Response to PIERRE’S REVIEW ON COMPETENCIES AND PRINCIPLES – POST 8.1

Hello Kamal,

Thank you for your post. Although we work in different health authorities and different settings, best practices seem to be universal. Employees need that personal touch to feel heard and respected.

I would like to provide a brief description of CLeAR for everyone else reading:

CLeAR stands for Call for Less Antipsychotics in Residential Care. The British Columbia Patient Safety & Quality Council (2017) describes CLeAR as

a quality improvement initiative that supports teams from residential care homes in British Columbia to address the behavioural and psychological symptoms of dementia (BPSD) with a focus on reducing inappropriate use of antipsychotics.

Antipsychotics are not the optimal choice for treating BPSD. These drugs are minimally effective, but increase the risk of stroke, unsteady gait, increased disruptive behavior, and death (Banerjee, 2009). The Canadian Academy of Geriatric Psychiatry and the Canadian Psychiatric Association recommend using these drugs only when measures not involving drugs have failed, and only if the behavior would be dangerous to self or others (Choosing Wisely Canada, 2017).

The Canadian Institute for Health Information (2017) says 25.9% of antipsychotics in British Columbia long-term care homes may be used inappropriately. With the minimal benefits and increased risks, many parties, including medical professionals and families, want to reduce the use of antipsychotics.

However, other medical professionals, nurses, families, and care staff resist change. As you said, “why change something that doesn’t need to be changed.” (Badesha, 2018) I agree with you about the need for communication, especially change talk. Perhaps one way of reframing the change is the use of expectancy theory.

Purvis, Zagenczyk, & McCray (2014) explain expectancy theory as “motivation on the degree to which an effort is perceived to lead to performance, performance leads to rewards, and the rewards offered are desirable.” In laymen’s terms, we answer the question, “what’s in it for me?” Why should care staff, nurses, families, and doctors care about this initiative? I have found discussing this question to be helpful with some stakeholders. For care staff and nurses, a decrease in antipsychotics may lead to lfewerside effects and deaths. We need to acknowledge when antipsychotics use is appropriate; CLeAR is fewer antipsychotics, not no antipsychotics.

For families, we can sell the idea of better health for their loved ones. Few families want to see residents with uncontrollable behavior, but these same families also don’t want their relatives to live as soulless zombies. We can convey the hope of managing the behavior while maximizing qthe uality of life.

Finally, for doctors, we can talk to them about potential side effects. Doctors know about the maxim of “start low and go slow” with medications. They are also aware of family sensitivity regarding overmedication. We can sell them on the idea of working together to maintain the highest quality of life.

Let me know what you think!

References:

Badesha, K. (2018). Response to Pierre’s review on competencies and principles – Post 8.1. Retrieved November 25, 2018, from https://create.twu.ca/kamalbadesha/2018/11/24/response-to-pierres-review-on-competencies-and-principles-post-8-1/

Banerjee, S. (2009, October). The use of antipsychotic medication for people with dementia: Time for action Retrieved November 25, 2018, from https://webarchive.nationalarchives.gov.uk/20130104175837/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_108302.pdf

British Columbia Patient Safety & Quality Council. (2017). CLeAR wave 2: Final evaluation report. Retrieved November 25, 2018, from https://bcpsqc.ca/wp-content/uploads/2018/07/2017-CLeAR-Wave-2-Evaluation-Report-Aug-3-2017_FINAL.pdf

Choosing Wisely Canada. (2017). Psychiatry. Retrieved November 25, 2018, from https://choosingwiselycanada.org/psychiatry

Purvis, R. L., Zagenczyk, T. J., & McCray, G. E. (2015). What’s in it for me? Using expectancy theory and climate to explain stakeholder participation, its direction and intensity. International Journal of Project Management, 33(1), 3–14. https://doi.org/10.1016/j.ijproman.2014.03.003

Response to Pierre’s Challenge of “Stella’s Strategic Competencies || Blog 8.1: D’Oh!

Hello Stella,

Thank you for your response post. I now have more understanding of how the education system works (although I’m sure there’s much more to it). I am intrigued by the complexity of education; I was certain teachers were entirely responsible for their classrooms. I also did not know how education for special needs students works. Thank you again for sharing.

I am happy you found the link I shared useful. This type of learning helps all of us learn beyond our local environments and experiences. I agree with your assessment of a team (complex) interdependence within your education system, like parts of the health care system. I guess there’s a reason health and education are together in this class!

