Healthcare Organization Analysis

This assignment requires students to analyze a healthcare organization, in this case, Cambridge Health Alliance, using the McKinsey 7S framework. The analysis involves examining various aspects of the organization, such as strategy, structure, systems, shared values, skills, style, and staff, and how they interact. Students must conduct a literature review on relevant concepts and utilize online resources to gather information about the chosen organization.

HEALTH INNOVATION

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
1. Content ...................................................................................................................................1
2. Context....................................................................................................................................4
3. Transformation process ..........................................................................................................8
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
The present report will help to understand the concept of change and innovation. In this
context, better solutions and ideas are applied to meet changing requirements and needs. To
understand this concept, Cambridge Health Alliance (CHA) is considered. It is a public safety
net health system which is based in Cambridge. The CHA formed ACO (accountable care
organization) which is made up of hospitals, physicians and other caring roles. The main motive
of CHA is to offer high quality and coordinated care service to all patients and they also want to
reduce the spending of service users by eliminating all types of unnecessary services (About
Cambridge Health Alliance, 2016). Within two years, cited organization had received National
Committee for Quality Assurance patient centered medical home recognition for six of their
primary care sites.
Stakeholders
Management of CHA has internal and external stakeholders which provide their effective
contributions to manage organizational work.
Internal stakeholders Description
Care workers They can contribute effective role for organization to provide
medical services to medical patients. They can give huge reliability
to manage their operations.
Managers They help the management of CHA to develop proper medical
policies which help to provide better health care services to people
and patients (Shiri, Anvari and Soltani, 2015)
Suppliers They help them to manage organizational activities of corporation
by providing quality medical instruments like X ray machine which
provide better flexibility to offer health care services.
External stakeholders Description
Patients They help the organization by providing their feedback regarding
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medical services which contribute effectively to develop new
policies in the UK.
Investors Management of CHA provide timely dividend to organizational
shareholders which increase trust between them. It provides huge
flexibility to manage monetary fund from investors to improve
health care services for people.
1. Content
Change and its type
As per give case study it is evaluated that CHA makes the decision to build ACO because
of the health care reforms in Massachusetts. In this context, Massachusetts passed on law which
aim was to cost control. On this basis, CHA thinks to adopt integrated delivery system or ACO.
For this purpose, they decide to move away from their fee for service system strategy. In this,
they think to convert from fee for service strategy to global payment system. As per Chaudoir,
Duganand Barr, 2013, term fee-for-service is a payment model in which services are paid
separately (Chaudoir, Duganand Barr, 2013). In same context, Lee, Lee and Abdullah, 2013
defines that according to this system payment is directly depend on quality of care rather than
quality (Lee, Lee and Abdullah, 2013). To successfully attain their mission, Cambridge Health
Alliance decides to restructure and transformed their broth financing models and delivery
systems. According to Ciccone, Berg and Pérez-Escamilla, 2012, the term change means
transforming the things with new innovations (Ciccone, Berg and Pérez-Escamilla, 2012).
According to case study, it is evaluated that CHA is adopting the changes in health care
environment by specifically developing ACO. Munn-Giddings and Winter, 2013 also define
change as a process in which firm changes their working methods and operations to deal with
new situations in more effective manner. (Munn-Giddings and Winter, 2013). According to case
scenario, it is seen that CHA focus on culture and policy change. In this context, transformation
process was based on improving health of population; enhance the experience of patients and
lowering the costs. In this, four major types of strategies are explored which are as follows:
 Establishing patient-centered medical homes
 Entering alternative payment arrangements with managed care organizations
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 Launching complex care management (About Cambridge Health Alliance, 2016)
 Establishing a partnership with a tertiary care institution.
These four strategies are adopted by CHA at the time of transformation. In this context,
Cambridge Health Alliance focus on development of patient-centered medical homes (Kochi,
Fabricant and Mehl, 2013). With the purpose of development, CHA also creates two types of
leadership position such as vice president and chief administrative officer. CHA involves three
factors in their transformation model such as payment reform, delivery reform and infrastructure.
At the time of implementing the transformation model at workplace, CHA also focus on training
and development of employees (Lee, Lee and Abdullah, 2013). The main motive of training was
to enhancing the management skills like leadership, collaboration, emotional intelligence and
complexity etc. According to Jay, 2013, the term training is learning process which helps to
improve the skill, capabilities, abilities and knowledge of person (Jay, 2013). At the time of
adopting the innovations and making changes in older systems, it is highly required to train the
staff members and caring roles. In order to meet the requirements and needs of patients, trained
caring roles and service providers are required (Lee, Lee and Abdullah, 2013).
