Planned Change: Leadership of Reduction in Workforce

XXXX Chamberlain College of Nursing NUR 534: Healthcare Systems Management Dr. Sandra Welling October 11, 2020

---

Introduction

Roxboro Medical Center (RMC) is facing a critical juncture due to a significant market share loss over the past 24 months. Despite efforts to mitigate the financial impact through alternative strategies, these measures have proven insufficient to ensure the organization’s long-term viability. As Palazzo (2015) asserts, when all other attempts to achieve financial stability have failed, implementing a Reduction in Force (RIF) becomes a necessary course of action. This paper explores the leadership strategies and decision-making processes involved in executing a RIF at RMC, focusing on the challenges, ethical considerations, and organizational restructuring required to meet the board’s mandate.

For more insights on managing organizational change in healthcare, visit nursingschooltutors.com.

---

Approach to the Organizational Mandate

The task of reducing the workforce at RMC is both a strategic and ethical challenge. As the Chief Nursing Officer (CNO), I am responsible for overseeing 33 management positions, including house supervisors (HS), unit managers (UM), and charge nurses (CN). The mandate requires the elimination of ten positions to align with the expectations of the board, CEO, and CFO. This reduction is necessary to stabilize the organization’s financial position, but it also demands careful consideration to avoid potential legal repercussions and to maintain morale among remaining staff (Siegal, 2020).

This paper will delve into the decision-making process used to select which positions to eliminate, the challenges and conflicts inherent in a RIF, the reorganization plan, and the proposed change model to facilitate restructuring. Additionally, it will discuss strategies to address system-wide issues related to morale and motivation. The ultimate goal is to execute the RIF in a manner that upholds the organization’s commitment to providing excellent patient care while ensuring financial sustainability.

Reduction in Workforce: Decision-Making Process

The decision-making process for the RIF began with an analysis of the 16 employees who have tenure of less than 15 years. Human resources provided a comprehensive table listing their performance ratings. The task was to identify the ten employees whose positions would be eliminated based on their performance and tenure.

The first step was to identify the eight employees with low or inconsistent performance reviews. High performance is critical in a healthcare setting, particularly in management roles where the ability to uphold the organization’s vision and values directly impacts patient care (Palazzo, 2015). Therefore, these eight employees were selected for dismissal due to their inability to consistently meet the organization’s standards.

The remaining two positions were determined based on tenure, with those employees having the least years since hire being selected for the RIF. This approach aligns with best practices in workforce reduction, where performance and tenure are key factors in making informed and defensible decisions (Siegal, 2020).

For further reading on best practices in implementing workforce reductions, visit nursingschooltutors.com.

Challenges and Conflicts in Implementing a RIF

Implementing a RIF presents several challenges, not least of which are the ethical dilemmas and potential conflicts that arise. One of the primary concerns is ensuring that the process is fair and transparent, as any perception of bias or favoritism can lead to legal challenges and damage to the organization’s reputation (Gandolfi & Hansson, 2011). Additionally, the emotional toll on both the dismissed employees and those who remain can significantly impact morale and productivity.

Another challenge is maintaining the integrity of patient care during and after the reduction. The loss of experienced management staff can lead to gaps in leadership and a decline in the quality of care, particularly if the remaining staff are overburdened or demoralized (Armstrong-Stassen & Schlosser, 2010). To mitigate these risks, it is crucial to involve key stakeholders in the decision-making process, including human resources, legal counsel, and department heads, to ensure that the RIF is conducted in a manner that aligns with the organization’s mission and values.

Reorganization Plan

The reorganization plan following the RIF involves redistributing the responsibilities of the eliminated positions among the remaining staff. This requires a detailed assessment of current workflows, management structures, and staff capabilities to ensure that the organization continues to operate efficiently and effectively.

A critical component of this plan is cross-training and professional development. By equipping remaining staff with the skills needed to take on additional responsibilities, RMC can maintain a high standard of care despite the reduced workforce. Moreover, providing opportunities for career advancement and skill development can help to mitigate the negative impact on morale and foster a sense of loyalty and commitment among the remaining employees (Cascio, 2012).

