MHA FPX 5040 Assessment 2 Case Study Analysis: Part 1

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Capella University

MHA-FPX 5040 Health Administration Change Leadership

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Date

Case Study Analysis on South Central Foundation

The South-Central Foundation (SCF) had 1,750 staff members as of June 2014 and recently expanded to include the Anchorage Native Primary Care Center and other local community health centers. The congruence model suggests examining the organization’s people, structure, work, and culture and analyzing the relationship between these categories. It is critical to acknowledge Katherine Gottlieb, who began with SCF in 1987 as a receptionist, worked her way up in the organization, and became the Chief Executive Officer. Katherine’s goal from the start was to better serve the AIAN people by creating a welcoming and safe environment. Her experience with the existing health system inspired her to challenge the status quo at SCF.

Katherine Gottlieb noted that the system management was very bureaucratic and government-driven when she began her journey as a patient. The entry point for all medical issues was through the emergency department, resulting in long wait times for all patients, regardless of the reason for their visit. The average wait time at SCF was 7-9 hours, with patients, including sick babies, waiting in long lines and feeling like numbers in a cattle prod. Katherine moved up the ranks at SCF due to her leadership tenure, concern for the overall well-being of the community, and her ability to develop relationships and partnerships. Her leadership and focus on improving the local healthcare system led to significant improvements and her rise to CEO and president.

Elements of The Problem

In 1998, the Alaska Area Indian Health Service (IHS) transferred ownership of the Alaska Native Medical Center to SCF and the Alaska Native Tribal Health Consortium (ANTHC). At this time, SCF lacked a vision and mission, leading to dysfunction and disorganization within the hospital. Consequently, patient wait times were 7-9 hours, regardless of medical need, causing dissatisfaction and a negative reputation for the healthcare organization. SCF had grumpy patients, extremely long waiting times, no vision, no mission, and an inability to deliver optimal healthcare in the community. Disorganized healthcare facilities often result in high readmission rates, medical errors, poor patient management, low-quality healthcare, and increased infection rates. The condition of SCF was poor due to the lack of organization, poor quality of care, poor outcomes, and overall dissatisfaction within the community. Katherine’s vision was to improve SCF’s culture, quality, and logistics, even as a receptionist (Visionary Leadership, Visionary Goals: NPHW@25, 2020).

Needs of the Community

Based on the problem elements, the need for better healthcare at SCF is paramount. Patients in the community endured long wait times to be seen, regardless of their healthcare needs, and had limited healthcare choices due to being in a rural area. Additionally, all patients were filtered through the emergency room for medical attention at SCF. The community desperately needed more facilities, better healthcare quality, and quicker medical attention. Many people in the community likely went without proper healthcare due to the long wait times at SCF, putting more people at risk of developing diseases and increasing mortality rates among the immune-suppressed population.

Need for Change

Katherine Gottlieb identified the need for change early on through her SCF patient experience. She quickly recognized the need for improvement by observing long wait times for multiple sick patients in the waiting room, including babies. Once hired, Katherine improved the organization by creating a friendly and approachable atmosphere. Over the next four years, she built partnerships across Alaska, investing 25% of her time with constituents and stakeholders to build community relationships. Katherine identified the gap between the current and desired state of SCF and worked to mitigate this gap throughout her career as CEO and President (Cooper, 2023).

Katherine enhanced her relationships with stakeholders through communication and collaboration. Through transparency and continuous meetings with stakeholders, political leaders, and healthcare leaders, she presented the issues at SCF and her vision for improvement. Katherine initiated the core concepts movement at SCF to train employees in empathy, relationship-building skills, and compassion. One hundred program directors and managers piloted the core concepts program to achieve buy-in for the concept of change.

MHA FPX 5040 Assessment 2 Case Study Analysis: Part 1

Once the majority of the workforce was trained through the core concepts program, training sessions were offered three to four times annually. The core concepts program increased community wellness and improved SCF’s reputation. Through her networking and relationships, Katherine developed a solid executive team to rebuild SCF’s culture and operational structure. This indicates that many people recognized the need for change in the organization through her leadership and believed partnering with her was the right decision. Katherine reshaped the culture to a customer-owner business and a culture of change, keeping each patient in mind.

Through Katherine’s leadership, SCF began to solicit feedback from customer-owners (patients) and key stakeholders to inquire about what worked well and what could be improved at SCF. Feedback was gathered through several channels, including iPads placed in multiple primary clinics, social media platforms, emails, comment cards, surveys, and more (Gauly et al., 2023). Katherine ensured that all team leaders were on the same page through regular meetings and directive reports. While obtaining feedback from patients and key stakeholders was the first step, Katherine responded to 10 customer-owner comments per day. She then implemented changes requested by patients to strengthen SCF’s vision and culture and increase patient satisfaction rates. As a result, patient satisfaction rates consistently exceeded 90%. Key leaders supported Katherine’s feedback and follow-up method due to its effectiveness and the increased patient satisfaction following changes. These strategies were effective for all stakeholders, improving patient care practices and ensuring staff members were adequately trained in customer service and patient care (Gauly et al., 2023).

Challenging the Status Quo

Pushing the status quo was something Katherine did from the beginning, showing success through perseverance, integrity, drive, and vision. Katherine Gottlieb challenged the status quo by establishing relationships with healthcare leaders and political leaders in rural healthcare organizations. She held many meetings throughout her leadership role with all staff members to convey her message and vision for SCF’s future. Katherine developed a customer-owner culture by listening to patients and key stakeholders through various feedback avenues. She committed to responding to comments and questions and continuously implemented changes to improve customer satisfaction and healthcare quality. Katherine built strong partnerships with SCF leadership to develop a solid infrastructure and services to meet the community’s needs. The infrastructure was flexible but solidified and difficult to change due to the validation of success.

Katherine’s efforts to challenge the status quo included launching the Executive Leadership Experience (ELE) in 2012. The ELE program allowed two staff members to shadow Katherine and assist her with projects to push the status quo at SCF. The ELE program aimed to develop new VP leaders, enabling more leaders to challenge the status quo at various SCF locations. By 2015, eight staff members were enrolled and trained as VPs. Katherine also established the Special Assistant Program (SAP) to provide executive-level experience. The SAP offered training for leaders aspiring to work at the VP level. Katherine successfully developed new leaders with fresh vision and challenged the status quo with new and established staff members by implementing numerous training programs.

Conclusion

SCF began as an inefficient organization lacking quality and compassion in a rural area of Alaska. All patients were filtered through the emergency room, requiring them to wait between 7 and 9 hours. When Katherine joined in 1998, a new era began at SCF, and she made immediate changes even as a receptionist. Changing the environment by purchasing a better desk was the beginning of Katherine’s vision and challenge to the status quo. As she moved up the ranks and eventually became the CEO and president, she trained staff members, developed new leaders, made the organization customer-focused, and increased revenue. Additionally, Katherine established excellent relationships with other healthcare leaders and stakeholders, further strengthening her ability to push for success both internally and externally in the organization and the community.

References

Cooper, J. (2023). Instructional leadership: Building relationships and community partnerships. Knowledge Quest, 52(1), 10-18. http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Finstructional-leadership-building-relationships%2Fdocview%2F2890973941%2Fse-2%3Faccountid%3D27965

Gauly, J., Court, R., Currie, G., Seers, K., Clarke, A., Metcalfe, A., Wilson, A., Hazell, M., & Grove, A. L. (2023). Advancing leadership in surgery: A realist review of interventions and strategies to promote evidence-based leadership in healthcare. Implementation Science, 18, 1-25. https://doi.org/10.1186/s13012-023-01274-3