Seniors Struggling in Need of Care
Eight in the morning, she had an appointment with the chiropractor, nine-thirty she had to visit her dentist and at eleven she was meeting her family doctor. At the age of 90, Stacy with her rollator had to struggle from one place to another.
The biggest challenge for older adults with chronic conditions is transitioning from hospital to home (Valaitis and Markle-Reid, 2018) or even vice versa. Long waits in the hospitals and frequent follow-ups only increase their inconvenience. 18.3% of people in British Columbia and Quebec together belongs to the age group of 65 and older (para 4). With increasing life expectancy in Canada, the percentage of 65 and older age group will only continue to rise (The State of Seniors Health Care in Canada, 2016) and present Homecare services are inadequate to tackle this increasing number (Valaitis and Markle-Reid, 2018).
Kamal, a psych nurse is all set to work on her new mission of serving seniors at their doorsteps. A Vancouver resident, who started Home care services a year back is all confident about her venture named Medi-Mental Health and Homecare (M-MHH). Kamal’s husband is a renowned naturopathic physician in the community; serving people for almost 15 years and now, is in full support to his wife’s new start-up.
M-MHH offers private homecare services across the lower mainland. Services provided include cooking, bathing, shopping, laundry, provide primary healthcare (giving medication etc.) for the seniors, and mental support and online counselling for every age group. M-MHH believes in giving back to the community by providing premium services at a cost lower than the average cost of any other Homecare providers. Service hours are flexible with a minimum requirement of one hour. However, M-MHH also provides “clustercare” and cost-sharing by serving 2, 3 or 4 seniors living nearby to break the minimum requirement of an hour. “The primary aim behind this”, says Kamal, CEO of M-MHH, “is we want to build a community, seniors would meet and talk with each other and relax.”
To provide optimum services, M-MHH team has healthcare professionals with different backgrounds and extensive knowledge about their work who are committed to serving 24 hours and 365 days. Nurses and supervisors are trained in wound care, diabetic care, CPR and to tackle other emergency situations.
With a mission of “Providing highest standards of care with love”, M-MHH aims at offering its services to nearly 2000 patients in a 5-year time span. With this, Kamal, CEO of M-MHH envisions to expand her company in Ontario in the near future.
Strategic Influence Development Plan
The Chief Executive Officer has a crucial role to play in an organization. From developing mission, vision, and values and communicating them to employees to influencing their relations and creating a positive image of the organization are the primary responsibilities of a leader (Resick et al., 2009, p. 4). The Health Angels (HC2) previously conducted the SWOT analysis for M-MHH. Using this information, HC2 developed a strategic influence plan which Kamal, CEO of M-MHH can use as a tool to foster relationships and promote the growth of the company.
Strategic influence is essentially different from persuading a group of people to believe in your vision and act accordingly (Hughes et al., 2014. p. 133). Persuasion helps to gain short-term support which tends to relapse instantly. Therefore, influencing others takes time and efforts. The staff members of M-MHH though few represent a diverse group of health care workers. At the moment the company has five Health care assistants and a licensed practical nurse. The aim is to develop full-time permanent positions for at least three health care assistants and one licensed practical nurse over the next year. This initial stage of the company is the perfect time to build a good rapport with the existing employees who are perfect candidates for these positions and to help the peers and support them once the company expands.
M-MHH is facing issues with a commitment from employees as it is hard for them to keep up with the company’s vision. Since it is a small working group; one way to address this is through meetings where everyone gets to put their ideas on the table to develop a plan for progression. Contributing gives a sense of belonging which will assist the staff to stick with the organization. Before the end of this year, Kamal can assemble everyone to discuss some ideas for advancement and this will also provide her with an opportunity to see if the values of the existing employees resonate well with the company’s mission and values.
It will take time and collective efforts of everyone involved to make M-MHH the best home support company with the help of realistic goals and landmarks (Lepsinger, 2010, p.104). M-MHH has a vision of expanding in other provinces by the end of five years but that is only possible if it becomes well renowned in B.C first. Over the next three years the CEO desires to spread the word by providing excellent services to patients and marketing M-MHH with the help of skilled staff. Being transparent and genuine about company’s growth will help the CEO gain employee trust. Starting years are always full of challenges and obstacles. With Kamal focusing on her Masters’ and not able to give her full attention and time to the company, the staff is growing impatient. Having meetings with the individual member and explanation of the short-term goals and long-term opportunities for the staff will help gain their commitment. Starting from now Kamal should have one check-in with staff every two weeks. Given her busy schedule, at this point, even Zoom calls to check if they need help to navigate things will suffice.
