Organizational Redesign - Shangri-La Hospital - Admission/Application Essay Example

Organizational Redesign Benefits to the organization of the new design The new design of restructuring the hospital along product/market lines will greatly help improve the efficiency of the hospital; it shall also increase accountability of services for resource utilisation. Product line management “is a business technique that focuses management on all of the product components, its market equivalents, and its competitive advantages” (Johnson, p. 1). The funds and resources of the hospital will be based on the delivery of quality health care services, and not be based on the presence of functions or departments in the hospital. In so doing, the hospital can cut cost in the most effective manner while still rendering the best possible quality of services to the patients. Product-line management (PLM) is also known for its rapid decision-making process and responsiveness to the needs of the customer. When a decision needs to be made about what the patient urgently needs, the hospital management can easily and speedily make the decision for the patient when he actually needs it, and not when his condition has already worsened. Hospitals have been traditionally organized under functional reporting lines. Pharmacy, radiology and laboratory departments usually report under ancillary services; patient care units report as nursing services to the nurse executive without regard for the kind of service they actually render to the patient. This approach focuses on departmental issues, not product cost or even quality. And the patient does not have the chance to give feedback on the services offered. “A product line management approach in healthcare is based on the premise that the hospital is a business enterprise with multiple service lines” (Johnson, p. 1). And the management coordinates these services within the different product lines in order to provide comprehensive care to each patient. Patients will benefit greatly from the PLM approach because there is a greater level of accountability on the managers who view themselves as responsible for delivering the best ‘product’ for the patients. This approach also offers organizations the most effective way to focus on the needs of the market – which is quality of health services – and to deliver this to the patients at the lowest possible cost. New Structure – Achievement of Performance Objectives The product line management can help the hospital demonstrate in measurable terms better quality control systems. Managerial specialists with specific and optimum knowledge about a product are usually assigned to check the quality of a single product line. Problems within the product line are also resolved by such specialist. These types of quality control helps focus the quality check on a particular product line and, in so doing, assuring a thorough assessment of the product and services that arise from the service. When applied to Shangri-La Hospital, each managerial specialist will be assigned to check on the quality of the product line he is assigned to. The manager’s skills as managerial specialist are highly focused on the particular product assigned to him. He is an expert on the area he is assessing and he is able to adequately and comprehensively check on the quality of the product line. He knows when the product is not functioning the way it is supposed to, and he knows which particular aspects of the product line need to be upgraded or improved. He can also detect the slightest change in the quality of the services rendered and subsequently resolve issues and problems arising from the product line. In order to achieve enhanced continuity of care for clients, the product line management approach allows the practitioners “to move fluidly across the different care units” (Keefe, p. 14). The health professionals will follow the progress of the patients from the initial admission up to discharge. In a cardiac care unit where this type of management was applied, administrators said that, “we see [patients] at the pre-operative visits, postoperatively in critical care, and again in after-care and rehabilitation” (Howe, as quoted by Keefe, p. 14). The health care team can assess the patients when it is appropriate to evaluate them for possible complications. Through the product line management, the patient is able to gain continuity of care at various stages of his illness and treatment. “Under product line management, the program director is responsible for directing all staff on the subacute unit, eliminating layers of hierarchic management” (Griffin, p. 108). In other words, there is a decentralization of the structures of management controlling the product line, allowing a free and seamless coordination of patient care from admission to discharge. The manager in the product line approach is charged with the cross-training of nursing and healthcare staff in the hospital. These staff members are trained to be adept in various aspects of care from basic health care to basic respiratory care and to patient transfers. Under these circumstances, the transition for the patient into the different aspects and stages of care will not be very stressful and will be handled by competent staff. Some authors also describe the product line management approach as being customer-based or patient-centred. Continuity of care is often best achieved in home settings where the healthcare system can make adjustments in the care of the patient. Most patients who suffer the brunt of cost-cutting in healthcare are those in the outpatient settings. Through product line management, it is possible to establish continued care to patients by justifying these services under the product line of service rendered by the hospital. It is now possible for the patients in the outpatient settings to receive and be allocated care under the product line approach because the allocation of care is largely based on the patients’ needs. In the case of Shangri-La Hospital, continuity of care can be achieved through the new product line management approach by allowing the services to fluidly flow from one stage of care to another. Through the new structure, a healthcare team can follow and monitor the progress of the patient from admission to discharge. There is lesser bureaucracy and hierarchic management concerns because there is a good coordination of services and healthcare professional in the different areas and aspects of care. The product line management approach can also help achieve cost-effectiveness for the hospital because the process of cutting cost in the hospital will be based on the services and products that the patients need, and not on what a hospital is supposed to offer. The product line management approach allows managers to analyse certain product lines and assess if they are making or losing money. “Such a policy