Introduction
Organizational theories try to explain why people in organizations behave in the manners that they do (Robbins & Barnwell, 2006). Therefore, organizational theories are developed from organizational behaviors. Another interrelated discipline in organizational behavior management, which focuses on people’s behavior, makes in-depth analysis trying to get an understanding of the reason for the behavior, and finally intervenes with the aim of improving behavior.
It is important to note that environments shape and influence behavior and, therefore, with a comprehensive study on an environment, one can easily get the explanation for a certain behavior, and come up with corrective measures where necessary.
This case study applies organizational theories in Florida Hospital in the United States, with the aim of demonstrating organizational behaviors behind the immense success and providing possible remedies for the existing organizational dysfunctions.
Background information and the history of Florida Hospital
Florida Hospital is a non-profit organization offering medical services in the State of Florida, the US. The hospital has 22 campuses spread throughout the State of Florida. Being a non-profit organization, its major drive is giving proper facilities and medical care to the community it serves.
The hospital’s inception was as visionary as it was necessary. The rural Orlando in the early 20th century needed a sustainable health program and a hospital to serve its community. Consequently, a group of Seventh-day Adventists came up with the idea of starting a hospital.
In 1908, the group mobilized fellow Christians to contribute to the noble idea, and they collected about $9000, which they used to buy the Florida Hospital’s first building. From a single, three-storied building, Florida Hospital has acquired more buildings that are more sophisticated to cater for the increase in population and the diversified health services (Florida Hospital, n.d).
In spite of the Hospital being a non-profit health service provider, it has pioneered crucial medical practices in the Florida health sector and made major contributions in the United States healthcare sector. For instance, it was the first hospital to offer digital mammography in the State of Florida and among the first hospitals to install a CT scanner in the US.
There is a steady increase in the number of talented clinical experts. Competence and expertise of the pool of clinicians have facilitated training for medical students, with tens of thousands of surgeons getting their training from Florida’s Nicholson Center.
With the mission, “Extending the healing ministry of Christ” (Florida Hospital, n.d), which is greatly informed by Jesus Christ teachings and his ministry of healing, the hospital offers nondiscriminatory services, serving people from all walks of life, all races, and religions among other diversities. The Hospital has immensely increased the number of its patients. Having an acute-care bed capacity of 2247, Florida Hospital serves the Greater Orlando and gets most referrals from Central Florida.
To realize its mission and goals, Florida Hospital is highly dependent on its employees and physicians. Currently, the hospital has approximately 2230 physicians and nearly 33000 employees. Since employees carry the organization, behaviors manifested by them replicate what really happens in the organization. Therefore, the great success realized by the hospital can be attributed to the pool of employees.
In spite of realizing immense success, Florida Hospital is failing in some sectors. For instance, there have been reports of negligence and incompetence among some employees. The hospital’s management has also been accused of contravening some of the federal government’s legislation on medical services providence, such as the Stark Law and the False Claim Act. In addition, nurse turnover rates have been relatively high, and claims of compromised cleanliness standards in some of the hospital’s units have been made.
Application of Organizational Theories: why the organization functions the way it does
To have a clear understanding of Florida Hospital’s organizational behavior, a discussion on each of the aspects of the organization is necessary. Some of the key aspects of the organization include people (the dedicated pool of employees and medical practitioners), the structure of the organization and its management, technology, and the environment in which the hospital operates.
People
Florida Hospital consists of physicians, nurses, and other supporting employees. Healthcare workers are responsible for day-to-day operations within the hospital. Florida Hospital has focused on promoting a culture of caring among its employees. Culture simply refers to the way organizations run their affairs. Caring is the core concept of nursing, and the hospital strives to instill this concept in all its employees. Consequently, it has developed systems and procedures to facilitate care provision.
The culture of Florida Hospital requires strict procedures and routines that all employees should follow when discharging their duties. Consequently, these practices are so deeply embedded in care provision. These practices ensure that physicians and nurses deliver the highest quality of patient care. Florida Hospital promotes a culture of excellence in care delivery.
