Hurricane Zara hit the Florida Keys and decimated the community. As an ER manager, you must coordinate rescue efforts throughout the area and triage patients showing up at your ER. Discuss the following questions with the class: How would you describe public health to someone unfamiliar with the term? What is the role of a healthcare organization (e.g., hospital, doctor’s office, etc.) in public health? Provide an example. What is the biggest ethical or legal issue you believe you may encounter as an ER manager (health care manager) regarding public health? Explain your response.

Please review the case study The Patient’s Experience: What Were They Thinking? – Case for Chapter 4 Sheila K. McGinnis Thanksgiving weekend.

Tanya Martinez is looking forward to a busy holiday weekend entertaining her extended family. Tanya, 29, is a busy stay-at-home mom. She has a degree in Business Administration and recently worked in marketing for a major insurance company in the city. Married nearly 8 years ago, Tanya and her husband Alex, 29, have two children. Tanya quit working several years ago to raise their two children, 4-year-old Randy and 2-year-old Samantha. The Martinezes, a multiracial couple, lived in a large city in the Northwest, where Alex works as a skilled construction carpenter on high-rise commercial building projects. Tanya, Alex, and the kids celebrated the holiday with Tanya’s mom Deidra, a city engineer; dad Michael, a college professor; her brother, a computer engineer; and her sister-in-law, a nurse practitioner. On Friday, Tanya felt some nausea and intestinal discomfort, which she assumed was due to the Thanksgiving festivities. While Tanya was typically active and athletic, she had to skip her usual long-distance run. By Saturday, her condition had quickly worsened. She was weak, vomiting with periodic abdominal pain, and using cold compresses for a high fever. With Tanya running a 103 o fever Sunday, Alex stayed home with Randy and Samantha, while her parents Deidra and Michael took her to Urgent Care at a nearby full-service medical center. There she was quickly sent to the Emergency Department of the 400+ bed, Level 2 Trauma Center. Various lab tests and a CT scan showed an elevated white blood cell count, but no conclusive findings regarding her non-specific intestinal discomfort. So, after rounds of antibiotics and fluids for dehydration, Tanya was sent home without any prescriptions or further instructions. Tanya’s condition did not improve by Tuesday, and she was still experiencing a high fever plus nausea, bloating, and abdominal pain. The family brought Tanya back to Urgent Care, where she was sent to the Emergency Department again, and then referred to the main hospital for observation care. Observation care is a hospital outpatient category (even though patients stay overnight). It is controversial because it blurs the lines between outpatient and inpatient care, which often increases the patient’s financial liability (due to larger co-pays). It can also compromise clinical care delivery due to poorer coordination of care during observation stays ( Hagland, 2018; Society of Hospital Medicine, 2017 ). In the observation care ward, Tanya was seen by several hospitalists who each interacted with her for different purposes and with different questions. They conducted a variety of additional blood draws and lab tests to assess intestinal illnesses such as Crohn’s disease, inflammatory bowel conditions, or possible intestinal blockage. While observation care is intended to take 24 hours, or 48 hours maximum, in practice it sometimes exceeds 48 hours ( Society of Hospital Medicine, 2017 ). Tanya ended up in observation care for 5 days. Observation ward rooms are shared, and during Tanya’s stay, three different female roommates entered observation care and were admitted to inpatient care shortly thereafter. Tanya’s first roommate did not permit Tanya’s husband Alex to stay overnight with Tanya, so her mother stayed with her each night. Alex, their children, and family were frequent visitors during the 5 days. One evening when both parents Deidra and Michael were visiting Tanya, they noted two uniformed city police officers in the corridor talking to the in-charge nurse. The pair of officers soon entered Tanya’s room unannounced saying “We have to check your belongings,” without offering any explanation. Tanya and her parents complied but were unclear about what was happening. When one officer asked, “Does she have a history of drug abuse?” Deidra exploded, saying “What are you doing here? Leave right now!” The officer explained, “We’ve had calls and a report there have been a lot of visitors and possible illegal drug activities here.” Next, the in-charge nurse burst into the room stating, “It’s a mistake, it’s not this room, it’s another room!” The officers were quickly redirected to search the nearby room occupied by a well-tattooed white male. Frustrated by days with no clear diagnosis or treatment plan and angered by the allegation his daughter was using drugs, Michael demanded “I want to see the nursing supervisor now or we are leaving this hospital and will sue you!” When the RN supervisor arrived, Michael confronted him “Why did you call the cops on my daughter?” The supervisor wanted to check on what happened and scheduled a meeting for the next day after the tempers had cooled. During a tense meeting with the RN supervisor the next day, her parents sought to transfer Tanya to a different hospital and leave “Against Medical Advice” (AMA). Informed that insurance might not cover an AMA transfer and that another hospital might not accept an AMA, they “felt like hostages, with no options.” Unwilling to take the risk, the parents compromised that the hospital could transfer Tanya to the medical floor on in-patient status with a private room. Michael and Deidra also confronted the floor nurses, asking “Why did you send the police to Tanya’s room?” The nurses explained that “somebody had called the cops,” leaving the nurses to guess which patient it might be. A junior nurse admitted she had pointed the police toward Tanya’s room. Even Tanya’s observation ward

Reference:
Buchbinder, Sharon B., et al. Introduction to Health Care Management, Jones & Bartlett Learning, LLC, 2019. ProQuest Ebook Central,

Questions
1.
a. How do you suppose each of the actors, in this case, interpreted the situation?
b. What did they believe they were seeing, and how would they explain it?
2. What cognitive bias, automatic thinking, and stereotype may be affecting how each of the actors sees this situation?
3. Which ones of assumptions and attributions you have generated could the actors check or verify? Note: we know that assumptions must be tested.
4.
a. If you were on the hospital’s risk management committee with responsibility for preventing misunderstandings that could lead to a complaint or lawsuit, what concerns and what further questions for you have regarding each charge?
b. What would you recommend the hospital do differently?
5. Based on the information in the case, how do you assess the family’s three complaints?

