This case study describes what happens when a health district merges four laboratories into one unit. Although the intention was to develop one centralized, efficient, and high volume centre, the inattention to the ‘people issues’ and the cultural differences of the work units results in chaos. The recently hired laboratory manager has implemented several stopgap measures intended to address the work load issues resulting from high turnover levels and sick leave usage. However, these measures do not improve the morale and performance problems of the laboratory. Time is running out for this manager as his supervisor gives him an ultimatum to ‘clean house or else.’

1. Although there are numerous problems presenting themselves in this situation, what is the key problem that seems to underlie the remaining problems? Why is this the key problem?

2. What constraints might influence the selection of alternative courses of action?

3. What alternative courses of action should the manager of the Amalgamated Laboratory pursue? Discuss the appropriateness, advantages, and disadvantages of these alternatives.

4. What course of action do you recommend given the available alternatives? Identify and justify the selected alternative(s) and some suggestions for implementation.