Organization Development Subject:

Kindly provide answer to these questions based on the case study.

Questions 1. How well did the OD consultants communicate with the CIO? Would you have done anything differently?

2. What issue has been discussed by consultant with the CIO and how well it has been defined?

3. Who is the relevant client? Discuss the relevance of the client with the organizational issue.

4. How effective was the contracting process described in the last part of the case? What is the scope and clarity of the agreement?

ENTERING ALEGENT HEALTH to application 4.1 for two years, doing a indeed a new CEO who had legent Health (AH) is a five-hospital sys The form of research is typically action tem that serves the greater Omaha, research, meaning the data will be valuable Nebraska, and western lowa region. for Alegent in not only assessing the impact Alegent was formed when two religious and effectiveness of the DA intervention but sponsored health care systems merged learning how to position this capability for health care industry changes and to improved Alegent organizational effective bargain more powerfully with physicians and ness. This can be quite valuable as Alegent insurance providers. The system had its own moves into the next round of change and managed care insurance program, was imple transformation. menting a consumer-directed health care pro- Thanks all gram for its employees, and had about 100 employed physicians in addition to the physi- talking to the two consultants about AH, its The researchers spent the next few days cians with privileges at its hospitals. Two well-known OD consultants had been history, strategy, structure, and culture, as working with AH for about two well as the motivation for the large group. deci- variety of OD work. By far, the largest project sion accelerator process. They also collected was the design and delivery of large group data on AH through the Internet. Alegent was interventions known as decision accelerators a unique organization. It was highly DAS) to create strategies for the major clinical successful from a financial point of view, had service areas, such as orthopedics, cardiology Florida, and had a strong faith-based mission had been brought in from and women's and children's services. [Note: Large group interventions are multistakeholder In the first phone call with the CIO, the meetings of over 50 people see Chapter 11 researchers introduced themselves, described for more information.] the mission of the research center, and their At an organization design conference in interest in doing a case study of change at April, one of the consultants was talking with Alegent. The Cio talked about the history of researchers from the Center for Effective Orga change at AH and asked questions about the nizations at USC. The conversation turned to a value the project would have for them. He saw of the work at AH and the possibil several benefits, including the opportunity to ity of evaluating the change effort. The generate a history of the change to learn researchers were excited about the organiza- about the impacts of the change process on tion development and large group intervention the organization's culture and members, and work in the health care context. The consultant to build a database that could be used to agreed to pitch the idea to AH's Chief Innova- advance AH'S objective of "changing the face tion Officer (CIO). of health care." The call ended with the agree- Following some additional background ment that the CIO would talk with others in the conversations with the researchers and the organization, including the CEO, and that the CIO, the consultant sent the following email in should begin to put together a June: project purpose, cost estimate, and schedule. In the second call , the researchers presented Dear Clo, their understanding of the project as a case study I would like to introduce you to the Center assessment of how innovation was created and for Effective Organization researchers. As implemented at Alegent. They descrbed a way we discussed, the researchers are very of working with organizationsthe establish- interested in the work being done at AH ment of a study team" composed of several and will be calling you early next week to key stakeholders in the organization. The study discuss the possibility of doing a research team would meet, before the project officially project on the Decision Accelerator effort. began to review the objectives of the study discussion of the researchers and ensure that the work was relevant to the organi- verbal agreement that the project should begin in zation. There was some conversation about who October. The CIO believed there was much to gain might be on that team, including the CEO, CFO, the from the project, and asked the Director of the hospital presidents, and the VPs of the clinical service Right Track office this was the internal name AH had given to the decision accelerator) to lead the Subsequent email exchanges among the con contracting process and to help the researchers sultants, the Cio, and the researchers led to a schedule meetings and interviews. areas CONTRACTING WITH ALEGENT HEALTH application 4.2 ollowing the verbal approval of the CIO to path was the project scheduling-who, when, begin the work, the researchers began and where. working with the Right Track director and the consultants to formulate an agreement on how to proceed with the case study and FORMAL CONTRACTING PROCESS assessment. The contracting process pro- The formal contracting process required the ceeded on two parallel paths. One path was researchers to propose a purpose, cost esti- the specification of the formal contract-who, mate, and schedule for the case study. The what, how much, and whyand the second researchers' initial proposal looked like November December January Write up archival data Work Stream September October DA archives . Collect DA . Coding materials Create coding scheme Interviews . Finalize First interview round of questions interviews Arrange Develop interview coding schedule scheme Second round of interviews Coding + Begin analysis of interviews Feedback meeting Governance Meet with "study Transfer learning to organization Article writing team The first work stream was the DA archives for interviews. data analysis, and direct The researchers had learned through the consul expenses, the support resources expected tants and the Right Track director, that the Right from AH, including the establishment of the Track staff kept nearly verbatim transcripts and study team, a statement about data confidential descriptions of each of the decision accelerator ity, and some suggested publication outlets. The meetings that took place. Thus, the researchers Right Track director reviewed the document and proposed an analysis of those documents as an asked for some additional detail. As described in important work strearn in the process. The second the "Project Scheduling Process" section below, work stream representing the bulk of the data col the start date had slipped to early November. lection would be two rounds of interviews with Dear Right Track Director, executives, managers, and staff involved in the change process. Finally, the project would be gov- We got a message from the consultants that erned by