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MHACB/506 v1
CASE STUDY:
EAST CHESTNUT REGIONAL HEALTH SYSTEM
MHACB/506 v1
Page 2 of 2
CASE STUDY: EAST CHESTNUT REGIONAL HEALTH
SYSTEMHistory
Within the last 10 years, East Chestnut Regional Health System
(ECRH) was formed from the merger of three
organizations: the East River Medical Center, the Northern
Mountain Hospital Consortium, and the Archway Hospital. East
River Medical Center (ERMC)
ERMC is the anchor hospital for the system. The medical center
resides along the east side of the Chestnut
River. Historically, ERMC was recognized as the location of
choice for medical care. However, this reputation has
deteriorated over the last 3 to 5 years. As the city of Chestnut
has grown, ERMC has found itself on the edge of an urban
blight. Safety has been a concern for patients, visitors, and
physicians who use and serve the medical center. The
technology offered at the medical center has been maintained at
an excellent level of proficiency. At the same time, the medical
staff is aging with the average age of the physicians being
57. There are younger primary care physicians who serve the
specialists, but the specialists are aging as well. ERMC boasts a
Level 1 Trauma Center with an air service. The total number of
licensed beds for ERMC is 550. On any given day, the
occupancy rate is 300 heads on the beds.
Northern Mountain Hospital Consortium (NMHC)
NMHC was originally formed in response to the migration of
patients to Chestnut. Due to the rather aggressive strategies
carried out by the hospitals in Chestnut, these rural hospitals
decided to create a consortium of rural hospitals so that they
could gain economies of scale in a number of areas,
which include group purchasing, benefit
administration, and physician and staff
recruitment. Additionally, they worked together to stem any
further deterioration of their market share. Patients were
selecting to go to the larger community for services and leaving
the smaller communities that collared the Chestnut metropolitan
area. NMHC represented individual hospitals in four counties
that circled Chestnut County: Walnut, Butternut, Oak, and
Maple. Walnut and Butternut Counties had good employment
with Oak and Maple Counties being mostly rural. In each
county, the inpatient facilities averaged about 20 years of
age. The upkeep of these facilities has been sketchy. No facility
needs any major upgrades, but modernization is needed. The
state does not have a Certificate of Need (CON) process. The
medical staff makeup varies each location. The hospitals in Oak
and Maple Counties are critical access hospitals. Further details
will be provided regarding these organizations later in the case
study.
Archway Hospital (AH)
AH is located directly in the community of Chestnut. It fully
resides in the urban area of the community. The hospital has
200 registered beds, but on any given day there are only
50 to 75 patients in this facility. This hospital was a Doctor of
Osteopathy (DO) hospital; therefore, most of the physicians that
worked out of this facility were DOs. The payer mix for this
hospital was heavily burdened with Medicare and
Medicaid. This payer mix composed nearly 85% of the
reimbursement. The facility is aging and needs considerable
repairs. It is questionable if it will be worth the investment in
this facility. Leadership and Organizational Culture
The original merger that created the East Chestnut Regional
Health System (ECRH) occurred 10 years ago. This merger was
between ERMC and AH. AH had a rather dynamic
leader who was about 57 years old at the time of the
merger. The AH CEO became the new President and Chief
Executive Officer of ECRH after the merger. Since this CEO
had only worked in a smaller organization, he had not
experienced the cultural changes and demands that
occur after the merging of a large organization. Additionally, he
began to change the culture of the organization such that
decisions were made on a decentralized basis. He trusted the
management team at AH to do the right things and make the
right decisions with low supervision. However, the Chief
Operating Officer (COO) who was put in charge was originally
from AH but left 2 years after the merger with a new COO
being put in place. This COO developed a rather poor reputation
and was known to want to build his own empire at AH and to be
dishonest at times. This reputation created a culture within the
traditional AH that lacked a cohesive team effort to create a
system. This positioning of the COO was left unattended by the
President and CEO of ECRH since he was actively pursuing the
acquisition of NMHC. The hospitals of NMHC were doing
okay, but those in the consortium realized that their ability to
stand alone was becoming difficult in today’s market. When the
leadership of the consortium assessed the market as to a
partnership, they decided that ECRH would be the best
choice. The other option was to develop a for-profit hospital
that also resided in Chestnut. The leadership was attracted to
what they saw happen with AH. They liked that the central
leadership of the system allowed AH to continue on as their
own entity without a lot of centralized control.
By the time all of this was put together, the President and CEO
of ECRH was near retirement. He retired about three years
after all of the merger activity was complete. During those three
years, he became lax in his leadership role. ECRH deteriorated
in market share and profitability during this time. Upon his
retirement, the Board of ECRH performed a national search for
a replacement. They employed Hunter Brown as the new
President and CEO. Mr. Brown was the CEO of a smaller health
system and had been in that position for nearly 10
years. Therefore, he had limited experience from other markets
in the art of strategic implementation. However, he was also
well trained, bright, and articulate in expressing his
knowledge. He has now been the President/CEO of ECRH for
nine months.
As for the remainder of the leadership team for ECRH, there is
a newly hired corporate counsel. She has 15 years of experience
and is extremely competent in the work that she does.
The CEO also hired a new Chief Financial Officer. He has taken
good strides in managing the accounts receivable throughout the
system as well as extracting exceptional dollars from high
quality supply chain management.
The Chief Operating Officer (COO) is new and has three years
of previous experience from the same organization where the
CEO departed.
The Chief Medical Officer (CMO) has been retained from the
old leadership team. His reputation is excellent, and he works
well with other physicians, including the medical staff and the
employed physicians.
The Chief Nursing Officer (CNO) is three years away from
retirement. She is known for not getting along with the medical
staff and will always defend nursing when at times this is not
appropriate.
The Senior Vice President for Human Resources is competent
and respected by management and staff throughout the
organization.
The remainder of the leadership team was retained from the old
regime. This included information technology, employed
physician group leadership, marketing, human resources, and
other vice presidents or directors responsible for varying
service lines. It should be noted that the IT leadership is just
completing the implementation of the EPIC system. The future
for this team depends on how well the overall implementation of
the system goes. Likewise those in the marketing department
will need to be stellar in senior leadership advisement regarding
the marketing of complex issues that will be encountered
ahead. They have been told if marketing misses the target, then
replacements will occur within this department.
The new CEO inherited the management team of AH and
NMHC. For NMHC the organizational structure was left intact
with the COOs for each of the individual hospitals being
retained. It was agreed that this traditional structure would be
left intact for at least five years. This agreement was near its
end and the new CEO had plans to change the existing structure
as well as management. This change was being considered for
this year’s strategic plan development. Even if the structure of
NMHC was going to be changed to a more direct relationship
with corporate leadership, all of the existing COO’s would be
retained as they have performed well since the merger. As for
the COO of AH, he had been recently terminated. An interim
COO is now in place pending the board approved closure of this
hospital.
Competitive Assessment
ECRH was not the only provider of care in the
community. There was a for-profit hospital, Banford Medical
Center (BMC), that had been purchased by a large publicly
traded for-profit health system about 10 years ago. The for-
profit health system was the largest in the country. The CEO of
this hospital was good at optimizing performance as a result of
the weaknesses of ECRH and its leadership. He was an effective
opportunist.
BMC has 400 registered beds with a current occupancy rate of
85%. They have been effective at taking market share away
from ECRH. For each loss of service line market share by
ECRH, BMC has shown proportional gains. After the
acquisition of BMC, the for-profit immediately moved to build a
new facility. This new facility is located on the
growing wealthy edge of the community. Additionally, at the
time that this new facility was developed, the for-
profit syndicated ownership to the physicians. The highest level
of syndication occurred with the obstetrics and
gynecology physicians in the community. Therefore, women’s
services deteriorated at ECRH. It should be noted that this
physician syndication occurred before the Affordable Care Act
was passed, which precluded hospital ownership by physicians.
It is important that additional information is provided regarding
ECRH. ECRH recently purchased 100 acres of land across the
interstate from BMC. This land is located northwest of
Chester. The intention is to eventually build a new medical
center on this location. The initial planning of this land
has occurred, and it has been approved to build a regional
oncology center on this site. The construction of the project is
already underway with an anticipated completion in 6 months.
In addition, ECRH has an orthopedic hospital attached to the
current ERMC site and a behavioral health hospital at this same
location. ECRH also has two ambulatory surgical centers that
are conveniently located on the growing northwest and
southwest side in the community. The one surgical center is
located on the 100-acre development site. The orthopedic
hospital has done well and has been listed in the top 100
orthopedic hospitals. However, the behavioral health hospital is
losing significant dollars, so the Board of Directors for ECRH
has decided to close down this hospital. ECRH has also
developed a joint venture imaging center with the
radiologists. This center resides across from a major shopping
area in the community. It is conveniently located near heavily
populated neighborhoods and shopping. The only downside is
the location is not close to physician offices that would refer to
this center. However, if a new facility is built on the 100 acres,
which would include physician offices, the imaging center will
be in an ideal location. Leadership is developing a free-
standing emergency center on the 100-acre site, which is on the
northwest side of Chestnut.
The last competitive issue is the location of a medical school
and hospital in the city of Chestnut. The facility resides in a
downtown location. This medical school had been established
by the state nearly 45 years ago and is associated
with Greenbranch University. It mostly serves the indigent
community in Chestnut and the surrounding area. This academic
center has a rather negative reputation in the surrounding
area. There are four other medical academic centers in the state
as well as a medical center with a world-
renowned reputation. There have been ongoing rumors that
this world-renowned organization was planning on assuming the
responsibility of the Chestnut academic
center. This change would substantially alter the complexion of
the local medical community if it were to occur. Speed in ECRH
dealing with some of its market issues is an imperative.
