Organizational Diagnosis Project

ORGD 6040X

Garry A. Gross
December 9, 2013

Executive Summary

This paper will document the process by which I assessed and diagnosed an systematic
problem for the Organizational Development department of the MetroHealth System in
Cleveland, OH. The department is currently facing a major decrease in the utilization of
its professional development programs.

Based upon information provided to me by the client and knowledge attained through
my recent studies, I will endeavor to diagnose the cause of this issue. This report will
highlight the method, model and data collection techniques used to assess the problem,
and will ultimately provide an initial diagnosis of the proposed cause of the issue.




The Client

The MetroHealth System is the county-subsidized healthcare provider for the citizens of
Cleveland, OH and Cuyahoga County. The hospital system prides itself in availing its
services to all residents of the county, regardless of the patients ability to pay.
Founded in 1837, making it the first hospital incorporated in the City of Cleveland,
MetroHealth has a rich and accomplished history of caring for the communitys most
vulnerable.

In June of 2013, Akram Boutros, MD, FACHE was appointed President and CEO of the
MetroHealth System. Since his appointment, he has led major change initiatives
including the revitalization of the systems Mission, Vision, Values and Pillars, and a
reorganization of the leadership structure.

In anticipation of the sweeping changes ahead for MetroHealth, including the
aforementioned naming of a new CEO, hospital administration commissioned the
formation of an internal Organization Development Department.
1
The charge of this
department would be to facilitate large-scale change efforts within the system as well as
to help middle managers create and maintain sub-organizations that operate with
optimal effectiveness. The new Organizational Development Department, known in the
organization as OD, was not created as a brand new department; instead the existing
Education & Training department was renamed, assigned new leadership and
expanded. Consequently, in addition to the change and organizational effectiveness
functions of the department, it would also remain responsible for the learning functions
of the organization.

The client for this diagnosis project will be the Organizational Development Department
of the MetroHealth System. The department has been presented with a problem;

1
The official name given to the department is Organizational Development. Subsequent references to the
department will use the official name.
particularly regarding the learning function of the organization. The diagnosis will focus
on these issues.




Diagnostic Approach

For the purposes of this exploration, I selected a symptom-based diagnostic process.
The project lent itself to a symptom-based approach because an existing organizational
issue has already been determined by the client; and there is already a general
understanding of the current state and the factors that may have led to it.

The client has noted an extreme drop in utilization of their instructor-led learning
programs. In 2012, utilization of training was 105%. To date, the utilization rate for
2013 is 38%. The primary symptom, and presenting problem, is this astronomical
variation in training utilization within a 1-year period.

Enveloped in the primary symptom are several related sub-symptoms:

Registration cancellations have increased from 2012 to 2013 by 22%
Participant no show rates have increased from 2012 to 2013 by 27%
The number of courses canceled due to low enrollment has quintupled from 2012
to 2013
Enrollment for no class in 2013 has reached maximum capacity. In 2012, 92% of
classes reached maximum capacity, many operating above capacity

Along with the clients understanding of the current state, the OD practitioners at
MetroHealth also have an understanding of some of the factors that may have led to the
aforementioned symptoms:

In response to the apparent shortage of available training in 2012, OD doubled
the number of training offerings for 2013
In an effort to make training more accessible to an increasingly busy staff, all
2013 training offerings are half-day courses (4 hours or less), previous classes
were always at least 1 full-day in length
In order to reduce the portion of the training budget spent on outside consultants,
all of the courses in 2013 are taught by members of the Organizational
Development staff. A portion of the classes prior to 2013 where facilitated by
external consultants and subject matter experts
In 2013, OD changed the learning design methodology for its courses. The
group began to use an adult learning theory pinned Accelerative Learning. This
method is much more interactive and participant driven than most; requiring pre-
work before the class, shying away from the use of PowerPoint slide
presentations, and requiring intensive self-reflection and in-class participation. A
methodology of this type is completely new to MetroHealth
Through growth, loss and attrition, only 2 of the original Education & Training
employees remain, only 1 is directly involved in training
All course topics for 2013 are new, none of the topics from the previously rotating
course calendar are being offered in 2013

In addition to these factors, we cannot neglect to explore some of the additional factors
in the internal and external environments that are not directly related to the classes
themselves, but could possibly affect enrollment; namely, the appointment of the new
CEO, the overall workload and available time for those who would utilize training
courses, and the new Healthcare Reform laws and their effects on those individuals.




Data Collection

Upon my initial observation of the symptoms, I thought it best to use a mixed-method
approach to collect data. According to Zikmund, et. al (2013), a mixed method study is
a study that employs any combination of survey methods (p. 229). For this project, it
was my intention to collect quantitative data through the use of an 8-question electronic
survey. I would then support and expound upon the data from the survey with
qualitative data gained as a result of several focus groups composed of 7-10 survey
respondents. The targeted population for the study would be those who attended a
class in 2012. I would ensure the sample contained equal parts of those who attended
training both in 2012 and 2013, and those who attended training in 2012, but did not
attend training in 2013. Using this stratified approach to sampling, (Zikmund, et.al,
2013, p.397), the data should reflect more accurately both what helps and what hinders
participation in 2013 courses.

In order to use the data to prepare for their 2014 course offerings, the client requested a
single-method approach in order to reduce the amount of time it would take to see and
analyze results. With this in mind, I selected the electronic survey, adding 2 of the
open-ended questions that were to be used to conduct the focus groups. According to
Harrison (2005), the advantages of self-administered questionnaires are that they are,
easy to quantify and summarize; [and they are the] quickest and cheapest way to
gather new data rigorously (21).