The structure and management of Florida Hospital
Florida Hospital is one of the non-profit organizations to have an elaborate organizational structure. At the helm of the organization’s leadership is the CEO, who is the overall leader of the hospital. There are 22 campuses of the hospital, and each of the campuses has an overall head.
On every campus, there are departments that are organized according to duty delivery. Under the departments are workgroups that are composed of workers with the same job descriptions.
Tasks and jobs are clearly allocated to each employee, with the leaders of each team or group coordinating activities to guide them to the alignment with the organizational objectives (Holloway, 2012). The departmental heads are responsible for the supervision of their respective juniors. The supervision hierarchy culminates to the CEO’s level, who supervises the whole of Florida Hospital.
The structure of Florida Hospital has helped it to realize tremendous growth it has witnessed. Employees understand their duties and the hierarchy of communication to facilitate service delivery, which is responsible for the success of the hospital.
Notably, there is a recent change in the organizational structure where the CEO’s role has been more specialized. Earlier, the Chief Executive Officer of Florida Hospital had another role as the CEO of the Florida Division. The roles are now separated to ensure efficiency in management and service delivery.
Allocation of jobs and tasks in Florida Hospital
Florida Hospital Management has clearly given its employees specific jobs and tasks, an exercise that relies heavily on the qualifications and competence of individual employees. Assignments start from the top leadership, which has the role of overall oversight and policy formulation to the branch heads who oversee the implementation of Florida Hospital’s policies across the 22 units.
Additionally, each of the Florida Hospital’s units is further divided into departments, which are allocated heads of departments. In each of the departments, there are groups of employees who have the same job descriptions and are the ultimate implementer of the hospitals’ objectives. Different employees in the workgroups include physicians, clinical officers, nurses, and support staff.
With the clarity of job descriptions and the tasks that every employee is assigned, the staff members of Florida Hospital have specialized in their areas and, thus, ultimately creating a culture of perfection in the delivery of duties.
The use of technology in Florida Hospital
The success of Florida Hospital has a direct connection to its use of technology. From the year it was started, the hospital has tried to be among the first hospitals to embrace the newest technologies in training its employees and medical students and offering medical services to its patients.
For instance, as mentioned earlier, the hospital premiered the digital mammography services in the State of Florida, while being among the first to make use of CT scanner in the United States. The trend has gone on throughout its history, and currently, the Florida Hospital has one of the best technologies in the US.
In a recent STEM day at the Florida Capitol, the hospital displayed some of its technologies and innovations to emphasize the significance of technology in medical training and medical services delivery (Florida Hospital, 2015). One of the major innovations on display was the “Patient simulators” mannequins. Based on its ability to imitate an array of medical conditions that a patient has, the hospital is using the innovation in the training of its employees and medical students.
In his speech, Pat Connors, the chief of simulation development and technologies at Florida Hospital, talked of the commitment in the delivery of the best medical care today and in the future. He also said that Florida Hospital had allocated substantial resources to emerging technologies to equip the current and future workforce with the suitable skills required for the provision of superior health care (Florida Hospital, 2015).
Further, in commitment and appreciation of technology, Florida Hospital is one of the many organizations that have enhanced efficiency and effectiveness in communication. For instance, using the Internet, patients can contact physicians and access their medical reports. Additionally, employees can get crucial information on their portals while potential employees can make applications online.
Environment
Florida Hospital cannot work in isolation. Some aspects that have great influences on the organizational behavior surround it. There are aspects of operations that employees and the management team can either do or not do due to the dictations of the environment. Such aspects that surround the Hospital include the federal government, the local government of Florida, the Adventist Health System, the local and international partners, and the Florida community.
Government
The federal government and the local government of Florida act as regulatory and supervisory bodies. Florida Hospital has a government relations team tasked with informing all stakeholders about the government’s legal regulations and laws that pertain to the Central Florida region health care provision. The team also links the hospital to businesses and community leaders. Therefore, all activities that the hospital undertakes in the process of meeting its objectives are guided by the legislation and regulations set by the two governments.
