Organization and Leadership AnalysisC200 Task 1Jamie K. Stevenson
Western Governors University
Organization and Leadership AnalysisC200 Task 1The organization I will be analyzing is a for profit hospital. The hospital is a full service 157 bed comprehensive medical facility and is fully accredited by the Joint Commission. The objectives of the hospital are to provide quality healthcare for our patients, make the community healthier, support physicians, and ensure fiscal responsibility. The laboratory department is the section to be analyzed. The laboratory department is made up of thirteen full time, four part time, and four PRN employees. The laboratory offers testing in the areas of chemistry, hematology, coagulation, serology, urinalysis, microbiology, and blood bank. For more complex studies, tests are sent outside the facility to a reference laboratory.
The three leadership practices that the lab director possesses are challenging the processes, motivator and mentor, and creating a vision for the laboratory employees to follow. Being relatively new to the hospital and laboratory, he came into the position with many hurdles to overcome, not only with the departments policies and procedures but also with the staff. He holds a daily huddle every morning to discuss the good and bad things that are happening within the department, updates on equipment and supplies, job duties for the day, and report census for the previous day. This allows opportunities for the staff to voice problems, propose solutions, report errors, and identify what is working well and what is not.
Challenging the processes is another leadership practice used by the lab director. He is constantly getting input from the staff on ways the processes and procedures can be improved to help the laboratory run more efficiently. Since he was introduced as the director, three new analyzers have been introduced to the laboratory enabling the lab to replace outdated testing with new and more accurate testing procedures. The laboratory information system has also been updated in blood banking to prevent errors such as giving a patient a unit of blood that is the wrong blood type in the event of a transfusion. There has been push back from technologists who have been in the field for many years who resist change. With his motivation and mentoring, he is successfully putting the laboratory in the position to grow and expand testing menus.
The ability to sell the vision of the clinical laboratory is a difficult job but the most important. The lab director instills his vision in every daily huddle and the monthly meetings. Each week there is a word of the week that all the staff can focus on. An example of this is the word compassion. He reiterates that the staff should find compassion in their work and how they treat patients they may interact with. His goal is to embrace the model and mission of the hospital and incorporate it into the laboratory.
The laboratory director sets the tone at the top when it comes to embracing and modeling the mission and values of the hospital and laboratory. Memorization of the hospital mission statement is a requirement for employment. The hospital hires and fires employees based on the mission and values. Every meeting within the laboratory is started with a mission moment to begin the day. A value is highlighted and discussed. High and low performers are evaluated the same. The goal is to hire slowly and fire quickly. Hiring slowly provides adequate time to find the person who fits the mission and values of the hospital. It is important to treat all employees fairly but does not mean to treat them equally. Problem solving within the laboratory is complex and collaborative. It often takes going backwards through a couple of shifts to find the root of the problem. Whether it be human or instrument error, the problem must be solved to prevent a patient from receiving unwarranted medications or surgery. An example of this is a hemolyzed blood sample being tested that gives falsely elevated potassium levels.
With the hiring of the new laboratory director, the laboratory has gone from a flat to a more hierarchical structure. Section leaders have been assigned to each section to provide a go to person and leadership in the event of a problem or a question. Performance in the laboratory is based on turnaround times, output, and quality of results. As the old saying says, quality over quantity.
Work and life balance are a growing concern in the laboratory field nationwide. The field is shrinking in size with more baby boomers retiring than students coming out of college. Most laboratories in the nation are understaffed which directly affects work and life balance in the workplace, specifically the high performers. High performers typically work more hours than the low performers leading to burnout. Typically for someone to stay with an organization more than five years, the benefits and the schedule must be good for them. As stated earlier, the current laboratory director is overcoming the obstacles of the previous director. He is slowly transforming the laboratory from a diplomatic style of leadership to a well-respected, trusted, and informational department in the hospital.
Strengths of the Organization
The strengths of the laboratory are availability and offering a variety of tests that other laboratories lack. The laboratory is available 24 hours per day and 7 days per week. This gives an advantage over other laboratories who are open during regular business hours Monday through Friday. The availability for local nursing homes to drop off specimens 24 hours per day can also be a selling point over the rivals. This allows for quick delivery of results for the patient. Offering a wide variety of tests is another strength of the laboratory. If the laboratory offers more complex studies, for example the ROM-Plus test to identify if a pregnant woman is in labor, doctors will be more inclined to use the hospital over another. Strengths are stepping stones for expanding the laboratory and business partnerships when external sources allow.
Weaknesses of the Organization
Weaknesses for the laboratory are cost of tests, cost of labor, and small in-house capabilities for analyzing specimens. When the cost of labor and testing material is driving up the cost of tests, patients may choose to go to a different facility for healthcare needs. This calls for a cost analysis of the laboratory and find where things can be cut to get costs down and avoid losing customers. If only basic and routine tests are performed in house, doctors will direct patients to go to facilities where all tests can be performed in one sitting. Otherwise, testing will be outsourced to a larger reference laboratory and would increase turn around time and can be costly to the patient. These weaknesses can be detrimental to the laboratory if not corrected.
