3 Management practices and role of leadership in an organizational transformation
Bibliographic record
Abstract
Background Ministry of Long-Term Care put the Hogarth Riverview Manor (HRM), the largest Long Term Care (LTC) Home in Ontario, Canada with 544-beds licensed capacity, under a Mandatory Management Order (MMO) when it repeatedly failed to meet the LTC regulatory standards to deliver safe resident care. Objectives Remove the Mandatory Management Order imposed by Ministry of Long Term Care Meet regulatory compliance to standards set by Ministry of Long Term Care Establish practices and infrastructure to ensure sustenance Create a happy work culture Methods Conducted transparent and honest conversations with staff while articulating the need for change. Balanced Scorecard measures established at the HRM level and cascaded to all clinical units and support areas. Management practices and infrastructure co-created with staff and leadership to implement quality improvement huddles daily, generate and implement change ideas, conduct mandatory program reviews weekly, senior leadership walkabouts every two weeks, quality, safety & risk steering monthly, and review balanced scorecard quarterly. Standard work created for key processes. Provided training to over 800 staff on PDSA and created safe environment for staff to experiment. Visual management leveraged to create organizational focus. Governance and audit process established to ensure compliance. Staff recognized and celebrated daily. Results 574 change ideas implemented. Resident-care metrics trending in the right direction. Zero compliance orders in the past year based on multiple ministry inspections. Joy in workplace. MMO lifted and today a sustainable, accountable, and a highly effective team proudly delivers resident-centered care (figure 1). Conclusions Transformation and organization culture change is possible when the elements of the journey are co-created with staff and the leadership is on-board. Transformation takes leadership and practice to change norms, improve persistence and resilience, communication and knowledge sharing, and coordination and systems thinking. Providing infrastructure is critical to create operational sustainability and to change the culture.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.007 | 0.008 |
| Scholarly communication | 0.011 | 0.004 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.008 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".