Create a Microsoft PowerPoint presentation, consisting of 10- to 12-slides, outlining the elements required to create a memo that informs staff in an accurate manner of an impending reduction in the workforce. Think about how you will be objective and informative in communicating this major management decision without deliberately raising anxiety amongst all staff.

Consider the challenges and elements of this week's case when constructing your memo. Your last 2-3 slides should be the actual memo.Lecture Notes:

Internal Memo

To: Bill Jenkins, President

From: Mary Jo Larder, Director, Human Resources

As you know I have been having regular meetings with hospital employees in my efforts to implement our quality assurance program. While the purpose of the meetings is educational in nature there is considerable discussion around many issues. Some of the comments concerned me enough to let you know about them.

A number of people said that they believe the management is being hypocritical in trying to implement a QA program when there are so many obvious outstanding problems that could be addressed by management.

1. There are physicians who have acted abusively toward employees and yet nothing appears to have been done to correct this behavior.

2. Management is continually commenting on the financial problems the hospital is having and yet they are building new facilities instead of giving raises.

3. Employees are also concerned about the hiring freeze because many say they can't carry a greater workload. Many are worried about their jobs and said they are looking at other opportunities.

4. Because of the hiring freeze, managers appear to be tolerating sub par performance by some employees for fear of not being able to replace them.

5. Some employees noted that they are sometimes embarrassed to tell friends and neighbors that they work here because the reputation of our emergency room is not good. They commented on the long waits and rude treatment by the staff.

6. A number of people felt that management does not recognize their good performance and hard work.

Mr. Jenkins, I know this is rather stark. I would be pleased to talk with you and provide more insight but I wanted to document what I heard over the past couple of weeks before I forget it.

Think about it

This case study presents a complex situation with different types of problems. Analyze the situation using the questions below before you read further.

• What should Bill Jenkins do with this memo? How important is it?

• Did Mary Larder do the right thing by sending this memo?

• The memo addresses a number of issues. How would you describe each and how important is it? Rank the issues in order of importance.

• How can Jenkins address the issues raised in the memo?

• Is there a process Jenkins should follow in addressing these issues?

• What other information does Jenkins need to respond to the contents of this memo?

• Whom should Jenkins consult, both within the organization and outside it?

• What are Jenkins' options? How would you prioritize them?

• How would you recommend Jenkins evaluate the success or failure of each of the chosen strategies?

• For each strategy, who will perceive they benefited and who will perceive they were hurt or harmed?

• If a strategy is shown to be failing what are the alternatives and exit strategies?

Physician Behavior

Working with a medical staff requires special skills and attention. In most hospitals, the physicians are in private practice. They are not employees of the hospital. In fact, being a member of the medical staff is more akin to being a member of a club. It does not instill any contractual relationship and the chief executive officer has no authority to order a physician to do something beyond that conferred by the medical staff by-laws, accrediting agencies, or state licensing regulations. Confronting a physician is a delicate matter and requires careful preparation and execution.

Abusive behavior by physicians must be addressed. It is not just harmful to the morale, it also exposes the organization to liability for violating the civil rights of employees. Nevertheless, care must be taken when this kind of behavior is noted. If an accusation is false, the physician's reputation is damaged and the hospital can be sued for slander. When you don't know the exact nature of the alleged abusive behavior, it is best to begin with a very quiet investigation. Bear in mind that where one incident has been reported, there are likely to have been others.

It is important to document meetings where grievances are aired because the situation could result in legal action. It is also important to keep the hospital attorney informed. At some point Jenkins needs to bring the hierarchy of the medical staff into the loop. Medical staff by-laws contain very specific language on dealing with abusive physicians. Jenkins should review this information to make sure he is complying with the by-laws.

The sooner Jenkins can put the issue of the allegedly abusive physician into the medical staff by-law process the better. However, he needs to take great care to make sure the process is followed correctly and that there is legitimate investigation done and appropriate corrective action taken.