a study team that would work to frarne you need a little extra "dril down detail" on the project objectives, receive the feedback and assist case study assessment project. We've taken in data interpretation and help to transfer the learn a stab at such a document and it is attached. The document includes a one-page ng back to the organization In addition to the timeline, the research pro- description of proposed dates, activities. posal outined the purpose of the project, the and information to be gathered. Please let kely benefits to Alegent, the estimated costs me know if this meets your needs. The document also lists a set of potential couple of options for using a survey during the questions for the initial round of interviews interview to collect information that would take There are two issues we could use your guidance too long to collect through just interview ques- on. First, what is the appropriate time frame for tions. Your counsel would be appreciated. questions about strategy Second, we've listed a Thanks. DATA COLLECTION PLAN-RIGHT TRACK ASSESSMENT PROJECT Activity Data to Be Collected Day 1 during - Meet with study team members Executive sense of business strategy. the wook of to verify objectives and mothods organization design, and Right Track November 6th and refine them in order to impact on organization incorporate sponsor concerns - Broad scoping of the post-RT Initial interviews with senior implementation/refinement activities cocecutives to understand germane to planning remainder of broad strategia context of arga interviews data gathering nization and Right Track proce - Initial draft of questions attached Day 2 during Initial interviews with senior Executive sense of business strategy. the wook of OxcDcutives to understand organization design, and Right Track November 6th broad strategic context of impact on organization organization and Right Track Broad scoping of the post-RT process implementation/refinement activities german to planning irernainder of interviews data gathering . Initial draft of questions attached) Prior to next visit Finalize detailed interview Work with Right Track office to questions for different schedule interviews stakeholders - Validate questions and sam- pling approach with stuy team Potential dates. Detailed interviews with RT Details about perceptions of RT November 27, 28 participants, nonparticipants. process, service-line strategies. December 4,5 service line managers, and implementation process, and December 7.8 other related managers implementation success December 13, 14 Ongoing Telephone interviews with key personnel unavailable during visits to Omaha January, 2007 Meeting with study team and Idate to be or extended stakeholder group mutually to review and discuss determined implications of findings February . Work with Alegent sponsors to determine publication strategy Shortly thereafter, the Right Track director sent the following email: Center for Effective Organization Researchers Thanks for this added info. 1, along with one of my staff members, have taken this along with all the documentation you have sent me to date and have attempted to create one cohesive doo urnent that can serve as the contract statement of work, action plan, cost estimate, etc. This document is attached for your review. I have also tried to answer some of the outstanding questions we have had in this doc- ument and have tried to further narrow the onsite dates and activities to include the inter- view list and the two questions you mentioned below. On your questions I think the two year window is appropriate and I preferred option 2 which is incorporated in the attached. Please review this latest document and pro- vide any feedback and/or changes you might have to us all. I will be out of town for a few daya but my staff can keep the process moving through Legal and the CIO's office in my absence. I can also be reached via cell phone through the rest of the week as needed. Thanks. The attachment referred to in the Right Track director's ernal was a standard, corporate consulting contract, with the researchers' proposal and revised schedule attached as the scope of work. Within the standard contract was a paragraph noting that all sur- veys, data, and documents created during the project would become the exclusive property of the Alegent Health corporation. The paragraph directly contra- dicted the confidentiality statement in the research ers' proposal. A number of conversations among the consultants, the researchers, and the different Alegent departments ensued. Eventuality, a para- graph was written that was satisfactory to all parties and allowed for the researchers to use the data in their publications, but also gave Alegent the right to review, edit and approve any articles, chapters, ar descriptions of the organization change effort. described above-involved working with the Right Track office to pick dates, schedule interviews, communicate with interviewees, and set up other logistical requirements to begin the study. Following a few introductory emails, and based on the CIO's interest in beginning in October, the researchers sent the following message in early September: Hi Flight Track Director, With the CIO's approval, we're ready to begin the Right Track assessment project. The con sultants and the researchers are very excited about the effort. We need your help to set up the first couple of days in October, ideally on the 17th and 18th. On the 17th, we'd like to have a meeting of the study team." This can be in the morn ing or afternoon, whichever best fits into the CIO's schedule. The balance of the 17th and all day on the 18th should be 60-minute interviews with the senior leadership of Alegent. Based on our dis- cussions with the consultants and the CIO, the list for the initial round of interviews would be 10 to 12 of the following people: [List of top 15 executives and 7 key physicians Thanks for your help. In response, the Right Track director sent back the following email: Center for Effective Organizations Researchers, Welcome aboard and looking forward to working with you on this effort. Is there a spe- cific reason you are targeting 10/17 & 1871 ask because there is a DA scheduled those two days that some of these folks are sup posed to be in and that I will be helping to support. It is actually an external group namely the Boy Scouts. Are you planning to come that week because of that or is this just a coincidence? My contact info is enclosed. Thanks Thus, there was some initial confusion on the start date of the project, and subsequent phane calls and emails clarified that starting the project in November would be a better fit for the Alegent orga nization. Some initial dates that fit in the researchers' PROJECT SCHEDULING PROCESS The project scheduling process which was done in parallel with the formal contracting process Schedule were not good for the AH executives and researchers flew to Omaha to begin the interview physicians, while dates that were good for AH didn't ing process. In the rush to schedule interviews, fit with the researchers' schedule. make travel arrangements, and finalize the inter- Eventually, the beginning of the project was view questions and survey items, the meeting of pushed back to early December, and the the study team was overlooked