Riverside Pediatric Associates

1. DISCOVERY

What worked? What didn’t?

• Survey the staff and patients to find the source of frustrations or happiness
• Address the accountants concerns, looking at how the problems came to be
• Identify why revenue is not being collected in a timely manner
• Review the use of supplies to find waste

• DREAM

Realizing the original dream, today.

• Improve service to patients and family
• Improve respect and collaboration among staff
• Save and invest money
• Collect patient fees in a timely manner
• Encourage creativity and innovation among staff to solve routine problems
• Hire an administrative staff to allow doctors to return to patient care

DESIGN

How do we get there?

• Provide mandatory training and team-building events for all staff
• Create a plan to save and invest for future changes
• Develop a payment system and payment (revenue) policies to reduce loss
• Staff are self-managed to solve conflict quicker
• Hire administrative help to allow the doctors to focus on their patients
• Create a timeline of change that is clear and openly communicated to all staff

DESTINY

The goal ahead?

• Annual reviews for staff to understand them and their environment
• Keep the company healthy by creating change when necessary
• Celebrating achievements
• Dreaming new dreams

Question 2

The accountant recommended that Sanchez and Hudson consider to use AI (Appreciative Inquiry) to facilitate positive change within the practice. How would you implement the 4 Steps of AI? Be specific. What kind of things would you expect to arise during the Discover and Dream steps of AI.

Question 1

Assume you are Sanchez and Hudson and plan to implement immediate organizational change within the practice. Where would you start? What steps would you take?

Question 3

EIGHT STAGE MODEL

Planned organizational change

Sanchez and Hudson are caught between being physicians and being leaders of their practice. How would you suggest them resolve this dilemma? What leadership qualities will Sanchez and Hudson need to display in order to lead positive change in their practice?

What kinds of things would you expect to arise during the discovery and dream steps of AI?

DISCOVERY. We believe they would find that the practice is lacking personnel and space, along with a plan to address continued growth as the surrounding populous grows. Charity attracts business, but the impoverished are not always capable of paying their bills. The loss of revenue needs to be addressed. Frustrations between employees are likely due to the confusion caused by overloaded systems and their increasing work load which doesn’t allow them to communicate effectively.

DREAM. The larger customer demand will give rise to other services that the practice may be able to provide. Charitable contributions will likely have to be cut back in order to balance the books. Any leniency towards late or non-payment of bills will need to stop. While the original dream may still be realized, there will have to be sacrifices.

SUGGESTIONS

QUALITY OF A CHANGE LEADER

Create an organizational structure and hire staff to balance the functions of the business. For example: hire an administration staff

Set out the vision, mission and goal for the company

Plan out the steps for the organizational change

Referred to the eight-step model

Communicate the need for change in the organization, to all of the employees in the Associates

Connect and recruit employees (nurses, doctors) that would like to see changes and implement changes

Build and communicate the vision and mission for the change and the company and the strategy need to be implemented. Discuss the vision with the employees for a potential organizational structure changes.

Make sure that all of the employees are a part of the change and the process. They should be up-to-date with the changes, processes and small or big milestones.

Hire administration staff to take care of paper works, invest in a better information system. Give the employees the tools to perform better (training, encouragement, mentorship).

Achieve and celebrate quick wins

Keep it moving

Make changes stick: change in governance and policies and procedures

LEADING CREATIVITY FOR CHANGE

• Define themselves as change leaders
• Demonstrate courage
• Believe in employees being responsible
• Assimilate and articulate values that promote adaptability
• Recognize and learn from their own mistakes
• Have vision and are capable of managing complexity, uncertainty, and ambiguity

• Instilling Creative Values
• Facilitate Brainstorming
• Promote Lateral Thinking
• Enable Immersion
• Allow Pauses
• Nurture Creative Intuition

ACTIVITY

Spaghetti Marshmallow tower

• Divide into 2 teams
• Each team is given the same amount of spaghetti sticks, tape and 1 marshmallow
• Build the tallest structure that you can with the marshmallow at the top
• The one with the taller structure win
• Prepare for surprises
• 8 minutes

QUESTIONS

References: 2015 Cengage Learning

Leading change

There is only one thing that is constant is CHANGE.

The Case

The Meeting

Social changes

Introduction

• Increased waiting time
• Increase in no. of patients
• Lower revenue
• Work load increase
• Overloaded internal systems

Dr. Alvero Sanchez & Dr. Josh Hudson

Riverside Pediatric Associates

- 5 doctors

- 6 nurses

- 1 accountant

The staff are caring and conscientious. They are partnered with YMCA to provide underprivileged with flu shots and health clinics.

Accounting problems:

• Declining reimbursement from insurance companies
• Delinquent patient payments
• Rising costs of medical supplies sand lab work
• Decreasing revenue

Dr. Sanchez's Proposal

• Improve service to patients and family
• Improve respect and collaboration among staff
• Save money
• Collect patient fees in a timely manner
• Encourage creativity and innovation among staff to solve routine problems

• Can’t focus on the patient care
• Decreased staff morale: fighting, resignations, unhappy work conditions

Riverside Pediatric Associates

Thao Nguyen & Brad Dressler