South Australia Ambulance Service Organizational Behaviour Case

South Australia Ambulance Service

Organizational Behaviour Case Analysis

Who

Ray Main should develop a system which empowers the culture of organization along with the shift towards automation and excellent customer service.

Has to do what

The leadership of South Australia Ambulance Service is required to do the following:

To set a strategic direction for SAAS this would be compatible to the new strategic plan.

Meet the service expectations of the clients by focusing more on efficient customer services.

Empower the service delivery personnel fully and hold them accountable for every action.

The expectations of donators and community should be aligned.

Make SAAS compatible to respond to mass casualties.

Workforce retention should be increased.

Emergency sector and healthcare should be integrated to respond efficiently to any casualty.

Interventions should be prioritized.

The impact of any change should be evaluated on the patient as patients' life is more important. (Daniels 2009)

The South Australia Ambulance Service (SAAS) should focus on developing a system which supports the leadership of the organization to create self-managed work-teams at the company cost. Traditionally, SAAS was hierarchical organization having no concept of work teams.

Why

The borders of South Australia are shared by all the mainland cities of Australia. South Australia should have a unified ambulance service in order to better cover the casualties. Thus there is a need to develop a system which empowers the leaders of SAAS to take initiatives and plan the work management of the organization more effectively. Ray Main was one of the project coordinators for SAAS. (Bucklin and Dickinson 2001) He attempted to standardize the system all across Australia but he faced certain difficulties in training and coaching of the staff. The coordinators responsibility is to train the leaders of the organization to take initiatives and decisions on the basis of the current situation. He is supposed to implement a system which standardizes the training courses of leaders. SAAS is reluctant to send its leaders to any training institute.

When

The standardized system of leadership training should be implemented in coordination with the implementation team as soon as possible. There is an urgent requirement for SAAS to take a u-turn and change the way they are managing their business. The centralized system of management is in place which is not a going-concern in this rapidly changing and competitive environment.

Analysis

Key Facts in Case

This case presents the need to introduce self-managed team at SAAS. The need for self-managed teams arises because the organization is currently running according to a centralized management system in which managers and leaders have no power to take initiatives and decisions. The key drivers to introduce a standardized system of leadership training is the need for improvement in ambulatory care services through high-tech equipment, the training schedules implementation, enhancing the career of staff through proper training compatible with latest ambulatory care equipment and the empowerment of work teams so that teams have the power to take on-the-spot decisions.

There was a try to change the organizational structure to work teams. The initiative was proved to be worthless because the staff was not prepared for change and the move towards work-teams failed. The reason for failure of this system was the expectations management. Teams at different locations were empowered. After empowerment, the expectations for win increased but due to lesser experience and false expectations, the morale of the empowered work teams drowned. This was the main reason why the initiative of Pickering did not work out. (Bucklin and Jackson 2000)

SAAS is undergoing fundamental transformation of its form and structure and means of self-regulation. At the same time it must continue to play its role of providing pre-hospital emergency care and transport of individual patients. He can not suspend operations to introduce new initiatives and strategies, but must improvise while implementation takes place. At the same time, it must change its structure to one that is compatible with modern standards of organization. This requirement is now required by an organization that is not necessarily suited to accommodate such a change, let alone the rate of change implemented.

Issues and Symptoms (cause and effects)

Misfit employees in the SAAS staff.

Work team concept failed.

There are certain standards in SAAS. The implementation of these standards is not up to the mark or they are not mandatory to follow. This deviation from the standards has led to inconsistencies in operational and the clinical performances of SAAS.

Lack of thrive to become the number ambulance service in Australia.

Seminars on empowerment and team leadership were organized by Bernie Morellini. The seminars were a great source of learning but these workshops again proved to be a failure as the skills learned were not properly implemented by the SAAS leaders into their operations.

Increased costs of operations due to unavailability of automated systems.

Due to limited knowledge of leadership, the staff has a little knowledge about the ambulance's role in emergency situations.

