Dudley Experiment
The National Health Service (NHS) in Great Britain is overhauling how it conducts business. One of
its experiments is being conducted in Dudley, where the Russells Hall Hospital is a gleaming modern
medical facility. The hospital presented the local NHS with a fundamental challenge because it did not
contain as many beds as the building it replaced. A collaboration between physicians, nurses, social
services, and the hospital was instituted to identify and support patients who can be helped in their
homes, and so avoid unnecessary emergency admissions. Extra money was set aside to establish teams
of physicians, nurses, social workers, and hospital administrators to care for patients who could be
treated outside of the hospital. This spirit of collaboration across the health service and social services
stands out in the new more market-driven and competitive NHS. These days in the health service,
money follows the patient. Keeping them out of the hospital may save money for the NHS, but it could
be very bad news for the hospital.
100. Refer to Dudley Experiment. What kind of advantage is created by the collaboration between
physicians, nurses, social services, and the hospital?
a.
The group can find the optimal solution.
b.
The group is able to view problems from multiple perspectives.
c.
Groups generate less conflict.
d.
Groups generate fewer alternative solutions.
e.
All of these describe advantages the groups have over individuals in the decision-making
process.
101. Refer to Dudley Experiment. The collaboration of physicians, nurses, social services, and the hospital
to determine how to deal with the fact that the new hospital could care for fewer patients than the older
facility is an example of a(n):
a.
semiautonomous team
b.
cross-functional team
c.
virtual team
d.
synergistic team
e.
ad hoc team
102. Refer to Dudley Experiment. The determination that patients with chronic conditions such as asthma
and diabetes should receive priority treatment by the teams is an example of a:
a.
team procedure
b.
contextual frame
c.
team norm
d.
group tenet
e.
policy of conduct
103. Refer to Dudley Experiment. Why is team cohesiveness important to the success of the Dudley
Experiment?
a.
Cohesive groups have a lower probability of success than groups that are not cohesive.
b.
The value of work provided by a cohesive group differs only slightly from that performed
by individuals.
c.
Cohesive groups always have positive group norms.
d.
Team goals are never allowed to replace organizational goals.
e.
Cohesive groups typically experience greatly reduced turnover.
104. Refer to Dudley Experiment. What type of conflict could most likely occur within the teams when
decisions need to be made about whether a patient simply desires more attention or really needs care
that can only be provided by a hospital?
a.
x-type
b.
affective
c.
behavioral
d.
cognitive
e.
b-type
105. Refer to Dudley Experiment. Once the collaborative team was formed to decide how to deal with the
problems of too few beds and too many patients, its next stage of development was most likely:
a.
reforming
b.
storming
c.
norming
d.
conforming
e.
performing
106. Refer to Dudley Experiment. Why would the members of the collaborative team need structural
accommodation?
a.
to create a basis for bureaucratic immunity
b.
to encourage cognitive conflict and to reduce behavioral conflict
c.
to prevent social loafing
d.
to change policies and practices that limit its ability to provide care outside the hospital
e.
to eliminate the need for performance appraisals, which can be time-consuming
Kaiser Permanente
With 8.5 million health plan members, 148,884 employees, and $31.1 billion in operating revenue,
Kaiser Permanente is the largest not-for-profit managed care organization in the U.S. Overall. Kaiser
has a solid reputation. Consumer Reports ranks Kaiser as an average to better hospital system, and
U.S. News and World Report ranks Kaiser Permanente Northern and Southern California 58th and 88th
respectively out of 257 health plans.
Lately, Kaiser has come under intensive scrutiny for a series of management and patient care
issues. After Northern California Kaiser Permanente began an in-house kidney transplant program for
its kidney transplant candidates, 56 people received kidney transplants, but twice that many died
waiting for a kidney. In contrast, more than twice as many people received kidneys than died during
the same period at other California transplant centers.
Another serious problem came to light when the California Office of Statewide Health
Planning and Development determined that Kaiser had 5 of the 28 hospitals with the highest
pneumonia death rates in the state. Though pneumonia is the sixth-leading cause of death in the U.S.,
timely diagnosis and treatment can greatly reduce patient mortality rates. A well-run hospital should
not have these kinds of problems treating pneumonia, which indicate that the hospital’s medical
control processes are breaking down.
Implementing work teams could help Kaiser identify and respond to its managerial and patient
care problems. Kaiser’s problems are both complex and require the involvement of many different
employee groups, such as doctors, nurses, office personnel, and lab techs. Other hospitals have had
success with work teams, and Kaiser might benefit from similar programs. Baptist Memphis Hospital
in Memphis, Tennessee empowered Rapid Response Teams to decide to call in the Medical
Emergency Team if a patient’s condition worsened. As a result, the number of cardiac arrests dropped
by 26 percent, and the survival rate doubled from 13 to 26 percent.
