Leading and Managing Organization | Case Study | Report

Leading and managing organization
1 / 1 0 / 2 0 2 0

Management 1
Contents
Introduction......................................................................................................................................2
Problems/change in the case............................................................................................................3
Recommendations............................................................................................................................5
Conclusion.......................................................................................................................................8
References........................................................................................................................................9

Management 2
Introduction
The report aims to analyse the case study and to apply the strategic thinking, formation of
strategy and strategic change within the business. The report includes a brief description of the
situation outlined in the case study. The problems/changes are identified which are faced by the
company and they need to deal with the issues. The analysis of entire stakeholders that could be
affected is identified with the benefits as well as the costs from their perspective. The case shows
that Eastern Massachusetts University (EMU) is facing problems or challenges within their
General Surgery Unit (GSU) department. In the case, this has been witnessed that Barbara Norris
is considered as one of the well-respected and successful nurses present at EMU. Barbara Norris
works as in the GSU as the nurse manager. A nurse works effectively by accepting all the
responsibility available in the GSU department apart from the issues that are occurring in the
department. It is expected that the nurse improves the present state by resolving the issue as the
work of the entire department get affected. At the end of the report, the recommendation for the
improvement has been discussed.

Management 3
Problems/change in the case
Barbara Norris, manager of the GSU unit is liable for managing the staff, scheduling as well as
budget for the entire unit. In GSU unit, the Norris staffs include the 33 staff which includes 25
RNs and 8 patient care assistants (PCAs). In GSU, the first month remained difficult as the nurse
lost the two RNs and on the six months before her joining the unit three RNs had left. This took
place because of the current instituted hiring got Freeze at the EMU which shows that there is a
challenge of lack of nurses in the department. It has been found that due to lack of nurses,
Barbara was not able to replace some of these positions. It is witnessed that the unit was
considered as the short-satisfied in which the level of stress among the nurses was high due to
the workload. Also, Barbara identifies that her predecessors had not kept complete as well as
accurate records of the annual performance reviews of the staff.
Also, in the departments of EMU, there is a high employee turnover rate which is another issue.
In the case study, this has been found that nurses need to take care of the patients present in the
unit and also to provide them with effective services. However, it has been found that patient
satisfaction scores were average and also declined steadily in the past few years. This shows
another major problem that involves the impact on one of the major external stakeholders of
EHU for which they are performing their operations. The level of satisfaction is declining
steadily which raise a big question on the EMU. In addition to this, the GSU department of the
EMU was popular because of their culture of the conformation, favouritism and blaming
(Groysberg, Nohria & Bell, 2009). It has been found that the unit has been renowned for its
culture where the elements of the favouritism have been quite evident and the nurses feel
deprived of being motivated by the management level.

Management 4
In the GSU department, there was a tense relationship between the nursing staff but also with the
many of the units who are attending the physicians. Further, to make the condition most badly,
over-time is not offered to the nurse because they don't want to pay the additional cost-cutting
measures. The EMU is looking for the cost-cutting die to which they don’t allow for the nurse to
work extra as they have to pay the high amount (Groysberg, Nohria & Bell, 2009). This leads to
the problem for Norris as if one of her nurses was sick or the vacation time then Barbara could
not provide any kind of over-time to their staff with the motive to cover such sort of absences
apart from the fact that they rely on the RNs from the normal general float pool. The reason
behind these floaters was not similar to the unit, its specific procedures as well as the care
protocols. This leads to the additional negative effect on the dynamics of the staff as well as the
quality of the patient care (Kotter, 2012).
It has been determined that the nurses are the stakeholders of the General Surgery Unit who get
affected as they are working under the pressure as well as they are facing the stress of work.
Moreover, they are not getting the appropriate performance review in the EMU as per their work
and they are dealing with the issues due to the high-cost cutting. Apart from it, the other
stakeholders of the EMU don't get the better outcome of their investment and lack of satisfaction
makes them stay from the General Surgery Unit of the EMU.
In the case, this has been found that Norris understood the entire situation as well as the issues
that they are dealing (Klev & Levin, 2016). Considering those, Norris understood the importance
of open communication as well as the transparent review system in the development as well as
the growth of any team. As per the case, Norris tries to improve the communication among the
staff for which they organised the Off-site for her GSU staff. The Off-site leads to the rise in a lot
of issues that came up and as per the activities three people put their grievances. On this, Norris

Management 5
attempted to ask for the solution related to the issues faced by the staffs which shows the
involvement of the employees in resolving the issue and making the right decision. The major
issue highlighted by the staff is related to the dissatisfaction with the performance review
procedures (Nelson‐Brantley & Ford, 2017). In this, Barbara found that every employee gets the
same amount irrespective of their performance. On this, it has been found that the performance
review system of GSU is a mystery as well as it doesn’t seem to provide the reward to good
performance.
Recommendations
In the case study, it has been found that there are different issues which are faced by Barbara
Norris in the EMU. Based on the above-presented issues, it has been found that possible
solutions or alternatives for the issues faced by the General Surgery Unit which are required to
be followed by the EMU: -
KPI- 1 Reducing the employee turnover rate
In the case study, it has been witnessed that GSU is dealing with the issue of the high turnover as
well as the low retention of the employees. General Surgery Unit has been under the severe
pressure where Norris is not able to determine the suitable replacement for the nurses that have
left the General Surgery Unit. It has been found in the case that cost-cutting is one of the
measures which restrict to hire the new nurses due to which the issue took place (Bernstein &
Linsky, 2016). To achieve this KPI, it is suggested to the Norris to hire the new staff within the
GSU. It has been found; in case nurses will hire the new nurses then they will be able to find
more staff who can work at the place of the other staff. Along with this, the availability of the
new nurses in the GSU reduces the level of stress in the Unit. The reduction in the level of stress