The Adventist Health System
Members of the Adventist Church started the Florida Hospital, and they still run the organization. The Adventist Health System is an umbrella body that governs and gives directions to a number of Adventist health care providers, which include the Florida Hospital. The Adventist Health System has a value system, which includes culture diversity, compassion, high ethical standards, and focus on community wellness, among others.
Since Florida Hospital subscribes to the leadership and guidance of the Adventist Health System, it upholds the values outlined by the System in carrying out its activities. It is imperative to note that most of the values of the System are in line with the Florida Hospital mission and vision and, therefore, the hospital organizational behavior is influenced by the Adventist health system.
Partnering
While elevating the standards in health care provision to communities, Florida Hospital is in a diversified partnership, collaborating with technology, entertainment companies, and renowned researchers, among others. The alliance has been crucial in meeting the diversified medical needs of patients. Through collaboration, the hospital is building an upsurge of health and wellness. The community and businesses around Florida have helped the accomplishment of the Florida Hospital mission.
The community
Since its inception, Florida Hospital has depended on the community around Central Florida, Orlando, in particular. In 1908, it got substantive sources of funding from the soliciting of funds from the local community, especially churchgoers. Throughout history, the organization has heavily relied on nearby business and community leaders for partnership. The partnership has enhanced the way the hospital has realized its goals in giving medical care to the community.
Partnering with the global community
Currently, a global collaboration of the Florida Hospital is a strategic goal that hospital management is gearing toward achieving (FLORIDA HOSPITAL). Becoming a global leader in providing faith-based and highly advanced health care is an aspect that the organization’s vision spells out with profound clarity. With the aim of realizing this vision, the Florida Hospital partnering strategy pursues the idea of having global partners that facilitate the exchange of ideas, research, and technical methodology in the medical field.
The hospital seeks collaboration from diverse fields globally including, medical practitioners, researchers, governmental entities, and academics, among others, with the ultimate goal of improving business opportunities and health care standards (Florida Hospital, n.d).
Having such a goal is a sign that the Florida Hospital is being driven by the vision of the hospital of not only serving the local community but also opening its wings to the entire world. This is a manifestation of the fact that the vision of Florida Hospital informs the organizational behavior.
Noted dysfunctions in Florida Hospital
In spite of the huge success that Florida Hospital has realized in more than a century, there are dysfunctions in some departments. The management can use organizational theories to give appropriate remedies to the dysfunctional departments. Discussed below are some of the organizational dysfunctions witnessed in Florida Hospital.
High nurses’ turnover rates
Organizations need a committed workforce in maintaining their culture. Therefore, measures to retain employees are important. However, Florida Hospital faces great challenges in recruiting and keeping its employees. The most affected are nurses and other related health workers.
According to a survey,” the 2012 FHA Workforce Survey”, the hospital faces major challenges while other hospitals in the country are not as affected. The projection of long-term shortages is a reason to cause worry. The shortages are linked to increases in service delivery coverage with the enactment of the Affordable Care Act.
However, a turnover rate of 12% creates disruptions in the workforce, and the negative effect is transferred to the delivery of care services. Additionally, the process of recruiting is expensive, especially if it is done often. The cost is even higher with the employment of momentary staff.
Organizational theories are tools that the management can use to understand why the turnover rate of nurses and other health workers is high. Therefore, the top leadership should make an in-depth study of employees’ behaviors, analysis, and, finally, come up with turnover mitigation measures.
For example, Florida Hospital hired a significant number of experienced nurses in 2012, together with another bunch of fresh graduates. Subsequent reports indicate that experienced nurses get remunerations similar to fresh graduates. This is a good practice in attracting new graduates, but it demoralizes the experienced ones. If this continues, the turnover of experienced nurses will go higher. The hospital management should put in place remuneration programs that are fair and give equal opportunities for growth to all.
The report also indicated a considerable percentage of people quitting their jobs in the first year of employment. This was attributed to a larger amount of workload that newly employed nurses experienced once they were employed. Another factor that could have caused this was a lack of proper orientation in Florida Hospital. Therefore, the hospital should strengthen its orientation programs and develop motivational methods to make new employees embrace their new working environment.
