the whole group in attempting to fulfill their functions in the hospital. From a widely fragmented group, they were able to create the cohesion necessary for the eventual success of the meeting. References Burgess, D. (2005) What motivates employees to transfer knowledge outside their work unit?. The Journal of Business Communication. Volume: 42. Issue: 4. Cabrera, A., & Cabrera, E. F. (2002). Knowledge-sharing dilemmas. Organization Studies, 23, 687-710. Davenport, T., & Prusak, L. (1998). Working knowledge: How organizations manage what they know. Boston: Harvard Business School Press. French, R., Simpson, P. & Harvey, C. (2001), ‘Negative capability’: the key to creative leadership. Presented at the International Society for the Psychoanalytic Study of Organizations 2001 Symposium. Retrieved on January 17, 2008 from www.sba.oakland.edu/ispso/html/2001Symposium/french.htm Huysman, M., & de Wit, D. (2003). A critical evaluation of knowledge management practices. In M. S. Ackerman, V. Pipek, & V. Wulf (Eds.). Sharing expertise: Beyond knowledge management (pp. 27-55). Cambridge, MA: The MIT Press. Isaacs, W.,(n.d.) Taking flight: Dialogue, collective thinking and organizational learning. Organizational Dynamics Richmond, V.P. & McCroskey, J.C. (2005) Organizational communication for survival: making work,work. Retried on January 17, 2008 from http://www.ilstu.edu/~llipper/com329/mccroskey_chapter.pdf Scott, E. (2007) Stress and burnout: burnout symptoms and causes. Retrieved on January 17, 2008 from http://stress.about.com/od/burnout/a/stressn_burnout.htm\ Tuckman, B. W. (1965). Developmental sequence in small groups. Psychological Bulletin, 63, 384–399. Wheelan, S. (1994). Group processes: A developmental perspective. Boston: Allyn & Bacon. Read More