A Process for Change

A Process for Change: Organizational Restructuring Karen Morken
Purdue University
November 13, 2018
Abstract
Healthcare reform has led to the restructuring and a work force reduction within Healthcare facilities. This is a very difficult and emotional process not only for the staff being affected by the RIF, but also the senior management implementing the change. Change is necessary for healthcare to survive and prosper, it is not always easy to accomplish. A Process for Change: Organizational Restructuring Organizational Restructure
Healthcare is in a time of change and development, not only in Medicine, but in the way, we do overall business. With these changes, a large long-term care facility is reorganizing to a new organizational structure. Currently a vertical hierarchy is being employed and will be changed to a horizontal structure.
Advantages and Disadvantages
The current vertical structure is gives distinguished lines of authority and tight control. For this to be successful the company needs a clear, defined, strong leader. In this organizational structure emphasis is placed on the individual and their ability to move up the hierarchy. Vertical structure is very organized and precise but can also take a long time for decisions to be made as they go through the chain of command.
This long-term care facility has chosen to change structure to the horizontal organization. This structure differs from a vertical structure in that there are fewer structural layers (Joseph, 2018). The structure emphasizes an employee-centered approach with focus on teamwork and collaboration (Hawthorne, n.d.). According to Hawthorne(n.d.) the horizontal organizational structure and the employee-centered approach to leadership focus on the ability of employees to come up with innovative solutions, and the focus is on the collective goals of the company. Where the vertical approach focused on the individual job, the horizontal focuses on the processes and procedures that directly affect products or services provided. Horizontal organizational structure emphasis the group, when a group works well together, everyone benefits (Hawthorne, n.d.). The group works together toward achieving the goal rather than an individual power struggle. With this approach economic incentives can be tied to performance (Hawthorne, n.d.).
Vertical and Horizontal Organizational Structure.

Resistance to Change
Change is one of the most difficult words in the English language to define and accept. In America today, we are creatures of habit and deviating from our perceived norms can be very challenging, especially in the work place. This is a very stressful time, for all involved, from senior-management to staff. How this change is communicated, including all layoffs and reduction in work force is paramount to the success of the restructure. Failure to effectively address the fear, anxiety, anger, blame and uncertainty that an organization has following a RIF will often result in diminished organizational performance for an extended period of time (Pemberton & Davidhizar, 1998). The most important component to combat resistance is to be open and honest during and after the RIF. A decrease in job security can lead to an angry and hostile work force. Pemberton & Davidhizar (1998) advocate promoting communication between the administrator/management and the employees to reduce the fear of job loss, decrease rumors, and raise morale. This can also increase productivity, promote perceived managerial support and promote stability in the workplace (Pemberton & Davidhizar, 1998). This can be completed in an open forum discussion with the administrator and employees. The administrator must have credibility, review the organizational climate, strategically select the time for the forum, have accurate information, anticipate questions and brief middle management before the forum (Pemberton & Davidhizar, 1998). The timing of the forum is critical to its success, 2-3 days after the notification of job loss is a good time to hold the discussion. The administrator needs to acknowledge the contributions of those let go and share the measures taken to assist them in preparing for or finding appropriate employment (Pemberton & Davidhizar, 1998).
What to present.
Accurate information
Anticipate questions and emotions
Recognize that this is a trauma
Present strategic factual information
Empower the employees feeling of control
Diffuse hostility and tendency to blame (Pemberton & Davidhizar, 1998).
Healthcare organizations that considered their employees in the process, providing long periods of notification, and allowing employee input, were able to decrease the negative outcomes such as dissatisfaction (Davis, et al, 2003). Being open and honest with your employees from the start of the restructure to the RIF and following will help alleviate any animosity and fear the employee may have towards the company.
Hard Decisions
Restructuring leading to a reduction in work force is very difficult. The process should seek to maintain a healthy staff and protect against low morale. (Davis, et al, 2003, Cascio 1995, Collins and Noble, 1992). The goal in the RIF should be both to legally discharge staff whose performance do not meet standards and to eliminate departments that do not contribute to the core business (Davis, et al, 2003). In the current restructuring from vertical to horizontal, this would entail the combining of departments and the loss of middle managers positions. Cutting employees who are low performers decreases the likelihood of employee morale declining (Davis, et al, 2003). Selective cutting also includes making the process inclusive by asking for staff input. Involving the staff gives the feeling of openness and the ability to apply for if required new positions within the organization.
Reduction in Work Force Plan
Due to the reorganization of the facility a reduction in work force is necessary. The move from vertical to horizontal will eliminate mid-level management jobs and combine departments. The initial plan will include:
Communicate widely and prolifically the vision, long-term strategies, competitive climate, and customer needs.
Communicate the values and culture desired and demonstrate them through your actions.

