WYM1 Task 1 Leading An Organization Within A Merged Culture
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1 WYM1 Task 1: Leading an Organization Within a Merged Culture Rebecca Rudd College of Health Professions, Western Governors University Tricia Jones July 4, 2023
2 WYMA 1: Leading an Organization Within a Merged Culture A1: Culture-Building Concept Fielder Community Hospital is about to embark on numerous changes within the organization. They will be adopting a new electronic health record system, along with merging the HIM department into a centralized location. Both projects will bring an array of emotions and reactions from existing staff. Each of the five existing satellite HIM departments has its own working environment and culture. Executive leadership is aware of the notable cultural differences between the locations and staff. The concept of work culture includes the attitudes, beliefs, and perceptions of the staff in relation to organizational mission, vision, and values (Bayot et al., 2022). Blending the cultures of the existing HIM departments will require use of culture building concepts to meet the organization’s strategic go
als. Leadership staff will be key in promoting a strong culture. The initial step to encourage continuous improvement and employee development is empowerment of staff (Healey, 2018, p. 136). Promoting empowerment of employees will allow them have investment and input for process improvement. This culture building concept also will streng
then the employee’s self
-image and in return improve customer service. Leaders will need to ensure transparency and open communication to instill a level of trust within the organization. Through trust and empowerment of staff, Fielder Community Hospital can build dynamic teams that have buy-in and respect for cultural differences. A2: Cultural Similarities and Differences Leadership will need to evaluate the cultural similarities and differences of the organization to plan for the multiple competing projects for the hospital. The current five HIM departments of Fielder Community Hospital have distinct patient populations they serve. One
3 cultural similarity between the five departments is that the employees are not excited to work with different types of patients and coworkers outside of the norm of their current locations. It is not uncommon for employees to resist change with departmental mergers in a healthcare organization. A second cultural similarity is the feelings of the current HIM directors regarding lack of time to prepare and inform their staff regarding pending structural changes to their working environments. How the HIM directors communicate changes for the organization will lay the foundation for employee perception and influence buy-in for change. The five current HIM departments are culturally different in their focus on patient satisfaction scores. The South department has the highest patient satisfaction scores of the group. This location also uses minimal amount of techn
ology which will impact employee’s adoption of an electronic health record system and depend upon their new manager for any technology usage. The department’s staff structure consists of long
-term employees who reside close to the location and are nearing retirement planning. The largest location has the lowest patient satisfaction scores, and the other location
’s scores need improvement. By the wide swing in patient satisfaction scores, it is evident that each location approaches customer service differently. The second culture difference is the buy-in for the adoption of the electronic health record system from both HIM staff and physicians. The hospital is experiencing physician recruitment concerns due to outdated use of technology for promoting interoperability. While leadership is investing in the platform, the strategic and financial planning for implementing and sustaining a complete electronic health record platform to promote improved patient outcomes and reduce staff burden has not been fully embraced. They have only allocated enough funding the basic platform, when many of optional features are what drives staff satisfaction for adoption. In addition, two of the HIM departments have low use of technology and will have a larger
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4 learning curve for learning the new platform. The cultural differences of staff’s knowledge and acceptance of technology will need to be considered for education and training. A3: Leadership Strategy Transformational leaders can bring about meaningful change by encouraging and motivating employees. The transformational leadership style supports others to understand the need for change (Healey, 2018, p. 31). This type of strategy focuses on organizational collaboration supporting a shared mission and vision for the organization. This type of leadership style focuses on building strong, positive relationship to promote change. When employees feel valued and empowered there is a positive energy for buy-in leading to a positive culture. A transformational leadership strategy will support the changes Fielder Community Hospital has committed to in both the merger of HIM departments and the adoption of new technology. A3A: Influence of A Manager
’s Style of Leadership There is a strong correlation between leadership styles and the culture within an organization. The influence of a leader based upon their style and actions can have either a positive or negative impact on the overall organizational culture. A leader within Fielder Community Hospital will need to adapt approaches based upon their employee audience. There are key approaches that will assist in empowering employees. Building trust promotes a sense of community and bonding among employees and leadership (Healey, 2018, p. 107). When trust is present, communication is open and there is less resistant to change. A leader who leads by example, will be seen in a positive light and can pave the path for organizational change management success. The reverse can be said for leaders who do not exhibit behaviors for open and honest communication. Managers who are unapproachable and fail to lead by example will have a negative impact of the organizational culture. Employees will be less trusting and will