I promise I didn’t laugh. I giggled a little bit, but only because I didn’t really understand Galbraith’s purpose at first either. I like your example of “twenty pieces of lego… we can put them together like this” (Peters, 2018). I would love to do what my kids do – take all the legos apart and build whatever I want. I can’t, for now, but I can see the connections and understand how things are put together. Just like you, I had my “eureka” moment; I can look at the current structure and figure out how I can renovate!

Reference:

Peters, S. (2018). Response to Pierre’s challenge of “Stella’s strategic competencies || Blog 8.1: D’Oh!.” Retrieved November 25^th, 2018, from https://create.twu.ca/stellapetersldrs501/2018/11/23/response-to-pierres-challenge-of-stellas-strategic-competencies-blog-8-1-doh/

Stella’s Strategic Competencies || Blog 8.1

Hi Stella,

Thank you for your post, and for sharing your ideas for improving your strategic leadership practice. I applaud you and your organization in achieving a 50% growth rate over two years. That is amazing! I see you recognize the challenges in rapid growth, and I believe you will be able to handle them.

I want to discuss one of your choices for your three least important principles. You used Figure 1.1, types of interdependence, as an example. What are the different teams within your organization? Does each teacher work on his or her own? Do teachers of different subjects work together to determine the learning plans? What does the administration do concerning the teachers? (I apologize if the questions seem very basic; I know very little about the education system).

In health care, the interdisciplinary team has four types of interdependence: pooled, sequential, reciprocal, and team (complex).  Galbraith (2014) defines pooled, sequential, and reciprocal but not team (complex). Cholette, Beasley, Abdiwahab, & Taplin (2017) describe team (complex) interdependence as members mutually interacting and collectively managing the flow of inputs and output between members. They use the example of creating a care plan for a patient with multiple chronic conditions; all the team members need to collaborate to make a comprehensive plan. Would this type of interdependence apply to a student with special circumstances?

I also want to ask you about your evaluation of Galbraith’s book. You say it is “too technically focused on business aspects.” (Peters, 2018) If you could start from scratch, to design an education system based on your ideas, would you find this book more useful? Do you think this thought experiment would help you come up with possible innovation for your current system?

Again, thank you for your post. I look forward to your response and learning more about education!

References:

Chollette, V., Beasley, D. D., Abdiwahab, E., & Taplin, S. (2017). Health information systems approach to managing task interdependence in cancer care teams. Journal of Oncology Practice, 13(3), 154–156. https://doi.org/10.1200/jop.2016.020156

Galbraith, J. R. (2014). Designing organizations: Strategy, structure, and process at the business unit and enterprise levels.

Peters, S. (2018) Stella’s strategic competencies || Blog 8.1. Retrieved November 23, 2018, fromhttps://create.twu.ca/stellapetersldrs501/2018/11/22/stellas-strategic-competencies-blog-8-1/

Sadie’s post is here: https://create.twu.ca/ldrs501/2018/11/22/5724/

Hello Sadie,

Thank you for your post. I agree with the principles you have chosen for your organization, specifically the ones where you catch someone doing something right and creating a supportive environment (Thompson, 2018).

At the end of your post, you discussed cooperation and competition (Thompson, 2018, para. 11). Ungerger, Ungerer, and Herholdt (2016) say “cooperation works better than competition” (p. 382). However, this statement does not mean you cannot have both. The term for a relationship that has both cooperative and competitive aspects is coopetition (Padula & Dagnino, 2007). Coopetition has been used by educational institutions to access resources unavailable to them individually (Dal-Soto & Marlon Monticelli, 2017). Another example of coopetition is seen in the health care industry, when multiple facilities form one bargaining association to deal with unions, while still competing for clients.

In your context, coopetition may work. The cooperative part of your environment could be a reward for all staff should the organization meet specific targets. I am unfamiliar with what a relevant target would be; for my organization, one of our targets is a 50% reduction in falls with injury by 2020. Should all our home reach that target, we get a bonus. In the meantime, the competitive part of this goal is the home achieving the lowest number of falls with injury getting a special prize. This competitive part of the goal does not hamper homes from helping their sister homes, but it drives individual homes to be the best among their peers. Something similar may work for in your context!