Openly discuss the benefits and difficulties involved process with staff.
Determine the information needed, who possesses the information and how it will be used.
Establish teams to analyze the data and incorporate staff during the process.
Establish expectations for ongoing communications and communicate the philosophy for staffing the organization (Beakey, et al. 2007).
A work force analysis will be completed to assess the needs of the organization. Initially this will be done by senior management and then will include staff. Including middle management and staff in the process gives senior management the ability to assess the persons desire, commitment and willingness to change and learn a new role. Departments can be combine with a reduction in staff, combining duplicate or similar jobs. Seniority is not always a predetermined factor in staffing new positions. If the employee with seniority is not performing at the level of another employee, the higher performing employee will retain employment. Stress with a reduction in work force is evident through all areas of the organization. Open communication with the staff and keeping them informed of the status of the plan and its implementation dates helps to decreased feelings of betrayal.
Employee notification will not be done at the long-term care facility while the employee is working. I feel this is demeaning to the employee receiving the “pink slip” and increases the feelings of self-worth that are already present. Mailing notices is not always the most proficient way to notify. In the age of instant communication mail is disregarded for the email. Emailing employees notification during non-business hours would guarantee reception. Sending with a read receipt required would give management a way to track who has been notified. This seems very impersonal to me, but in the day and age of technology, the most efficient. This email would also include all the contact information for counseling, career services, job placement and an employee hotline. Aiding employees shows compassion from management not only to the those displaced, but the entire workforce. With the heaviest cuts coming in middle management the assistance programs become vital to the success of the displaced employee and the organizations morale and productivity.
Conclusion
Restructuring a long-term care facility corporate headquarters is a very difficult process. Much research and time is needed to manifest these changes. To be successful the entire organization is involved through the communication process and varied input. In this process, as an administrator, you cannot make everyone happy. In a service industry that is very difficult as we want to please and heal people. For an organization to be able to care for people effectively management must be able to instill changes even though they are difficult and not pleasant. If the organization does not thrive, there will be many more employees without a job.
References
Cascio, W. (1993). Downsizing: What Do We Know? What have we learned? Academy of Management Executives, 7 (1), 95-104.
Collins, A. L., Noble, R. (1992). Hospital Rightsizing: In Line with Long Term Strategies and Economic Realities, Healthcare Management Forum, 5 (1), 4-10.
Beakey, D., Webster, K., Rubin, J. (2007). Organizational Design and Implementation,
Graziado Business Review, 10(4), 1-17. Retrieved from https://gbr.pepperdine.edu/2010/08/organizational-design-and-implementation/
Davis, J. A., Savage, G., Stewart, R. T., & Chapman, R. C. (2003). Organizational downsizing: A review of literature for planning and research / practitioner application. Journal of Healthcare Management, 48(3), 181-99; discussion 200-1. Retrieved from https://libauth.purdueglobal.edu/login?url=https://search-proquest-com.libauth.purdueglobal.edu/docview/206726865?accountid=34544Hawthorne, M. (n.d.). The Advantages of Horizontal Organizational Structure. Small Business-Chron.com. Retrieved from http:/smallbusiness.chron.com/advantages -horizontal-organizational-structure-30904.html
Huebsch, Russell. (n.d.). The Vertical Structure Vs. the Horizontal Structure in an Organization. Small Business – Chron.com. Retrieved from http://smallbusiness.chron.com/vertical-structure-vs-horizontal-structure-organization-4904.html
Murphy, M., & Murphy, E. C. (1996). Cutting healthcare costs through work force reductions. Healthcare Financial Management, 50(7), 64. Retrieved from https://libauth.purdueglobal.edu/login?url=https://search-proquest-com.libauth.purdueglobal.edu/docview/196373048?accountid=34544
Pemberton, J. H., & Davidhizar, R. (1998). Facing the staff after a reduction in work force. Hospital Materiel Management Quarterly, 20(1), 13-22. Retrieved from https://libauth.purdueglobal.edu/login?url=https://search-proquest-com.libauth.purdueglobal.edu/docview/234417098?accountid=34544
Rondeau, K. V., Wagar, T. H., & Howell, R. E. (2002). Managing the workforce reduction: Hospital CEO perceptions of organizational dysfunction. Journal of Healthcare Management, 47(3), 161-76; discussion 176-8. Retrieved from https://libauth.purdueglobal.edu/login?url=https://search-proquest-com.libauth.purdueglobal.edu/docview/206725738?accountid=34544
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