Dropbox 1.2 Cultural Leadership

Introduction
This short essay will attempt to provide insight to the culture of the Health Care Organization I current work for. Consideration will be given to the current challenges and opportunities of the financial, staffing, legal and community for which it serves. As stated by the very name of this organization, King’s Daughters, one can understand that this is a faith-based organization. This essay will wrap the premise of how this organization strive to provide both culture and faith in the decisions it makes when working though its challenges.

Culture There is a saying that history will teach us nothing, but in this case, it will help in providing a roadmap of where the organization was when I started in 2008 and where they are today. In the beginning (2008), this organization was in a growth cycle where the profit margin was between 10 to 12 present any given quarter. The development of neuro and cardiac specialty services where at the forefront of the strategic planning and development. The monies where flowing and the coffers where open as team members where provided one hundred dollar bills, sometimes twice per month as bonus for performance. Easy to see that the atmosphere was that of positivity and pride in work well done.
Now for the turn in the epic story; in the late spring of 2010, our Health Care Organization (HCO) was made aware that our baseline utilization was in the 90th. percentile for Cardiac Catheterization among its population by the Centers for Medicaid and Medicare Services (CMS) and the Department of Justice (DOJ). This was the second of healthcare organizations in the stated of Kentucky to be investigated. At first, there was not a be sense of concern toward this notification. However, within the next several moths and with the monitoring of the other HCO defending itself, the culture changed greatly. Second to this, were the effects of the recession that this region started to see about 18 months later then the rest of the country, truly a one-two punch for this organization and an indicator of thing to come that can best be described and the polar opposite of where this origination was in 2008.

Challenges and Opportunities What the previous section did not provide is the challenges outside of the culture. As one could imagine, the cost to defend an investigation is a large one. The impact to the bottom line was nearly 5% of the operating income of the organization per financial quarter. This along with the reduction in healthcare spend and the disproportionate share payout by the state of Kentucky resulted in negative operating margins. Over the next three years, the organization, like most in this situation, proceeded with reduction in force (RIF’s) practices. Further driving down the moral and negatively effecting the culture, but ultimately improving the profit margin - yet still negative. Although negative to common view, necessary to continue to provide measure to its stockholders, the community. As our teaching in chapter one indicates, each of the team members, and in this case community members as a non-for-profit, benefit or do not based on the operations of the HCO (White & Griffith, 2014).
What has however surfaced in light of the these challenges, are opportunities, many in fact. With the investigation of our cardiac program, community trust in these services where driving these services nearly 60% less then that prior. This allowed for true leadership to occur. This organization moved to secure Certificates of Need in other core specialty programs and build the core operations of the organization; Emergency services, Pediatrics, Oncology and Women’s services. When considering the true nature of transformational leadership, one can see the need for both change as well as digging in on what fundamentally define this organization. Of transition, our CEO of 13 years was provided his two-year parachute program option and our COO moved into this role. In correlation to this change in power, our creditors, pursuant to the S&P drop in our bond rating required a management company to monitor and make recommendations to transformational strategic plans. “High-performing HCO’s expect their managers’ professional actions to personify and implement the mission, vision, and values” (White & Griffith, 2014, p. 22). This was present among the remaining leadership team. However, the ability to more towards a positive operational margin continue to plague my organization.

Path to Transformational Culture This is where this examination of my HCO concludes. The current path towards re-branding and profitability is currently underway and positioned to improve its provider contracts, more especially its hospitalist and primary care performance for pay from a salaried approach to a work revenue unit (RVU) pay schedule. Reduction in the denied claims payments by its commercial payers, mostly due to poor provider documentation. And its ease of individuals access to our facilities. As the transition of Impatient to Outpatient based services see higher reimbursement to expense margins (persons through the door vs. persons in the bed), the culture of how our organization promotes health and steerage away from the Acute Impatient seating will be crucial in mooring toward profitability as indicated by forecasting the total number of patient encounters vs. number of possible reimbursable services per individual (White & Griffith, 2014, p. 260)

References
White, K. R., & Griffith, J. R. (2014). The well-managed healthcare organization (7th. ed.). Chicago, IL: Health Administration Press (original published 2010).