References:

Dal-Soto, F. & Marlon Monticelli, J. (2017). Coopetition Strategies in the Brazilian Higher Education. RAE: Revista de Administração de Empresas, 57(1), 65–78. https://doi.org/10.1590/S0034-759020170106

Padula, G. & Dagnino, G. (2007). Untangling the rise of coopetition: The intrusion of competition in a cooperative game structure. International Studies of Management & Organization, (2), 32. Retrieved November 22, 2018, from https://ezproxy.student.twu.ca:2420/10.2753/IMO0020-8825370202

Thompson, S. (2018). Competencies, principles, and me. Retrieved November 22, 2018, from https://create.twu.ca/ldrs501/2018/11/22/5724/

Ungerer, M., Ungerer, G., & Herholdt, J. (2016). Navigate strategic possibilities: strategy formulation and execution practices to flourish. Randburg: KR Publishing. ISBN 978-1-869-22623-7.

Kunal’s original post can be found here: https://create.twu.ca/ldrs501/2018/11/20/strategic-leadership-competencies/

Hello Kunal,

Thank you for your post. I find myself agreeing with you on some points yet wanting to seek clarification on some of your other points.

Samson has provided an excellent response to your point of self-management, located here: https://create.twu.ca/chiefanalyzerofthings/2018/11/22/the-importance-of-building-personal-competency-for-success/, so I will not touch on that point.

I wanted to discuss one of the points you chose as least essential; the “evolve, do not install” point from Galbraith (2014). I am having trouble locating the specific reference in Galbraith; would you be able to provide the relevant section or chapter?

You state, “it is one of the company’s policy to not intrigue in other’s work and especially administration. To focus more on their work” (Singla, 2018, para. 11). Does this mean teams within the organization cannot collaborate? Usually, policies have a purpose or rationale behind them. Was there a history of employees interfering in other people’s work? Now I’m intrigued!

Further, I want to get some clarity regarding the definition of “evolution”. Combined with your statement of “the organization adopts the methods which are best suitable for them and the benefit of the organization without thinking of employees and considering them” (Singla, 2018, para. 10), I wonder how this organization functions. It seems as if the organization is using the old economy value of coercion, holding power over employees instead of collaborating with them (Ungerer, Ungerer, & Herholdt, 2016). It appears your organization would not appreciate innovation generated by front-line staff. Have you found the organization implementing new initiatives to a significant degree of success, or has there been much pushback?

Finally, you state the “organization core committee have trust issues with every employee, and they do not trust anyone’s work” (Singla, 2018, para. 9). I am saddened to hear this. I have trouble understanding how exactly this organization continues to function without rapid turnover and/or severe burnout. I do not mean to offend you or your organization, but I know I would have trouble working there. Reina and Reina (2006; as cited in Hughes, Beatty, & Dinwoodie, 2014) describe three dimensions of trust: contractual, competence, and communication. Your organization does not seem to have competence trust if they do not trust anyone’s work.

I look forward to discussing with you further.

References:

Galbraith, J. R. (2014). Designing organizations: Strategy, structure, and process at the business unit and enterprise levels.

Hughes, R. L., Beatty, K. M., & Dinwoodie, D. (2014). Becoming a Strategic Leader: Your Role in Your Organization’s Enduring Succ. John Wiley & Sons.

Singla, K. (2018). Strategic leadership competencies. Retrieved November 22, 2018, from https://create.twu.ca/ldrs501/2018/11/20/strategic-leadership-competencies/

Ungerer, M., Ungerer, G., & Herholdt, J. (2016). Navigate strategic possibilities: strategy formulation and execution practices to flourish. Randburg: KR Publishing. ISBN 978-1-869-22623-7.

Ungerer, Ungerer, and Herholdt (2016, p.34) cite the story of a Zen master teaching a man about the importance of “emptying the cup” to learn something new. LDRS 501 course materials provide us with new ideas and new ways of implementing strategic leadership. Some of the material has been immediately useful, while other material may be helpful in challenging my way of thinking even if I cannot directly implement the concept.

I believe these three competencies will be the most important to my organization and me moving forward:

1. Building Trust (Hughes, Beatty, & Dinwoodie, 2014, p. 148)

Browning (2013) refers to trust as “the lubricant that enables a leader to bring about transformational change.” Reina and Reina (2006; as cited in Hughes et al., 2014) refer to three dimensions of trust: contractual, competence, and communication. Health care magnifies all three dimensions due to the life-and-death decisions made with clients and their families. Leaders deemed untrustworthy by their employees will result in poor practice and possibly even loss of life.

Conversely, a justified sense of trust between leaders and their employees will likely lead to best practice. I plan to build trust by focusing on these three dimensions. Contractually, I will “let my yes be yes, and my no be no” (Matthew 5:37), not making impossible promises. I will increase my competence by continuing to hone my clinical and leadership skills, and by trusting my frontline staff with their assessments and care plans. Finally, I will continue to have open communication with my employees and our clients, being honest and sincere.

