Organizational Analysis:
Centre Volunteers in Medicine
(CVIM)
Brought to you by:
Triple “B”
Bill Castor
Bethany Walker
Bowser Juanita
Organizational Background
• Non-profit corporation
• Provides services to the medically
underserved population of Centre
County, Pennsylvania
– Working uninsured
Structure and design
• Board of Directors
• Five full-time employees
• Flat or informal functional design
General direction, mission, goals,
and strategy
• “To seek to understand and serve the health
and wellness needs of the medically
underserved who are residents of Centre
County .”
• Acquire necessary external resources
– Resource Dependence Theory
– Coalition with Mount Nittany
• Distinctive niche within Centre County
Culture and values
Vision Statement
“May we have eyes to see those who are
rendered invisible and excluded, open arms
and hearts to reach out and include them.
Healing hands to touch their lives with love
and in the process heal ourselves”
Culture and values
• Overall culture is welcoming and informal
– Friendly atmosphere
– Child-friendly waiting rooms
– Casual Dress code for Staff
• Creates welcoming environment for patients
– Holistic Approach to health care
• Clinical Services
• Social Services
Decision-making process
• CVIM’s organizational structure most
resembles a functional design
• Decision-making process must synch with
org culture
– Informal culture
• Horizontally decentralized
– Influence and decision making is shared
laterally throughout organization
– Policy changes and assurance measures are
more easily implemented when decision-making
and communication is lateral
Conflict, power, and politics
• Internal conflict
– Conflict arises when top-down decisions must
be made
– Accountability to patients
– Functional in nature
• External conflict
– Competition over obtaining funds, could be
avoided
– Functional in nature
Conflict, power, and politics
• Power
– At time lies with the Board of Directors but also
can be distributed between volunteers and
employees
• Politics
– CVIM is able to use its position to form
relationships within the community to obtain
assets
– Does not duplicate services already provided in
the community
– Very little internal politics present
Organizational domain and
environment
• Non-duplicative primary and preventive
dental and medical services to the working
uninsured residents of Centre County
• Potential patient base of 11,000
• Shares environment with Penn State, health
care organizations, and non-profit
organizations
Inter-organizational relationships
• Mount Nittany and Geisinger
• Pharmaceutical companies
– $470,000 in medications from indigent
drug programs
• Written rules and procedures to
remain eligible
• Resource Dependence Theory
Evaluation of effectiveness
• Annual Report Anaylsis
– Treated 4,528 patients in 2004-05
– $500,000 budget, value of care was $2 million,
which is comparable to similar organizations
• Tracking of Common Diagnoses
– Depression, hypertension, high cholesterol, and
anxiety
– Tracked to make sure they are providing care
that addresses the main needs of the community
Size and life-cycle stage
• Since its inception in 2003 CVIM has
experienced an increasing number of
patient visits
• Fiscal year 2003-2004, 5,061 visits
• Fiscal year 2004-2005, 7,328 visits
• Goal for 2005-2006 is 9,000 visits
Size and life-cycle stage
CVIM’s operations have outgrown its current
capacity
• Currently CVIM operates with:
–
–
–
–
5 physical examination rooms
3 dental examination rooms
Cramped receptionist area
Small medical records room
• To serve more pts and operate efficiently CVIM is in
need of:
– 6-8 physical exam rooms
– 5 dental examination rooms
– Larger receptionist area and medical records room
Size and life-cycle stage
• As CVIM grows, the importance of adequate space
and functional equipment becomes increasingly
important
– Patient Service and Satisfaction
– Morale of employee and volunteer staff
• Herzberg’s Two Factor Theory
 Motivation: Volunteers and employed staff work at CVIM
because they are motivated by the intrinsic rewards of helping
others
 Hygiene: Hygiene factors influencing CVIM staff include
adequate workspace and functional equipment
» If these hygiene factors are not present staff will become
dissatisfied and unmotivated
Size and life-cycle stage
• Health care service organizations
typically go through four phases in their
life cycles (Starkweather & Kisch, 1971)
–
–
–
–
Search
Success
Bureaucratic
Succession
Size and life-cycle stage
Life Cycle Phases
1. Search Phase
• Organization is new
• Focused on establishing identity
• Finding methods of procuring necessary resources
• Organization is open and informal
2. Success
• Found achievement in procuring resources
– Staff, patients, and finances
• Organizational design becomes more formal to accommodate
larger scale operations
Size and life-cycle stage
•
Life Cycle Phases continued…
3. Bureaucratic
•
•
•
Conformity to rigid rules and procedures
Little feedback from clients
Organization may begin to decline b/c of inability to
respond to environmental changes
4. Succession
•
Development of new ways of providing services
Size and life-cycle stage
• Currently
– CVIM is in the success phase
• Successful at procuring resources
• Formalizing structure to accommodate growth
• Future
– Moving toward Bureaucratic phase
• Stricter operating rules and procedures
• May decline due to changes in environment
Future changes and adaptations
• CVIM is in “darling” phase
– Once organization leaves this phase,
there could be fundraising problems
• Supply changes in the
pharmaceutical industry
– Potential problems obtaining free
medications
Conclusion
• Even though CVIM differs from health
care organizations in the area, CVIM
still aims to effectively interact the
elements of cost, access, and quality.
Special Thanks to:
Maryanne Neal, Clinical Director, CVIM
Thank you for your time and attention.
Feel free to ask any questions.