MHA 5040 Capella Wk9 Business Strategies

MHA 5040 Capella Wk9 Business Strategies

MHA 5040 Capella Wk9 Business Strategies

Course Project: Final Assignment

Your final course project assignment is due at the end of this unit. In order to complete this presentation, you must:

  • Conduct benchmarking research to identify best practices to improve both the clinical and nonclinical practices of the organization.
  • Analyze the customer service and satisfaction drivers present in this case study and apply those drivers to the customer facet of the balanced scorecard.
  • Consider the costs and revenue implications in the case study and apply those considerations to the financial facet of the balanced scorecard.
  • Determine how to assess the organizational success, timeliness, effectiveness, and efficiency of services after the change was implemented.
  • Describe measures will you use to make this assessment and provide your rationale for selecting these measures.

Once you have completed the steps outlined above, use the material you have gathered, along with the feedback you received from your previous project assignments in Units 5 and 7 to prepare a PowerPoint presentation outlining the actions you believe Ellen Zane must take in order to lead Tufts Hospital to the next level of sustainability in a highly competitive health care marketplace.


attachment_1Ellen Zane: Leading Change at Tufts-NEMC

Nicole Jeffries

Capella University



Ellen Zane: Leading Change at Tufts-NEMC


Massachusetts is known for healthcare, computer technology and education around the world. Boston was the centre of medical activities with Academic Medical Centres and healthcare institutions of high profile. Due to Boston’s renowned healthcare operations, the medical centres of the region received $2.3 billion which is research grant money from the National Institute Health. This is a higher amount as compared to what the medical centres of other regions received. In the 1970s and 1980s, hospitals in Massachusetts accumulated huge debts to renovate the facilities and purchase new technological equipment (Ingols and Brem, 2006).

Tufts-New England Medical Center is among the healthcare facilities that were experiencing financial struggles during the 1990s. The costs of operation in the organization were increasing and the organization continued to make losses. The case study has described the condition of Tufts-NEMC which has recently shown improvement by posting a profit of $18million after making losses for a long period. This is due to the current CEO known as Ellen Zane who joined the company in 2003 (Ingols and Brem, 2006). The paper will provide an analysis of the case study based on the given requirements. MHA 5040 Capella Wk9 Business Strategies

Description of the Inputs to the Organization Using the Congruence Model

The congruence model for an organization involves a change management process that evaluates the performance of the organization based on the effectiveness of its operations (Sabir, 2018). In determining the inputs of Tufts-NEMC, the organization is broken down into several elements and the different elements are evaluated to determine the problems and how solutions can be made. Tufts-NEMC has various inputs that facilitate its operations. The inputs entail the resources and other environment inputs that are merged to help in the operations of the company.

One of the inputs of Tufts-NEMC entails the people in the organization. Tufts-NEMC has approximately 5000 employees. It has people that govern the board of the hospital and leaders such as Allen Zane, the CEO of the company, Greenwood John who is the VP of finance and Michael Burke who is the senior vice president. The other people that may have a direct or indirect influence to the organization include its partners, patients, board members and the shareholders.

The other input element of Tufts-NEMC is finance which make up the capital of the organization. Tufts-NEMC has, however, been having financial struggles due to the losses that it has made in the previous years. The other inputs of the organization entail the work and the services offered by Tufts-NEMC (Ingols and Brem, 2006). The organization offers healthcare services and it is known for having strong and effective programs of transplants, neurosurgery and cancer treatment. The technological inputs include technological equipment and resources of the organization that are used to promote healthcare services. The culture of Tufts-NEMC is another input as organization culture affects the behavior of the employees; this may affect the output or performance of the organization.

The Multiple Elements of the Problem and a Breakdown of Those Elements, Indicating Casual Relationships

Several elements revealed the issues and struggles of Tufts-NEMC. One of its major problems was on finances. A breakdown of this element includes accumulated debt, increased costs from a patient stay in hospitals, overspending and failure of the insurance to provide payment to the hospital. These led to increased overall costs causing the organization to make losses before making profits in 2006 (Ingols and Brem, 2006).

The other element of the problem is in the market environment. In the 1990s, the healthcare facilities in Massachusetts were experiencing a financial crisis due to accumulated debts and high costs of operation. Some of the organizations opted to merge to reduce the costs of operations and increase the revenue. Tufts-NEMC was indecisive of merging but ended up to merge with Lifespan. The outcome was not as expected as Tufts-NEMC continued to make losses and lose money. The merger finally ended resulting in a huge negative impact on Tufts-NEMC. The losses Tufts-NEMC made increased from $3 million to $6 million every month (Ingols and Brem, 2006).

