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CASE STUDIES 11-1, 11-2, 11-3
Week 3 Case Studies
Simonette P. Elgert
Siena Heights University
LDR609- Health Systems Management
September 15, 2013
Dr. John W. Fick
CASE STUDIES 11-1, 11-2, 11-3
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Case Study 11-1: Is the Matrix the Problem or the Solution
1. Why do you think the PSO members reacted as they did?
The PSO members did not like the new structure developed by the Vice President
using the matrix design. Given that they have issues with their working relationship
with the nursing service, this design will force them to communicate more amongst
each other and work closely with them. I think the PSOs are not ready to make things
better for their organization. Or their reaction could also be caused by the effect of the
matrix design being too complex and confusing since they have to report to two
different managers. The dual authority may cause division among employees and
managers, which can result in employee dissatisfaction and low morale and may
cause an organization to experience high employee turn over (Johnson, 2013).
2. Is there anything inherently wrong with the matrix design? Is it inappropriate for
psychiatric hospitals?
I don’t believe that there is anything wrong with using the matrix design especially
for a psychiatric setting. The matrix organizational structure “brings together
employees and managers from different departments to work towards accomplishing
a goal” (Johnson, 2013). In this case, improved patient care and increased physician
satisfaction. It consists of functional managers who are responsible for the different
staff functions and the program/product line managers who are responsible for the
products and clinical programs (Longest & Darr, 2008, p. 505).
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The matrix design facilitates rapid change in two or more environments
simultaneously. This is what the hospital needs, as they have issues with patient care
and staff morale. It permits more efficient exchanges of information and data sharing,
efficient use of resources, improved motivation and managers are more adept. The
decision-making comes within the group, which will help employees experience
higher levels of motivation and commitment (
In my opinion, this is the kind of structure the hospital need, even on a temporary
basis, in order to improve their issues with turnover, relationships and poor delivery
of care.
3. What should the president and vice president for nursing do now?
- I think the president and the vice president, before even changing the structure, should
identify the root of the problems that the hospital is experiencing. They can start out by
doing a work environment survey, interview key people, including management, leaders
and physicians. Zero in on the issues and come up with immediate solutions. The
provision of good patient care cannot wait until the reorganization of the hospital
structure. There seems to be a missing link as to why staffs are not getting along and why
morale is low. Perhaps they should look at immediate leadership and how the hospital is
being led.
Case Study 11-2: Trouble in the Copy Center
1. What do you think about Arnold’s decisions and behavior?
CASE STUDIES 11-1, 11-2, 11-3
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- Arnold’s decision to terminate the supervisor was not a good move. First, her decision
was solely based on her assumption that she was the reason why the receptionist
resigned. She did not go through the formal process of investigating employee behavior
that is affecting the operation the unit (such as possibly doing an exit interview with the
newly hired receptionist, perhaps getting specific behavior of how her peers acted
towards her. Conducting peer interviews and most importantly having a conversation
with the center’s supervisor).
2. Why did the copy center’s employees react as they did?
The newly hired administrative resident (Janice Arnold) already had a plan of how
she is going to “reform” the copy center from the very beginning of her appointment
to the job. She immediately started her “transformation” plan after only talking to the
center’s supervisor. Again, she used her assumptions of the staff and formulated her
ideas based on those. She failed to dig deeper as to why the staff felt overworked. She
tried to remedy it by asking for a higher wage before she did her own fact finding.
She also did not pursue her observation of her staff discussing personal matters
during work time; perhaps it is one of the reasons why there were too many
interruptions. I think Ms. Arnold failed to act on important steps prior to coming up
with solutions immediately. Her leadership lacked the involvement of the key
participants; she did not use the participatory approach, which could have likely
brought motivation and commitment from her subordinates. In matrix management,
leaders allow their subordinates to becoming more democratic and allow them to
bring their expertise on the table.
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3. Why did the center’s employees not help the receptionist?
I believe the employees did not help the new receptionist because they felt threatened.
It could also be that she is not part of the “click”. As stated in the case study, the six
people who ran the copying equipment socialized after work and participated in
personal matters during work time. Also the employees have shown no motivation to
change and improve. Though they have the ability to do the job, they showed
dissatisfaction as evidenced by frequent complaining of being overworked and
4. If you were the vice president for administration, what would you do?
- As the vice president for administration, I would meet with Ms. Arnold and have a
conversation with her regarding her leadership skills, decision-making ability and
behavior. I will remind her of the expectations and goals that she need to achieve in order
to be successful in the job. I will have her shadow the center’s supervisor for maybe a
week, have her list all of her observations, both good and bad. I will meet with her after
the observation period to discuss what she found and agree on the next steps of how to
best handle the situations. I will have her present her observations to the supervisor first
and then the remainder of the staff. I will have her identify all of the goals she would like
for the team to work on and prioritize. After these steps have been carried out, and there
are still remaining issues that require approval, then I will have her present those to me
with a corresponding solution and alternatives, if any.
CASE STUDIES 11-1, 11-2, 11-3
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Case Study 11-3: “I Cannot Do It All”
1. Is this an organization problem? What factors might be contributory?
I believe the issues with the vice presidents of Healthcare, Inc. is an organizational
problem. Their inability to make even the simplest decisions cripples their efforts
towards the attainment of the organization’s strategic goals. This could be due to the
organizational design they were accustomed to. One of the five basic organizational
designs is the machine bureaucracy. “This design is characterized by a large, well
developed technostructure and support staff” (Longest & Darr, 2008, p. 523). This
design has a great emphasis on work standardization and major decisions are made in
the strategic apex, which features rigid patterns of authority (p. 523). If I have to
choose amongst the five basic designs, I think Healthcare, Inc.’s organizational
structure is the machine bureaucracy design. Because of its element of rigidity, it
created non-functional vice presidents since decisions are centralized, originating
from the apex (usually Presidents and CEO’s). The fact that this structure creates
departmentalization, may have also contributed to the organizational problem. One
thing that stood out to me was the vice president’s open discussion of their own
problems, thus contributing to low productivity. This is usually a sign of being “not
present” or disengaged. It seem as though they are not increasing their effort to come
up with solutions to the problems, but instead they are giving the task to the
2. In terms of organization design, what can Brice do?
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- Mr. Brice should identify reasons as to why his vice presidents were not making
- Mr. Brice should review the current organizational structure and make changes as
necessary (temporary vs. permanent)
-Reorganize and revisit the need to have vice presidents in each of the departments. This
step is critical in identifying how to best allocate resources.
CASE STUDIES 11-1, 11-2, 11-3
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Longest Jr, B. B., & Darr, K. (2008). Managing health service organizations and systems (5th
ed). Baltimore, MD: Health Professions Press, Inc.
(n.d.) Matrix management and structure. Retrieved from