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History, Development and Challenges of the Institute of Public Health

Info: 3646 words (15 pages) Nursing Essay
Published: 3rd Dec 2020

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Tagged: public healthhistory

Background/Situation-

The Institute of Public Health in Ireland was created in 1999 to promote cooperation for public health in the whole of the country.  This was a big cross-border initiative that happened at the same time as the Belfast Agreement that intended to end the centuries conflict.  The Institute of Public health provided public health information, strengthened the public health capacity, and advised on public policy.  The reality of this was to tackle the inequalities in health, unite public health initiatives, and promote cooperation for public health throughout Ireland.  An original idea came from the Chief Medical Officer in Northern Ireland and identified the need for greater cooperation of health.  A small group to explore was set up and discussed the idea and its potential success with a wide range of people from universities to environmental health.  After networking and many discussions later the Institute of Public Health of all Ireland was established.  The institute needed someone to develop the original idea and move the agenda of health further with limited number of resources.  Jane Wilde was given the title Director of the Institute in 1998 and is a consultant in public health and on the health board, and she has trained in both the United States and United Kingdom.             

Key Individuals

Former US Senator George Mitchell, Canadian General John de Chastelain, Finnish ex – Prime Minister Harri Holkeri were the main few that led in talks to the agreement on Good Friday. The United States President of the time, Bill Clinton, provided political support and encouragement for the IoPH to get passed through. The original idea stemmed from Chief Medical Officer in Northern Ireland. Jane Wilde was appointed Director of the Institute in the autumn of 1998. Her background in the health and political field included Northern Ireland Women’s Coalition and professional as Director of the Health Promotion Agency.

Issues/Problems

 Right away a number of challenges arose for the Institute of Public Health in Ireland. The location was the first big issue, because of the differences The Republic had vs. Northern Island. With their different jurisdictions, different budgetary regimes, different political institutions, time periods, different cultures, and different health care structures. Originally the Institute was to be located within the Royal College of Physicians in Dublin, which seemed like amazing news at first. Until they realized they weren’t given very much space to work with, and were placed in a closet with no windows and a poor computer system to work with. Jane had great aspirations for the Institute that didn’t agree or match up to the Royal College’s ideas and plans. Jane wanted the Institute to be modern, transparent and permeable, facilitative and enabling, rather than strict and laying down the law. The Royal College was more focused on tradition, standards, specified training and examinations were mandatory, which Jane did not have in mind. At first, the Director had a very small network on the island and that was going to be a challenge for her expansion plans. Until she linked up with the Chief Medical officer who took her in and acted the role as her sponsor, setting her up with connections and meetings to expand the Institute of Public Health in Ireland.

Causes-

The actions of the institution were challenged by political sensitivity as well as cultural differences. The management team had to be cautious in their approach in order for the project to be successfully initiated. While the non-executive management board had to work around this issue with the interest of the executive board they functioned on a system of transparency. Having this collaboration focused and consensual approach the institute would be able to follow their initial vision of unity in Ireland. The ability of having a successful management staff that posed credibility helped further the institutes position as well as the outgoing actions by the director Jane Wilde. THe leadership styles overall were important as they needed to balance between affirmative, democratic and authoritative. Using this insight they would be able to engage in building community trust and gain stakeholders who saw growth in the institute. Having a strong vision and people behind it who supported the functions was seen with the transition to the college where they were faced with a very below average result. Handling themselves and moving forward to encourage their position was highly constructive and graceful which would lead to better sponsorship.

Decisions/Alternatives

In order to move forward the IoPH must demonstrate a desire to work on the heath inequality agenda. This will actively create a positive response amongst the people and it will be politically neutral wich will be necessary for a smoother transition.

Conclusions/Recommendations

After establishing this institute a lot of key lessons were learned during the change process.  It was necessary to have good sponsorship from a person who was well respected and who had authority in the field of work already, know as Chief Medical Officers.  They had a role in good sponsorship because they were there for the first idea and the take off of the organization to it being taken by the management board.  They learned the importance of knowing whos involved within and outside the organization.  Identifying the stakeholders and seeing what they need and want and giving them information on all plans within is very important.  Since the Institution did not operate on specific powers it had to adopt an influencing style that was constructed on drawing people into discussions and offering knowledge.  Building on someone’s ideas and sharing power works best when no formal power is in motion.  The importance of the ‘what’ from visions and ‘how’ from values helped create a route to achieve the objectives in place.  The what and how was the major part of the decision making process in order to become successful. In order for the organization to become successful they needed to demonstrate it by enabling the health inequalities agenda to move on.  In order to move that on, it needed to develop a lean, agile and responsive organization during recruitment for good people with good influencing and enabling skills.  A transformational leadership style was adopted by the senior management team.  The Institute recognized the need to invest in leadership processes that will pay due regard to either an individual or a team that will take action.  A stronger relationship between non executive board and senior management team needs to happen in order to create a fully effective organization.  The stronger relationship between the non executive board and the senior management team will ensure the clarity of goals and effective operating processes. The leaders of the organization also saw that they needed to be close with all of their stakeholders as well. By doing this, the organization can build an amount of trust and the needs of the people whom they represent. These strong relationship are developed through the vision and values that the institution has been built upon. The vision and values of any organization are very important. The vision and values are “even more important than a clear set of objectives.” The vision and values of an organization will be a key factor in helping transitioning through change.