would be good for the patients and good for the institution. To balance service and solvency, hospitals must eliminate their low volume, low quality services” (Eastaugh, p. 201). The products and services that will now be offered by the hospital will be based quality and cost-effective services. Product line management also helps eliminate the possibility of duplicated services. It will force the managers to assess the services and products offered by the hospitals and to decide which services are duplicated and which services need to be eliminated. In the case of Shangri-La Hospital, the product line management would require the managers to evaluate the services and products being offered by the hospital in line with the needs of the community. The community surrounding Shangri-La Hospital is mostly composed of young families with marginal socioeconomic circumstances; the community is also home to the largest population of indigenous people. By assessing the needs of the community, Shangri-La Hospital will be able to cut cost and improve coordination of services. Upon initial assessment, it may be able to establish that it needs to eliminate its aged care services because the community is composed of young inhabitants. Allocations for aged care may instead be directed to indigenous health/public health services. The manager can further assess the common illnesses or affectations in the community and thereafter make adjustments in the hospital services based on services needed by the community. It may also be possible to approach cost-cutting in terms of specialization of services. The hospital already provides specialized services in several areas, but it may still be possible to cut down services not needed by the community in favour of services direly needed by the community. “If hospitals desire to maximize quality more institutions might consider specialization; yielding fewer departments with more volume per department (and hopefully more quality per product line)” (Eastaugh, pp. 202-203). It may be possible to eliminate oncology and psychiatry services from the hospital and concentrate on the other fields of specialization. There will indeed be fewer departments in the hospital, but the quality of services offered in the current services offered will be in the highest possible degree. Patients seeking care in oncology, psychiatry and other eliminated areas of service can seek medical care in other hospitals or medical centres. If these changes are not done by the hospital managers, the hospital may later close-down its services entirely. Therefore, it is better for the hospital to undertake cost-cutting measures that would benefit the community and the institution. Environmental Factors Environmental factors will greatly influence the implementation of a new organizational strategy and design. Environmental factors may involve the following: social, technological, economic, and political. In the implementation of the new organization strategy the social aspects of the community like demographic trends, changes in births and death rates, consumer preferences, and community values of the community about health can impact on the implementation of the new design (Harris, et.al., p. 274). The young population of the community surrounding Shangri-La Hospital will affect the implementation of the new strategy. Many of them will likely benefit from the improved public health care and indigenous care that the hospital will offer. They will likely also support these changes because they will be entitled to better care and coverage under the product line management approach. The indigenous community will also bear great impact on the new design. They will be encouraged to seek care for their health concerns because they know they will be better served through the improved indigenous healthcare program. Cultural trends in the community will also affect the implementation of the new strategy and design. These cultural trends are especially relevant in the case of the indigenous community which are likely to observe cultural practices in different aspects of their life. Some indigenous patients may choose to apply their own traditional practices alongside conventional medical treatment. In applying new strategies in the organization, the hospital will be prompted to examine and assess its medical practice and communication with indigenous patients. Technological factors will also influence the implementation of the new organizational structure. “Technological factors affect few industries more dramatically than they do health care” (Berkowitz, p. 18). Innovations in technology will influence the new organization design. In order to adhere to the improved quality of services that the product line management approach calls for, the hospital is also required to keep up and update itself with the latest technological advancements being offered in the medical market. The success of medical procedures set to be offered through the product line management approach will depend largely on the measures undertaken by the hospital to update itself. Technological factors will prompt the hospital administrators to follow “trends in the development of technology for treatment, prevention, and early detection of health problems” (Harris, et.al., p. 274). It is imperative for administrators to note that the success of the new organizational structure will be affected by the presence or absence of technological advances adapted by the hospital management. Economic factors are especially crucial in the new organizational structure. Economic factors include fiscal policy, spending on infrastructure, changes in personal income, and trend in the cost of health care in the community (Harris, et.al., p. 274). Considering that the hospital is already financially constrained, all the more that economic factors will impact on the success of the implementation of the new organizational structure. Economic factors will influence the level of progress and the extent of the implementation of new policies in the hospital. It will also influence how much of the hospital services need to be modified in order to comply with the product line management approach. The success of the new organizational structure will depend on how much the hospital can afford to change while still staying true to its aims in delivering quality health care services. The cost of medical equipment and technology is also rising, and the hospital needs to be able to afford these technologies in order to stay as updated as possible. The product line management approach implies that the quality of medical services must always be maintained. The hospital management must try its best to overcome these financial difficulties in order to successfully implement the new organizational structure. Political factors will also influence the successful implementation of the new organizational