5 exhibit behaviors that will have a negative impact on those surrounding them along with customer service. A negative culture will be toxic and impede the path to meet organizational and departmental goals. A4: Impact of Employee’s Perception
In most cases, the employee’s perception of organizational culture is their reality (Healey, 2018, p. 172). Employees bring their own belief systems and values to the table when interpreting their view of Fielder Community Hospital’s culture. In some cases, the employee’s perceived reality may not be an accurate depiction of the organization. We tend to have biases on how we interpret and react to certain instances. The organizational culture will have impacts on employee engagement, which affects their overall job satisfaction and work performance (Possibleworks, n.d.). When a positive culture exists, employee’s
perception of work responsibilities, leadership support, and opportunity for advancement align to provide a higher level of job satisfaction. Overall, employees want to feel valued and appreciated within the organization. Patient outcomes and customer service scores are improved when there is harmony amongst the team. There are other instances when culture can impact the work environment. For example, if two coworkers are experiencing an interpersonal conflict it will have impacts on surrounding peers. Managers will need to fully understand the underlying rational for the conflict and intervene when there is risk of negative impact within the organization. When conflicts and negativity is permitted to continue with an organization, the result will be decreased job satisfaction, distrust, lack of open communication and problems with retention of staff. A5: Cultural Diversity and Sensitivity Strategies
6 One strategy Fielder Community Hospital can implement to promote cultural diversity and sensitivity is to include key language in the organizational mission and vision statements (Johns, n.d.). The hospital will also need to examine existing organizational policies to ensure they support diversity and inclusion. Employees at all levels will require education and notification of the organizational policies and expectation. By forming a diversity, equity, and inclusion (DEI) committee that includes employees from varying cultural and diverse backgrounds, the organization can empower employees to promote a positive culture and impact change. This committee can also further adoption by creating an organization charter that outlines the principles and expectations for the organization for diversity, equity, and inclusion. A second strategy to support cultural diversity and sensitivity would be to conduct an organizational assessment survey of employees, and if resources available a version for patient perception of organizational diversity. This type of assessment has the potential to uncover areas of concern that may not be evident in day-to-day operations. For example, the employee’s perception of the executive suite structure is a good question to uncover if there are feelings that certain genders or age ranges are not represented. If employees do not feel that they are adequately represented by others with similar beliefs and values, they may seek to find employment outside the organization. By analyzing employee perception, the organization can develop strategic plans to address concerns and ensure that all employees feel heard and appreciated. B1: Key Leadership Skills Fielder Community Hospital has adopted three strategic goals for the organization. The HIM departmental goals roll up to the strategic goals for the hospital. Improving patient experience, measuring productivity related to reporting quality performance, and adapting a new
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7 payment-managed care model will require an effective leader to manage change. Leadership skills that will be required include empowerment, innovation, and communication. Empowerment skills are necessary to engage employees in decision making and process improvement related to change. The five HIM departments all have distinct patient satisfaction scores and could learn by sharing innovative ideas for overall improvement for a merged department. Those sites with the highest scores can lead discussions on best practices and promote a patient centered model of care. Effective empowerment skills require trust between the leader and employees (Healey, 2018, p. 54). Any leader that is truly tied to the mission and vision of the organization need to have the ability to inspire and support a learning environment for team members. It will be key when selecting the new overall HIM manager to consider the people development skills of the applicant. The new merged department will require a leader who is able to show empathy while promoting change in a positive light. As the hospital looks to adopt new value-based payment model of care, the team will need to be creative in finding pathways for reducing cost while improving quality of care. They will also need to establish benchmarks for quality and productivity reporting to effectively measure the impact on financial and quality performance. The skillset of innovation requires the leader to be accepting of a degree of failure, so employees do not fear the risk of being penalized (Healey, 2018, p. 56). The leader should consider using Six Sigma Lean principles to build resilience and remain flexible under pressure. The essential skill is communication. The leader needs not only to effectively communicate with the team, but also to actively listen. When providing directions, goals, or expectations, the communication should be delivered with transparence and clarity. This skill also requires some emotional intelligence for the leader to understand how they impact the
