PHASE I - DEFINE THE REALITY

Foreword:

     Phase  I pertains to those activities which are attended  to 
before  the  design and development of a plan of  action  can  be 
initiated.   During this phase, the participants' activities  are 
focused upon carrying out two major functions:

          The SITUATION ANALYSIS in Stage 1 and
          The SYSTEM ANALYSIS in Stage 2.

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STAGE 1 - SITUATION ANALYSIS
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     A  study  of  the  organization (GSI in  this  case)  as  an 
integrated whole and of the interdependent parts of the system is 
the first logical step to take.

     STAGE 1 consists of 2 steps:

          Step 1. Define system boundaries.
          Step 2. State vision-mission.

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STEP 1. DEFINE SYSTEM BOUNDARIES.
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     Information  is gathered to define and describe  the  system 
being studied (GSI).  Boundaries are clearly delineated.

     What is a SYSTEM?

     A system is a structure or organization of an orderly  whole 
made  up of a number of parts, elements or functions  related  to 
each other and to the whole in such a way that each part and  the 
totality  of  the parts work together to  accomplish  a  specific 
mission. (Ryan, 1973)

     From this definition, the following criteria emerge:
     - There must be a structure or an organization.
     - The structure or organization must be conceptualized as a 
          whole.
     - The whole must be orderly.
     - The whole has parts.
     - Parts can be shown clearly relating to each other.
     - Parts can be shown clearly relating to the whole.

                                             (Ryan, 1973)

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STEP 1 ACTIVITIES:

     1. Identify the focal system (GSI).
     2. Identify the subsystems within the focal system, which 
          may be subspecialty sections or specialized functions.
     3. Identify the macrosystem and supermacrosystems in  which 
          the focal system is established.
     4. Identify the related systems of the focal systems  within 
          the macrosystem and supermacrosystems.

***INSTRUCTION 1: Fill up the blanks below:

          Supersupermacrosystem:       _________________________

          Supermacrosystem:            _________________________

          Macrosystem:                  Department of Surgery

          Related systems:              Other Divisions in the 
                                         Department of Surgery

          Focal system:                 GSI     
     
          Subsystems:                  __________________________
                                        
                                       __________________________

***INSTRUCTION 2: After you have filled up the blanks below, make 
     a drawing that illustrates and situates the focal system and 
     its subsystems as well as the related systems,  macrosystem, 
     and supermacrosystems. 

***INSTRUCTION  3:  After  you are  through  with  your  drawing, 
     analyze  it and decide whether all the criteria of a  SYSTEM 
     as defined by Ryan are present.
 
          (  ) Yes, all the criteria of a systems are present
               in my illustration.

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STEP 2. STATE VISION-MISSION.
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     The  Vision  and Mission of the whole organization  and  the 
macrosystem  are spelled out.  From here, the Vision and  Mission 
of the focal system is formulated.

     What is a VISION?

     A  Vision is a statement of the overall and continuing  ends 
to be accomplished and for which all available resources will  be 
used.

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     A Vision is the ideal purpose or reason why the organization 
exists.

     It is dream that the organization ardently wishes to attain.

     Vision gives the direction.

     Characteristics of a Vision:

          1. Abstract
          2. Permanent
          3. Timeless
          4. Always in the process of being attained

     How Vision is formulated:
          
          1. In a noun phrase
          2. In view of the receiver
          3. Does not include the problem
          4. States the ideal-end result

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     What is a MISSION?
     
     A  Mission  is  the  pledge, solemn promise,  or  vow  or  a 
commitment  to  live  certain  values,  beliefs,  conviction,  or 
lifestyle to come closer to the vision.

     Mission contains ideals for ourselves; values expected to be 
found  and lived by every member of the organization.  It is  the 
purpose commitment of the organization.

