Problem Analysis

Statement of the Problem

How will CCHMC keep hold of its culture of continuous improvement considering the
dilemmas faced from lack of succession planning and the effect of limited capacity of the
improvement resources?
Succession Planning
With too much focus on quality improvement of patient care, the management failed to
take into consideration that the key leaders of the organization are soon retiring. Next in
lines are not clearly in place, potentials were not identified and succession process is not
clearly defined. Key leaders were too engaged in the operations that they forgot to zoom
out and think strategically, one of which is to think about succession planning. The
solution to this problem is going to be a long process and the price is the anxiety of
losing the culture of improvement that they have ingrained within the organization for the
longest time.
Limited Capacity of Improvement Resources
The organizations thrust in continuous improvement has been hampered due to the
limited number of quality improvement specialists focusing on each divisions
improvement projects. There are numerous improvement projects being implemented in
the organization, however, the quality of work being done in these projects are not all of
the same standard. Due to the limitations of each quality improvement specialists
capacity to work or lead these projects, the management has resorted to selecting of
projects rather than doing it all. The deeper problem arises when the time of choosing
which project to be implemented and which ones are to be phased out takes place.

Recommended Courses of Action:

After a thorough analysis of the problem, the group was able to identify
recommendations for each of the underlying management challenges.
Succession Planning

Considering the Performance-Potential Matrix, the group must identify the

performance and the potential of each subordinate in terms of metrics set
by the organization. We are referring to the matrix illustrated below:

TALENTPERFORMANCE-POTENTIAL(P-P)MATRIX

PERFORMANCE

C
LOW

RISING

HIGH

POTENTIAL

The Performance of each subordinate shall be evaluated on the basis of

the metrics that the organization has set beforehand or simply through
their key performance indicators (KPIs). The Potential of each
subordinate shall also be evaluated on the basis on how they were able
to exemplify the kind of leadership quality that the organization needs and
also the kind of values that they have shown and would merit so as not to
jeopardize the culture of continuous improvement.
These identified high potentials should then be subject for shadowing and
mentoring sessions with the outgoing leaders for a certain period of time
to facilitate an easy and smooth sailing transition.

Dr. Uma Kotagal should not be the successor of Jim Anderson. Aside
from the fact that Dr. Kotagal is also retiring in five years, Dr. Kotagal is
just too operations-minded. A Chief Executive Officer of an organization
should be someone who can think strategically. Mr. Thomas Cody could
handle the CEO position temporarily while looking for Mr. Jim Andersons
successor. Mr. Anderson could still be CEO-Emeritus for the time being
until they could find his successor. His successor could be from the
outside or within the company.

In order to preserve the culture of continuous improvement, the group

suggests that Dr. Uma Kotagal should be promoted as the Chief
Operating Officer. Through this, Mr. Thomas Cody, as the acting CEO
when Mr. Jim Anderson retires, wont have to worry on running the
hospital operations, as Dr. Kotagal is very much trusted and competent in
this position. Mr. Cody should not in any way be too much engaged in the
operations side as he, Mr. Anderson and Dr. Kotagal always do. They
have to let Dr. Kotagal run the operations.

Limited Capacity of Improvement Resources

To address the challenge of limited improvement resources capacity, the

group suggest for the organization to hire additional quality improvement
specialists thereby reducing the workload of existing staffs. Each should
then narrow down and direct their focus exclusively on three projects.
Handling a minimum number of projects would mean efforts would be

more concentrated with every project getting more traction. Results and
impact of improvement should expectedly be achieved rapidly.

Since there are 28 recognized projects, a total of 9 QIS would be

adequate to implement the initiatives. These QIS should preferably be
placed in one centralized department rather than being embedded in
different medical divisions. This kind of set up would be more conducive
for sharing of best practices and could foster easier calibration of
improvement standards and processes. Moreover, a specialist can
immediately reach out to other specialists when encountering difficulties
in carrying out a certain task or activity if situated in one area.

External an internal support for QIS should also be required and provided
through up trainings, team building activities and one on one coaching for
real-time feedbacks. These support schemes, in one way or another,
could effectively increase the resources capacity for sustained quality
improvement.