8 message and delivery from both verbal and nonverbal cues. Leaders should always provide an open door for employees to communicate with them without fear of retaliation. Fielder Community Hospital will need to evaluate all applicants for the new and lateral move positions to ensure diversity of the team and the buy-in to support strategic goals. B1A: Leadership Theory The existing staff in the five HIM departments are distinctly different for culture within the team. There is resistance to the adoption of an electronic medical record system by older staff who are not familiar with new technologies and the movement of healthcare to promote interoperability. While an effective leader must often use several leadership theory approaches, the transformational leadership theory provides the ability to influence and effective communication to promote change. The employees need to feel that their concerns are being heard and addressed in relation to the adoption of new technology. A transformational leader will need to effectively listen to concerns and devise strategies to address those concerns. For example, a physician may not be familiar with computerized provider order entry. By addressing the various knowledge gaps of the staff, a training program can be developed to ensure all staff are provided learning opportunities to learn the system and best practice workflows. An additional helpful approach would be to identify the tech savvy employees and devise a super trainer approach, so they can assist in the teaching and training of others from a peer-to-peer approach. Rationale for adoption of the new electronic health record system should be clearly communicated to all stakeholders. By explaining the movement to a value-based payment model leveraging interoperability to improve patient outcomes, assist in patient safety, and reduce healthcare costs, employees will have the opportunity to understand the driving force for changes
9 at the hospital. This open communication is key to transformational leaders building positive relationships with employees and others in the organization. It also will motivate staff to work together to meet strategic goals of Fielder Community Hospital. Transformational leadership approaches are beneficial to managing changes that could be disruptive to the organization (AdventHealth University, 2020). B1B: Leadership Method The path-goal theory looks at the level of staff motivation necessary to achieve organizational goals (Healey, 2018, p. 26). This method allows leaders to mix and match leadership styles depending upon the circumstance. Fielder Community Hospital is in support for remote employees for coding and revenue cycle roles. The new Clinical Documentation Improvement team will consist of both on-site and remote workers. There will four new positions in this department and available for lateral moves for existing coding team staff. Some of the current HIM department directors support remote work and are excited for changes within the organization. Others are fearful of the changes and being demoted to managers from a director level. The path-goal theory approach will allow the best leadership style to be utilized when dealing with each of the existing locations since they vary for culture and diversity. This approach will assist leadership in removing obstacles for goals and improve employee satisfaction. A participative style approach will work to involve employees in decision-making. This would be beneficial approach is working with existing employees to determine level of interest in remote work versus on-site. Some employees who are more traditional or lack resources in home environments for connectivity may not desire to work remotely due to barriers and preferences. By including employees in the decision-making process, the leader can build comradery amongst the team.
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10 B1C: Workflow Processes Fielder Community Hospital will compile a listing of workflow processes that will be impacted by organizational changes for the adoption of an electronic medical record system and merge of the five HIM departments into a centralized location. By decentralizing some of the processes, upper leadership resources can focus on strategic goals rather than day-to-day operations. A decentralized organization offer the opportunity for increased creativity and innovation and give middle management decision making power. When reviewing the workflow process list, considerations for faster decision making along with standardization will need to be taken under consideration. As the HIM departments merge, there will need to be new job descriptions developed to include level of responsibility and authority. The electronic health record system will eliminate the need for paper charts and improve electronic communication opportunities with staff and providers. Physician clinical oversight should remain a centralized process under the chief medical officer for the hospital. However, monitoring of coding and chart compliance could be decentralized and placed under the new HIM director to ensure analytic staff are generating reports per timeframes and reviewing for any areas of concern. The individual managers of the departments could oversee the communication with the physicians for chart completion and coding documentation. There will need to be an open communication channel for the departmental managers to report over arching concerns to the HIM director so they can follow up with the chief medical officer, as applicable. Each process will need examined to determine where the authority should be placed based upon the tasks and responsible parties. By identifying the outcomes of the process, along with components the organization can evaluate the best resource for the autonomy to manage and monitor with a goal of improving employee satisfaction, better patient outcomes, and financial stability.
