Effects  of  Organization Development  on  Organization  Climate,
Performance,  and Problem Resolution in the Division of Head  and
Neck,   Breast,  Esophagus,  and  Soft  Tissue  Surgery  of   the
Department of Surgery of the Philippine General Hospital

Background Information

The   Philippine  General  Hospital  (PGH)  is  a   tertiary government hospital with about 1000 bed-capacity.  It has various clinical  departments such as departments of  internal  medicine, pediatrics,   obstetrics   and   gynecology,   family   medicine, ophthalmology,   otorhinolaryngology,  rehabilitation   medicine, radiology, anesthesia, and surgery.

The  Department  of  Surgery  is one  of  the  four  biggest departments in PGH. It has about 200-bed capacity.   Organization wise,  the  Department  consists of  12  subspecialty  divisions,namely:

1. Division  of Head and Neck, Breast, Esophagus,  and  Soft
Tissue Surgery (GSI)
2. Division of Colorectal Surgery (GSII)
3. Division of Gastrointestinal Surgery (GSIII)
4. Division of Trauma
5. Division of Pediatric Surgery
6. Division of Urology
7. Division of Neurosurgery
8. Division of Thoracocardiovascular Surgery
9. Division of Plastic and Reconstructive Surgery
10. Division of Burns
11. Division of Surgical Intensive Care
12. Division of Organ Transplantation

As its name implies, GSI handles all patients with  surgical diseases of the head and neck, breast, soft tissue, and esophagus in  PGH.   It handles instructions on surgical  diseases  of  the head  and  neck, breast, soft tissue, and esophagus  for  medical students  from  the  U.P. College of Medicine  and  for  surgical trainees in PGH.

GSI  has  8 consultants, 2 fellows, and about  6-7  rotating residents  to fulfill its service duties and responsibilities  in PGH.   It  has 27 regular beds.  Annually, GSI has  about  10,000 consultations, 1,000 admissions, and 1,500 operations.

GSI has an annualy teaching duties and responsibilities to 2 fellows,  about 28-30 surgical residents, and about  640  medical students.

I. The Problem

1. Situational Analysis

1.1 Global Reality
     
Every  health  management  organization  (HMO)  is expected  to provide quality patient care; effective,  efficient,and  humane  staff;  and  relevant  and  effective  research  and development programs.  These are universal expectations which are considered  ideal and as such, difficult to attain.   There  will invariably   be   deficiencies  and  inadequacies   which   every administrator  of an HMO must constantly try to improve in  order to reach as near as possible to the ideal.

Cite problems in HMO internationally, globally.

1.2 National Reality

In  the  Philippines,  there is  an  abundance  of health  management  organizations.  The expectation  for  quality service, anticipation of shortcomings, and need for vigilance are applicable to the Philippine HMO.

Describe  the  Philippine  health  care   delivery system.

Cite data on problems in Philippine HMOs.

1.3 Local Reality

Description  of  PGH, Department of  Surgery,  and GSI.

Based  on an Organization Planning System done  by GSI  on September, 1996; on data from a thesis on  Evaluation  of the  General Surgery Residency Program; and on data from a  paper on the Process Evaluation of Minor Surgery Operating Room at  the PGH  Outpatient  Department, GSI has the  following  problems  to contend with:

Patient Care

Long waiting time for service
Discourteous staff
Poor record system

Staff
Ineffective training program
Inadequate consultant supervision
Absenteeism of consultants

Research and Development Programs
Inadequate research activities

The  root-cause problem was identified to be  poor organization  management which affected the commitment  of  staff and the relationships among staff.

2. Statement of the Problem

With the expectations of GSI to provide quality patient care,  effective, efficient, and humane staff, and  adequate  and relevant research and development programs;

With the awareness of existence of shortcomings in  GSI on  the expectations and with the root-cause problem having  been identified;

there  is  a need to implement  certain  organizational improvement action plan.