2. Lead the organization by building culture (Ungerer et al., 2016, p. 36)

Hughes et al. (2014) remind us of culture’s ability to eat strategy for breakfast. Health care culture has unfortunate aspects, especially with the idiom of “nurses eating their young” (Gillespie, Grubb, Brown, Boesch, & Ulrich, 2017). Instead of trying to fix problems with the workplace with quick-fix solutions, I would need to help the organization with a culture shift. I can do this by promoting the creation of a “just culture”, one where learning and client safety are of utmost importance (Boysen, 2013). A “just culture” acknowledges errors and analyzes why they happen, looking to solve problems within the system instead of immediately dealing out punishment towards individuals. This type of culture in the workplace seeks quality improvement without sacrificing accountability.

3. Creating a Supportive Environment (Lepsinger, 2010, p. 69)

Lepsinger says a supportive environment makes people comfortable so they can try new things. I have previously described my organization as recovering from an environment of authoritarianism. I have no interest in having frontline employees acting like robots with no initiative. I want employees to exercise their free will and to challenge me when they feel a course of action is inappropriate. I would start creating this environment through many 15-minute unit meetings with all of the staff, encouraging them to express themselves and share their ideas. I believe innovation comes from frontline staff, not from a few “gurus”.

I believe this competency may not be as useful to my organization and me:

1. Act decisively in the face of uncertainty (Hughes et al., 2014)

Health care organizations tend to be risk averse due to the need for stability in all circumstances (ASC Communications, 2016). Because of the nature of the field, health care organizations seek to reduce the amount of risk possible, sometimes to the point of near paralysis. Instead of acting decisively in the face of uncertainty, I would instead implement more PDSA cycles (American Society for Quality, n.d.) to reduce potential negative impact to low levels while still moving toward quality improvement.

I have found the following three principles most helpful to organizational practice:

1. Learning from Addicts / Change Readiness (Lepsinger, 2010)

Some of my clients have substance use issues, while others are addicted to questionable practices. Some have resigned themselves to their addiction, saying they are too old to change, while others fear the withdrawal effects. Some of these withdrawal effects can be dangerous; for example, delirium tremens is a form of alcohol withdrawal which may lead to confusion, hyperactivity, and even death (Burns, 2018).  Other times the withdrawal effects can be merely unpleasant.

I have extended this line of thinking into the practice of my frontline staff. Some of my employees became addicted to the status quo, to the thought of “it’s always been done this way”. Yesterday, I introduced a small trial involving a linen cart and a process flow change with laundry. This change would affect 20 residents and two staff – about 10% of the organization. Immediately one senior staff member objected to the change, saying “this will not work” and “why change something that’s working”, even though the old process was wasting valuable time.

Over the past year, I have seen the effects of withdrawal from my staff to various levels. Some of the staff eagerly embraced the change, as if they were free to fly. Other individuals, like the senior staff member above, furiously clung to the old ways, convinced her world would flip upside-down. A few staff chose to retire (career death) rather than change.

I have made the mistake of wanting to cause rapid, abrupt change in the organization, believing the best way to shake things up is by treating behavior like an old bandage – removing it quickly to the effect of more pain but less time. I have inadvertently caused the organizational equivalent of abstinence syndrome, or “cold turkey” (Ghodse, 2010, p.181). Ghodse also says,

Rather than treating relapse as a failure, any worthwhile period of abstinence should be welcome as a success and the patient’s achievement recognized. A positive approach encourages cooperative rather than confrontational attitudes between patients and staff, and in this atmosphere more patients will be prepared to try again.

I resolve to apply Ghodse’s approach to addiction withdrawal – I will seek to encourage employees on their journey to wellness, instead of berating them when they slip into old habits. I am a fellow addict, at times chained to my current ways of thinking. I resolve to journey with my staff, seeking freedom from mediocrity and traveling with them to greater success.

2. Strategic Thinking (Hughes, Beatty, and Dinwoodie, 2014; Ungerer et al., 2016)

The mind is powerful. Recent research discusses the placebo effect or the improvement of symptoms for a condition with a substance that should not have any physiological effect. Crane (2016) says “the ability of the mind to affect physiology, whether through expectancy., meaning, or context, is increasingly accepted”. Western medicine may see this mind-body connection as new, but Eastern thought held this idea millennia ago. One Middle Eastern source says, “Guard your heart above all else, for it determines the course of your life.” (Proverbs 4:23).

