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Constellations in Healthcare

Caroline L. Schmid

Master of Human Services, Antioch University, YellowSprings, Ohio, USA

HSA-5230: Human Service Organizations and Systems

Dr. Tera McIntosh

September 20, 2020

This paper considers solutions in healthcare by way of networking and mission driven goals over

organizational in both private and public settings. Adaptive challenges such as understaffing and

burnout are addressed, and community networking is discussed as a means to better serve their base.
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Constellations in Healthcare

In “Four Network Principles for Collaboration Success” it states that, “nonprofit leaders must let go of

conventional wisdom and shift their focus from organization-level goals to network-level impacts” (Wei-

Skillern, J., & Silver, N., 2013, p. 122). The mission should come first and any preconceived notions of

being the top of the market should be replaced with humility and community connectivity. This should

be true in many areas, but especially in healthcare where the focus is on caring for people in distress.

The poor and sick need our help the most as they are often unable to achieve good health and

wellbeing, or at least comfort, without some type of aid. Health organizations, for-profit and nonprofit

both, need to consider their community as a whole and their employees’ needs in order to overcome

current issues such as burnout and understaffing while continuing to improve availability of care to all.

Technical solutions such as computer logging and questionnaires have been established, but while they

save some time, they also decrease the amount of face-to-face communication with patients and do not

address the larger issues (C. Pickens, September 7, 2020). So how do we begin to rewrite a multilevel

system that is already so focused on profit and procedure?

Profit and Care

Doctors in private practices, according to Dr. C. Pickens (September 7, 2020) are encouraged to

see four to five patients per hour; fifteen minutes per patient or less. This is a type of performance

metric meant to increase profit (Wei-Skillern, J., & Silver, N., 2013). As a multilevel organization, profit

must travel up to the top before being distributed amongst the base in the form of pay and benefits. The

money at the top can be used to expand the organization and provide additional resources and

programs for the community. However, it can also be used to pay executives larger salaries and

bonuses. This top-down organization-focused business method leaves many underwhelmed and

vulnerable in the community.

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Strict, profit-driven performance metrics, in my experience, can mean patients feel unheard,

mistreated, and overcharged. Doctors and nurses in private and public offices and hospitals can be

overburdened with patients who need advanced care, and often suffer burnout exacerbated by

intentional understaffing (C. Pickens, September 7, 2020).

In my opinion, and reinforced by our readings this week, health service organizations should

focus on the wellbeing of the community over their executives’ salaries (Wei-Skillern, J., & Silver, N.,

2013). Increasing wages and providing affordable health services to their employees who don’t have

insurance or competitive pay would encourage more people to enter the field of healthcare. They could

start by providing benefits to workers labeled PRN; those who are only required to work about two days

a week but always seem to be scheduled for full time hours. I was such a worker.

They should also increase their staffing to counter burnout and problems with patient care. I

would often encounter patients in our public hospital that would go hours without receiving aid; people

with soiled beds, crying because they were tired of sitting in their chairs, and people who felt ignored, as

if they were a burden. On one particular occasion we had a patient who wasn’t eating; it turned out they

were blind and despite being there for three days, no one on their care team knew. Attentive care and

deep conversation are essential to a patient’s wellbeing.

Increases in staffing and wages are some costly but simple solutions that would advance the

quality of care for my community, but I don’t think they should stop there.

Doubling Down: Increasing the Network

In being a part of a constellation versus the center of their own universe (Wei-Skillern, J., & Silver,

N., 2013), health service organizations are capable of providing care on a much deeper and more

affordable level. They are also capable of supporting other community programs that are unrelated but

still improve lives.

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Currently my local health network includes a number of hospitals and private offices and labs.

They also have rehabilitation centers and longterm living and nursing facilities. Beyond that, I don’t think

they do much. However, recently they built a new emergency room branch because they wanted to be

more competitive, or so they said during an assembly meeting that I witnessed. It’s debatable as to

whether the facility was necessary as another health network has an emergency room nearby. What if

they had simply chose to work with the other network?

Two strategies for “being the change” (Wei-Skillern, J., & Silver, N., 2013, p. 128) include working

across sectors and supporting grantees in experimental efforts. These would be very beneficial in

combination to health service organizations. Currently, at my local hospital, elderly volunteers are

utilized to do simple tasks; but what if they had younger volunteers as well? They could connect with

high schools as well as activities assistants and gardeners to provide opportunities for learning and

recreation. It seems candy stripers used to be more prominent. High school students with an interest in

healthcare professions, or who wanted to fulfill a community service requirement, would volunteer at

hospitals giving personalized care to patients under the supervision of a nurse. They were in my

community as well, but not anymore. I wonder why because they seem like a valuable asset and provide

a stronger connection for people in the community to their hospitals and to people in need.

Another issue is that our hospital buys and throws away dozens of pounds of food everyday. Why

can’t they donate more or create a food line for the homeless in the area? And while they’re at it, they

could pay homeless groups to tend to gardens for the kitchen. Maybe that’s a bit ambitious due to food

regulations, but I’m sure they could research and experiment for alternatives.

Other possible areas to improve on would be domestic violence, alcohol and drug dependency,

and mental health networking. Providing resources and visits with representatives from local agencies as

well as increased resources posted on social media would benefit the community. Often I would see

people who needed more than physical health support but were ignored and forgotten. Some people
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were repeat patients who were treated every month for the same self-inflicted issue, but were never

referred to clinics or offered counseling of any kind. Helping people connect to outside resources should

be as much of a priority as solving their immediate health needs.

Finally, some individual outreach projects could include popup clinics and imaging vans for low

income neighborhoods and shelters. Social media might be used as well to promote events and help

educate on chosen topics. Involving as many in the community as possible during these events might

require extra physicians, but if they support other networks as well as their own staff, I’m sure someone

would be willing to donate their time and expertise for one day.

Conclusion

Healthcare networks are already vast, but the majority of focus in my community is on what can

profit them and allow for growth within their own organization as opposed to following through on their

mission fully. They should reorganize to better support employees, their community, and other

networks and organizations that have commendable missions. Again, these are complex adaptive issues

that would require a change in approach to how they do business (Heifetz & Laurie, 2001). However,

their employees deserve to be treated fairly and they should stay true to the mission they promote.

Networking with the community is the best way to do that and will drive future donations and support

amongst those they have served.

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References

Heifetz, R. A., & Laurie, D. L. (2001). The work of leadership. Harvard Business Review, 79(11), 131–141.

https://antioch.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?

direct=true&db=bth&AN=5634863&site=ehost-live&scope=site

Wei-Skillern, J., & Silver, N. (2013). Four network principles for collaboration success. Foundation

Review, 5(1), 121–129. https://doi-org.antioch.idm.oclc.org/10.4087/FOUNDATIONREVIEW-D-

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