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Sharp Healthcare: Factors Related to Organizational Behavior Aima Payton Timothy S. Godfrey, SJ Hollis Misiewicz

SHARP HEALTHCARE Sharp Healthcare: Factors Related to Organizational Behavior Organizational behavior is influenced by the interaction of many complex factors that

exist whenever people work together (Borkowski, 2011). Individual and group dynamics within an organization can influence the working environment and determine whether that organization will succeed in attaining its goals. In Chapter 11 of Masterpieces in Health Care Leadership: Cases and Analysis for Best Practice, Pelote and Route (2007) demonstrate by the testimonies of employees, patients, and executive leadership of Sharp Healthcare Outpatient Pavilion how leaders within the organization transformed their vision into reality. The purpose of this paper is to analyze factors influencing the organizational behavior of Sharp Healthcare as reflected in the accounts of the employees of the Outpatient Pavilion endoscopy center, and describe how leadership enacted and sustained change within the organization to realize their vision and mission. Team Building Not all people who happen to work together can be defined as a team. A team is a special group of individuals who have a shared goal and defined tasks. They have skills that complement each other and have a common purpose (Borkowski, 2011). As shown by the accounts of employees, leadership, and patients of the Sharp Healthcare Outpatient Pavilion the staff of the endoscopy center are not just a random group of people thrown together by the circumstances of their employment but an effective team. Katzenbach and Smith (as cited in

Borkowski, 2011) list eight approaches for the development of a successful team. The leadership at Sharp Healthcare Outpatient Pavilion demonstrated several of these methods in developing a team that shared a common purpose and goal.

SHARP HEALTHCARE The first approach to team building is to establish urgency and direction (Borkowski,

2011, p. 346). Sharp Healthcares vision of being the best place to work, practice medicine and receive care is the guiding light and beacon for employees at the Outpatient Pavilion (Pelote & Route, 2007, p. 197). This vision was communicated to the entire organization at allstaff assemblies where leadership emphasized that all employees are owners and participants in the goal of realizing this vision. At one assembly a video of a mother and baby who were saved by the actions of staff of the ER and ICU was shown to emphasize how each individual working together as a team can have a dramatic impact on the life of a patient (Pelote & Route, 2007). Sharp Healthcare was the best place to receive care for this mother and her baby and those who saved them were working in the best place. For a successful team, members must be selected on the basis of their skillsnot just personality (Borkowski, 2011). Sharp Healthcare demonstrated this in their care in selecting people with the right fit (Pelote & Route, 2007). The executive leaders and managers hired employees who showed compassion, caring and a concern for patients. They did not hire people who had potential but those who already had the customer service skills and necessary attributes to fit into the organization. This was demonstrated when a candidate for a receptionist position was hired because she asked questions about how her role would fit into the philosophy in the endoscopy clinic and showed a hunger to contribute something to the department (Pelote & Route, 2007). Setting clear rules of behavior is important to the successful development of a team (Borkowski, 2011). The leadership at Sharp Healthcare made it clear that all employees were expected to be compassionate to patients and considerate to each other. Testimonies of the staff at the Outpatient Pavilion of the endoscopy center illustrate this point.

SHARP HEALTHCARE The commitment to consideration to coworkers, for example, was demonstrated when a

manager let an employee go who would cut down the nurses in front of the physicians (Pelote & Route, 2007). Although he was competent at his job, his personality did not enhance the efforts of the team at the endoscopy center. Sharp Healthcare did not tolerate poor customer service and fired employees who exhibited this behavior (Pelote & Route, 2007). Spending lots of time together was specified as an approach to team building by Katzenbach and Smith (as cited in Borkowski, 2011). At Sharp Healthcare five-star service was a part of the organizations vision (Pelote & Route, 2007). As evidenced by the training involved for new hire front-line staff, Sharp Healthcare emphasized the importance of spending time together to learn to work together as a team even before actually embarking on a new position. When front-line staff was first hired, the management would take them on field trips where they would sit in lobbies of hotels and take notes about what delineated a five-star hotel from an inferior hotel. Afterwards, they analyzed what they had observed, and then participated in a retreat where they practiced service behavior through role-playing, video-taped their new skills, and then critiqued each others performance (Pelote & Route, 2007). Spending time together, especially at the beginning, is important for building effective team performance (Borkowski, 2011). The stories shared by the staff and leadership of Sharp Healthcare Outpatient Pavilion endoscopy center reveal a team that is committed to a common goal and vision. As a team, the staff works together to provide compassionate and excellent patient care. Through their vision and mission, good fit of personalities and skills, clear rules for behavior, and opportunity to

