Assignment 2: Midterm Case Study
HSA 501 Management in Healthcare

February 4, 2015

Assignment 2: Midterm Case Study
As the Director of Health at Kaluyu Memorial Hospital, there are some things within the hospital that I observed about the inner workings of this hospital. It appears that the staff is afraid of their superiors, and there is a lack of communication on all fronts within the hospital. There seems to be a lot of animosity between the doctors and the nurses, and all of that will be. There is also an uncontrollable amount of call offs and tardiness with lack of valid reasoning.
Major factors affecting motivation at Kaluyu Memorial Hospital There are many motivational problems at Kaluyu Memorial Hospital that should be so that the staff will be better motivated to do better at work. The first of these issues is the lack of effective communication between the staff and the management. The staff is terrified of the management personnel so much so that it is affecting the staff’s ability to communicate with the management at all. The staff believes that the management does not take into consideration anything that is needed to get the job done, and the management constantly yells at the staff. By treating their subordinates as though they are incompetent, the management is emasculating the staff.
Also, this leads into the staff call-offs. I believe the staff is calling off because they are not respected by the authority figures here at the hospital. If the staff feels disrespected, they are not going to be willing to come into work and continue to deal with the degradation and humiliation that comes from the management here at Kaluyu Memorial Hospital. The staff doesn’t take their commitment seriously because they feel very unappreciated and undervalued in their positions. According to Ojakaa, Olango, and Jarvis (2014), there is a high correlation between job satisfaction and motivation. As a result, the staff will be more motivated to come into work if they are appreciated and satisfied with their job. Showing appreciation applies in particular to the nursing staff. They do not take pride in their work any longer because they do not know how to deal with all of the animosity that comes from their superiors. The animosity is also leading to a lack of hygiene from the workers in which they are coming into work with the same clothing on that they wore the day before. The lack of hygiene is a cause for concern because they lack the basic motivation to do something as simple as wear clean clothing to work.
The employees and nurses who are on the same professional level are trying to overstep their standard of authority with their peers. The overstepping is causing a rift between the workers because there are some who are disregarding their bounds and others who have to deal with these authoritarian coworkers. The overstepping of authority causes a shift in morale among the employees and further annihilates the chances of having a cohesive bunch of employees at Kaluyu Memorial Hospital.
Why these motivational problems need to be If this particular area is not with by the hospital’s administration, the staff is going to continue to call off at alarming rates. The increase of call off rates will require the use of outside sources like temporary agencies. The use of these outside sources puts an enormous financial strain on Kaluyu Memorial Hospital because it requires a heightened allocation of funding to pay the temporary staff. In addition, there becomes a problem of patient safety when the employees refuse to follow hygienic practices on a daily basis. The nurse who comes to work and doesn’t bother to change her clothes from what she was wearing yesterday could very easily cause an illness to another patient. It is quite unsanitary to wear the same clothes to work two days in a row, especially if it is. There are many patients who have HIV/AIDS, who have very compromised immune systems, and any little thing could endanger their health. Along with that, there is the lack of morale that the employees endure that could lead to them terminating their employment with the hospital and finding a job elsewhere. The lack of professionalism amongst the staff is also an issue. Once patients realize the staff is not working together cohesively, they will seek their medical attention elsewhere, which results in a loss of revenue. A loss of income would be devastating to this hospital.
Model of Motivation for Kaluyu Memorial Hospital The motivational theory that best applies to this situation is Herzberg’s two-factor theory. The first factor is motivators, and the second factor is the hygiene factors (Burns, Bradley, and Weiner, 2012). Burns, et al. (2012) Buble, Juras, Matic (2014) as motivators of itself with interpersonal, (p. 98; p166). The rewards that come from the work that they do is called intrinsic rewards, and the most highly motivated employees are usually not motivated only by the extrinsic factors (Buble, et al., 2014). How this relates to the workers at Kaluyu Memorial Hospital is that we have to increase their extrinsic factors in order for them to be better motivated to do an excellent job at the company. First, the administration is going to have to improve the working conditions by addressing the interpersonal relationships between the employees and how they interact with one another. There need to be clear guidelines as to who is in charge and the repercussions for the individuals who take it upon themselves to overstep these boundaries.
Also, we need to work on the supervisors within the hospital and get them all on one accord and working with their subordinates in a good way. Essentially, this means is that we need to address the issue of the management disrespecting the employees by doing leadership training for those who are in leadership positions. The hope with this implementation is that it will help those in leadership roles to know how to communicate better with their subordinates, which will in turn lead to less fear and anger from the subordinates as it relates to their superiors. This helps by allowing for there to be better and more open lines of communication throughout the chain of command. It is my belief that once the extrinsic factors that are significantly affecting the morale in Kaluyu Memorial Hospital, there will be a greater level of intrinsic factors for many of the employees to begin taking pride in their work once again and allowing for them to be more highly motivated to come to work and get their job done to the best of their ability. It is the opinion that those who lack the extrinsic factors will not even begin to be pleased in their work environment and will lack the motivation, and if we can get the extrinsic factors under control, there will be a better level of satisfaction and pride in the work of the individuals who are employees of this hospital.
Communication System for Kaluyu Memorial Hospital Currently, there is destitute communication on all levels at Kaluyu Memorial Hospital, and that has got to change. “Communication is extremely consequential in health care organizations because poor communication can result in loss of life”(Cornell, Gervis, Yates, & Vardaman, 2014, p.334). It is my proposal that Kaluyu Memorial Hospital implement a few formal patterns of communication. Burns et al. (2014) discusses a variety of different types of communication systems, and I believe that there are going to be times where we can implement most of these different communication systems.
There definitely needs to be a chain of command that must be at the hospital; however, there also are going to be times when individuals need to speak directly with one another in order to accomplish different tasks. For this reason, there is a necessity to implement both of those types of communication networks. What this means that going formal chain command when it comes how information supposed flow the organization however that does mean that times where in there needs information person another Implementing these communication systems will keep down the confusion when it comes to the question of who is in charge of what, and it will disallow the peers to try to boss one another around.
It is my hope that by having a more open form of communication between superiors and subordinates, it will better help with the problem of fear of superiors that is currently happening in the hospital. I believe that if there is less fear of superiors, there will be better and more direct communication between peers as well because they will know who is in charge and therefore will not feel the need to try to overstep bounds and take over
Conclusion
If all of these changes are as it relates to Kaluyu Memorial Hospital, there should be almost immediate improvement within the hospital. I believe that if there is more open communication, a greater amount of improved extrinsic factors and higher overall motivation from the employees, there will be an overall improvement in the hospital and also in the hospital’s revenue.

References
Buble, M., Juras, A., & Matic , I. (2014). The relationship between managers’ leadership styles and motivation. Management: Journal of Contemporary Management Issues. 19 (1) p.161-193. Retrieved from eds.a.ebscohost.com
Burns, L.R., Bradley, E. H., & Weiner, B.J. (2012). Shortell and Kaluzny’s Health Care Management Organization Design and Behavior. (6th ed.) New York: Delmar Cengage Learning.
Cornell, P., Gervis, M.T., Yates, L., & Vardaman, J.M. (2014). Impact of SBAR on nurse shift reports and staff rounding. MEDSURG Nursing 23 (5) p.334-342. Retrieved from eds.a.ebscohost.com
Ojakaa, D., Olango, S., & Jarvis, J. (2014). Factors affecting motivation and retention of primary health care workers in three disparate regions in Kenya. Human Resources for Health 12 (1) p. 1-24. Doi: 10.1186/1478-4491-12-33.