1

Organization and Leader Analysis

Anita Packwood

Western Governors University

Tuyet Case

July 29, 2023

 2

Organization and Leader Analysis

A. Organization Description

Within a small rural community in Idaho there is a hospital, Rural Medical Center, that

services an entire county on its own. This hospital was started by a man who, originally by horse

and buggy, made house calls in 1897. He purchased an old hotel and renovated it into a hospital

that has been going strong for 125 years. It has always been the objective to provide quality care

to the community. They not only provide quality medical care, but also provide financial

assistance so all patients get the care that they need. Rural Medical Center provides free

mammograms through their Bosom Buddies program and cancer treatments through the Light a

Candle program. The hospital is also actively involved with donating money to the community to

better the health and wellness of all. They have expanded to the surrounding small towns by

adding six different rural clinics with their own staff. At monthly staff meetings, the CEO and

CFO review the main objectives of growing the company. They express a desire to keep adding

specialties to the hospital in order to drive revenue up and make the community all-

encompassing for needs.

A1. Leadership Practices

Teresa Best is the CEO of Rural Medical Center and has been for about eight years. She

started as the chief financial officer and was promoted when the previous CEO died in a tragic

accident. Teresa is exceptional at peer relationship building. She uses this, in part with

transactional leadership, to create good connections with her employees. While, yes, there are

friendly competitions to help build productivity, it never gets in the way of fostering positivity in

the workplace. She has mastered the line on how to balance this so perfectly. There is an event

that Teresa puts on every spring called the Rural Graze. The Rural Graze is a potluck that takes
 3

you to all the different departments and clinics affiliated with the hospital. You must take your

passport and have each department stamp it and it is then entered into a drawing for prizes. But

that is not even the best part of the event. The best part is being able to connect with individuals

that you don’t normally get to know. The comradery that this event creates is incredible and

highly appreciated.

A1. Leadership Practices

Transparency about the goals of the hospital is another practice that Teresa is excellent at.

During the Covid-19 pandemic, Teresa made it a point to have daily Zoom calls with her

employees to update them on what the current safety protocols were. She made it a priority to

keep her employees informed. Once the pandemic winded down she was able to have monthly

meetings that were staff wide. At these meetings she would inform everyone of changes that

were coming, like the introduction of a urology clinic. Teresa always made sure that there was

understanding of the goals and that her staff understood their part in how to achieve that goal.

A1. Leadership Practices

The core values of the hospital are the foundation of what makes that place a great

resource for the community. Teresa lives and breathes the Rural Health Clinic’s values:

compassion, integrity, collaboration, accountability, respect, and excellence. Teresa makes it

known that exceptional care is so much more than the moments that are had with a doctor. You

need a full encumbrance team to make the experience whole. She appreciates and shouts out to

all departments and gives kudos when it is due. There were uncomfortable situations that Teresa

had to be a part of, and she made it to the other side never once losing her cool. She is a

wonderful example of treating people how you want to be treated.

A2. Effects of Current Leader on Culture

 4

Having been part of the team at Rural Medical Clinic, there has been a firsthand account

of how Teresa Best has developed the culture of the work environment. When speaking with

Teresa once can clearly see that she cares for the community and wants to provide what they

need. She wants to give them a one stop shop in their hometown, so they feel more comfortable

and surrounded by those who understand the small-town mindset. There was an instance when

Teresa was being berated by an older gentleman, who is a farmer, about the unfairness of his

billing for a stay. She listened to what he had to say, kept her body language neutral, and made

that man feel like he mattered. The conversation ended with the man in tears as he hugged Teresa

for forgiving his debt. She is compassionate and has really helped to bring back the core values

of the institution. She sends out a weekly email that has shoutouts to employees that have gone

above and beyond for their patients and other coworkers. Teresa truly has set the expectation that

a good experience is what Rural Medical Clinic is about.

B. SWOT Analysis

B1. Current Strengths

One of Rural Medical Center’s greatest strengths is that they have multiple clinics in the

neighboring small towns. This was a strategic move in order to create convenience for the

patients. If patients do not need to drive over 30 minutes to see their doctor, they are not going

to. Rural Medical Center, therefore, is able to generate more revenue as they claim patients with

convenience. Outside of Rural Medical Clinic’s home base there are over 10 small towns within

a 50-mile radius of three of which have Rural Medical Clinics, owned by Rural Medical Center.