The other element that had problems is in the people or stakeholders of the organization. The breakdown, in this case, involves the employees and the issues that they had that resulted from the financial crisis. Tufts-NEMC reported high turnover rates as the doctors kept on leaving the hospital as soon as they had joined. Most of the physicians did not refer patients to Tufts-NEMC and this was one of the reasons why doctors did not stay in the company. The elements that have been identified have casual relationships with each other in that they all affect the outcome of the company in terms of services offered, revenue and performance.

Separation and Categorization of the Key Elements into Manageable Components

The accumulated debts and increased costs due to patient stay in hospitals can be categorized into the cost component. Managing the cost component can be done in a step by step process by Tufts-NEMC. When Allen Zane entered the organization, she figured out how to manage and cut off the costs of the company.

The elements that entailed struggling market structures can be categorized in market strategy. Market strategy is a component that can easily be managed and help the organization regain its authority and prowess in the healthcare market (Sabir, 2018). Zane is currently promoting a fair market environment for the organization by use of her appropriate negotiation skills and her good relationship with the partners. The elements entailing people in the organization can be separated to form two manageable components that include tasks of employees and management.

Assess the Needs of the Community As They Relate To the Organization

The major needs of the community that can be related to the organization are under health needs. One of the healthcare needs of the community is maternity needs and the needs of the cancer patients to be taken care of. The needs are associated with the services of cancer treatment and maternity care offered by the organization. The needs of the organization for surgical services and transplant also relate to the services offered by the organization including transplant and neurosurgery.

Five Approaches Used to Heighten Awareness of the Need for Change

The first approach used to heighten awareness of the need for change is communicating the need for change. Individuals in an organization will be aware of the change when effective communication relating to change has taken place. The second approach to increase awareness for change is having the desire for change. Having a desire for change, will cause individuals to promote embrace any activities that promote change (Hickman, 2009).

The third approach is developing mental toughness. This is necessary to prevent cases of resistance and other barriers from preventing change. The fourth approach is high competency and know-how for the change that is to take place. Change can only be promoted when a person is aware of what is to be transformed (Storberg-Walker & Gardiner, 2017). The final approach is appropriate timing and planning for the change. The change should be introduced at an appropriate time to prevent disruptions (Hickman, 2009). MHA 5040 Capella Wk9 Business Strategies

Synthesis of My Understanding of These Approaches with the Case Study

In the case study, Allen Zane has applied the discussed approaches to promote change in Tufts-NEMC organization. In communicating change, Allen was open with the employees and other stakeholders of the organization regarding the state of the company and why the change was needed. She had a desire for change to improve the conditions of the organization. Allen Zane developed mental toughness in promoting change especially when she was replacing some of the employees and changing others. Zane had appropriate timing and planning for change. This has been indicated in her approach to cutting the costs of the organization. She also had the knowledge and know-how of what needs to be changed in the organization to improve its operations and revenue (Alavi and Gill, 2017).

How the Organization Challenged the Status Quo to Prepare Itself for Change

The organization challenged the status quo by separating with Lifespan after they had merged for five years. After separation Tufts-NEMC made huge losses in their financial revenue the year after separation. Some of the officials of the organization stated that the organization lost its identity after merging with Lifespan. The costs of operation of Tufts-NEMC remained high even after merging with Lifespan. This is why the two organizations had to separate. The separation of Tufts-NEMC and Lifespan created a sense of crisis that prepared the organization for change (Ingols and Brem, 2006).

How the Organization Energized and Motivated Others for Change

The organization motivated and energized others to get on board with the change by engaging them in the change process. Zane communicated and interacted with the nurses and this motivated them to be part of the change. She also communicated with the patients to identify the basic issues that need to be addressed. The organization through its leaders motivated others to participate in the change through cooperation. The individuals cooperated with the changes that were taking place including replacing employees. The organization came up with strategies that reduced the rate of turnover of doctors as Zane established good relationship with the physicians and identified the issues that can be solved to make the physicians refer the patients to the hospitals causing the doctors to stay (Ingols and Brem, 2006).


Tufts-NEMC has experienced financial struggles and huge losses in the past few years. The company was in a point of closure after the merging process and separation with Lifespan. It needed change and a turnaround for its operations to continue. Making Zane the CEO of the organization was the best decision that the board members made. Her prowess in bargaining, negotiation and management skills caused a lot of changes and a huge improvement resulting in a profit of $18 million in 2006. Despite Zane having fears of future trajectories, she has done superb work in transforming Tufts-NEMC (Ingols and Brem, 2006).