Reason for the change
The culture change and workforce ware the two major core principles of CHA. IN this
context, the main reason of change at CHA was to follow the law which was passed by
Massachusetts. In addition, CHA also face diversity at workforce such as more than 40 percent
care patients speaks other language rather than English. At the time of preparing transformation,
main motive was to provide high quality care and support services to all population of patients.
To meet the objective of transformation changes, CHA uses task force model. In order to
develop recommendations on compensation, education, care redesign and performance metrics,
CHA creates five work groups. According to Kochi, Fabricant and Mehl, 2013, innovations and
changes are influenced by both external and internal factors (Kochi, Fabricant and Mehl, 2013).
Before applying transformation procedure, it is essential to examine organizational
strategies. For this purpose, strategic aspects are divided in three parts such as context, content
and process. It offers conceptual guide for the implementation of strategic change. This aspect is
also known as Pettigrew and Whipp's typology model or content, context and process model.
These three aspects are defined as below:
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 Content- In this, changes are considered such as aprocessual, acontextual and ahistorical
in character. Before making any type of strategic decision, it is essentially required to
evaluate the context of CHA. In this phase, leadership styles are considered like
transformation leadership, strategic leadership and self learning leadership. CHA
involves three factors in their transformation model such as payment reform, delivery
reform and infrastructure.
 Context- Basically, the term context is a type of situation. In terms of configuration, it
defines the situation of Cambridge Health Alliances. In this, it considers both internal and
external situation of the cited organization. The internal aspects include culture, structure,
resources, skills and power distribution, etc. Whereas, the external aspects of CHA
includes outside elements of organization like legal, social, environmental and economic.
As per given case study, it is evaluated that due to complexity in financial structure, CHA
was facing the financial pressure.
 Process- After analyzing content and context aspects of CHA, the final phase of this
model is process. In strategy implementation, strategic changes are considered as
processes. In this phase, implementation is enclosed. According to the given case study, it
is evaluated that in this phase, CHA transformed their both financing models and delivery
systems. CHA also creates two types of leadership position such as vice president and
chief administrative officer. Cited firm also focuses on enhancing employee engagement
with the help of training programs.
On this basis, CHA starts to focus on training concept and provide to all caring roles and
staff member at required time frame. In addition, with the purpose of transformation, CHA
establishes 15 work groups and their main motive was to focus on key areas which were related
to infrastructure and clinical development. On this, Glasby and Dickinson, 2014 defines that to
manage and complete the tasks in effective manner; team work concept is very beneficial
(Glasby and Dickinson, 2014). Due to the complexity in financial structure, cited organization
was also facing the financial pressure. Main reason of transformation to help CHA is stabilizing
their both short and long term finances. In order to remain financial sustainable, CHA essentially
requires narrowing their operating losses (Kochi, Fabricant and Mehl, 2013). The changes were
also required at CHA because cited firm did not offer lucrative specialized care and their most of
hospital admission were for psychiatric care and medical treatment. In this context, DSTI
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(delivery system transformation initiatives) was one of the most important financial opportunities
for CHA (About Cambridge Health Alliance, 2016).
CHANGE CONTENT:
This change is a transitional change as it creates CHA to replace all its present procedure
with the new activities. It is necessary for working as per the requirements of market. The main
cause behind the change is alteration in the Massachusetts health care market and its rules of
environment. It is necessary for the CHA firm to work as per alteration for holding its place and
brand value.
Scope of the change
At CHA, the changes take place at organizational culture, financial system, job and
policy changes. At the time of transformation, Cambridge health alliance set the goal to convert
their each and every primary care site into PCMHs (patient centered medical homes). In order to
support and develop high functioning team based care at CHA, work flow standards and process
were continuously analyzed at every six week cycles. Further, at the time of transforming
changes in environment, CHA starts to update their job description of nurses (Glasby and
Dickinson, 2014). In addition, changes and innovations were also made in organization culture.
