Weisbord Six-Box Model as it

¶ … Weisbord six-box model as it regards to health care organizations, including its purpose, structure, and other integral components of the model. Marvin Weisbord developed his six-box model of organizational diagnosis to fit any organization, but it especially helpful in the health care field. From time to time, it benefits any organization to assess its operations and modify them where necessary. "Classically, organization development has been seen as a process of problem solving or of conflict management" (Oleari, 2000, p. 4). To begin, an organizational assessment is necessary. First, a small planning team is formed to represent all areas of the organization and gather input from organization members. This team's purpose is to represent each area (or component) and decide what (if anything) needs to change or alter in that area. The diagnosis of these assessments includes input from all areas and all levels of the organization. Any organization can benefit from this initial assessment of needs and wants.

The Weisbord six-box model is a method of assessing an organization's performance in six areas. As one health care writer notes, the model is an excellent tool in the health care industry. She writes, "A subacute care organization's diagnosis can determine the appropriateness and profitability of its current business, any gaps that must be rectified and the action plan that must be undertaken" (Stahl, 1997, p. 1). Thus, applying the six-box model is an important part of overall organizational management, and the model can help point out areas of need as well as areas that are successful and do not need to be address. Stahl continues, "According to Weisbord, identifying and solving a problem must be done systematically by the same people, because by so doing, they learn from their own situation and then seek improvement" (Stahl, 1997, p. 1). The model contains six components, purpose, structure, relationships, rewards, helpful mechanisms and leadership

Purpose. Perhaps the most important component of Weisbord's six-box model is purpose (sometimes called strategies in some six-box models) (Boesen, 2005, p. 13). This component is elemental to the purpose of the organization itself. It helps assess what type business of health care the organization engages in, how this meshes with the overall health care industry, and if it is viable for the future. Markets and segments continually change and grow or disappear, so this analysis is especially important. If the answers to these purpose questions and discussion differ too far from what the organization is currently accomplishing, they may discover they need to totally change their purpose or drastically change its central function. Thus, the purpose could change often within an organization, depending on what aspect of health care it addresses and how many other providers offer the same or similar services in the area. All aspects of the model interact with each other, and purpose is most closely aligned with two other components - structure and relationships.

The next component of the model is structure, which basically assesses how work is divided in the organization. In the health care industry, it also looks at patient satisfaction with the work and service provided and patient success rates. Analysis of this section can point to areas where patient coverage or care is lacking, or identify areas where there are overlapping jobs or assignments. It can also look at what patient care needs may be in the future, and how to meet them. This can be particularly useful to health care faculties who often have small staffs anyway, and must cover a variety of assignments effectively and with great attention to detail. Stahl continues, "Thus, diagnosing the organization's structure should clarify functional responsibilities and staff accountabilities" (Stahl, 1997, p. 2). Structure interacts most closely with rewards and relationships, and this makes sense, since these are all important components of the work related aspects of an organization.

The next component in the model is the relationships component, and this is another important aspect as it relates to staff, management, patients, and others. If the relationships component of the model is dysfunctional, then the entire model becomes suspect. The patient is the primary consumer in this model, but in a health care organization there are many other consumer relationships too, such as doctors, managed care representatives, staff, managers, and others. Even family can fall into this category. Thus, there can be many areas where dysfunctional relationships could develop, and many areas that can be affected as a result. 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.