SHARP HEALTHCARE spend time together prior to beginning a new position, the team that emerges is successful in creating a place that is the best place to work, practice medicine and receive care. The Change Process The leadership of Sharp Healthcare took a bold step when they announced to their stakeholders both within and outside the organization that they were instituting a new vision of delivering health care that was going to be known as The Sharp Experience (Pelote & Route,

2007). The success of this innovative transformation identifies Sharp Healthcare as an exemplar of the strategic planned-change process known as organizational development which is a systematic process of addressing organizational issues or implementing change strategies (Jones, 2011, p. 370). Managing such a systemic change process requires an approach which engages all facets of the organization, and creates a whole new culture as exemplified by the testimonies of the leadership and staff of Sharp Healthcare (Pelote & Route, 2007). One systemic approach that produces such an organizational change is The Model for Organizational Transformation in Health Care Systems developed by Lukas et al. (2007). The model depicts the transformative process that is necessary within a health system to produce better health outcomes for patients and effect sustained systemic change (Figure 1). The process is not a once-and-for-all program, but an iterative process that prompts further change within the organization over time (Lukas et al., 2007). As depicted in the model, the transformative process is a dynamic one consisting of five key elements: (a) an impetus for change, (b) leadership that is committed to change, (c) improvement initiatives (evidence-based practice) that engage all levels of staff, (d) integration of the subunits of the system, and (e) alignment of system-wide goals. These key elements do not stand alone, nor do they progress in an orderly or linear fashion; rather, they are part of a

SHARP HEALTHCARE dynamic process that impacts all facets of the system. The five elements interact dynamically with the components of a system (mission, operations, processes, infrastructure) to bring about systemic change that results in positive health outcomes over time (Lukas et al. 2007).
The Model for Organizational Transformation in Health Care Systems

Figure 1. Transformation begins with an impetus for change. Leadership oversees

alignment and integration across system with improvement initiatives coming from within the whole organization. All aspects of the organization are impacted, with improved patient care as an outcome. Change is sustained over time, producing further transformation. Adapted from Transformational Change in Health Care Systems: An Organizational Model, by C. V. Lukas, S. K. Holmes, A. B. Cohen, J. Restuccia, I. E. Cramer, M. Schwartz, and M. P. Charns, 2007, Health Care Management Review, 32(4), p. 314. Copyright 2007 by Wolters Kluwer Health / Lippincott Williams & Wilkins.

Leadership plays a central role in the change process by maintaining a sense of urgency for change, disseminating evidence-based practice models throughout system structures, and incorporating accountability measures for the change process (Lukas et al., 2007). The leadership of Sharp Healthcare was committed to a new vision of health care deliveryThe

SHARP HEALTHCARE Sharp Experienceand it engendered this same urgency and commitment within the organizations employees (Pelote & Route, 2007). The leaders also invested in the training and education of the staff in best practices of industries outside of health care to create the five-

star model of patient care, and leadership development focused on employee selection to ensure that new hires would be the right fit for the organization (Pelote & Route, 2007). Finally, the leadership integrated the subunits of Sharp Healthcare (such as the outpatient endoscopy unit) so that the product of the organization was The Sharp Experience, and they aligned all of the employees through the common mission of providing the five-star experiencethe performance standard to which all were held accountable (Pelote & Route, 2007). Supervisors demonstrated their readiness to assist in problem-solving and coaching employees for success; they were equally clear that unacceptable behaviors would not be tolerated. In one case, for example, a manager terminated an employee because he was not in line with what we wanted to do at the pavilion (Pelote & Route, 2007, p. 202). By building a strong sense of team and instilling that spirit into the organization through a systemic change process, Sharp Healthcare initiated an organizational change that emphasized the five-star experience which was translated into the performance of each individual staff member (Pelote & Route, 2007, p.216). The difficulty with any organizational change, however, is to sustain the change over time. Sharp Healthcare also instituted activities into the change process that ensured that the change towards the five-star model of delivering care was embedded into the system.