Additional Market Information: Population Demographics
Chestnut County
· With 433,689 people, Chestnut County is the 6th most
populated county in the state.
· The largest Chestnut County racial/ethnic groups
are Caucasian (70.1%), African American (18.5%), and
Hispanic (6.5%).
· In 2015, the median household income of Chestnut County
residents was $41,777. However, 21.1% of Chestnut County
residents live in poverty.
· The median age for Chestnut County residents is 37.7
years old.
· Employment is strong in Chestnut County. Unemployment
resides at 4.5%. Employer diversity is strong since the
community is not dependent on singular large
employers. Employment includes some high-tech jobs, general
manufacturing to support the automobile industry, and there is a
large university, Greenbranch University, located in the
community. The university has 25,000 students and offers most
majors, which includes engineering and nursing.
Walnut County
· With 42,537 people, Walnut County is the 57th most populated
county in the state.
· The largest Walnut County racial/ethnic groups
are Caucasian (89.8%), followed by Hispanic (7.2%) and
African American (3%).
· In 2015, the median household income of Walnut County
residents was $55,120. However, 10.8% of Walnut County
residents live in poverty.
· The median age for Walnut County residents is 39.8
years old.
Butternut County
· With 38,352 people, Butternut County is the 65th most
populated county in the state.
· The largest Butternut County racial/ethnic groups are White
(87.0%), Hispanic (9.5%), and African American (1.7%).
· In 2015, the median household income of Butternut County
residents was $50,663. However, 13.4% of Butternut County
residents live in poverty.
· The median age for Butternut County residents is 39.7
years old.
Oak County
· With 37,120 people, Oak County is the 66th most populated
county in the state.
· The largest Oak County racial/ethnic groups
are Caucasian (93.3%), Hispanic (4.0%), and African
American (1.1%).
· In 2015, the median household income of Oak County
residents was $42,492. However, 14.9% of Oak County
residents live in poverty.
· The median age for Oak County residents is 46.6 years old.
Maple County
· With 27,816 people, Maple County is the 79th most populated
county in the state.
· The largest Maple County racial/ethnic groups
are Caucasian (90.8%), Hispanic (7.1%), and African
American (1.0%).
· In 2015, the median household income of Maple County
residents was $39,353. However, 15.4% of Maple County
residents live in poverty.
· The median age for Maple County residents is 48.2 years old.
· Both Oak and Maple Counties are rural with an older
population. Many patients have Medicare and Medicaid that
come from these two counties. Likewise the hospitals located in
each of these counties have been designated as critical
access. Like many rural counties, Oak and Maple have been
blighted with younger people using drugs, including
methamphetamine.
Employed Physicians
ECRH employs 400 physicians throughout its system. The
breakdown for each location is as follows:
Chestnut County
· 135 primary care
· 100 specialists
Walnut County
· 40 primary care
· 10 specialists
Butternut County
· 30 primary care
· 12 specialists
Oak County
· 27 primary care
· 10 specialists
Maple County
· 25 primary care
· 11 specialists
There have been ongoing complaints from the newly recruited
physicians that their practices have not been marketed
well; thus, their patient volumes have been slow to grow.
Service Line Performance Information
The following is a list of bullet points regarding service line
performance by ECRH and issues of operational concern.
1. Women’s health services deteriorated significantly since the
syndication by Banford Medical Center. Obstetrical deliveries
are down 20% across the system. BMC has done an excellent
job of creating attractive facility and services for women. This
includes nurse navigation, women’s breast center, and a series
of other amenities. BMC has also started a neonatal intensive
care unit, which rivals the services of ECRH.
2. The cardiologists at ECRH are aging. This has been a
traditionally strong service for ECRH, but 50% of the
cardiologists will be retiring within the next 3 to 5 years. All
cardiologists who serve ERCH are employed by the health
system. Cardiology is a service that is gaining strength within
the Greenbranch Medical Center, particularly since they brought
in a renowned cardiologist to rebuild their program.
3. The orthopedic volumes are down 7%. ECRH
does jointly operate an orthopedic hospital with an independent
orthopedic group located in the community. There have been
some internal problems within the orthopedic group where the
old guard of orthopedic surgeons has forced a low retention
with younger, and to some degree better
trained, surgeons. Retention is becoming a growing concern
regarding the status of this group with consideration of ECRH
hiring their own surgeons. The joint venture hospital does not
exclude other surgeons from working in this hospital.
4. Emergency department (ED) volumes are down 5%. The
hospital uses an emergency physician group to supply
physicians to cover all of the EDs within ERCH. These
physicians are known for poor customer service and making
rude comments to patients who are self-pay or Medicaid.
5. The ambulatory visits and services are up 3%. This volume
increase is from the younger primary care physicians who have
been employed by ECRH. This young group of physicians has
become great support for ECRH and refer patients loyally to the
organization.
6. General surgery cases are down 4%. The aging surgeons
are starting to retire, and it is difficult to recruit new surgeons
to replace past demand. Some of this work is going
to Greenbranch since they have good general surgeons.
7. The oncology services for ECRH have increased in volume
and revenue by 4%. ECRH’s development of the new oncology
center has created a magnet for referrals to the oncologists. The
oncologists are very enthusiastic about the development of this
new center and have begun to shift work to ECRH.
8. ECRH has the regional burn center. ECRH works
with Greenbranch Medical Center for training residence in the
burn setting. This includes the plastic and general surgeons. The
downside of this service is that it is losing money. A decision
has been made to close down this service
with Greenbranch starting their burn center.
9. ECRH is a Level 1 Trauma Center, and this designation has
been a historical positive for the system. The helicopter service
is well recognized by the community as well as first responder
professionals found in the region. They historically have
been top of mind for major trauma cases. The usage of this
service is down 5% since the for-profit has established a similar
service. BMC however only has a Level 2 Trauma Center. They
have worked diligently to acquire ambulance services in some
of the outlying communities. This has helped feed patients to
BMC.
10. The ECRH Board of Directors decided to close down the
behavioral health hospital. It is uncertain where patients will be
able to receive inpatient care. An active out-patient service will
still be provided by ECRH.
Payer Mix
The payer mix for ECRH has deteriorated. The current inpatient
payer mix for the entire system is as follows:
· 55% Medicare
· 15% Medicaid
· 30% Commercial
There has been a long-standing joint venture relationship with a
national insurance company for commercial
insurance. Administratively this venture has not developed as
anticipated; however, in some of the regional markets, the
Chestnut Care insurance has a strong presence. Of the 30%
commercial pay, 20% is Chestnut Care based. The national
insurance company in the venture is Aetna. The next strongest
product is Anthem. It is the expectation of the CEO that
Chestnut Care be leveraged and positioned for growth.
The 15% Medicaid has helped the hospital gain additional
disproportionate share dollars, which does help the bottom line
of the hospital.
Historical Strategic Initiatives
Accountable Care Organization
When the Affordable Care Act was passed in 2010, ECRH
decided to get into the one-sided model of an accountable care
organization (ACO). This venture has not gone well, and ECRH
has decided to leave the ACO business. However, they are
concerned about the public image of this decision. The details
of the termination are under discussion with a need to determine
how to minimize the public perception of termination,
particularly since there was so much marketing of their getting
in this venture. The regulatory requirements of the government
regarding the timing of terminating an ACO venture further
complicate this decision.
Primary Care Medical Home
The employed primary care group has been active in
establishing accredited primary care medical homes within all
of the primary care offices throughout the ECRH system.
This initiative is a positive emerging strategy for ECRH. It has
also been an attractive draw for the family practitioners
from Greenbranch Medical Center residency program
since Greenbranch has established an accredited medical home
for their family practice residency program.
American Nursing Credential Center Status (ANCC)
ECRH has been working on becoming a magnet status for
ERMC. This work has stalled out as an initiative. Some of this
is due to the nursing leadership within ERMC. The CEO intends
to move this priority up in the organization’s goals.
Information Technology
ECRH has invested heavily in their information technology
infrastructure. This investment became a requirement just to be
able to gather the data needed for the ACO development. This
cost has become significantly greater than anticipated. ECRH
fully implemented EPIC as their core information technology
system. There have been implementation problems since the
ECRH was operating off of multiple systems before the decision
to consolidate to one platform. The implementation of EPIC
required considerable retraining for the
staff and physicians. Data conversions have gone well. The
difficulties have been more human-related relative to the
effective use of the system. One of the major issues has been
the lack of ECRH not meeting meaningful use requirements
which has cost ECRH significant lost revenue from not meeting
these goals.
Legal Actions Pending for ECRH
Federal Trade Commission Investigation
With the merger and acquisition of NMHC, questions of
antitrust have been raised. In the service lines of cardiology and
oncology it has been found that ECRH controls 60% of the
cardiology market and 52% of the oncology market. Chestnut
Care in some markets has been strong in steering patient
volumes to ERMC. Union leaders for the varying trades were
instrumental in precipitating this investigation. At the time that
this issue was raised, the President and Executive Branch of the
federal government were very pro-labor, thus, their interest in
pursuing this matter.
As to the projected disposition of this case, it is anticipated that
a negative determination will be made due to the market share
control in oncology and cardiology. This could force ECRH to
divest their ownership in the Chestnut Care insurance
venture. Another option might be that certain hospitals of
NMHC be divested. It is not anticipated that both
determinations would occur. This case has cost ECRH
considerable money to stave off investigation of this allegation.
Predatory Collections and the Loss of Not-for-profit Tax Status
for NMHC
NMHC negotiated that they would continue to act
independently. The consortium leadership set policies that
included predatory collections for the patients that would be
served in the NMHC hospitals. In a recent evening news
report, an investigative reporter interviewed an elderly patient
that had her home taken from her to pay for her medical
bills. This home had been in her family for over 100 years. This
story prompted the state’s Attorney General’s Office to
investigate the predatory collection policies of
ECRH and NMHC.