Hughes mentioned multidirectional approach with considerate thinking about everyone’s expectation of the project be it employees or customers aids in moving forward with the best practices ( Hughes et al., 2014, p. 153). M-MHH should plan certain benefits and bonuses for the existing staff to help with employee retention. Extended health packages for the employees, acknowledgment of their birthdays, giving bonuses to the employees for their exceptional services should occur over the next year. Kamal can begin by providing certificates of appreciation in recognition for the remarkable efforts of employees. We hope this plan assists Kamal in decision making and assessing the growth of the organization by influencing the staff members of M-MHH.
Organization Design for Medi-Mental Health and Homecare
The design of an organization is of significant importance to allow effective delivery of services and to ensure efficiency in operations. With organizations becoming more complex and offering additional services to attract clients at a rapid pace, the interest of organizational design increases over time (Galbraith, 2014). The design of the organization will depend on many factors. Some of these factors include the type of service/products the organization provides, size of the organization, and the goal of the organization. Using the Star Model as suggested by Galbraith (2014) to address organizational design through strategy, structure, process, reward, and people, the HC2 team proposes the following organizational design for M-MHH to achieve strategic influence in the health industry and to meet its goal to expand their operations in the near future.
Strategy
Mental health issues and the ageing of the population is increasing at an alarming rate in Canada. Coupled with an overburdened public health care system, unable to meet the demands of patients, allows a private company such as M-MHH to alleviate the burden of the hospitals and provide access to health care for those with urgent needs. M-MHH is a private home support and mental health services organization in the infancy stage of start-up. Like many other start-ups, M-MHH potentially faces challenges in early stages such as operating with a limited resource and managing competition and risks (Hunckler, M., 2017). To overcome such barriers, HC2 team proposes M-MHH utilize a lean start-up model and focus on a customer-centric strategy to strengthen the services they provide and continue to build their base of clients and patients (Galbraith, 2014).
Rather than focusing on creating the best product or services, the lean start-up model suggests the company create a bare-bones product or service and providing it to clients quickly. The company get a reaction to the product or service, redesign it, then provide it to clients again. This process is repeated until the leader of the company discovers a profitable product, service, or business model (Galbraith, 2014). While there are no shortages of clients who require mental health and homecare services, there are other competitors in the market providing similar services, including the public health system that offer these services for free. Using the lean start-up model, M-MHH can consider innovative ways of providing care to the public that is currently not available by competitors. One example is the development of a mobile app installed on the client’s mobile device. The nature of a mobile app provides clients with access to medical professionals during inconvenient times when urgent care is needed. When M-MHH provide services to clients, the data collected should be considered for subsequent services and provide direction to potential new and improved services in the future. This step should be done at a rapid pace to provide the best service possible to potential clients.
In addition to the lean start-up model, M-MHH should also utilize the customer-centric strategy focusing on the needs of the customer and structuring the organization to create products based on the customer’s preferences (Galbraith, 2014). Interacting with clients and patients to provide mental and homecare is a deeply personal activity. People often feel their most vulnerable when they are in need. For M-MHH to utilize a customer-centric model means the organization go above and beyond the call of duty. HC2 suggests the M-MHH create deep and meaningful relationships with their clients and patients to provide the best possible care experience. This will be in stark contrast of the public health systems, where health authorities operating over capacity and there is little time for health care units to spend the time to provide the same level of customer service. HC2 recommends the use of customer-centric strategies for M-MHH as an organizational strategy to effectively provide quality and timely services not possible for the public health care system.
Using the lean start-up model and focusing on being a customer-centric company will allow M-MHH to make a significant impact in the community with regards to mental health care and the homecare industry. The use of these two strategies allow M-MHH to address the needs of their clients and patients in a timely manner, allowing them to provide the level of care that is not possible by competitors, including the public health system.
Structure
In the early stages of the organization when M-MHH is still acquiring additional staff members and partners, there may very little structure as with most start-up companies (Galbraith, 2014). On the contrary, a structure is sometimes an impediment to a company in its infancy stages (Galbraith, 2014). A company with a small group of generalist can move quickly and with more agility. Being an agile organization will greatly help M-MHH to learn and adapt to client’s needs quickly. Agility in the sense of strategy is the organization’s ability to sense and respond to turbulence in the competitive environment quickly and effectively (Hughes et al., 2014). The ability of M-MHH to cater to their client’s needs in a quality and timely way is a big advantage compared to the public health care system.