structure and design. Political factors refer to the trends in national and state policies, the trends in health policies, the changes in political and legal requirements, and the power of pressure groups (Harris, et.al., p. 274). These factors will affect the type of changes that will be implemented in the organization. Trends in national and state health policies are constantly changing, and the hospital has to align the changes it will implement based on national and state health policy trends. These changes must not violate legal requirements and standards prescribed by the state and the federal government. Pressure groups are also part of the checks and balances in hospital administration. These groups help keep the hospital in line with legitimate and societal demands. Strategies to assess organizational culture There are different strategies that may be applied in order to assess organizational culture. These strategies may be illustrated as follows: gathering stories, identifying problems, and learning the language. “One of the best ways to learn about an organization’s core values and identity is to ask members to relate stories about its founding, legendary figures, and notable successes and failures” (Boyle, et.al., p. 43). By gathering stories, it is possible to establish what the members of the organization value, how they work in harmony or disharmony with each other, and the social dynamic that permeates the organization. Through stories gathered, it is possible to determine the causes of problems that may be seen in the organization. It is also possible to establish good and open communication lines with the members of the organization, to gain their input and suggestions on how to improve the hospital, and to gain insight on how the process of restructuring may impact on the health services offered by the hospital. By identifying problems in the organization, it is possible to highlight issues and to identify how the organization deals with issues. What employees may consider as problems may be different from what administrators define as problems. Even the solutions to these problems may be different depending on the person one is talking to. Employees may have an opinion of how a problem should be addressed; and these solutions may be different from the suggestions that the administrators may come up with. “Observing organizational rituals or following employee evaluation and promotion procedures helps an analyst assess how closely values match practice” (Boyle, et.al., p. 43). By identifying these problems and various solutions, it is possible to understand the organizational culture that is being practiced in the organization. By learning the language of the organization, it is possible to establish a clear understanding of the organization. Each organization has its own ‘language’ and before any changes can be implemented in the organization, this ‘language’ needs to be deciphered. Deciphering the language “helps identify which aspects of an organization’s culture are commonly agreed upon and considered important and which are in dispute and considered less important” (Boyle, et.al., p. 44). Framework to implement change process for restructure The framework that may be adapted in order to implement the change process required for the restructure would particularly focus on the decentralisation of decision-making practices to the product line managers. In this set-up the “manager assumes complete authority and control over the investment, production, and marketing functions within the product line” (Brown, p. 157). In the case of Shangri-La Hospital, product lines or services for the paediatric, obstetrics and gynaecology, indigenous and public health shall be considered primary services in the hospital. These are the product lines which are likely needed by the community because of its young, economically marginalized, and indigenous population. Each product line shall be assigned a trained and highly-specialized manager. Nursing services shall be assigned for each area and all members of the healthcare staff shall be highly trained in their field or department as well as in other related fields of care. The training of the medical staff shall not be focused on their area of assignment, but it shall cover other departments and fields as well. This will help ensure that the patient will have continuity of services as he is referred or transferred from one stage of treatment to another. By using this framework, there is better accountability and responsiveness to the environment as the hospital is now focusing on the needs of the community. The oncology, aged care, psychiatry, and endocrine departments have to be slowly shut down in order to redirect and reallocate funds to the other departments which are needed by the community. These are difficult transitions to undertake, however, the cost cutting measures and the restructuring of the hospital services has to be made after assessing the environmental factors prevalent in the community. The community is composed of mostly young people with minimal income. They need public health services. Shangri-La Hospital is the perfect candidate for product line management restructuring. In order for the hospital to weather through the various financial constraints, it has to be restructured under the product line management approach. This approach will refocus the organization towards the needs of the community, and to eliminate services that are redundant and are not direly needed by the community. By so doing, it is possible to operate within the budget at the same time serve the medical needs of the community. Works Cited Berkowitz, E. 2006. Essentials of health care marketing. Massachusetts: Jones & Bartlett Publishers Boyle, P., et.al., 2001. Organizational ethics in health care: principles, cases, and practical solutions. San Francisco: Published by John Wiley and Sons Brown, M. 1992. Health care management: strategy, structure, and process. Massachusetts: Jones & Bartlett Publishers Eastaugh, S. 1992. Health care finance: economic incentives and productivity enhancement New York: Greenwood Publishing Group Finkler, S. 1999. Cost accounting for health care organizations: concepts and applications. Massachusetts: Jones & Bartlett Publishers Griffin, K. 1995. Handbook of Subacute Health Care. Massachusetts: Jones & Bartlett Publishers Harris, M., et.al., 2005. Managing Health Services: Concepts and Practice. Sydney: Elsevier Australia Johnson, J. (n.d) Product Line Management in Healthcare. Corazon, Inc. 17 May 2009 http://www.corazoninc.com/downloads/articles/productlinemgt.pdf Keefe, S. (n.d) Building a Cardiac Product Line. Advance Web for Nurses. 17 May 2009 http://nursing.advanceweb.com/Editorial/Content/Editorial.aspx?CC=138408 Taylor, S. 1994. The AUPHA manual of health services management. Massachusetts: Jones & Bartlett Publishers Read More