The importance of thinking and the personal mind extends into the organization and its collective mind. Ungerer et al. (2016) ask the question of why seemingly intelligent people act in evil ways. Enron, Lehman Brothers, and Bernie Madoff show the effects of greed as a corporate value. Conversely, Bagozzi, Sekerka, Hill, and Sguera (2013) say strong morals lead to strong intentions, which increase the chance of completing moral acts.

Strategic thinking requires an organization to come together and think about its current state, future state, and its systems (Hughes et al., 2014, p. 70). Ungerer et al. (2016) discuss five interrelated thinking stances that will help an organization succeed, namely “possibility thinking, collaborative thinking, abundance thinking, new economy values thinking and paradox thinking.”  All of these thinking stances challenge our perception of reality, to go from “how things have always been” to “how things are and where they will be.”

3. The New Economy (Ungerer et al., 2016)

This principle has had the most impact on my way of thinking about organizations and systems. When I first started in nursing, a hierarchical structure existed where doctors where in charge and the nurses acted as their handmaidens. I also learned to respect my elders and to refrain from questioning their decisions. This structure was the “old economy” of coercion. When I moved from the Philippines to Canada, I saw more collaboration within the interdisciplinary team, thus leading towards the new economy. However, I do not feel we have reached the last stage of the new economy, which is co-creation. To achieve this stage, I believe I will need to implement servant leadership within the organization and recognize all of my co-workers as partners.

I have found these principles to be less useful to my organization and me:

1. The Reconfigurable Business Organization (Galbraith, 2014)

I am confident this principle may be helpful to our CEO and his vice-presidents, but I do not see as much value with our local leadership. Our local facility must conform to the requirements laid out by the local health authority, including the provision of care, recreation, dietary, and housekeeping services. There may be “informal” teams that could lead individual initiatives, but our organization is static overall.

2. The Business Model Canvas (Ungerer et al., 2016)

Just like the reconfigurable business organization, I can see the value of the canvas for very high-level leadership and those interested in the overall business model of the organization. I do not currently see the value of this principle for my leadership team and my staff, as this specific principle would likely generate any interest within our current employees. Instead, they would be more interested in how best to care for residents. They are not interested in revenue streams, cost structure, or revenue streams.

3. The Value-Adding Conglomerates (Galbraith, 2014)

Similarly, this concept makes sense for the CEO and vice-presidents. My parent organization has multiple arms in retirement, long-term care, and real estate, but front-line employees would not any interest in something that seems very abstract. They would instead focus on information and processes that affect them directly.

And the Winner for Least Useful Resource Is…

Sorry, Mr. Galbraith. I can see some value in designing organizations if my organization was a start-up or if I was not involved in long-term care. I am currently working in a mature field with a low tolerance for organization change, so I don’t currently see any practical application for Designing Organizations. Perhaps when I get further in my career…

References:

ASC Communications (2016, March 29). Hospital boards are often risk-averse. Here’s why they need to embrace it — and how. Retrieved November 18, 2018, from https://www.beckershospitalreview.com/hospital-management-administration/hospital-boards-hate-risk-here-s-why-they-need-to-embrace-it-and-how.html

Bagozzi, R. P., Sekerka, L. E., Hill, V., & Sguera, F. (2013). The role of moral values in instigating morally responsible decisions. Journal of Applied Behavioral Science, 49(1), 69–94. https://ezproxy.student.twu.ca:2420/10.1177/0021886312471194

Boysen, P. (2013). Just culture: a foundation for balanced accountability and patient safety. The Ochsner journal, 13(3), 400-6.

Browning, P. (Ed.). (2013). The currency of trust. Independence, 38(1). Retrieved from https://ezproxy.student.twu.ca/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edsaed&AN=rmitplus197641&site=eds-live

Crane, G. S. (2016). Harnessing the placebo effect: A new model for mind-body healing mechanisms. The International Journal of Transpersonal Studies, 35(1), 39–51. Retrieved from https://ezproxy.student.twu.ca/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=lsdar&AN=ATLAiFZK160930001397&site=eds-live

Galbraith, J. R. (2014). Designing organizations: Strategy, structure, and process at the business unit and enterprise levels.

Ghodse, H. (2010). Drugs and addictive behaviour: A guide to treatment. Cambridge, UK: Cambridge University Press.

Gillespie, G. L., Grubb, P. L., Brown, K., Boesch, M. C., & Ulrich, D. (2017). “Nurses eat their young”: A novel bullying educational program for student nurses. Journal of nursing education and practice, 7(7), 11-21.

