The nature of the problem in this analysis is the chemistry technician’s (Arnold's) lack of concern regarding his mistake(s). He failed to process a stat lab order. This could mean life or death for the patient. Elsie, Arnold's laboratory supervisor, verified past mistakes to establish a trend or pattern in Arnold's behavior to substantiate a written warning. One main reason behind this problem is Arnold's view of the warning being a punishment as opposed to performance improvement. Elsie mentions four separate infractions over a three-year period. Elsie used Arnold’s past mistakes to show a pattern; however, this made Arnold defensive.

Arnold became defensive because Elsie used dated mistakes, some of which were three years old, to substantiate the written warning. She did not document the previous infractions or the exact period between occurrences. Therefore, Elsie forgot details of previous mistakes and she is unable to substantiate previous warnings. Organizations have policies and procedures that dictate adherence to documenting escalating disciplinary actions for poor performance. Elsie failed to adhere to these policies and procedures. In addition, Elsie did not promote the labor-management partnership. Her approach was coercive and did not facilitate two-way communication or the team-approach to problem-solving. Communication is integral to effective problem-solving. Both parties demonstrate ineffective communication skills. Arnold is close-minded and defensive in his responses to Elsie. Elsie has an authoritarian communication style which sabotages interactive communication. This demonstrates a lack of accountability on both Arnold’s and Elsie’s part. As a result, there was a communication breakdown. To improve Arnold’s performance, Team A will explore various aspects of critical thinking, accountability, and communication.

Problem Defined

In this case, Arnold is receiving a written warning from his immediate supervisor for incorrectly labeling a test request. Arnold labeled a STAT lab specimen as routine. Although the patient did not suffer any ill effects because of the error, this is Arnold’s fourth mistake in a span of three years. Anonymous (2002) declared, “An error like the one Arnold admits to could conceivably cause a state-reportable incident to which the organization will have to respond” (Response to “The Periodic Offender” section, ¶ 2).

The major issues are performance improvement and accountability. Arnold refuses to acknowledge the seriousness of what seems to be a pattern of errors. The case study did not specify whether Arnold was required to sign previous warnings. However, based on his reaction to Elsie’s request to sign and to insert any comments on this warning, it is questionable. This would present a problem in consistency of disciplinary action: correction of behavior in organizational policies. Arnold will not be a satisfied or productive employee if he feels singled out. It will intensify his apparent lack of concern for quality performance. Both Elsie and Arnold need to work on their individual communication styles. If Elsie had used a performance management approach as opposed to a punitive approach, Arnold may have acknowledged the severity of his mistake and worked together with Elsie to improve his performance.

Desired Outcomes

Although Arnold required a written warning, the goal or desired outcome is performance improvement as opposed to punishment. A team approach to problem solving is an appraisal method used in performance management/feedback. Heathfield (2002) concluded,

In a performance management system, feedback remains integral to successful practice. The feedback, however, is a discussion. Both the staff person and his manager have an equivalent opportunity to bring information to the dialogue. Individual performance objectives are measurable and based on prioritized goals that support the accomplishment of the overall goals of the total organization. (¶ 4)

Improvement in Arnold’s overall performance and the execution of STAT laboratory orders are the desired outcomes identified in this case.

Positive Aspects

Bringing the mistake to Arnold’s attention should make him more cautious in the future. This will help alleviate potentially life-threatening errors. Arnold brings up a valid concern in that Elsie may be using past mistakes as a punishment measure as opposed to performance improvement. Elsie and Arnold should review the “organization’s personnel policies for declaring a warning invalid after a given amount of time providing there has been no reoccurrence of the offending behavior” (Anonymous, 2002, Response to “The Periodic Offender” section, ¶ 3). The written warning makes Arnold aware that his actions and behaviors have consequences. The hope is that Arnold will look at the situation as a performance improvement measure and make the necessary changes in his work habits.

Possible Solutions

The purpose of most written warnings is to improve performance and to correct undesirable behavior. Hierarchies of actions that are progressive in severity are helpful in establishing accountability. For example, depending on the severity of the incident, counseling is the first step followed by an oral warning. If performance does not improve, then a written warning is the next step, followed by suspension without pay, and finally termination. This provides Arnold an ample chance to improve his performance.