The state has already taken an aggressive stance to investigate
the status of not-for-profits not fulfilling
requirements (e.g., charity care, research, and education). The
state is in economic trouble and is seeking revenue from
wherever they can find it. The outlook is dim regarding the
anticipated final decision of the Attorney General’s Office. If
NMHC is required to pay taxes, this would wipe out the bottom
line for these hospitals and many of the needed services
supplied to the indigent population by ECRH would be reduced
or eliminated.
Faith & Main Consultants Report
Within the last year, ECRH contracted with Faith & Main to
study the market perception of their women’s services. The
following is a summation of the findings of Faith & Main.
Interest in a Women’s Center Crosses County Lines
· 36% of women in the service area would travel across county
lines to receive excellent women’s health services
· 72% of women in Chestnut County would consider using the
women’s services of East Chestnut Regional Medical Center
· Women in all counties were most interested in these services:
· Breast care
· General gynecology services
· Female doctors
· Services in one area
· Physicals for women
Interest in a Heart Care and a Health Information Line
· A physician approved source of information
· A nurse help line that could be a resource for women’s care in
heart health as well be a source for health navigation.
Clear Expectations Regarding Getting Appointments
with Their Primary Care Physician
· Women expect same-day appointments
· In the collar counties to Chestnut County, women ranked
this in the top 28.7%
· Chestnut County women ranked this in the top 37.7%
· Expectation of same-day appointments ranked highest
for women of childbearing age
· Percent expecting same-day appointments
· 42.9 % of Chestnut County women of childbearing age
· 31.3% of collar county women of childbearing age
· Willingness to be Seen by
a Nurse Practitioner Overwhelmingly “Yes”
· 75.7% of Chestnut County women of childbearing age
· 76.1% of collar county women of childbearing age
Respondents Expressed How Health Care Could Be Improved
· 24% of all Chestnut County women, and 26% of all collar
county women named adding more primary care
doctors and more children’s care with urgent care outranking
any other single topic.
Respondents of Childbearing Age Widely Represented in Study:
· 86% of women respondents of childbearing age in Chestnut
County had children under the age of 18
· 76% of women respondents of childbearing age in the collar
counties had children under the age of 18
Willingness to be seen by nurse practitioner was viewed as
favorable by those in this study.
This data from Faith & Main will be used to ramp up
improvements in the women’s services for ECRH.
Strategic Plan Goals for the Upcoming Year
· Women’s service line improvement
· Increase obstetrical deliveries by 20% over 3 years
· Establish nurse navigation system for the entire system
· Facility improvement and development for women’s services
· Improve access standards for women’s care
· Assist in the marketing of the implementation of the
consultant’s report regarding women’s services
· Oncology Center grand opening
· Mature the retail strategy with the primary care employed
physician group
· Assess the market impact of the lawsuits and develop
marketing strategy to counteract the negative impact if
decisions are made against ECRH
· Aggressively recruit new physicians to reduce the average age
of the medical staff and strategically enhance service line
development
· Use lean management processes to correct service issues found
in the ED. Improve ED visits by 6%.
· Review physician contracts to enhance physician service
performance
· Investigate the fast track ED concept
· Implement the free standing ED strategy
· Abandon the Accountable Care Organization (ACO)
· Re-establish relationships with regional emergency medical
services to raise the utilization of the medical air
service. Growth goal is to get back to the previous level of
utilization within 18 months
· Decision to close the regional burn unit and let those cases go
to the academic medical center
· Implement the decision to close the behavioral health services
of ECRH
· Implement the decision to close AH
CEO Instruction to Marketing Team
The marketing department for East Chestnut Regional Health
System will be asked to step up their game to develop a
marketing plan for the regional health system. The CEO has had
some concerns regarding the ability of the marketing department
to keep up with the rapidly moving strategic environment that
he has created. So he established a time line for the department
to develop a system wide marketing plan over the next six
weeks. The VP of marketing has been in all of the senior
leadership cabinet meetings so she is aware of all of the
details. Therefore, the learning curve regarding the institutional
strategic goals is of no concern.
The following are elements that the CEO wants in the marketing
plan.
1. A consultant, Faith & Main, was used to test the impression
of the women in the key service markets for East Chestnut
Health System. The summary of the consultant’s report can be
seen above. The survey covered all aspects of women’s
care. The marketing department will need to develop a
marketing campaign to match the recommendations of the
consultant’s report.
a. It is recognized that the age span for communicating with
women consumers will be quite variable. On one end of
the spectrum you have the younger childbearing age women,
next are the women that are middle aged followed by women
that are pre-elderly then those that are elderly. Therefore, a
communication plan using social media to conventional
marketing techniques will be required.
2. A communication plan will need to be developed for the
closure of the regional burn center as well the exiting the
accountable care organization and the closure of the behavioral
health hospital.
3. A communication plan will be needed to deal with the closure
of AH.
4. A branding strategy will need to be developed to overcome
the current weak brand identity that is in place for the combined
ECRH entities.
5. Develop marketing strategy for new physicians being
recruited to the system. The ideal situation would be to have a
common identity for all marketing material. In the past the
marketing material has been local hospital based.
6. Develop marketing plan for the Primary Care Medical Home
strategy as well the retail strategy for the primary care
network.
7. Proactively lay out a framework of communication to manage
any negative outcomes of the legal matters that the health
system is now confronting.
a. The Federal Trade Commission investigation of the anti -trust
issues for ECRH.
b. The predatory collections occurred as part of NMHC. It is
felt that this case will force these rural hospitals to move to a
taxable entity with the loss of their not-for-profit status. The
development of this problem came as a result of poor leadership
within the consortium.
8. Develop advertising campaign for the opening of the new
oncology center.
9. Develop advertising campaign for the ED/Trauma services of
ECRH.
Copyright 2020 by University of Phoenix. All rights reserved.
Copyright 2020 by University of Phoenix. All rights reserved.
Running head: LEADERSHIP 1
LEADERSHIP 6
Leadership Styles Rationale
Shawn Cyr
LDR 535
8 February 2021
Dr. Gwen
The needed change is that Samsung needs to respond to the
various ecosystems which are there. It is important to make sure
that the software tools of the company are able to respond to the
needs in every market. It is critical to make sure that the
technicians have the awareness of the markets in addition to
understanding the systems which are there. All of the
knowledge needs to be customized to the culture of the
consumer and their needs.
There are several leadership styles which can be used when it
comes to the proposed change and the organizational culture.
The first style is the behavioral theory. The theory has a focus
on the behavior of the leaders. There is the assumption in this
theory that the behavior that one has can be copied by the other
leaders in the organization. The leaders are not born but they
are created through the learnable behavior. The behavioral
theory has a belief that the success of a type of leadership is
based on the actions of the leader. It is important to note that
the action is emphasized more compared to the qualities which
are there. There are several leadership types which are under
this style such as dictatorial, country club, as well as people-
oriented leaders (Burke, 2017). In the Samsung case, it’s
important to look at whether the actions can translate
throughout the organization.
The contingency theory has also been selected and it is also
referred to as the situational theory which focuses on the
context of the leadership. This theory insists that the situation
and context is more important compared to the personality of
the leader. The theory suggest that the good leaders can
adjusted to the situation based on their leadership styles. The
situation of the leader will determine the best kind of leader
(Hussain et al., 2018). It is important to note that that this style
in the context of Samsung can be used to determine the kind of
leader to make the company more dynamic.
The next theory is the participative theory. In this theory,
participative leadership is the democratic leadership. This is
where the employees are given the Chace to directly affect the
decision making. The leader in this work needs to work in the
facilitation of conversation and listen to the suggestions so as to
come up with the best action (Offermann and Coats, 2018).
Every member of the team is involved and the leader comes to
the decision after listening to all of the suggestions.
The best leadership style to use in the case of change at
Samsung is the behavioral theory. This is the best theory to use
to effect change at Samsung so as to have technological
solutions which take into account the various ecosystems. The
first advantage of using this theory is that the leaders can learn
and make decisions on the actions which are needed in the
implementation of the change. Decisions can be easily made and
guide the rest of the company towards being more culturally
responsive. The theory is also important as the leader is more
flexible and can make the decisions easily (Offermann and
Coats, 2018). When there are any changes, the leader can
always change back to fit the circumstances. It is important to
note that everyone can become a leader and this is the best
guide. The leader can inspire others and lead others to becoming
better leaders.
The behavioral theory of leadership is important will support
the sustainable success of the organization in various ways. The
best way one can see this is that the theory of leadership is
flexible. It is important to note that the tech industry requires a
company which is constantly adapting to changes and this is
what Samsung is called to do. It is important to note that the
behavioral theory assists the leader to guide the rest of the
company in the culture change. The change of culture is
important in ensuring that there is sustainability (Hussain et al.,
2018). Every change that is made towards a better culture
ensures that more customers are retained.
The behavioral leadership style integrates the mission and
vision of the organization. The vision of the company is that it
looks forward to attaining the development of technology and
software programs which help the people to interact and engage
with all of them productively. It is important to note that the
company seeks to have these software’s that will help people to
engage in an effective manner. The best thing is to make sure
that there is cultural responsiveness among the software. The
behavioral theory is flexible in the long run and helps people to
be more productive (Burke, 2017). It is critical to make sure
that the organization grows moving forward with these
software’s and the best thing is for the staff to understand the
various cultures. The technologies need to respond to various
ecosystems. It is important to make sure that there are these
changes for achievement of this vision. The people can interact
with these programs when they are built considering the culture
and ecosystem of the individual. The behavioral theory will see
these changes which are required so that the whole culture goes
into every team in the organization. The actions will go forward
leading change throughout the company.