Alavi, S. B., & Gill, C. (2017). Leading change authentically: How authentic leaders

influence follower responses to complex change. Journal of Leadership & Organizational Studies, 24(2), 157-171.

Hickman, G. R. (2009). Leading change in multiple contexts: Concepts and practices in             organizational, community, political, social, and global change settings. Sage             Publications.

Ingols C and Brem L (2006). Ellen Zane: Leading Change at Tufts/NEMC

Sabir, A. (2018). The Congruence Management-a Diagnostic Tool to Identify Problem    Areas in a Company. Journal of Political Science and International Relations,   1(2), 34-38.

Storberg-Walker, J., & Gardiner, R. A. (2017). Authentic leadership in HRD—Identity

Matters! Critical explorations on leading authentically. Advances in Developing Human Resources19(4), 350-361.

attachment_2Ellen Zane: Leading Change at Tufts/NEMC

Nicole Jeffries

Capella University



Ellen Zane: Leading Change at Tufts/NEMC

How the organization used structures and systems to deal with environmental uncertainty and complexity

Tufts-NEMC was at a point of falling apart before Ellen Zane was appointed as the CEO of the organization. The organization was struggling financially and was affected by negative market changes and forces. Tufts-NEMC was making loses, losing its physicians, market share and some of its partnership. This caused a lot of environmental uncertainties and complexities. Tufts-NEMC first dealt with the environmental uncertainties by merging with Lifespan. This, however, did not work out well. The organization ended up being brain drained, it lost its identity and made huge finances loses (Ingols and Brem, 2006). MHA 5040 Capella Wk9 Business Strategies

After Zane joined Tufts-NEMC as the new CEO she used various structures and systems to deal with environmental uncertainties. She recruited a consultancy firm which helped in investigating why the company was making huge financial loses. This helped in determining the areas that needed to be changed. Zane used appropriate systems to ensure that the costs of the organization were reduced.

There was an application of teamwork in that the senior management team cooperated with the new CEO to help promote the changes in the organization. Zane is an individual that is well versed with how hospitals operate and this caused her to have accurate knowledge on what was to be done to deal with the environmental complexities and uncertainties of the organization (Ingols and Brem, 2006).

The types of power that were at play within the organization

Several types of power were at play within the Tufts-NEMC organization. The first one is legitimate power. It results from an authoritative position in the organization. This form of power is manifested when the employees recognize it and submit under its authority (Hofmann et al, 2017).

Zane is a good example of an individual that had legitimate power. She had authority in making certain critical decisions in the organization including firing some of the employees and recruiting new senior staff members. Zane also made serious decisions regarding the changes that the organization needed to make including reducing costs. This caused the organization to move in the right direction.

The second type of power that was used within the Tufts-NEMC organization is referent power. It is the kind of power that is based on the personal characteristics of an individual and how the person is respected, admired and valued by others. Zane had referent power based on the prowess she had in her career. She had established good networks and was respected, admired and valued by most individuals who knew her. The third kind of power that was used in the organization was expert power. Expert power results from skills and knowledge that individuals possess (Hofmann et al, 2017). The physicians and doctors of Tufts-NEMC organization had expert power and could leave the organization if they felt that they needed a better place with better resources to practice their skills. Zane had expert power as she had the right skills and knowledge to promote change in the organization.


Stakeholders and departments that were impacted

The senior management team was among the stakeholders that were affected by the changes in the organization. The senior vice president that deals with strategy and is in the management team was replaced with an individual identified as Deborah Joelson. This was immediately after Zane took the office of the CEO of Tufts-NEMC organization. In the management team, seven members were replaced after Zane resumed the office. The other stakeholders that were affected were the board members. One of the board members was not satisfied when his favourite was fired in the process of promoting change in the organization (Ingols and Brem, 2006).

The other stakeholders that were affected are the doctors, physicians and the other staff members. The turnover rates of the physicians and the doctors reduced. Zane had good negotiation skills that helped in promoting effective communications and building healthy relationships. The doctors began to appreciate the changes that were taking place in the organization and this caused most of them to stay. MHA 5040 Capella Wk9 Business Strategies

The external physicians began to refer patients to the organization after they had personal discussions with Zane. The other staff members were affected in that their morale to work for the organization was increased. This is because they were frequently engaged in staff meetings and were given information regarding the state of the company. They were not overlooked by the CEO and this promoted their zeal to help in improving the performance of the organization (Ingols and Brem, 2006).

