Non-Profit Change Management

Administration & Policy Development The author of this report is to engage in an assessment task that centers on human services and social workers in a clinical setting. The author of this report shall be focusing on the social work department in a hospital and juxtaposing the conditions and issues within that hospital to the scholarly research that is to be referenced and mentioned throughout this report.

At specific issue is the number of patients being seen by the social workers, the high physical and mental demands that this fact and others put on the social workers and the remedies that can be conjured up and implemented to address both of those issues. Complicating these aggravating factors are penny-pinching bureaucrats that are focused on budget limits and saving dollars than preserving the mental health of the employees and quality of care for the patients.

While solutions may seem elusive, they mots certainly exist and they need to be come to and implemented in a results-based and fact-oriented way rather than on assumptions or blind preferences or biases. Analysis The hospital in question for this report will be referred to as Bellmint hospital.

As noted in the introduction, the limits and lengths to which the employees are being spread is entirely too much and this needs to be remedied for the benefit of both the patients who might receive less than stellar care and the social workers who are being pushed too far too often to save a few dollars. In total, Bellmint social workers are seeing seven patients a day and this is entirely too many to keep up quality and consistent service for all patients.

There is a loss of complete and sufficient focus on patient needs. The organizational model, whether it is flawed for prescient, causes a loss or gain in overall quality of care.

As such, the leadership owes it to the patients, the employees and the bottom line to make sure that the social work department of the hospital is fully staff and has the resources, both money and otherwise, to get their job done effectively and timely without treating patients like an assembly line or employees like a renewable resource with no end.

Given the conditions as they exist, there clearly needs to be a reallocation or even an increase in the resources made available directly to the social workers that exist as well as future additional or replacement employees. Bellmint apparently as an issue whereby a glut of the cash and resources available to allocate are going to people and places other than the "front line" employees in the hospital's social work department. At the same time, the social workers in the hospital are being stretched very thin.

To truly provide some fact-based clarity towards how to proceed with the Bellmint quandary, the author of this report will now look at some scholarly research. The first example may not seem like an obvious one but it could perhaps educate the ostensibly aloof bureaucrats that are short-changing the social workers in Bellmint. As authored and offered by Terry Shaw (2011), social work can indeed be a "green" profession and this can translate to less spending and conservation of resources.

This could absolutely be done to the extent that it could allow for quicker operations and more money for additional workers, or at least overtime, so as to allow patients to be served properly. For example, using electronic documents whenever possible rather than using paper and toner to print things and/or using forms and documents that have as little dark ink on them as possible (i.e.

no blocks of black anywhere) or even just using monochrome printers unless color is truly needed are all little but also big things that can be done to free up money for other ventures. The rub is that the bureaucrats should not use these savings as license to constrict the budget more and/or to go so far with the "green" ideas so as to be ridiculous or even endanger continuity of operations (Shaw, 2011).

Another danger in allowing things to go as they have been with the social work department in Bellmint is a carelessness will seep in whereby patients or other people will be referred to in loaded terms or even with pejoratives. How someone is referred to both behind the scenes and to the patients' faces absolutely matters.

This is not to say that the Bellmint people are trying to be incendiary or heartless but when people get burned out and stretched thin, they get irritable and perhaps might say things they should not. Given that, whether or not the burnout/spending issues at Bellmint are every truly addressed, the proper terms that should be used should be defined and enforced. While that may seem like overkill, it is not.

For example, in a clinical setting, patients can be referred to as client, patient, customer, consumer, expert by experience, service user and so on. Just as noted before in part, terminology can convey how one feels about another. When speaking of medical service users, this is the distinction between a patient feeling like a number or someone that the social work department is truly able and willing to help (McLaughlin, 2009).

Another way in which behavior, terminology and perceptions can create a flare-up in a social work setting is when speaking of gender identity issues in general, most of which are centered around lesbian, gay, bisexual and transgender (LGBT) people. Indeed, there are many people in the United States and around the world that vehemently prefer to be referred to with a gender pronoun that differs from their biological gender. Reasons that this can become issue can range from the innocuous to the overtly bigoted.

As noted before, the majority of this prism is not applicable to Bellmint as the people there are doing the best they can with what they have. However, when it comes to subjects and issues like any perceived or actual discrimination or disparate treatment as it relates to people that are LGBT, a careless statement or reference can be insanely damaging and this could happen even if the carelessness or ambivalence is the result of burnout and/or shuttling patients in and out too quickly.

