UNIVERSITY OF TORONTO FACULTY OF APPLIED SCIENCE AND ENGINEERING FINAL EXAMINATION, 27 th April 2017 DURATION: 2 and %hrs Fourth Year - Industrial Engineering MIiE459 - Organizational Design Exam Type - A Examiner - Stephen C Armstrong Room HA 403; 2PM - 4:30PM Student Name Student Number Please Note: The exam consists of three (3) sections. Write ALL answers inside this question paper. i.e. Do NOT use a separate answer booklet. The first section requires you to answer 12 multiple-choice questions. Circle one (1) answer directly on this paper. The second section consists of questions that tests knowledge from each module (7-13). There is one question from each module (modules 7 to 13). You are to answer five (5) questions. If more than 5 questions are answered, we will only mark the first 5 answers and ignore the rest. The third section is a case study. Please answer the three (3) case study questions. Please write in PEN and use BULLET POINTS. Very important to write legibly! Section # Actual Marks Maximum Marks 1 24 2 40 3 36 Total _______ 100
Transcript
UNIVERSITY OF TORONTO
FACULTY OF APPLIED SCIENCE AND ENGINEERING
FINAL EXAMINATION, 27 th April 2017
DURATION: 2 and %hrs
Fourth Year - Industrial Engineering
MIiE459 - Organizational Design
Exam Type - A
Examiner - Stephen C Armstrong
Room HA 403; 2PM - 4:30PM
Student Name
Student Number
Please Note: The exam consists of three (3) sections. Write ALL answers inside this question paper. i.e. Do NOT use a separate answer booklet.
The first section requires you to answer 12 multiple-choice questions. Circle one (1) answer directly on this paper. The second section consists of questions that tests knowledge from each module (7-13). There is one question from each module (modules 7 to 13). You are to answer five (5) questions. If more than 5 questions are answered, we will only mark the first 5 answers and ignore the rest. The third section is a case study. Please answer the three (3) case study questions. Please write in PEN and use BULLET POINTS. Very important to write legibly!
Section #
Actual Marks
Maximum Marks
1 24 2 40 3 36
Total _______
100
Section I - Multiple Choice Questions - Worth 24%
(i.e. 2 points I question). Circle one (1) answer directly on this paper.
MOD 7—MANUFACTURING AND SERVICE TECHNOLOGIES
1. Which kind of production represents mechanization and standardization one step beyond those in an assembly line?
continuous process large-batch
technical complexity small-batch
2. What is the purpose of the socio-technical systems approach? --
to apply the theory of job enlargement to provide qualified management to an organization in a turbulent environment to offer the most advanced information technology possible to maximize organizational competitiveness to combine human needs with technical efficiency in job design
MOD 8—INFORMATION TECHNOLOGY AND CONTROL
3. What term is used for the process of continually measuring products, services, and practices against those of tough competitors or other organizations recognized as industry leaders?
the balanced scorecard benchmarking
C . Six Sigma d. enterprise resource planning
4. Which of the following is the term for the efforts to systematically find, organize, and make available a company's intellectual capital and to foster a culture of continuous learning and knowledge sharing so that organizational activities build on what is already known?
enterprise resource planning Six Sigma
knowledge management
benchmarking
2
MOD 9—ORGANIZATION SIZE, LIFE CYCLE, AND DECLINE
5. What is the major goal of an organization during the entrepreneurial stage of the life cycle?
6. At which stage in the life cycle of a newly established hierarchy do departments emerge and
get established, along with the beginnings of division of labour? entrepreneurial formalization
collectivity elaboration
MOD 10—ORGANIZATIONAL CULTURE AND ETHICAL VALUES
7. Why is it that organizations do NOT typically come face-to-face with the power of culture until they try to implement new strategies that go against basic cultural norms and values?
Culture is usually written and when a change is attempted written cultural policies create obstacles to change. Culture provides members with a sense of self and members rely on this sense and therefore resistant to change. Culture generates commitment to improving market share and a change that alters culture leads to reduced revenues. Culture generally goes unnoticed until a change is made and the power becomes noticeable.
