Technological, socio-cultural, political, and economic changes in the modern world require coordinated leadership and organizational development strategies to facilitate sustainable competitive advantage (Wynen et al., 2019). Organizational change requires that leaders identify the most desirable and suitable form that the organization’s future should take (Wynen et al., 2019). Implementation of innovative approaches is crucial for business, health, and healthcare settings. High staff turnover is a common issue in organizational and management practice. Leaders face demanding tasks in retention of quality workers. Contrary to common belief, high turnover is not necessarily negative for all organizations (Wynen et al., 2019). In most cases, it is likely to cause substantial losses to the company if not managed appropriately. Springbrook hospital has received criticism for low levels of professionalisms in dealing with employees. Interventions within the past 10 years have often failed due to ineffective planning and implementation. Inappropriate organizational management at the Springbrook Hospital-Oglethorpe is the core reason to high turnover rates in the organization.
The Organization
The organization reviewed is the Springbrook Hospital-Oglethorpe located in Hernando County, Florida (Maglio, 2018). Springbrook offers 24-hour in-patient variety of programs including older adult program, general psychiatric care, substance abuse and dual adult program tailored towards attending to different patients’ needs (Maglio, 2018). Springbrook hospital is the only designated Baker Act-receiving facility in Hernando County. It means that Springbrook hospital can handle both mental health issues and substance abuse (Maglio, 2018). Patients have access to teams of psychiatrists, social workers, therapists, nurses among other staff members (Maglio, 2018). Psychiatric health workers identify sources of psychological issues, individual strengths, areas of difficulty and situational factors aggravating patient medical crisis (Maglio, 2018). In the past 10 years, Springbrook has experienced high turnover rates due to issues such as poor working conditions, lack of support from the management, manager unprofessionalism, low staffing, and work overload (Maglio, 2018). Most of these problems are linked to leadership and management issues based on responses from past employees.
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Problem Investigation
Psychiatric facilities are emotionally demanding settings, increasing the rate of employee dissatisfaction and higher rates of turnover (Kelly et al., 2016). Employees at Springbrook hospital endure poor working conditions. The working environment is unsanitary, suffers from insignificant building maintenance and inadequate medical equipment. According to Kelly et al. (2016), psychiatric staff performance is correlated to the development of therapeutic environments, which promote staff well-being and increased patient care. In Springbrook, employees work in possible hazard and unhealthy environments increasing disease prevalence (Kelly et al., 2016). Such conditions are a direct violation of the occupational safety and health act of 1970, which states that employers must provide a workplace that ensures health and safety for employees (Kelly et al., 2016). Springbrook downsizes for renovations leading to problems with patient housing. Evidence indicates that rooms contain fixtures that could potentially aid psychiatric patients in hanging themselves (Kelly et al., 2016). Patients are exposed to living quarters with poor conditions, which is detrimental towards their continuous recovery. Psychiatric staff suffer repercussions of maintenance undercuts by dealing with aggravated patients making the job more unbearable (Kelly et al., 2016).
Unprofessionalism within Springbrook is identified among the key factors leading to employee distress. Professionalism is a crucial aspect in the relationship that exists between healthcare organizations and the society (Brennan & Monson, 2015). Springbrook is a for-profit organization that relies mainly on financial gains to facilitate the services provided at the institution (Kelly et al., 2016). Employees indicate that the management relies too much on amassing profits at the expense of other factors such as employee satisfaction and retention leading to high turnover rates (Brennan & Monson, 2015). Leaders lack communication skills, limiting their interactions with employees and identification of issues affecting productivity within the workplace. Leaders have a role in motivating, mentoring, and facilitating developing in their organizations (Mason, 2017). Springbrook employees lack mentorship and oversight, which potentially leads to medical errors while dealing with patients (Brennan & Monson, 2015). Over the past ten years, the management has failed to create an integrated system where employees can actively engage in decision-making and development of policies.
Low staffing and work overload substantially affects Springbrook hospital leading to high turnover rates. Shortage of skilled professional and unbalanced skill levels in the hospital is a result of budget cuts to meet the profit requirements from the management (Wynen et al., 2019). Springbrook hospital indefinitely lays off employees for insignificant and petty reasons. Workers who retire are not replaced quick enough leading to overburden of the remaining employees. Springbrook works under a constrained workforce, required to accomplish tasks that most members are unqualified to undertake (Wynen et al., 2019). Pay is not competitive compared to other organizations offering similar services. An RN staff nurse at the organization indicates that they work with numerous untrained mental health technicians (MHT) (Wynen et al., 2019). Every year, Springbrook applies impromptu budget cuts leading to reduction in basic supplies and lack of psychiatric hospital grade equipment (Wynen et al., 2019). Eventually, employees suffer from fatigue and burnout and decide to leave for jobs with better working conditions (Maglio, 2018). Morale is lacking within the Springbrook workforce.
