Read the below case and then write a paper. you must have a minimum of 3 scholarly sources (peer-reviewed journal articles). Please ensure that you follow standard APA formatting. Your paper must have a title page and a reference page. You must have a minimum of five (5) in-text citations. During the paper, answer these questions. DO NOT put this in a question and answer format. Make sure there is an introduction and conclusion, and some parts of the questions as headings and subheadings and follow the recommended outline to ensure that all questions are answered.  Respond to the following questions in an essay (3 page minimum). 1. Assemble the diagnostic data into a framework and prepare feedback to the senior administrators of the hospitals. What’s your sense of the organization’s current structure and employee involvement issues? 2. What changes would you recommend? Is a total quality management intervention appropriate here? What alternatives would you propose? 3. Design an implementation plan for your preferred intervention. Be sure that you describe the most common organization structures used today as well as their strengths and weaknesses.  Describe the employee involvement and how it relates to performance. Consider whether there should be a sociotechnical systems work design.    Selected Cases THE SULLIVAN HOSPITAL SYSTEM PART I At the Sullivan Hospital System (SHS), CEO Ken Bonnet expressed concern over market share losses to other local hospitals over the past six to nine months and declines in patient satisfaction measures. To him and his senior administrators, the need to revise the SHS organization was clear. It was also clear that such a change would require the enthusiastic participation of all organizational members, including nurses, physicians, and managers.   At SHS, the senior team consisted of the top administrative teams from the two hospitals in the system. Bonnet, CEO of the system and president of the larger of the two hospitals, was joined by Sue Strasburg, president of the smaller hospital. Their two styles were considerably different. Whereas Bonnet was calm, confident, and mild-mannered, Strasburg was assertive, enthusiastic, and energetic. Despite these differences, both administrators demonstrated a willingness to lead the change effort. In addition, each of their direct reports was clearly excited about initiating a change process and was clearly taking whatever initiative Bonnet and Strasburg would allow or empower them to do.   You were contacted by Bonnet to conduct a three-day retreat with the combined management teams and kick off the change process. Based on conversations with administrators from other hospitals and industry conferences, the team believed that the system needed a major overhaul of its Total Quality Management (TQM) process for two primary reasons. First, they believed that an improved patient care process would give physicians a good reason to use the hospital, thus improvin ...

1. Read the below case and then write a paper.
you must have a minimum of 3 scholarly sources (peer-reviewed
journal articles). Please ensure that you follow standard APA
formatting. Your paper must have a title page and a reference
page. You must have a minimum of five (5) in-text citations.
During the paper, answer these questions. DO NOT put this in a
question and answer format. Make sure there is an introduction
and conclusion, and some parts of the questions as headings and
subheadings and follow the recommended outline to ensure that
all questions are answered.
Respond to the following questions in an essay (3 page
minimum).
1. Assemble the diagnostic data into a framework and prepare
feedback to the senior administrators of the hospitals. What’s
your sense of the organization’s current structure and employee
involvement issues?
2. What changes would you recommend? Is a total quality
management intervention appropriate here? What alternatives
would you propose?
3. Design an implementation plan for your preferred
intervention.
Be sure that you describe the most common organization
structures used today as well as their strengths and weaknesses.
Describe the employee involvement and how it relates to
performance. Consider whether there should be a sociotechnical
systems work design.

2. Selected Cases THE SULLIVAN HOSPITAL SYSTEM
PART I
At the Sullivan Hospital System (SHS), CEO Ken Bonnet
expressed concern over market share losses to other local
hospitals over the past six to nine months and declines in
patient satisfaction measures. To him and his senior
administrators, the need to revise the SHS organization was
clear. It was also clear that such a change would require the
enthusiastic participation of all organizational members,
including nurses, physicians, and managers.
At SHS, the senior team consisted of the top administrative
teams from the two hospitals in the system. Bonnet, CEO of the
system and president of the larger of the two hospitals, was
joined by Sue Strasburg, president of the smaller hospital. Their
two styles were considerably different. Whereas Bonnet was
calm, confident, and mild-mannered, Strasburg was assertive,
enthusiastic, and energetic. Despite these differences, both
administrators demonstrated a willingness to lead the change
effort. In addition, each of their direct reports was clearly
excited about initiating a change process and was clearly taking
whatever initiative Bonnet and Strasburg would allow or
empower them to do.
You were contacted by Bonnet to conduct a three-day retreat
with the combined management teams and kick off the change
process. Based on conversations with administrators from other
hospitals and industry conferences, the team believed that the
system needed a major overhaul of its Total Quality
Management (TQM) process for two primary reasons. First, they
believed that an improved patient care process would give
physicians a good reason to use the hospital, thus improving
market share. Second, although the Joint Commission on

3. Accreditation of Healthcare Organizations (JCAHO) had
enacted policies some time ago encouraging hospitals to adopt
continuous improvement principles, SHS's system was sorely
behind the times. The team readily agreed that they lacked the
adequate skills and knowledge associated with implementing a
more sophisticated TQM process. This first meeting was to
gather together to hear about how TQM, engagement, and other
strategic change processes had advanced and the issues that
would need to be addressed if more sophisticated processes
were to be implemented. During the meeting, you guided them
through several exercises to get the team to examine methods of
decision making, how team-based problem solving had
advanced, and explored their understanding of the hospital's
current mission, goals, and strategies.
Although you were concerned about starting the process with a
workshop that explored a solution rather than understanding the
problem, you remembered Roger Harrison's consulting rule,
“Start where your client is at,” and agreed to conduct the
workshop. You were assured by Bonnet that the hospital system
was committed to making substantive changes and that this was
only the first step. In addition, and in support of this
commitment, Bonnet told you that he had already agreed in
principle to begin a work redesign process in a few of the
nursing units at each hospital and had begun to finalize a
contract with a large consulting firm to do the work. The
workshop was highly praised and you convinced the team to
hold off on the work design implementation long enough to
conduct a diagnosis of the system.
Following the retreat, your diagnosis of the SHS organization
employed a variety of data collection activities including
interviews with senior managers from both hospitals as well as
a sampling of middle managers and staff (for example, nurses,
ancillary professionals, and environmental services providers).
Questions about the hospital's mission garnered the most