Not only have they spread to other towns but have added more specialties to offer. The nearest

large city that has multiple hospitals is over a two-hour drive away. Rural Medical Center added

urology, general surgery, gastroenterology, orthopedics, and cancer infusions. The need for those
 5

specialties was in high demand as the general population is of retirement age and Rural Medical

Center capitalized on it. They were able to meet the demand and provide convenience.

B1. Current Strengths

Rural Medical Centers has perfected that the customer is always right. Customer service

is a huge part of the values of this hospital; every employee is expected to function under the

“Rural Way.” Having instilled this expectation, Rural Medical Center thrives on positive patient

feedback. In a small town, the word travels fast and when the word travels, the people listen. It is

a free advertisement for Rural Medical Center. Teresa Best led the hospital into the Golden Age.

The experience in the hospital is like being welcomed home and treated like royalty. The staff in

the cafeteria is genuine, kind, and learns every patient’s name. The clinical staff takes the time

that is necessary to explain procedure to the patients and allows time for questions. If you have a

negative experience, Teresa will make it right. If it was a horrific medical experience, she was

more than willing to write off the patient’s balance. Teresa cared more about the patients’

experience and less about the revenue. The revenue kick started itself.

B2. Current Weaknesses

A current weakness of Rural Medical Center is their high employee turnover rate that has

led to not having enough hands-on deck. Despite the hospital having a relatively positive

environment there are a few select departments that have trouble finding and keeping employees.

The business office alone has gone through seven new medical billers in ten months.

Environmental services have been understaffed since the pandemic began. Teresa has done her

best to create incentives to drive employees into the hospital. She offers sign-on bonuses and

better benefits. But the fact of the matter is that the neighboring state that is only eight miles
 6

away is the highest paying in the nation for medical workers. Rural Medical Center is offering

what they can, but they truly cannot afford to compete.

B2. Current Weaknesses

Earlier it was discussed that Rural Medical Center also runs clinics in some of the smaller

surrounding towns. Because of this the hospital uses three different electronic medical records

systems. The three systems do not interact with one another and there, makes it incredibly

difficult to create a complete medical record of a patient. It creates extra steps for the patients as

the hospital requires three different release forms for the three separate systems. The multiple

hoops that patients and staff must jump through creates frustration.

B3. Current Opportunities

Professional development is utilized quite a bit by Rural Medical Center. Teresa enjoys

finding ways for her employees to improve and hone their skills. She sends the business office to

insurance seminars every year and pays for them to get certified. Clinical staff is able to take

professional development courses that are paid for by the hospital as well. There are also many

speakers that come to the hospital to help improve leadership skills. The biggest push has been

MOAB training. MOAB is management of aggressive behavior, and it is required that every

employee participate in this seminar. Teresa is constantly looking for ways to drive professional

development forward to give her employees the tools for advancement or knowledge.

B3. Current Opportunities

There is an opportunity that has arisen for Rural Medical Center to absorb another local

surgery center. The surgery center is a private practice owned by a doctor who is preparing for

retirement. It’s an incredible way for the hospital to expand how many surgeries they are able to

do. Teresa plans to move the same day surgery practice to this new building. This, in turn, will
 7

free up more beds for patients who have to have overnight stays due to the severity of their

condition.

B4. Current Threats

A threat that Rural Medical Center is facing is new legislation that was passed in the state

of Idaho surrounding reproductive rights. Idaho put their trigger ban into effect after Roe vs.

Wade was overturned in 2022. The trigger ban, or Idaho Code 18-622, prohibits abortion at all

stages of pregnancy. “Federal law is clear: patients have the right to stabilizing hospital

emergency room care no matter where they live” (Justice Department sues Idaho to Protect

Reproductive Rights, 2022). This is a continuing legal battle, and it is causing patients to seek

care in another state. As mentioned earlier, the neighboring state is only eight miles away. Rural

Medical Center must follow the law, but which law trumps the other?

B4. Current Threats

Data breaches are ever rising in the United States and is always a potential threat. Just a

month ago, United HealthCare had a data breach that affected three million people; 306 were

students at the local University. Rural Medical Center is not immune to cyber-attacks or

phishing. As healthcare facilities increasingly rely on technology to store and manage patient

files, perform critical procedures, and coordinate care, the vulnerability to malicious cyber

activities has significantly increased. A successful data breach on a hospital could have

devastating consequences that jeopardize patient safety, compromise sensitive medical records,

and disrupt the day-to-day operation of the hospital. Therefore, it is imperative that healthcare

organizations prioritize cybersecurity measures, including robust firewalls, access controls,

regular system patching, and staff training, to mitigate the risks associated with such threats.

