Business Research

Solving the issue of poor performance in a large service organisation

If a Hospital is to optimise/improve the performance of their emergency waiting times, we have two approaches to solving the problem:

Option A – Monitor the patient numbers, bed numbers and availability of resources as well as waiting and treatment times.

Option B – Speak to the hospital staff – Doctors, Ambulence crew, Nurses etc. to gather their views on what are the areas that need improvement.

Buchanan and Huczynski (2010) challenge us to ask “why?” and tell us how difficult it is to have a single correct answer; I’d like to pose the same thinking pattern to this situation and not choose a single correct method for solving this solution.

As discussed by Buchanan and Huczynski (2010) throughout the first chapter, we should not expect an organisation to be bound by the rules of natural sciences; looking at just the numbers as proposed by the first group would give us good measurements and accurate figures on how things should be working – where the problems lie – but, if we are running a hospital inundated by overworked, underpaid emergency room doctors, nurses and orderlies then simply adding more beds and more underpaid employees will not necessarily solve our problem.

I am inclined to think that option B (speaking to the employees) would provide an answer to option A but it is not safe to assume based on the opinions of others only so I do believe that the numbers must also be produced. An article by Ference (2001) on Improving Organizational Performance illustrates a trademarked process used by a Casino in Las Vegas which is survey based to produce what they call a “Service-Culture Map” which focuses on “employee satisfaction, commitment, and customer responsiveness as the keys to a strong return on owner investment”. It might be considered “cold” to compare a hospital to a casino but I think that the same rules could quite well apply which would, in-turn, support option B’s approach.

The case study in the paper by Ference (2001) talks about cross-functional meetings, and I believe that this is something that would also support option B – issues may lie with miscommunication between doctors and nurses, without conducting an equal-opportunity meeting between the two parties the problem may never be solved.

To conclude it may seem like I have strayed more towards group B, while I am more inclined towards that approach, the problem could simply lie in the number of beds available or the efficacy of the booking system. Perhaps an approach of using option B to narrow down areas of concern and option A to back up where necessary the problem could be solved or improved.


Buchanan, A. & Huczynski, A. (2010) Organizational Behavior. 7th Edition. Upper Saddle River: Prentice Hall.

Ference, G (2001). Improving Organizational Performance [Online]. Available from: (Accessed: 6 February 2011).