Hughes, R. L., Beatty, K. M., & Dinwoodie, D. (2014). Becoming a Strategic Leader: Your Role in Your Organization’s Enduring Succ. John Wiley & Sons.

Ungerer, M., Ungerer, G., & Herholdt, J. (2016). Navigate strategic possibilities: strategy formulation and execution practices to flourish. Randburg: KR Publishing. ISBN 978-1-869-22623-7.

Original post can be found here: https://create.twu.ca/robtegelberg/2018/11/12/post-7-1-conflict-and-cooperation/

Thank you, Rob, for your post. To be frank, I am envious of your workplace! You say “the joy of the Lord is present in the staff, even when disagreements arise.” (Tegelberg, 2018, para. 1) There are days I have trouble finding any joy in our organization, let alone the joy of the Lord! I am also happy to hear the school’s culture to allow staff to grumble and have a sympathetic ear (Tegelberg, 2018, para. 2)
You have also shared the secret of this harmony – being disciples of Christ who love one another (Tegelberg, 2018, para. 3; John 13:35).

I would like to answer your discussion questions below.

1. Have you ever begun a conflict resolution meeting with prayer? Do you feel that it makes a noticeable difference to the tone of the meeting?

My current workplace, being secular, does not currently use prayer as part of a conflict resolution meeting. I sometimes pray silently before entering into a meeting. I find my results mixed. Upon self-reflection, I do note a difference between prayer for the sake of habit versus prayer as a request for God’s guidance, wisdom, and love. Toussaint, Kamble, Marschall, & Duggi (2015) note a “statistically significant” decrease in thoughts of retaliation after participants prayed for others. Prayer may modify the motives of participants, helping them to seek and provide forgiveness as well as cooperation. I forget to follow the command of “praying without ceasing” (1 Thessalonians 5:17) and have to deal with potentially avoidable escalations.

In situations where public prayer is used prior to conflict resolution meetings (i.e. church business meetings), results have also been mixed for me. At times, personal passions override the goal of reconciliation, especially if certain actions have caused deep pain. I feel conflict resolution in this case may need long sessions of prayer and fasting, as well as multiple meetings to completely resolve these issues.

2. I have worked at many schools that struggle with an attitude of gossip and grumbling? What actions or traits do you think prevent that attitude from arising at my current school? Are there any tangible tools one could take from this example into another situation to dissolve an existing negative school culture or environment?

You have stated the traits of love, service, and support as underlying desires that prevent gossip and grumbling. Stragetic leadership, as defined by Hughes, Beatty, & Dinwoodie (2014, p. 11) is the creation of direction, alignment, and commitment needed to achieve enduring performance. Having the abovementioned traits as organizational values forms the foundation of DAC within the school. Many organizations would benefit from creating and maintaining this culture. The most tangible “tool” to take from your school is the worldview of treating everyone, including frontline staff, as God’s children. Lepsinger (p. 62) says we should assume value and listen for the positives with supposed low-performing employees. How much more value should we have when we see each person as one God loves so much to die for us!

3. Should a situation arise in the future where a staff member were to take advantage of the current school environment that I work in, what strategies would you employ in creating an attitude of collaboration? For a hypothetical example: a new staff member joins the team. They bring with them an attitude of negativity, a desire to only do required tasks, and teach the curriculum that they want to teach. How would you bring them into the collective vision.

I believe the school culture addresses many of the concerns noted with a potentially problematic staff member. The staff member would need to fit himself or herself within the current culture of love, service, and support. He or she would need to follow the current DAC set by current leadership. He or she would also have to determine if personal culture and organizational culture would be a good match; otherwise, he or she would feel increasingly isolated, not because other staff would actively shun that person, but because his or her behavior would be incongruent with organizational culture. The culture clash may reach a point where a staff member would voluntarily leave to avoid the discomfort of values dissonance, or would work with leadership to seek employment elsewhere.

References:

Hughes, R. L., Beatty, K. C., & Dinwoodie, D. L. (2014). Becoming a strategic leader: Your role in your organization’s enduring success. San Francisco, Calif: Jossey-Bass.

Lepsinger, R. (2010). Closing the execution gap: How great leaders and their companies get results. Jossey Bass.