Interventions Review
The need for mental health workers in the US is exceeding the available supply. Springbrook has failed in coping adequately with the high turnover rates (Wynen et al., 2019). After the passage of the Affordable Healthcare Act in 2010, more than 11 million Americans with issues pertaining drug addiction, mental illnesses and psychological distress have applied for services (Mason, 2017). With healthcare becoming more affordable, for-profits organizations such as Springbrook have to identify other ways of sustaining their budgets while still providing safe healthcare (Wynen et al., 2019). The institution has faced challenges in adapting to the new medical care provision demands leading to implementation of principles that regularly fail (Maglio, 2018). Springbrook has changed its leadership numerous times within the past 10 years. The most recent change came in March 2018, where Jim Harris stepped in as the interim hospital administrator (Maglio, 2018). Change management is often difficult to navigate because it requires time for the workforce to adapt new methods and policies (Hao & Yazdanifard, 2015). At Springbrook, management is changed at such an intense rate that company culture becomes corrupted leading to a lack of direction within the workforce.
Springbrook has tried to amend the management crisis by introducing a variety of medical professionals including psychiatrists, CNAs, nurses, physical therapists, and recreational therapists (Maglio, 2018). New employees are involved in rehabilitation programs in three departments including voluntary, co-occurring disorder program and general adult program (Maglio, 2018). Inefficient hiring and retention practices lead to high turnover rates at Springbrook hospital. Majority of health practitioners employed are often not qualified for their jobs and go through a limited background review (Maglio, 2018). The intervention, introduced in 2010, was designed to ensure that patients received adequate and supervised care at all times making treatment and hospitality more effective (Hao & Yazdanifard, 2015). High turnover rates have similar effects to both clients and workers in inpatient organizations. Staff turnover disrupts patient-worker relationships (Hao & Yazdanifard, 2015). By changing staff after short spans of time, Springbrook inhibits the development of working relationships between caregivers and patients (Bukach et al., 2015). Eventually, patient conditions deteriorate leading to dissatisfactory service.
In-patient psychiatric institutions expose workers to more hostility and aggressiveness leading to conflicts with patients (Scanlan & Still, 2019). Research indicates that in most cases, violence eventually emerges among colleagues and supervisors limiting personal and professional functioning (Scanlan & Still, 2019). Springbrook is aware of such occurrences within their organization and implemented a plan to seek and retain qualified staff. Projects commissioned in 2018 to include a child and adolescent facility, meant that the institution had to increase its workforce (Maglio, 2018). However, being the only in-patient Baker Act receiving facility in Hernando County, Springbrook faced difficulties in obtaining registered nurses with psychiatric capabilities (Maglio, 2018). Available RNs lacked qualifications for the proposed project. Despite Springbrook hospital’s efforts in increasing workforce numbers, the organization has failed to address the underlying factor leading to high turnover rates; managerial lack of direction (Scanlan & Still, 2019). Therefore, nurses are incorporated into a dysfunctional system, eventually leading to dissatisfaction and lower retention rates.
At the same time, Springbrook is aware that, introduction of new technologies have led to turnover in the facility (Scanlan & Still, 2019). Notably, innovative technologies in the healthcare sector disrupt traditional ways of offering psychiatric services (Mason, 2017). They end up changing the landscape of healthcare delivery (Scanlan & Still, 2019). In some cases, the innovative methods cause further shortages and may cause redundancy by replacing or making the provision of services efficient. Healthcare sector has embraced computer programs, robots, and other equipment, which have improved the way things are done (Mason, 2017). Notably, the disruptive technology has led to high quality, reduced costs, and improved safety.
Proposal
Healthcare as a labor-driven sector requires hiring and retention of talented and experienced staff members. Research suggests that medical practices will experience an influx of patients within the next decade due to the ACA (Mason, 2017). Springbrook has encountered difficulties in amending its issues due to incompetent management and relationship between leaders and subordinates. Research indicates that the cost of replacing a single RN ranges from $33,300 to $56,000 annually, resulting an average hospital loss of $3.6m – $6.1m (Colosi, 2020). Management should avert their focus in amassing profits towards budgeting on providing high quality healthcare and purchasing modern medical equipment (Wynen et al., 2019). Springbrook requires extensive changes at the top chain of management. The organization should make a complete review of its policies and company culture, followed by appointment of leaders who can carry forward the company’s new vision (Hao & Yazdanifard, 2015). Consistent changes in leadership have corroded company culture. It is recommended that the organization places its trust in competent leaders and provide all the necessary resources to finance their organizational change. Hao & Yazdanifard (2015) suggest that change management involves making changes at the organizational and individual level, while allowing the overall organization to settle into the new environment at its own pace and style.