MOD 11—INNOVATION AND CHANGE
8. Which of the following is best example of radical change? organizational turnarounds and business transformations
any series of continual progressive changes affecting one organizational part, and ti
another implementation of sales teams in the marketing department
bringing new technology to product development
9. Once decision makers choose to go ahead with a proposed idea, which of the following elements
needed for a successful change occurs? need recognition adoption implementation 1
resource acquisition
MOD 12—DECISION-MAKING PROCESSES
10. What are the first four steps of the rational approach to decision making specifically designed to help a manager do?
follow the scientific method devise a problem solution
evaluate alternative solutions identify the problem
11. What is the last step in the rational approach to decision making? defining the decision problem evaluating alternatives implementing the chosen alternative diagnosing the problem
MOD 13—CONFLICT, POWER, AND POLITICS
12. Which of the following is probably the greatest cause of intergroup conflict in organizations?
goal incompatibility
differentiation
task interdependence
limited resources
Remember to CIRCLE your answers DIRECTLY inside this paper.
Do NOT use a separate booklet.
Section 2 - Essay Type Questions By Module (use bullet points). Please answer FIVE (5) of the 7 questions - Worth 40% (i.e. 8 points / question). Write answer directly on this paper.
REMINDER: Only answer five (5) questions.
If more than 5 questions are answered,
we will only mark the first 5 answers and ignore the rest.
Question #
Actual Marks
1
2
3
4
5
6
7
Total
REMINDER: Only answer five (5) questions.
If more than 5 questions are answered,
we will only mark the first 5 answers and ignore the rest.
5
REMINDER: Only answer five (5) questions. If more than 5 questions are answered,
we will only mark the first 5 answers and ignore the rest. USE BULLET POINTS!
1) Mod 7 - How do flexible manufacturing systems and lean manufacturing differ from other manufacturing technologies? Why are these new approaches needed in today's environment?
Provide a practical example of the application of group technology to support the FMS / Lean philosophies.
REMINDER: Only answer five (5) questions. If more than 5 questions are answered,
we will only mark the first 5 answers and ignore the rest. USE BULLET POINTS!
2) Mod 8 - Information technology enables management planning decision-making and control,
and supports lean process management, flexible manufacturing and collaborative teamwork.
Key IT systems include Enterprise Resource Planning (ERP), Knowledge Management, data
management between CAD / CAM / ERP / MRPH, Web 2.0 tools and intranets. Please discuss
the application of two of these technologies from an IT perspective providing examples to
7
REMINDER: Only answer five (5) questions. If more than 5 questions are answered,
we will only mark the first 5 answers and ignore the rest. USE BULLET POINTS!
3) Mod 9 - Apply the concept of life cycle to an organization with which you are familiar, such as a university or a local business. You can refer to Grieners model. What stage is the organization in now? How did the organization handle or pass through its life cycle crises? Please discuss the characteristics of each of these phases, and use examples to illustrate your understanding.
Ls
REMINDER: Only answer five (5) questions. If more than 5 questions are answered,
we will only mark the first 5 answers and ignore the rest. USE BULLET POINTS!
4) Mod 10 (answer both A and B)
A. What importance would you attribute to leadership statements and actions for influencing
ethical values and decision making in an organization?
B. Codes of ethics have been criticized for transferring responsibility for ethical behaviour from
the organization to the individual employee. Do you agree? Do you think a code of ethics is
valuable for an organization?
REMINDER: Only answer five (5) questions. If more than 5 Questions are answered,
we will only mark the first 5 answers and ignore the rest. USE BULLET POINTS!
5) Mod 11 - Describe the main phases of an innovation management process (innovation funnel) and discuss how the management of radical change differs from the management of
incremental change?
10
REMINDER: Only answer five (5) questions. If more than 5 questions are answered,
we will only mark the first 5 answers and ignore the rest. USE BULLET POINTS!
6) Mod 12- Describe the 6 major steps of problem solving. Do you think intuition is a valid way
to make important business decisions? Why or why not? Can you think of a time when you used
intuition to make a decision? Use an example to describe the 6 step decision-making /
negotiation process of problem solving.
I,'
REMINDER: Only answer five (5) questions. If more than 5 questions are answered,
we will only mark the first 5 answers and ignore the rest. USE BULLET POINTS!