Stanford University Hospital created Patient-Centered Care Teams to manage everything from
admission to discharge and Process-Centered Care Teams to identify hospital processes and make
them more efficient and effective. Kaiser could benefit from teams such as these. Team members
should also be involved in setting team goals, and rewards should be based on both individual and
team performance. Team members should also receive training in interpersonal skills.
If teams are not assigned a leader one might naturally emerge, but once the team reaches
performing stage, it is best if leadership responsibilities are shared among team members. If teams are
to truly be self-managing, management must also give them a relatively high level of bureaucratic
immunity. The structure of the team, its size, and its level of autonomy should generally depend on the
task at hand. Cohesiveness is important too, and Kaiser can build team cohesiveness by making
employees feel that they are part of an organization that cares about its patients and by making
employees believe that what they do on their jobs makes a difference in the lives of others. The Kaiser
story is an ongoing saga and more information about the successes of Kaiser (or lack thereof) might
come to light as you are reading this case and analysis.
107. Refer to Kaiser Permanente. Which of the following is a potential disadvantage that Kaiser
Permanente needs to address before setting up its teams?
a.
the absence of a commitment to finding an ideal solution
b.
initially high employee turnover
c.
lack of creativity in decision making
d.
decreased employee satisfaction as a result of team membership
e.
all of these
108. Refer to Kaiser Permanente. Teams at Kaiser Permanente will vary in terms of autonomy. This
means that teams will:
a.
not have the same group norms
b.
vary in terms of deep-level and surface-level diversity
c.
vary in how will the members get along with one another
d.
have different degrees of independence in making decisions about how to accomplish their
goals
e.
all have different stretch goals
109. Refer to Kaiser Permanente. Which of the following is one of the factors that Kaiser Permanente
should consider when selecting people who are suited for teamwork or for working on a particular
team?
a.
individualist versus collectivist orientation
b.
the level of grapevine communication
c.
bureaucratic versus participative management styles
d.
organizational acculturation needs
e.
organizational norms
110. Refer to Kaiser Permanente. Which of the following statements describes how Kaiser Permanente
should train its team members?
a.
It should overestimate the amount of training required to make teams effective.
b.
It should use cross-training for teams of highly skilled workers.
c.
It needs to know that the most common type of training provided is training in technical
skills.
d.
It should realize that team leaders typically do not require training.
e.
It should understand that the most common type of training needed is training in
conceptual skills.
111. Refer to Kaiser Permanente. Would gainsharing work for its teams?
a.
Yes, nonfinancial rewards are typically good motivators.
b.
Yes, hourly wages are proven motivators.
c.
Yes, financial rewards are typically good motivators.
d.
No, gainsharing would not work if Kaiser Permanente wants to use the equity theory of
motivation.
e.
No, gainsharing does not satisfy motivational requirements.
SHORT ANSWER
1. What are work teams? Briefly comment on why work teams have become increasingly popular in
business since the mid to late 1980s.
2. Define cross training. Briefly explain how cross training can lead to increased job satisfaction.
ANS:
3. What are the five guidelines managers use to determine if teams should be used?
4. List the five types of teams on the team autonomy continuum. What is each team’s highest level of
responsibility (i.e., the highest level of task that they have independent control over)?
5. Identify the three special kinds of teams that can’t be easily categorized in terms of autonomy. For each
of these teams, identify the probability that it would be formed on a temporary or permanent basis.
6. What are project teams? List the advantages associated with their usage.
7. How does a team’s size influence its performance?
8. Explain what managers can do to effectively manage conflict in teams.
9. List the stages that teams pass through as they develop and grow as well as the stages of decline that
may occur if teams are not managed properly once they achieve peak performance.
10. What are stretch goals? What four things must occur for stretch goals to effectively motivate teams?
11. List and briefly describe the three methods of compensating employees for team participation and
accomplishments.
ESSAY
1. Briefly identify the advantages and disadvantages of using teams. Describe a situation in which you or
someone you know worked in a team setting. Be sure to specify which of the general advantages
and/or disadvantages of using teams were manifest in that situation.
ANS:
2. Identify the key dimension on which teams differ. Define and describe the continuum of teams used by
companies along this dimension. If a manager had a high need for personal power and control, explain
which of these types of teams he or she would probably be most happy working with in a managerial
capacity, and how he or she might react to a proposal to introduce teams into his or her work unit.
3. What are virtual teams? Speculate on their likely role in global organizations in the future.
4. What are norms? What is cohesiveness? Why is team size an important consideration? How should a
manager cope with team conflict? Specify how these characteristics are related to team performance.
ANS:
5. Describe the four factors that companies can manage to make teams more effective. Specify which of
these four factors you feel is of greatest importance in enhancing team performance. Explain your
rationale for your choice.