SHARP HEALTHCARE Sustaining Change Sharp Healthcare sustains change over time and stays in line with their mission and

vision of being a premiere healthcare center by creating a balance between patient and employee satisfaction. Staff feels valued as essential members of the organization and patients feel as if their business is valued. This is shown throughout the vignettes of the Sharp Healthcare organization. From the CEO down to the maintenance team, the staff is encouraged to exceed expectations and provide the consumer with the utmost experience during their stay (Pelote & Route, 2007). Sharp Healthcare continuously strives to provide quality health care while maintaining the highest level of customer service. This becomes increasingly important when addressing the emotional needs of the patient and balancing their basic health care needs. The Sharp employees make it their mission to maintain a certain level of comfort and professionalism. The staff focuses on providing a personal touch which enhances the Sharp experience. Each patient is treated as an individual and their business is appreciated and valued. From the first encounter with the concierge and the receptionist, the patient encounters the five-star experience at Sharp (Pelote & Route, 2007). Patient satisfaction appears to reign supreme within the mission and values of the organization. As stated in the vignette by the CEO, One of things we learned on this journey is that if you dont come to us with customer service ingrained within you we cant teach you (Pelote & Route, 2007, p. 200). This displays how seriously the leadership takes patient satisfaction at the Sharp healthcare organization. As

stated by one of the patients, First of all, what impresses me is that they treat us like people in a five-star hotel. They are a well-oiled machine (Pelote & Route, 2007, p. 206).

SHARP HEALTHCARE Each patient is given ample opportunity to expresses their grievances to management regarding their stay. This prompts management to intervene as necessary and make improvements in the processes of the organization. As stated by the CEO, I have been known to bring patients who have been harmed in our organization to speak to our leadership teams. Weve had 1,100 people sobbing after realizing what has happened because of our mistakes (Pelote & Route, 2007, p. 199).

In continuing with their vision of patient satisfaction, Sharp Healthcare instituted a policy of sending thank you notes to every patient who received care in their facility. The personalized notes were written and signed by the individual members of the patients health care team. This personal touch is highly valued by the patients, and they mentioned often how elated they were to receive signed notes from their doctors and nurses. As one staff member stated, One hundred percent of our patients receive a thank-you note, and its signed individually by those people that have actually touched the patient. It is now mailed to the patient at the home and sent at the end of their procedure day (Pelote & Route, 2007, p. 212). The patients even expressed to the CEO how much joy they received and how shocked they were to obtain the personalized thank you notes (Pelote & Route, 2007). The emphasis on patient satisfaction and the five-star experience also increased staff satisfaction, resulting in a higher functioning staff as evidenced in the various testimonies of the staff at the Sharp Healthcare. The leadership reinforced the importance of patient satisfaction by rewarding and praising their staff when they did a good job (Pelote & Route, 2007). Finally, the staff of Sharp Healthcare participates in the decision-making processes of the organization, facilitating their sense of ownership of the enterprise. The CEO modeled this inclusivity by stating, I made time to talk with every staff member and had staff meetings about

SHARP HEALTHCARE what was important to them and what they wanted to see in the department (Pelote & Route, 2007, p. 203). The staff viewed the leadership at Sharp Healthcare as being fair, inclusive and


cognizant of their personal and professional lives. As one employee reflected, My manager is a great leader because she lets us be. If she feels she needs to step in, she will, but she respects us enough to let us figure it out (Pelote & Route, 2007, p 210). The mutual respect displayed in such a statement enhances the staffs ability to provide the utmost care to their patients, and serves as an impetus to sustain the five-star experience over time. Conclusion The Sharp Healthcare leadership infused the organizations mission and values into the care, policies, and procedures of the organization. From the CEO to the maintenance staff, each employee demonstrated compassion and a drive to provide excellent patient care, making each staff member an integral and valued member of the care team. The leadership team maintained a mission-driven focus within the organization by outlining clear and precise expectations for all of their employees, and feedback from patient satisfaction surveys and data collection allowed for continuous evaluation of operating procedures and improvement. By integrating the various units of the organization to provide The Sharp Experience and aligning all the employees through team-building activities to perform at a five-star level, the leadership of Sharp Healthcare brought about an organizational change that not only improved patient outcomes, but increased staff satisfaction as well. Identifying key organizational behaviors, engaging the appropriate process for change, and employing strategies to sustain the desired change enabled Sharp Healthcare to accomplish systemic transformation. This systemic transformation produced an environment of utmost patient and staff satisfaction, allowing Sharp Healthcare to become an organization of excellence.



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