It is also necessary to specify the consequences of reoccurrence of the infraction within a particular period, such as one year. If Arnold is not 100% compliant with the policy, further disciplinary action should follow. This will give Arnold and Elsie established guidelines to follow and to negate any possible bias. 

A performance management approach to problem-solving would not put Arnold on the defensive and would help eliminate any possible bias. This would strengthen the labor-management partnership and make Arnold feel more accountable for his actions. Other departments would benefit from the increased quality of Arnold’s work. Together, Elsie and Arnold could identify the possible causes of the infraction and could work out solutions. Without identifying the cause of behavior, it is impossible to correct the behavior.

Implementation and Follow-up

Forming an action plan in this case helps to identify specific goals and helps to give details about reaching the identified goals. Elsie and Arnold should work together on forming the action plan. It is obvious that Elsie needs to review the policy and procedure for processing lab requisitions with Arnold. This will clarify the company’s expectations of his performance. It is also necessary to have his performance evaluated periodically to assure he is compliant with organizational policies. Appointing a trained preceptor, or mentor, to be with Arnold will help to identify other areas of improvement. 

Accountability Issues

Both Arnold and Elsie have accountability issues that need addressed. Two areas that Arnold needs to be accountable are his apparent lack of concern for quality and his attitude toward the disciplinary process. “Arnold scowled and said, ‘I don't deserve a warning and certainly not for negligence.’ He spread his hands and added, ‘What am I supposed to be-- perfect? I can't make an honest mistake once in a while?’” (Anonymous, 2002a, ¶ 3). A mistake like the one Arnold acknowledges could cause a state-reportable event to which the organization must respond. Through self-regulation and observance of regulatory guidelines, an individual chooses to be accountable for his or her actions. If that individual decides to disregard regulatory guidelines, organizational oversight and enforcement measures make that person accountable for his or her actions. A written warning, correctly applied, is not a form of punishment. However, Arnold views the written warning as a form of punishment as opposed to performance improvement. Anonymous (2002b) pointed out, “Arnold appears to regard a warning as only another ‘gotcha!’ that takes him a step closer to termination. He has apparently never learned, or perhaps has chosen to ignore, the true purpose of most disciplinary action: correction of behavior” (Response to “The Periodic Offender” section, ¶ 3).

Areas in which Elsie needs to be accountable include adhering to organizational policies and procedures and promoting the team approach to problem solving. Elsie failed to document Arnold's previous errors. In fact, Arnold acted surprised that this was his fourth occurrence in three years. He stated, “‘I can’t believe you’d hold something against me that happened 3 years ago. A warning that old ought to be wiped out. You’ve got no business using that against me.’” (Anonymous, 2002a, ¶ 12). There is a valid point in Arnold’s concern about the age of previous warnings. Many organizations’ personnel policies extend direction for decreeing a warning invalid after a certain period. Elsie used Arnold’s past mistakes to show a pattern; however, this put Arnold on the defensive. Greene (2005) concluded, “We determine by our actions the employee morale and satisfaction” (Week 3 lecture, ¶ 5). In order to improve his performance, it is important that Arnold feels valued as an employee. Due to the nature of his mistake, Arnold did deserve a written warning; however, a performance management approach that emphasized two-way communication and joint problem-solving would make Arnold more receptive.

Ownership of Defined Problem

When reviewing Arnold and Elsie’s behavior in this case study, Team A discovered that both parties lacked ownership in their respective roles. Two areas of concern identified regarding Arnold’s behavior are lack of accountability for making a mistake in labeling a specimen and lack of understanding for the true purpose of disciplinary action.

Arnold does not hold himself to a higher standard of responsibility. He stated, “‘All that proves is that I’m human, that maybe I’m a little careless once in a while, like everyone else.’” (Anonymous, 2002a, ¶ 1). The nature of Arnold’s comment substantiates careless behavior and lack of responsibility. Additionally, in the case study Arnold stated, “‘Nothing happened to the patient, did it?’” (Anonymous, 2002a, ¶ 7). Arnold must experience accountability; he must take ownership for the results of his actions. He must own his actions! Arnold cannot accept ownership of either problem until he recognizes that these problems exist. 

