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The topic of organizational change can bring about many different emotions along with a feeling of stress for all employees and leadership of an organization, and Parkway Nursing Care is no exception. Founded in 1972 with only two nursing homes in Phoenix, Arizona, Parkway Nursing Care became a well-established business and began to make profit in the 1980’s. However, in 1993, venture capitalist Robert Quine changed the low-file approach as he invested a large amount of money in the expansion of Parkway.
The company now has nearly 30,000 employees and went from owning 180 homes in 2000, till now owning 220 facilities in the southwestern region of the United States. After winning numerous awards for its achievements, Parkway was one of the best healthcare facilities in its region. As the Baby Boom generation become senior citizens, Parkway understands it needs to be fully equipped for this growing need. However, with the need for expansion and increased government scrutiny, Parkway Nursing Care is beginning to feel the pressure to provide increased documentation, or they could face a reduction in funding.
What do the data on employee injuries, incidents, absences, and turnover suggest to you? Is there a reason for concern about the company’s direction?
The given data provides a statistical representation of the issues faced by Parkway Nursing Care. In the figure, it shows the frequent increase in each listed category such as, injuries per staff member, incidents per patient, certified absences per staff, and other absences per staff year after year. From the year 2000 till 2009 the number of patients has increased, however, there is statistical evidence that raises concerns in all categories. For example, as the number of patients has increased, incidents per one patient have also increased. Also, as incidents per one patient have increased, injuries per one staff member have also increased. Additionally, the number of injuries per staff member have led to an increase of certified absences per staff.
According to the statistical evidence, there is a need for concern about the company’s direction. As the organization continues to expand, the rate of failures such ad injuries due to slips and falls, medication errors, and other accidents have also increased, which causes the efficiency of its staff members to be affected. With that being said, to produce change, Parkway Nursing Care, must place more emphasis on the health and well-being of both its staff and patients. For example, Parkway could implement an employee wellness program. In this program, employees could choose from different wellness techniques such as mindfulness training, parent-career coaching, and emotional-intelligence development training. By implementing this program, Parkway would demonstrate commitment to employees by helping them find balance in their personal and professional lives. To support the well-being of patients, Parkway could create a patient-centered care program. In this program, nurses and other staff members would complete a daily activity outside of the nursing facility with the option to involve family and friends. By implementing daily activities, this could reduce the anxiety they feel about being in the facility.
The company is going to be making some significant changes based on the AI process, and most change efforts are associated with resistance. What are the most common forms of resistance, and what would you expect to see at Parkway?
Typically, an employee has an emotional and behavioral attachment to established work routines. However, an organization that is experiencing a massive transformation will face resistance to change. Types of resistance to change can be obvious and abrupt such as reduced efficiency and complaining. Other types of resistance to change can be more difficult to recognize, which can lead to an unexpected and severe reaction such as resentment, rebellion, and resignation. Per the case provided, there is a conflict between the younger caregivers and the older care givers about potentially changing some operations of the organization. First, shift leader Maxine Vernon had been employed with Parkway for 15 years. She feels that because the government keeps a closer look on staffing levels, management hires younger staff members that do not care for the patients the way they should. Also, younger caregivers would like an electronic method to document patients because they can type faster than they write, while older caregivers are committed to the paper-based process because they feel switching systems would require more work.
Resistant and not ready for change, older caregivers are unwilling to rid themselves of old habits. Another form of resistance present at Parkway is implied or delayed. Staff members that have been employed with Parkway Nursing Care for over a decade and have created an emotional bond with company, have not been satisfied with the actions of HR and management. Also, there are younger staff members that joined the organization are already looking for other employment due to the amounts of both physical and emotional stress that has taken place. However, after employees voiced their concerns and human resources making significant changes to the AI process, Parkway is taking steps to eliminate needless routines and programs to improve organization performance.
Given the board of directors’ desires to reenergize the workforce, what advice would you provide for creating a leadership strategy? What leader behaviors should be nursing home directors and nurse supervisors demonstrate?
