Florida Gulf Coast University Health Information Services Department Discussion

Ann is employed as a scanning clerk in the health information services department at William Medical Center, an inner-city, unionized facility. Ann has worked as a scanning clerk in the department for several years. Prior to joining the record activity team, Ann had worked in several other departments of the hospital over the past 10 years. Ruth, Ann’s mother, is a member of the board of trustees at William Medical Center.

The personnel file containing Ann’s records includes a long history of disciplinary actions taken against her for issues including poor work performance, attendance irregularities, and unacceptable conduct. The informal grapevine reported previous supervisors of Ann had been subject to physical threats including telephone calls and being followed by a car filled with young men. Because the disciplinary actions had failed to motivate Ann to improve her work performance, her team leader chose to ignore the problem and allow Ann to do whatever she liked. The team leader then left the department.

Marilyn was hired as team leader of the record activity team. As Marilyn reviewed the activities of the team members, she found that Ann’s daily duties included scanning records and loose reports. Ann was also responsible for answering the telephone in the team’s work area. During Marilyn’s orientation to the department and her duties, Ann was on leave for a supposed back injury. This was one of her many workers’ compensation leaves.

Marilyn and the team joined in an effort to develop performance standards for their team, and when Ann returned to work, the plan for production standards was explained to her and included the completion of a daily work log. Ann failed to submit the work log each day and Marilyn reviewed the plan with her again and specifically asked that the work log be submitted daily. As Marilyn reviewed Ann’s work performance, several problems became evident:

  • The work log showed that records and loose reports had been scanned; yet, several days later these items would be found hidden somewhere in the department.
  • Patient accounts complained that requested copies of records were not received; Ann stated she had sent them. They were not found and insurance reimbursement was in jeopardy.
  • Abuse of the telephone occurred frequently. Ann had many friends in and outside the hospital and used the team phone and phones outside the department during work time. One day a pizza delivery came for her when she was not scheduled for lunch or a break.
  • Responses to Marilyn’s questions about anissue were verbalized in a loud voice that everyone in the department could hear. Ann stated she was given more work than anyone else in the department and did not think it was fair. She said that Marilyn and the department manager were singling her out.

The next step Marilyn chose was to interact with Ann at the beginning of the workday, try to motivate her, and verbally give her daily work assignments and review priorities. And, Marilyn asked that she continue completing the work log on a daily basis. In addition, Marilyn checked periodically on Ann’s progress with her daily work assignment. Using leadership skills, Marilyn attempted to coach Ann toward increasing her productivity through positive reinforcement.

When the trial period for verbal daily assignments ended, Marilyn had to admit it failed to motivate Ann and her next step was to give Ann daily written work assignments. Marilyn retained a copy of the assignment sheet and monitored Ann’s progress. Even this close monitoring and documentation was unsuccessful. For example, Ann neglected to scan records for patient accounts during a 1-week period, resulting in the billing loss of approximately $40,000. Each time errors were found, Marilyn documented the incident and forwarded a copy to Jim, the department manager.

Documentation of these incidents was forwarded to hospital administration, who discussed the issue with Jim. Jim and Marilyn were asked at this point to tread lightly as Ann and Ruth, her mother, might cause trouble for the facility. Ruth had already visited top administration and voiced her opinion that Ann was being treated unfairly and threatened to sue the hospital. Ruth asked the administration to talk with Ann and made an appointment for her to do so.


Meanwhile, the human resources department offered limited support because of fear of repercussions from Ruth. Ann had already been suspended twice and a third suspension for another offense would result in dismissal.

Additionally, Marilyn began sensing dissatisfaction from the other team members because they had to perform Ann’s work when crises occurred. Some team members admitted they were thinking of transferring to another area of the hospital because of the problem.

QUESTIONS:
Describe a plan of action for Marilyn and the team members that would change this team into a cohesive group.

Discuss the theoretical reasons for your plan of action.

Would using the team approach for accomplishing objectives in the HIM workplace assist in resolution of this problem? Why or why not?

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