Tegelberg, R. Conflict and Cooperation. Retrived November 15th, 2018, from https://create.twu.ca/robtegelberg/2018/11/12/post-7-1-conflict-and-cooperation/

Toussaint, L., Kamble, S., Marschall, J. C., & Duggi, D. B. (2015). The effects of brief prayer on the experience of forgiveness: An American and Indian comparison. International Journal of Psychology, 51(4), 288–295. https://doi.org/10.1002/ijop.12139

Original post can be found here: https://create.twu.ca/ldrs501/2018/11/12/working-of-a-nonprofit-organization/

Thank you, Avisha, for your post. I believe this is the first time I am responding to one of your posts.

Can I ask for clarity regarding your briefing periods and check-in processes? Am I correct in assuming front-line employees have time for an individual half-hour check-in with leadership, as well as briefing meetings three times a week? If so, kudos to your organization for making a large time commitment for meetings. Do you believe having these many meetings helps with clarity and morale?

My organization would have difficulty with the number of meetings, not to mention the amount of time used. Is face-to-face interaction required, or are there alternate methods of communication such as email or other technological solutions? Although you quote Hughes, Beatty, & Dinwoodie (2014, p.158) regarding the importance of the one-on-one relationship, this relationship does not always need to be face-to-face.  A quick phone call or email update may suffice depending on the leader-employee relationship.

I, too, am surprised about the idea of competition within a non-profit organization. Lepsinger (2010, p. 160) says cooperation and coordination are critical to execution. What contributes to the spirit of competition? You mentioned a performance-based measurement for job appraisal and the performance improvement plan. Conversely, is there a bonus of some sort for greatly exceeding targets? If so, is this advertised in the employee value proposition? If not, what other factors contribute to competition within the workplace?

I look forward to your response. Thank you.

References:

Hughes, R. L., Beatty, K., & Dinwoodie, D. L. (2014). Becoming a strategic leader: Your role in your organization’s enduring success.  San Francisco, CA: Jossey-Bass.

Lepsinger, R. (2010). Closing the execution gap: How great leaders and their companies get results. Jossey Bass.

Jessica’s post can be found here: https://create.twu.ca/jessicalaugsawatzky/2018/11/12/hc-1-leader-post-7-1/

Thank you, Jessica, for your post. I have been away from the Fraser Health Authority region for just under a year, but still maintain a working relationship with some of the project leads. I can relate to your story of conflict and interdepartmental communication.

I am not sure if you have heard of CommuniCARE. According to Findlay & Merkel (2014), CommuniCARE is a process to identify patients in acute care who live in Residential Care and Assisted Living sites. The intent of CommuniCARE was to “standardize written and verbal communication tools and processes” (Findlay & Merkel, 2014). Examples include standardized sheets for transfers to and from the hospital, pink wristbands to identify residential care patients, and daily calls from the residential care nurse to the acute care nurse for updates and discharge planning. These processes were supposed to solve the complaints from residential care nurses of a lack of communication from the acute care department, as well as helping acute care nurses understand the needs of residential care to facilitate a smooth transfer back to residential care.

Unfortunately, CommuniCARE worked poorly during my time within the Fraser Health region. I worked in an affiliated residential care home and received multiple complaints from my nurses about the worsening lack of communication from acute care, mainly due to acute care nurses saying “I’m busy, I can’t talk to you right now” during the daily calls. Similarly, discussions from acute care members gave the impression of CommuniCARE being merely a “make work” project.

I discuss this example because acute care, residential care, and home support are three parts of the same organization, with the same mission, vision, and values, but with wildly different foci. I agree with Warkentin (2018) when he cites Lepsinger (2010) regarding the need for collective objectives. In the case of Fraser Health, the collective objectives should align with its purpose, stated as “to improve the health of the population and the quality of life of the people we serve” (Fraser Health Authority, n.d.)  One way of thinking about collective objectives is to adopt a mindset of the continuum of care model, defined as “a system that guides and tracks patients over time through a comprehensive array of health services spanning all levels and intensity of care.” (Healthcare Information and Management Systems Society, 2014) This system may cover care from birth through end of life. Fraser Health is in a great position to cover an individual through all life stages.

You stated the importance of playing to individual strengths. This is a great idea, and I believe it could be extended further to holding each department accountable for their strengths. If acute care, residential care, and home support understood each other’s roles, scope, and capabilities, this shared understanding may lead to greater cooperation as everyone could hold each other accoutnable for their part in client / patient / resident care.

You also state the importance of education for all staff to address conflict resolution. This is a great idea. Part of conflict resolution includes the alignment of interests and the establishment of common ground (Lepsinger, 2010, p. 170). In the CommuniCARE example above, nurses from acute care and residential care failed to understand the benefit of effective communication for the coordination of a resident’s care, thus resulting in conflict. I suggest future education be held with a mix of acute care and residential care employees in attendance, with mixed groups working together throughout the day to understand each other’s roles and challenges. In the case of your home support example, I recommend a 10-minute workplace huddle with “respectful workplace” as one of the standing agenda items. These huddles could address minor conflicts before they balloon into massive blowups.