The second proposal involves fostering a new team mentality within the workforce through better motivational, mentorship and communication strategies (Wynen et al., 2019). Springbrook must consider strategies that ensure the delivery of high quality healthcare while still maintaining quality by eliminating inconsistencies such as impromptu budget cuts. Prioritizing on intrinsic motivation is a powerful driver of employee behaviors. Largade et al, (2019) asserts that motivation is derived from two different sources including satisfaction from undertaking actions that benefit patients and improving the interest of undertaking the task itself. Evidence suggests that motivated healthcare providers show derisible attitudes and behaviors towards mental health patients reducing the occurrence of violence in the workplace (Largade et al., 2019). Gray et al. (2019) asserts that healthcare workers in psychiatric institutions experience high rates of mental issues including stress, depression, and burnout. Depression for workers in healthcare settings is a result of excessive workloads, workplace violence and bullying (Gray et al., 2019). Mental health inpatient jobs face issues such as high work rate, low social support, atypical working hours, and effort-reward imbalance (Gray et al., 2019). Mentorship programs within the workplace, ensures that psychiatric health workers value their roles at Springbrook and do not feel demeaned by their superiors. A group of 10 MHTs should have an experience supervisor tasked with assessing patient treatment, guiding the team and checking for any medically unsafe practices (Wynen et al., 2019). The ultimate goal is to create a safe space to foster the patient-worker relationship by providing safe care.
Retention begins with hiring the right individuals. Springbrook hospital development is inhibited at the hiring process by offering jobs to inexperienced individuals lacking necessary skills (Scanlan & Still, 2019). While the hiring process is never assured to provide the best hires, the interview and screen capability ensures that candidates are carefully assessed for skills (Scanlan & Still, 2019). It is common for healthcare organizations such as Springbrook to only considering professional competences when hiring (Scanlan & Still, 2019). Identifying a wholesome employee requires consideration of behavioral competencies such as compassion, attitude, communication, and customer service orientation (Scanlan & Still, 2019). Healthcare organizations often rush to the hiring process when experiencing high turnover rates (Bukach et al., 2015). The management does not think about internal issues such as workload, leadership, and growth opportunities. For Springbrook, these issues greatly affect functionality calling for a better system of managing these issues within the organization before venturing into the market for new workers. In addition, new hires must be adaptable to the company culture (Scanlan & Still, 2019). Hiring people to fill voids leads to productivity reduction because incompatible workers face difficulties aligning with an organization’s mission, vision, and values.
Springbrook must offer competitive salaries and benefits. Compensation is not necessary in keeping employees satisfied with a job, but it is the most obvious way of ensuring retention (Wynen et al., 2019). Evidence shows that current employees as well as those who have already left the organization cite low wages and compensation for overtime as the main constraints in Springbrook. Employees have to endure a 30-minutebreak, which is also deducted from their monthly pay. Springbrook management coerces employees to mandatory overtime, which is compensated at insignificant rates (Scanlan & Still, 2019). Research suggests that employees are willing to work for lower wages as long as the organization provides better benefits (Gray et al., 2019). An effective training program must follow better wages and benefits. High performing employees feel more inclined to leave a job when it offers limited opportunity for career development (Wynen et al., 2019). It is recommended that Springbrook implement cost-effective online courses for sharpening employee skill set (Scanlan & Still, 2019). The program should facilitate social engagement exercises for improving inter-personal communication in the leader-follower relationship.
Finally, Springbrook should guarantee their employees job security and allow decentralized ways of decision-making (Wynen et al., 2019). Research indicates that secure personnel with psychiatric facilities display greater morale and involvement towards the organization’s operations (Wynen et al., 2019). In addition, the personnel tend to work harder to improve productivity without the fear of eliminating their jobs (Wynen et al., 2019). At the same time, psychiatric deals with a wide range of issues and some require decisions are made in a timely fashion (Scanlan & Still, 2019). Delayed decisions sometimes affect outcome and end up demoralizing employees. Workers in this field enjoy wide autonomy and discretion in the way they complete their tasks within a team concept (Scanlan & Still, 2019). In that sense, Springbrook should allow their team freedom to make decisions for the god of the patients.
Conclusion
Healthcare delivery in the United States is experiencing constant systemic change requiring organizations to adapt to new systems of operation and organizational change. Interventions in the past decade have often failed due to ineffective planning and implementation. Inappropriate organizational management at the Springbrook Hospital-Oglethorpe is the core reason to high turnover rates in the organization. Employee retention has been immensely affected due to poor working conditions, lack of support from the management, unprofessionalism, low staffing, and work overload. Increased turnover subjects organizations to financial burdens. Programs tailored towards employee satisfaction are essential for controlling costs, increasing patient satisfaction and employee morale. In that sense, implementing the suggested proposals, assures Springbrook of a replenished level of consistency in employee productivity. The management should consider providing high quality healthcare and purchasing modern medical equipment. In addition, the facility should make a complete review of its policies and company culture, followed by appointment of leaders capable of carrying forward the company’s new vision. Secondly, the hospital should foster the new team mentality within the workforce through better motivational, mentorship and communication strategies. The move will help boost intrinsic motivation, which is one of the major driving impetuses among employees. The hospital’s hiring team should be keen while interviewing new candidates to ensure they settle on candidates passionate about their work. Finally, to ensure employees retention, Springbrook should be prepared to offer competitive packages.
References
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