Faith Community Hospital is a not-for-profit health care services organization that is currently facing a situation, which may compel it to resort to stringent cost cutting measures just to break even, and that too providing the average reimbursement rate does not change. Financial problems, however, are just one of the several problems that Faith Community Hospital must resolve in order for the organization to maintain and further build its reputation as a quality health care services provider. In brief, some of the other critical issues that the hospital needs to address are the conflict between the organization's spiritual heritage and values and the ethics of the medical profession; non-compliance with government, managed care, and insurance regulations; and non-adherence to hospital operational policies. Indeed, it is evident from the preceding list of issues that Faith Community Hospital has an organizational management problem on its hands, which needs to be thoroughly analyzed rather than attempt to solve the various problems piecemeal.
Identifying the Key Issues: Although there are several, disparate issues mentioned in the CEO's brief to Chris Smith, a closer analysis reveals that Faith Community Hospital's problems can be categorized as related to the organizational mission; organizational culture; and organizational processes. This conclusion can be reached using the affinity diagram as a problem solving tool. The affinity diagram was chosen for the purposes of this analysis as it allows for uncertain facts and thoughts to be organized; for ideas that need clarification; and for achieving unity within a team (SkyMark, 2003) or organization. The problems and issues that were uncovered by the affinity diagram (refer Appendix 1) are discussed in detail in the following section of this paper. The affinity sets have been compiled using inferences from the CEO's briefing to Chris Smith, and by using the need for Faith Community Hospital to enhance its reputation as a quality health care services organization as the key issue that needs to be addressed.
Organizational Mission, Culture and Processes: The mission statement plays a critical role in setting direction and laying the foundation for the culture and goals of any organization. Indeed, this is clearly expressed in Hyrum Smith's model of instructive goal setting, which is commonly referred to as Smith's "Success Triangle." This model places an organization's governing values at the base of the goal setting process and recommends that goals must be linked to specific governing values in order to be meaningful and to help the organization achieve its mission (Parker, 2003). The mission statement of Faith Community Hospital appears to adhere to the strategic principles inherent in Smith's "Success Triangle" to the extent that it clearly emphasizes the organization's commitment to promoting the health and well-being of the people in the communities it serves, using its spiritual heritage and values as the foundation. However, since spiritual values can vary vastly across religions and individual beliefs, Faith's mission statement has led to broad individual interpretations that have, in turn, led to an organizational culture, which allows too much leeway for individual decision-making. This is evident in the anecdotal cases cited by the CEO of doctors independently deciding to either treat patients pro bono or insisting on insurance coverage prior to commencement of treatment; the pharmacist filling prescriptions for uninsured patients; and the inconsistency in adhering to hospital policy in areas such as 'Do Not Resuscitate' (DNR) decisions. Implicit in the preceding examples is also the fact that the broad interpretation of the organization's mission statement with its ensuing culture has further resulted in ineffective organizational policies and processes, leading to conflicts with the ethical/legal standards of the medical profession, and organizational inability to manage its financials well. Thus, it is evident that the root cause underlying Faith Community Hospital's problems in the area of ethical standards, organizational processes; financial costs; and patient safety / welfare lies in the perhaps overdue emphasis placed on the spiritual heritage and values of the organization in its mission statement. Indeed, the far-reaching influence of the organization's emphasis on spiritual values is evident in the Fishbone Diagram in Appendix 2, which uses the key issues thrown up in the Affinity Diagram to demonstrate the ultimate effect of Faith Community Hospital's current situation.
Organizational Goals: Although the mission statement of Faith Community Hospital implies a broad goal of promoting the health and well-being of the people it serves…