The turnover rates are not evenly distributed in all the sections of Florida Hospital. For instance, the report shows that ARNP, emergency, and CCU have the highest vacancy rates. The departments also register the longest time when it comes to filling the vacant positions. This could be attributed to the sensitivity of these departments and the associated work stresses.
The hospital should come up with measures that specifically address these departmental challenges. For example, to deal with stress and working hours, the hospital should look for more nurses to facilitate proper shift programs and adopt favorable work-life balance and flexible schedules. Additionally, the hospital should come up with more incentives to attract more employees to these departments.
Medical mistakes
Human errors in hospitals are not only hazardous, but they are sometimes fatal. Wrong surgeries, erroneous medication, hospital-acquired infections are among the leading sources of deaths and injuries related to medical errors in the Florida Hospital. Although the rates of these fatalities and injuries have subsided in the hospital, Florida Hospital’s contribution to the national deaths and injuries is still huge.
Communication errors
These errors occur when communication is not done properly. The doctors and nurse attending to patients must have every bit of information about the patients. Breakdown of information comes in when the patient is attended to by more than one specialist, resulting from changes in shifts. Patients face risks whenever there are changes in medication, while communication is not effective. Florida Hospital management and staff should improve communication channels by paying considerable attention to swiftness and seamless change of shifts.
Errors emanating from understaffing
As discussed earlier, Florida Hospital is facing a shortage of nurses and medical workers. As a result, delays in care delivery to patients are common, and even when they are attended to, pressures and ultimatums affect the efficiency and effectiveness of the workers.
The hospital management should focus on human resources practices that will improve employee recruitment and retention.
Hospital-acquired infections
Maintaining high standards of cleanliness protects patients from acquiring more infections from hospitals. However, some of the Hospital’s units are in deplorable conditions. For instance, claims of “Dead rats falling from the kitchen ceiling, cockroaches found on eating trays, buckets filled with bugs, dead rodents, and feces” (Cheney, 2015) have been reported. With such conditions, patients are at high risk of getting more infections in a place where they were seeking treatment.
Florida Hospital Management should carry out a systematic study to determine factors that contribute to deplorable conditions. After obtaining the necessary information for such, which could range from lack of proper supervision of the support staff, understaffed, lack of clean procedures, and overworked support group to even negligence among others, the hospital should adopt appropriate corrective measures.
Misdiagnosis and wrong surgeries
Diagnosis is a crucial aspect of the medical service offering the procedure, which can be dangerous if not properly done. The diagnosis will determine what treatment will be administered to a patient. Therefore, the competence of the working state of mind of the health caregiver should not be compromised. There have been reports of cases of misdiagnosis from the Florida Hospital, where incompetence and negligence were the main causes.
The human resource should carefully study such grievous performance and make a proper analysis. In cases of incompetence, emphasis should be put on training programs, with regular refresher courses recommended for all employees, especially those affected. The motivation of workers to have a culture of excellence and perfection should be emphasized to regulate cases of negligence.
Improper identification of patients
Patients should be clearly identified and proper labeling of their specimens done. Specimens from patients must have proper and correct labels. Otherwise, medications and treatment can be administered to the wrong patient. One patient sued the hospital after she was operated on because of incorrect labeling. Her name was put on the specimen from a patient who had colon cancer. As a result, the patient underwent operations that led to the removal of parts of her colon. The hospital later realized the mistake and communicated to her (Law Office of Robert A. Miller, 2014).
Human errors, such as the ones mentioned here, are manifestations of either negligence or work-related stress.
An in-depth study of such behaviors should be done to curb the re-occurrences of the same.
Misappropriation of funds and financial fraud
Whistle-blowers have sued Florida Hospital and the Adventists on allegations of fraud, funds misappropriations, and a grave violation of the US laws. This negative picture can taint the image of one of the biggest non-profit organizations in the US.
For instance, two whistle-blowers filed lawsuits in 2012, and by former employees, who purported that the hospital and the doctors made grave violation of the Stark Law and the False Claims Act. They allegedly did this by paying its doctor’s shockingly high amount of money and gave the substantial benefits as part of the organization strategy to “capture and control physicians’ referrals for inpatient and outpatient services near its hospitals” (Miller, 2015).
