Posted: May 25th, 2022

Solutions for Twin Oaks Hospital Analysis

Solution for Twin Oaks Hospital

John Smith

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Twin Oaks Memorial Hospital

Dear Mr. Smith,

I’m writing as a reply to the Board of Overseers on the issues raised in the last Board Meeting: unionization of personnel, increase of salaries and shortage of janitors. After a complete analysis, the results show that fighting against the unionization would have harmful effects on the overall functioning of the hospital; salaries cannot be increased yet compensation on the basis of merit might be acceptable and the shortage of janitors can be fixed through the use of alternative part-time of non-paid individuals.

On the issue of unionization of personnel, it is the position of the HR Department that opposing this movement from the nurses and doctors will not lead to positive results for the hospital. As the National Nurses United has joined the Twin Oaks Hospital staff in promoting various organizational patterns, it is preferable to offer the Executive Body’s support in creating this Union that would be a member of the National Nurses United. From a small term business perspective, this appears as a negative movement, as negotiation powers will increase, having in view the other demands for salary increases. A solution would be to create a long-term strategy in which the Hospital decides to accept the Union as a partner in negotiations only on the basis of accepting that, under the current economic circumstances, a salary increase of more than 3.5% for nurses is impossible. Also, an advantage for accepting the unionization which is almost impossible to prevent, is the positive image that the Hospital will receive. As important will be the satisfaction and professionalization of current staff as we see in various unionization movements in the last decades: improving the “nurse-to- patient staffing in our hospital which will help us retain and recruit experienced nurses” (National Nurses United, 2011) is an important aspect we should also take into consideration.

Regarding the issue of salary increases that many of the employees are asking for, the solution presented above seems feasible from an HR and financial perspective. Nonetheless, a 3.5% salary increase will not suffice the needs of many of the second tier personnel, and through the newly formed Union support they will ask for more. It the HR Department proposal to re-introduce the bonus system that the Hospital has used several years ago for nurses and additional staff members. In order to improve the pay-for-performance system and eliminate previous cheating-the-system schemes we will have to use an effective internal auditing / monitoring system that will “help to control and weed out any misrepresentation, which can occur under any payment scheme” (Cadsby, 2010) as Fei Song argues in a recent study on cheating the pay-for-performance system.

Regarding the current shortage of janitors due to the health caused retirement of 4 of our janitors in less than 3 months; the HR Department proposes a measure that would lead to a double-sided profit for the Hospital. By taking in individuals as part-time and several volunteers the salary fund would save significant amounts of money each month. Also, the image of the Hospital would have a great deal to win from such a decision. A good example of operational efficiency and positive public visibility is the Greenwich Hospital in Connecticut that offers volunteers the possibility to work in Patient and Family Areas by escort patients to testing areas; assisting and comforting family members; delivering mail, flowers, books and magazines to patients’ bedsides; serve as a Pharmacy courier to nurses’ stations; Administrative Assistance or Hospitality and Retail. (Greenwich Hospital, 2011)

Hoping that the aforementioned suggestions will lead to positive outcomes,

Kind regards,

Janie Smith

HR Department


Cadsby, C.B; Song, F.; and Tapon, F. (2010) Are You Paying Your Employees to Cheat? An Experimental Investigation. The B.E. Journal of Economic Analysis & Policy: Vol. 10: Iss. 1 (Contributions), Article 35.

Greenwich Hospital Website. Volunteer Section. Retrieved in May 2011 from

National Nurses United (2011) Florida Medical Center RNs Vote by 83% to Join NNOC-Florida [Press Release] Retrieved from

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