Sample Coursework Paper on Governance and Infrastructure in a Medical Practice

The three major organizational issues evident in this situation include problems in organizational leadership, organizational structure, and the management of organizational behavior and change. For instance, although the founding physician was capable of establishing and building the practice during its formative years, the practice began experiencing leadership problems when he recruited four new neurologists to join and help build the practice further. The recruitment of these new neurologists appears to have introduced power struggles and politics into the organization’s leadership and functions. This made the new doctors take over and force the founder out of the practice. The organizational leadership problem is further evident in the increasing mistrust amongst the new doctors, and their inability to select a leader amongst themselves to become the voice of the practice when building new relationships with referring physicians (Robinson 21). Secondly, the lack or establishment of poor organizational structure mainly caused the organizational problems facing the practice. Its organizational structure appears to be more informal, thereby lacking clear organizational hierarchy frameworks for guiding the allocation of tasks, the differentiation of roles, and the flow of information into and out of the organization. For example, the practice experienced problems in tracking calls and distributing appointments and tasks equitably amongst themselves (Robinson 19). Furthermore, it lacked departments with clearly defined responsibilities. For instance, the practice’s information technology department was the owner himself, and lacked structures for attending to the outpatient needs (Robinson 20-21). The third issue concerns poor organizational behavior and management of change. For example, the practice lacked policies, procedures, and basic business documents, such as employment manual for its personnel to enhance observance of the practice’s rules and regulations (Robinson 21). Additionally, it lacked a culture of resource sharing and allocation as each physician wanted to have his/her personal computer, and further develop different revenue stream through the practice (Robinson 21). They experienced problems managing change, such as choosing a new practice leader and upgrade their infrastructure systems, to more developed ones.

The situation facing the practice can be described using the system approach theory that emphasizes the organization’s interaction with the larger environment, such as the problems of relationships, structures, and interdependence, rather than individual elements. For instance, the practice ought to have realized the importance of having excellent employee relations, a competent IT department and infrastructure, workplace policies, and appropriate leadership for managing organizational activities and change to increase the practice’s overall performance. Secondly, the situation can also be described by the Weber’s theory of bureaucracy, which recognizes the importance of organizational structure, specialization, and democracy in managing organizational relationships, decision-making authority, guiding allocations of tasks, and flow of information within the organization, and with the outside environment to improve organizational performance.

As a new administrator, my first task would include would include involving the practice’s staff in the establishment of the organization’s rules and regulations to encourage the formation of a standard organizational behavior. For instance, the creation of employee relations policies would be instrumental in enhancing respect amongst employees, thereby strengthening the foundation for other organizational activities and policies. Secondly, I would embark on developing a clearly understandable organizational structure that would guide the decision-making authority within the practice, distribution of tasks, and flow of information to reduce or eliminate confusion in organizational leadership and avoid role conflict in the execution of tasks (Masters 183). Furthermore, the organizational structure would be important in establishing departments within the organization according to their specialized roles to enhance professionalism in the execution of tasks. The structure would also guide the interactions between departments to improve the overall organizational performance. Thirdly, I would ensure the practice develops its mission and vision statements, and eventually encourage their internalization amongst the staff. The mission statement would help the personnel and customers understand the reasons for the practice’s existence (Daft 146). This understanding would be critical in guiding their daily work activities and their interactions with clients and other relevant stakeholders. The vision statement will help the personnel and stakeholders understand the practice’s long-term goals and the role the important role they play in the realization of such goals (Grella and Hudkins 32). This would ensure every employee and other stakeholders work towards the achievement of the common good. Fourthly, I would establish mechanisms for ensuring the practice’s adapts effectively to internal and external forces of change, such as technological advancement to ensure it remains relevant. For instance, the organizational information systems should be improved continuously to facilitate communication and information management because they are core to organizational success. Finally, I would develop an employee development program to ensure the staffs constantly improve their competencies to enhance organizational performance, while also supporting their self-actualization efforts.