7) Mod 13 —Describe the role of socio-political management during a business transformation initiative. Include the difference between power and authority? Is it possible for a person to have formal authority but no real power? Include a description of your understanding of the shadow
organization versus the economic organization. Provide examples to illustrate your understanding.
12
Section 3 — Integrative Case Study
- Worth 36%
Case Study: The hospital for Sick Children (SickKids)
Please answer ALL THREE (3) at the end of this case.
(i.e. 12 points I question). Write answer directly on this paper.
The Hospital for Sick Children cKr-ias')'
Th 1,;rital for Sick Chtldren. commonly and a Icc-
uotaately dot-a-ri as Srckads, is located in hospital rosy
in IcarOLItCL SLk Kida, is ,i avorld-rcnowrred macLrtiir, and
rccarch hoeptial and is one of -Toronto's hcst-knuss'iiand'
naurh-iovc,] knJuaiks,
rtaar /ar-.s-ra'."c an-a Iii ri
a nan- ,,I?fj inn Liii Hp-/-auras-:i P 'sos CI tiSan-Z, nit 6r'e. 5a.,nr
t.)aa rra.-C)rrntr centre Mairnast NtSlrjrp ta,ari'n Cl SIC i -OtIS i
cairO ,ah seppoi
at SickKitls, aisit hetpa'ctvsv.eickkids.eir/inl,o LIT iTSC:
scctron.zispaa=Htstor---andi NElittici&plD=1 I
ltIikstnnes&sslD=455;.
Stratyt'
S ickK;d h_a a ii dieS r and e ompti Pine vision— Hcjhbi f'
chridrn. A Oaitna'r anror!J °' SnckKrds it ptnded by Sac err:-
topic darecrauns: 111 to lead rirarionnrlir and notrirnaironiafia
12110 enhance system caperlailidee liv piiiircrrig san-h tirhir
orpera :narion,, NO tit., child ten base eq ufttiIrle across an
health care: (di to integrate further its carla-ned-s ci care,
thing ten-nt ripia! end imnie-diatclv transferred fret iii
bickKldi, for fin—rim exantroarnon.
In thai Ernrrgeocs Department, doctors re-ran all the
blood CoSts 10 coinfifm tire dtanosis ol Ireadriania. Caituini
as-as adru tied to the I-lematology!Cuiieolcrgy inpatient un-i.
where she had to endure even more tC5t'n. Doe-c-irs ds.
covrd that nsciry of her orcrnn.s were enlarced front the
dice-ace, and started her on circmnirhrrepv immediately .
Citlin was imsiucily at htokKnis for over seven
Aitliotirdi she responded at-eli to rreatment, she had her tip-
and downs. \\'hcn she first started chemcrchi'rapy, ;hcre sacte
rein-rOut complications, inaciudiiag seva'niil bout, of hove-
rnuianrmarron. Since many of the chenionhenapy •Jnigs sids
stIrs taking an-ri result in pimeuaoatoans_ I-na-n trcan,rienl had to'
- In 1R73, Elizabe th Mc-iasir.r !ei a stoop of
deit-. moed toe riH ç'roil.nent Wi 'men o tound
ilrc ito ,itrl. The Lid,_,., Co dire car, the
- hotprr I I tnt 1 vents. tdc\iistitr sass cci I x Is
na ols -d in the on aria rime itt o f The iso-rcri a it
-- - 1391. nor. atr'd hr a 5p1rr1ir..l comrnrui,rrr Lu
FIR -' ccreii'l act un, she hccamc a trained iner-.e ai.d
nisad is lads sin-cr I nc'td_nt) \Vh-'ni the hos-
ptia, 51.irlc(i to cp,riinJ, ta cot crn.inr_e Is n5 Lr3r
tcntcd to a hr-aid Cif trunrc'e.,, era c'rantzacrnrnal d-sirzn char
Os iii' ciii -5 :oc cv. it, in- c' SC CKid las ci d inally accoin-
call-in-is ni-c I to 1938 the hnsprr.l in-La led the hr,i m,IL
p a-ct ni -i raca p -ant Ii Canada, 30 cars bantenne at an-c lei,olla-
rn.-d,d. 2 t it niorics- r d i-eniowieei trigczil d,n elriprartirtc
