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Research Paper
Research Paper
UPMC
Anthony Soricelli
DBA: Marketing
Liberty University
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Research Paper
Abstract
Organization in today's climate are faced with different problems from time to time
whether it be; competition from other similar businesses, high employee turnover, and/or budget
restraints. The main purpose of this research paper is to elaborate on two problems that UPMC
faces in day to day operations. University of Pittsburgh Medical Center (UPMC) is an American
nonprofit health enterprise that prides itself in being the leading American health care provider.
There are several issues of note preventing UPMC from operating at its full potential. One is a
drastic change in employee hours. Another is the workforce itself and how management views its
employees. The management structure of UPMC is problematic as well. The specific issues of
management are the lack of communication between mid-level managers. All these issues are
addressed by the author in the research paper. A summary of how UPMC could better serve its
employees, its customers and itself are offered.
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Research Paper
University of Pittsburgh Medical Center (UPMC)
The company chosen for this research paper is University of Pittsburgh Medical Center
(UPMC). University of Pittsburgh Medical Center (UPMC) is an American nonprofit health
enterprise that prides itself in being the leading American health care provider. UPMC closely
affiliates with the University of Pittsburgh who has one of the top medical programs in the
country. UPMC was founded in 1893, officially becoming what it is today in 1986 when the
decision to consolidate several hospitals and health centers into one group. UPMC offers several
services from health insurance, cancer centers, hospitals, community medical clinics,
rehabilitation services, etc. One of the services listed is rehabilitation services where they offer
physical therapy, occupational therapy, speech therapy, and other specialty services across their
60 clinics alone throughout Pittsburgh.
Although most of the issues presented within this paper are specifically looking at the
operations of the organization within their rehabilitation services sector, UPMC must be looked
at as a whole, because it is a national company. There are some issues that obviously arise from
the inter-relationship from the rehabilitation services sector and corporate itself. UPMC
Rehabilitation Institute, is an interesting example of a successfully functioning company
operating well below its full potential.
There are multiple issues observed within the operations of this company. The primary
problem observed with the firm is with the workforce. The other major problems are within the
management team itself. One of the biggest problems with UPMC is that the management team
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does not communicate well with each other, at the mid-level, this leads to missed information
being out there and the marketing team taking the heat for misinformation out to the community.
High level management operates out of the main headquarters located in Pittsburgh, but still
forgets to pass along important changes in the company throughout the levels of management.
This ends up effecting all levels and causes the marketing staff to have issues being proficient at
their job.
Management Theories
Some of the theories to consider are scientific management theory, contingency theory,
and bounded rationality theory. UPMC has a unique combination of rational, open, and natural
system perspectives. The open system perspective, is where the system and environment interact,
utilizing resources from the external environment that are deemed useful for an organization.
UPMC is focused on increasing profits over everything else, so they focus on certain employees
that they see fit as key assets to the company's success. UPMC also has a rational system
perspective where goals are set for each department throughout the UPMC system, due the fact
of them offering multiple services and products. Employees are constantly micromanaged and
are pressured to focus on profitability no matter what it takes to do so.
Rational system models focus on the formal structures as a tool for the efficient
achievement of an organization. Whereas, am open system views an organization as a system
that is affected by the environment in which they operate. Organizations can choose using an
open-rational and/or open-natural system assumes that the organization’s decision-makers and
managers are in charge of making decisions that will adapt to environmental changes. Corgent et
al., (2021) stated, that social collaboration is the most effective way to change an organization.
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Natural systems emphasize a liaise style through relationships and human interaction (Garris,
2021).
When looking at management theories I believe, bureaucratic theory is easily applicable
to UPMC system. Bureaucratic theory is all about having strict governance where management’s
authority cannot and will not be questioned. This typically means that people in charge of an
organization will make the decisions that are implemented without opposition. UPMC, like most
organizations rely on their administration to make the decisions and implement them without
taking in the consideration of employees and customers. UPMC breaks down their management
in lower levels but they have very little authority to perform their duties and have to answer to
corporate management. Raises, benefit additions, location transfers all go through corporate
management with a little bit of influence of front-line management.