I’m looking forward to your response. Thank you.

References:

Findlay, E. & Merkel, M. (2014). CommuniCARE improving patient information sharing and discharge planning [Powerpoint]. Retrieved November 13th, 2018 from https://www.slideshare.net/bcpsqc/communicare

Fraser Health Authority (n.d.). About Fraser Health. Retrieved November 13th, 2018 from https://www.fraserhealth.ca/about-us/about-fraser-health#.W-vJf5NKiUk

Healthcare Information and Management Systems Society (2014). Definition: Continuum of Care. Retrieved November 13th, 2018 from https://www.himss.org/file/1307141/download?token=ny_X7URU

Lepsinger, R. (2010). Closing the execution gap: How great leaders and their companies get results. San Francisco: Jossey-Bass.

Warkentin, M. (2018). Discipline that Restores – Thought on HC 1 Leader´s Post 7.1. Retrieved November 13th, 2018 from https://create.twu.ca/marcelowarkentin/2018/11/13/discipline-that-restores-thought-on-hc-1-leaders-post-7-1/

Original post can be found here: https://create.twu.ca/psonvane/2018/10/23/317/

Hi Palak,

Thank you for your post. I read your post and tried to imagine myself in that situation. I find it hard to feel anything more than rage and disappointment. I can relate to schools run by businesses. There are at least 493 nursing schools in the Philippines, yet the passing rate for the most recent board exam was only 43.82% (Professional Regulation Commission, 2018). Many of these schools are also owned by business groups without expert staff. The Philippine nursing education system is designed to export nurses to other countries (Brush, 2010). Overseas Filipino workers (OFWs), including nurses, account for 10 percent of the Philippines’ GDP (Cuaresma, 2018). Therefore, many of the nursing schools are designed to be cash cows for owners.

You note the business owner’s investment in schools and colleges was for improving brand image, yet you also indicate poor outcomes and subsequently poor college reputation. I am unfamiliar with the Indian education system, but wouldn’t the Dental Council of India have a say in the college? The DCI’s website says it is responsible for “Maintenance of uniform standards of Dental Education – both at Undergraduate and Postgraduate levels” by ensuring “uniformity of curriculum standards” and “supervision over all the dental institutions.” (Dental Council of India, 2014) I believe the DCI is responsible for accreditation, and part of accreditation is accountability.

Lepsinger (2010) says a failure of accountability results in substandard work, dissatisfied customers, and blame – matching your description of the school! It seems multiple bodies failed to hold people accountable, including the business owner, the DCI, the teachers, and even the customers (students).

You note visionary leadership, effective communication, and resource planning as the steps necessary to shift negative impacts. These steps are admirable and would help; however, accountability joins all these steps. Visionary leadership is difficult without corresponding results. Effective communication, including that from students, goes nowhere without someone being responsible for action plans. Finally, the steps you noted for planning the resources are all accountability steps, from management being responsible for supplies to controlling human resources, to penalizing students for errant behavior.

I do like your idea of “Oath Day”. It is good for all parties to reaffirm their commitment to the mission, vision, and values of the organization. It is a good start, but it requires action to build it up. Lepsinger (2010) says “vision without execution is hallucination.” James, an author from the 1^st century, concurs, writing “faith by itself, if it does not have works, is dead” (James 2:17).

Thank you for sharing your insight into the Indian dental education system. I see you have a passion for improving the system and I look forward to discussing this more with you!

References:

Brush, B. (2010). The potent lever of toil: nursing development and exportation in the postcolonial Philippines. American journal of public health, 100(9), 1572-81.

Cuaresma, B. (2018). OFW remittances hit $28.1 billion in 2017. Retrieved October 25, 2018, from https://businessmirror.com.ph/ofw-remittances-hit-28-1-billion-in-2017/

Dental Council of India. (2014). Objectives. Retrieved October 25, 2018, from http://www.dciindia.org.in/Objectives.aspx

Lepsinger, R. (2010). Closing the execution gap: How great leaders and their companies get results. San Francisco: Jossey-Bass.

Professional Regulation Commission. (2018). June 2018 nurse licensure examination performance of schools in alphabetical order. Retrieved October 25, 2018, from https://www.scribd.com/document/382095450/Performance-of-schools-NLE-results