11 C1: Leader’s Behavior
The organizational change occurring at Fielder Community Hospital will require that I use multiple approaches to leadership in the HIM systems director role based upon the audience. There will be a need to manage resistance amongst various pockets of staff across the organization. Each of the enterprise-wide strategic goals will need shared with stakeholders with transparency. By creating an environment for open communication amongst the team, I will promote open dialogue without fear of retaliation with a goal for buy-in to support change. If there is not transparent and honest communication of goals and action plans, employees will develop their own perceptions whether they are accurate or inaccurate. The information shared in communications across the organization must be understood by individual staff members from all departments and disciplines (Healey, 2018, p. 197). I will also need to provide Fielder Community Hospital leadership team with ongoing reports to measure established metrics for monitoring. This will provide them the ability to ask questions and provide suggestions based upon scores. My behavior will need to be always professional and remain optimistic for success in meeting strategic goals. Active listening and problem-solving skills will be necessary with working the physicians. My approach to training will be instrumental in laying the foundation for adoption of the new system. The focus will need to remain on improving patient outcomes, while demonstrating system efficiencies that can be gained. It will be key for my role to identify actual and potential areas of conflict to quickly assess and address, as applicable. If negativity is permitted to gain momentum, it will be difficult to swing perception back to positive support. As HIM system director, addressing physician concerns as they arise will be instrumental in aligning their support for goals with the ability to see the larger impact on patient satisfaction, clinical
12 patient outcomes, and impacts on healthcare delivery costs. By building strong relationships with employees and physicians, I hope to gain trust and support of organizational change. When working with HIM leadership and staff, I will need to adapt my approaches based upon the current location and diversity of the team I am mentoring. I will need to share accurate information with all the current locations and teams with clarity. It will be important that consistency is maintained for communication, as to not cause any discord or perception that not all information is being shared universally. Employees will need the opportunity to share feelings and concerns related to adoption of new system, merge of the five locations, remote work locations, and other questions related to organizational and departmental goals. Bringing together culturally diverse teams has the potential to create conflict situations. My behaviors in addressing their concern and conflict will impact the overall project plan for success. An important factor to consider as I appoint managers to the new departments will be the leadership style of the applicants. An important factor to the success of the organization, will be the relationships with individual managers and the HIM system director. I will need to have the skillset to inspire the team to rise to challenges and learning new technologies, while being open to change. My behavior could be a positive or negative impact on the organization. Negative impacts would include low employee morale and productivity, and increased resistance to change. While positive impacts can include efficiency, improved metric scores, and team cohesiveness. C2: Principles of Team Building A remote workforce has become more of a norm since the COVID-19 pandemic. Technology was quickly adopted to meet the needs of companies to continue business in quarantine. Clark (2022) notes that team building, communication, and project management are best practices for managing a remote team. Team building will require unique approaches due to
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13 the geographical location of the team members. Team building activities are creative in a virtual environment. Encouraging team members to turn on their cameras when in meetings is a method to encourage active participation in meetings. Meeting rules will be helpful to ensure everyone is given the opportunity to participate. For example, by using the virtual meeting platform options attendees can virtually raise their hand when they would like to speak. This reduces the occurrences of speaking over each other when cameras are off and there are no visual cues. Fostering trust and mutual respect among team members is necessary for positive engagement and outcomes (Johns, n.d., p. 202). Communication skills are essential when managing a remote work force. When outlining project expectations, a communication channel will need to be established. I will need to take into consideration the preferences of team members while leveraging technology. Email communication can be missed or even perceived with inaccurate emotions of the sender. Microsoft Teams offers the ability to assign a dedicated team channel where instant messaging can occur, only with sharing of files, along with documents within SharePoint application. Team members will require easy access to necessary materials, resources, and tools. Another consideration is the time zones employees reside within for scheduling meeting times. Time differences need to be evaluated to determine optimal meeting windows of time to ensure all team members are treated fairly and their personal time is respected. As the HIM system director and project manager, I will need to promote open communication including feedback opportunities. This will allow innovation and creativity of the team to work together to overcome barriers in meeting project goals. Activities and team support to build morale and engagement are essential for active participation. The team will be expected to value individual diversity and be open to sharing and