4. consensus and passion. There was almost unanimous
commitment to the breadth of services provided and the values
that played a prominent role in the delivery of those services by
a Catholic-sponsored health care organization, such as SHS. A
mission and values statement was clearly posted throughout the
hospital and many of the items in that statement were repeated
almost verbatim in the interviews.
From there, however, answers about the organization's purpose
and objectives became more diverse. With respect to goals and
objectives, different stakeholder groups saw them differently.
Senior administrators were fairly clear about the goals listed in
the strategic plan. These goals included increasing
measurements of patient satisfaction, decreasing the amount of
overtime, and increasing market share. However, among middle
managers and supervisors, there was little awareness of hospital
goals or how people influenced their accomplishment. A
question about the hospital's overall direction or how the goals
were being achieved yielded a clear split in people's
perceptions. Some believed the hospital achieved its objectives
through its designation as the area's primary trauma center.
They noted that if someone's life were in danger, the best
chance of survival was to go to SHS. The problem, respondents
joked, was that “after we save their life, we tend to forget about
them.” Many, however, held beliefs that could be labeled “low
cost.” That is, objectives were achieved by squeezing out every
penny of cost no matter how that impacted patient care.
Opinions about the policies governing the hospital's operation
supported a general belief that the organization was too
centralized. People felt little empowerment to make decisions.
There also were a number of financial policies that were seen as
dictated from the corporate office, where “shared services”
existed, including finance, marketing, information systems, and
purchasing. Further, several policies limited a manager's ability
to spend money, especially if it wasn't allocated in budgets.

5. In addition to the managerial sample, a variety of individual
contributors and supervisors were interviewed either
individually or in small groups to determine the status and
characteristics of different organization design factors. The
organization's policy and procedure manuals, annual reports,
organization charts, and other archival information were also
reviewed. This data collection effort revealed the following
organization design features:
· •
The hospitals' structures were more bureaucratic than organic.
Each hospital had a functional structure with a chief executive
officer and from two to five direct reports. Both hospitals had
directors of nursing services and professional services. The
larger hospital had additional directors in special projects,
pastoral care, and other staff functio ns that worked with both
hospitals. Traditional staff functions, such as finance,
procurement, human resources, and information services, were
centralized at the corporate office. There were a number of
formal policies regarding spending, patient care, and so on.
· •
The basic work design of the hospitals could be characterized as
traditional.
Tasks were narrowly defined (janitor, CCU nurse, admissions
clerk, and so on). Further, despite the high levels of required
interdependency and complexity involved in patient care, most
jobs were individually based. That is, job descriptions detailed
the skills, knowledge, and activities required of a particular
position. Whenever any two departments needed to coordinate
their activities, the work was controlled by standard operating
procedures, formal paperwork, and tradition.
· •
Information and control systems were old and inflexible.

6. From the staff's perspective, and to some extent even middle
management's, little, if any, operational information (that is,
about costs, productivity, or levels of patient satisfaction) was
shared. Cost information in terms of budgeted versus actual
spending was available to middle managers and their annual
performance reviews were keyed to meeting budgeted targets.
Unfortunately, managers knew the information in the system
was grossly inaccurate. They felt helpless in affecting change,
since the system was centralized in the corporate office. As a
result, they devised elaborate methods for getting the “right”
numbers from the system or duplicated the system by keeping
their own records.
· •
Human resource systems, also centralized in the corporate
office, were relatively generic.
Internal job postings were updated weekly (there was a
shortage of nurses at the time). There was little in the way of
formal training opportunities beyond the required, technical
educational requirements to maintain currency and certification.
Reward systems consisted mainly of a merit-based pay system
that awarded raises according to annual performance appraisal
results. Raises over the previous few years, however, had barely
kept pace with the cost of living. There also were various
informal recognition systems administered by individual
managers.
PART II
This diagnostic data was discussed and debated among the
senior team. A steering committee composed of physicians,
managers, nurses, and other leaders from both hospitals was
convened, and creating a vision for the system and the change
effort became one of their first tasks.
The steering committee spent hours poring over vision

7. statements from other organizations, discussing words and
phrases that described what they thought would be an exciting
outcome from interacting with the hospital, and trying to satisfy
their own needs for something unique and creative. When the
first draft of a statement emerged, they spent several months
sharing and discussing it with a variety of stakeholders. To their
dismay, the initial version was roundly rejected by almost
everyone as boring, unimaginative, or unreal. The group
discussed the input gathered during these discussions and set
about the task of revising the vision. After several additional
iterations and a lot of wordsmithing, a new and more powerful
vision statement began to emerge. The centerpiece of the vision
was the belief that the organization should work in such a way
that the patient felt like they were the “center of attention.”
Such an orientation to the vision became a powerful rallying
point since many of the hospitals' management teams readily
understood that there was an existing perception of poor service
that needed to be turned around.
The three months spent working and adapting the vision
statement was well worth it. As it was presented to people in
small meetings and workshops, each word and phrase took on
special meaning to organizational members and generated
commitment to change.