Read the following case study describing Roberto’s experience with addiction and then answer the question parts (a), (b) and (c). (Please note that ‘Roberto’ is not a real person,

The Case of the Warm Brownies – Case
for Chapter 5
Susan Casciani

Yolanda pulled into the parking lot of North County Clinic (NCC)
already dreading the upcoming day. After months of back to back
meetings, the strategic plan update she had led for the development of the clinic was finally being implemented. She should be happy and enjoying some well-deserved downtime, but
instead she was in the hot seat with Tom, NCC’s new Administrator. As Yolanda trudged to her office, she tried to figure what had gone wrong. NCC is a large, 30-physician primary care clinic located in the suburbs of a small metropolitan area in the Midwestern U.S. The
clinic has many ancillary services on location, including laboratory,
imaging, diagnostic, and pharmacy services. It was not unusual for
NCC’s employees to have been with the clinic for many years, and
several employees have spent their entire career with NCC. NCC
is patient-centric and enjoys a great reputation for quality of care in
the community, but NCC’s competitive advantage had always
been their personal touch in everything they do. Employees are
known to bring in homemade baked goods to share with patients,
and the clinic sends birthday and holiday cards to patients every
year. It truly seems to just about everyone that NCC takes care of
patients like family. Last year the clinic hired a new Administrator, Tom Gardner, and it
didn’t take long for him to fit into the family of NCC. Tom had a
warm personality and was well liked by the majority of the staff.
About 6 months ago, Yolanda started the annual process of updating the clinic’s strategic plan; they were currently entering the
last year of a 3-year plan. Tom came on board at NCC right as last
year’s planning cycle ended, and this year he instituted a lot of
changes to how NCC normally did their planning. As an example,
in the past Yolanda and her staff would meet with various clinic
stakeholders on an ongoing basis to gather market information
and monitor trends. This helped Yolanda ensure the clinic’s
strategies stayed on track and were responsive to the market and
hospital resources. Tom, however, was more comfortable with
getting market data from third-party companies that specialized in
tracking health care data and trends and he instructed Yolanda to
outsource this function this year. Although the information these
companies provided seemed on target, Yolanda felt that
something was missing, but she could never quite put her finger
on what.
Once the external assessment was completed based on the third-
party data, Tom had Yolanda present the information to the
management of the clinic. This group included managers from
each of the operational areas, along with the lead physician.
Everyone seemed pleased with Yolanda’s presentation, although
few questions were asked. Yolanda found this interesting as the
data pointed toward discontinuing the clinic’s personal outreach
services in favor of a more high-tech marketing approach. She
thought for sure managers wouldn’t like this trend as it would
involve less time staff would spend out in the community, but most
seemed excited by the prospect of being in television commercials
for the clinic. Many of the managers started joking about getting
asked for autographs once they became “famous.”
Yolanda then worked with Jed, the clinic’s financial manager, to
put together the financial forecasts for the upcoming year. Tom
saw to it that none of the outreach workers were laid off; most
were moved to different roles and a few opted to retire. Other than the increase in funding necessary for the new outreach, the rest of
what was already in the 3-year strategic plan was confirmed for
going forward; there were no major changes to be executed and
the clinic would hold a steady course. Yolanda expected smooth
sailing.
With funding in place, a marketing firm was retained for the new
outreach plan. Managers and other staff were buzzing about the
new commercials that were going to be made, which were to
include both television and radio ads. Most were excited to take
part in what they saw as a fun opportunity to be in a commercial,
although with such a large clinic the staff didn’t stop to realize they
couldn’t all be in the commercials. It turned out not to matter
anyway as the marketing firm decided to use real actors, and
already had some footage and voiceovers from other projects that
were merged into the clinic’s new campaign. Once the
commercials aired, patients who had been coming to the clinic for
years asked staff why they didn’t recognize anyone in the
commercials. Staff didn’t really have an answer, but eventually
everyone seemed to forget about the new outreach efforts and
went about business as usual.
A few weeks later Jed was talking to one of his financial analysts
who told him he was starting to notice a decreasing trend in new
patient visits. The analyst thought it was odd since it was fall and
the weather was starting to turn, which meant the clinic normally
would be seeing an uptick in visit volume. Jed dug into the volume
data and found that returning patient volume was also starting to
decrease. Since both numbers were decreasing and not just new
patient volume, Jed didn’t see a connection with the new outreach
efforts, as those were focused only on new patients. The numbers
were discouraging, however.
As several more weeks went by, visit volume continued to
decrease but the more insidious nature of the matter was starting to surface. Tom had been noticing during his weekly administrative
rounds that increasingly there were no baked goods at the front
entrance to the clinic. Although Tom was sure his wife would be
happy that he was doing better sticking to his diet, he missed the
homey smell of those fresh brownies and cookies. Tom also
noticed that staff did not seem as cheerful lately, but he tried to
chalk that off to the decreasing hours of sunlight as winter
approached. Then Tom remembered what Jed told him about the
continuing decreases in visit volume, and it all started to click.
There was definitely a problem, and Tom felt that he was only
seeing the very beginning of what was to come. That’s when he
decided to call a meeting with Yolanda
1.
a. How does the planning process undertaken at NCC compare to an ideal process?
b. Are there any steps missing?
c. Is the level of analysis appropriate for the planning stage (last three years of the 3-year plan)?
2. What could Yolanda have done differently to effect a better outcome for the planning process?
3.
a. What unintended consequences are surfacing the decision to move the clinic’s outreach plan to television and radio ads?
b. How are these issues affecting the clinic as a whole?
4. How does the clinic’s organizational culture play a role in this case?
– Organization and citation:
B. Reply to two other students:
1. What did you miss and others did not?
2. What you covered, and others did not?
3. What did you learn; how would you change your post after reading others’?
Reference:
Buchbinder, Sharon B., et al. Introduction to Health Care Management, Jones & Bartlett Learning, LLC, 2019. ProQuest Ebook Central, https://ebookcentral-proquest-com.libproxy.umflint.edu/lib/umichigan/detail.action?docID=5944567.

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