According to Brunt, 2014, organizational culture is basically a system which defines behavior,
values and beliefs of employees who works in organization (Brunt, 2014). With the changes in
culture, CHA adopts various types of strategies to communicate vision of ACO-PCMH
throughout the organization. At the time of implementing transformation model, CHA specially
focus to build skills in teams and workforce. In order to track the outcomes, few methods were
used such as motivational interviewing, health literacy data reports and process improvements. In
this context, Farchi, Barrett and Dopson, 2013 critiqued that changes in organizational culture
are not beneficial because for certain time period, it lowers the performance of company (Farchi,
Barrett and Dopson, 2013). But in contrast, Shiri, Anvari and Soltani, 2015 defines that
innovations in organizational culture increases the productivity and performance of firm (Shiri,
Anvari and Soltani, 2015). In order to reduce the emphasis on productivity, CHA begins
planning for changes in more effective manner.
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2. Context
Few key aspects are considered at the time of implementing the transformation model
which is defined as below: Health system reconfiguration- In order to increase the efficiency of care services, CHA
made significant changes across their entire system. In this context, CHA transitioned
their primary care sites (Farchi, Barrett and Dopson, 2013). Prevention of readmission- In order to improve the coordination and transition, CHA
focus on medication management, patient education and appointment follow up. Service improvements- CHA focus on redesigning the emergency departments in order to
reduce the waiting time and lengthy stays. This step helps to increase the patient's
satisfaction level in effective manner (About Cambridge Health Alliance, 2016). Expertise with global payments- In present time CHA is using global payment initiative
model across their entire network. Patient centered medical homes- Across their ambulatory network; CHA is continuously
building their PCMH care model. Complex care management- In order to improve the health, chronic, intensive conditions
of patients, CHA is using the planned care team approach model at their medical home
sites. This approach helps to reduce the burden of costs and illness rate. In order to
manage health of safety net population, CHA learns many things while working with
network health. ACO infrastructure- at the time of transformation and adoption of new things, CHA plans
to develop their administrative support and infra structure. Integrated continuum for care for medical and behavioral health- In order to fulfill the
requirements and needs of patients, CHA tries to develop integrated based continuum
care services for service users (Shiri, Anvari and Soltani, 2015).
 Integration for both physical and behavioral health- With the purpose of intensive mental
health illness, CHA develops mental health care home model to attain this goal.
In addition, CHA provides excellent specialty services and care programs to population
of patients. The main mission is to improve the health of communities which it serves. Further,
their objective is to offer high quality and coordinated care services to all patients. In order to
improve their delivery system, CHA has high level of dedicated extensive resources. In addition,
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CHA pools their heavy investments in improving their policies, procedures, patient safety and
medical information technology (Shiri, Anvari and Soltani, 2015). Further, CHA also gives
response to policy environment. According to given case study it is evaluated that Cambridge
Health Alliances specifically focus on their quality management in respect to care and support
services. With the changes, CHA makes the commitment with public related to providing high
quality care in Cambridge. The CHA has expertise in specialty care, primary care, care service
for complex & diverse population and mental health services. To attain the objectives and
mission of CHA, all medical and administration staff remains committed towards teaching,
living and learning (About Cambridge Health Alliance, 2016).
In addition to this, position of CHA is effective but firm suffers with various issues in
health care market. Organization needs to improve the quality of medical service which
contributes effectively to improve its position in an appropriate manner. By using this strategy,
management of CHA provide effective help to achieve its goals, objectives, mission and vision.
Further, organization can provide better medical services to patients in various areas.
Model Implementation
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In order to develop and implement the change processes at workplace, Cambridge Health
Alliances uses the model which is known as McKinsey 7S model. With the help of this model,
CHA is able to attain their planned objective and they can also work according to changes in
market and organizational policies. This model specially focused on 7 elements such as strategy,
structure, system, shared values, skills, style and staff. This models help the organization to
improve performance, examines effects of future changes, align processes at the time of merger
and in last it also determines the best way to implement the strategy which is proposed by
management (Framework of McKinsey, 2016).
Strategy factor
In order to attain the objectives, CHA develops four main types of strategies such as:
 Entering alternative payment arrangements with managed care organizations
 Establishing patient-centered medical homes
 Establishing a partnership with a tertiary care institution
 Launching complex care management.
In this context, Singh, 2013 describes that for implementing the changes in working
environment, CHA uses the strategies which focus on quality of care services and requirements
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Illustration 1: McKinsey 7S model
Source: (Framework of McKinsey, 2016)

of service users (Singh, 2013). BY focusing on strategies, CHA develops emergency
departments, patient centered medical homes, effective payment arrangements and complex type
care management. Zentner, 215, defines that in order to remain committed in respect to effective
care services, CHA also establish partnership concept with territory care organizations and
institutions (Zentner, 215). With the principles of education workforce, CHA focus on safety set
health system which aim was to educate, develop and manage effective culture.
