APA 6th edition Format
Consult Case Study 6.2 (“Preventive Services at Greenwood Family Medicine”) in Chapter 6 in the textbook. What do you immediately notice about the dynamics of the team? Who had the most authority? Why was this team ineffective in accomplishing its goals? What could the team members have done differently to collaborate more effectively?
State Donor Services (SDS) centrally manages the state’s organ procurement and donation process. There had been a trend of declining organ availability for transplant, despite efforts to increase awareness and success in registering donors through the Division of Motor Vehicles. To help solve the problem, SDS approached State University Hospital (SUH), one of the biggest sources of and utilizers of donated organs through its renowned organ transplant programs. Initial exploration of the problem quickly indicated a consistent demand for organs, but organ donations at SUH were down, matching the pattern seen by SDS.Chris Carter, the new administrator for SUH’s emergency department, was asked to build a team to solve this problem for SUH. The hospital’s Chief Operating Officer (COO) told Chris that this was a top priority because of the high visibility of the transplant programs, the revenues it brought to the institution, and the fact that the Chairman of Surgery had just threatened to leave the institution if SUH “didn’t fix this problem it had obviously created.” The COO gave Chris 2 weeks to get a team together and develop a solution, which Chris would present at SUH’s monthly Executive Committee meeting. Chris asked the COO for advice regarding whom to have on the team, and the COO referred him to the Chief Nursing Officer (CNO).Chris went immediately to the CNO, but the first available meeting time she had was in 3 days. In the meantime, Chris gathered as much information as possible. On the third day, the CNO’s secretary called to cancel the meeting but suggested that he talk with the Nursing Division Director for Medicine. She met with Chris that afternoon, and together, they formulated a list of people they thought would be able to address the issue. SUH was a functionally structured organization, so they built a team with nursing directors from each of the transplant services and the emergency department, the Director of Patient Care Services, a clerk, a physician from the emergency room, and the State Medical Examiner—whose office was located at SUH and who was responsible for autopsies—as well as a clerk from his office.The earliest possible meeting time for this group was in 3 weeks— well beyond the COO’s deadline. Nonetheless, Chris set up a meeting with as many team members as possible and met with the others individually. The team would be able to meet only once or perhaps twice given the aggressive deadline and members’ schedules.Fearing the approaching deadline and wanting to waste no time, Chris got right to business when the group met. He told the group his goals and invited an open discussion of each team member’s experiences with organ procurement. It quickly became evident that several members of the team were too new or too junior to be helpful, with some of Chris’s invitees having asked more junior colleagues to be a part of the team in their stead. The Medical Examiner immediately called into question the validity of the group and the authority by which he had been called to this meeting. When Chris told him this was a high-priority project for the COO and CNO—stating only their names and not their titles—the Medical Examiner indignantly replied that he had never heard of these people and that this was a waste of his time. When Chris clarified their titles, the Medical Examiner became less vocal, but remained indignant. He had been focused on solving a problem of declining autopsies, which placed SUH at risk of violating a state regulation. He was angry to have been diverted from this pressing problem and felt that Chris’s group would draw organizational focus and energies away from his own needs. His resentment spread to others in the group, which, coupled with their inexperience and a lack of appropriate representation, rendered the meeting—and the group—effectively useless.In an effort to avoid a public display of this disaster, Chris reported his lack of success to the COO prior to the Executive Committee meeting. The COO realized the impossibility of the goals he had set for Chris. He extended the deadline 3 months and also utilized his own authority by agreeing to 176Chapter 6 Understanding and Improving Team Eff ectiveness in Quality Improvemen© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION. 9001 eam meeting. These two key factors allowed Chris to rebuild a more knowledgeable, representative, and experienced team.Ultimately, the organ donation problem was traced to a series of new federal regulations and SUH’s fragmented approach to processing end-of-life paperwork. In summary, each operational unit had established its own processes for responding to the regulatory requirements, none of which were integrated with the other operational units, thus creating hours of work for the clinical staff, most of whom gave up trying to secure organ donations. Interestingly, the Medical Examiner’s problem of a declining autopsy rate was also a result of this same disjointed method of paperwork processing.177Understanding and Improving Team Eff ectiveness in Quality Improvemen
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