In efforts to re-energize the workforce, there are several pieces of advice we would provide in creating a leadership strategy. First, Parkway Nursing Care should emphasize core values such as compassion, dignity, and integrity, while creating a fun and productive environment that is beneficial to all employees. For example, during the onboarding process, Parkway could have managers guiding employees around the facility, so they can get an understanding of the environment. Second, management should ensure that all employees share the same vision to provide quality care for all patients, and for the company to carry out its mission and goals. For example, Parkway Nursing Care is a nursing facility attending to the physical and emotional needs of the elderly, so values such as, compassion, respect, teamwork, and integrity are all vital traits one must possess in this field of work.
Understanding that emergencies happen, Parkway can develop an on-call procedure. For example, if an employee must leave work due to sickness or a family emergency, then whoever is on call at that time will have to report to work within 30 minutes. Third, while addressing workload concerns, management should ensure suitable physical strength of employees to meet the needs of patients. Per the case provided, Carmen Frank has experienced physical pain due to her strenuous workload, which should not be present in a shared work environment. For example, if a patient needs to be transported, helped up, or assisted in some other way, there should always be more than one person to help perform that function. Lastly, leadership should lead by example. Members of management should be active and readily available, while encouraging employees to work as a team to accomplish a task. If an employee is shown care, they are more likely to experience job satisfaction.
With the expansion of Parkway Nursing Care, it is important that the company’s leadership styles make essential changes to ensure proper efficiency. It should be expected that the company’s leadership style would change from when it first started, as the goal is to improve company performance. This change will create an increased rate for success for Parkway. To foster in this change, we would recommend that the Directors and other members of leadership utilize Transformational Leadership. It will be there responsibility to create an environment for increased employee performance and tasks that individuals can achieve. For nurse supervisors, we recommend the Authentic Leadership style. This leadership style will allow them to be open with both patients and management and decrease the communication barrier between the two. There should be an establishment of trust between nurses and leadership and most importantly the patients should trust them. Using these two would create an environment that is easier to adopting changes
What are the major sources of job stress at Parkway? What does the research on employee stress suggest you should do to help minimize the experience of psychological strain for employees? Create a plan for how to reduce stress among employees.
According the case, some of the major sources of stress at Parkway are the lack of skilled staff to care for the increasing number of patients. Parkway seems to be hiring at a quick pace to fill vacant positions and not considering if a candidate possesses the skills and abilities necessary for the position. With the hiring process happening so quickly, it is causing patient incidents an issue amongst the company. A second source of stress at Parkway are the physical and emotional demands. Because employees spend many hours with their patients, oftentimes it becomes overwhelming and strenuous. As provided in the data, there is a significant increase in the number of injuries, which is one of the main causes of concern for the company. A third source of stress at Parker is lack of schedule flexibility. Per the case, representatives spoke on the inability to take time off from work, which causes their work responsibilities to suffer and forcing someone else to complete their tasks. A fourth source of stress at Parkway is increased government scrutiny following investigations. Because of patient abuse and billing fraud, there is increased documentation and paperwork which causes stress on employees that must tend to patients.
There are several ways to reduce the stress on employees. First, increase the numbers of employees to ensure a reasonable workload. Once hired, ensure that all new employees are properly trained so other employees can be at ease when completing their tasks. Second, provide stress reduction techniques. Third, provide wellness trainings and facilities such as a gym or pool in the office. By doing so, it allows employees to take time out for physical activities and reduce work-related pressures.
Based on the information collected in the focus groups, design a survey to hand out to employees. What sort of data should the survey gather? What types of data analysis methods would you like to employ for these data? (Survey provided on following page)
Parkway can be successful in required change using the Appreciative Inquiry method. The following qualitative survey contains open-ended questions, that assist Parker Nursing Care understand its strengths and weaknesses to help improve its performance. The data will then be used to further explore the effects of Parkway Nursing Care and are indicative of employees within the company.
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