The mission of Samsung is to devote the human resource and
technology to create superior products and services, thereby
contributing to a better global society. The world today has
changed and this is why Samsung wants to contribute to a better
society. The superior product will come in place when the
behavioral theory is implemented (Offermann and Coats, 2018).
The actions which are taken by the leadership will contribute to
changing to products and services which respond to the needs of
the people. It is important to note that the global society has
changed and this is why one must devote technology and
resources towards changing. The flexibility is also important
when changing to making the world better through these
products.
The behavioral leadership style will increase the value the
various stakeholders in the company. One of the stakeholders
that will benefit are the shareholders. The shareholders benefit
when the company is more responsive in the products and
services which it provides. The changes that are implemented
will lead to growth in the customer base and profits (Hussain et
al., 2018). The customers will also benefit in having the
products and services which are customized to their situations.
These will be products which they know and understand. It is
also important to note that the staff of the company will benefit
from a more open work environment. The leadership will
provide a guide on the actions which can make their jobs easier.
References
Burke, W. W. (2017). Organization change: Theory and
practice. Sage publications.
Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H.,
& Ali, M. (2018). Kurt Lewin's change model: A critical review
of the role of leadership and employee involvement in
organizational change. Journal of Innovation &
Knowledge, 3(3), 123-127.
Offermann, L. R., & Coats, M. R. (2018). Implicit theories of
leadership: Stability and change over two decades. The
Leadership Quarterly, 29(4), 513-522.
Running head: LEADERSHIP THEORIES 2
LEADERSHIP THEORIES 2
Leadership Theories
Shawn Cyr
LDR 535
2 February 2021
Dr. Gwen
Leadership Theory
Definition
Advantages
Disadvantages
Behavioral Theory
The behavioral theory has a focus on how the leaders will
behave. There is the assumption in this theory that the behavior
can be copied by other leaders. The theory can sometimes be
referred to as the style theory and it suggests that the leaders
are not born successful but it is created through learnable
behavior. The behavioral theories focus on the actions which
the leader is going to take. The best predicator of the success of
a form of leadership is on the actions of the leader. The action
is emphasized as opposed to the qualities. There are various
styles of leadership under this such as status-quo leaders,
dictatorial leaders, country club leaders, and people-oriented
leaders.
There are several advantages of this theory.
· The primary one is that leaders can learn and make decisions
on what actions they need to implement to become the type of
leader which they are desiring to be.
· The theory is also good as it allows the leader to be flexible.
· A leader can also adapt to any circumstances that can come
their way.
· The theory also suggests that anyone has the potential of
becoming a leader.
There are some disadvantages of this theory.
· The theory does not directly suggest how someone needs to
behave in some circumstances.
· The theory is too broad and does not provide the right
suggestions for any situation which may arise.
Contingency Theory
This theory is sometimes referred to as the situational theor y
and its focus is on the context of a leader. It looks at the failure
or success of a leader. It insists that while the personality of a
leader is a small factor, the most important is the situation and
context of a leader. The theory suggests that the good leaders
can situationally adjust their leadership styles. It makes the
suggestion that it may be best to select the right kind of a leader
in every situation.
There are several advantages of this theory.
· The advantage is that leaders are able to ensure effectiveness
despite the context of the situation.
· The theory has criticism because there is not enough detail
which will go into the context of whichever situation is there.
· It focuses on the importance of a situation but there is not
enough focus on the psychology of the employees or the
organization.
· The theory does not appreciate the change of the leadership
styles over time periods.
Participative Theory
The participative leadership is not common when it comes to the
corporate world. It is also referred to as democratic leadership.
The theory suggests that employees should be directly involved
in decision making. The leader needs to work towards
facilitating a conversation and then takes the suggestions and
generates the best possible action. Each member of the team is
involved when it comes to decisions and what the leader offers
is direction.
There are several advantages:
· The employees feel motivated and engaged as they contribute
to the outcomes.
· The employees take more ownership of the vision of the
organization.
· There is a lot of criticism of this theory that it makes the
leadership of an organization appear weak.
· At the same time, this theory can make one appear
unnecessary in the context of decision making.
· The theory does not also get the best outcomes as they
concentrate more on what the people want and not what the
organization requires.
Improving Organizational Culture
Shawn Cyr
LDR 535
26 January 2021
Dr. Gwen
Current Culture
The current culture when it comes to Samsung is that it doesn’t
respond to different ecosystems.
The company has software tools but they do not seem to
respond to all markets.
The technicians have only mainstream knowledge of the systems
and are unable to customize the knowledge to individual
customers.
Samsung has a current culture whose systems and tools do not
respond to various ecosystems.
There is little knowledge of the various tools among the
consumers.
It is important to make sure that these tools respond to each
persons needs.
Technicians need the knowledge to move forward and respond
to the needs of each consumer.
2
Change Management Plan
Create Urgency
The technicians at Samsung need to know how the various
software systems work with every product.
It is important to know how each tool will attract various
customers.
The first part of the plan is to create urgency
The technicians need to understand how these products can
attract various demographics.
It is important to know the right product which will be
attractive to the various consumers.
3
Form a Powerful Coalition.
The upper management needs to support the technicians.
All issues need to be understood and everyone should be on
board.
Create a Vision for Change
The goal is to make sure everyone attends and this ultimately
leads to happy and satisfied customers.
It is important to make sure that there is support for all
technicians from the upper management.
The management also must make sure that everyone is on
board(Wiki, 2019).
The goal is to make sure that service delivery improves together
with the happiness of the customers.
4
Communicate the Vision
The communication should be done through emails and signs
around the office.
Feedback can be brought individually for expression of
opinions.
Remove obstacles.
Every training session should be communicated well in advance.
It is important for the vision of the company to be
communicated towards everyone(Burke, 2017).
Emails and signs around the office will improve the outcomes of
the program.
It is important for these training sessions to be communicated
effectively.
All of the modules need to be communicated effectively.
5
Create Short-Term Wins
The company should have small wins along the way for
motivation. There should be rewards for completing each
module successfully.
Build on the Change
There should be continuous building on the changes which are
made.
Every new technician needs to complete these changes.
It is important to cultivate the small wins through rewarding
successful completion of the modules.
It is important to make sure that there is continuous training for
all of the technicians(Burke, 2017).
6
Anchor Changes in Corporate Culture
It is important for these changes to continue and become part of
the culture.
Every technician from that point onwards should be trained
properly.
It is important to have the instructional materials as part of the
standard orientation program.
The changes should at the core of company culture.
The culture is enhanced through these changes and everyone
should be subsequently trained on the same (Wiki, 2019).
7
Desired Outcome
The desired goal is for the company to focus on new quality
software.
Each of the tools need to respond to every ecosystem.
There should be innovation in the products.
The innovation will ensure a better future and achievement of
long-term goals.
There should be focus on having quality software for long-term
sustainability.
The tools should be able to focus on the various ecosystems.
It is important to drive innovation for satisfaction of every
customer.
8
Alignment
The change in culture will enhance the mission of the company
to create superior products and services.
The changes will bring forth a better global society.
The change is also aligned towards the vision of attaining
software tools that people can interact with an engage
productively.
The changes will enhance the values of the company towards
excellence, change, integrity, people, and co-prosperity.
These values will be enhanced when technicians are able to
respond better.
Any negative energy will be repelled through the enhancement
of these values.
The changes of the company will lead towards better values for
the company.
These values such as integrity and people will be enhanced
through the changes enhanced.
The values support the changes that are there and help in
building a better culture (Burke, 2017).
11
The change leads to creation of a better strategy.
The strategy of the company is that it is willing to devote talent
and technology to it.
There will be a common source of success when all of the
efforts are towards the goals of the organization.
The strategy of the company is to devote technology and talent
towards the goals.
These changes will be build towards the strategy.
The success will be built effectively when the strategy is
followed.
12
References
Burke, W. W. (2017). Organization change: Theory and
practice. Sage publications.
Wiki, C. I. O. (2019). Kotters 8 step change model.[Online]
Available at: https://cio-wiki.org/wiki. Kotter% 27s_8-
Step_Change_Model [Använd 31 mars 2020].
Running head: APPLY: KOTTER’S 8-STEP CHANGE MODEL
CHART
APPLY: KOTTER’S 8-STEP CHANGE MODEL CHART
Apply: Kotter’s 8-Step Change Model Chart
Shawn Cyr
LDR 535
January 19, 2021
Dr. Gwen
Step one: Create Urgency
Due to the COVID-19 pandemic, Samsung’s technicians need to
understand how different software systems go with each product
while working on other demographic sites. The business might
not competitively position itself in the market if these
technicians do not understand how different software systems
function with the right product that attracts customers in every
job site.
Step two: Form a Powerful Coalition.
These technicians require quality support from the upper
management, which can be designing an education and training
program for every member. Once the underground issues are
well understood, every technician will get on board with this
training program.
Step three: Create a Vision for Change
This training program projects a visionary goal that if everyone
attends the scheduled classes, there will be improved service
delivery, and customers will remain happy and satisfied. As a
result, every technician will have the knowledge, skills, and
necessary resources at hand to market the products.
Step four: Communicate the Vision.
Communication to every technician will be via emails, and some
signs posted within the office. Besides, feedback will be
conveyed individually to give room for technicians to express
their opinions about the coming changes.
Step five: Remove Obstacles.
The training's commencement will be communicated to every
technician in advance, reminding them about the exact time and
date. During the training session, each technician will complete
some modules to recap what is being taught.