After all, medical care and insurance are deemed by many to be a right, evne if not codified by a specific law, and therefore people will be much more sensitive to any perceived or actual derision or discrimination. Any appearance of the medical professionals being rude or non-compassionate is going to get a very vitriolic reaction of some form or another (Powell, 2012). One avenue that would result in the bureaucrats and leaders of Bellmint seeing the plight of the social workers is to listen to the consumers themselves.

This precise strategy is recommended by Donna Hardina (2011) in a recent treatise. In that article, it is actively recommended that social service managers and leaders actively and intentionally elicit the feedback and feelings of the patients themselves and thus allow them to help shape and form the decisions that are made by the social service leaders. According to Hardina, the precedent and results that feed this conclusion are both recent and fairly far in the past.

Indeed, a secondary source cited by Hardina, that being the work of Berger and Newhaus in 1977, note that citizen participation in non-profit ventures has a demonstrable effect on the results and performance of those non-profit organizations and this is especially true in low-income areas (Hardina, 2011). Bellmint leaders and bureaucrats could certainly get some benefit from getting feedback from both the social workers as well as the patients as they all have a vested and specific interest in the social work department of Bellmint operating in a smooth and proper fashion.

Indeed, Hardina notes that a participative based approach yields much better results because the people directly affected and impacted by decisions of higher management are directly involved in the feedback chain and thus can give the decision makers they leverage and information they need to make the right choice for everyone involved.

Empowerment is also a great tool to use as it reinvigorates and greatly increases the performance of the workers that are given expanded control over their own destiny rather than being relegated to a simple "worker bee" role that is only led in a top-down fashion (Hardina, 2011). Even with all the feel-good verbiage above, it is imperative for the support of these initiatives to go all the way to the top or it will not be as effective.

As noted by Hardina, "the research literature on empowerment in organizations also identifies the support of organization managers as critical in the effective implementation of this approach." The research pool that Hardina used was dominated (more than two thirds) by organizations whose primary focus was the service of clients in social work and similar situations. Given that, the applicability and usefulness of this research as well as the research that was cited in Hardina's literature review is easy apply and use in the Bellmint situation (Hardina, 2011).

The work of Bargal (1993) was both similar in subject and outcome to work of Hardina just mentioned above but was actually published more than two decades before Hardina published her report. One remark that Bargal made in his work is that change in human service organizations can be extremely hard to pull off if there is any lack of perceived legitimacy or need for change by the outside public as the funding/support of those outside people is often non-optional to pull off any changes effectively.

However, the other side of that coin is that if the public is demanding of higher levels of service from social workers in Bellmint and it is not forthcoming, a huge amount of pressure will be brought to bear on the workers and, by extension, the leadership of the Bellmint social workers. What this means is that if the public is exerting pressure against the cost saving and low staffing techniques of Bellmint, they will be vocal and bluntly honest about it when asked for their opinion.

Even if it is not asked for, it will probably be offered in the form of a letter of complaint or even with the media. The latter of those is when the proverbial mess will hit the fan and tangible action of some sort will required since it deals with medical care and the aforementioned "right" of quality healthcare will be demanded (Bargal, 1993) Bargal also speaks to something else that can be applied to many executives including those in the Bellmint situation.

Many executives thrive and strive towards efficiency and lower costs, even to the extent of being "superficial" and a bit odd about it. However, Bargal notes that this can lead to a feeling and action set that looks at the corporation as a self-sustaining body and not dependent or needing to care about the predilections and opinions of exterior sources. However, feeling that way regarding a social work and/or hospital situation, given that Bellmint is actually both at the same time, is sheer lunacy to put it lightly.

Turning a blind eye or ear to the feelings and thoughts about the people outside of an organization is very unwise. Later on in the report, Bargal drives the point home by stating (when referring to the economic travails of the early 1980's) that "strategic change is requisite in a time of crisis I the modern welfare state." While the economic problems of 2007-2009 are mostly behind the United States, the employment and social service stats from a government perspective (e.g.

food stamps, welfare, etc.) are not all that encouraging right now (Bargal, 1993).

One last source, as authored by Andrew Jones and John May in 1992, states that "it needs to be stressed that while the focus of the human relations approach is, at first sight, the needs of the workers." However, they also note that when speaking of social work and human relation services, there should be no "fundamental conflict between the workers and the management." This is clearly not the case with Bellmint as there is obviously a disparity between what the leaders are doing and expect and the perceived needs as defined by the workers in the social work department.

Given the above, the recommendations as offered by the author of this report are as follows. First, there needs to be a meeting of the minds between the entire staff of the social work department and anyone/everyone that affects the allocations and resources of the same. If the people who work in the department are not there, there will not be a proper airing of the perspective that will be informative of the problem.

If the people controlling the purse strings and/or are making budget decisions are not there, then the people that can effect and induce change will not be in.