The Orange Valley Community has a large health facility that offers physician services, outreach programs, addiction services, mental health and nutrition counseling for the 6,000 people living in the surrounding area. The Centre employs over 400 people that work with the ethnically diverse, mostly elderly community members who have used the facility for the past 15 years.

In the mid 2000's, a number of pressures threatened the organization's existence and its ability to change, including an over reliance on outdated and inefficient procedures and processes. For example, the method of requesting and securing appointments was very time consuming as patients had to call the Centre and wait on the phone for as much as 20 minutes before being answered. Often times, appointments had to be cancelled or delayed because of health emergencies that occurred during the day that left client appointments behind schedule. The lack of specialized staff to deal with the elderly population was a second problem that contributed to both a lack of continuum of care and appointment delays as physicians were constantly struggling to address health issues outside of their expertise.

In addition, the Centre's management and culture were deeply rooted in a command and control, top down, management style mind set. Decision making abilities were highly centralized (only a few people were making the decisions) with all the decisions were being made by those with formal power. The key decision makers sometimes had conflicting interests regarding priorities and activities at the Centre and furthermore had no plans to change the way the organization functioned. The employees, who had no decision making power, detected a lack of vision by the leadership for the future of the organization and had little respect for those in power, leaving them without a sense of optimism or happiness.

Worst of all, the agency operated within a framework of extensive rules and regulations that constrained the employees' ability to adapt and treat patients in a timely manner. Multiple forms had to be filled out, unnecessary cross checks had to be made between the various practitioners at the Centre, and no training opportunities for employees left them feeling frustrated and on the brink of leaving. This rigid, highly hierarchical workplace had no "rich" channels of communication or opportunities for meaningful dialogue in which to discuss much needed change initiatives. Senior leaders use the "spray and pray" strategy of communicating, and ill conceived external rewards to keep the workforce in line, resulting in a trail of stress and anxiety everywhere in the organization!

One employee named Frank, who had gained significant informal power within the organization, blurted out angrily at a meeting," In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists". We are unhappy, frustrated employees and no one here is managing the change process. We need a vision for transformational change, not superficial change! We need a deliberate planned change initiative that honours our needs as employees as well as the needs of the organization!" Everyone at the meeting was in agreement with Frank.

ANSWER THIS:

A.The PROBLEM(s) presented in the case:

MACRO(Factorsor elements in an organization's general environment that affect the entire workplace performance. Thesefactorsinclude social and cultural forces, demographic forces, technological factors, decision making protocols, workplace attitudes, economic factors, policies, norms, workplace structures, communication protocols etc.)

MICRO(Factors or elements that involve interpersonal, group or department interactions.These factors can include interactions between managers and employees; lack of consensus between board members or upper management, promotion of incompetent managers, dynamics within a group or conflict between different groups or departments);

B.TheCAUSESof the problem(s);

C. TheSYSTEMSof the organization that are affected; Structural; Psychosocial; Technical; Managerial; Goals and Values

D.TWO POSSIBLE ACTIONSthat could be taken by the organization;

E.ONE FINALRECOMMENDATIONchosen from options presented in part "D" to address the problem(s), and arationaleas towhyit was chosen.