Step six: Create Short-Term Wins
Accordingly, once the technicians have completed the training,
the company is guaranteed to report positive feedback about
each job site's customer service. Also, technicians wil l feel
motivated because they have all the available tools and
resources required to handle the job competitively.
Step seven: Build on the Change.
The company will record a high turn-up rate from technicians
from remote areas that now, after the training, they have the
right tools to complete the job without asking for assistance.
The software will be handled by technicians who complete and
pass all the modules.
Step Eight: Anchor the Changes in Corporate Culture
As the organization expands, all the new technicians should
finish this training before going to places of work all alone.
Having this as a standard instructional course will promise that
everybody stays on the same wavelength regarding the work
that should have been finished.
References
Burke, W. W. (2017). Organization change: Theory and
practice. Sage publications.
Wiki, C. I. O. (2019). Kotters 8 step change model.[Online]
Available at: https://cio-wiki. org/wiki. Kotter% 27s_8-
Step_Change_Model [Använd 31 mars 2020].

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MHACB506 v1CASE STUDY EAST CHESTNUT REGIONAL HEALTH SYSTEM

  • 1. MHACB/506 v1 CASE STUDY: EAST CHESTNUT REGIONAL HEALTH SYSTEM MHACB/506 v1 Page 2 of 2 CASE STUDY: EAST CHESTNUT REGIONAL HEALTH SYSTEMHistory Within the last 10 years, East Chestnut Regional Health System (ECRH) was formed from the merger of three organizations: the East River Medical Center, the Northern Mountain Hospital Consortium, and the Archway Hospital. East River Medical Center (ERMC) ERMC is the anchor hospital for the system. The medical center resides along the east side of the Chestnut River. Historically, ERMC was recognized as the location of choice for medical care. However, this reputation has deteriorated over the last 3 to 5 years. As the city of Chestnut has grown, ERMC has found itself on the edge of an urban blight. Safety has been a concern for patients, visitors, and physicians who use and serve the medical center. The technology offered at the medical center has been maintained at an excellent level of proficiency. At the same time, the medical staff is aging with the average age of the physicians being 57. There are younger primary care physicians who serve the specialists, but the specialists are aging as well. ERMC boasts a Level 1 Trauma Center with an air service. The total number of licensed beds for ERMC is 550. On any given day, the occupancy rate is 300 heads on the beds. Northern Mountain Hospital Consortium (NMHC) NMHC was originally formed in response to the migration of patients to Chestnut. Due to the rather aggressive strategies carried out by the hospitals in Chestnut, these rural hospitals decided to create a consortium of rural hospitals so that they
  • 2. could gain economies of scale in a number of areas, which include group purchasing, benefit administration, and physician and staff recruitment. Additionally, they worked together to stem any further deterioration of their market share. Patients were selecting to go to the larger community for services and leaving the smaller communities that collared the Chestnut metropolitan area. NMHC represented individual hospitals in four counties that circled Chestnut County: Walnut, Butternut, Oak, and Maple. Walnut and Butternut Counties had good employment with Oak and Maple Counties being mostly rural. In each county, the inpatient facilities averaged about 20 years of age. The upkeep of these facilities has been sketchy. No facility needs any major upgrades, but modernization is needed. The state does not have a Certificate of Need (CON) process. The medical staff makeup varies each location. The hospitals in Oak and Maple Counties are critical access hospitals. Further details will be provided regarding these organizations later in the case study. Archway Hospital (AH) AH is located directly in the community of Chestnut. It fully resides in the urban area of the community. The hospital has 200 registered beds, but on any given day there are only 50 to 75 patients in this facility. This hospital was a Doctor of Osteopathy (DO) hospital; therefore, most of the physicians that worked out of this facility were DOs. The payer mix for this hospital was heavily burdened with Medicare and Medicaid. This payer mix composed nearly 85% of the reimbursement. The facility is aging and needs considerable repairs. It is questionable if it will be worth the investment in this facility. Leadership and Organizational Culture The original merger that created the East Chestnut Regional Health System (ECRH) occurred 10 years ago. This merger was between ERMC and AH. AH had a rather dynamic leader who was about 57 years old at the time of the merger. The AH CEO became the new President and Chief
  • 3. Executive Officer of ECRH after the merger. Since this CEO had only worked in a smaller organization, he had not experienced the cultural changes and demands that occur after the merging of a large organization. Additionally, he began to change the culture of the organization such that decisions were made on a decentralized basis. He trusted the management team at AH to do the right things and make the right decisions with low supervision. However, the Chief Operating Officer (COO) who was put in charge was originally from AH but left 2 years after the merger with a new COO being put in place. This COO developed a rather poor reputation and was known to want to build his own empire at AH and to be dishonest at times. This reputation created a culture within the traditional AH that lacked a cohesive team effort to create a system. This positioning of the COO was left unattended by the President and CEO of ECRH since he was actively pursuing the acquisition of NMHC. The hospitals of NMHC were doing okay, but those in the consortium realized that their ability to stand alone was becoming difficult in today’s market. When the leadership of the consortium assessed the market as to a partnership, they decided that ECRH would be the best choice. The other option was to develop a for-profit hospital that also resided in Chestnut. The leadership was attracted to what they saw happen with AH. They liked that the central leadership of the system allowed AH to continue on as their own entity without a lot of centralized control. By the time all of this was put together, the President and CEO of ECRH was near retirement. He retired about three years after all of the merger activity was complete. During those three years, he became lax in his leadership role. ECRH deteriorated in market share and profitability during this time. Upon his retirement, the Board of ECRH performed a national search for a replacement. They employed Hunter Brown as the new President and CEO. Mr. Brown was the CEO of a smaller health system and had been in that position for nearly 10 years. Therefore, he had limited experience from other markets
  • 4. in the art of strategic implementation. However, he was also well trained, bright, and articulate in expressing his knowledge. He has now been the President/CEO of ECRH for nine months. As for the remainder of the leadership team for ECRH, there is a newly hired corporate counsel. She has 15 years of experience and is extremely competent in the work that she does. The CEO also hired a new Chief Financial Officer. He has taken good strides in managing the accounts receivable throughout the system as well as extracting exceptional dollars from high quality supply chain management. The Chief Operating Officer (COO) is new and has three years of previous experience from the same organization where the CEO departed. The Chief Medical Officer (CMO) has been retained from the old leadership team. His reputation is excellent, and he works well with other physicians, including the medical staff and the employed physicians. The Chief Nursing Officer (CNO) is three years away from retirement. She is known for not getting along with the medical staff and will always defend nursing when at times this is not appropriate. The Senior Vice President for Human Resources is competent and respected by management and staff throughout the organization. The remainder of the leadership team was retained from the old regime. This included information technology, employed physician group leadership, marketing, human resources, and other vice presidents or directors responsible for varying service lines. It should be noted that the IT leadership is just completing the implementation of the EPIC system. The future for this team depends on how well the overall implementation of the system goes. Likewise those in the marketing department will need to be stellar in senior leadership advisement regarding the marketing of complex issues that will be encountered ahead. They have been told if marketing misses the target, then
  • 5. replacements will occur within this department. The new CEO inherited the management team of AH and NMHC. For NMHC the organizational structure was left intact with the COOs for each of the individual hospitals being retained. It was agreed that this traditional structure would be left intact for at least five years. This agreement was near its end and the new CEO had plans to change the existing structure as well as management. This change was being considered for this year’s strategic plan development. Even if the structure of NMHC was going to be changed to a more direct relationship with corporate leadership, all of the existing COO’s would be retained as they have performed well since the merger. As for the COO of AH, he had been recently terminated. An interim COO is now in place pending the board approved closure of this hospital. Competitive Assessment ECRH was not the only provider of care in the community. There was a for-profit hospital, Banford Medical Center (BMC), that had been purchased by a large publicly traded for-profit health system about 10 years ago. The for- profit health system was the largest in the country. The CEO of this hospital was good at optimizing performance as a result of the weaknesses of ECRH and its leadership. He was an effective opportunist. BMC has 400 registered beds with a current occupancy rate of 85%. They have been effective at taking market share away from ECRH. For each loss of service line market share by ECRH, BMC has shown proportional gains. After the acquisition of BMC, the for-profit immediately moved to build a new facility. This new facility is located on the growing wealthy edge of the community. Additionally, at the time that this new facility was developed, the for- profit syndicated ownership to the physicians. The highest level of syndication occurred with the obstetrics and gynecology physicians in the community. Therefore, women’s services deteriorated at ECRH. It should be noted that this
  • 6. physician syndication occurred before the Affordable Care Act was passed, which precluded hospital ownership by physicians. It is important that additional information is provided regarding ECRH. ECRH recently purchased 100 acres of land across the interstate from BMC. This land is located northwest of Chester. The intention is to eventually build a new medical center on this location. The initial planning of this land has occurred, and it has been approved to build a regional oncology center on this site. The construction of the project is already underway with an anticipated completion in 6 months. In addition, ECRH has an orthopedic hospital attached to the current ERMC site and a behavioral health hospital at this same location. ECRH also has two ambulatory surgical centers that are conveniently located on the growing northwest and southwest side in the community. The one surgical center is located on the 100-acre development site. The orthopedic hospital has done well and has been listed in the top 100 orthopedic hospitals. However, the behavioral health hospital is losing significant dollars, so the Board of Directors for ECRH has decided to close down this hospital. ECRH has also developed a joint venture imaging center with the radiologists. This center resides across from a major shopping area in the community. It is conveniently located near heavily populated neighborhoods and shopping. The only downside is the location is not close to physician offices that would refer to this center. However, if a new facility is built on the 100 acres, which would include physician offices, the imaging center will be in an ideal location. Leadership is developing a free- standing emergency center on the 100-acre site, which is on the northwest side of Chestnut. The last competitive issue is the location of a medical school and hospital in the city of Chestnut. The facility resides in a downtown location. This medical school had been established by the state nearly 45 years ago and is associated with Greenbranch University. It mostly serves the indigent community in Chestnut and the surrounding area. This academic
  • 7. center has a rather negative reputation in the surrounding area. There are four other medical academic centers in the state as well as a medical center with a world- renowned reputation. There have been ongoing rumors that this world-renowned organization was planning on assuming the responsibility of the Chestnut academic center. This change would substantially alter the complexion of the local medical community if it were to occur. Speed in ECRH dealing with some of its market issues is an imperative. Additional Market Information: Population Demographics Chestnut County · With 433,689 people, Chestnut County is the 6th most populated county in the state. · The largest Chestnut County racial/ethnic groups are Caucasian (70.1%), African American (18.5%), and Hispanic (6.5%). · In 2015, the median household income of Chestnut County residents was $41,777. However, 21.1% of Chestnut County residents live in poverty. · The median age for Chestnut County residents is 37.7 years old. · Employment is strong in Chestnut County. Unemployment resides at 4.5%. Employer diversity is strong since the community is not dependent on singular large employers. Employment includes some high-tech jobs, general manufacturing to support the automobile industry, and there is a large university, Greenbranch University, located in the community. The university has 25,000 students and offers most majors, which includes engineering and nursing. Walnut County · With 42,537 people, Walnut County is the 57th most populated county in the state. · The largest Walnut County racial/ethnic groups are Caucasian (89.8%), followed by Hispanic (7.2%) and African American (3%).
