1. Organizational Analysis: Centre Volunteers in Medicine (CVIM) Brought to you by: Triple “B” Bill Castor Bethany Walker Bowser Juanita

2. Organizational Background Non-profit corporation Provides services to the medically underserved population of Centre County, Pennsylvania –Working uninsured

3. Structure and design Board of Directors Five full-time employees Flat or informal functional design

5. General direction, mission, goals, and strategy “To seek to understand and serve the health and wellness needs of the medically underserved who are residents of Centre County.” Acquire necessary external resources –Resource Dependence Theory –Coalition with Mount Nittany Distinctive niche within Centre County

6. Vision Statement “May we have eyes to see those who are rendered invisible and excluded, open arms and hearts to reach out and include them. Healing hands to touch their lives with love and in the process heal ourselves” Culture and values

7. Overall culture is welcoming and informal –Friendly atmosphere –Child-friendly waiting rooms –Casual Dress code for Staff Creates welcoming environment for patients –Holistic Approach to health care Clinical Services Social Services

8. Decision-making process CVIM’s organizational structure most resembles a functional design Decision-making process must synch with org culture –Informal culture Horizontally decentralized –Influence and decision making is shared laterally throughout organization –Policy changes and assurance measures are more easily implemented when decision-making and communication is lateral

9. Conflict, power, and politics Internal conflict –Conflict arises when top-down decisions must be made –Accountability to patients –Functional in nature External conflict –Competition over obtaining funds, could be avoided –Functional in nature

10. Conflict, power, and politics Power –At time lies with the Board of Directors but also can be distributed between volunteers and employees Politics –CVIM is able to use its position to form relationships within the community to obtain assets –Does not duplicate services already provided in the community –Very little internal politics present

11. Organizational domain and environment Non-duplicative primary and preventive dental and medical services to the working uninsured residents of Centre County Potential patient base of 11,000 Shares environment with Penn State, health care organizations, and non-profit organizations

12. Inter-organizational relationships Mount Nittany and Geisinger Pharmaceutical companies –$470,000 in medications from indigent drug programs Written rules and procedures to remain eligible Resource Dependence Theory

13. Evaluation of effectiveness Annual Report Anaylsis –Treated 4,528 patients in 2004-05 –$500,000 budget, value of care was $2 million, which is comparable to similar organizations Tracking of Common Diagnoses –Depression, hypertension, high cholesterol, and anxiety –Tracked to make sure they are providing care that addresses the main needs of the community

14. Size and life-cycle stage Since its inception in 2003 CVIM has experienced an increasing number of patient visits Fiscal year 2003-2004, 5,061 visits Fiscal year 2004-2005, 7,328 visits Goal for 2005-2006 is 9,000 visits

15. Size and life-cycle stage CVIM’s operations have outgrown its current capacity Currently CVIM operates with: –5 physical examination rooms –3 dental examination rooms –Cramped receptionist area –Small medical records room To serve more pts and operate efficiently CVIM is in need of: –6-8 physical exam rooms –5 dental examination rooms –Larger receptionist area and medical records room

16. As CVIM grows, the importance of adequate space and functional equipment becomes increasingly important –Patient Service and Satisfaction –Morale of employee and volunteer staff Herzberg’s Two Factor Theory  Motivation : Volunteers and employed staff work at CVIM because they are motivated by the intrinsic rewards of helping others  Hygiene : Hygiene factors influencing CVIM staff include adequate workspace and functional equipment »If these hygiene factors are not present staff will become dissatisfied and unmotivated Size and life-cycle stage

17. Health care service organizations typically go through four phases in their life cycles (Starkweather & Kisch, 1971) –Search –Success –Bureaucratic –Succession

18. Size and life-cycle stage Life Cycle Phases 1. Search Phase Organization is new Focused on establishing identity Finding methods of procuring necessary resources Organization is open and informal 2. Success Found achievement in procuring resources –Staff, patients, and finances Organizational design becomes more formal to accommodate larger scale operations

19. Size and life-cycle stage Life Cycle Phases continued… 3. Bureaucratic Conformity to rigid rules and procedures Little feedback from clients Organization may begin to decline b/c of inability to respond to environmental changes 4. Succession Development of new ways of providing services

20. Currently –CVIM is in the success phase Successful at procuring resources Formalizing structure to accommodate growth Future –Moving toward Bureaucratic phase Stricter operating rules and procedures May decline due to changes in environment Size and life-cycle stage

21. Future changes and adaptations CVIM is in “darling” phase –Once organization leaves this phase, there could be fundraising problems Supply changes in the pharmaceutical industry –Potential problems obtaining free medications

22. Conclusion Even though CVIM differs from health care organizations in the area, CVIM still aims to effectively interact the elements of cost, access, and quality.

23. Special Thanks to: Maryanne Neal, Clinical Director, CVIM Thank you for your time and attention. Feel free to ask any questions.