In order to gain the trust of the individual physicians, I would first have to affirm my personal values, such as doing the right thing, respecting them, and performing my tasks with excellence. By affirming such values, these physicians would start gaining confidence in me, thereby facilitating the building of trust. Secondly, I would clearly share my vision and strategies to enable them understand the direction of the organization and their role in the realization of our common success. By sharing my strategy for success, I would be acknowledging my trust in them, thus resulting in mutual trust.

The management strategy that I would work to establish is the information management system. The medical practice in the case study is experiencing severe information problems as it continues to expand. For instance, its entire communication was depended on proprietary software that was difficult to upscale, and its entire platform, including the billing program was an outdated technology. Furthermore, the practice manager possessed outdated skills as she had failed to upgrade her skills in information management since the practice was founded. These factors resulted in information problems related to billing, reimbursement, and the changes in medical terminologies and procedures. Therefore, the new management system integrating technology and technological expertise will be important in the management of costs, communication, information, and patient information to improve the delivery of quality health care.

An infrastructure development can gain enormous strength if the staffs are involved in its planning and implementation. Through participation, the staff will have a sense of ownership, thereby increasing their commitments in making the infrastructure an organizational success. Their engagement process should also include developing their competencies to ensure they fully utilize the established infrastructure to improve personal and organizational performance (Raymond and Martin 94-95).

Before starting the process of recruiting new physicians to work in the practice, administrators should create a clear work-plan highlighting the different duties and expectations required of the new physicians. This would make them know how the practice looks like and function to facilitate their integration into the system once recruited. Administrators should ensure there is a vacancy, review the job description, and eventually identify the characteristics desirable for such position. Finally, a recruitment process should be defined to ensure the selection of the most suitable candidate.

To determine whether governance is going in better directions, one should consider objective for success, such as accountability, participation, predictability, and transparency (Friedland 94). It accountability, people are always willing to accept the outcomes of their actions. If such outcomes are negative, they will be more willing to rectify the issue to facilitate realization of positive outcomes. Participation often ensures all diverse opinions or interests are taken into consideration with the aim of coming up with inclusive and more superior solutions/outcomes. Predictability is important in ensuring fairness and consistency in the realization of desired/positive governance outcomes. Finally, transparency concerns the availability of information in the establishment of clear rules and guidelines in accomplishing tasks to enhance success.

A fractured group adversely affects the delivery of care to patients, as it would compromise the coordination of various activities, which collectively lead to the provision of quality care (Spouse, Cox, and Cook 336). They would also interfere with decision-making abilities because the delivery of quality care requires complementary knowledge and skills. Finally, a fractured group would be characterized by poor communication, role conflict, and poor coordination, which can result in delays in delivery of patient care or delivery of poor quality care. This can result in further deterioration of patient health, or even death in some instances.













Works cited

Daft, Richard L. Understanding Management. Mason, OH: South-Western Cengage Learning, 2011. Print.

Friedland, Julian. Doing Well and Good: The Human Face of the New Capitalism. Charlotte, N.C: Information Age Pub, 2009. Print.

Grella, Thomas C, and Michael L. Hudkins. The Lawyer’s Guide to Strategic Planning: Defining, Setting, and Achieving Your Firm’s Goals. Chicago, IL: ABA Law Practice Management Section, 2004. Print.

Masters, Kathleen. Role Development in Professional Nursing Practice. Sudbury, Mass: Jones and Bartlett Pub, 2009. Print.

Raymond, Susan U, and Mary B. Martin. Mapping the New World of American Philanthropy: Causes and Consequences of the Transfer of Wealth. Hoboken, N.J: Wiley, 2007. Print.

Robinson, Dea. From Nothing to Something: Defining Governance and Infrastructure in a Small Medical Practice. Cases in Health Care Management. By Buchbinder, Sharon B, Nancy H. Shanks, and Dale Buchbinder. Sudbury, Mass: Jones & Bartlett Learning, 2014. Print.

Spouse, Jenny, Carol L. Cox, and Michael J. Cook. Common Foundation S