  • 8. · In 2015, the median household income of Walnut County residents was $55,120. However, 10.8% of Walnut County residents live in poverty. · The median age for Walnut County residents is 39.8 years old. Butternut County · With 38,352 people, Butternut County is the 65th most populated county in the state. · The largest Butternut County racial/ethnic groups are White (87.0%), Hispanic (9.5%), and African American (1.7%). · In 2015, the median household income of Butternut County residents was $50,663. However, 13.4% of Butternut County residents live in poverty. · The median age for Butternut County residents is 39.7 years old. Oak County · With 37,120 people, Oak County is the 66th most populated county in the state. · The largest Oak County racial/ethnic groups are Caucasian (93.3%), Hispanic (4.0%), and African American (1.1%). · In 2015, the median household income of Oak County residents was $42,492. However, 14.9% of Oak County residents live in poverty. · The median age for Oak County residents is 46.6 years old. Maple County · With 27,816 people, Maple County is the 79th most populated county in the state. · The largest Maple County racial/ethnic groups are Caucasian (90.8%), Hispanic (7.1%), and African American (1.0%). · In 2015, the median household income of Maple County residents was $39,353. However, 15.4% of Maple County residents live in poverty.
  • 9. · The median age for Maple County residents is 48.2 years old. · Both Oak and Maple Counties are rural with an older population. Many patients have Medicare and Medicaid that come from these two counties. Likewise the hospitals located in each of these counties have been designated as critical access. Like many rural counties, Oak and Maple have been blighted with younger people using drugs, including methamphetamine. Employed Physicians ECRH employs 400 physicians throughout its system. The breakdown for each location is as follows: Chestnut County · 135 primary care · 100 specialists Walnut County · 40 primary care · 10 specialists Butternut County · 30 primary care · 12 specialists Oak County · 27 primary care · 10 specialists Maple County · 25 primary care · 11 specialists There have been ongoing complaints from the newly recruited physicians that their practices have not been marketed well; thus, their patient volumes have been slow to grow.
  • 10. Service Line Performance Information The following is a list of bullet points regarding service line performance by ECRH and issues of operational concern. 1. Women’s health services deteriorated significantly since the syndication by Banford Medical Center. Obstetrical deliveries are down 20% across the system. BMC has done an excellent job of creating attractive facility and services for women. This includes nurse navigation, women’s breast center, and a series of other amenities. BMC has also started a neonatal intensive care unit, which rivals the services of ECRH. 2. The cardiologists at ECRH are aging. This has been a traditionally strong service for ECRH, but 50% of the cardiologists will be retiring within the next 3 to 5 years. All cardiologists who serve ERCH are employed by the health system. Cardiology is a service that is gaining strength within the Greenbranch Medical Center, particularly since they brought in a renowned cardiologist to rebuild their program. 3. The orthopedic volumes are down 7%. ECRH does jointly operate an orthopedic hospital with an independent orthopedic group located in the community. There have been some internal problems within the orthopedic group where the old guard of orthopedic surgeons has forced a low retention with younger, and to some degree better trained, surgeons. Retention is becoming a growing concern regarding the status of this group with consideration of ECRH hiring their own surgeons. The joint venture hospital does not exclude other surgeons from working in this hospital. 4. Emergency department (ED) volumes are down 5%. The hospital uses an emergency physician group to supply physicians to cover all of the EDs within ERCH. These physicians are known for poor customer service and making rude comments to patients who are self-pay or Medicaid. 5. The ambulatory visits and services are up 3%. This volume increase is from the younger primary care physicians who have been employed by ECRH. This young group of physicians has
  • 11. become great support for ECRH and refer patients loyally to the organization. 6. General surgery cases are down 4%. The aging surgeons are starting to retire, and it is difficult to recruit new surgeons to replace past demand. Some of this work is going to Greenbranch since they have good general surgeons. 7. The oncology services for ECRH have increased in volume and revenue by 4%. ECRH’s development of the new oncology center has created a magnet for referrals to the oncologists. The oncologists are very enthusiastic about the development of this new center and have begun to shift work to ECRH. 8. ECRH has the regional burn center. ECRH works with Greenbranch Medical Center for training residence in the burn setting. This includes the plastic and general surgeons. The downside of this service is that it is losing money. A decision has been made to close down this service with Greenbranch starting their burn center. 9. ECRH is a Level 1 Trauma Center, and this designation has been a historical positive for the system. The helicopter service is well recognized by the community as well as first responder professionals found in the region. They historically have been top of mind for major trauma cases. The usage of this service is down 5% since the for-profit has established a similar service. BMC however only has a Level 2 Trauma Center. They have worked diligently to acquire ambulance services in some of the outlying communities. This has helped feed patients to BMC. 10. The ECRH Board of Directors decided to close down the behavioral health hospital. It is uncertain where patients will be able to receive inpatient care. An active out-patient service will still be provided by ECRH. Payer Mix The payer mix for ECRH has deteriorated. The current inpatient payer mix for the entire system is as follows: · 55% Medicare · 15% Medicaid
  • 12. · 30% Commercial There has been a long-standing joint venture relationship with a national insurance company for commercial insurance. Administratively this venture has not developed as anticipated; however, in some of the regional markets, the Chestnut Care insurance has a strong presence. Of the 30% commercial pay, 20% is Chestnut Care based. The national insurance company in the venture is Aetna. The next strongest product is Anthem. It is the expectation of the CEO that Chestnut Care be leveraged and positioned for growth. The 15% Medicaid has helped the hospital gain additional disproportionate share dollars, which does help the bottom line of the hospital. Historical Strategic Initiatives Accountable Care Organization When the Affordable Care Act was passed in 2010, ECRH decided to get into the one-sided model of an accountable care organization (ACO). This venture has not gone well, and ECRH has decided to leave the ACO business. However, they are concerned about the public image of this decision. The details of the termination are under discussion with a need to determine how to minimize the public perception of termination, particularly since there was so much marketing of their getting in this venture. The regulatory requirements of the government regarding the timing of terminating an ACO venture further complicate this decision. Primary Care Medical Home The employed primary care group has been active in establishing accredited primary care medical homes within all of the primary care offices throughout the ECRH system. This initiative is a positive emerging strategy for ECRH. It has
  • 13. also been an attractive draw for the family practitioners from Greenbranch Medical Center residency program since Greenbranch has established an accredited medical home for their family practice residency program. American Nursing Credential Center Status (ANCC) ECRH has been working on becoming a magnet status for ERMC. This work has stalled out as an initiative. Some of this is due to the nursing leadership within ERMC. The CEO intends to move this priority up in the organization’s goals. Information Technology ECRH has invested heavily in their information technology infrastructure. This investment became a requirement just to be able to gather the data needed for the ACO development. This cost has become significantly greater than anticipated. ECRH fully implemented EPIC as their core information technology system. There have been implementation problems since the ECRH was operating off of multiple systems before the decision to consolidate to one platform. The implementation of EPIC required considerable retraining for the staff and physicians. Data conversions have gone well. The difficulties have been more human-related relative to the effective use of the system. One of the major issues has been the lack of ECRH not meeting meaningful use requirements which has cost ECRH significant lost revenue from not meeting these goals. Legal Actions Pending for ECRH Federal Trade Commission Investigation With the merger and acquisition of NMHC, questions of antitrust have been raised. In the service lines of cardiology and oncology it has been found that ECRH controls 60% of the cardiology market and 52% of the oncology market. Chestnut Care in some markets has been strong in steering patient volumes to ERMC. Union leaders for the varying trades were
  • 14. instrumental in precipitating this investigation. At the time that this issue was raised, the President and Executive Branch of the federal government were very pro-labor, thus, their interest in pursuing this matter. As to the projected disposition of this case, it is anticipated that a negative determination will be made due to the market share control in oncology and cardiology. This could force ECRH to divest their ownership in the Chestnut Care insurance venture. Another option might be that certain hospitals of NMHC be divested. It is not anticipated that both determinations would occur. This case has cost ECRH considerable money to stave off investigation of this allegation. Predatory Collections and the Loss of Not-for-profit Tax Status for NMHC NMHC negotiated that they would continue to act independently. The consortium leadership set policies that included predatory collections for the patients that would be served in the NMHC hospitals. In a recent evening news report, an investigative reporter interviewed an elderly patient that had her home taken from her to pay for her medical bills. This home had been in her family for over 100 years. This story prompted the state’s Attorney General’s Office to investigate the predatory collection policies of ECRH and NMHC. The state has already taken an aggressive stance to investigate the status of not-for-profits not fulfilling requirements (e.g., charity care, research, and education). The state is in economic trouble and is seeking revenue from wherever they can find it. The outlook is dim regarding the anticipated final decision of the Attorney General’s Office. If NMHC is required to pay taxes, this would wipe out the bottom line for these hospitals and many of the needed services supplied to the indigent population by ECRH would be reduced
  • 15. or eliminated. Faith & Main Consultants Report Within the last year, ECRH contracted with Faith & Main to study the market perception of their women’s services. The following is a summation of the findings of Faith & Main. Interest in a Women’s Center Crosses County Lines · 36% of women in the service area would travel across county lines to receive excellent women’s health services · 72% of women in Chestnut County would consider using the women’s services of East Chestnut Regional Medical Center · Women in all counties were most interested in these services: · Breast care · General gynecology services · Female doctors · Services in one area · Physicals for women Interest in a Heart Care and a Health Information Line · A physician approved source of information · A nurse help line that could be a resource for women’s care in heart health as well be a source for health navigation. Clear Expectations Regarding Getting Appointments with Their Primary Care Physician · Women expect same-day appointments · In the collar counties to Chestnut County, women ranked this in the top 28.7% · Chestnut County women ranked this in the top 37.7% · Expectation of same-day appointments ranked highest for women of childbearing age