Elsie needs to take ownership of her role as Arnold’s manager. In her conversation with Arnold, it is apparent that he does not understand the purpose of disciplinary action other than something meant to be punitive. Elsie’s role as the manager is to assist Arnold to understand that the disciplinary action process is to correct behavior. To assist Arnold, Elsie needs to confront him regarding his attitude “that it is okay to be mediocre.” According to Brightman (2005),

We call confrontation, “care-frontation.” This means: care enough to confront. If you do not hold people accountable, you will perpetuate unsatisfactory performance. Giving a positive consequence for a negative behavior prevents change. Not holding people accountable may even lead them to believe they are hopeless. (¶ 1)

In order to promote Arnold’s feelings of self worth, Elsie needs to take ownership of applying performance management measures that encourage Arnold to be a team player. Once Arnold feels like Elsie takes his concerns and input seriously, he will most likely make the necessary changes to improve his performance. By adhering to performance improvement measures and to organizational standards, both parties promote change.

Changes in Accountability

Understanding organizational standards help define managers and employees roles in organizations. Managers are accountable for ensuring employees are compliant with organizations rules and regulations and for ensuring a team approach to problem solving. All employees must adhere to their responsibilities and must alter inappropriate and destructive attitudes. Leverage, engagement, alignment, and development (LEAD) are the four cornerstones of accountability in leadership. LEAD represents a systemic way of thinking and acting that greatly increases a manager’s effectiveness and promotes change in accountability. Kraines (2002) declared,

Organizations must build accountability leadership. In an accountability framework, managers are hired to leverage the creative capabilities of their people to make the total result of their contributions greater than the sum of the parts. The key for managers to become effective leaders is to understand what they are leveraging. Managers must leverage the collective mental force of their people in order to elevate the whole organization’s ability to the customer. (p. 4)

Kraines (2002) stated, “Effective managers engage commitment by understanding what goes into a healthy ‘psychological contract,’ a term coined by Harry Levinson in the 1950s to describe how managers understand and created conditions necessary for people to feel supported and successful” (p. 4). Employees that feel valued and have a full understanding of their roles and responsibilities are more likely to provide successful results. It seems as though Arnold has not taken the time to understand his role as an effective employee and Elsie has not recognized that Arnold needs to feel appreciated as a valuable employee. Negotiating strong, mutual, and reciprocal contracts require that managers acknowledge what their employees value, how they define success, and what demonstrates that the organization supports their pursuit of success. Kraines (2002) stated, “Assistance in reaching one’s full potential within the organization is one avenue in assuring employees adhere and take responsibility for their actions” (p. 4). Another aspect of accountability is employees prefer clarity, not vagueness. The very process of jointly defining intentions and ambitious and attainable Quantity, Quality, Time and Resources (QQT/R) promotes the concepts of engagement and alignment.

“Employees are aligned when they understand the relationship between their activities and goals and those of their organization, managers, and co-workers - and then act on that understanding” (Kraines, 2002, p.4). As an effective manager, Elsie should have promoted alignment by making Arnold accountable for his responsibilities. This promotes development in his skills.   

“Employment development, as a continual, career –long process, represents the surest path to a long process, represents the surest path to a workforce with enthusiastic commitment at its full potential” (Kraines, 2002, p. 5). To develop potential, a manager must acknowledge the employee’s capabilities. A manager ascertains the employee’s potentiality by assessing the ability to handle complexity. Arnold has the potential to complete his job without error; however, Elsie must foster the labor-management partnership and maintain adherence to organizational policies and procedures to foster performance improvement.

Accountability Solutions

To promote the labor-management partnership and to ensure compliance with organizational policies and procedures, there needs to be some sort of starting point for both Arnold and Elsie. Both parties need to sit down individually and review their job descriptions as well as the list of expectations that accompany those job descriptions. This is the only way that management can be certain that there are no mistakes in understanding the expectations for each of them in their positions.

Arnold and Elsie need to sit down together and review the current policies and procedures. Elsie’s supervisor should be a part of this meeting. Not only would Elsie’s supervisor be a witness to the fact that both Arnold and Elsie understand what they are accountable for, but also could help them to understand the need for consistency in the disciplinary process. At this point, Elsie’s supervisor could also explain the disciplinary process to alleviate any confusion in the future.

Due to the severity of Arnold’s error, a verbal warning is not appropriate. Arnold received a written warning; however, counseling and explaining expectations should accompany the warning. Simply handing Arnold a form and asking him to sign it is not true disciplinary action. In fact, it borders on coercion. If Elsie is at all uncomfortable with this action, she needs to consult with her supervisor.