Opportunities for the Organization
Opportunities within the laboratory include cost control, wide range of testing, and streamlining processes. Cutting costs of labor, finding new suppliers for testing material, and cutting wait times in half by streamlining the phlebotomy area may provide the opportunity to serve more patients each day. Adding more complex testing, such as flow cytometry and genetic assays, would entice more specialized physicians to send patients to one hospital over another.
Threats for the Organization
Competition of other laboratories is always a threat in the medical industry. Reference laboratories are establishing pop up labs in small, rural communities that offer next day results. It is necessary for the laboratory director to reach out to clinics and nursing homes to possibly enter into a business agreement to offer same day testing at a lower price for the business. Another threat is a shortage of qualified staffing. Especially in small, rural communities, it is difficult to find qualified staffing who are willing to possibly take a pay cut to work closer to home instead of driving to larger hospitals. This can directly affect the quality and quantity of results that are analyzed each day.
“Transformational leadership is based on the leader inducing positive feelings in their followers, which then motivate loyal and committed performance”. (Leadership in Healthcare) A transformational leader strives to create better morals and to motivate followers to be their very best. The leader also has high expectations for the goals they set and provide recognition when goals are completed.
Strengths of the Leader
The three strengths of the lab director are he has good decision-making capabilities, he is accountable, and he is comfortable with delegation and empowerment. Decision-making is being capable of making the right decision at the right time. No matter if the decision is positive or negative, it affects everyone involved. Once the decision is made, he stands by it and never falters. For example, the decision to cut phlebotomy from the night shift and have technologists do the work had major backlash from all involved. He stuck by that decision and it has worked.
The laboratory director also holds everyone, including himself, accountable for the actions and work they are assigned. He is gives praise when a task is completed successfully and makes them see their mistakes if not. He works together with the staff to fix the problem and see where the task went wrong for them to learn from their mistakes. Hold the staff responsible for their mistakes gives a since of pride and seriousness of their job.
The lab director recognizes that he can’t do everything in the lab and still be successful. He focuses on his important responsibilities while delegating the rest to the staff. If a leader micromanages the staff, he would not be able to focus on his responsibilities and it would create trust issues with his subordinates. When he delegates certain responsibilities to the staff, he provides the framework for the task and lets them perform. Once completed, he evaluates to how they performed and assigns another task. This makes the staff more responsible for the work that is accomplished in the laboratory.
Weaknesses of the Leader
The weaknesses of the lab director are his communication skills, his inability to reprimand low performers, and has trouble taking tasks away from staff who are underperforming. Communication is key when leading a department. When it comes to communicating schedules, messages to all shifts, and tasks, the lab director is lacking. For example, when the schedule is completed for the next month the night before it starts. The staff should be notified of any changes to their regular schedule, so it can prevent the staff from missing a day of work.
Low performers are more common than high performers within the laboratory department. The lab director has difficulty reprimanding low performers because of staff shortages. When errors and misconduct happen with the low performers, there is a blind eye because there aren’t enough team members to cover the remaining shifts. This behavior is tolerated when it shouldn’t be.
When the lab director was hired to lead the laboratory, the previous director stayed in the laboratory and stepped down to a supervisor role. This has caused some tension within the department due to the previous director not wanting to let go of the tasks the was completing before the current director arrived. She is trying to keep control of certain things that she underperforms at, for example ordering supplies. Recently the laboratory has run out of necessary supplies that are pivotal in analyzing specimens. The ordering should be delegated to each section in the department to avoid running out of supplies.
“People in leadership and management positions become more effective when they select a leadership style that is appropriate to the development level of the group they want to influence.” (Ledlow ; Coppola, 2011, p.73) Transitioning from a leadership style that was situational to a transformational leadership style has benefitted the laboratory. The staff felt as though they were treated unfairly, undermined, and their ideas were overlooked. With a charismatic leader who involves the staff in decisions and asks for ideas to better the laboratory, the lab director has changed the culture within the department. The staff now feels they have a voice into the changes in the laboratory and are motivated to perform at higher levels.
The second recommendation is a communication log. Currently, there isn’t a way to relay messages to colleagues that work a different schedule other than email. If a communication log was created, this would allow for pertinent messages, problems, or suggestions to be communicated to all employees.
The third recommendation is to motivate the staff to take more responsibility for the work that is performed. The high performers should have the task of mentoring the low performers to for a more uniform team in the laboratory. The laboratory needs to be standardized meaning, every team member needs to perform every test the same, so the results will not vary from person to person.
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