Recent orders
Governance. The success or failure of the change is always attributed to various issues
Governance
Most governments, especially those in the developing world are moving to e-government in order to enhance better service delivery to the citizens in their respective countries. However, frequently the change to e-government ends up partially successful or failing completely. The success or failure of the change is always attributed to various issues.
An unnamed government from southern Africa decided to come up with a single personnel information system. Currently, the office of the civil service has been given the mandate of recruiting employees for the different ministries, but it is the responsibility of the ministries to keep their own records. After the first phase of implementing the system, it was found that the Design-Reality gap totaled to 42 (Ho, 2002). This was attributed to a variety of factors. In terms of information, the data was not accurate and incomplete. The setback called for some action to be taken in order to rectify the situation (Belanger, & Carter, 2008). The first step that I would have taken as the director of the office would have been to assess the ITPOSMO acronym because this is the only way to understand the difference or the gap.
In terms of the information perspective, I would make use of prototyping. This will be done through giving the users a chance to test the application then provide a feedback on what they really want. The gap in the processes can be solved by doing things as they were done before, which in this case in manual entry (Beckmann, 2009). Initially, clerks were given the duty of amending records except those that were considered as confidential. The gap in objectives and values can be solved by calling a meeting of all the top management in order to compel those who are withholding any information that is worth sharing to avail it in the meeting (Williams, 2008).
On staffing and skills, the best way to deal with the situation would be outsourcing of people with skills and have them operate the system (Design-Reality gap, 2013). Some staff that were taken for the training and did not take that seriously should be fired and other skilled workers employed.
Evaluation
The issue whether the project was a failure or a success can be determined after a period of about two years after the system is fully implemented. As it stands, the system cannot be referred to as a failure or a success. The overall rating of 42 is a warning that the system might fail if something appropriate is not done to reduce the gap (Kjær, 2004). In addition, if nothing is done then the project will be a partial failure. The system is only having trouble in certain areas but most of the vital parts are a success. The project was completed within the allocated budget and time frame and employees were taken for training in time.
Conclusion
The project was an all-inclusive one as all the major stakeholders participated to ensure that it become successful. Experts in various fields such as information system analysts guided the project. Even though the project did not perform well in terms of the Design-Reality gap, there is still time to work on certain issues that are contributing to the widening gap. Moving from manual to e-government is not an easy task. Many African countries are trying to switch to the new system in order to be able to offer better services to their citizens. Challenges might be present but with time, they will surely overcome them.
References
HYPERLINK “http://www.bibme.org/” o “Edit this item” Beckmann, F. v. (2009). Rules of law and laws of ruling on the governance of law. London: Ashgate Pub..
HYPERLINK “http://www.bibme.org/” o “Edit this item” Belanger, F., & Carter, L. (2008). Trust And Risk In E-government Adoption. The Journal of Strategic Information Systems, 17 (2), 165-176.
HYPERLINK “http://www.bibme.org/” o “Edit this item” Design-Reality gap . (n.d.). Design-Reality gap . Retrieved November 11, 2013, from http://www.catedras.fsoc.uba.ar/rusailh/Unidad%202/Silcock%202001,%20What%20is%20E-gov.pdf
HYPERLINK “http://www.bibme.org/” o “Edit this item” Kjær, A. M. (2004). Governance. London: Polity Press.
HYPERLINK “http://www.bibme.org/” o “Edit this item” Ho, A. T. (2002). Reinventing Local Governments And The E-Government Initiative. Public Administration Review, 62 (4), 434-444.
HYPERLINK “http://www.bibme.org/” o “Edit this item” Williams, C. (2008). Effective management (3rd ed.). New York: Thomson/South-Western
Governance Challenges at good Hands Healthcare
Governance Challenges at good Hands Healthcare
Introduction
Good Hands Healthcare is a nursing home business operating more than 400 facilities in three areas: nursing homes, assisted living and outpatient facility, and care units for people with Alzheimer’s disease. A number of issues could be the reason behind the reduction of the organization’s performance. One of the issues encountered by the Good Hands is the decrease in the federal funding of elderly care. The healthcare industry was relying mainly on the government reimbursement services. In addition, the organization encountered increased liability due to increased lawsuits filed by patients’ families due to poor elderly care. Lack of succession plan, mission, vision, goals and objectives is another issue. Despite the poor performance of Good hands, their competitors managed to increase their profitability and market share.
Situation analysis
The financial position of Good Hands has deteriorated in the last three years and has experienced a decline in sales and net income. The company was in a critical cash position. This could be attributed to the decrease in federal funding and to the composition of the payer mix. The occupancy rate in 1999 was 86% and in the past three years, Good Hands’ percentage from each source has been about 55% from Medicaid, and 23% from private and other payors. This is one of the weaknesses of the organization because 43% of revenue is from Medicare. Moreover, the 1995 National Nursing Home Survey suggested that elderly Americans were reducing their use of nursing home care, thus the need to attract more Medicare patients.
Increased liability due to lawsuits is another external factor that affected Good Hands. One of the strengths of Good Hands is that they considered themselves as an extension of patients’ families. The Good hands culture had long emphasized that employees should treat residents as they would treat their own families and that each of the organization’s facility was similar to the family community. Good hands started to redesign several facilities to reflect he newest trend in nursing homes. The problem, however, is in the quality of staffing. 30% to 34% of the staff at a given facility was certified and skilled nursing professionals, while the rest was staff paid below the minimum wage. In addition, 98% of Good Hands’ employees were female with an average of high school education for non-certified staff. Liability is expected to reduce when good quality services are provided to customers.