Elsie needs to have an action plan written down to accompany Arnold’s disciplinary warning. This action plan needs to detail specifically the progression of discipline, should Arnold continue to have difficulty abiding by the company’s policies and procedures. In this case, it is appropriate to expect Arnold to be 100% compliant. The action plan should provide a probationary period and termination should follow if Arnold is not able to avoid repeating his mistakes.

Communication Facilitation

The purpose of communication facilitation is to evaluate issues and to establish a process for clear and complete communication. “Communication facilitated allows one to coach or counsel individuals or groups to establish a short and concrete list of measurable objectives and a timeframe for completion” (True Intentions, 2004, p.1). Sharing pertinent information with employees is critical for organizations. Each participant must recognize his or her responsibility. Managers who fail to explain organizational objectives and goals are more likely to suffer with negative outcomes. According to True Intentions (2004), “Suggestions capitalize on your strengths, construct a clear plan of action to resolve any communication barriers, and when applicable setup follow-up sessions” (p.1). “It is important to create a safe productive atmosphere” (Communication Options, 2004, p.1). In this case, Elsie failed to communicate serious violations with Arnold, which resulted in him being less concerned with making mistakes.

The importance of facilitating allows both parties to come to a consensus on pertinent matters. Identifying both the employee and management’s weakness promotes change and improvement Unresolved tensions and misunderstandings affect performance, culture, teamwork, employment relationships and quality (Effective Mediation Resources, 2005). In this case, Elsie failed to implement problem-solving techniques. Communication facilitation promotes group consensus through clear communication (Communication Options, 2004). If appropriate communication tools were utilized the outcome may have been different.

Management Communication Styles

Management Communication Styles (MCSs) influence negotiation, effective communication, decision-making, and problem-solving. The four MCSs are Tell, Sell, Consult, and Join. The MCSs of supervisors are a combination of personal traits and organizational expectations.

In the Tell communication style, communication is primarily downward, one-way, and absent. Inquiries about decisions are discouraged or even impermissible. Interest in employees’ satisfaction is uncommon. Elsie demonstrates the traits of this MCS.

The manager tries to encourage support from the employees regarding decisions in the Sell communication style. According to the University of Phoenix Management Communication Skills text (1995), “Communication is primarily downward, bi-directional, and generally interactive. Concern with employee satisfaction is often explicit” (p. 49).

 In the Consult communication style, the problem normally originates from above the manager; however, the decision does not. “Communication is primarily upward, bi-directional, and interactive” (University of Phoenix, 1995, “Management Communication Skills,” p. 49). The employees normally prefer the Consult communication style. This communication model encourages employees to become more involved. This promotes teamwork and enhances the labor-management partnership, which improves employee satisfaction. If Elsie uses this MCS, Arnold may become more receptive to this performance management approach.

The manager applying the Join communication style does not make the decision. Rather, subordinates have the right to make the decision. The University of Phoenix Management Communication Skills text (1995) ascertained, “Typically, majority opinion determines the final decision after open communication. This MCS is the least preferred communication style because the subordinates become responsible for any outcomes related to the decision” (p. 49).

Ineffective Communication Strategies

No matter which communication style a manager uses, how an individual communicates is as important as what a person communicates. Ineffective communication strategies such as non-attentive listening, interrupting while someone is speaking, inconsistent or inaccurate messages, emotional overreaction, and defensive behavior ensure a breakdown in communication. 

The scenario of Arnold and Elsie hints at ineffective communication. Arnold became defensive when given a written warning. If Elsie had taken time to explain to Arnold the purpose of disciplinary actions, this would alleviate that reaction. As a manager, Elsie needs to maintain consistent and specific communication, both verbal and non-verbal, with Arnold as well as other staff. Clemmer (2005) stated,

Leadership and communications are inseparable. Our ability to energize, inspire, and arouse people to ever higher levels of performance is directly related to our ability to communicate. Strong leaders are strong communicators. If my communication skills (especially verbal communication) are weak, I'll never be much of a leader. I may be a strong administrator, director, technician, team member, or manager. But without strong verbal communication skills, I'll be a weak leader. Unless I improve my communication skills, I'll become a victim of the shifting balance between managing things and leading people. (p.1)

Ineffective communication strategies and effective communication strategies will determine the difference between a disgruntled employee and an employee who will accept ownership and accountability for his or her responsibilities.