For strategies on cross-training and professional development in the wake of organizational change, visit nursingschooltutors.com.

Proposed Change Model: Lewin’s Change Theory

To facilitate the successful implementation of the RIF, Lewin’s Change Theory will be applied. This theory is particularly effective in guiding organizations through complex changes by breaking the process down into three manageable stages: Unfreezing, Changing, and Refreezing (Lewin, 1951).

• Unfreezing: The first stage involves preparing the organization for the upcoming change. This includes communicating the necessity of the RIF to all stakeholders, addressing concerns, and building a coalition of support among key leaders and staff members. Transparency is crucial at this stage to reduce anxiety and resistance (Burnes, 2004).
• Changing: The second stage is the implementation of the RIF itself. This involves executing the plan according to the established criteria and ensuring that all legal and ethical standards are met. During this stage, continuous communication and support for affected employees are vital to maintaining organizational stability (Schein, 1996).
• Refreezing: The final stage focuses on solidifying the new organizational structure and ensuring that the changes are sustainable. This includes reinforcing the new roles and responsibilities, providing ongoing training and support, and monitoring the impact on patient care and employee morale (Lewin, 1951).

By following Lewin’s Change Theory, RMC can navigate the complexities of the RIF while minimizing disruption and maintaining a focus on patient-centered care.

Strategies for Addressing Morale and Motivation

The impact of a RIF on employee morale and motivation cannot be understated. The fear and uncertainty that accompany job cuts can lead to decreased productivity, increased absenteeism, and a decline in overall job satisfaction (Gandolfi, 2008). To counteract these effects, RMC will implement two key strategies:

1. Transparent Communication: Ensuring that all employees are fully informed about the reasons for the RIF, the process by which decisions were made, and the support available to those affected is critical. Open and honest communication can help to rebuild trust and reduce the anxiety that often accompanies organizational change (Kotter, 1996).
2. Employee Support Programs: Providing resources such as counseling, career coaching, and financial planning assistance can help employees navigate the transition more effectively. Additionally, offering retention bonuses or incentives for remaining employees can help to maintain motivation and reduce turnover (Cascio, 2012).

For more detailed strategies on managing morale and motivation during a RIF, visit nursingschooltutors.com.

Conclusion

The implementation of a Reduction in Force (RIF) at Roxboro Medical Center is a complex and challenging process that requires careful planning and execution. By applying a structured approach based on leadership principles and change management theories, RMC can navigate this difficult transition while maintaining its commitment to high-quality patient care. The use of Lewin’s Change Theory provides a solid framework for managing the change, while transparent communication and employee support programs are essential for maintaining morale and motivation.

Through thoughtful and strategic leadership, RMC can emerge from this process stronger and more resilient, better positioned to meet the challenges of the evolving healthcare landscape.

References

Armstrong-Stassen, M., & Schlosser, F. (2010). Perceived organizational downsizing and employee performance: The moderating role of trust in management. Journal of Occupational Health Psychology, 15(4), 361-375.

Burnes, B. (2004). Kurt Lewin and the planned approach to change: A re-appraisal. Journal of Management Studies, 41(6), 977-1002.

Cascio, W. F. (2012). Downsizing: What do we know? What have we learned?. The Academy of Management Perspectives, 7(3), 95-104.

Gandolfi, F. (2008). Learning from the past—downsizing lessons for managers. Journal of Management Research, 8(1), 3-17.

Gandolfi, F., & Hansson, M. (2011). Causes and consequences of downsizing: Towards an integrative framework. Journal of Management & Organization, 17(4), 498-521.

Kotter, J. P. (1996). Leading change. Harvard Business Review Press.

Lewin, K. (1951). Field theory in social science: Selected theoretical papers. Harper & Row.

Palazzo, G. (2015). Ethical decision-making in workforce reductions: Strategies for leaders. Healthcare Leadership Review, 32(4), 45-50.

Schein, E. H. (1996). Kurt Lewin’s change theory in the field and in the classroom: Notes toward a model of managed learning. Systems Practice, 9(1), 27-47.

Siegal, D. (2020). Avoiding legal pitfalls during workforce reductions. Legal Management, 39(2), 14-18.