Introduction

In a global business environment where organizations can no longer rely on traditional factors that historically lead to a competitive advantage such as access to proprietary technology, exclusive rights to raw materials, or proximity to customers and markets, many organizations have re-structured to capitalize on new success factors. In the United States that has resulted in a shift in many cases from product or service-based businesses to knowledge-based businesses (OECD, 1996; Powell & Snellman, 2004). Powell & Snellman (2004) define the key components of a knowledge economy as. .a greater reliance on intellectual capabilities than on physical inputs or natural resources.” (p. 201). This case presents the challenges facing an organization as it transitions from its traditional business model to one that incorporates greater reliance on the knowledge of its workforce. The focus of this case is on the role of the organizational behavioral system in facilitating a successful transition to the new corporate strategy.

The Case Scenario

The Delta Pacific Company (DPC) has a long history of success. The company has been at the forefront of the development of information technology since the 1970s and led the market in technology development, manufacturing, and sales throughout the 1980s to the mid-1990s. DPC was a success story. They consistently met or exceeded their profit targets, successfully integrated new technology into their products, and were considered one of the best employers in the country. With generous benefits packages, high quality of work life, industry-leading salaries, and a corporate culture that considered its employees to be part of a family, potential employees were lined up for opportunities to join DPC.

However, with the advent of globalization, freer trade, and low-cost overseas labor, DPC found itself slowly losing market share for its primary product: computer hardware. DPC had prided itself on producing and selling the best products and training its sales force to develop long-term relationships with clients that brought them back year in and year out for DPC’s technology. Along with hardware, DPC also sold service contracts and training classes for the end users of their products. By the late 1990s, it became clear to the leadership at DPC that they could no longer compete with less expensive products being produced overseas. At one time they could sell their higher-priced goods on the premise that they were of higher quality, but that was no longer the case. Foreign-made products were now being produced to match or even surpass the quality standards set by DPC. However, conversations between sales representatives and their clients did indicate one thing: the clients valued the personal interaction they had with the sales reps and the personalized advice that they could provide to their clients to help them to reach their goals. DPC recognized that they needed to make a change and they believed they had a new vision for their company.

As they entered the 21st century DPC moved away from hardware solutions to business challenges and shifted instead towards knowledge-based solutions. Rather than selling equipment, DPC began to market the extensive knowledge of its workforce. DPC would no longer sell the equipment; they would instead provide integrated knowledge-based solutions to information management problems. Essentially they would become a consulting firm that would assist their clients to set up systems that would facilitate information management. But now their solutions would go beyond hardware and encompass software, organizational design, data collection management, workflow, and overall information management re-engineering. Sales reps underwent significant training to prepare them for their new roles. However, the redesigned jobs were not a good fit for all of the sales reps. some moved on to other types of positions within the company, but others left to pursue opportunities elsewhere.

As expected, profitability declined during the initial introduction of this new organization’s mission as employees became accustomed to their new roles. Due to the time taken to train employees, they were spending less time in the field with their clients generating revenue and more time in the classroom being oriented to their new roles. However, the decline persisted much longer than anticipated and the company’s leadership team, board of directors, and shareholders were growing impatient with the slow returns. It became increasingly apparent that while the training, resources, and equipment were in place, significant changes in the organizational behavior system at DPC were necessary to ensure long-term success.

Please read the above scenario and answer the below questions in bulleted lines.

You serve as the change leader for Delta Pacific Company (DPC). Up until this point, the organizational culture has been one of traditional culture as the company had a manufacturing environment.

DPC has undergone an extensive change from manufacturing to consulting, including new employee roles and responsibilities, training, and resources. However, there have been organizational barriers and employee resistance to the changes, resulting in declining profitability.

You have decided to design a Change Leadership Strategy plan to present to the leaders of DPC to meet their goal of changing the culture from a more traditional manufacturing environment to one of a contemporary consulting environment. To complete your Leading Change Plan, please include the following:

• Identify the problems facing Delta Pacific.
• Analysis of the different roles leaders and managers use for the successful implementation of change.
• Discuss the roles and responsibilities of leading team members for change.
• Compare and contrast the advantages and disadvantages of two (2) popular change models (Please work on Kotter and ADKAR). Discuss at least three (3) similarities and three(3) differences between change models. Select one (1) model that you feel best complements your strategy.
• Explain how the change model you selected to use will ensure the most effective and efficient process of changing organizational culture.
• Discuss at least two (2) strategies for overcoming barriers to change.
• Discuss the behaviors that Delta Pacific leaders need to exhibit to ensure a positive and successful cultural shift for the long term.