Leadership Mrs. Smith knew before any of her staff at General Valley Ob/Gyn that the practice had been sold to the area’s leading health system.

Professionalism The pressure was mounting with the nursing rank and file that nursing needed to become part of a bargaining unit.
January 11, 2020
Identify a clinical question and apply the PICO format.
January 11, 2020
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Leadership Mrs. Smith knew before any of her staff at General Valley Ob/Gyn that the practice had been sold to the area’s leading health system.

Write a brief explanation that explains why the case represents its particular ACHE competency domain. (Be sure that the explanation justifies the assigned competency domain based upon the facts and circumstances of the case.)

Case:

Case 3: Leadership Mrs. Smith knew before any of her staff at General Valley Ob/Gyn that the practice had been sold to the area’s leading health system. The physician-owners of the practice were sure to keep her informed almost from the very beginning of the negotiation for the purchase of the practice. It took three months for all of the elements of the sell to be finalized, but in the end the physicians would become employees of the health system along with Mrs. Smith and any of her staff she deemed appropriate to maintain their positions. She had been in her role as senior practice manger for 15 years and had witnessed this practice become one of the most productive Ob/Gyn businesses in the region with nine practicing physicians and close to 45,000 patients. The practice has relocated three times to accommodate the space needs for this ever increasing volume of business. The original owners, two physicians, had expanded their partnership to three more physicians during this 15 year period. It was no wonder that area health systems were interested pursuing the practice for ownership. In the end one system offered the most comprehensive package and the most lucrative arrangement for the physician partners over any other offers. But the expectation was that the non-clinical staff under the supervision of Mrs. Smith would remain in place to assure continuity of patient service and satisfaction. Faced with this significant change from a small business that felt like a family operation to a corporate unit within a large health company regarded major leadership on the part of Mrs. Smith. She understood that several of her staff could easily respond to the news that the practice was purchased in a “knee-jerk” fashion and quit on the spot. Any form of walking out would be a serious challenge and certainly if it represented more than one individual in the office personnel. To manage this situation, Mrs. Smith decided to proactively orchestra a change process that would minimize any negative perceptions on the part of staff about this buy-out. She wanted to maintain the trust and loyalty the staff had with her and to orient the staff to the new reality of being employees of a corporate health care company rather than a small business. Her first task was to develop a clear vision of what this change would mean for people and to know how to answer key questions they would have almost from the moment of being informed of this change. Second, she needed to influence key members of her staff that this was a positive change and one they could embrace. Doing this for a few, well respected employees would allow them to influence the others and help get these folks on board. Finally, Mrs. Smith needed to have all staff members understand this new reality and be able to describe it in their own terms. It had to become personal in a positive way for every office member. Fortunately, Mrs. Smith understood such a process could not happen overnight. She would need to work on this this for a number of weeks if not months to create the buy-in for change that was required. She would also need to spend this much time to assure that people would truly embrace the change and feel that it was to their advantage to support it. On the day the health system and the physician owners signed the sales agreement, it was almost impossible to see any difference in how the staff was working or handling the patients. They knew that at that moment they were employees of the health system, but they also knew that they understood what that change would mean for them and what the benefits would be. It was a welcome change.