As M-MHH continues to grow, the HC2 team recommends M-MHH to adopt the functional organization structure to provide quality services to their intended clients. Even though functional organization structures are the most common, it continues being an effective way of structuring an organization, especially for young companies. Companies organized by their function allows for ideas, knowledge, and contacts to transfer more efficiently and allow for a greater level of specialization (Galbraith, 2014). An example of a functional organization structure for M-MHH is shown below.
To leverage emerging technology, such as the development of a mobile app, HC2 also recommends the Network organization structure to increase collaboration opportunities with other experts and contract out certain activities to preserve human resources for other purposes (Galbraith, 2014). With the development of a mobile app, it is difficult to hire an experienced app developer to meet the needs of M-MHH, not to mention it can be very costly to keep staff. Instead, M-MHH can contract out the development of the mobile app with a third-party company experienced in developing apps with similar functionality. This will greatly reduce the risk of attempting to develop something from the ground up, where the development could take a substantial amount of time and cost. Another example of how M-MHH can utilize network organization structure is to establish partnerships with companies to provide cleaning services as part of homecare services. While partnering with companies will lower the profit for M-MHH in the beginning, it can provide benefit such as knowing the clients are supported by an experienced company. The network organization structure can be used until M-MHH grows to a medium-sized company, where it may be more profitable to hire its own technical or cleaning staff.
Structuring the organization to be more agile by utilizing the functional organizational structure and leveraging on potential partnerships with Network organizational models will strategically position M-MHH as an adaptable organization that is ready to make the necessary adjustments to fulfil their organizational goals, which is to provide the best home support company. When compared to the government-funded health care system bound by numerous red-tape and unnecessary policies, M-MHH will be a company putting patients and clients first, allowing quick, effective changes and decisions affecting care. This will greatly affect M-MHH’s influence in the mental health and homecare industry.
Process
M-MHH is in its initial stages. There is not many staff currently working with M-MHH. Partially this is due to lack of patients/clients in the community. This means less work and no permanent schedule available, therefore, the staff is only casual.
One of the strategies for M-MMH is to have the website up and running as soon as possible. This will be a good way of marketing the services. At this point, marketing is very poor. M-MHH needs to develop a good marketing strategy. At this time there is not much financial profit. A big reason for this lack of process in marketing is the CEO’s inability to dedicate time for this company. The CEO is working full-time with another organization, trying to complete masters of arts in leadership and teaching online periodically. This gives her no to very little time towards M-MHH. In the upcoming months, the CEO has a plan to put more effort into M-MHH. Marketing and making sure the website is ready for the public is one of the main goals. Once the website is up, patients and clients can access bookings for assessments online. This will briefly cut the cost of hiring a receptionist to answer phone calls. “Financial control is the straightforward budget allocation, measurement, and accountability to meet the financial targets” (Galbraith, 2014, p.197). The better the technology and easy access for the public, more cost effective it will be in the long run.
CEO is suggested to meet with the accountant to open a holding account for the company, once M-MHH’s profit increases. There are other home care companies out there serving the public. M-MHH will need to ensure it stays on top of the services. Since M-MHH is in its initial stages, it will need to work very hard to develop a strong relationship with its patient/clients. There is a lot of competition and fostering secure relationships will create a good reputation for M-MHH. Word of mouth is a way of marketing, therefore, M-MHH needs to ensure the services they provide to their patients and clients leaves them well satisfied.
In near future, M-MHH will hire an accountant permanently to do payroll for employees. CEO will run M-MHH without any other obstacle and challenges by Summer 2019. M-MHH will increase their presence on social media and will increase their public influence by Summer 2019. Social media includes Instagram, facebook, and a well-finished website. The public will be able to book online assessment assessments with the nursing staff, also by Summer 2019. There are many promising changes and improvements coming towards M-MHH by Summer 2019,
Rewards
At this point, it is difficult to keep staff happy due to lack of work. Eventually, the goal for M-MHH should be to create better and secure positions for staff. M-MHH can begin to focus on how to create a permanent part-time position. For every 12 clients, one staff can be sufficient. This will allow guaranteed work for staff. M-MHH needs to focus on keeping good staff, therefore creating at least a few part-time permanent positions for now.