     Characteristics of a Mission:

          1. Abstract/General
          2. It changes as needs change

     How Mission is formulated:

          either Noun phrase or Infinitive verb

STEP 2 ACTIVITIES:

     1. Study the Vision and Mission of the following:
               UP Manila
               Philippine General Hospital
               UP College of Medicine
               Department of Surgery
               GSI

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     2. Formulate the Vision and Mission statements for GSI using 
the  process  of  cascading.   "Cascading"  is  the  process   of 
identifying  the appropriate portions of the overall  Vision  and 
Mission to the different organizational divisions/levels so  that 
a balanced and proportionate part of the total Vision and Mission 
is achieved at each component/level of the organization.

     3. Group consensus of the vision and mission of GSI.

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STAGE 2. SYSTEM ANALYSIS
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     What is SYSTEMS ANALYSIS?

     This  is  a  process  which  requires  a  COMPREHENSIVE  and 
SYSTEMATIC  study  of the state of things: 
          the  present  and  the future,
          the current situation and the desired situation.

     This process demands an HONEST-TO-GOODNESS assessment of the 
conditions of a system.

     It  involves  a COMPARATIVE analysis of the  "WHAT IS"  and 
"WHAT SHOULD BE".

     This  leads  to an INTEGRATED comprehension  of  the  "total 
reality".

     Stage 2 consists of 4 steps:

          1. Assess conditions.
          2. State problem.
          3. Identify and prioritize needs.
          4. Propose courses of action

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STEP 1. ASSESS CONDITIONS.
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     In  order to determine a root-cause problem  in  preparation 
for  a  planned  change,  an assessment of  the  system,  of  its 
potentials  and limitations, is indicated in view of learning  as 
much  as needed about the system and the people who are  part  of 
the system.

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     Moreover,  a realistic and exhaustive look at the system  in 
the  context of three categories, namely, a) SYSTEMATIZATION,  b)  
COMPATIBILITY,  and  c) WHOLENESS in the light  of  the  system's 
Vision  and  Mission,  will  enable  the  team  to  situate  more 
accurately the organization problem/s.     

     SYSTEMATIZATION -
          When  there  is systematization, there  is  METHOD  and 
     ORDER.  The  system and its parts operate  functionally  and 
     efficiently.

     COMPATIBILITY -
          If  the systems are compatible, they are in accord,  in 
     SYNCHRONIZATION  among themselves and with  the  environment 
     (macrosystem).   Each one is attuned and responsive  to  the 
     other, each one can reconcile his own goal with that of  the 
     other  at work, for the same purpose, for the system  within 
     the macrosystem.

     WHOLENESS -
          Wholeness  is defined as the degree to which each  part 
     of  a system is INTEGRATED to every other parts.   Wholeness 
     considers  the  measure of integration and  the  quality  of 
     UNITY  between  and  among the parts  with  respect  to  the 
     Vision-Mission and Goal of the system.

STEP 1 ACTIVITIES:

     1.1  Group assesses reality in the focal system  (GSI)   and 
subsystems in the area of SYSTEMATIZATION.

     1.2  Group spells out indicators and judgements which  bring 
to awareness the existence or nonexistence of SYSTEMATIZATION  in 
the system.  

          INDICATORS are facts. Thus, they are observable  and/or 
               measurable.  They are empirical statements of  the 
               obtaining conditions in a situation.  They can  be 
               positive or negative depending on the  perspective 
               of evaluating a reality.  Negative indicators  are 
               dysfunctions  pointing  to  the  existence  of   a 
               problem.

          JUDGEMENTS  are conclusions or interpolations on  given 
               factual  data.   They  are  conceptual  evaluative 
               judgements about the reality.  Negative judgements 
               are  statements of the existence of problems in  a 
               system.

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          PROBLEMS  are statements describing  some  dysfunctions 
               and/or dissonance in a system.  They express  that 
               there  is something wrong in the system  and  that 
               the situation does not measure up an ideal.