14 learning new approaches. By understanding the personality traits of the individual team members, each member can understand their own personality impacts on communication and team building and take actions to adjust approaches to meet other personality styles. Meeting formats will need to be productive and follow a set agenda for time management. By effective planning, meetings can stay on track for deliverables and timelines. C3: Team-Building Strategies Fielder Community Hospital currently monitors the provider
’
s chart completion metrics. Patient visit documentation and services rendered must be documented before claims can be billed. It has been noted that several physicians are delinquent for completion of chart documentation. Currently, this is labor intensive in the paper world and requires the movement of charts between locations. This often causes the patient
’
s chart to not be available for a visit, due to the physical requirement to retrieve and bring to the clinic. The adoption of an electronic health record system will streamline processes and eliminate the need for manual physical moving of charts. All patient related documentation will be available within the system regardless of physical location of staff. Several team building strategies will be beneficial when communicating with physicians. Communication must be clear and timely and allow physicians to provide feedback on new expectations for chart completion in the system. By providing key details of the rationale for timely completion, the physicians will be able to acknowledge understanding of the billing process and the impact of delinquent charts on financial stability of the hospital. Another approach could be to identify a provider champion and offer them the availability to mentor peers who are struggling with the technology and time management. Providing incentives for meeting expectations for chart closure scores will also demonstrate leadership
’
s appreciation of their engagement and improvement. These team building strategies
15 of communication, recognition of high performers, and a reward system will lead to motivation of the physicians to meet organizational metrics for chart completion. C4: Team Performance and Enterprise-Wide Goals Quality is threaded throughout every department and function of a healthcare organization. Often clinical quality of care is the only piece that stakeholders think is related to quality. When in fact quality relates to everyone and everything within the hospital system. The patient experience begins with the first interaction with the institution. This interaction could be over the phone or in person when visiting the hospital for the first time. If the grounds outside are unkept or they are not greeted warmly upon entering the facility, the perception could begin with a negative impression. The five facility locations currently have a wide variance in patient satisfaction scores. It would be beneficial for leadership to explore the workflows of the South facility whose patient satisfaction scores are great. The goal would be to establish standardized workflows that could be implemented across Fielder Community Hospital. The south director is new to her role and has empowered her employees without micromanaging day to day tasks. Empowering employees encourages continuous improvement, active participation with goals, and good customer service (Healey, 2018, p. 137). The South location has verbalized concern with merging with other locations who do not have the same focus on customer service. Team building activities will need to occur to establish a new culture for the newly centralized HIM department. By offering employees the opportunity to learn, collaborate within the team, and open to their ideas, a culture of enhanced performance will be of benefit to both employees and patients (Healey, 2018, p. 138). The organization
’
s strategic goal for measuring productivity and report quality performance will require planning and establishing goals. Current performance will need to be
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16 obtained as benchmarks to assist in establishing improvement goal percentages. There should be a set of metrics determined for providers across each specialty that includes not only clinical quality measures, but also productivity for patient visits, appointment kept rates, appointment cycle times, and chart completion. The overall scores for each specialty should be posted internally for all stakeholders to promote transparency in performance. Individual providers should also receive individual specific scores for tracking improvement or identify areas of concern. Similar processes should also occur for each of the HIM subgroups. In providing transparency for goals, staff will see that they are all responsible for the improvement of the organization both individually and the team they reside within. In a negative culture or organization filled with distrust, a team philosophy is often not visible. Employees do not share a common goal and lack unity to work with others for creativity and innovation. As healthcare continues to evolve and the patient centered model of care moves to new value-based payment models, Fielder Community Hospital leadership team will need to fully evaluate payer contracts for cost sharing and possible payment risks. The adoption of an electronic health record system will streamline discrete data collection for reporting. Each team will be impacted by the adoption and new processes. The project manager for the adoption will need to evaluate end user familiarity with technology from basic typing skills to advanced skills such as connecting to virtual platforms for telehealth. In addition, the lateral project to centralize the HIM department will add increased stress upon employees. A project timeline will need developed to ensure new HIM positions and other departmental changes have occurred prior to investing into a costly training program for the new system. Scattered throughout every team within Fielder are those individuals who are resistant to change and can potentially derail the overall organization