Structure factor
In order to transformation changes in CHA, Huhtala, Feldt, Hyvönen and Mauno, 2013
stated that cited firm has the matrix type structure. At the time of changes, cited firm focuses on
two points such as financial model and delivery system (Huhtala, Feldt, Hyvönen and Mauno,
2013). With the help of this type of changes, cited organization wants to achieve the objective of
provide effective care services to population of patients (Singh, 2013). In contrast, Zentner, 215
critiqued that “The main motive of CHA is to stabilize the long term finances with the help of
changing structure of their financial system (Zentner, 215).
System factor
With the help of excellent system at workplace, organization is able to operate and
manage their practices and operations in effective manner. According to Cadden, Marshall and
Cao, 2013, the effective systems of CHA are such as communication, human resources,
technology, financial and data ware house which helps the firm to manage their success in an
effective manner (Cadden, Marshall and Cao, 2013).
Shared values factor
As per the given case study, it is evaluated that CHA has values which aim is to develop
management skills of employees at the time of changes in culture, structure and policy of
organization. The main motive of CHA's values is improved health conditions and welfare of
patients. The authors Christopher, Wendt and Goodman, 2014 defines that CHA has the very
strong and effective values which is seen in their staff members and caring roles. The reason they
all are highly dedicated towards their work to attain the mission of cited firm (Christopher,
Wendt and Goodman, 2014). On other side, Maybin, Park and Quilligan, 2014defines that “Core
values of Cambridge Health Alliances are basically based on few factors such as respect,
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integrity, community, excellence, learning and compassion etc. (Maybin, Park and Quilligan,
2014).
Style factor
This factor defines the leadership style of Cambridge Health Alliances. In this context,
Brennan and Monson, 2014 describes that in order to lead the human resources and team in right
direction, cited firm creates two positions such as vice president and team administrators
(Brennan and Monson, 2014). According to given case study it is evaluated that democratic type
leadership style is used at workplace of CHA because at the time to making the decisions, cited
firm involves their all staff members. But in contrast, Cummings and Worley, 2014 critiqued
that decision making process of CHA is very slow because many staff members faces the
conflicting issues which wastes most of time (Cummings and Worley, 2014).
Staff factor
In order to enhancing the managerial skills o employees and staff members, CHA focuses
on training and development program. Christopher, Marece and Goodman, 2014 define that in
order to implement transformation model in an effective manner, CHA focuses on enhancing the
employee engagement (Christopher, Marece and Goodman, 2014). With the help of training,
CHA wants to enhance the abilities, skills, capabilities and knowledge of all caring roles and
staff members. On other side, Cummings and Worley, 2014 stated that safety net healthy system
is applied at workplace of CHA with the motive of increasing the roles of all staff members
(Cummings and Worley, 2014). This system clearly raises the number of employment facilities.
Skill factor
At the time of making and implementing the innovations and changes at workplace, it is
essentially required for every organization to enhance he capability and skills of human
resources. The reason is, after changes staff members are not aware about new technology then
they will face issues at the time of working (Shiri, Anvari and Soltani, 2015). For the solution of
this type problem, it is essentially requires to train the staff members in effective manner. In
same way, Cummings and Worley, 2014 defines that by enhancing the skills and abilities of staff
members, they are able to cope up with the changes in their working environment (Cummings
and Worley, 2014). According to given case study it is evaluated that CHA focus on enhancing
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management related skills of staff members with consideration of complexity, problem solving,
leadership, collaboration and emotional intelligence (Cambridge Health Alliance, 2011).
3. Transformation process
At the time undertaking transformation process at workplace, CHA focuses on few
factors such as market, policy and organizational factors. For the success of transformation
process which is related to safety net system, these factors are highly required to be tracked. In
order to remain financial solvent, CHA focused on delivery system and financing models in
transformation process. The transformation model is focused on community, population health
and infrastructure of Cambridge Health Alliances. In this context, CHA consider two factors
such as payment reforms and delivery reforms. In the changes in transformation model,
infrastructure focuses on partnership, communication, structure and culture (Cambridge Health
Alliance, 2011). The main motive of transformation process at workplace is to stabilize the long
term and short term financial pressures which were caused due to complexity of financial
structure. The new and innovative changes are made to resolve the financial problems of CHA.
In this context, delivery network system of CHA also losses around $30 million (Shiri, Anvari
and Soltani, 2015).
