Use the Psychsocial Systems Model as this will be the model you will use to analyze this case. and follow this guide:

Introduction

1. Leadership Assessment

2. The Contextual Factors in the Case

3. The Required System

4. The Emergent System

5. The Gap

6. Recommendations

At this point, answer any questions at the end of the case. Page 3 of 3

Below are a few questions to get you to begin systems thinking. It is not an exhaustive list, and you may think of many more. You might use the questions along with the Systems Model to help you understand each case:

Can you use the Model to place the individuals into buckets and describe the flow of actions and information between them?

What is the management/leadership style in the case? Y

ou should evaluate ALL levels of management in each case. In fact, is there, any management or leadership exhibited? Is the work group productive?

How do the personalities of the team members affect the productivity of the work group?

How would you describe the nature of the work they have to do and compare it to work in healthcare?

What is the quality of the work produced? How does the workgroup interact and how does that affect productivity? How satisfied are the team members and how does their satisfaction affect their ability to work and perform up to expectations?

Case Study 2

Conflict at the Academic Medical Center: Productivity Levels By Carolyn Massello and Thomas Massello

PART ONE

Caroline Summer is a newly hired data analyst for an academic medical center (AMC). Jack Burke, the executive assistant to the chief of staff, has called Caroline into his office for an assignment. "Caroline, I need you to look at the productivity of individual surgeons in each specialty and make recommendations based on your analysis." Caroline hesitated for a moment, wondering to herself what Jack would include in his consideration of "productivity," since productivity is a performance measure that includes both effectiveness and efficiency. After a moment of thoughtful consideration, Caroline asked, "What specifically are you looking for? Productivity would include looking at how many cases they perform and how efficiently they are performed. What is the cost of our input versus the cost of the outputthat sort of thing? Do you want to know how much revenue each surgeon generates compared to the salary he or she draws? Do you want to include how much each procedure costs us in the form of physician compensation compared to how much each procedure gets reimbursed? Do you want a ranking of how many procedures are performed by each surgeon sorted by specialty? If you can be more specific on what type of outcome and what level of detail you're after, I can get started on this right away." Jack mulled this over for a minute or two, and then stated, "At this time, I would just like to know the caseload and salaries of each surgeon sorted by specialty. I want to know who our most productive surgeons are." Caroline said, "I can have this information and my recommendations on your desk by the end of the day." As she left, she was thinking about what specific data fields she should pull before she starts to analyze the data. She would need to know number of cases completed, salary, and specialty, for sure. She wondered if the seniority of the surgeon would affect the results, so she included age as well. Jack watched her leave and recalled his conversation earlier that morning with two of the newest surgeons. They were very stressed and complained that they felt they were being taken advantage of by the older surgeons, who appeared to be getting by without contributing much to their departmental workload. It just didn't seem equitable to them, and they were frustrated and angry. Jack assured them that their efforts were certainly appreciated and thanked them for their hard work. But it made him wonder if their complaint was valid. He knew he couldn't go to his boss with the complaint without data to back it up. He would know soon enough whether he needed to elevate their concerns.

Back in her office, Caroline prepared her database query to sort by specialty, caseload, salary, and age, in that order. When she had her printout, she began to look at the results to make meaning out of the data. She noticed that the youngest surgeons do the most cases, but the oldest surgeons are paid the highest salaries. She decided to check with Human Resources to see how the surgeons are compensated. She contacted Jenna Turner, the HR compensation specialist, who told her that the salary is strictly by senioritynot productivitywith a 1.5% raise across the board every 2 years. CASE

STUDY DISCUSSION QUESTIONS

1. Do you think the compensation policies are equitable?

2. What does equity theory tell us concerning its impact on motivation and productivity?

3. What, if any, recommendations would you make for changes in the compensation policies?

4. Discuss the organizational consequences of each recommendation, along with the consequences of making no changes.

PART TWO

Three years have passed since a new productivity pay component was added to the AMC's compensation system. Jack Burke, executive officer to the chief of staff, was perplexed. Despite giving bonuses to surgeons to increase their caseloads, the AMC is struggling with decreasing revenues and increasing costs. Jack called data analyst Caroline Summer for her assistance. When Caroline arrived, Caroline noticed that Pat Jurgins, the HR director, was present. Jack said, "Since we instituted a compensation policy change a few years back, the surgeons have been given a 'performance pay opportunity' of up to a 25% annual bonus based on the number of surgical cases performed in the previous year. Our caseloads are up; however, our bottom line hasn't improved. In fact, it's gotten worse. What went wrong? Could you two please revisit this issue and get back to me?" Caroline said, "Pat, let me pull some data and then you and I can meet to discuss what I find." Caroline Summer was curious about what she might discover as she returned to her office to revisit the "productivity of surgeons by specialty" assignment to see if there is an improvement in surgeons' productivity. However, this time, Jack Burke has asked that she also include reimbursement revenue in her data pull to see if caseloads increased and, if so, whether revenues increased. Sure enough, when she pulled the data, she noticed an increase in the number of cases performed, but a decline in revenue. Closer analysis indicated a marked increase in the number of small cases being performed, but a decrease in the number of large (more highly reimbursed) cases. She also noticed that the more junior surgeons who had previously been identified as being most "productive" were now completing even more cases. It appeared that every surgeon had shifted their focus to completing many quick, easy cases to take advantage of the performance bonus. She dialed Pat Jurgins' number and arranged to meet. CASE

STUDY DISCUSSION QUESTIONS

1. What went wrong?

2. What recommendations would you make?

3. State the consequences that might ensue from each of your recommendations.