’
s goals. Developing a team charter could be a useful tool to begin a culture
17 shift and establish a common goal. Team member
’
s expertise, experiences, strengths, and weaknesses can all provide a foundation for creativity as new processes are mapped and implemented. Poor collaboration and lack of teamwork can lead to distrust and conflict. Failure of leadership to empower the team and provide efficient communication leads to employee dissatisfaction which in return impact patient satisfaction. The big picture is team performance can either have positive or negative impacts on enterprise goals. Highly functioning teams will lead to improved employee satisfaction, increased patient satisfaction, and higher quality metric scores. Poorly formed teams or pockets of dissatisfied staff can negatively impact the overall culture of the hospital. If conflict is not addressed effectively and timely, there is risk of loss of good employees who become disengaged due to ineffective leadership styles. D1: Conflict Resolution Strategy for Enterprise-Wide Changes The problem-solving conflict management strategy will be helpful when teams are challenged by the enterprise-wide changes for Fielder Community Hospital. This strategy will allow teams to focus on the problem related to challenges and barriers in meeting goals. Six Sigma Lean approaches can assist teams in defining workflows and decrease redundant or useless steps to improve efficiency. The black and green belt sponsors can keep team members on task and focused to avoid disruptions to the process. This conflict management strategy
’
s approach is for teamwork to overcome the obstacles. Staff members will be involved in collaboration, rather than barriers to the change (Stuart, 2015). Leadership will need to remain open and listen carefully to opinions and perceptions of employees regarding difficulties they are encountering with each of the changes. This activity will aid in determining any correlation of concerns to projects within the organization incurring change or highlight personnel biases of
18 change in general. The problem-solving conflict resolution strategy can lead to innovation and creativity for meeting enterprise-wide goals, along with allowing employees to openly share concerns. The activity supported with this strategy can also build trust within the organization and lead to improved performance for patient satisfaction, employee retention, and change acceptance. D2: Conflict Resolution Strategy for Negative Attitude An employee
’
s negative behavior can quickly become toxic in the workplace. It can lead to impacts on the morale and support for enterprise-wide goals within the organization. Patient satisfaction will also suffer as the organizational culture shifts to negativity. The manager of the employee should first attempt to assess the rationale for the employee
’
s behavior. In this scenario, the employee
’
s behavior is also affecting the support of the enterprise-wide changes by others at Fielder Community Hospital. Due to the timelines for project success and the importance to have support to adopt the changes within the hospital, the conflict strategy of forcing should be used. In this scenario, a resolution is needed urgently to stop any further negative impacts. The severity and risk to the overall organization must be taken into consideration. Forcing conflict management strategy provides the ability to quickly act from a managerial stance to address the employee
’
s behavior and impact on the surrounding culture. It will be necessary to have clear communication when speaking with the employee. The manager will need to remain professional and focus on the employee
’
s specific behaviors that are concerning. Allowing the employee to share their opinions regarding the changes within the hospital system will give them an opportunity to be heard. The manager will need to set expectations for behavior with the employee. A performance improvement plan is a tool to outline the problematic behavior, steps to improve, consequences if expectations are not met, and
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19 the overall expectations. By placing in writing and reviewing with the employee, the expectations of the employee are formally reviewed and communicated. D3: Conflict Resolution Strategy for New Workflow Processes Fielder Community Hospital adoption of an electronic health record system will impact existing workflows and processes. The organizational assessment concludes that staff represent a wide swing for the skillset to effectivity utilize the new technology. In addition, there are differences in opinion amongst pockets of employees regarding the benefits. The collaborating conflict management strategy will be beneficial in addressing this conflict within the organization. Leadership will need to effectively listen to feedback regarding new workflow processes, and employees will need to understand the rationale and importance driving the new processes. As the HIM departments merge into a single location, new positions and job roles will be part of the transition. Prior responsibilities may shift amongst the team related to the adoption of the electronic health record system. The organization can utilize the plan, do, check, and act (PDCA) improvement cycle to monitor for areas of concern. By having a multidisciplinary team representative of the overall organizational roles involved in the process, the building blocks for collaboration and success have been laid. Discussions within the team can lead to creativity and innovation for adapting workflows by allowing employees to assist in evaluating effectiveness of new workflows. Collaboration promotes relationship building and trust. In this strategy, new workflow processes can be discussed that can be a compromise of the feedback while ensuring the organizational requirements are met. This strategy allows both sides to have a piece of success by mutually coming together to problem solve and identify beneficial resolutions.