The   general   objective  is  to   implement   certain organization   development   interventions  and  find   out   the effectiveness  of  such on improving  the  organization  climate, performance, and resolution of problems in GSI.

2.1 Specific Objective:

Specifically,  this  research aims  to  accomplish  the following objectives:

1.  To determine the profile of  organization  climate, performance, and resolution of problem in GSI prior to and  after organization development interventions (ODIs).

2. To determine the effectiveness of the selected  ODIs in   improving   the  organization  climate,   performance, and resolution of problems in GSI.

2.2     Research Questions

2.1  What  is  the  profile  of  organization  climate, performance, and resolution of problem in GSI prior to and  after organization development interventions (ODIs)?

2.2  What is the effectivenes of the selected  ODIs in improving  the organization climate, performance, and  resolution of problems in GSI?

2.3  Research Hypothesis

The  selected  ODIs  used  in  trying  to  improve the organization climate, performance, and resolution of problems in GSI is not effective.

3. Definition of Terms

Division of Head and Neck, Breast, Soft Tissue and Esophageal Surgery -

Organization Climate -

Organization Performance -

Resolution of Problems -

4. Scope and Delimitation of the Study

The  study is confined to GSI only.  It  involves  only the GSI consultants and nurses during the entire period of  study (1998-2000)  and the fellows and residents who are with  the  GSI during this period.

5. Significance of the Study

To GSI - resolution of problems and improvement of organization

A  model  to the other divisions of the  Department of Surgery  and other departments in PGH  which  have practically the same problems as GSI

A  model  that can be introduced  to  practitioners  of hospital administration

A  regimen of ODIs for the OD practitioners who may  be asked to solve HMO problems

Effects  of  Organization Development  on  Organization  Climate,
Performance,  Problem  Resolution, and Leadership  Style  in  the
Selected   Divisions  of  the  Department  of  Surgery   of   the
Philippine General Hospital

Background Information

The   Philippine  General  Hospital  (PGH)  is  a   tertiary government hospital with about 1000 bed-capacity.  It has various clinical  departments such as departments of  internal  medicine, pediatrics,   obstetrics   and   gynecology,   family   medicine,ophthalmology,   otorhinolaryngology,  rehabilitation   medicine,radiology, anesthesia, and surgery.

The  Department  of  Surgery  is one  of  the  four  biggest 
departments in PGH. It has about 200-bed capacity.   Organization wise,  the  Department  consists of  12  subspecialty  divisions, namely:

1. Division of Head and Neck, Breast, Esophagus, and Soft Tissue Surgery (GSI)
2. Division of Colorectal Surgery (GSII)
3. Division of Gastrointestinal Surgery (GSIII)
4. Division of Trauma
5. Division of Pediatric Surgery
6. Division of Urology
7. Division of Neurosurgery
8. Division of Thoracocardiovascular Surgery
9. Division of Plastic and Reconstructive Surgery
10. Division of Burns
11. Division of Surgical Intensive Care
12. Division of Organ Transplantation

Description of a division to serve as an example:

As its name implies, GSI handles all patients with  surgical diseases of the head and neck, breast, soft tissue, and esophagus in  PGH.   It handles instructions on surgical  diseases  of  the head  and  neck, breast, soft tissue, and esophagus  for  medical students  from  the  U.P. College of Medicine  and  for  surgical trainees in PGH.

GSI  has  8 consultants, 2 fellows, and about  6-7  rotating residents  to fulfill its service duties and responsibilities  in PGH.   It  has 27 regular beds.  Annually, GSI has  about  10,000 consultations, 1,000 admissions, and 1,500 operations.

GSI has an annualy teaching duties and responsibilities to 2 fellows,  about 28-30 surgical residents, and about  640  medical students.

