Organizational Design, Culture, and Adaptation – Health System Example

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"Organizational Design, Culture, and Adaptation" is a perfect example of a paper on the health system. The audience selected for this program includes 50 health care professionals within Boston Penitentiary facilities. The selected number of professional health care personnel covers five facilities in which about 10 professionals are selected from each. Although the total of professional health care officers may be more than this, the programs would involve handouts that can be used by the participants to educate and train their colleagues at their respective correctional facilities. 1. How was the program restructured or reengineered to adapt to internal and external factors impacting it? With reference to the target audience identified in module 1, 50 health care professionals were identified for training for treatment and intervention training within Boston penitentiary facilities.

With reference to the identified 5 penitentiary facilities, the focus was initially the training of professional health care providers from which the training was aimed at managing the psychological as well as personal issues affecting juveniles in penitentiary facilities. In this case, the program has to focus on the patients rather than the professionals.

The program is engineered to accommodate the factors that affect the juveniles as well as the pre-programmed factors that influence the professionals’ tolerance to external stressors. Thus, the strategy of transformation is to interpret the specific factors that influence the behavior of inmates. Thus, with the inclusion of health care professionals and penitentiary guards, evidence on the factors that affect inmates can be gathered as these factors depend on the type of lifestyles that the target patients lead in the confinement settings. Reference to how inmates respond to stressors is gathered from penitentiary inmate records.

On the other hand, personal attributes such as chronic violence and trauma history are addressed with reference to psychologists’ records, observational notes, mental status, and the level of participation of the target population. As identified in Module 1, the five penitentiary facilities within the Boston area accommodate up to 50,000 inmates from whom voluntary participation in this intervention is a function of personal choices, need for intervention, and availability of professionals that can handle specific inmate issues. Surveillance and legislation factors are to be reconfigured as patient-centered intervention requires evidence to ensure that healthcare professionals are well equipped with information about a target patient (Liff, 2011). 2.

What internal and external factors were considered in the transformation? In the transformation from professional-centered to patient-centered intervention, factors such as family, personal psychologists, and criminal backgrounds are considered. While the initial professional-centered training was based on the alleged stressors expected from a penitentiary facility, the patient-centered intervention focuses on the exact issues that affect individual inmates. For instance, professional-centered training prepares professionals for the expected stressors while patient-centered intervention focuses solely on the factors that push an inmate to act violently.

These factors include trauma history, abuse within the facility, and lack of justice in sentencing. Therefore the transformation from professional-centered intervention to patient-centered intervention uses factors affecting the patient rather than the expectations of a professional. 3. What were the barriers or obstacles were encounteredIn the transformation from professional-centered to patient-centered intervention, two major limitations are expected. Firstly, the professionals have a better understanding of the inmates based on previous experiences and this may cause program-vs. -experience issues thus risking the viability of the intervention.

Secondly, interventions that are not familiar to the patient are likely to be met with resistance thus requiring slow adaptation and delayed results. 4. What is the potential impact on the program of technology, legislation, etc on the services provided on the programTechnologically, the program ensures that patients are monitored via surveillance systems to ensure that abuse to patients can be detected and addressed with reference to circumstances, conditions, and the social environment within the confinement facility. The program, on the other hand, requires that prison guards as well all stakeholders such as family be incorporated into the intervention.

The policies of Boston penitentiaries may restrict the interaction of family and external entities from getting more than enough access to inmates. Hence, this program requires target facilities to amend their inmate accessibility restrictions to facilitate this program Roy (Liff, 2011).


Liff, R. (2011). Promoting cooperation in health care: creating endogenous institutions. Qualitative Research in Organizations and Management, 6(1), 46-63.
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