such as the Sa(tcr cyrrauon to n-pan the disiiaca:ton of a
h- and dic Mn-tied operation to correct an o1ien-.-I
bran defect- 113j in tine lOdOs, it opened one of the Prat
iflic-ic Sri CitC an-re in North America dcvritcd ,ito,1t15it.ril\
in the of crc iclls iii nets born and pin-nature bad-tit,;
rd 'h ita, reacrrehcrs ,Llercr"itncd ilic; ii unntirrs- is an joel-
four -nc tin-rat-s for the i,ro:nc,n echrdlhyroct ailnlciic croup
S kKids ha-, :1st-. piloted the use of PLliBLL$ Pro-
P. ldtiiititt id-i P,rmging Lc ti-log Lnvra.ait'ncnra m
Staid-ott). Pi_riltl Era dIn-p stud--rita to risintain a urn-cc
rt.Jii to fir I tn-ann let d ccc noca I environment I ri-ira an Is0-
I:IICJ end ,' tusuad SaL: ins. push as a h.tpit.iL PEIfBLES a
on' iiiadnrs,rin r- In the Le'itre for Li,irniritt I echraoiogrt-s
,it Ri inn fin is emit-, tOri Adaptive Ta,Jiiioiosti R -r nttr C
c C art ci at ;lie Car cran ,; I oi onto, and Teicboncs.3
Ia; 206, hickKids launched the brckKtds Cciii rang
institute as hose purpose is to trihatice train-rip and Cliii
citron 1a LoordtC300p, .rti,,- rtec across professions and
specialties. acording to Di. Susan Tall ett, director of rot
neonate, dat ir.aki op S(cklsrds' exper tise more accea
saitic - 'va' will bin 1sf locii l. cii icari.r I, and i nrernar ni rn-il ncr
corks of eduauvris and learners that cars as rink irapether
on key din 4 5i c r'suca.' (To t'e maria mort flitltatOtics
13
he deavcd until she recovered. She was so ill at one point thri i Li-Ic C: irkd Care I rain at 516,}<idr was on standby in
cast sltt bud to he rransterrcd to the Critical Cart Unit.
She recei ved chrmotherapv is nn aurpaticrir at LCf
Inca hospital, which was set up as one of dit satellite
oncology centres. I here, pediatricians and tunics trained
at Si-ckKkLs admnktercd chrncrherapv and took care of cyrirruil lines. Though ihe vs as treated at a satellite local ho;piral, she still cams to SickKidsevsry Il weeks for
checkups, blood tests, and lumbar punctures.
Caitlsn recently celchrared a big milestone—she finishcd her chr-inoiherap rrcalmcnr for the leukemia sIn-s fought for wnsnd-ui-haif vrars.
Eeriaorcv Dçortnent herr:9a:o6rr In 2002, iipprns:marclv Sb 111CMIXT5 of the Emergency Department team participated in a luitilitated strategic retreat.
Luth E-faj-Asszad, the director of the department. asked par-ucipairs to work err rae )oulirwi:isi three ass:gnnicnts: 1 i what ss-e v, ant the Esncrucnsv Dcp.rimcin to bc—for prt1rnr5, the departiuirri ii. crud uursclsr.s. Crctrurri& a Vision for rite Enter-gcncv Drp.smncnr (2) how we aced to hirwnon to make rime vision Irulpori: Tire ououi sri na with ius and (s how ss t will irnprrrve Emergency Departnsenr decisinri rirakirig: 1lw pro-
posed deparrtncntal structure At the retreat, Haj-Assaud ciescrilwd ii possible structure, a shared gosernarice model. Panicipanrs vets divided into cx working groups for the dat. Following each tvcrgnnirnt. cscb working group presented il,c results of their work to the Dines group. The detailed trio let are presented at Exhibit I ott pgc 5)7.
Furi-snieven participants ealuajed the retreat and lmrrv-rhree gave a pns:rive scssssrneir of the experience. See Table I for their responses.