20 D4: Employee Complaint The perception of favoritism can create unhealthy relationships within the organization. Compromising conflict management style can be used to assist the employee and the manager in resolving concern. In addressing an employee
’
s complaint regarding their manager showing favoritism to a coworker, I would first schedule a dedicated time to meet with the employee in a confidential location. If the complaint is not addressed in a timely manner, there can be decreased motivation and reduced productivity effects. In listening to the employee, I will need to be actively listening and make the determination if there is any basis of discrimination related to the complaint that would be reportable. I will ask clarifying questions when the information presented is unclear and use paraphrasing to ensure I am understanding what is being communicated. There are certain types of discrimination that will need to be reported to Fielder Community Hospital
’
s human resource department for escalation. For this scenario, discrimination is not identified. I would encourage the employee to speak with her manager as a first attempt to resolve the conflict. However, if they do not feel comfortable meeting with them individually or the initial attempt to resolve is unsatisfactory, I would serve as a mediator between the two for a crucial conversation. The manager will be coached prior to the session to remain professional and engaged during the conversation and to not become defensive in responses. The goal would be for them to be able to resolve the conflict and have positive interactions in the future. I would follow up with the employee at dedicated intervals for monitoring. There is a larger picture for this scenario. Fielder Community Hospital should set clear expectations within the culture of the organization with strong policies and practices. The hospital should also have job specific descriptions that outline job responsibilities, qualifications,
21 and expectations. While there are enterprise-wide goals, departmental goals can also serve as metrics to measure employee performance. This ensures that all employees in the department are held to the same metric standards for performance review. The goals will be specific, measurable, achievable, relevant, and timely (SMART). The hospital should also consider training opportunities for managers surrounding cultural differences and how to adapt leadership styles based upon employee personality styles. D5: Conflict Between Leaders I tend to revert to a transformational leadership style. My strategy for conflict management is often seen as collaborating. I use this strategy in hopes to identify the best solution to a problem. This process is not quick and takes time to come to a best solution. It does require that all parties are willing to have a seat at the table and open to communication that is transparent and honest. Based upon the timeline for the merge of the five HIM departments, time is of the essence for beginning collaboration. Project planning will be crucial to meet expectations. My goal is to inspire and motivate employees with the organization
’
s vision and mission to support organizational goals. There is concern that not all existing staff have the education, credentials or technology expertise that is necessary. I would advocate for formal training and education opportunities for existing staff. There are instances when a staff member may not have the credentials listed on the job description, but their experience and expertise meet and often exceeds other candidates. Some of my peers in the scenario do not feel that there has been ample time which could lead to conflict in how they approach the merge to meet departmental goals. Another leader with an autocratic leadership style, may perceive that I provide the employees with too much power for shared decision making. Their style has the leaders making
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22 all decisions with no input from employees (Healey, 2018, p. 25). There can be conflict between our two styles related to decision making and where power is placed to manage change. While my style promotes collaboration with employees, their style could have negative impacts on culture as employees are not given the opportunity to share concerns or collaborate for best practices. The autocratic style would support quick responses and more likely a quickened timeline for the department merge. My transformational style has the risk of delaying progress if the project is not effectively managed. The optimal solution would be for both of us to align our styles based upon project deliverables. There will be specific instances that will need an autocratic approach, while other tasks could allow collaboration amongst the team. This would lead to a compromising approach to resolving the conflict. D5A: Conflicting Subcultures
As the five locations are merged, the reality of pocket of subcultures must be addressed. Each of the current locations has its own culture and diversity and there is resistance to melt into a new uniformed culture at the present time. These subcultures may hold onto prior beliefs and behaviors from the prior locations after the merger. This can cause conflict withing the organization with either positive or negative impacts. For example, a positive impact would be if a subculture shares a prior workflow that meets requirements and policy with others in the new team. This would be an example of expert power for the benefit of the overall organization. If the subculture has a best practice workflow and does not share with others on the new team, this could have a negative impact on the overall metrics for the organization. Remote workers may also feel disengaged and have their own unique subculture because of geographical locations. Consideration for meeting format and virtual platforms will need to be conducive to all employees to promote unity.
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23 In summary, subcultures can be good and bad for an organization. Leadership will need to monitor departments to allow for open dialogue for meeting goals. Some subcultures will strengthen the overall organization culture leading to improved employee and patient satisfaction, improved productivity, and effective change acceptance. If negative impacts are being seen from a subculture or group of individuals, quick assessment and intervention is needed to resolve prior to lasting negative impacts on workflow processes.
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24 References AdventHealth University. (2020, July 27). 5 Types of Leadership Styles in Healthcare. AdventHealth University
. https://www.ahu.edu/blog/leadership-styles-in-healthcare Bayot, M. L., Tadi, P., & Vaqar, S. (2022, September 18). Work culture
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