Stahl notes, "An ongoing dysfunctional relationship that several freestanding subacute care providers continue to wrestle with is the conflict between the regular SNF nursing staff who have been employees for several years and the newly hired acute care or critical care nurses who often are hired at higher salaries" (Stahl, 1997, p.2). Relationships interact most closely with purpose and helpful mechanisms.
Another important component in the model is rewards. Staff motivation is key to a successful organization, and that is true of the health care industry as much as any other organization. Rewards are often thought of as salary and benefits, but they do not have to be financial rewards. For example, personal job satisfaction and personal growth are two areas that fall into the reward category and are exceptionally important in the overall happiness and functionality of the staff. Boesen continues, "An organization's informal reward system is, however, also important because a formal reward system does not guarantee that staff will feel and act as if they are rewarded" (Boesen, 2005, p. 13). Ultimately, the rewards component will succeed when the staff fully supports the purpose and goals of the organization. Empowering the employees to make their own decisions and be the best they can be, while using the six-box model can help assure the staff will support these goals, resulting in a functional working environment.
The helpful mechanisms component is made up of what some might call the administrative side of a business, such as auditing, planning, budgeting, and such. This component interacts closely with reward and relationships. This could also cover such areas as billing, medical records, and the many other support personal that are required to keep a health care facility funded and running smoothly. The assessment of this area is extremely important because helpful mechanisms can include unnecessary procedures and positions that when evaluated effectively can be eliminated or pared down. This is another reason periodic organizational assessments should take place in any health care organization. As needs and goals change, so do many of the necessary helpful mechanisms, and using mechanisms that are unnecessary or outmoded can add cost and frustration to the organization. It is important not to overlook any of the support functions in this area, as they might "fall through the cracks" of the organizational model and create frustration when the final plan is implemented.
Although it is last on the list, the leadership component of the six-box model forms the hub of the physical model. The five other components circle around it, all interacting with each other and the hub. In fact, the purpose of the leadership component is to help coordinate the other five boxes. Another expert notes, "Some may question the central role and influence of top management in the model, but it is their responsibility to deal with factors that constrain capacity and to realign relationships between the boxes" (Boesen, 2005, p. 13). The leader must be flexible, open to comment and change, and most of all, able to coordinate effectively. It is the role of the leader to make sure the model succeeds and the changes are executed and necessary. In addition, it is the role of the organization's leaders to ensure the integrity of the organization. Without integrity, a health care organization is doomed to failure and public scrutiny. With integrity, the organization gains trust and reputation with the staff and community. However, all components of the model work with each other, and so without one, the model cannot be a success.
In conclusion, the Weisbord six-box model is used throughout a wide variety of businesses, communities, and institutions. It is especially helpful in the health care industry, which often follows the same organizational model for years without assessment or updating. The health care field is changing rapidly. More people are aging, people are living longer, and new epidemics, such as diabetes and obesity are becoming more prevalent. This means many organizations will find it necessary to change their organizations' services and goals, and using the six-box model can make the process quicker, easier, and more complete.
Boesen, N. (2005). A results-oriented approach to capacity change. Retrieved from the Um.dk Website: http://www.um.dk/NR/rdonlyres/780914 AD-A4C4-42C2-8039-8115F4CA0DDB/0/KortCDbriefintro.pdf26 Oct. 2006.
Oleari, K. (2000, December). Making your job easier: Using whole-system approaches to involve the community in sustainable planning and development. Public Management, 82, 4.
Stahl, D.A. (1997). Organizational diagnosis: A six-box model. Nursing…