Implementation:
Referral process is used by CHA firm in which patients can get primary and better care
facilities in comparison of other heath care organizations. On the other side, the partnership with
Beth Israel Deaconess medical centre also provides effective regarding pricing. It also helps the
medical victims to reduce their cure cost in the CHA. In addition to this, organization also
develops to provide access to the health of patients which helps to analyses the major medical
morbidities.
RECOMMENDATIONS
 In order to support and attain organization's mission, firm can hire new skilled staff
members.
 Cited firm can implement democratic leadership style.
 For future survival, organization can focus and plan effective planning.
 In order to recognize the requirements and needs of social determinants with poor health,
CHA can include social workers and community resource specialist.
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CONCLUSION
With the help of this system, it is articulated that innovation and change plays an
important role in attaining both; success of organization and its objectives. At the time of making
changes and adopting the new things, every organization requires to focus on several things such
as strategy, culture, structure and human resources. The present research helps to understand the
importance and impacts of innovations at workplace. It is evaluated with research that with the
help of transformation model, Cambridge Health Alliances improves the quality of their care and
support services. Further, it is also defined that for the success of transformation process, cited
firm implements the McKinsey 7S elements.
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REFERENCES
Books and Journals
Chaudoir, S. R., Dugan, A. G. and Barr, C. H., 2013. Measuring factors affecting implementation
of health innovations: a systematic review of structural, organizational, provider, patient,
and innovation level measures. Implement Sci. 8(1). p.22.
Lee, Y. K., Lee, P. Y. and Abdullah, K. L., 2013. Health innovations in patient decision support:
Bridging the gaps and challenges. Australas Med J. 6(2). pp.95-99.
Ciccone, D. K., Berg, D. and Pérez-Escamilla, R., 2012. A model for scale up of family health
innovations in low-income and middle-income settings: a mixed methods study. BMJ
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Munn-Giddings, C. and Winter, R., 2013. A handbook for action research in health and social
care. Routledge.
Jay, J., 2013. Navigating paradox as a mechanism of change and innovation in hybrid
organizations. Academy of Management Journal. 56(1). pp.137-159.
Kochi, E., Fabricant, R. and Mehl, G., 2013. Health innovations as health system strengthening
tools: 12 common applications and a visual framework. Global Health: Science and
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Glasby, J. and Dickinson, H., 2014. Partnership working in health and social care: what is
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Brunt, L.M., 2014. Celebrating a decade of innovation in surgical education.Bull Am Coll
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Farchi, T., Barrett, M. I. and Dopson, S., 2013. When Does Search Openness Really Matter? A
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Shiri, S., Anvari, A. and Soltani, H., 2015. Identifying and prioritizing of readiness factors for
implementing ERP based on agility (extension of McKinsey 7S model). European Online
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Singh, A., 2013. A Study of Role of McKinsey's 7S Framework in Achieving Organizational
Excellence. Organization Development Journal. 31(3). p.39.
Zentner, A., 2015. A fork in the road of change: A comparison of simple and complex
organizational change models. Available at SSRN.
Huhtala, M., Feldt, T., Hyvönen, K. and Mauno, S., 2013. Ethical organisational culture as a
context for managers’ personal work goals. Journal of Business Ethics. 114(2). pp.265-
282.
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Cadden, T., Marshall, D. and Cao, G., 2013. Opposites attract: organisational culture and supply
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Christopher, J. C., Wendt, D.C., Marecek, J. and Goodman, D.M., 2014. Critical cultural
awareness: Contributions to a globalizing psychology. American Psychologist. 69(7).
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Maybin, J., Park, S. and Quilligan, S., 2014. Rethinking ‘quality’in health care. Journal of health
services research & policy. p.1355819613518522.
Brennan, M. D. and Monson, V., 2014, May. Professionalism: good for patients and health care
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Cummings, T. and Worley, C., 2014. Organization development and change. Cengage learning.
Aveyard, H., 2014. Doing a literature review in health and social care: A practical
guide. McGraw-Hill Education (UK).
Online
About Cambridge Health Alliance. 2016. [Online]. Available through:
<http://hms.harvard.edu/about-hms/hms-affiliates/cambridge-health-alliance>.
[Accessed on 21st March 2016].
Cambridge Health Alliance. 2011. [PDF]. Available through:
<http://www.challiance.org/Resource.ashx?sn=CHAAcademicOverview>. [Accessed on
21st March 2016].
Framework of McKinsey. 2016. [Online]. Available through:
<http://www.valuebasedmanagement.net/methods_7s.html>. [Accessed on 21st March
2016].
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