          The  assessment  of the system should be  done  in  the 
               context of "WHAT HAS BEEN/WHAT IS" 
               1. within the focal system (GSI)
               2. within the subsystems in relation to the
                  focal system (GSI)
               3. within the related sytems as far as it affects 
                  the focal system (GSI)
               4. within the macrosystem and supermacrosystem  as 
                  far as it affects the focal system.
 
     2.1  Group assesses reality in the focal system  (GSI)   and 
subsystems in the area of COMPATIBILITY.

     2.2  Group spells out indicators and judgements which  bring 
to  awareness the existence or nonexistence of  COMPATIBILITY  in 
the system.  

     3.1  Group assesses reality in the focal system  (GSI)   and 
subsystems in the area of WHOLENESS.

     3.2  Group spells out indicators and judgements which  bring 
to  awareness the existence or nonexistence of WHOLENESS  in  the 
system.  

***INSTRUCTION  1:  Spell out the indicators  and  judgements  on 
     existence or nonexistence of SYSTEMATIZATION, COMPATIBILITY, 
     and WHOLENESS using the table below as a guide.

                                   SYSTEMATIZATION
     
                         Indicators          Judgements
                                        Positive     Negative

Focal system

Subsystems

Related systems

Macrosystem

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                                   COMPATIBILITY
          
                         Indicators          Judgements
                                        Positive     Negative

Focal system

Subsystems

Related systems

Macrosystem

                                     WHOLENESS

                         Indicators          Judgements
                                        Positive     Negative

Focal system

Subsystems

Related systems

Macrosystem

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STEP 2. STATE THE PROBLEM.
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     Observable events resulting from the presence or absence  of 
the three characteristics of a healthy system -  SYSTEMATIZATION, 
COMPATIBILITY,  and  WHOLENESS  -  will  lead  to  judgements  of 
realities  in the situation.  Negative judgements or problems  in 
each  category/characteristic will lead to spelling out  of  Sub-
Problems.   Carefully compiled and analyzed,  these  Sub-problems 
will  eventually pave the way to the identification of the  Root-
cause Problem.

          PROBLEMS  are statements describing  some  dysfunctions 
               and/or dissonance in a system.  They express  that 
               there  is something wrong in the system  and  that 
               the situation does not measure up an ideal.

          SUBPROBLEM/ROOT-CAUSE   PROBLEMS  are  the   underlying 
               problems which "bother the system".  They are  the 
               statements   which   convey   the   existence   of 
               dissonance in a system at a deeper fundamental but 
               manageable level.

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STEP 2 ACTIVITIES:

     From  the  analysis  of the given  negative  indicators  and 
judgements, the teamcan now deduce the existence of problems in 
the system, particularly the focal system (GSI).

     The  problem  as identified represent the situation  of  the 
focal  system  as  far  as  SYSTEMATIZATION,  COMPATIBILITY,  and 
WHOLENESS are concerned.

***INSTRUCTION  1:  From  the  3 tables in Step  1  of  Stage  2, 
          determine  the  cause of each  negative  indicator  and 
          judgement.  Then compile the causes (or PROBLEMS) using 
          the table below as a guide.

                   COMPILATION OF PROBLEMS ON

SYSTEMATIZATION           COMPATIBILITY              WHOLENESS

_______________         _________________         ________________

_______________         _________________         ________________

     A further analysis of the list of the PROBLEMS now leads the 
teamto the formulation of the SUB-PROBLEM for each category  or 
area of SYSTEMATIZATION, COMPATIBILITY, and WHOLENESS.

***INSTRUCTION  2.  After  compiling all  the  problems  in  each 
     category, formulate a SUBPROBLEM also in each category.  Use 
     the table below as a guide.

                           SUBPROBLEMS

SYSTEMATIZATION           COMPATIBILITY              WHOLENESS

_______________         _________________         ________________

     A thorough diagnosis of the system by way of analysis of the 
subproblems  should  lead in a way to the identification  of  the 
principal  underlying problem which is the source of most of  the 
organization problems and dysfunctions.

