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"I declare that in submitting all work for this assessment I have read, understood andagree to the content and expectations of the Assessment Declaration."RMIT INTERNATIONAL UNIVERSITY VIETNAMBUSM2301 – ORGANIZATIONAL ANALYSISAssignment 2 – ORGANIZATIONAL ANALYSIS REPORTSubject Code: BUSMSubject Nam...

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"I declare that in submitting all work for this assessment I have read, understood and agree to the content and expectations of the Assessment Declaration."

RMIT INTERNATIONAL UNIVERSITY VIETNAM BUSM2301 – ORGANIZATIONAL ANALYSIS Assignment 2 – ORGANIZATIONAL ANALYSIS REPORT Subject Code:

BUSM2301 ORGANIZATIONAL ANALYSIS

Subject Name:

Location & Campus

RMIT Vietnam , HCMC / Hanoi

Class Group Number:

SG – G02

Student Name:

Tran Duc Minh

Student Number:

S3778141

Lecturer’s Name:

Dr. VO HONG DUC

Assignment Due Date:

21TH August, 2021

Word Count:

2000

Table of Contents 1.

Lessons learned from the process improvement pilot: a critical functionalist perspective...................3

2. The value of incorporating interpretivism / social relativism into the design of a new process improvement project....................................................................................................................................4 3.

Proposed consultation process, informed by interpretivism / social relativism....................................5

4.

Reflections on consultancy assumptions and their strengths and limitations.......................................5

5.

Proposed consultation process: challenges and limitations..................................................................5

6.

Reference.............................................................................................................................................5

1. Lessons learned from the process improvement pilot: a critical functionalist perspective In order to understand the limitation of the Improver Advisor plan, we need to identify and separate several problems of the original issue. The Emergency Department (ED) is having trouble meeting the timely provision of emergency care issued by the government. The problem emerges since the patient complaint about the long waiting time for assessment, treatment and discharge or admission when their situations are life threatening. This led to a chain reaction from the patient to the whole ED work flow. Due to the waiting pressure, the patient’s family and careers are putting even more pressure on the working staff such as nurse or doctor. As most of the hospital in Singapore, they are overcrowded (Singapore Business Review 2019). Furthermore, the staff who already suffered from the overcrowding patient now facing even more pressure from the patient’s family or careers. As the demand of the patients and their followers is not met, the hospital reputation plus staff morale is sinking as second passed. The main concerned for the staff is the quality of care and timing for each case as their performance is opposing their target. Understanding the difficult situation, the hospital is facing, the board has hired a professional consultancy firm whose specializes in the Toyota Production System. The firm is expected to apply all the improvement derivatives of Toyota Production System to reconstruct the flow of the ED and improve the overall outcome. As they already have some experience with the Toyota Production System, they want to apply the same ideology to the ED meaning that the core idea and implementing process will based on the functionalist perspective which mean the consultant will view the ED as a machine. Firstly, they create a hierarchy with the top is the nurse then doctor and other staff and the patient is at the bottom. The new process set actors, doctors and nurses, as “interdependent parts arranged in a specific sequence” (Morgan, G. ,1997). This pyramid model has given too much power and pressure for the nurse as they are the first to meet with the patient and can control the flow of low-risk patients. The nurse in this situation must use their experience and knowledge to diagnose and do preliminary “workup” which is the work of a doctor. Therefore, fault or unnecessary test will happen and lead to more time consuming or waste of money. The doctor role is narrowed down to critical case and add some final touch to the treatment process. Through the process, the interaction between a nurse and low-risk patient with the doctor is nearly zero. Without zero interaction and abundant information, the error possibility in diagnose will rise as the doctors is overcame with the technical information that they don’t need or wrong data. Lastly, the time pressure is even more terrified for the administrative staff as they need micromanagement for each patient in each case. The work is rising to an imaginable scale and complexity. The nurse will

suffer more pressure from the ticking clock, hence create faultier diagnose. The complexity and zero interaction between staff in the ED is the main reason lead to the failure of the plan.

