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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ORGANIZATIONAL ANALYSIS 3
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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ORGANIZATIONAL ANALYSIS 4
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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ORGANIZATIONAL ANALYSIS 5
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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ORGANIZATIONAL ANALYSIS 6
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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ORGANIZATIONAL ANALYSIS 7
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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ORGANIZATIONAL ANALYSIS 8
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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ORGANIZATIONAL ANALYSIS 9
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
5 %INTERNET SOURCES
6 %PUBLICATIONS
8 %STUDENT PAPERS
1
2
3
4
5
6
7
8
9
10
EXCLUDE QUOTES OFF
EXCLUDE BIBLIOGRAPHY OFF
EXCLUDE MATCHES OFF
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
2%
2%
2%
1%
1%
1%
1%
1%
< 1%
< 1%
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