C. Leadership Evaluation
 8

“Transactional leadership is a style of management based on the distribution of rewards

and punishments” (Discontinue, 2022). Leaders that identify with this leadership style tend to

rely on their authority and think less of other feelings.

C1. Strengths

Confidence is exactly what Teresa Best’s greatest strength. She can keep her composure

in some of the most intense situations. There was an instance when S.W.A.T. had to enter the

hospital to look for a fugitive. Teresa did not even bat an eye and made sure every employee was

safe. There was a committee that had to meet with a patient who made a very serious accusation.

Teresa entered that room with a smile on her face and once the complainant left, they had a smile

and were shaking Teresa’s hand. She has the knack to perfect the balance between confidence

and stoic-ness. However, her confidence can cross that line in the negative when the time calls.

Her intimidation that stems from her confidence allows for authority over employees.

“Transactional leadership focuses on promoting leaders and their followers’ individual interests

and achieving the satisfaction of contractual obligations on behalf of both leaders and followers

by establishing objectives and monitoring the results” (Min-Hyu, 2022). The sort of transaction

that comes between Teresa and an employee can end with a high turnover rate as it typically can

be a negative interaction.

C1. Strengths

Teresa is one of the most resilient people; she knows that failure is not an option

and will push through her obstacles. She has faced challenges with courage and determination.

When the previous CEO of Rural Medical Center died tragically; the board did not feel that

Teresa was qualified to step into the CEO role. Teresa appealed to the board and proved to them

that despite her age, her experience was more than enough. The next year she acquired her first
 9

rural clinic under the hospital brand. “Leaders who are positive and authentic, thoughtful and

transparent, and who build confidence and commitment among their staff will be actively

cultivating in others” (Lowe, 2019).

C1. Strengths

With her incredible negotiation skills, Teresa was able to get a contract to run the local

University’s health clinic. That was a huge revenue draw for the hospital and with the influx

Teresa was able to break ground on her Therapy building. The services that Rural Health Center

was able to provide were physical therapy, occupational therapy, speech therapy, and massage

therapy. The addition brought a whole new set of patients in the doors as the closest service was

over an hour away. “The ability to negotiate is valuable to business managers because the skills

developed through practicing negotiation skills develop critical thinking aptitudes and effective

communication skills” (Zohar, 2015). Teresa understands what the other party’s needs are and

finds a way to satisfy both sides.

C2. Weaknesses

Teresa is leading the Rural Medical Center in the direction of growth, achieving goal

after goal. She is relentless in her pursuit of the end goal and because of that she is overlooking

the needs of her employees. By neglecting the employees, she is impacting the overall wellbeing

of the hospital. Since Teresa’s focus is on the big picture, she tends to not pay attention to

employee complaints of burnout, lack of motivation, and productivity decreases. The high

turnover rate is due to a lack of care from administration. A healthy balance between goal

attainment and employee well-being is necessary for sustained success. “One of the rallying cries

behind company calls for a return to the office is the watercooler moment, which builds

relationships, boosts engagement, and fosters employer loyalty” (Burton, 2023). It would be
 10

beneficial for the CEO to recognize that the employees are their greatest assets, and by prioritizing

their needs, they can pave the way for long term success.

C2. Weaknesses

Time management is not one of Teresa’s strengths; she is consistently late to meetings

and functions. She does not enforce deadlines that makes others work suffer. When a leader fails

to prioritize tasks, they often spend time on tasks that are not the most important. Because there

is lack of priority other team members feel as if the work that they do is not valued. “There are

many ways and means to manage time and through such methods you can play a very effective

role in your daily life and be successful in your business life and your social life as well”

(Tourangbam, 2011). Since Teresa is unable to meet the deadlines, she must negotiate with

employees for them to pick up the slack.

C2. Weaknesses

A lack of communication between leaders and their employees can have a detrimental

effect on transactional leadership. Without effective communication, leaders cannot effectively

communicate their expectations, goals, and rewards to their employees. This can lead to a lack of

motivation and engagement within the team, as employees feel that their efforts are not being

recognized or valued. Additionally, a lack of communication can prevent leaders from receiving

feedback from their employees, which can lead to a lack of understanding of their needs and

wants. This can make it difficult for leaders to effectively manage and motivate their team.