2. The value of incorporating interpretivism / social relativism into the design of a new process improvement project In this part of the report will apply the view of a facilitator into the plan of creating new working model. In this case, the perspective of the consultant, Improvement Advisor (IA), the staff (doctors, nurse, administrative personnel) and the patient will be analyses. In the patient view, the new model seems to be faster but less accurate. Some are good with this situation some will complain especially those have medical certificate and understanding of their present situation as their main diagnose report comes from a nurse which will cause more problem later. Beside the ED’s staff, IA also understand the bottleneck of the situation. They understand that the ED need a new model to work ASAP, but they don’t have any real connection with the staff to get the micro detail of a big picture. During the plan development period and minimum connection to the ED staff, IA is more concern about their plan result than the real situation that happen to the staff which mean they lack participation that lead to half-heartly agreement. Furthermore, with the view of a functionalist consultant right next to them, it is easy to understand why they want to separate the staff work and emphasize in the efficiency of each process. Moving on the view of the consultant, as they are more familiar with Toyota Production System, the way of working is also based on that ideology. In their view, they want to have a hierarchy so as each department of the ED can have separate process and through that process, they can reach to maximum time efficient. Furthermore, as they are the consultant, they don’t participate in the informal aspect of the ED to see the problem under the eyes of the staff. Last but not least, they overlook the issue of knowledge and power. They should have understood that nurses are not appropriate personnel to make a first contact diagnose and give doctor advise on the patient case. The conflict exist between a doctor and a nurse will happen as their experience and knowledge in the ED is different. In addition, the lack of communication between the ED and IA lead to the lack of consensus. The staffs do not understand the plan of the board as high level of pressure exist throughout the plan combine with extreme complexity. Therefore, the consensus of the organization is broken which result in the current situation. There are several methods to participated in the ED work environment and make better decision based on the new collected data. The consultant and the IA must agree and form into one united group to decide what kind of information do they want to end up with. Since this is not about a financial decision, the quantitative data is not the priority. The priority of the plan needs to focus on the social condition of the ED which mean the environment surrounding the staffs. Another method is using surveys. Surveys are a collection of question which the result can be achieved through interview face-to-face, on the phone, online or by post ( or self-completion). In this scenario, survey through phone isn’t going to make any success since the result will just be lifeless qualitative data which is not our top priority. The face-to-face and self-

completion is going to be the best option for this case as the result will reflect more lively data and insight of what is really going on in the ED.

3. Proposed consultation process, informed by interpretivism / social relativism The result of implementing functionalism into the ED workflow has resulted in terrible outcome. This new process will replace some part of the original plan, and some will keep unchanged. Firstly, the consultant need to make a mutual agreement with the IA to decide the focus group in this case is the ED staffs and workflow. Moving on, the Consultant and IA must invite the presentative of the ED staff members to make a council. At this point, all the decision of the council will base on the agreement of three parties consists of ED presentative, IA and Consultant. The ED presentative must be chose through voting, and including a doctor, nurse, administrative staff. This will ensure all the problem relevant to all aspect of the ED will not be missed. After forming a council, the council need to attend a week inside the ED to fully understand the environment and the problem exist. A pilot plan will be presented next to the whole ED staff, receive feedback, and make some changes if needed. The final plan will be presented to the ED staff and implemented. The final plan will have a consensus through out the whole ED staff avoiding the last plan result.

The Consultan t

Doctors, Nurse, Staff of ED Voted ED Presentati ve

Agreement

The IA member

Focus group and Problems Forming a Council with ED presentative Participate in the ED for a week Forming a pilot plan Present the plan to the ED members Receive feedback and make alternative change if needed Final plan and implementati on Figure 1: Consultation Process

4. Proposed consultation process: challenges and limitations The advantages are outweighed the disadvantage, however, there are still some drawbacks of this consultation process. Firstly, the agreement between the IA

and the consultant need to be united which is quite difficult as the ideology of the consultant is about work efficiency regardless of the staff working environment and condition. Furthermore, the staffs of ED are already busy, and they might not agree to attend in the council as it will increase the workload and pressure without bringing any instant benefit for them. As the plan is presented to the ED members, the numbers of idea contributed to the plan will be huge an take a lot of time to process which will prolong the consultant process leading to costing more money. Regarding of the financial issue, as all the members comments are valid, hence the final plan that suit all demand will be a costly one. This is a big limitation of the social relativism as the view of an organization, in this case is the hospital, is not taken into consideration. The hospital main priority is efficiency include profit and working time. However, the main idea of the consultation process is to let the ED working environment more comfortable which mean they need to make some trade-off which can be time or profit.

5. Reflections on consultancy assumptions and their strengths and limitations The action and role that reflect "order/regulation" end of the aixis is lied in the consultation plan. In the original plan, doctors and nurses have a conflict between doctors accepting the advice of the nurses. This is the result of not considering the staff experience since doctors are trained to make highly accurate diagnose and have the power to control the process of treating a patient. When that power is converted to the nurse, it causes distorted chain of command as nurses aren’t trained for giving diagnose to patient, their role is to follow the doctor order and help him. Furthermore, the ED work can not be separated and must be intertwin between the staffs. This cohesiveness required a consensus thoroughly in the staff role to prevent any expected problem. Last but not least, the plan emphasizes in the cooperation between three parties. It shows that the united council with reconciling distinct views will ensure the consensus of the final ED workflow plan. This is an emphasize in the order and regulation axis. The benefit of viewing the world through the perspective of socialism is learning how to cope all the idea of the member to unite into one singular view. Furthermore, this view emphasize on harmony which mean the workflow is a collection of consensus between the shared understanding, values and beliefs of all members. The downside of this view is not fond of by the cooperation as it is not concentrate on efficiency and a chain of command set up through a hierarchy.

6. Reference Burrell, G & Morgan, G 1979, Sociological paradigms and organisational analysis : elements of the sociology of corporate life, Routledge, London, p. 11, viewed 1

August 2021, . Morgan, G 2018, Images Of Organization., Corwin Press Inc, S.L., pp. 18–22. Singapore Business Review 2019, Singapore public hospitals cave under pressure of overcrowding, Singapore Business Review, viewed 21 August 2021, ....