Volunteer retention as well as recruitment was also a problem for SAAS. Due to limited systems, people do not see SAAS as career-oriented organizations. (Azaroff and Austin 2000)

External Analysis

Brief industry analysis

Many ambulance routes in South Australia under the roads, with the South Australian Government in the privatization contract, the operation of the direction of the private sector ambulance services. In recent years, the new ambulance service has been installed along the roads of South Australia, and the existing configuration and operation of ambulance services were reviewed. In these road ambulance services, ambulance provides the people involved in traffic accidents the first treatment, to the nearest hospital (if required), and then return to their base on the road. These systems are generally zero-line capacity, and their work, especially the ambulance distribution policy, which states that only certain vehicles can be transported to the road (part of the backup), mainly due to time constraints travel distance or area. In addition, some policies involve a number of scheduling, in some cases (depending on call type), it is necessary to send more than one ambulance to the same call. (Azaroff & Harris 2001)

Average response time is considered the main measure of performance. In general, the response time limit specified in the privatization contracts, must be followed by the private sector, which is for road management. Ambulance service and other performance indicators to balance work load, not by the requirements of the scores of ambulance services (loss probability) services, and telephone scores did not fail at a predetermined threshold (ie, scores and response times call for more services than T. minutes). The first measure is, in particular the use of ambulance services analyst. For example, the United States Ambulance Service Act of 1973 showed that 95% of the emergency medical response should be 10 minutes in rural areas in the city area for 30 minutes. Some of the roads in the South Australia Ambulance Service, the statistical data were also used to evaluate the system, the privatization of these regulations are stipulated in the contract. (Smoot and Duncan, 1997)

Many studies have suggested that rather than the development of emergency response in recent decades in the analysis of the classical model of the system changes. In particular, the hypercube model of the spatial distribution of queuing theory and Markov approximation for these systems based on the analysis of one of the most effective ways. The model involves solving the O (2n) of the linear equations (N is the number of ambulances in the system), which involves the probability of a variable steady-state system. With these probabilities, the performance of a number of measures related to essential systems management, can be estimated. Hypercube model used in the example of American city ambulance services can be found in different studies. Recently, the hypercube has been considered is the deployment model to deal with terrorist attacks and other major emergencies. In South Australia, hypercube model is applied to analysis of urban ambulance service and ambulance service on the highway. (Rummler and Brache 1995)

Some studies have extended the original model of the cube to withdraw the route the ambulance service purposes its strict assumptions. For example, many researchers have modified the model, consider some of the backup, the other to expand the model to study multiple servers send the same and different, and the heuristic model proposed on the basis of Mendonca and Morabito study to estimate large scale systems, the loss probability. Other studies have focused on the hypercube model and optimization program combination. These studies provide a comprehensive study of hypercube ambulance heuristic methods applied to local problems to achieve success. (Peters and Waterman 2002)

Recently, some researchers have integrated into a genetic algorithm to determine the primary and secondary ambulance (cutting issues) the optimum region cube model, given the current position, taking into account the different conflicting objectives, so that the average user response time, workload balance and call the ambulance response time and part exceeds a predetermined threshold. In this study, results showed that the best way of these goals is through a simple change, and without moving, without additional investment in the ambulance and the ability to satisfy the atomic size of the system.

STEP analysis

Social

SAAS is a socially responsible organization investing in disaster prevention and primary care.

Due to increase in disaster care and primary care interventions, the mortality rates of heart disease and cancer are decreasing. This is resulting in increased life of an individual.

The demographic trend is slowing down.

Life expectancy is increasing due to increased access to primary care and standards of living.

Raising taxes earmarked for health leads to higher expectations.

Technological

Medical science is advancing at a rapid pace. There is an increase in technological advances including treatment ways, and advanced pharmaceutical procedures.

Due to advances in surgical equipment, the patient hospital stay time has decreased.

Genetic advances leading to improvements in diagnosis and treatment with improved results.

Patients will have better access to information about their disease through telecommunication and Internet.

Health care professionals use IT to improve operational management and productivity

The increased use of information technology has resulted in decreased clinical errors and increased clinical decision making.

Diagnostic tools are being miniaturized.

Economic

Due to increased public spending on donations, the health sector is growing at a rapid pace.

The inflation rate in public sector is increasing.

Private Health sector is encouraged to work closely with the public health sector.

Substitution effect between public and private sectors depends on the quality of care provided by SAAS and differentiation between sectors.

There are certain healthcare inequalities between the Social Classes.

Twenty five percent of the population is smokers and smoking is linked to social class.

Profiles of local disease reflected in the halls of the city with poor housing that reflects the increased demand for primary and secondary care services.

Political ( & Environmental)

The government has a manifesto commitment to reform health and social services in line with greater decentralization to local level.

Public services should be delivered by the government.

Health is the main component of utility Hospital Foundation is a key element of the reform of government health.

The Government is keen to encourage the plurality of independent suppliers, including treatment centers (ISTC) Local outboard staff receive broad support.