The primary objective of the survey is to determine which of the factors identified by the
client are most affecting the decline in training utilization. Additionally, the survey will
identify if there are other factors, not previously identified by the OD team, that are
affecting the decline.





Data Interpretation

The model employed in this diagnostic exercise is the Open Systems model.
According to Harrison (2005), the [open] systems model reminds practitioners to
consider all major system components when starting a diagnosis and not concentrate
too soon on an evident and easy-to-study issue (p. 31). When looking at
MetroHealths Organizational Development Department as an Open System, in relation
to this particular issue, I took into consideration the following components:

Input: Employees (students), curriculum, Accelerative Learning theory,
instructors
Throughput: Training/learning events, registration process
Output: Trained/educated staff, able to validate usefulness of courses
Task environment: New President/CEO, large scale change projects,
reorganized leadership structure, healthcare reform

The key to diagnosing this problem effectively is determining which of these
components is placing a strain on training utilization. According to Harrison (2005),
when there is a poor fit among interdependent components or functions, effectiveness
suffers and signs of ineffectiveness appear (p. 30).

When assessing the data from the survey, I focused on the two top box responses for
each question to determine how likely it is for a category to have an effect on that
employees decision to attend or not to attend training. These would be the two most
favorable responses (i.e., Strongly Agree, Agree). Because were interpreting the data
from the positive end of the continuum (at the request of the client), a lower percentage
would indicate that that category has more of an effect of an individuals inability to
attend training.

Question % Top Box
1. My supervisor supports my personal and professional development
by encouraging me to attend MH sponsored courses
95%
2. My schedule allows me an opportunity for personal and
professional development through attending MH sponsored
courses
66%
3. The course topics offered meet my personal/professional learning
needs
89%
4. The OD staff/instructors meet my personal/professional learning
needs
92%
5. The half-day course format makes attending classes more feasible
for me.
31%
62% of respondents
were Neutral
6. The method of course delivery meets my personal/professional
learning needs
97%
7. If I am interested in the topic, I will attend a course; regardless to
who is facilitating the course
93%
8. I plan to continue to attend MH sponsored courses in the future 98%
The two additional open-ended questions were:
What, if anything, is prohibiting you from attending MH sponsored courses?
o Most common answers referenced not being able to take time away from
work duties

What should the MetroHealth OD team consider when planning the 2014 course
catalog?
o Responses varied: consolidate catalog too many courses to choose
from, repeat courses so I can take I didnt have the opportunity to take,
mix half and full-day courses




Diagnosis

Based upon data from the survey some initial conclusions can be drawn:

The quality of the training offered by the new OD team is acceptable to the
population
The new learning methodology meets the needs of the population
There is no major preference for external consultants over internal instructors
Employees are encouraged to develop themselves
Employees are impartial to half-day or full-day courses
Only 2/3 employees can arrange time in their schedules to attend training
Most employees plan to continue to utilize training

Based on these findings, I am prepared to form an initial diagnosis on why there has
been such a drastic change in training utilization from 2012 to 2013.

To the clients benefit, the results of the survey where overwhelmingly positive. It seems
that the type and quality of programming they offer is meeting the needs of the
employee population. What the survey, does not do, however, is point to one factor that
would explain the decrease of training utilization. The only area of concern that
presented itself on the survey is the inability of 1/3 employees to attend training based
on schedule or workload, but mathematically that would not be enough to cause such a
drastic reduction in utilization.

Therefore, the crux of my diagnosis lies on quantity instead of quality. The clients
decision to double the amount of training for 2013 was not met with an increase in
employees to take the classes. In essence, the supply exceeds the demand.
Therefore, if the client offers fewer courses in the future, then the utilization of
that training will increase.

In the stated hypothesis, the independent variable is the number of courses offered
while the dependent variable is the utilization of training. We cannot ignore the
moderating variable, which is the ability of employees to make time to attend training.
This third variable affects the relationship between the independent and dependent
variables (Zikmund, et.al, 2013, p.490). The moderator helps to answer the remaining
question: Why didnt the existing students take advantage of the additional training
offerings? In addition, the moderating variable could help to address some of the other
stated symptoms, including the increase in cancellations and no-shows.




Conclusion

Upon sharing my findings and hypothesis with the client, they were pleased with the
results and agreed to accept my findings. In planning their course catalog for 2014,
they will reduce their course offerings by 50%.

The status of this diagnosis project is ongoing, because of the long range of time this
study encompasses, the test of my initial diagnosis will not produce any results until well
into the year 2014, during which data can be collected to verify or negate the validity of
my diagnosis.

A competing diagnosis could name employees time availability as the independent
variable, which would likely lead to a systematic diagnosis to determine how to provide
more time to employees to focus on the professional development. If my hypothesis is
disproven, this would be the next logical step.

Ultimately, the true results of this study remain to be seen. I am confident, however,
that the diagnosis provided is correct, and the client will see positive results in the
future.




References

Harrison, Michael I. (2005). Diagnosing Organizations: Methods, Models, and
Processes (3
rd
ed.). Thousand Oaks, CA: Sage Publications, Inc.


Zikmund, W. G., Babin, B. J., Carr, J. C., & Griffin, M. (2012). Business Research
Methods (9
th
ed.). Mason, OH: South-Western Cengage Learning.