Case Study Questions

Individual Change-

1.         What were the main ways in which people were motivated during the change process together with any underlying assumptions?

The main ways in which people were motivated during the change was through collaboration, teamwork, and creativity.  As long as they have these 3 key aspects they will be motivated with the help of others and themselves.  Working with others will keep the motivation flowing because other ideas are being thrown out and they are able to work around it with keeping one main goal in mind.

2.         If you were a manager (not leading the change) at loPH what would be some of your key tasks?

If I was a manager at loPH some of my key tasks would be organization, promoting collaboration, and understanding the future needs and scenarios to come.  These would be key tasks because you always need to prepare no matter what the case may be or even if you are not the one leading the change.  Also having everything organized for yourself as a manager, loPH, and everyone else involved is very important.

3.         Using the Satir model describe how the loPH change process evolved?

The loPH change processed evolved by having their old problem, to resisting any change from happening, to having everything go wild and not being able to handle what is to come, to actually dealing with the change, and then having the change become real and established.

Satir Model:

-old status quo

-resistance

-chaos

-integration

-new status quo

Team Change

A)    In terms of the four personality types, which one(s) were most in evidence? What might some of the benefits and pitfalls of this type have been?

The B personality type was most often exhibited in the case. Jane Wilde, the director of the institute, was hired to be creative and innovative all while displaying a credible reserved presentation. She is outgoing and very much concerned with face to face communication. Participating in meetings initially in her position she was able to acquire 80% of the Republic’s vote for the belfast agreement all because of her communication success. The reason type B stood out more so than the type A personality, was due to the influence of emotions that were much more present in how Jane conducted her position as Director. She had the ability to focus on everyone and not pressure certain people where an A type personality would lose sight of this action. A large benefits of a type B individual is the ability to recognize other people's opinions and have a small amount of attention focused to what people think. While this may seem like a pitfall it can go both ways. Consumer opinion has a direct effect on income for a company and in this particular situation in the beginning of the IoPH the process of creating such a platform needs agreement from outside entities.

B)    If you were a team manager/leader in loPH which of the five elements of effective team work would be most important?

Commitment would be the most important aspect out of the five elements of effective team work if I were a manager in IoPH. Holding true to the vision of the decision in relation to the companies values would be key in keeping all actions relatable. Commitment keeps the goals and actions of a business functioning at a high level which will achieve success. Operating with specifics is something the Institute desired to create but has not capitalized on because of a lack of commitment. The ability to do a task relies on the motivation employees are faced with. Creating an environment that gives more credit to the employees will in turn strengthen the institute as a unit to bring about change in Ireland.

C)    Would you create any different types of teams at the loPH to help in its evolution? (Cameron)

While reading about the Institute of Public Health in Ireland we have come up with a few different types of teams that can be implemented to help the evolution of the organization. A problem- solving team would definitely be something that could benefit IoPH. This team would be a temporary, cross-functional group of people who come from different departments, and possess different roles, skills and interests. A fast, permanent solution to a specific problem is the problem-solving team's priority. Another team that they could benefit from would be a quality- solving team. This specific team would be in charge of take a methodical approach to identifying and resolving workflow issues that have a negative and ongoing impact on the organization's efficiency and working conditions. Lastly, since the location of the IoPH, they would greatly benefit from a Online/ Virtual team. Technology now in 2018 allows people to participate in an organization's activities regardless of their geographic locations. Online teams communicate online, through various conferencing and collaboration technologies. Thanks to social-networking tools, virtual-team members can be in touch continually and access group projects, no matter where they are.

Organizational Change

1.    Identify some examples of the political systems metaphor, and the Flux and Transformation metaphors in action in this case study.

Some of the examples of political systems come with the influence of the people who were involved with the IoPH. More directly the IoPH provides public health information and surveillance which would strengthen public health capacity, and lastly, advising health policy.

2.    William Bridges wrote about transitions in his work. Can you see and evidence of Endings, Beginning’s or Neutral Zones in the process of change at IoPH in Ireland? If so, what ended, and what began? What was accomplished by the leadership in the neutral zone? If not, does that mean there was no real transition? Discuss.

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1.     Ending, Losing, Letting Go – The time of ending a process within and organization and beginning the new one of the most difficult time while going through the change. Employees of any level may feel some levels of sadness, anxiety, or anger towards the change that the company is going through. Good Friday agreement provided “necessary momentum to crystallize the idea and the Institute of Public Health for all Ireland was established.” This was the starting point where they would employ six people of various health backgrounds and would see what would happen. One of the jobs being the Director’s which would be granted to Jane Wilde. This would start the transition into forming IoPH.