Administrative theory is another option to apply, which is a rational systems approach to
organizations. Administrative theory focuses on two parts of the organization's structure
coordination and specialization. Coordination is the hierarchical organizational form controlling
the relations between organizational participants. Whereas, specialization is how activities are
grouped among work groups. Administrative theory compared to a scientific management
approach, looks beyond the individual and focusing on the organizational structure. However, it
does have similarities to scientific management, by fixating on studying formal aspects of
organizations in an effort to maximize efficiency and effectiveness.
While rational systems perspectives focus on the formal aspects of organizations there are
natural systems perspectives examining its informal aspects. Nowadays, the formal structures of
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modern organizations are important. Sanguinetti-Toudoire et al., (2023) goes into detail about
formal structures by stating:
Formal structures have long used a closed way of performing innovation but, nowadays,
open innovation has become very popular (Bogers et al., 2019). The question of sharing
innovation with communities was theorized (West et al., 2014) but mainly studied from
the point of view of the communities rather than from the point of view of the formal
structures (Kim et al., 2022). (p.608)
Although most often the individuals in organizations do not strictly adhere to the formalized
rules. Cooperative systems theory takes a natural systems approach recognizing the informal
interpersonal relations necessary for organizations to exist.
Human relations theory is a research focused on people’s desire to be a part of a
supportive team that facilitates development and growth. Like scientific management, human
relations theory focused on the individual level as well. However, it differs from scientific
management due the fact it focuses on the informal aspects affecting productivity. Omodan et al.,
(2020) talk about the assumption of human relations theory by saying:
The assumptions of the theory are as follows: the needs, such as belongingness,
inclusiveness and recognition, determine workers’ morale than physical conditions of
work environments; informal or formal social group within workplaces such as team
effort, social conformity and group loyalty determines individual and group behaviors;
people develop affinity for one another in the group that comprises individual with
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various affinities; employees are motivated by social and psychological needs coupled
with economic incentives; communication, power, manipulative influence authority
devoid of autocracy are important, and therefore, should be encouraged and developed in
organization (Mayo, 1933; McGregor, 1960; Moreno, 1953). (p.3)
UPMC supports those who are the most liked and favor employees who are in specific
social circles. On the flipside, for whatever reason they don’t support those who they deem
replaceable, regardless of competency and how well they perform at their job. This leads to
UPMC keeping employees who don’t hit the required criteria and continue to support the goals
of these employees. UPMC deciding to do this causes a decrease in overall productivity of others
and ultimately decrease the overall performance of the organization. The organization will just
replace good employees with even cheaper employees, keeping cost low and cycle through to
keep operations floating just above required minimum level of care.
Technological Structure
To understand a specific organization, the organizational structure it possesses must be
studied in detail. The structure of an organization is based on the rules and regulations developed
for the organization’s set goals for success. Root (2020) states, that the structure of an
organization is based on communication, so that operational control can be dedicated to those
actually doing the work for the organization. Technology plays a huge role in influencing the
structure of the organization nowadays. Technology is typically defined as the machine
complexity of the company or the complex processing ability of the company, but in reality, its
combination of the intellect and knowledge people possess to use the technology in the company
to get the job done.
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Müller et al., (2021) states, one way for firms to keep up with rapidly changing
technological developments, and to cope with the increasing complexity of technology and
technological knowledge, is collaboration in research and development. Employees focused in
research and development, helps them build even more intellect to be able to run the machinery
they are supplied with to do their job. This combination of the machine and intellect of
employees is needed because machines cannot dictate what to do, so humans' knowledge is
required to calibrate and ensure they perform effectively. When looking at UPMC, the
technology is the knowledge of the employees and the tools they have to maintain the upmost
level of patient care. UPMC needs to promote research and development throughout the ranks
and support their employees in these endeavors.