  • 16. · Percent expecting same-day appointments · 42.9 % of Chestnut County women of childbearing age · 31.3% of collar county women of childbearing age · Willingness to be Seen by a Nurse Practitioner Overwhelmingly “Yes” · 75.7% of Chestnut County women of childbearing age · 76.1% of collar county women of childbearing age Respondents Expressed How Health Care Could Be Improved · 24% of all Chestnut County women, and 26% of all collar county women named adding more primary care doctors and more children’s care with urgent care outranking any other single topic. Respondents of Childbearing Age Widely Represented in Study: · 86% of women respondents of childbearing age in Chestnut County had children under the age of 18 · 76% of women respondents of childbearing age in the collar counties had children under the age of 18 Willingness to be seen by nurse practitioner was viewed as favorable by those in this study. This data from Faith & Main will be used to ramp up improvements in the women’s services for ECRH. Strategic Plan Goals for the Upcoming Year · Women’s service line improvement · Increase obstetrical deliveries by 20% over 3 years · Establish nurse navigation system for the entire system · Facility improvement and development for women’s services · Improve access standards for women’s care · Assist in the marketing of the implementation of the
  • 17. consultant’s report regarding women’s services · Oncology Center grand opening · Mature the retail strategy with the primary care employed physician group · Assess the market impact of the lawsuits and develop marketing strategy to counteract the negative impact if decisions are made against ECRH · Aggressively recruit new physicians to reduce the average age of the medical staff and strategically enhance service line development · Use lean management processes to correct service issues found in the ED. Improve ED visits by 6%. · Review physician contracts to enhance physician service performance · Investigate the fast track ED concept · Implement the free standing ED strategy · Abandon the Accountable Care Organization (ACO) · Re-establish relationships with regional emergency medical services to raise the utilization of the medical air service. Growth goal is to get back to the previous level of utilization within 18 months · Decision to close the regional burn unit and let those cases go to the academic medical center · Implement the decision to close the behavioral health services of ECRH · Implement the decision to close AH CEO Instruction to Marketing Team The marketing department for East Chestnut Regional Health System will be asked to step up their game to develop a marketing plan for the regional health system. The CEO has had some concerns regarding the ability of the marketing department to keep up with the rapidly moving strategic environment that
  • 18. he has created. So he established a time line for the department to develop a system wide marketing plan over the next six weeks. The VP of marketing has been in all of the senior leadership cabinet meetings so she is aware of all of the details. Therefore, the learning curve regarding the institutional strategic goals is of no concern. The following are elements that the CEO wants in the marketing plan. 1. A consultant, Faith & Main, was used to test the impression of the women in the key service markets for East Chestnut Health System. The summary of the consultant’s report can be seen above. The survey covered all aspects of women’s care. The marketing department will need to develop a marketing campaign to match the recommendations of the consultant’s report. a. It is recognized that the age span for communicating with women consumers will be quite variable. On one end of the spectrum you have the younger childbearing age women, next are the women that are middle aged followed by women that are pre-elderly then those that are elderly. Therefore, a communication plan using social media to conventional marketing techniques will be required. 2. A communication plan will need to be developed for the closure of the regional burn center as well the exiting the accountable care organization and the closure of the behavioral health hospital. 3. A communication plan will be needed to deal with the closure of AH. 4. A branding strategy will need to be developed to overcome the current weak brand identity that is in place for the combined
  • 19. ECRH entities. 5. Develop marketing strategy for new physicians being recruited to the system. The ideal situation would be to have a common identity for all marketing material. In the past the marketing material has been local hospital based. 6. Develop marketing plan for the Primary Care Medical Home strategy as well the retail strategy for the primary care network. 7. Proactively lay out a framework of communication to manage any negative outcomes of the legal matters that the health system is now confronting. a. The Federal Trade Commission investigation of the anti -trust issues for ECRH. b. The predatory collections occurred as part of NMHC. It is felt that this case will force these rural hospitals to move to a taxable entity with the loss of their not-for-profit status. The development of this problem came as a result of poor leadership within the consortium. 8. Develop advertising campaign for the opening of the new oncology center. 9. Develop advertising campaign for the ED/Trauma services of ECRH. Copyright 2020 by University of Phoenix. All rights reserved. Copyright 2020 by University of Phoenix. All rights reserved. Running head: LEADERSHIP 1 LEADERSHIP 6
  • 20. Leadership Styles Rationale Shawn Cyr LDR 535 8 February 2021 Dr. Gwen The needed change is that Samsung needs to respond to the various ecosystems which are there. It is important to make sure that the software tools of the company are able to respond to the needs in every market. It is critical to make sure that the technicians have the awareness of the markets in addition to understanding the systems which are there. All of the knowledge needs to be customized to the culture of the consumer and their needs. There are several leadership styles which can be used when it comes to the proposed change and the organizational culture. The first style is the behavioral theory. The theory has a focus on the behavior of the leaders. There is the assumption in this theory that the behavior that one has can be copied by the other leaders in the organization. The leaders are not born but they are created through the learnable behavior. The behavioral theory has a belief that the success of a type of leadership is based on the actions of the leader. It is important to note that the action is emphasized more compared to the qualities which are there. There are several leadership types which are under this style such as dictatorial, country club, as well as people- oriented leaders (Burke, 2017). In the Samsung case, it’s important to look at whether the actions can translate throughout the organization. The contingency theory has also been selected and it is also
  • 21. referred to as the situational theory which focuses on the context of the leadership. This theory insists that the situation and context is more important compared to the personality of the leader. The theory suggest that the good leaders can adjusted to the situation based on their leadership styles. The situation of the leader will determine the best kind of leader (Hussain et al., 2018). It is important to note that that this style in the context of Samsung can be used to determine the kind of leader to make the company more dynamic. The next theory is the participative theory. In this theory, participative leadership is the democratic leadership. This is where the employees are given the Chace to directly affect the decision making. The leader in this work needs to work in the facilitation of conversation and listen to the suggestions so as to come up with the best action (Offermann and Coats, 2018). Every member of the team is involved and the leader comes to the decision after listening to all of the suggestions. The best leadership style to use in the case of change at Samsung is the behavioral theory. This is the best theory to use to effect change at Samsung so as to have technological solutions which take into account the various ecosystems. The first advantage of using this theory is that the leaders can learn and make decisions on the actions which are needed in the implementation of the change. Decisions can be easily made and guide the rest of the company towards being more culturally responsive. The theory is also important as the leader is more flexible and can make the decisions easily (Offermann and Coats, 2018). When there are any changes, the leader can always change back to fit the circumstances. It is important to note that everyone can become a leader and this is the best guide. The leader can inspire others and lead others to becoming better leaders. The behavioral theory of leadership is important will support the sustainable success of the organization in various ways. The best way one can see this is that the theory of leadership is flexible. It is important to note that the tech industry requires a
  • 22. company which is constantly adapting to changes and this is what Samsung is called to do. It is important to note that the behavioral theory assists the leader to guide the rest of the company in the culture change. The change of culture is important in ensuring that there is sustainability (Hussain et al., 2018). Every change that is made towards a better culture ensures that more customers are retained. The behavioral leadership style integrates the mission and vision of the organization. The vision of the company is that it looks forward to attaining the development of technology and software programs which help the people to interact and engage with all of them productively. It is important to note that the company seeks to have these software’s that will help people to engage in an effective manner. The best thing is to make sure that there is cultural responsiveness among the software. The behavioral theory is flexible in the long run and helps people to be more productive (Burke, 2017). It is critical to make sure that the organization grows moving forward with these software’s and the best thing is for the staff to understand the various cultures. The technologies need to respond to various ecosystems. It is important to make sure that there are these changes for achievement of this vision. The people can interact with these programs when they are built considering the culture and ecosystem of the individual. The behavioral theory will see these changes which are required so that the whole culture goes into every team in the organization. The actions will go forward leading change throughout the company. The mission of Samsung is to devote the human resource and technology to create superior products and services, thereby contributing to a better global society. The world today has changed and this is why Samsung wants to contribute to a better society. The superior product will come in place when the behavioral theory is implemented (Offermann and Coats, 2018). The actions which are taken by the leadership will contribute to changing to products and services which respond to the needs of the people. It is important to note that the global society has
  • 23. changed and this is why one must devote technology and resources towards changing. The flexibility is also important when changing to making the world better through these products. The behavioral leadership style will increase the value the various stakeholders in the company. One of the stakeholders that will benefit are the shareholders. The shareholders benefit when the company is more responsive in the products and services which it provides. The changes that are implemented will lead to growth in the customer base and profits (Hussain et al., 2018). The customers will also benefit in having the products and services which are customized to their situations. These will be products which they know and understand. It is also important to note that the staff of the company will benefit from a more open work environment. The leadership will provide a guide on the actions which can make their jobs easier. References Burke, W. W. (2017). Organization change: Theory and practice. Sage publications. Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin's change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. Offermann, L. R., & Coats, M. R. (2018). Implicit theories of leadership: Stability and change over two decades. The Leadership Quarterly, 29(4), 513-522. Running head: LEADERSHIP THEORIES 2 LEADERSHIP THEORIES 2
  • 24. Leadership Theories Shawn Cyr LDR 535 2 February 2021 Dr. Gwen Leadership Theory Definition Advantages Disadvantages Behavioral Theory The behavioral theory has a focus on how the leaders will behave. There is the assumption in this theory that the behavior can be copied by other leaders. The theory can sometimes be referred to as the style theory and it suggests that the leaders are not born successful but it is created through learnable behavior. The behavioral theories focus on the actions which the leader is going to take. The best predicator of the success of a form of leadership is on the actions of the leader. The action is emphasized as opposed to the qualities. There are various styles of leadership under this such as status-quo leaders, dictatorial leaders, country club leaders, and people-oriented leaders. There are several advantages of this theory. · The primary one is that leaders can learn and make decisions on what actions they need to implement to become the type of leader which they are desiring to be. · The theory is also good as it allows the leader to be flexible. · A leader can also adapt to any circumstances that can come their way. · The theory also suggests that anyone has the potential of becoming a leader.
