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INTRODUCTION
Within the organization of Kaiser Hospital and any organization, applied critical thinking skills provide an essential foundation for all effective planning, problem-solving, and decision-making activities. Employees who can analyze and reason effectively can help and communicate workplace problems (http//www.ohrd.wisc.edu/reg/catalog_course.asp?course_key=447). A recent problem I have heard spoken through upper management involves the negative and neglecting operations of our hospital. Much discussion has been recently filtered to the department managers regarding patient quality and satisfaction based on feedback provided by our Southern California region from our patient members. Although, solutions within the organization have yet begun, many questions came to mind when thinking of the pieces to frame this problem. I would like to discuss various ideas to frame this problem with specific forces of influence. Also, describe the types of thinking groups may have to influence and minimize the problem. In addition, discuss other avenues within our forces of influence, which may influence how the problem is framed, from our organization's culture to ethics. Finally, take what is applied, to answer this question, How do we accept each others differences and still get anything done?
PROBLEM IDENTIFICATION
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As already mentioned, there is a growing problem that has been addressed from upper management, facing all operations of Kaiser Hospital.
For the first time in my 11 years at Kaiser, have management directed the statement that discussed administrative staff employees down to the nurses and doctors, that all personnel have lost the intent and scope of the vision of Kaiser. According to Kaiser's marketing strategies, patient health care is there priority. Also, quality of care from physicians and staff strive to ensure the safety of patients while they are under the care of Kaiser (http//www.kaiserpermanente.org/locations/california/aboutkp/). After analyzing the statement from upper management and the statements based on our promising messages to consumers, describes how the "highest quality of care" advertised, may pose to some consumers and employees as a fallacy. The issues at hand are enough to identify, but is this the core of the problem?
I believe the core problem lies with the different agendas that are being introduced into the daily operations. It has become a very difficult task for the management team and the various members of its support staff to effectively run and maintain the hospital. This apparent loss of structure is tearing the communication of Kaiser's vision to a negative surface.
FRAMING THE PROBLEM
Based on the presentation of upper management, there is currently a wide array of concerns that are plaguing the hospitals ability to run and maintain its daily functions. These concerns have become so connected to our daily operations that the stability of the hospital has become threatened. There are three major concerns that need to be addressed and are currently effecting the internal operation of the hospital. The first major concern is the employees inability to follow the rules and standards set by the hospital.
Employees justify their actions by using their own personal set of opinions and standards, which they allow to dictate their individual routines at the hospital. They have single handedly set their own ethical and moral agenda, which they are pushing on to the patients of Kaiser Hospital in the form of how they are being treated medically. They have decided not to follow and uphold the mission statement that was put in place to achieve higher medical standards. The second major concern is the rising costs of running the hospital, coupled with an up and down yo-yo patient population. The hospital is experiencing an increase in cost from the previous year, which is making it difficult to provide the necessary care to its patients. The large percentage of unbalanced patient drops has affected the operating budget and is forcing cutbacks to the organization. The third concern is trying to balance these problems and brainstorm ways to handle the future cutbacks that will ultimately affect the existing staff with additional duties. Regardless of the reason surrounding the concerns or problems facing Kaiser Hospital, there needs to be immediate actions taken to put an end to the frustration, and to continue the steps of providing excellent healthcare to any and all patients.
FORCES OF INFLUENCE PLAN I
There are a variety of alternatives or influential methods that can be used to stop the abuses currently at the hospital. Before the alternatives are put into place, it is important that the decision makers use a systematic approach to problem solving. The contextual factor is the first part of the systematic approach in analyzing and stating the current problems (McCall, 10), which are occurring within the groups of Kaiser's staff. The second step in decision-making is to prioritize the urgency of those problems to be addressed as action items (McCall, 10).
All the problems that were addressed require immediate attention and decisive response; however, a system of setting priorities will alleviate the daunting task of tackling all of the problems at once.
FORCES OF INFLUENCE PLAN II
Another method to alleviating Kaiser's morale problem is taking action within the importance of our mission statement. By taking action, means providing group-thinking discussion and examining Kaiser's mission statement. This reviews the initial contract between employer and employee and also attempts to put an end to the problems that are facing the organization. The final step is to conduct a follow-up analysis to ensure that the changes are working appropriately and that all parties involved are following them and to address any issues that were raised during the problem-solving actions.
THINKING METHODS ALONG WITH OTHER FORCES OF INFLUENCE
There is no doubt the hospital needs to have the staff follow and uphold company policy and ethics. Logically thinking, the organization has implemented rules, regulations, a mission statement, and various other policies to protect employees and patients alike. These guidelines for behavior and conduct should be followed without question. A lack of discipline for those who violate the guidelines presents a barrier to increased morale and compliance. The organization needs to immediately enforce and punish those who are not willing to be in compliance with hospital policy. All employees should be notified of the organizations desire to immediately enforce the rules and regulations; those that are unwilling to follow will be subject to disciplinary actions, up to and including termination.
The identification of the other problems addressed, which are the rising costs of health care and the decrease in the patient population. The patient population should change once the organizations culture changes. The negative attitude that is present in the hospital staff that does not follow rules and company policy will eventually have a profound affect on peoples decision to choose the hospital for service. Using creative thinking strategies, the organization should attempt to reestablish the culture that has been successful in the past. The need may arise when the hospital may have to cut programs and employees, in an effort to run leaner. Finding creative ways to choose the programs that need to be cut will be the key to running at a lower cost. The fixed costs should be cut instantly if they are not being utilized or running below the required profit margin. The organizations thinking should direct the facts of their existing economic status of running as a not-for-profit and operate according to the balance sheets and budget.
ANSWER TO DILEMMA
Now, with all that has been shared in identifying the problems with morale in the hospital, how do we accept each others differences and still get anything done? It is reasonably possible and natural to examine the problems mentioned in various ways of thinking. The immediate response is to believe those that want to make a positive difference within themselves, will take the initiative to make a positive difference for their organization. This idea will protect employees in their jobs and promise the organization the provisions of their service. Therefore, providing a turn around in patient quality and satisfaction and taking those differences within each other to work for each individual and the organization they work.
CONCLUSION
Within Kaiser, and any organization for that matter, rapid changes can occur and be identified by using applied critical thinking and problem resolution actions. Our forces of influence encourage us to use a positive approach to fix the problems at hand. Kaiser's upper management, I believe, have identified the core of the problem of employee morale, rising costs and patient decline. My idea of framing the problem and using various influences of thinking may be an idea coming from one person but a great influence to other staff in finding a creative solution. Regardless of the reasons surrounding the concerns or problems, Kaiser Hospital must take immediate action by communicating the processes of problem resolution to all staff so the end result complies with providing excellent healthcare to our patients.
Schutt, D, Director. Office of Human Resource Development. Retrieved July 8, 00 from http//www.ohrd.wisc.edu/reg/catalog_course.asp?course_key=447.
Kaiser Permanente 00. Retrieved July 7, 00 from http//www.kaiserpermanente.org/locations/california/aboutkp/.
McCall, M. W., Jr., & Kaplan, R. E. (10). Whatever It Takes The Realities Of Managerial Decision Making (nd Ed.). Upper Saddle River, NJ Prentice Hall.
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