A633.3.4.RB – Complexity Science

As a healthcare organization, health care reforms and the consumers’ shift to value are pushing organizations like mine to deliver enhanced outcomes and patient experienced at a reduced cost.  We are under pressure from regulatory agencies to align our patient care standards and initiatives in providing high-quality patient care with cost efficiency.  Organizations like mine are trying to reassess our existing capabilities and technology to manage our workforce, finances, and elevate our standard of patient experience re-defining focus on investments to best approach the challenges we face and expand for the future.
While different research in innovation has provided a higher understanding and perception of the social, economic and individual benefits extrapolated from new technologies, there has been minimal significance in the dialogues regarding the probability of detrimental effect that innovation may induce (Edgell & Vogl, 2013).  According to Carmeli, Gelbard, & Gefen (2010), organizations are steadfastly finding different avenues to cultivate internal and external strategic fit because the fit is not only critical to organizations’ capacity to change and conform to contingencies that are unforeseen and can act as an impediment to unauthenticity.  Carmeli et al., (2010), defined fit as an organization’s demands, goals, objectives, and needs on one component are congruent or aligned with the another component’s demands, goals, objectives, and needs.
In our organization, diversification, and growth are driving how we manage finances and our workforce directing a higher level of flexibility and scalability.  The required regulatory changes are forcing our Executive Leadership in restructuring cost management, engaging employees in decision-making to fully leverage talents, and data changing resulting in adopting new technologies that reinforce imperatives cost and P&L governance gearing to a value-added reporting and analysis.  Although new technology-based product development is one of the most explanatory variables for a beneficial organization performance (Suzuki, 2014), we can also say that exploitative and exploratory innovation significantly influence organizational performance (Suzuki, 2014).  According to Suzuki (2014), exploitation relates to increased efficiency, organizational improvements and incremental adjustments while exploration equates to new possibilities, radical or revolutionary change, and diversified generation.
If I were to examine and assess the decision-making of our executive leaders, I could say that they have utilized three methodologies in dealing with our multiple current issues across the Adventist Health System campuses as follow:
Navigating Data-Rich Environments.  Our organization built the information base across the board by deciding to change to a new business model called Shared Services utilizing PeopleSoft application.  Shared Services will be responsible for AHS’s Talent Acquisition, Payroll, Supply Chain, and Human Resources Administration.  Corporate decided to use Waterman Hospital as the Alpha campus to roll-out the new business model.  The go-live implementation did not meet the expectations of the Executive Leaders, employees, and its stakeholders.  At least 30% of the new system was not working appropriately.  There were issues with Payroll, Talent Acquisition, and Supply Chain.  Some of the technological problems discovered were, position requisitions were not posting on the website, candidates can’t complete their application submission, supervisors were not able to complete purchasing supplies request, paid days off were not recalculating accurately, etc. 
Our campus at Memorial Medical Center was selected to be the Beta campus which meant, whatever did not work at Waterman, needed to be fixed before our go-live.  The announcement was made six months before the go-live and panic-stricken among the department heads and most specifically the clinical employees.  Yes, the “why” behind the system change was communicated, but I believe it was not 100% understood by hospital employees and its stakeholders.  For every change management, transparency and open communication are of utmost importance. 
I have always believed that useful communication and transparency from the executive leaders is the essential element to the success of a leader and any change management within the organization.  Open communication is essential in strategic alignment and accountability that comes with change either in leadership or system technology to empower the employees and stakeholders in buying-in to leadership initiatives.  This is where the executive leaders were a little bit short.  The efficiency of the system should have been tested over and over until all possible technical problems were identified before going live with Shared Services & PeopleSoft application.  Shared Services were paid to make sure that our organization’s data mining and data warehousing were accurately and efficiently working before the go-live of Waterman and the Florida Hospital Memorial Medical Center. 
