Turnaround and Transformation
Duke University Children's Hospital was facing a financial crisis in 1996 that required turnaround and transformation in order for the hospital to survive (Spector, 2013). On top of the financial crisis, caused by decreased Medicaid allowances and an increase in capitated reimbursement patients, patient and staff satisfaction had reached an all-time low (Spector, 2013). The hospital's chief medical director, Jon Meliones, understood that the hospital could only do so much to control their financial outcomes and a united front would be needed to bring about effective and impactful change (Spector, 2013).
Kurt Lewin's Field Theory & Process-Driven Change
According to Spector (2013) Lewin's field theory has three steps: 1) unfreezing; 2) Moving and; 3) refreezing. Unfreezing and refreezing serve as bookends to the process. Unfreezing requires members of the group to be unsatisfied with the status quo (Spector, 2013). In the case of Children's Hospital, the financial crisis and employee moral/satisfaction were at all-time lows which created the dissatisfaction with the status quo (Spector, 2013). Once a new status quo and new patterns of behavior have been implemented refreezing can occur (Spector, 2013). However, in order to get to refreezing, moving needs to occur which encourages members of the group to alter their behavior (Spector, 2013).
One way to encourage members of the group to alter their behavior, or move, is through process-driven
In 1997 University of California, San Francisco (UCSF) merged its two public hospitals with Stanford’s two private hospitals. The two separate entities merged together to create a not-for-profit organization titled UCSF Stanford Health Care. The merger between the health systems at UCSF and Stanford seemed like a good idea due to the similar missions, proximity of institutions, increased financial pressure with cutbacks in Medicare reimbursements followed by a dramatic increase in managed care organizations. The first year UCSF Stanford Health Care produced a profit of $22 million, however three years later the health system had lost a total of $176 million (“UCSF-Stanford Merger,” n.d.). The first part of this paper will address reasons
This case study looks at the challenges faced by Matt Hayes, executive director of Riverview Regional Medical Center (RRMC). Previously named as “The Holy Name of Jesus Hospital”, the facility was owned and operated by Catholic nuns. The Hospital Management Associates (HMA) bought the facility in August 1991 and modify the name to Riverview Regional Medical Center. Hospitals that were taken over by HMA upgraded to state-of-the-art facilities that provided high quality medical care. RRMC run numerous private practices throughout the city and shared common medical staff with their chief opponent, Gadsden Regional Medical Center (GRMC). However, the common staff from the Emergency and Radiology department were not shared. Over the past years, RRMC has been facing multiple challenges concerning the different services provided by the facility (Swayne, Duncan, & Ginter, 2013).
This research paper provides an in-depth look into Jackson Memorial Hospital’s financial trouble. The paper is broken down into several chapters to better analyze the issues that have led to Jackson’s financial crisis. The first chapter focuses on the research proposal and introduction. It provides a brief history, outlined a list of essential as well as issues over the years. A research question and hypothesis are also formed to further explain the issues. In addition, a detail of the research significance and purpose is discussed, as well as an insight into the research method. In the second chapter, a literature review discussed the two theoretical concepts of lack of internal control and poor strategic planning and two other organizations
Throughout the years, health care leaders have tackled many challenges in the health care organization. Some of the challenges include knowing the difference between needs and wants, affordability, and sustainability, consequently these challenges can be confronted by evolving and transforming over to modern business models. For health organizations to be successful they must use planning, decision making, and training. Regardless of the changes, health care organizations must conserve excellent services. The purpose of this report is to recapitulate information shared throughout an interview between Dr. Kyle Grazier and Ronald G. Spaeth. The interview gave readers insight on Spaeth’s work, educational background, awards highlighted, and his philosophies or strategies for health care. This report will also enclose the biggest obstacles that Spaeth believes today’s health care administrator is facing in addition to the school of management theory he mostly used and why. In conclusion, I will state my opinions on Spaeth’s approaches and the lessons that individual’s can learn from the interview.
Additionally, the unwillingness of the business office employees to accept onsite help from the hospital financial analyst team. They appear to be content with the status quo, which has resulted in their current financially precarious situation. They do not have the foundation needed, which should be as described by Weiss, Hassell, and Parks (2013) “…fertile enough to accept the seeds of change and to nurture them to grow” (p. 492).
