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Zane case Page 1
Ellen Zane at Tufts Medical Center: Spring 2011
Teaching Notes
Cynthia Ingols
Professor of Practice
School of Management
Simmons College
Boston MA
Case Synopsis
In January 2004, Ellen Zane, a highly successful hospital administrator, became CEO of New England
Medical Center (NEMC). NEMC was still reeling from its failed merger with a Rhode Island hospital
group. Desperate to save the hospital, Tufts University’s President Larry Bacow recruited Zane to turn
around NEMC. Case A documented Zane’s turnaround of NEMC from 2004 to December, 2007.
By spring, 2011, Zane had solidified the hospital’s position in the Boston marketplace. She had rebranded
NEMC to Tufts Medical Center, thereby drawing upon the marketplace value of the name of Tufts
University. She had articulated and begun to implement a strategy that she labeled, “distributed academic
medical center” medicine. This hard work paid off with the recognition from the University Health
Learning Objectives
By the end of a classroom discussion of this case, students will know:
1. That changing a hospital like Tufts Medical Center (TMC) is a never-ending
process because the environment is constantly pushing and challenging its leaders
and the institution.
2. That continuously changing a hospital, such as Tufts Medical Center, requires a
leader who is a skilled and tough negotiator.
Intended Course
Zane case Page 2
This case and videotape was planned for an undergraduate course on leadership and organizational
change. Organization behavior courses designed for MBA students should also be able to use this case
and videotape.
Theoretical Underpinnings of Case
There are two streams of literature that are relevant for this case discussion. There’s the literature about
organizational change and there’s material about leaders and their skill sets.
Organizational Change: Organizational theorists have developed different categorization schemes of
theories of organizational change. To help students to understand the magnitude of the work of turning
Other theorists have further sub-divided these two categories. Nadler and Tushman (Palmer, Dunford &
Akin, 2009) argue that whether organizational actors are anticipating or reacting to environmental
pressures adds another dimension to managing change. Consequently, they claim that there are four types
of change: tuning which involves improving, enhancing first-order change; adaptation, which is
internally initiated reactive, incremental change; reorientation, which involves second-order “frame
bending” of identity or values; and re-creation requires fast change of all basic organizational elements
(Palmer, Dunford, & Akin, 2009, pp. 85 - 93).
Since there is no agreement in the field about how to categorize change efforts, it is not surprising that
other theorists staked out different territories. Two additional theories are: “midrange organizational
change” and “punctuated equilibrium theory” (Palmer, Dunford & Akin, 2009, pp. 93 – 96). Mid-range,
It is useful for students to keep these different schemas of organizational change in mind as they discuss
Zane’s negotiations with Blue Cross Blue Shield and the nurses’ union.
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Leaders: In their fourth edition of The Leadership Challenge, Kouzes and Posner (2007) return to their
“five practices of exemplary leadership” (pp. 3 – 26). Interestingly, while they speak eloquently of such
skills and habits, such as “challenging the process,” they do not argue that a critical leadership skill is the
ability to negotiate. Indeed, one finds no reference to “negotiation” or “negotiate” in the Index (p. 377 –
388), nor is there an entry for “power.” There is a listing for “powerlessness” (p. 385) and “powerful
times” but there is no listing of “power.” This way of leading appears to ignore issues of power,
organizational politics and the need for leaders to negotiate.
Power is also associated with organizational politics, positioned as both a tool and an outcome.
Through the last decade, scholars have determined that politics are an inevitable part of organizational
life, described as “the daily process through which the abstractions of power and organization are
experienced” (Davey, 2008, p. 651). But are managing organizational politics, and the attending uses of
power, a critical leadership skill?
Gandz and Murray (1980) examine the definitions of workplace politics in the literature of
organization behavior and note two fundamental definitions of power. One category of researchers
defines power and politics in a “neutral” fashion, describing it as yet another kind of behavior found in
organizations that revolve around conflict over the allocation of scarce resources. The second category
defines politics “in terms of consciously self-serving behaviors… These writers subscribe fully to the
concept of politics based on the pursuit of self-interest” (p. 238). This self-interest is often at the expense
Zane case Page 4
resources they need to advance their agendas. To be successful, all managers must be proficient in the
use of power and be willing and able to negotiate.
Research Methods
In response to written questions about the progress and process of change at Tufts Medical Center, Ellen
Zane spoke and was videotaped at our school. Her talk lasted two hours. We then transcribed her speech
Teaching Plan
Viewing the video and discussing the negotiation skills of a leader takes approximately 50
minutes and is a set up for students to engage in a negotiation exercise (the exercise is not part of
this teaching plan since it is purchased from a vendor). The purpose of the discussion is for
students to see and then articulate the skill set of an effective leader/ negotiator. While this
teaching plan was designed for upper-level undergraduate students, it could well work for MBA
students.
Study questions:
1. Watch the approximate 15 minute video of Ellen Zane while she talks about her negotiations
with Blue Cross Blue Shield. As you watch, make notes about the numerous skills that make
Classroom Discussion
1. Show the talking-head video of Zane. Then ask: What are the interlocking webs of attitudes,
knowledge, and skills that make Zane such a powerful negotiator? (This is the third segment of the video
Zane case Page 5
Zane’s attributes
as a negotiator:
Attitude
• She’s tough
• She’s readily voices her opinion
• She challenges the process and she expects to “win”
• She knows that she has strong allies
• She’s comfortable with her own power, authority and
ability to influence others
• She knows that she is smart
Knowledge
• She knows what Blue Cross Blue Shield pays other
hospitals and Boston-area medical centers.
2. What, if any, weaknesses does Zane have as a negotiator?
Students have a difficult time articulating any shortcomings in Zane as a negotiator. Some
3. What words would you use to describe Zane as a negotiator?
4. Imagine that it is spring 2011 and the nurses at Tufts Medical Center are threatening to strike.
As Zane thinks about and plans to negotiate with the MNA, how is this situation different from
her negotiations with Blue Cross Blue Shield?
The latter are outsiders, where as the nurses are internal stakeholders within TMC. Patients can
only receive good care within a hospital if the nurses are productive employees. Zane cannot
Zane case Page 6
5. Is Zane’s power base different when she is negotiating with Blue Cross Blue Shield than when
she is negotiating with nurses at TMC?
Most students readily agree that Zane’s power base is different in these two situations. With Blue
Cross Blue Shield, Zane could publicly ask for and get the support of people such as the
Conclusion of this exercise
As students prepare to engage in a negotiation exercise themselves, ask them to keep in mind the
attributes of a powerful negotiator, as exemplified by Zane.
Zane case Page 7
References
Bolman, L. & T. Deal (2008). Reframing Organizations: Artistry, Choice, and Leadership. San
Francisco: Jossey-Bass.
Cervero, R.M. & Wilson, A.L. (1994). Planning Responsibly for Adult Education: A Guide to Negotiating
Power and Interests. San Francisco: Jossey-Bass (cited by Hanscome, 2000).
French, J.R., & Raven, B. (1959). The bases of social power. In Dorian Cartwright (ed.). Studies of
Social Power, Chapter 9, 150-167, Ann Arbor, MI: Research Center for Group Dynamics, University of
Michigan.