Navigating Multistakeholder and Environmental Complexity.  Adventist Health System uses to improve and develop the standardization across the 52 campuses continuously is listening to stakeholders.  When the first and second go-live with Shared Services’ outcome was not to par or every stakeholders’ expectations, Adventist Health System’s Executive Leadership sat down with Shared Services to lay down expected results and timeline.  Linking Shared Services mapping process and aligning AHS’ mission of “Extending the Healing Ministries of Christ” and company strategy cannot be in jeopardy due to systems failure or employees and stakeholders unable to perform their tasks due to data error or inability to hire skilled and able clinical or non-clinical team members. 
My two-cents with the Corporate Executive decisions regarding the implementation of Shared Services and utilization of PeopleSoft application should have been implemented at the Corporate level.  The primary constraints experienced by Waterman and the East Florida Region Hospitals’ employees and stakeholders’ perceived lack of confidence in the new business model by Corporate Executive Leaders.  From the employees’ standpoint, if Shared Services is that useful from a strategic point of view, then why did the new business model not implemented at the Corporate Office first to ensure that the model/system was working as expected before implementation to other AHS hospitals.  Shared Services business model is very efficient and effective in establishing governance and procedures, optimizing workforce within process improvement and work consolidation as long as all systems function as anticipated.
Navigating Systemic Complexity.  After the challenges, we faced from the go-live of Shared Services and People Soft; Corporate Executive Leadership decided to enhance our PeopleSoft application.  With the improved PeopleSoft application, we can efficiently manage the organizational workforce to lessen the loss of productivity and time by strategically tracking absences, work time, and appropriately schedule our workforce labor.  It gives us opportunities to forecast workload demand and work, and define the workforce programs to meet our operational objectives and capture employees’ time worked and absences in adherence to federal and state labor and pay rules.  With the enhanced PeopleSoft Supplier Relationship Management systematically integrates procurement with Human Resources to administer full time, part time, per diem, and contingent workforce management.  The enhancement has been communicated to the hospitals’ leadership and employees on a regular basis to lessen if not avoid past confusion and misunderstanding.  Executive Leaders are more transparent and open with their line of communication at this time.
In today’s environment, may it be personal or business, the relentless development of technology is unstoppable which means leaders will have to be more flexible in their decision-making approaches.  At differing levels, innovation will take place on products and services resulting in dramatic and meaningful breakthroughs.  It is also inevitable that implementation of innovation comes with resistance to change from employees, customers, community, and stakeholders.  The success or failure of these changes depends on how leaders position themselves to be in a place to innovate and be adaptive, allowing them to generate breakthroughs and discover new elements and possibilities in the midst of the environment of resistance.
Ten years from now, I see myself as a better innovative and adaptive leader, enabling my team to adopt a creative or entrepreneurial mindset, freeing ourselves with ego, being sensitive and perceptive to the needs of others.  Understanding that innovation is a team initiative, taking time to observe the people around us identifying those that require solutions would be critical.  Being sensitive and perceptive to my team will enable me to be a supportive change agent recognizing or identifying opportunities for everything improving my team’s performance.
References
Carmeli, A., Gelbard, R., & Gefen, D. (2010). The importance of innovation leadership in
cultivating strategic fit and enhancing firm performance. The Leadership Quarterly, Volume 21, Issue 3, Pages 339-349, ISN 1048-9843. 
Edgell, R. & Vogl, R. (2013). A theory of innovation: Benefit, harm, and legal Regimes, law,
            innovation and technology, 5:1, 21-53. http://dx.doi.org/10.5235/17579961.5.1.21
Hoch, S. J., & Kunreuther, H. C. (2005). Wharton on making decisions. (1st edition.).
Hoboken, NJ: John Wiley & Sons Inc.
McKeown, M. (2014). The innovation book: How to manage ideas and execution for outstanding
            results (1st ed.). FT Press. ISBN: 978-1292011905.
Obolensky, N. (2014). Complex adaptive leadership (2nd ed.). London, UK: Gower/Ashgate
Suzuki, O. (2015). Unpacking performance benefits of innovation ambidexterity: Evidence from
the pharmaceutical industry. Management Revue, 26(4), 328-348. doi: http://dx.doi.org.ezproxy.libproxy.db.erau.edu/10.1688/mrev-2015-04-Suzuki

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