“””the division leader is clearly not providing the leadership required to advance his division”””
I think this quoted statement needs further analysis; is he resistant or is it the lack of ability to lead and achieve, is it personality, does he listen to his colleagues, is he aware he is behind etc
I believe the right diagnosis is needed for the remedy to work.
I believe expanding the span of control is not a long term issue in a laboratory setting as processes are repetitive and once there is a system in place I think it should be ok. Alternatively, it might be a good idea to have an interm high-performance task force to handle the merger and stabilise the processes and the system. Later on the HOD may delegate some functions to supervisor and seniors in the department if necessary and he remains overwhelmed.
It is very important to get them engaged, they know their business better than anyone else so they will uncover the hidden data that neither IT nor operations and finance would figure out. Multidisciplinary team is the way to go with dashboards and the presence of medical, finance and operations in the setup of dashboards and gauges become informative to all parties. it is not very uncommon to see useless data being collected just because the right people were not involved!!!!
Major issues may include:
Un-used capacities and duplication of services e.g. many centres of excellence exist but are not be completely utilised
Over-staffing and low productivity
Improper resource utilization, mainly over utilization
Primary care is not serving its purpose and secondary and tertiary may have to deal with what is supposed to be handled by primary care
Proper utilization of resources and performance improvement is expected to be enough to make up the first stage of budget cut
Mergers or consolidation, integration of services at a national/regional levels and Improving primary care should also make up another portion of the cut
Making medical services available to cash payers and insurance companies to generate revenue should also take place
These may resemble the practical way of doing it
However, innovative solutions may provide better outcomes such as complete privatisation of governmental healthcare facilities but can be scary if such transformation is not well planned
This is a personality issue and will never change regardless of how hard you try. A group of people other than the new Chairman should call for a meeting with the board to lay the facts and convince the board members and seek the boards direction based on that, the board is the key in solving such difficult situations otherwise you will end up having two leaders in one place, a state pf chaos and unhappy people.
Few suggestions from past experience:
The reason behind the change and its positive impact on processes, people and the organisation have to be well presented by highly acceptable and respected staff in a logical and easy to understand way and frequently.
You need champions everywhere to keep momentum and prevent u-turns, they need to work hand in hand, set an example and celebrate the success and prove the effectiveness of the change.
Since you are hiring new blood, it’s a chance to incorporate the ability and openness to change as an essential element of new hires, there are tools and probing questions that help you identify your targets.
And finally the way I see it: “convince me and I will go with you”
I think one should think about it from two angless and and which one is more feasible and applicable; to attract skilled people to settle in remote areas and this is not easy; they want attractive salaries, best education for their kids in the form of good schools and universities, the quality of life and access to all the good things they see in bigger cities etc which ends up so difficult to achieve and may only provide temporary satisfaction. On the other hand one may focus on providing acutely needed services only in remote areas which will require less number of skilled staff and specialties, this however needs to be backed up by an efficient system of referrals and logistics to secure specialised and tertiary care availability in a timely manner. Duplication of specialised services especially when accompanied by unused capacity can be so costly in remote areas when compared to the cost of referrals and logistics given there is no compromise on patient care.