“Communication strategies are executed through engagement among teams and individuals who

understand and have a stake in the best achievable outcomes reaching and enhancing stakeholder

interests and mutuality” (Harrison, 2014). The CEO of Rural Medical Center could begin

overcoming her lack of communication by creating an open and honest conversation with her
 11

employees. This would be the opportunity to share the goals and expectations, as well as receive

feedback from the team.

C3. Actionable Items

Listening is more effective than lecturing as it allows for more open communication and

collaboration between leaders and their employees. “Active listening involves reflecting feelings

and meanings to show understanding. Ideally, the listener also pays attention to body language,

tone, and other nonverbal clues regarding the speaker's message” (Comstock, 2022). Teresa

could gain insight into her employees’ perspective and better understand how to best motivate

and guide them. Listening also shows respect for followers and builds trust, which can be

essential for getting buy-in from followers and for creating a positive team dynamic. Teresa

thrives at transactional leadership but would really thrive with the transaction of listening to her

employees versus trying to buy them.

C3. Actionable Items

The CEO of Rural Medical Center would be more relatable and in tune with her

employees if she made visits to each department on a regular basis. She would see the

overworked and understaffed Business Office or the overly crowded emergency room.

“Individual transactional leadership behavior is positively related to subordinates’ creative

performance in teams with higher empowerment climate, but negatively related to subordinates’

creative performance in lower empowerment climate” (Feng Wei, 2016). By making the effort to

become familiar with the different areas of operations she would be able to more effectively

make decisions to improve the work that they do.

C3. Actionable Items

 12

Leaders should always follow procedure and adhere to the policies that are in place for

employee protection. The CEO would do well to help others uphold the policies. There are

instances of HIPPA violations and hazing that happen within the hospital that go without

repercussions. “Citizens who do not consider themselves active participants still find their lives

affected by the ubiquitous influence of the policymaking and policy enacting process. Those,

however, who take a voluntary and active stance in grassroots efforts, participate in activities that

serve as foundational catalysts for the trajectory of local, state, and national policy” (Journal of

Leadership Education, 2019). Policies provide guidelines for how the organization should

operate and following them ensures that all members are held accountable for their actions. By

adhering to policies, leaders can also ensure that their organization is operating within the

bounds of the law.

 13

References

Biscontini, T. (2022). Transactional leadership. Salam Press Encyclopedia.

Burton, A. (2023). Genpact is using A.I. to flag employee dissatisfaction and tying leaders’

bonuses to the results. Fortune.Com, N.PAG.

Comstock, N. W. (2022). Active listening. Salem Press Encyclopedia.

Feng Wei, Xin Yuan, & Yang Di. (2016). Effects of Transactional Leadership, Psychological

Empowerment Climate on Creative Performance of Subordinates: A Cross-level Study.

Frontiers of Literary Studies in China. 10(1), 29-46.

https://doi.org/10.1007/s11782-010-1112-6

Harrison, E. B., Muhlberg, J. (2014). Leadership communication: how leaders communicate and

How communicators lead in today’s global enterprise (First edition.). Business Expert

Press.

Journal of Leadership Education. (2019, June 21). Policy Leadership: A Theory-Based Model -

Journal of Leadership Education. https://journalofleadershiped.org/jole_articles/policy-

leadership-a-theory-based-model/

Justice Department sues Idaho to Protect Reproductive Rights. (2022, August 2).

https://www.justice.gov/opa/pr/justice-department-sues-idaho-protect-reproductive-rights

Lowe, G. (2019). Resilience and Beyond. Education Canada, 59(4), 25-27.

Min-Hyu, K. (2022). Transformational, Transactional Leadership, and Perceptions of

Organizational Performance: The Moderating Role of Relational Authenticity as a

Leader. Transylvanian Review of Administrative Sciences, 65E, 64-86.

https://doi.org/10.24193/tras.65E.4

Tourangbam, D. K. (2011). Time Management. Vij Books India Private Limited.

 14

Zohar, I. (2015). “The Art of Negotiation” Leadership Skills Required for Negotiation in Time of

Crisis. Procedia – Social and Behavioral Sciences, 209, 540-548.

https://doi.orh/10.1016/j.sbspro.2015.11.285