One of the internal factors that cause this poor performance is the lack of succession plan and the absence of internal effort to develop leadership for the future vision. The other factor is the CEO’s personality and attitude. He considered the company as an extension of himself, which created an issue with the top management team thus; they started to play a supportive role to the CEO’s vision. Most of the board directors are related to the CEO in one way or another and he tends to favour and defend them during aggressive discussions.
Alternatives and recommendation
The organization should set realistic objectives and determine their mission and vision.
It should also increase operation revenue by attracting more Medicare patients and private payors by providing better and attractive incentives.
It should decrease liability by recruiting more qualified staff and skilled nurses to provide quality services
Expenses can be cut down by decreasing the number of nursing home facilities and purchasing of consumables, pharmaceuticals in bulk so as to pay less.
The organization’s board of management should have high transparency and trust and no relations with the employees so as to avoid bias and favoritism.
Implementation and results
The organization should set realistic goals work toward achieving the organization’s long –term objective and vision.
The organization’s performance should also be monitored regularly in order to determine the effectiveness of the implemented initiatives. A good measurement of performance is the achievement of the predetermined goals (Chong, 2008).
The organization could also attract more Medicare residents by providing better incentives and providing them with long-term care, nutritional services, rehabilitation services, speech therapy, and social and recreational therapy.
The top management should also recruit a more qualified workforce so as to ensure implementation of the best clinical practices. The recruited staff should also be skilled especially qualified nurses so as to provide patients with quality services.
The management should also cut some expenses by focusing on cost –saving models like drugs and pharmaceuticals and hiring of more clinicians and nurses.
The management should also implement initiatives to improve the safety of patients in the organization and also increase the organization’s performance.
Governance and Long Term Care
Governance and Long Term Care
Author
Institution
Introduction
The term Long-term care may be used to describe varied services that are known to take care of both medical and non-medical needs of people who suffer from chronic diseases or disability, as well as those incapable of taking care of themselves for a long period. Governance and leadership incorporate both positive and negative effects and impacts on the long term care as they determine how long term care organizations are operated.
Long term care organizations are usually composed of various professionals, support staff among other employees. The most valuable competitive advantage of any long term care organization is, therefore, based on it leadership. Effective long term care leadership mainly requires that the leaders dedicate their resources and identify their organizations needs (Dana & Olson, 2007). Success in long-term care organizations requires leadership which has excellent management skills. Lack of these can result to a negative impact in the organizations.
Due to the various challenges that are facing the healthcare business in the world, it is essential that long term care organizations develop an effective leadership practices while at the same time ensuring that their management is improved. It has been observed that most long term organizations promote people to a leadership position because of their loyalty, and they are do not cause any problems to the organization(Dana& Olson,2007). This results to ineffective leadership in the organization due to lack of appropriate leadership and training. Due to this, the leadership and governance in the long term organization faces various challenges such as conflict resolutions in the organizations, lack of proper problem solving methodologies and poor communication skills.
Long term care demands have progressed over time. Traditionally, governance and leadership in long-term care organization emphasized more on the management process. However with the changing environment and increasing demands, most leaders in these organizations have given little or no significance to the leadership process (Dana& Olson 2007). This has subsequently impacted negatively on the sector and impaired the ability of organizations to meet the expectations of the people who need their services. Due to this, leadership in the long term care organization is unable to come up with visionary planning, which result in failure of the organizations.
The quality of leadership and governance in the long term care determines the quality of services that are offered by these organizations. It has been noted that most of the leaders in theses organization have the desire to deliver the best services but due to lack of support from other stakeholders, they usually end up not delivering the required results (Hayes, 2002). This subsequently results to such leaders losing their vision and, therefore, the organization may not be able to achieve it set objectives. This shows that, for governance and leadership in the long term care to be effective, there must also receive enough support from the rest of the people who are involved in the care.
The effectiveness of long term care service mainly depends on the quality of communication among the staff in search an organization. Communications, on the other hand, depend on how the staff in such organization relate with each other (Hayes, 2002). Good relationships among the staff is mainly enhanced or developed by the leadership of such an organization. Through this, the organizations that offer long term care are able to offer the expected services to those who need them. In addition, good communication ensures that everyone in the organization knows what is expected of them.
Good leadership and governance in long-term care determines the quality and the type of services offered in the organizations. This is usually achieved through involving the staff and all the employees in shared goals, enhanced knowledge as well as ensuring mutual respects among all the staff (Hayes, 2002). By the leadership ensuring that there is good working environment in the organization, it is possible for such an organization to achieve it objectives and goals. Poor leadership, on the other hand, results into lack of harmony in the organization and therefore, poor services are delivered.
Organizational culture plays a vital role in ensuring the satisfaction of all the stakeholders in long-term care sector. In the organization where their priority is quality services, client’s satisfaction is usually high (Rock & Schwartz, 2006). In such organization, the stakeholders are in constant consultation with the organization management in giving ideas of how the quality of their services can be improved. In organizations that are not quality services oriented, they are usually faced by many challenges and in most cases such organization ends up failing in total.
In conclusion, leadership in long-term care organization is the one of the most crucial aspects that determines the success of such an organization. Poor governance in such organization usually results to not only low quality services but also but also dissatisfaction among the stakeholders. Long term care organization requires leaders who have the capacity to plan for the future of the organization, and manage the daily operations of such organizations.
Reference List
Dana, B., Olson, D. (2007).Effective Leadership in Long term Care: The Need and the
Opportunity. American College of Health Care Adminstrators, 1(1), pp.4-25
Hayes, L. (2002). A Primary Care Leadership Program. Primary Health Care, 12(10), p.22
Rock, D., Schwartz, J. (2006). “The Neuroscience of Leadership.Strategy and Business,
1(1), pp.72-81.