7-S Alignment

My wife recently worked as a nurse at a local residence/care facility for handicapped individuals. After learning about the McKinsey 7-S model, I realized that this organization was misaligned in a lot of ways with their overall strategy.

Strategy

Provide high quality care and high quality of life for the most number of patients.

Structure

The organization has a relatively flat structure with two owners, 6-8 administrators, a director of nursing, nurses, and "habilitation techs" (who provided for non-nursing patient needs). While this flat structure would seem to be beneficial to the company with few levels in between nursing staff and the owners, the owners tend to micromanage instead of allowing administrators or the director of nursing to make decisions based on what they encountered on a day to day basis.

Systems

Incentive systems- Wages are somewhat competitive, but on the lower end, making it difficult to attract employees with a broad level of experience with patient care.

Human Resources/Hiring- For nurses, they hire a lot of recent graduates, often with little work experience. For the habilitation techs (HTs), they often hire high school graduates with little to no college or vocational training. Many of the HTs do not even speak English well, making patient care and coordination with nursing staff difficult at best. Because of high turnover, it is difficult for them to find experienced nurses to train new nursing staff. Thus, training is inconsistent and unstructured leading to a lower quality of patient care. As they add more patients, instead of hiring more staff, they just add to the already heavy workload of nursing staff.

Shared Values (Superordinate Goals)

The ultimate goal of most employees is to provide high quality care for each patient, which is consistent with the strategy outlined above of providing great care for the most number of patients.

Skills

As mentioned above under hiring systems, some of the staff lack the experience and/or training to provide the kind of care that the institution requires.

Style

While some of the managers are highly capable and good and motivating and training employees, the owners tend to micromanage, thus making the manager ineffective at accomplishing their goals.

Staff

Most of the staff see this as a temporary job, with very few long-term employees. Staff are therefore not motivated to try to improve the system or help patients reach long-term goals.