Ayesha Malik
212507224
Midterm
ADMS 3930
W15

Harbor General Hospital initially began as two separate hospital under two different managements, however after a merger the two are under one management with very different climates. This merger has not united two organizations as it should have and instead has caused dysfunction, demoralizing behaviors, and lack of leadership to take place in the organization. To prevent the problems that have occurred at General Harbor Hospital, at the time of the merger, management could have implemented policies and taken action. These policies and actions, which fall under organizational culture, Organizing, and Decision Making, could have prevented the problem presented in the case if implemented at the time of the merger. The root cause of the problem is the lack of communication between employees at the harbor site, the disengagement along with lack of synergy in the organization, and poor decision-making on the management’s part.

The merger seemed as a hostile takeover to both employees at the harbor, and general hospital. The employees at general hospital believe they are superior, because of the hospital’s size and employee count, in comparison to the harbor site. This type of immoral behavior is affecting the synergy of the entire organization. Employees are more likely to have conflicts, if they believe one site is more superior to the other. By using an accommodative strategy and a proactive strategy, during the merger, the hospital could avoid future mistakes, like this one. An accommodative strategy is when an organization accepts responsibility for the problem and solves it. In this case the hospital has accepted the problem and decided to solve it, by uncovering the missing records, and filing them to the government for late reimbursement. A proactive strategy would have helped the hospital in the future, by preventing similar errors. Through the implementation of internal mission and vision statements, the employees will be informed and aligned in their practices in the workplace. They will know how and what to do in order to perform their best, and avoid errors like these. A united mission and vision statement will increase the sense of community between both General and Harbor Hospital. The disengagement between the two right now proves they are not on the same page, which further causes problems such as described in the case “Don’t they talk to each other over there”. Through a united mission and vision, this organization would have benefited by having an increase in synergy between both hospitals, and increase in morale across the organization.

Keeping the structure of an organization in order is an important element, in order to ensure the organization is running smoothly. In the case of Harbor General Hospital management should have implemented organizational goals that provide the overall objectives, purpose and mission of the business. To avoid this sort of mistake, management should have aligned practices for each department, and the criteria to which they should perform their jobs. As part of the organizational goals, management should have implemented task structure. Task structure, refers to the degree of difficulty of a task, which is made clear to the employee who has to perform it. This would have been an important policy to implement in the charting department. This department at harbor hospital who is known for its coders needing a lot of guidance, could have used a task structure policy. This would help them to understand how to perform their jobs in relation with the analyzers. This policy, which, could include how coders and analyzers in that department should communicate, and explain their instructions to one another, could have helped avoid the problem in the hospitals. Span of control, which was not exercised at the harbor site, should have been. The harbor site, which is smaller in comparison to the general site, did not have a supervisor present physically at all times. A supervisor would generally go over the work of the coders and analyzers to ensure accuracy. However, the lack of presence of a supervisor contributed to the problem. At the time of the merger management should have hired another supervisor, to exercise span of control at the harbor site.

The chain of command, which flows down ward to supervisors, should have been made clearer at the time of the merger. Although the community at harbor general is closer, than at General, the chain of command is also different. The authoritarian style that employees were used to at harbor has changed, and has become consultative. The chain of command, which flows to the employees, after the merger could have involved the input of the employee’s at the harbor site known as decentralized decision making. This input would have been helpful to the chain of command to execute instructions for the staff. The chain of command could also be useful in executing interaction standards for staff members to communicate. After the merger the employees at both sites still used their older email systems, and the new one to communicate, meaning two separate emails for communication. Management should have normalized one system for all employee communications, so that there would be no error or misunderstanding in instructions. Also the intranet is rarely used, and most communication is done by mail. This is not useful, because not all staff will receive paper mail. The intranet of the organization should be used with more accuracy and consistency. Communication is vital since the supervisor is not present at the Harbor site, and its coders are known for needing “handholding”.

Rational decision-making should have taken place at the time of the merger, to avoid these types of problems. If management had thought of ways to transition both hospitals into the merger, the problem would not have existed. Systems used at General hospital are different than those used at Harbor. If management had employed all of the same technologies, and practiced organization the problem would not have existed. As mentioned in the case, the lack of communication between employees in the department was also at fault. However, this would not have occurred at General, since the employees are well informed on how to proceed about their jobs on a day-to-day basis. Routine decisions are those that do not have too much thought put into them, in this case the coders and analyzers overlooked the charts, and did not put much thought into the instructions they were receiving. Although “clinics” are held for coders and analyzers to be on the same train of thought, on how they do their job, there remains differentiation. If management had standardized the way coders and analyzers were to perform their jobs at the time of the merger, this mistake would not have occurred.

Therefore, if the policies and actions mentioned above were used at the time of the merger there would not have been issues. Organizational culture is important to implement in an organization especially if two are merging. The lack of synergy and communication between each hospital and the hospitals is faulty, since immoral behaviors have occurred as a result. By using a internal mission and vision the hospital can benefit by building a sense of community. It is important to establish structure in an organization like a hospital since, the lack of structure also contributed to the issues presented. Lack of supervisory conduct, failing chain of command are all contributory to the problem at Harbor General Hospital. Decision making policies should have been implemented at the time of the merger. Rational decision-making, and routine decisions should have been implemented at the time of the merger to avoid mistakes. Hence if policies and actions as suggested above were implemented at the time of the merger the problems in the case could have been prevented or lessened.