Eventually, looking into extended health benefits for permanent employees will increase their loyalty and motivation towards M-MHH. “The purpose of the organization’s reward system is motivation” (Galbraith, 2014, p.44). Without motivation and encouragement employee will not be satisfied. The CEO will need to create opportunities to sit with the employees and explore what their goals are. Long-term lasting employees will need to have similar ideas and vision as M-MHH. The CEO will need to have regular check-in and meetings with employees to probe what their needs are and whether they are being met. Those employees with unmet needs will seek employment elsewhere.
The now may be challenging and difficult but the future is very promising for M-MHH. M-MHH is determined to succeed. There may be obstacles and bumpy roads ahead but the vision is so strong for M-MHH. In the next five years, M-MHH will create 10 permanent full-time and 5 part-time positions. There will be a minimum of ten casual staff members, five of them will be long-term care aides and five Licensed Practical Nurses (LPNs). In the next five years, M-MHH will also have extended health benefits for staff members with permanent positions. Promised work and benefits are going to be very rewarding for employees of M-MHH.
People
M-MHH is offering mental health support and homecare services for the public. The types of people working M-MHH will either make or break its reputation. If the reputation is broken before the company, it will be very difficult to build the business. “The people dimension of organization design focuses on choosing the skill sets and mindsets that align with the company’s strategy” (Galbraith, 2014, p.52). It is crucial; M-MHH hires employees with a similar vision. Many different professional backgrounds will be working for M-MHH but are the professionally trained also personable? Do they have the ability and willingness to build a relationship with clients? M-MHH has a client-centred approach and those working with M-MHH must also have similar ideas which align with the company’s mission, vision and values. This is an open conversation the CEO should have during the hiring process.
M-MHH can create a promising and reliable team to serve the public in the next one-year time frame. The public will hire M-MHH for their loved ones due to the quality of care it provides. The team of M-MHH can create a good reputation for this company by the end of 2019. This will create much more opportunity for M-MHH. The competitors will have to strategize how to keep up with them and by the end of year five, M-MHH will feel at ease and experience fewer threats from opposing homecare companies.
Conclusion
M-MHH has the potential to succeed in the mental health and homecare market in Canada, given the overwhelming need for patients to get access to health care in the lower mainland. However, M-MHH is a start-up company at its infancy stage with little strategic influence in the community. The HC2 team recommends M-MHH to follow the strategic influence development plan to strengthen the workforce and promote the growth of their business in the community. Intentionally designing the organization to align with M-MHH’s organizational goals of providing effective services in the community and expanding to other provinces in Canada. The first couple of years of the business will focus on staff development and engagement. Maintaining a team of high-quality staff members will ensure excellence in patient care and be influential in their community. M-MHH will also continue to develop their marketing strategy for the growth of their business via social media. The next couple of years will continue the development of their service strategy to meet the needs of patients in a timely way. M-MHH will need to excel in these things in the first five years to expand their business outside of Vancouver. The road ahead for M-MHH will be challenging, but with the appropriate strategic influence plan, it is possible for M-MHH to succeed as a renown mental health and homecare company.
References
Galbraith, J. R. (2014). Designing organizations: Strategy, structure, and process at the business unit and enterprise levels (3rd ed.). San Francisco, CA: Jossey-Bass.
Hughes, R. L., Beatty, Collarelli-Beatty, K., & Dinwoodie, D. L. (2014). Becoming a strategic leader: Your role in your organization’s enduring success. San Francisco, CA: Jossey-Bass.
Hunckler, M. (2017, Mar. 22). 12 Challenges Startup Culture Must Overcome In Order To Thrive in 2017. Forbes. Retrieved from https://www.forbes.com/sites/matthunckler/2017/03/22/12-challenges-startup-culture-must-overcome-in-order-to-thrive-in-2017/#768426757592
Lepsinger, R. (2010). Closing the execution gap: How great leaders and their companies get results. San Francisco: Jossey-Bass.
Resick, C. J., Whitman, D. S., Weingarden, S. M., & Hiller, N. J. (2009). The bright-side and the dark-side of CEO personality: examining core self-evaluations, narcissism, transformational leadership, and strategic influence. Journal of Applied Psychology, 94(6), 1365.
The State of Seniors Health Care in Canada. (2016). Retrieved from https://www.cma.ca/En/Lists/Medias/the-state-of-seniors-health-care-in-canada-september-2016.pdf
Valaitis, R. and Markle-Reid, M. (2018). Opinion: We must do more for seniors coming home from hospital. Vancouver Sun. Retrieved from https://vancouversun.com/opinion/op-ed/opinion-we-must-do-more-for-seniors-coming-home-from-hospital