(Perlow 2001)

Internal Analysis

South Australia Ambulance Service is based on health, which is emergency care, clinical care and patient transport services, the sole supplier of more than 1,043,514 km square in southern Australia, the spread of more than 150 million Australian region the people's government. (Matt 2003)

Service employs approximately 1,200 people, 1,500 volunteers and 105 who use the workplace, business 323, emergency ambulance, non-emergency medical, rescue and recovery of the entire country. (McShane and Stern 2008)

SA's ambulance service is known throughout the operation of the state, moves more than emergency vehicles each year and non-emergency varieties:

Mercedes-Benz Sprinter light commercial vehicle operations in 315 metropolitan areas, and countries and regions using the Ford F350 and Mercedes-Benz Sprinter vans 316,315 and 318. All vehicles delivering unique high visibility LED lights and warning lights and sirens. Recently introduced a new coating designed to improve visibility and safety. (Magnus, pipe 1997)

All emergency ambulance crew roster in Adelaide city of nursing qualification, the level of at least a lot of teams eligible for health care workers in intensive care. Mercedes-Benz Sprinter cars have replaced the use of patient transport ambulance service 315 Fute Ling. These vehicles do not carry the same equipment as the standard emergency ambulance, but are equipped with basic life support level. Software as a Service also operates the nursing home staff, including management Benz Vito car team. (Komaki 1986) nurses in the metropolitan Adelaide early warning sprint for four-wheel drive Subaru Forester vehicles.

Use the software as a service team leader and manager of the Holden Commodore (sedan, station wagon, and the Captiva variants) and the mixture of the Ford Territory four-wheel drive vehicles. The special operations team uses two four-wheel drive vehicles, Nissan patrol answered by SOT unique role. Toyota Motor (CV1) and the general public Kombi cars (CV2) is used as a program of events and major incident command vehicle. Bicycle ambulance response units can also be used for large-scale activities, in response to events. (Komaki and Minnich 2002)

SaaS is the committee of three rescue helicopters crash (MAC) of the regulatory authorities in response to road trauma, medical training, exercises and operations of WFP and the Food Safety Center extraction use. Royal Flying Doctor Service Pilatus number of aircraft operations in the area of PC12 and remote areas, the regional ambulance services, the first transfer between hospitals. (Komaki and Jensen 1986)

Nurses Special Rescue Team (SOT) are well-trained high-risk rescue procedures. They work closely with other emergency services and the Secretary for the South Australian police star. Explore the new health care workers also used the recovery services SOT Medstar. (Kaplan and Norton 2006)

SaaS Business Center (EOC), based in Adelaide, the main emergency response three zero (000) call distribution and use of ambulance services, coordination of resources classification system SA System. Equal Opportunities Commission is responsible for coordinating the State Bank of Adelaide sent a rescue helicopter services. Equal Opportunities Commission, candidates can also call the hospital informed the MedicAlert Foundation's clients, coordination of fund-raising network from the emergency room and trauma services in divers SA. (Johnston & Pennypacker 2003)

Financial Analysis

Income Statement

SA government has a tax of about 45% of total revenue is consistent with the previous four years, reflects the dependence on government funding the ambulance service. (McShane and Stern 2008)

Ambulance transport revenue in 2007 increased by ambulance following the load in the use of eight per cent and four per cent increase in ambulance service prices.

In 2007, staffing and related costs increased by 12.7 to 78.1 million AUS dollars. This increase was mainly due to the level of the average wage increase per eight percent and 4.8%, the increase in the number of ambulance service personnel. Staffing and related costs have also been defined benefit pension plan movement. (Johnston & Redmond 2001)

Ambulance services sprang from an enterprise agreement approved Amendment 1 in January 2007 causing wages. Ambulance Service has recorded 3.1 unpaid wages and the revised commercial agreements to bring the cost of salaries million.

Under the revised auxiliary enterprise agreement rate increased to further negotiations have been identified as the "reserved area" to allow the circumstances, by the South Australian Industrial Relations (Commission) Commission employees Ambulance progress. Enterprise bargaining agreement, the Commission shall be assisted in the business than in the original agreement, including those award-winning higher wages, then the result will be the first pay period began on December 31, 2006.

Claimed $12,100,000, mainly related to ambulance service fees, ambulance current assets 34%. Receivable balance includes a doubtful debt by taking into account the June 30 following the four previous years, the value of allowances, the ambulance service said, 29 June 30 per cent of outstanding receivables in 2007 is unlikely be collected.

Non-current assets increased by $5,900,000, mainly due to 12.8 million of property, plant and equipment acquisition value of $7,700,000 offset by the depreciation. (Hopkins, 1999)

Total liabilities increased by $7,600,000, mainly due to U.S. dollar 390 million AUS dollars of commercial loans increased by $3,500,000 donation liabilities. The increase was mainly due to commercial creditors, a creditor for the purchase of ambulances and the fitout is not in the June 30, 2007 increased. Staff in liabilities was mainly attributable to increased employee compensation increases, because the revised enterprise bargaining agreement negotiations.