Social Boundaries
Technological structures have shown that humans are essential for technology being used
in an organization to operate properly. The reason for this, is that simply technology cannot work
on its own without the knowledge of humans operating the technology. Social boundaries and
technology structures go hand and hand. Social boundaries are analyzed to determine to what
extent each person should be involved with the organization and where the boundaries need to be
placed to protect employees’ interest. This is an essential to decision because boundaries
between social life and organizational life is vital for retention in employees. Schotter et al.,
(2017) states, that these separate functions provide the foundation and groundwork for the
creation of subunits as well as in-groups and out-groups allowing for the organization to separate
itself away from the external environment. Which this leads to confusion between organizational
boundaries and social boundaries.
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When analyzing organizational boundaries its hard for most to realize they are different
from social boundaries. In all honesty, organization and the external environment interact or
depend on each other, and therefore it is challenging to know the border of the organization
which make it difficult to differentiate. When using a natural system, the organization is viewed
as a social unit which is the same as the participants. Therefore, it focuses on its own needs to be
performed by the people for it to function, unlike a rational system, where an organization is seen
as a means to help to achieve the goals of an organization. Mair & Seelos (2021) states, the
boundaries change with each interaction by redefining the relationships within the company and
outside with the board and stakeholders. Organizations like UPMC need to keep this mind when
setting social and organizational boundaries.
Network organizations are systems that monitor and report on the commitment of
corporate organizations to long-term initiatives such as environmental protection. Organizational
networks provide a feeling of solidarity to achieve shared goals between organizations and their
members. Jiang et al., (2020) states, as a result, they contribute to the motivation of others and
the improvement of the working team and the company. Scott & Davis (2016) states, at this
analytical level, it is sought to find where players fit into the network at the organizational level;
it determines where actors fit into the network. A network is both a social and organizational as
the network classifies and interprets the relationship between coworkers, acquaintances, friends,
and family. There are many different types of network organizations as well as advantages and
disadvantages in organizational networks. Furthermore, network organizations greatly impact
numerous aspects of life, such as environmental processes.
Types of Network Organizations
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GGNetwork organizations are systems that monitor and report on the commitment of
corporate organizations to long-term initiatives such as environmental protection.GGThis is why
environmental protection policies and the implementation of environmental protection measures
go hand and hand. Technical societies assist in facilitating the exchange of information and
perspectives. Organizational networks provide a feeling of solidarity to achieve shared goals
between organizations and their members.
GGGGGGGGGGGGAhmady et al., (2016) states, a stable network organization is one in which a major
business plays a significant role in establishing market-based linkages for the partners inside the
network, even while the partners continue to service clients from outside the network
organization.GThere are also internal networks. This sort of network organization emerges when
firms buy and sell products and services within themselves at prices established by the open
market. Market transactions should be able to take place outside of organizations' borders while
yet remaining inside organizations' constraints.
Wu et al., (2021) states, the close communication, stability, and trust among members of
the internal network positively affect the innovation and growth of incubates by promoting
knowledge transfer and resource flow. Organizations focusing on internal networks need to build
a team that can communicate and work well with each other for it to be successful. The internal
network refers to the collaborations among incubates, which plays a nurturing function and
serves as the entire incubator network’s core. The internal cooperation in the incubator network
is particularly important for incubates’ survival (Wu et al., 2021).
Personal Perspective & Concluding Thoughts
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The Bible teaches that people are to uplift the lowest among us. We need to do this as
children of God. UPMC’s mission should not be short-term profitability but the long-term
sustainability of its operations and retaining the staff that makes them profitable. Without
maintaining employees that focus on patient needs, they will fail in the long term and lose
business to their competitors. Merida (2015) states, Solomon was the king in Israel and his
structure, organization, and diplomacy made the political and economic leaders happy. We learn
from Merida, how organization leaders need wisdom to grow their business and need to be
supported from upper management to succeed.
By supporting the goals of employees, they would keep its employees happy and
motivated. Employees will be more likely to be productive and contribute to the growth of the
company while achieving their personal career goals. When taking a look at the current structure
at UPMC, they fail to support their entire work force. Focusing on employees that are close with
management, regardless of work quality and performance. In the Bible it states, but he said to
me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will
boast all the more gladly of my weaknesses, so that the power of Christ may rest upon me
(English Standard Version Bible, 2001, 2 Corinthians. 12:9).