  • 25. There are some disadvantages of this theory. · The theory does not directly suggest how someone needs to behave in some circumstances. · The theory is too broad and does not provide the right suggestions for any situation which may arise. Contingency Theory This theory is sometimes referred to as the situational theor y and its focus is on the context of a leader. It looks at the failure or success of a leader. It insists that while the personality of a leader is a small factor, the most important is the situation and context of a leader. The theory suggests that the good leaders can situationally adjust their leadership styles. It makes the suggestion that it may be best to select the right kind of a leader in every situation. There are several advantages of this theory. · The advantage is that leaders are able to ensure effectiveness despite the context of the situation. · The theory has criticism because there is not enough detail which will go into the context of whichever situation is there. · It focuses on the importance of a situation but there is not enough focus on the psychology of the employees or the organization. · The theory does not appreciate the change of the leadership styles over time periods. Participative Theory The participative leadership is not common when it comes to the corporate world. It is also referred to as democratic leadership. The theory suggests that employees should be directly involved in decision making. The leader needs to work towards facilitating a conversation and then takes the suggestions and generates the best possible action. Each member of the team is involved when it comes to decisions and what the leader offers is direction. There are several advantages: · The employees feel motivated and engaged as they contribute to the outcomes.
  • 26. · The employees take more ownership of the vision of the organization. · There is a lot of criticism of this theory that it makes the leadership of an organization appear weak. · At the same time, this theory can make one appear unnecessary in the context of decision making. · The theory does not also get the best outcomes as they concentrate more on what the people want and not what the organization requires. Improving Organizational Culture Shawn Cyr LDR 535 26 January 2021 Dr. Gwen Current Culture The current culture when it comes to Samsung is that it doesn’t respond to different ecosystems. The company has software tools but they do not seem to respond to all markets. The technicians have only mainstream knowledge of the systems and are unable to customize the knowledge to individual customers. Samsung has a current culture whose systems and tools do not respond to various ecosystems. There is little knowledge of the various tools among the consumers. It is important to make sure that these tools respond to each persons needs. Technicians need the knowledge to move forward and respond
  • 27. to the needs of each consumer. 2 Change Management Plan Create Urgency The technicians at Samsung need to know how the various software systems work with every product. It is important to know how each tool will attract various customers. The first part of the plan is to create urgency The technicians need to understand how these products can attract various demographics. It is important to know the right product which will be attractive to the various consumers. 3 Form a Powerful Coalition. The upper management needs to support the technicians. All issues need to be understood and everyone should be on board. Create a Vision for Change The goal is to make sure everyone attends and this ultimately leads to happy and satisfied customers. It is important to make sure that there is support for all technicians from the upper management. The management also must make sure that everyone is on board(Wiki, 2019). The goal is to make sure that service delivery improves together with the happiness of the customers. 4 Communicate the Vision
  • 28. The communication should be done through emails and signs around the office. Feedback can be brought individually for expression of opinions. Remove obstacles. Every training session should be communicated well in advance. It is important for the vision of the company to be communicated towards everyone(Burke, 2017). Emails and signs around the office will improve the outcomes of the program. It is important for these training sessions to be communicated effectively. All of the modules need to be communicated effectively. 5 Create Short-Term Wins The company should have small wins along the way for motivation. There should be rewards for completing each module successfully. Build on the Change There should be continuous building on the changes which are made. Every new technician needs to complete these changes. It is important to cultivate the small wins through rewarding successful completion of the modules. It is important to make sure that there is continuous training for all of the technicians(Burke, 2017). 6 Anchor Changes in Corporate Culture It is important for these changes to continue and become part of the culture.
  • 29. Every technician from that point onwards should be trained properly. It is important to have the instructional materials as part of the standard orientation program. The changes should at the core of company culture. The culture is enhanced through these changes and everyone should be subsequently trained on the same (Wiki, 2019). 7 Desired Outcome The desired goal is for the company to focus on new quality software. Each of the tools need to respond to every ecosystem. There should be innovation in the products. The innovation will ensure a better future and achievement of long-term goals. There should be focus on having quality software for long-term sustainability. The tools should be able to focus on the various ecosystems. It is important to drive innovation for satisfaction of every customer. 8 Alignment The change in culture will enhance the mission of the company to create superior products and services. The changes will bring forth a better global society. The change is also aligned towards the vision of attaining
  • 30. software tools that people can interact with an engage productively. The changes will enhance the values of the company towards excellence, change, integrity, people, and co-prosperity. These values will be enhanced when technicians are able to respond better. Any negative energy will be repelled through the enhancement of these values. The changes of the company will lead towards better values for the company. These values such as integrity and people will be enhanced through the changes enhanced. The values support the changes that are there and help in building a better culture (Burke, 2017). 11 The change leads to creation of a better strategy. The strategy of the company is that it is willing to devote talent and technology to it. There will be a common source of success when all of the efforts are towards the goals of the organization. The strategy of the company is to devote technology and talent towards the goals. These changes will be build towards the strategy. The success will be built effectively when the strategy is followed. 12 References Burke, W. W. (2017). Organization change: Theory and
  • 31. practice. Sage publications. Wiki, C. I. O. (2019). Kotters 8 step change model.[Online] Available at: https://cio-wiki.org/wiki. Kotter% 27s_8- Step_Change_Model [Använd 31 mars 2020]. Running head: APPLY: KOTTER’S 8-STEP CHANGE MODEL CHART APPLY: KOTTER’S 8-STEP CHANGE MODEL CHART Apply: Kotter’s 8-Step Change Model Chart Shawn Cyr LDR 535 January 19, 2021 Dr. Gwen Step one: Create Urgency Due to the COVID-19 pandemic, Samsung’s technicians need to
  • 32. understand how different software systems go with each product while working on other demographic sites. The business might not competitively position itself in the market if these technicians do not understand how different software systems function with the right product that attracts customers in every job site. Step two: Form a Powerful Coalition. These technicians require quality support from the upper management, which can be designing an education and training program for every member. Once the underground issues are well understood, every technician will get on board with this training program. Step three: Create a Vision for Change This training program projects a visionary goal that if everyone attends the scheduled classes, there will be improved service delivery, and customers will remain happy and satisfied. As a result, every technician will have the knowledge, skills, and necessary resources at hand to market the products. Step four: Communicate the Vision. Communication to every technician will be via emails, and some signs posted within the office. Besides, feedback will be conveyed individually to give room for technicians to express their opinions about the coming changes. Step five: Remove Obstacles. The training's commencement will be communicated to every technician in advance, reminding them about the exact time and date. During the training session, each technician will complete some modules to recap what is being taught. Step six: Create Short-Term Wins Accordingly, once the technicians have completed the training, the company is guaranteed to report positive feedback about each job site's customer service. Also, technicians wil l feel motivated because they have all the available tools and resources required to handle the job competitively. Step seven: Build on the Change. The company will record a high turn-up rate from technicians
  • 33. from remote areas that now, after the training, they have the right tools to complete the job without asking for assistance. The software will be handled by technicians who complete and pass all the modules. Step Eight: Anchor the Changes in Corporate Culture As the organization expands, all the new technicians should finish this training before going to places of work all alone. Having this as a standard instructional course will promise that everybody stays on the same wavelength regarding the work that should have been finished. References Burke, W. W. (2017). Organization change: Theory and practice. Sage publications. Wiki, C. I. O. (2019). Kotters 8 step change model.[Online] Available at: https://cio-wiki. org/wiki. Kotter% 27s_8- Step_Change_Model [Använd 31 mars 2020].