Cash Flow Statement

The following table summarises the net cash flows for the four years to 2007.

2007

2006

2005

2004

$'million $'million $'million $'million

Net Cash Flows

Operations

12.8

9.9

7.8

12.5

Investing

(10.0)

(12.3)

(8.6)

(6.0)

Change in Cash

2.8

(2.4)

(0.8)

6.5

Cash at 30 June

23.4

20.6

23.0

23.8

(Gilbert 2006)

Cash flow analysis indicates that $2,800,000 in cash to increase in 2006-07. The increase was primarily due to reduced capital expenditure. 2007-08 budget, including ambulance service U.S. $19,100,000 in capital expenditures. $10,400,000 of which will be the future of government funding, and the remaining 8.7 million of funds from existing cash reserves or exploitation.

Ambulance coverage plan has a fee income of operating ambulance services, excluding transport costs offer a significant impact to the user. Premium income of 1,690,788,000 AUS dollars to 2006-07 million, and provide benefits to users increase from 35,000 to 30,100,000 AUS dollars.

SWOT Analysis

Strengths

Although there is no monopoly, there is no real competitor for the SAAS.

While private hospitals are available throughout South Australia, the accident and emergency department is unique to the SAAS.

The fact that there is continuous monitoring of waiting lists is evidence that demand exceeds supply

The SAAS has been established since 1948 and continues to grow and expand its services.

Weaknesses

Unable to meet demand due to population increase

Perhaps the management of the chain links, for resource assessment

Opportunities

There is a great opportunity for SAAS to use the marketing tactics to increase the market share and profile of the company.

Private investment can be attracted.

Threats

The contractors' reputation can negatively affect the image of SAAS.

High staff turnover might prove to be a threat for SAAS.

(Geller 2006)

Implications of External and Internal Analysis

Of course, the above written SWOT analysis of the SAAS do not know first hand the work of the Trust. Like most of the SWOT analysis is based on the above views, which in turn is based on the interpretation of the information in the public domain, according to regular articles in the media. This effect, the market has the impact of this view. This is a lot of people may have different views on the SaaS, depending on their views and personal experience, they may have. However, given the number of SAAS business trust and the number of different operating units, and even the staff working on the business unit may have other different views.

Another tool to evaluate SaaS is a marketing audit, thorough, systematic, independent and periodic environmental marketing company. Identify problems and opportunities. (Daniels and Daniels 2004) This is indeed a complex issue. Each of the strategic responsibility of his trust, then we can assume his responsibility for its marketing activities, and has a website SAAS indications are that this is the central air conditioning. Included in the audit of the audit should be outsourcing companies and their representatives SaaS way. With the different companies and the South Australian business trust or even bound to a different corporate culture, and should be reviewed and processed, if possible value.

Alternatives

Viable Alternatives

1. Establish a unit that is responsible to and under the direction of the donor to the progress of Ambulance Service Strategy, advising donors, and administer health policy and SAAS provides strategic leadership for the sector.

2. Develop transparent, sustainable funding model(s) that point to external factors agreed service expectations

3. Develop performance indicators results mandate to monitor the performance of contracted suppliers

4. Develop a framework to facilitate effective consultation with the community about the long-term planning for the quantity, location and funding of ambulance service.

Decision Criteria

1) Quality of Service of the team leaders

2) Availability of Resources

3) Time of training during the career of leader

Analyze Alternatives

Alternative 1:

Objective: To have a central function of accountability to donors (Department of Health and SAAS) with responsibility for advancing health policy and SAAS, in consultation with stakeholders

Action 1: Strategic leadership should be established within the organization so as to increase the accountability and the management of donor investments.

• The funding structure of SAAS should be re-build so as to cater the demands of new investments through contract with vendors

• planning at the requirement level of resources as well as human capital is very essential to meet the management objectives.

• Structure of management with governance should be established to:

• make sure that overall strategy is reflected by priorities, and • provision of advice to donors of funds

Alternative 2:

Objective: To outsource the training function in order to better align the leadership training with the organizational needs

Action 1: Improve the alignment of the SAAS and the training organizations to • Identify apparent, sustainable training models for consideration by the organizational management

• Identify and change the training procedures that are incompatible with the philosophy accepted by different trainers

• Assess whether training of leader is helping them to form self-managed teams or not. This should be evaluated very cautiously by SAAS

Action 2: The resources necessary to achieve the desired performance levels should be identified