I. The Problem

1. Situational Analysis

1.1 Global Reality

Every  health  management  organization  (HMO)  is expected  to provide quality patient care; effective,  efficient, and  humane  staff;  and  relevant  and  effective  research  and development programs.  These are universal expectations which are considered  ideal and as such, difficult to attain.   There  will invariably   be   deficiencies  and  inadequacies   which   every administrator  of an HMO must constantly try to improve in  order to reach as near as possible to the ideal.

Cite problems in HMO internationally, globally.

1.2 National Reality

In  the  Philippines,  there is  an  abundance  of health  management  organizations.  The expectation  for  quality service, anticipation of shortcomings, and need for vigilance are applicable to the Philippine HMO.

Describe  the  Philippine  health  care  delivery system.

Cite data on problems in Philippine HMOs.

1.3 Local Reality

Description  of  PGH, Department of  Surgery,  and Divisions

Based  on an Organization Planning System done  by GSI  on September, 1996; on data from a thesis on  Evaluation  of the  General Surgery Residency Program; on data from a  paper  on the Process Evaluation of Minor Surgery Operating Room at the PGH Outpatient  Department;  and on consultation with  the  different division  chiefs  and  the Department of  Surgery  chairman,  the following problems were cited:

Patient Care

Long waiting time for service
Discourteous staff
Poor record system

Staff
Ineffective training program
Inadequate consultant supervision
Absenteeism of consultants

Research and Development Programs
Inadequate research activities

The  root-cause problem was identified to be  poor organization  management which affected the commitment  of  staff and the relationships among staff.

2. Statement of the Problem

With   the  expectations  of  each  division   of   the Department of Surgery to provide quality patient care, effective, efficient,  and humane staff, and adequate and relevant  research and development programs;

With  the  awareness of existence  of  shortcomings  in practically   all  the  divisions  of  the  Department   on   the expectations   and  with  the  root-cause  problem  having   been identified;

there  is  a need to implement  certain  organizational improvement action plan.

The   general   objective  is  to   implement   certain organization   development   interventions  and  find   out   the effectiveness  of  such on improving  the  organization  climate, performance,  leadership  style  and resolution  of  problems  in selected divisions of the Department of Surgery.

2.1 Specific Objective:

Specifically,  this  research aims  to  accomplish  the following objectives:

2.1.1 To determine the profile of organization climate, performance,  leadership style and resolution of problem  in  the selected  divisions  of the Department of Surgery  prior  to  and after organization development interventions (ODIs).

2.1.2  To determine the effectiveness of  the  selected ODIs   in  improving  the  organization   climate,   performance, leadership style and resolution of problems in selected divisions of the Department of Surgery.

2.2   Research Questions

2.1  What  is  the  profile  of  organization  climate, performance,  leadership  style  and  resolution  of  problem  in selected  divisions  of the Department of Surgery  prior  to  and after organization development interventions (ODIs)?

2.2  What is the effectivenes of the selected  ODIs  in improving the organization climate, performance, leadership style and   resolution  of  problems  in  selected  divisions  of   the Department of Surgery?

2.3  Research Hypothesis

The  selected  ODIs  used  in  trying  to  improve  the organization   climate,   performance,   leadership   style   and resolution of problems in selected divisions of the Department of Surgery is not effective.

3. Definition of Terms

The Different Divisions

Organization Climate -

Organization Performance -

Resolution of Problems -

Leadership Style -

4. Scope and Delimitation of the Study

The  study is confined to the Department of Surgery  of PGH only.  It involves only the consultants and nurses during the entire period of study (1998-2000) and the fellows and  residents who are with the Department during this period.

5. Significance of the Study

To  the selected divisions - hopefully,  resolution  of problems and improvement

A  model  to the other divisions of the  Department  of Surgery  and other departments in PGH  which  have practically  the  same problems  as  the  selected divisions

A  model  that can be introduced  to  practitioners  of hospital administration

A  regimen of ODIs for the OD practitioners who may  be asked to solve HMO problems

Effect  of Organization Development on the  Working  Relationship
Between Nurses and Residents in Manila Doctors Hospital