Effective Communication Strategies

Effective or ineffective communication methods can influence the actions of others. Heathfield (2005) declared,

One study at UCLA indicated that up to 93 percent of communication effectiveness is determined by nonverbal cues. Another study indicated that the impact of a performance was determined 7 percent by the words used, 38 percent by voice quality, and 55 percent by the nonverbal communication (¶ 7).

Nonverbal communication constitutes various facial expressions, gestures, and body language. To be effective communicators, both

Elsie and Arnold need to be mindful of nonverbal communication and to use various techniques such as asking open-ended questions, maintaining eye contact, using silence, asking questions for clarification, incorporating space, listening attentively, and using appropriate voice infliction.

Since Elsie’s leadership role puts her in a position to counsel and discipline Arnold, she needs to implement effective communication techniques. In addition, it is important to remain steadfast in her position that there is a deficiency in Arnold’s performance, or she will lose her credibility as a supervisor. When discussing the issues, it is important for Elsie to remain factual and to keep the emotional aspect of the situation separate from identification of the problem. By identifying, clarifying, and getting feedback through verbal, nonverbal, and written communication, Elsie ensures that Arnold is fully aware of how his actions and behaviors have hazardous and potentially life-threatening consequences.

Communication Plan of Action and Follow-Up

In this case, Elsie needs to get the message across to Arnold that his behavior is not acceptable to the company. When considering a communication plan, Elsie needs to use an effective approach that addresses Arnold’s actions and behaviors in order to improve performance. “Important issues are Who do you need to communicate with, and What do you want them to do as a result of your communication” (Grindborg Ltd. CO., 2005, ¶ 1). The most effective way to communicate this message is to speak to Arnold directly and to get his feedback. Because Arnold claims that he is not accountable for his poor practices in the past, it is preferable for Elsie to have her supervisor there to witness the conversation as well. During this communication, it is important to communicate not only what the problems are, but also to identify the disciplinary actions that will follow, if the problem continues.

Elsie, who is now concentrating on her management communication skills, decides to quickly type out the results of the meeting, and places them into Arnold’s personal file. This way there is no mistaking that a discussion regarding the issue occurred and that each party understood the discussion. Elsie has the documentation of the issue and its resolution, if further disciplinary action is required. 

Arnold’s behavior needs to improve because people’s lives are dependent on his accuracy and promptness. Elsie needs to implement critical thinking strategies to identify and to rectify Arnold’s poor performance, while making him feel valued as an employee. Ineffective communication approaches contribute to both Arnold’s and Elsie’s unsuccessful attempt to solve this problem. In addition, lack of accountability on both Elsie’s and Arnold’s part adds to the severity of the situation and decreases the likely hood that there is a forthcoming resolution to this dilemma. Accountability has to happen both ways to be effective. Identification of unacceptable behavior is a vehicle for change. In this scenario, applying critical thinking strategies, defining accountability issues, and applying effective communication skills are the vehicles needed to implement change and to improve performance.

References      Arnold and Elsie

Anonymous. (2002a). Case in health care management: The periodic offender. The Healthcare Manager, 20(4), 36-39.

Anonymous. (2002b). Case in health care management: The reclassification request. The Healthcare Manager, 21(2), 17.

Brightman, T. (2005). Be accountable! Promote positive outcomes. Retrieved August 30, 2009, from http://cc.msnscache.com/cache.aspx?q=2060871077321&lang=en-US&FORM=CVRE2

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http://www.clemmer.net/excerpts/communication_strategies.shtml.

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Greene, N. (2005, July 12). Accountability, responsibility, and fun [Week 3 lecture]. Message posted to BSBA8.06-28.BSAP0152K8-HCS463.Course-Materials.  

Grindborg Ltd. CO. (2004). Communication plan. Retrieved on August 30, 2009, from http://www.grindborg.com/communicat.htm.

Heathfield, S. (2000). Performance appraisals don't work. Retrieved August 30, 2009, from http://humanresources.about.com/library/weekly/aa061100b.htm

Kraines, G. (2002). Accountability leadership. The Systems Thinker, 13(10), 1-5.

True Intentions (2004). Facilitation. Retrieved August 30, 2009, from http://www.trueintentions.com/facilitation.html

University of Phoenix. (Ed). (2002). Management communication skills. [University of Phoenix    Custom Edition]. Boston: Pearson Custom Publishing.