yOGL 481 Pro-Seminar I:

PCA-Structural Frame Worksheet

Worksheet Objectives:
1. Describe the structural frame
2. Apply the structural frame to your personal case situation

Complete the following making sure to support your ideas and cite from the textbook and other
course materials per APA guidelines. After the peer review, you have a chance to update this and
format for your Electronic Portfolio due in Module 6.

1) Briefly restate your situation from Module 1 and your role.

New patients coming into Mayo Clinic talk to schedulers who run a decision tree to

determine which is the best specialty and provider that can treat the patients condition or

concern. These decision trees are built with an algrothm behind the scences to guide the

scheduler with questions to ask the patients. The algrothm is determined by a combination of

best practice workflows, rules and questions. While working with Sleep Medicine in Rochester,

Minnesota to create their decision trees, we were up against a time crunch due to the project

deadlines. The chair of the department was innovative beyond our build capabilities at the time

which made it difficult to finalize workflows. I was also a new analyst when it came to the type

of system build for the project and my confidence level in my capabilities were low. I had to

work overtime to completed the build including after hours meetings to come to an agreement.

The final outcome had to be demoed to all the stakeholders within the department. This took

place in a large presentation hall pushing my public speaking skills to grow exponetually. This

situation also pushed me to think outside the box and collobrate with other build team members.

2) Describe how the structure of the organization influenced the situation.

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 At Mayo Clinic the organizational structure of each specialty clinic or department is

consistent. There is the Chair of the department is held by one of the physicians in the

department. The Operation Adminastor (OA) is held by a non-clinical person that the providers

within the department reports to. The OA is also in charge of meeting finachials and patient

access into the specialty. Then you have the Operation Manger (OM) who is the assistant to the

OA but is also in charge of the supervisors over the schedulers and desk staff. The Supervisors

and assistant supervisors support the OM and is also in charge of the desk and scheduling staff.

In my role I work very close with the supervisors and assistant supervisors. If a large practice

impact decision is needed then I will work with the Chair, OA and OM.

There are checks and balances over the departments at Mayo Clinic. The Regional

Access Leadership (RAL) analyzes and providers the departments with specific access

requirements for patients and financials to meet. Larger practice decisions that will impact

patient access must be approved by RAL. There are many other commities that major projects

and build changes must get approval from before the changes can be implemented. This ensures

the goals of Mayo Clinic are kept in alignment with the asks by the departments.

For my personal case analysis, the structure was not as strict as it is today. The goal of the

project was to get the current state scheduling process built into the new system. Many

departments, including sleep medicine, tried to push new ideas that were out of scope. Part of my

task was to keep the department in scope but also keep them ‘happy’. If the chair or OA of the

department made enough ‘noise’ our manager would step in to come to a compresmise.

3) Recommend how you would use structure for an alternative course of action
regarding your case.

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 The structure previously described would have helped mitigate project delays due to out of

scope tasks being requested by departments. The process to get approval for changes now is

much longer than it was during the project. I can understand the need to meet project deadlines

by removing barriers but with these barriers in place it keeps the departments ‘in check’. Some

of the delays with Sleep Medicine could have been avoided if they had to get additional approval

for out of scope requests. The departments took advantage of analysts assigned to departments

and regions they were not familiar with to push out of scope requests.

When the project started many staff was recruited to assist, including myself. There was no

additional training only crash classes explaining what the objectives were. My lack of experience

made the tasks intimidating pushing me to grow daily. For my case having a training and

resource structure in place would have been helpful. In this structure knowledge would have

been passed along to each of the analysts to better understand their assigned departments. Having

that background information would of instilled more confidence in the decisions that were made.

4) Reflect on what you would do or not do differently given what you have learned
about this frame.

Understanding the organizations structure prior to starting on the project leading to my

situation would have helped me a lot. The structure also varies from sight to sight. This was a

large gap of knowledge for me. Some colleagues did try and inform me about these variations

but at the time I didn’t understand why that would affect how decisions are made within

departments. In Arizona I was used to working directly with the OA and OM but in Rochester I

worked directly with the Supervisors and the physician chair of the department. Providers in

Rochester are more involved with the access decisions in the department whereas in Arizona

they are more hands off and the OAs handle the access decisions.

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 Decisions are approved by the correct chain of command. Not knowing who to start with to

get the approval process started caused delays. When scheduling meetings and sending emails

knowing who should be included will naturally be more productive but I constantly ran into just

the opposite and not given all the names of who needed to be involved. This did led to more

delays in getting decisions made to meet the deadlines. Different stakeholders had to be involved

depending on the type of decision it was and this was not easy to keep straight. I have learned to

keep detailed practice contact information available for the team including which areas within

the department they are in charge of.