The patients were also affected by the changes that were made in the organization. The changes promoted a reduction in the length of stay to minimize operating costs. The patients could, therefore, stay for fewer days compared to before the initiation of the changes. The final group of stakeholders that were affected is the shareholders. The shareholders had lost a lot of revenue for several years in the organization. After Zane resumed the office of the CEO the losses began to reduce. The increase in revenue of $18 million that was later reported was a huge relief to the shareholders of the organization (Ingols and Brem, 2006).

How the change disrupted the psychological contract that existed in the organization

The change affected the psychological contract that existed in the organization in a positive way. The psychological contract relates to the set of expectations that the employers and the employees have but they are not written. They may be expressed through communication. Most of the employees had a negative psychological contract before the change because of the situation that the organization was in.

After the change, most employees and other stakeholders developed a positive psychological contract because of the results of the change (Cawsey, Deszca and Ingols, 2015). The positive psychological contract was also enhanced through effective communication strategies that were imposed. In that, the employees were updated on what was happening in the organization

The various conflicts and resistance to change

There were fewer cases of conflicts and resistance to change. One of the instances of resistance to change that was reported was during the replacement and firing of some of the staff members. Most of the individuals that were fired did were not in agreement with the decisions that Zane had made. An example is when he fired a certain individual who was the favorite of one of the board members of the hospital. The board member had initially resisted and challenged the idea of Zane of hiring and firing staff members at her own will. The board member eventually ended up to agree on the decision that Zane made of firing the person.

Apart from the issue of hiring and firing staff members, there were no other cases of resistance to change that were reported. Majority of the staff members trusted what Zane was doing as they were aware of her professional background and work ethics.  Most of the staff members, from the senior officials to the housekeeping staff were engaged in what Zane was doing through communication. Effective communication and engaging every stakeholder in promoting change was one of the main reasons why there were few cases of resistance to change (Ingols and Brem, 2006).

Whether the change is programmatic, discontinuous or emergent

The change is a programmatic type of change. Programmatic change can be defined as a strategic and long term change that is done according to a certain plan or which follows a certain method. The strategic change is programmatic as Zane came up with a strategy or plan on the changes that will be taking place in the organization. In the programmatic type of change, the senior official is in charge of the change process (Cameron and Green, 2019). In this case, Zane who is the CEO of Tufts-NEMC was the one who initiated the change program.

In instituting the change some of the employees in the management team were replaced. This is a change to enhance the future performance of the organization. The Length of Stay in hospitals was also reduced to reduce the costs of the organization. The change plan was strategically set to serve the organization for a long period until the expected outcome is achieved.

Analysis of Ellen Zane’s communication practices throughout the change management process and the synthesis of the best practices identified in the outlined in the text and if Zane’s communication strategy was effective.

Zane did not hide any information regarding the state of the organization. She is a good communicator of both bad and good news. This made it easier for her to communicate with every staff members on the financial crisis and other challenges that the organization was facing (Ingols and Brem, 2006).

Zane held several meetings and gave everybody a chance to attend. In the meeting, she used a chart to explain the situation of the firm and ensured that every individual understood (Ingols and Brem, 2006). This explains one of her strengths in communication of passing the message in an effective way. Apart from the meetings, Zane could send follow up emails to the members of the staff members regularly to update them on what was happening. Zane’s effective communication strategy allowed him to reach out to the partners and physicians thus promoting a good relationship with them.

One of the best practices outlined in the text is communication having a feedback strategy. Zane received feedback from individuals and she also asked questions to collect information. The other best strategies include using different forms of communication and communicating the right information to the right people at the right time. In this case, therefore, Zane’s communication strategy was effective (Cawsey, Deszca and Ingols, 2015). MHA 5040 Capella Wk9 Business Strategies



Cawsey, T. F., Deszca, G., & Ingols, C. (2015). Organizational change: An action-           oriented toolkit. Sage Publications.

Cameron, E., & Green, M. (2019). Making sense of change management: A complete    guide to the models, tools and techniques of organizational change. Kogan Page           Publishers.

Hofmann, E., Hartl, B., Gangl, K., Hartner-Tiefenthaler, M., & Kirchler, E. (2017). Authorities’ coercive and legitimate power: the impact on cognitions underlying cooperation. Frontiers in Psychology, 8, 5.

Ingols C and Brem L (2006). Ellen Zane: Leading Change at Tufts/NEMC