Though they are not entirely comprehensive tools, a great deal can be learned about a hospital or other healthcare organization for-profit or not-for-profit from an examination of their annual financial documents (Finkler & Ward, 2006). The balance sheet and statement of revenue and expense can both yield valuable clues even in the absence of other evidence about changes that might be occurring in the organization, a definition of the type and degree of certain problems that it might be facing, and potential opportunities for improvement in performance that might exist (Finkler & Ward, 2006). Comparing two or more years' worth of financial information yields even more valuable insights, tracking movement in the hospital or other organization's ability to finance its activities and thus continue providing services at the same level, quantity, and scope as current operation.
ABSTRACT The purpose of this article is to summarize several change theories and assumptions about the nature of change. The author shows how successful change can be encouraged and facilitated for long-term success. The article compares the characteristics of Lewin’s Three-Step Change Theory, Lippitt’s Phases of Change Theory, Prochaska and DiClemente’s Change Theory, Social Cognitive Theory, and the Theory of Reasoned Action and Planned Behavior to one another. Leading industry experts will need to continually review and
Lewin’s change theory involved applied behavioral science, action research and planned change each of which is necessary to examine during the implementation of change programs (Burnes & Cooke, 2012). Lewin’s field theory involves a number of concepts that can be used as a guide to help understand the forces that comprise group dynamics within their life space or environment. Lewin’s framework also explains the totality and complexity of people’s behavior within a social setting that can be modified to bring about successful change.
For several decades health care has been tied to the economy and with the current downturn we see continued efforts to control and reduce over-head costs. Health care organizations in their effort to become more efficient and address changes in the industry have altered their strategic business plans. Lee & Alexander (1999) researched organizational change in hospitals and their survival, in this paper I hope to discuss their findings and add other examples to validate their conclusions.
The health care market in Northeast Ohio has garnered an enormous amount of changes within the last few years. These changes have been seen prominently within the health care market for children with serious illnesses. Hospitals that have not been involved in pediatrics are now emerging into this particular field. In order to contest this, Akron Children’s Hospital (ACH) decided to try to figure out how the selection of institutions and physicians amongst parents with seriously ill children work. This is an effort to differentiate itself from other health care providers entering the pediatric care market.
Using Kurt Lewin to “described the mental representations we form of the important elements in our lives and how we organize those cognitive elements within our “life space”” (413). Teddy’s behavior was “determined by complex interactions among a person’s internal psychological structure, the forces of the external environment, and the structural relationships between the person and the environment” (Friedman & Schustack 221). For example, when he arrives home to find his wife s all wet and no children’s around, later their dead bodies in the lake. Which lead him to kill her because at the moment the behavior occurred to him was focused internally on grief of his children being dead and wife who did not care what she did. This led him to create
The delivery of healthcare has evolved and changed over the years and with the advances in science and technology, the ability to provide safe, quality care to all patients has been impacted by the changes. With the rising healthcare costs and decrease in reimbursement for care provided, organizations must look for ways of cost containment to maintain viability for the future. Fabre (2005) noted that administrators are struggling to maintain financial stability and retain competent nurses during these difficult
The results of my survey based on the Kurt Lewin’s theory questions ten different adolescents. I provided seven different questions that will help me determine whether my hypostasis about Lewin’s theory. My hypothesis is that social groups will change though out time because people grow up and move on to different things. There were five female and five male adolescents that participated in my survey that aged from 18-19 years old. The first question asked if there are any first from their childhood still present in their life. Ten out of ten of the adolescent answered yes. This proofs that people will continue to have a good friendship with their childhood friend in their teen years. The second question, asks if the adolescents social circles have changed in the past five years.
While many health care practitioners are willing to change, the issue is that change is often mismanaged by leaders whom are either incompetent or lack the resources to follow through in the implementation of change. An example was documented in a study of a California hospital unit where patient satisfaction scores rose and immediately fell. At the time, the hospital was going through transition. The nurses in the unit saw this as an opportunity to improve patient satisfaction score. They initiated the process by recommending that the new chief executive officer (CEO) change the current procedure to one that could led to the improvement of patients’ satisfaction. The result, in a few months
In this week's discussion we're focusing on how Cincinnati Children's Hospital applied key principles of system thinking, and areas where such concepts could are lacking. In addition, we're going to discuss the value of system thinking to the leadership of Cincinnati Children's Hospital for new levels of quality. The organization shifted it focus toward the improving children's health. Furthermore, the hospital focused on quality improvements and different ways to achieve such goals. Firstly. the hospital started to shift from using historical practices toward proven methods when applicable. Consequently,many of these methods harmed maximization of profitability, but shifted toward providing a better quality of service to patients. Applying