To Change or Not to Change
April 7, 2008
Introduction
In the world of large organizations there is a strong temptation to streamline operations by having blanket systems and procedures in place. This is intended to achieve a consistent end product or service, particularly if an organization has multiple locations providing similar services. McDonalds and Home Depot, as well as many other retail franchises are great examples of success in that area. You can go to any McDonalds in the country and expect to get the same Big Mac in the same amount of time with the same procedure for ordering, paying and receiving your food. This works well when the product is the same and when all other conditions and functions are the same.
The problems occur when those procedures are duplicated in environments which may appear to be the same from the outside, but with a closer look, are not the same at all. This can happen when decisions are made by upper management without real understanding of the significant differences which may be present between two similar departments. The rationalization for the duplication may be well intended, but far too often the underlying reasons are for the convenience of upper management to be able to view the organization without having to understand multiple procedures.
Our Organization and its Situation
I work as a respiratory therapist at the largest level-one trauma hospital in the most southeastern part of Tennessee. We are located in Chattanooga and serve 50 surrounding counties. The nearest hospitals with this level of service are in Nashville, (100 miles to the north), and in Atlanta, (130 miles to the south). Our hospital is divided into two distinct parts. The main hospital is for adults and then ...