2.     The Neutral Zone – The neutral zone is the halfway point of the organizational change. During this time there still may be some confusion and anxiety amongst employees but there are ways to ease them through this process. Some of the ways a manager or executive can help is to involve everyone in the change process, have the employees work in a collaborative manner and build teamwork. Also, sharing reports of progress will help ease the company along with the change. This is especially helpful because it reminds the team that they are working positively through the change. Finding a reason location for the institute, which would be located within the Royal College of Physicians in Dublin. Overcoming old Northern Ireland jurisdictions, cultures, and health structures became a problem in which Jane and the IoPH would have to tackle. Overcoming more challenges such as the developing infrastructure. With the new infrastructure came “technology, such a we and Internet, e – mail and other lines of communication.” Along with this came recruitment, which then the institution needed to establish financial systems. The organization also started stepping away from just providing advice and information. The members of the organization were now focused on aiming on having “wider determinants of health, highlighting the interconnections between  transport, housing, education and social works.”

3.     New Beginning - The new beginning is when the change has gone through completely and employees are starting to feel excited about the change. This new change that was implemented feels like it’s the “only way.” Helping your team in this stage can be as simple as providing the necessary information for your team, or painting a clear picture of how outcomes will look due to the new change. The new beginning was starting to take form when the IoPH’s new approach was widely accepted. This allowed the institution to be more involved than just the normal realms of health and this guided them through that process over overcoming the change.

3.    Take Kotter’s eight steps to transforming your organization, and see if you can find any parallels, or obvious areas of mismatch. Is there any work still to be done, or work that was missed out, that you can deduce from carrying out this comparison?

1.     Create Urgency

2.     Form a Powerful Coalition – The group of individuals who led talks for the agreement. Some of the people are former US Senator George, Canadian General John de Chastelain, and Finnish ex – Prime Minister Harri Holkeri. The group of these folks played an important part in gaining the support for the Good Friday Agreement.

3.     Create a Vision for Change – Chief Medical Officer in Northern Ireland began conversations with his counterparts to begin the vision for the change needed with the health systems of Ireland.

4.     Communicate the Vision – the vision for the new health care system was most effectively communicated through the director, Jane Wilde. Jane Wilde would go out meeting people and communicating with them that this new institution was not a direct competition.

5.     Remove Obstacles – Technology played a massive role in the efforts to remove obstacles for the institution. Some of the technology they used was the web and Internet, e – mail communication as well as other lines of communication. Having very streamlined communication as such made for a more efficient place of work.

6.     Create Short – Term Wins – There were many wins, big and small that the IoPH went through. They gained the support from people within the health field. They also had other wins from their technology with their communication. The biggest win the institution saw was the openness to broaden the range of their work within the health field. When it was accepted by people that they would make the scope of their work bigger, it was a big win for the institution.

7.     Build on the Change – Building on the change was easy. The IoPH did not have to go through a great deal of change with the change happening during the beginning of the IoPH. With this, every person within was able to adapt to the change easily. This was made simple by Jane Wilde and the vision she set within the institution. The first six months when she went out meeting people was crucial in helping the change process. 

8.   Anchor the Changes in Corporate Culture – The vision and values that are talked about have a very strong impact on how this organization is ran. On page 22, it’s stated, “the vision and values are crucial, even more important than a clear set of objectives.” Maintaining the core values of this organization are an instrumental part of their operations. They execute these visions and values they hold within their company by recruiting health professionals from all parts of the world.

Leading Change

  1. Warren Bennis is said to be the “Father of Leadership”, whenever someone mentions a great leader, Bennis is rarely not mentioned. Jane Wilde, the director of the institute, was hired to be creative and innovative all while displaying a credible reserved demeanor. She stayed persistent in her trials to expand the Institute of Public Health in Ireland through all of her challenges that came her way and that’s the true definition of a leader.
  2. Jane Wilde’s story could be encapsulated by the drive and motivation she had as a leader. Jane Wilde had a very clear take on the importance of the vision and the values to the IoPH and the way it worked. The visions and values are very crucial, even more important than a clear set of objectives. Vision and values are at the top, and infrastructure is at the bottom. The vision is that Jane Wilde had was motivating.
  3. Leaders are necessary for organizational change. For an organization to be operating at the full effectiveness a strong relationship is required between the senior management team and the non- executive board members. The senior management team adopted more of a transformational leadership qualities such as: creating a facilitating environment, enabling people to operate in an environment of trust, recognizing that building overall capacity and capability instead of being directive and hierarchical.

References

  • Organization of Effective Teams. (n.d.). Retrieved February 23, 2018, from http://smallbusiness.chron.com/organization-effective-teams-19426.html
  • The 5 elements of an effective team. (2010, October 16). Retrieved February 26, 2018, from http://propertycollectives.com.au/2010/10/the-5-elements-of-an-effective-team/
  • Understanding the 4 Personality Types. (n.d.). Retrieved February 26, 2018, from https://www.hiresuccess.com/help/understandingthe4personalitytypes

 

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