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Case 3 Summit River Nursing Home The management team at SRNH con- (SRNH) is a 60-bed nursing sists of an administrator, a finance director, home that serves a suburban community in an HR director, a director of nursing, and the Midwest. The facility provides a broad administrative support personnel. Recently, range of services to residents, including rec- concerns about quality have emerged at the reational activities, clinical laboratory ser- nursing home. Several instances of comvices, dental services, dictary and housekeep- munication breakdown among staff have ing services, mental health and nursing occurred, and several instances of medicaservices, occupational and physical therapies, tion error have also taken place. A resident pharmacy services, social services, and diag- satisfaction survey also revealed problems nostic X-ray services. of which management had been unaware. The facility has a good reputation in Some of the problems concern contract staff the community and is well staffed. Licensed who have not been included in the organipractical nurses administer medications and zation's performance management process. perform certain treatment procedures. Each Discussions with management and nursing home resident receives at least two employees established that a team atmohours of direct nursing care every day. Certi- sphere among staff was lacking. Each memfied nursing assistants perform most of the ber of the management team was asked to direct patient care. A dietary service supervi- develop a strategy to improve the level of sor manages the daily operations of the food teamwork in the facility. The HR director service department along with a registered agreed to take action in three areas: dietitian. Activity coordinators provide nonmedical care designed to improve cognitive and physical capabilities. Two social workers on staff work with residents, families, and other organizations, and an important part of their role is to ease residents and their families' adjustment to the long-term-care environment. They also help to identify residents' specific medical and emotional needs and provide support and referral services. facility with a goal of providing a clean and safe facility for the residents. Housekeeping staff also have considerable contact with residents on a day-to-day basis. SRNH has contractual relationships with a dental practice, to discuss these changes. With the assispance physical therapists, a pharmacist, a psycholo- of an outside consultant, a training progist, and a multispecialty physician practice. Gram was implemented to teach employces communication and conflict management it includes methods to assess and improve stills. Several, but not all, contract employ- team performance for both full-time permaees attended the training program. nent as well as contract employees. The third strategy raised some dif- You are a consultant to the HR direcficulties. The existing performance manage- tor. Your job is to develop a method by ment system was traditional, using a 12 -item which teamwork will be integrated into the graphic rating scale (some with behavioral performance management process. descriptions) that measured aspects of work such as attitude, quality of performance, Case Questions productivity, attention to detail, job knowl- 1. How would you proceed with the edge, reliability, and availability. The form task of modifying the performance also provided room for comments by both management process to include a supervisors and employees. This rating teamwork component? approach,however,wasfoundtobeinca-1.2.Howwouldonegoaboutcollecting pable of addressing the team components 2. How would one go about collecting notfullyintegratedintotheorganization.organizationarenotfull-time3.Giventhatsomemembersof Other employees are obtained for temporary organization are not full-time employment through local staffing agencies. involve them? These staff members do not go through the 4. How could the compensation system process; only full-time permanent employees be used to reinforce positive team are integrated into the performance manage- behaviors? What are the advantages ment process. The HR director wants to modify the as a factor decisions? performance management process so that