Management 6
will make the nurses stay for a longer period because they don't find any stress (Iles, 2017).
Thus, this contributes in reducing the turnover rate. In addition to this, nurses in the GSU will be
able to take the leave for their personal purpose as there replacement is available in GSU.
KPI- 1 Weekly meeting and sessions
In the case study, this has been relationship among the staff remains quite cold as well as
reserved where they don’t find anyone who remains ready to provide the support to another
employee (Gu & Itoh, 2016). The issues of the communication between the staff affect them as
well as the patient which affects their level of satisfaction with GSU. To attain this KPI, it is
suggested to the Norris to conduct the regular meeting as well as interactive sessions amongst the
nurses. These sessions help them to communicate effectively and this allows them to support
each other while performing the activity. Thus, the communication issues can be resolved with
this KPI.
KPI-3 Improving patient retention
Considering the different issues witnessed in the case faced by the nurses, the KPI that has been
suggested is for improving the retention of the patient. It has been considered that patient
retention is possible when they find that the services provided by the nurses are effective and
they are getting the services on time. It is suggested that to meet the KPI, the nurses need to
enhance their performance in which they co-ordinate. In addition, patient retention is one of the
criteria that will be considered by the top management at the time of the review of the
performance of the nurses (Stillwagon, 2015). It is suggested to record the transaction effectively
as this is the way through which the performance will be upraised. In the management of the
performance appraisal or review, the superior manager of EMU should consider all the records

Management 7
which help them in reviewing the performance (Bergeron, 2017). Thus, this KPI helps in dealing
with the issue of the performance review and proper review will help the employees to feel
motivated and stay for long-run within EMU.
KPI-4 Patient satisfaction scores
In the case, this has been witnessed that the patient satisfaction score is getting affected due to
the high level of the stress on the nurses for performing the activity in the absence of another
person. It has been witnessed that the culture of the conformation, favouritism and blaming
affects the nurses as they feel motivation due to which the patients get dissatisfied. This decline
in the level of satisfaction is required to cater to whom the recommendation for KPI has been
provided (Noe, Hollenbeck, Gerhart & Wright, 2017). To attain this KPI, it is recommended to
manage the behaviour towards the staff as it helps them in dealing with the entire nurse and
offering them a high level of satisfaction. Along with this, this will allow the nurses to work
effectively because they won’t be able to find any differences in the culture that positively
motivates them and they work for the safety of the patients (Ahmed, Siantonas & Siantonas,
2017). Thus, this KPI is essential as it helps in dealing with patient satisfaction which is required
to be maintained by EMU.

Management 8
Conclusion
At the end of the report, this can be summarized that Barbara Norris deals with the different
issues in the General Surgery Unit. It has been found that the job of the manager is considered as
one of the difficult jobs and in GSU Barbara deals with a wide range of issues. The issues are
related to the nurses that are present in GSU such as high turnover, favouritism, inadequate
performance review and many others. Thus, considering all issues, management decided to bring
the Off-site activities which helped them in understanding the opinion as well as the issues faced
by the nurses in GSU. At the end of the report, recommendations in the format of the KPIs that
are linked with the issues that are witnessed in the case are discussed. All these KPIs contribute
in reducing or eliminating the issue identifies in the case by Barbara.

Management 9
References
Ahmed, A., Siantonas, G., & Siantonas, N. (2017). The 13 key performance indicators for highly
effective teams. Routledge.
Bergeron, B. P. (2017). Performance management in healthcare: from key performance
indicators to balanced scorecard. Productivity Press.
Bernstein, M., & Linsky, M. (2016). Leading change through adaptive design. Stanford Social
Innovation Review, 14(1), 48-54.
Groysberg, B., Nohria, N., & Bell, D. (2009). Barbara Norris: Leading change in the general
surgery unit. HBS Case, (409-090).
Gu, X., & Itoh, K. (2016). Performance indicators: healthcare professionals’ views. International
journal of health care quality assurance, 29(7), 801-815.
Iles, V. (2017). Leading and managing change. ABC of Clinical Leadership, 24(1), 49-87.
Klev, R., & Levin, M. (2016). Introduction: The Practice of Leading Change. In Participative
Transformation (pp. 15-24). Routledge.
Kotter, J. P. (2012). Leading change. Harvard business press.
Nelson‐Brantley, H. V., & Ford, D. J. (2017). Leading change: a concept analysis. Journal of
advanced nursing, 73(4), 834-846.

Management 10
Noe, R. A., Hollenbeck, J. R., Gerhart, B., & Wright, P. M. (2017). Human resource
management: Gaining a competitive advantage. New York, NY: McGraw-Hill
Education.
Stillwagon, A. (2015). 14 Key Performance Indicators (KPIs) to Measure Customer Service.
Retrieved from: https://smallbiztrends.com/2015/03/how-to-measure-customer-
service.html