The retreat resulted in lit e unmediare action steps: fl) circulating the facilitator's notes to all stall and
physicians of the department, (2 riviting staff feedback and qursusins regarding tire Utah stun sjned during the strategic retreat and prapo;cd organr7urnonsi) ;truUture
wrihin esso sarcics; (3) asking [Irergency Department ca11 to sign up to participate in vine of dic decision-making councils, (4) assigning Hai-Assaad to chair the first
meertac of cacti decision-making council to help fault-rate the dereiopmenr of council ground rules and terms of relerences, and to help select a c'harperson: and (S) schedaling the Governance Council-, first meeting in April 2002.
The liari-d goserrianec mock) spints dcci sion making lOtu SIX enuiscilcu policy and prtic
rice, cducation, research, human rc.sourcc and scheditrig. stirlal, aid qualirs and ethics. Tire
G•
Council i -
oscroance tinner) s cia-urged strili straicglc planning, poal sctmir:g. and performancc mcmi-luring. his the formal link bers'een the six coun- ci Is and ucals ,-i ih any its icc that are not ith ru 5t --- -
the councils' purview. isre Fgure I - -
The Policy and Practice Cuuncil has ihcc mandates: fI in review, promote and esahtiars profrv-siorrab tied clinical pr-ictiu.ei )2) 10 develop, review and appruse policies and procedures wiThin the department and 3) to foster continuous patient Care rflprovctfle'it.
Ihe Educanon Conner) has tour mandates. I l Li, J,rin irk a forum for cducarion that enhances professional pracri C,
(2) to mdent'f sra't learning cdc, 3lto dc clog plans to meet s:ar educational needs, and (4) to dcvclnp in equi-table aystem to reimburse stair cducanonal cxpcncca. The 1-IR and Scheduling Council's mandate spans the range of human resource activities from work assignment -o
employee selection to skills tissessorL-ni in developing ruks
for schdale charges. The Ethics and Qua in Management Council has four niandtites: i 1) no pun ide .s forum tar
Retreat Evaluation Data
Cu oil J(W,c LSt Utsiji: tind bwtn'iTnrrnuon
Ti-emoind nu:id5c1p11r13r1 parlicipsiliun, 23%
Vscrkec lide a taarnivvorksd ,i learn;, 16%
Sotionirroilive ocurod, 7%
Go o Know/r000t merribet-5 of ream, 13516 Fc'elirei tteres hope. 6%
Feeling LbereS leadethip, 9%
Lunch, 6%
Shared governance model, 4%
We have a common ;ulSrOr5 2%
Struciure ol the day/vie v,ere on time, 2%
- -- -- -
S - • t'ti I i' 'U.: I,. i -'-- nii 0........ - . - -' • .3'c- - t .ti' — ,-
dccc concrete iiJlLtI0ni/dilrCliUe 2:1%
Mote inrormaTion about SliotCh governance 17%
More planning of commuttoes and snared governance, 130%
More of the Emergency Department doctors present. 49,0 Agenda in advance, 4%
Talk about conflict resolution re: staff who won't play ball,' 4%
More staff participation, 2%
Discussion geared to medical stakeholders, 2%
More siaff, present, 2%
14
E met g en c Deprtmeni Structurp,
October 2007 Policy and
Practice
üijalitysind: Ethics
Education
Secial
Governance
HR and
Scheduling
Research
IsaisMon of etfucal situations, 2f to romLiur risk and
qualiry management Issues. i3 to dvelop:iudir tonic and
to contlue: audits. and 4) to rco imend change, as nec
,caiv. Tlir Social Urn nc:I5 ma ndwe to deidop tactics to
WA morale and to plan acris tICS based On sratT inecrest,
l.astiv, h' Ifesoniab Council is responAk for approving
ant' studira conducted in thc dcparrmcnt and crieuriiig
An all rrsesrh fellows aprcipriste ethics proioculs.