***INSTRUCTION 3: State the one ROOT-CAUSE PROBLEM.

The ROOT-CAUSE PROBLEM OF GSI is: ______________________________.

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STEP 3. IDENTIFY AND PRIORITIZE NEEDS.
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     In  order to be able to properly determine the needs in  the 
system,  the team  should first present the "ideal situation"  or 
"what should be" for each subproblems in each category or area of 
SYSTEMATIZATION,  COMPATIBILITY, and WHOLENESS.  This means  that 
the team makes an  effort to describe the VISION-MISSION in  less 
abstract   statements   in   the   areas   of    SYSTEMATIZATION, 
COMPATIBILITY,  and  WHOLENESS  with  due  consideration  to  the 
identified SUBPROBLEMS.  

     Making    a   comparative   study/analysis   of   the    two 
status/situations, the team  will be able to determine the  needs 
to  fill  the  gap  which  clearly  exists  between  the  current 
situation  and  the  desired  situation.  The team then  makes  a 
consolidated list of spelled out needs.

     NEEDS  are what bridge the gap between "WHAT IS"  and  "WHAT 
SHOULD BE"; the present situation and the ideal situation in  the 
system.

                what are needed to link the 
                         two states
     WHAT IS <-------------------------------> WHAT SHOULD BE
                      Courses of Action        Vision-Mission

***INSTRUCTION 1: Fill up the table below:

SUBPROBLEMS              NEEDS              IDEAL SITUATION
                                            (V-M SITUATION)

SYSTEMATIZATION

_________________    __________________   ______________________

COMPATIBILITY

_________________    __________________   ______________________

WHOLENESS

_________________    __________________   ______________________

     Having  spelled  out  a good  number of needs, the  team now 
weighs and ranks these needs according to priority.

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     A  kind of matrix using the two criteria of  IMPORTANCE  AND 
URGENCY  will  help the team  in coming up with  priority  needs.  
Finally  by way of consensus and agreement, the  team is able  to 
identify PRIORITY NEEDS.

***INSTRUCTION 2: Fill up the table below:

                         Important           Not Important
     
Urgent                ________________      ________________   

Not urgent            ________________      ________________

     After  discussion  and  deliberation, the  team  shall  have 
arrived  by  way  of agreement and consensus  on  at  most  three 
clearly defined and understood PRIORITY NEEDS.

***INSTRUCTION 3: Jot down the PRIORITY NEEDS.

PRIORITY ONE:

PRIORITY TWO:

PRIORITY THREE:

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STEP 4: PROPOSE COURSES OF ACTION.
-----------------------------------
     Each  member  of the team  is asked to  study  the  PRIORITY 
NEEDS  and recommend accordingly COURSES OF ACTION which  can  be 
undertaken in order to respond to these needs.  This study should 
include consideration of the advantages and disadvantages of  the 
proposed courses of action.  Thus, each member must have in  mind 
the given potentials/capabilities and constraints/limitations  in 
the system.

     Each member presents a list of courses of action with  their 
advantages and disadvantages.  From this, the team comes out with 
a consolidated list of available courses of action.

     Having spelled out several tentative courses of action,  the 
teamnow selects those which are MOST APPROPRIATE AND FEASIBLE.

     COURSE  OF  ACTION  is a general procedure or  a  series  of 
steps  to be undertaken in order to bring the "status quo"  to  a 
desired situation.

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***INSTRUCTION 1: Fill up the table below:

                              ADVANTAGES          DISADVANTAGES

PRIORITY ONE:                 

 COURSES OF ACTION:

 GROUP DECISION:

PRIORITY TWO:                 

 COURSES OF ACTION:

 GROUP DECISION:

PRIORITY THREE:                 

 COURSES OF ACTION:

 GROUP DECISION:

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