The Adventist paid the US government $118.7 million in the settlement, which can be termed as one of the largest healthcare-fraud settlements of its kind. Based on this, it can be noted that hospital management failed to promote ethical practices, integrity, and prudence in financial management (Horwitz, 2005). Therefore, the Hospital should review its value system, the culture, and ethical practices in medical services offering.
It appears that not-for-profit hospitals face challenges related to accountability. For instance, in the year 2004, over 50 lawsuits were filed against non-profit healthcare facilities claiming that they had violated their charitable roles (Horwitz, 2005). In this regard, regulators should introduce new laws and regulations to assist not-for-profit hospitals in improving accountability.
Conclusion
It is evident that Florida Hospital, as a non-profit organization has realized immense success in spite of the challenges it faces. The success of the organization and the dysfunctional aspects in some parts can be linked to organizational behaviors witnessed across various organizations.
The success that the Florida Hospital has realized is attributed to a combination of both the organic and the mechanic elements of the organization. For instance, Florida Hospital has used modern technologies to train its staff, train medical students, and enhance effectiveness and efficacy in health care delivery. The use of technology has a positive correlation to organizational behavior and ultimate success. Therefore, the management and staff should continue embracing technologies and focusing on more advanced technologies as they encourage innovations.
Florida Hospital also strives to promote a culture of excellence among its employees. It is an organization where negligence and mistakes are not encouraged, while organizational behaviors that lead to success are encouraged. Therefore, the Hospital management should put in place mechanisms to improve a culture of excellence. In addition, the Hospital may use techniques such as reward and punishment to promote service excellence and develop efficient processes.
The environment that the organization operates in shapes some aspects of organizational behavior. For instance, some entities such as the federal government, the local government of Florida, the Adventist Health System, local and global partners, and the local community have greatly affected the daily functions of Florida Hospital. The management and the staff of Florida Hospital should work in line with the expectations of the environment.
Florida Hospital’s organizational structure focuses on excellence in management. It has a clear and elaborate arrangement of workgroups that makes departments. Departments come together to form a hospital unit, and the 22 units are making the entire Florida Hospital. With such a structure, management functions can easily be rolled throughout the hospital.
Channels of communication and hierarchy of command being clear to all have immensely contributed to keeping the organizational culture and rallying every employee to accomplish the hospital goals. Additionally, the recent change of the CEO’s jurisdiction is strategic for the structure of the hospital since it led to the elimination of ambiguity and overlapping of roles.
A clear sense of duty and elaborate job descriptions have allowed employees of Florida Hospital to specialize in some major duties with the aim of improving outcomes.
However, the success of Florida Hospital has experienced setbacks due to employee-related issues. For instance, high rates of employee turnover, medical errors, and mismanagement of funds allegations require sufficient organizational management. Florida Hospital could apply aspects of organizational theories to solidify success and correct the dysfunctional areas.
References
Cheney, Z. (2015). Nightmare Conditions at Florida Hospital Are Everything Wrong With How We Treat Veterans. Web.
Florida Hospital. (2015). Florida Hospital showcases technology, experts at STEM Day at the Capitol. Web.
Florida Hospital. (n.d). History and Organization. Web.
Holloway, J. B. (2012). Leadership Behavior and Organizational Climate: An Empirical Study in a Non-profit Organization. Emerging Leadership Journeys, 5(1), 9-35.
Horwitz, J. R. (2005). Making Profits And Providing Care: Comparing Nonprofit, For-Profit, and Government Hospitals. Health Affairs, 24(3), 790-801. Web.
Law Office of Robert A. Miller. (2014). Woman sues after false cancer misdiagnosis. Web.
Miller, N. S. (2015). Adventist settles health-care-fraud case for $118.7 million. Orlando Sentinel. Web.
Robbins, S., & Barnwell, N. (2006). Organisation Theory: Concepts and Cases (5th ed.). New York, NY: Pearson Education.