[Ji council In .1 chair ---- be!slic works on the from
line in the dpai rincot. In late 2007. three were chatced b
hysiciaii, tsvo nv nurses. and one lava volunteer and an
employee ol ihe Child We Specialist. Ha-Assaad chairs
dw Occrnaiacr Council. All the cou nc ils are open to all
A Emei'cricv Detmrrnlenr stall. l-losvcvcr, univ the per
maneni isieiithei:s ol a parrtcuiai council cat: tore on Inc
council's dreisions. Membership on a council is ntis 00 by
being an active participant in the councils work. Councils
rnke naov difficult arid sometimes contentious deciiniric
In the five years of the shared governance model es:peri-
cnce-, 1-Ic.Ascaad hat not had to veto any votilisil decisions,
IN shatcd governance modal was a radical dpar_
tare from the previous daparintenral strUcture. As ivrll, A
A a structure that is OOr used un other hosaitals' emergency
rooms in the may it is inipleniented at SickKldc. The struc-
ture is guided by direr cure princftes—the structure must be
i n rhi' hr'st titc'i esis cal the OSOetSIS, thu-ri the depa rtnicnt
as a whole, and, hisri'', the dilfersuit disciplines. The structun
allows for decisions to be made as cloc as possible to point
of service and, as a insult, is empower:i:g. it also req tiets
:iccouirtahlir and thcre' rio place fur non-psimucipation
nun -ownership of die process.`
5
riff nugege'oreoi 10 the upciratin;i elf the Jepariclten!
e'xZrc'rne/' poi't'1641 acid cmpurtani In the success of un
:'ork. The iuh'grity and si;tceru of ibe Jeparr we) it 's
rrsiip in aicp/iortiri lilt' /,ta,cd gol'eriiacice atrottutc
paramount. Tl;e undc'rstwding of the staff nrcnrhcrs t, -
u/sal the strlaal,re is and/or is not rnaiae inipftrnnriiiic
md lh-iug :r much easier. The ith.Cgic was cnea;15
iiiciccasc' the Jcparrl:cirt cffrctnensss and pror'ide a ecu:
test jinr partnership, equity, acowovMity, acid owner-
sLip. On flairs occasio',s, the staff iwudcd to he renz:,zh':
I/.0 r/::s desigo is not deanrte.ra!zrthased as riurch as ;i a
acortnta!sitil-Iiascd, NO, i/ftC new staff is hired, rI:c
structure o e_vplairred to dicril web the expectation that
ever c'rir[t/OrCc of she dcpartanrnr p/ass 3 ole ill
nra/s/nC s'niirr thrui.gh councils' representation or decisits':
rcctp/cu 'IC trial air.
Often i/se staff jilt // go to the iirsJni7Ci5 UOt/) ItO 5511:
and it's aiva.s ielupiiLg to mike a slCcLSIisri and sol
15
the problem, (-lotvever, the manager has to be conscious u and must aired !be CPflpiOVCC to ta/Cd
bzsfncr issue eviti, petcertutl hf trwis to the appru,nwre cc_t 'ccii.
JJai'iesc uscd this dcstn fur ,evcr (t'c 'rears, 1 cant
:Inagillc the J- ,,ie, seizc'r T),parinrcerr stiff accct:'i,,' any. aitrnat0 'a dccts er-nothing structure.
1. J. "i'c,urii. 'A Poetic Mission: klirnberh McN1.tsicr iid the 11cspnal for Si ck Ch i ldren. I 975-92. CBMJ-f/
The Hospital for Sick Ch,ldrcn 2006-07 Annual Report. 15. ibid.
'Vekornc to Emcrgcncy (Sepeecnbrr 7 2007) it
hrrp://www.sickk id s.ca/Farn ilyIn formation/section. asp?srFsnemerlcy&s1D=7385&cs=Wc1cseme4 tot hem rgcucv&ssll)=73'i9 (accessed Jtily 12. 200.
Each team will present its findings to tire large group
17
Detailed Findings from Retreat (Continued)
Results
The six qroups presented the iSSUeS they identified To the larger group. along with some of their solutions.
