Introduction
Novant Health (NH) is a leading not-for-profit, integrated healthcare system of over 350 physician practices, 15 hospitals and numerous outpatient centers in the United States. NH employs over 26,000 team members and physician partners in North Carolina, Virginia, South Carolina, Georgia, and follows a personalized model of care CITE NOVANT?. The purpose of this paper is to provide an advanced organizational analysis of NH’s structure of leadership, culture, learning, and interprofessional collaborative practices.
*apply the polarity thinking model as well as Jim Collins’ framework for advanced organizational analysis (2001)*mention this somehow? Complex Adaptive Systems A Complex Adaptive System (CAS) is a collection of individual agents with freedom to act in ways that are not always totally predictable, and whose actions are interconnected so that one agent’s actions changes the context for other agents (CITE BOOK/SCHOOL REFERENCE?). With regard to healthcare systems; healthcare providers that render services to patients make decisions based on their establishment’s policies and protocols for treatment, in addition to internal rules that may not be explicitly shared, or even viewed as logical to another provider. NH is a large integrated healthcare System which has a network of physician clinics, outpatient facilities, and hospitals strategically placed across the southeastern United States. Patients that receive care within the network’s hospitals and clinics may also receive care at partnership or affiliated clinics as well. For instance, NH Hemby Children’s Hospital (Formerly known as NH Blume Pediatric Hematology & Oncology), is an affiliate of St. Jude Children’s Research Hospital.
A pediatrician or behavioral health specialist can assess a child at the local children’s hospital, and an oncologist specialist from St. Jude Children’s Research Hospital can assess the same patient at the affiliate clinic on site. The challenge with that is, decision making and treatment pathways may differ between the two providers, and the communication and collaboration of services rendered between these two sites can have a direct effect on future decisions for treatment of the patient. Although individual agents or providers within a CAS operate upon different protocols and internal rules, these individuals are continuously being transformed, and they are capable of learning by experience over time.
In this respect, adaptation within the system can be for better or worse, depending on how the changes are regarded. The evolution of one system or organization can influence and be influenced by another, which can lead to conflict and paradox that can never be fully resolved. In this respect, agents and systems cannot be fully understood without reference to the others. NH Mission and Vision NH’s mission and vision statement is “To improve the health of communities, one person at a time, and deliver the most remarkable patient experience in every dimension, every time.” (CITE NOVANT).
NH exemplifies and “lives” their mission and vision statement by making investments in the health of communities they serve. NH brings world-class technology, personal connections, and care that is easier for patients to access by strategically placing its facilities and affiliates across the southeastern United States. In 2016, NH provided over $32 million dollars in community benefit to the Eastern Carolina market of North Carolina. These community benefit programs include subsidized health services, community health improvement, health professional education, research, community building activities, and cash donations (CITE NOVANT). In lieu of past and present community outreach and exposure, NH remains to be viewed as a largely positive organization. As an employer, this organization has been recognized among the “2015 50 out front best places for women & diverse managers to work” by Diversity MBA (CITE NovantHealth TeamMember News WEBSITE) NH Culture and Climate Edgar Schein defines culture as “find source and quote.” NH promotes a “Culture of Giving,” which is based on their “Giving.Serving.Together” campaign.
As a not-for-profit organization that relies on communities that give in order to operate, this system-wide campaign is something that offers the staff of this organization an opportunity to join together and make a difference where they work and live. (CITE NOVANT?). NH’s culture is largely driven by their people credo and core value of diversity and inclusion, “At Novant Health, people are our business. We treat each other with respect and compassion. We embrace the differences in our strengths while fostering an environment of inclusion, empowerment, inspiration and courage.” NH ingrains this philosophy into their team members early on with an on-boarding process that is tailored to their core mission, vision, and values. The on-boarding process is especially critical because, early in the employment experience, is when new-hires establish attitudes about the position, coworkers, management, and climate of the company itself.
NH demonstrates a caring climate by means of their retention strategy; “the care of all people, starting with our team members.” Leaders of this organization are driven to focus on creating and maintaining a work environment that fosters team member engagement by way of facility specific team member engagement initiatives and team member activities (CITE NOVANT). NH, A Learning Organization NH has developed strategies that aim to design new work practices, better quality care, enhanced knowledge management, and continued professional development in health care. One of these strategies is their investment in the training and education of future nurses through the Student Nurse Apprentice Program (SNAP). Students in their junior and senior years of college work side by side with their preceptor, a registered nurse, and apply the skills they have learned in the classroom to live patients in a supervised hospital setting.
NH’s investment in future nurses demonstrates their commitment and dedication to professional growth and development. Additionally, NH uses problems as an opportunity to learn by way of their “First do no harm” program. Transparency remains a hallmark of this program; therefore, shared stories called “it happened within our walls,” about mistakes made in the organization are shared will all team members in order to encourage open dialogue. This approach helps to provide a learning opportunity for all team members to ensure that such events do not happen again. NH Leadership The predominant leadership style NH advocates as an establishment is the transformational style.
Transformational leaders are proactive, and convince followers to strive for higher performance (CITE A DEFINITION OF LEADERSHIP STYLE). NH guides team members in leadership positions in part with leadership development programs and required on-boarding training classes for new leaders. One of these effective leader classes is called “Leading Transformational Change.” This course is designed to facilitate leaders’ understanding of the forces behind change within the organization, as well as illustrate how to effectively lead team members through change in order to create the “remarkable patient experience in every dimension, every time” (CITE NOVANT). Core Competencies of Interprofessional Collaborative Practice According to the Interprofessional Education Collaborative Expert Panel of 2011, there are four interprofessional competency domains (CITE IPEC 2011?). The first core competency is “Values/Ethics for Interprofessional Practice.” Interprofessional values and related ethics are an essential part of crafting a professional identity. Values and ethics that are instilled in a healthcare organization’s employees center toward a sense of shared purpose to support the common good in healthcare and patient satisfaction.
This fosters a sense of community and promotes patient-centered and community population oriented care (CITE IPEC TEXT). The second core competency is “Roles/Responsibilities.” The development of an interprofessional requires “an understanding of how professional roles and responsibilities complement each other in patient-centered and community population oriented care” (CITE IPEC TEXT). In relation to healthcare professionals; providers and front line caregivers must be able to identify their own professional roles and responsibilities to support staff and other team members of other professions, and understand others’ roles and responsibilities in relation to their own as a core competency domain for collaborative practice (CITE IPEC TEXT). The third core competency is “Interprofessional Communication.” In most competency frameworks, communication is considered a core aspect of interprofessional collaborative practice (CITE IPEC TEXT).