Jesus taught us, we must look out for the weakest among us and be a light to guide them.
They are not a lesser man because they are weaker and/or not as educated, they just haven’t had
the opportunity to be taught how to be strong and/or educated. To improve UPMC operations
they need to maintain its workforce and allow their leadership to lead. UPMC can accomplish
this by taking more time with some employees to help them to improve and show support to their
ideas for how the company can operate efficiently. A lot of organizations struggle with actually
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listening to their employees and making decisions that can have a major effect on their
organization’s life cycle. UPMC recently has laid off 1000 employees in their Pittsburgh sector
alone, so UPMC can really use taking a look at these suggestions and make better decisions in
the long run.
References
Ahmady, G. A., Mehrpour, M., & Nikooravesh, A. (2016). Organizational Structure. Procedia -
Social and Behavioral Sciences, 230, 455-462. https://doi.org/10.1016/j.sbspro.2016.09.057
Corgnet, B., Gunia, B., & Hernán González, R. (2021). Harnessing the power of social
incentives to curb shirking in teams. Journal of Economics & Management Strategy, 30(1), 139–
167. https://doi.org/10.1111/jems.12405
English Standard Version Bible. (2001). ESV Online. https://esv.literalword.com/
Garris, M. (2021, April 3). Rational, natural, and open system perspectives of organizations.
Above the Fray and Beneath the Surface. https://www.mattgarris.com/post/rational-natural-open-
system-perspectives-of-organizations
Jiang, F., Zhao, X., & Bai, Q. (2020). Simulation and stability analysis of conflict events
between employees and organization based on the social network. Concurrency and
Computation: Practice and Experience, 32(6), e5097. https://doi.org/10.1002/cpe.5097
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Mair, J., & Seelos, C. (2021). Organizations, Social Problems, and System Change: Invigorating
the Third Mandate of Organizational Research. Organization Theory, 2(4).
https://doi.org/10.1177/26317877211054858
Merida, T (2015). Christ-centered exposition: Exalting Jesus in 1 & 2 Kings. B&H Publishing
Group.
Müller, M., Kudic, M., & Vermeulen, B. (2021). The influence of the structure of technological
knowledge on inter-firm R&D collaboration and knowledge discovery: An agent-based
simulation approach. Journal of Business Research, 129, 570-579.
https://doi.org/10.1016/j.jbusres.2020.01.067
Omodan, B. I., Tsotetsi, C. T., & Dube, B. (2020). Analysis of human relations theory of
management: A quest to re-enact people’s management towards peace in university
system.SA Journal of Human Resource Management,18, e1-
e10.Ghttps://doi.org/10.4102/sajhrm.v18i0.1184
Root III, G. N. (2020). What impacts organizational structure? Small Business - Chron.com.
https://smallbusiness.chron.com/impacts-organizational-structure-75.html
Sanguinetti-Toudoire, V., Chauvet, V., & Goudarzi, K. (2023). Interactions between formal
structures and knowing communities: What does open source community involvement mean?
European Management Journal, 41(4), 607-620. https://doi.org/10.1016/j.emj.2023.04.002
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Schotter, A. J., Mudambi, R., Doz, Y. L., & Gaur, A. (2017). Boundary spanning in global
organizations. Journal of Management Studies. 54(4). 403-421.
https://doi.org/10.1111/joms.12256
Scott, R. W, & Davis G. F. (2016). Organizations and Organizing: Rational, Natural, and Open
Systems Perspectives (1st ed.). New York, NY: Taylor and Francis Books. ISBN:
9780131958937.
Wu, W., Wang, H., & Wu, Y. J. (2021). Internal and external networks, and incubatees’
performance in dynamic environments: entrepreneurial learning’s mediating effect.The Journal
of Technology Transfer,46(6), 1707-1733.Ghttps://doi.org/10.1007/s10961-020-09790-w