There was a high degree of overlap between the issues identified by gioups, and a
nigh degree of consensus amerco participants that those issues are important. the key issues are listed below:
Patient flow
Physical resource alincetlir:in and use
- Stall tesuurce ailotetion and use (rnciud:rig skit m ix versus reed) Commurircariori berween seam memners and teems
- Qual i ty assurance end measurement - Protocols, qudelines, and standards being rnfollowcrd - Mutual rospecJnioaIeThow we treat each other - Educaton, orientation, and mentonng In the discussion following the piresentation of the Emergency Department internal issues, thiec istues suhced: - rs was noted that the tension and pressure inherent in an Emergency
Depadment often resu)t i n people treating each other in ways They otherwise wouldn1. Under soess. respect, courtesy, and dignity are often compromised
- There is a high deoroc of frusvation :nside the Errietqency Degartment that was ljllirt dils stress; russranon a: the lack of Droaress and (,range, and a feetrig of powerlessness to effect change.
- While the morning exercises were valuable, the group imd created a vision and identified a similar Ift ot issue: confronting the Division tour years ago. Nothing had changed in the interim
Inc ensuing dici:ussion focused on accountability, summarized by the following questions
1. is each of us accountable for how ss'e treat others—icr what we say and how ne behacen What are we saving about ourselves vxlirn we say the stress arid tension of the Emergency Department make us behave in wa's were nut accauriiaole for? Are ice or are we not accountable for our own actions?
2 Nothing ins changd in tour years snce these issues were First identified—wire is uc•:ountabe or dbsving shrs to cOntinue? W10 are we now holdrng accoumable for making the necessary changes 'a'e've discussed rooay? Who Will we point the finger at if thu chances don't hapoan over the next four years:
or someone elset
5 Does oath of us 1el oersona/iy accountable for moving Inc Ennvrgrency Department toward the vision?
C. How we'll improve Emergency Department decision making: The proposed departmental structure.
Background
ThCR is irustranon wltmnn the Emergency Department at the lec of postive mea ningful change and decision making .
People feel psyNeriess to effect change.
We each need to be more accountable for moving the Emergency Depamnient in
the direction of the vision.
Detailed FnUin gs
from Ret rea
-
w as introduced as a meant Or putting decision meting coo
(Continued) accountcsilty in the hands of the Emergency Gap tmem ivarri.
Six decision-making groups were described: education, research, human resources
and scheduling, social qualrty and ethics, and policy and practice. The tvenTh
group, the Governance Council, was introduced as The link between the six groups
as wail as providing direction and counsel
- Group decsron-ma king processes need to be decided nd worked out by the learn.
Group composaron, membership, and rules of conduct need to be estabfrhd.
'sJlien asked for comments or questions, there was mostly silence from participants-
A. couple of people in the ieam remarked that the concept sounded positive.
- Mostly people seemed eaher shocked by the idea or puied as to whaS it really
meant cr10 how ri would 3ffecT them and the Erneigency Department .
The Assignment
The Cnalançy' Ag&n form six groups Each vJll be assigned to 0110 Or the six
cojnci's Pick ore of he high-p,iormt issues frjrri the kt that you nini is mo't
clOel) r&dted to your cojcil man Decide I ha ci d ajout th is sl _Ie'inn
(2) the best process for deciding what to do about it.
Results
Tie sr groups wrestled viih rherr issues. Sorrie had healc±o cr'.cr ssnns.
- Tho groups presenrec ther indnq ru the entire group.
Some presoritwJ lis-ts of ideas and poteniral solutions, but little in he way of
decisions
- Diners presented decisions, arid processes for making future decrsions.
- In this exercse, participants experienced a litUe of v'itot shared Qovernacce is
about.
- Participants were asked, in the coritexl of shared gDvernance, what they wanted
from trirsir leadership. Here's what they said:
Trust our decisions.
Sunpoct our decisions and, when you can't, give us direction
Be visible fl ihe depertrrienl.
4 Tete an interest in whrn we're doing and what we're cenitonlng.
5. Be 'esporrsive with feedback: it is can't be none, tell us why not, and it it
can, tell us Mien.
it. Keep us tin track and focused on she vision in shored governance groups.
Help us deal with conflict and group impasse in our shared governance
decision making.
Give us more information about shared qoverrtaoco leg., how it works,
history, phiotophy, principles, and examples)
19
USE BULLET POINTS! Please answer the following Questions:
1) Describe the key issues facing sick kids and what approach they took to address these issues.
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