The Carolina Clinic

Read the following paper and just answer the questions.
The Carolina Clinic is a non-profit, primary health clinic that serves approximately 6000 clients in a multi-county rural area.  The staff includes a full-time administrator, two family medicine physicians, two  full-time nurse practitioners, three  part-time nurse practitioners, two full-time medical office assistants, one part-time intake specialist, two full-time receptionists and two full-time staff performing medical coding/billing.  Mental health services, physical therapy and some complementary/ alternative therapies are provided by contract providers in the Clinic’s facility.  Lab services are available three days a week.  Carolina Clinic is a Medicare/Medicaid provider and accepts most insurance plans.  Patients are encouraged to pay co-pays, deductibles, and non-covered services with cash rather than with debit or credit cards as an attempt by clinic administration to keep operating costs as low as possible. 
April Harper is the clinic administrator, reporting to an independent community Board of Directors consisting of 12 area citizens and community leaders that includes the clinic Medical Director, Dr. Myra Hancock.  Ms. Harper was hired last year to help Carolina Clinic get out of past financial difficulties and she runs a very tight ship. She has been able to get the clinic back on stable financial footing through cost-cutting initiatives. The Board and Dr. Hancock often congratulate Ms. Harper on her ability to manage expenses, especially the extreme amounts of staff overtime that the prior clinic administrator allowed.   However, staff often feel they are forced to cram 10 hours of work into an 8-hour workday.  The pace feels hectic and rushed, and staff are often frustrated about the work environment and not having the supplies and resources they need to provide good patient care in the clinic. One of the issues faced by Carolina Clinic recently has been a large amount of turnover of the staff due to resignations.  Almost all the clinic positions have been vacant at some point in the past year.  Ms. Harper isn’t too concerned about the turnover since she views this as getting rid of the ‘deadwood’ and being able to hire the staff that she wants.  
Ms. Harper is proud of her accomplishments since being hired 1 year ago.  She feels the prior clinic administrator was lax and didn’t manage the employees closely enough.  She is at work every day by 7:30am to monitor that employees all arrive on time.  She has high expectations of employees, often calling them into her office to ‘discuss’ performance issues.  The employees perceive these meetings as being chewed out constantly for things that are out of their control, and Ms. Harper is never open to their suggestions for how to improve the efficiency and working conditions of the clinic.  Her routine response is that she has more experience than all of the employees and she knows the best way to run an efficient clinic.  Ms. Harper roams through the office observing the staff in their work, and is quick to interject feedback, which is usually abrasive and intimidating.  “Mary, you’ve left that phone call on hold for too long!”   “Who left the EKG machine in the hallway - you know where it is supposed to be stored!!!”  Small things upset her easily and she is constantly bellowing orders and criticisms to and about the clinic employees.  Most employees enjoy taking their lunch in the breakroom, when they have time to eat.  Ms. Harper never joins them -- she thinks it's inappropriate to socialize with the people she supervises.  She never has personal conversations with the staff, so she knows nothing about their families or personal interests.  Ms. Harper is all business, and her interactions with staff are always focused on either telling them how to do their job, or pointing out the mistakes they have made.  
The physicians and nurse practitioners of Carolina Clinic convinced Ms. Harper that the clinic desperately needs to change to a new electronic health record system.  The one installed 6 years ago has just not worked out well and is causing the staff to spend too much time entering patient information for a clinic that is as busy as Carolina Clinic.  “One more thing that the last administrator screwed up,” thought Ms. Harper.  But she reluctantly agreed that the system needed to be upgraded.  She agreed that she would talk to some vendors and prepare a summary of the pros/cons of various systems to discuss at the next staff meeting.  Dr. Aaron Jones and nurse practitioner Amanda Miller were especially excited by the prospect of a new system.  Both of them were heavily involved in choosing a new EHR system at the clinic where they previously worked, a clinic very similar to Carolina Clinic.  They organized and led the installation of that new EHR system very successfully. Dr. Hancock, the Medical Director took note of their expertise, which was one of the reasons she recommended they be hired 6 months ago. 
At the staff meeting scheduled to begin discussing initial information about various EHR systems, Ms. Harper reported that she was too busy to contact different companies about their systems.  “What’s the use anyway…. It’s obvious that we should go with Best Patient Record (BPR).  My good friend’s clinic uses BPR and it is very cost-effective.”  Dr. Jones was horrified…. “What do you mean? Maximum Health is a much-better system and I’ve also heard very good things about Docu-Master.  At my last clinic we installed Maximum Health and while it might be more expensive and a bit complicated to learn, it is a much better system and integrates better with the patient billing functions,” he said.  “That is why we really needed your preliminary collection of information today so we can begin evaluating how the advantages and disadvantages of the different systems would impact us.”
Ms. Harper was getting red in the face.  “Well I don’t have the luxury to waste my valuable time on something that is as clear-cut as going with BPR.  I’ve already made the decision that it suits our needs and it will be the lowest cost option.  You must have forgotten that we are a non-profit -- we can’t waste money we don’t have on an overpriced EHR system.  You should tend to your job which is seeing patients and let me do my job, which is making all the hard decisions around here!” she stated to Dr. Jones.  “Oh, and by the way, I will be overseeing the installation….. I don’t need you doctors and nurses fouling up a good system, which is why we are having to replace our current system.”  After that, she stormed out of the room.    
The doctors and nurse practitioners left the meeting upset and angry… a few of the office staff were in tears.  They were so afraid of what was ahead, with Ms. Harper leading the installation of the EHR system that she didn’t work with and didn’t understand very well.  Dr. Hancock, the Medical Director called the Chairman of the Board of Directors and asked for a meeting.  Unbeknownst to Ms. Harper, the Board held a private meeting two days later.  The following morning after the Board meeting, Ms. April Harper was terminated from the Carolina Clinic.
Based on what you know about desired leadership traits and behaviors, does Ms. Harper’s leadership style seem appropriate for the organizational setting? Explain whether or not she demonstrates the new paradigm of leadership described in Chapter 1.  Briefly explain where you would place her behaviors on The Leadership Grid (Chapter 2).
Using a contingency perspective of leadership, does Ms. Harper’s approach fit the situation? Use one of the contingency principles in Chapter 3 (for example, Situational Theory, Path-Goal Theory or the Vroom-Jago decision model) to briefly analyze Ms. Harper’s approach to the EHR replacement and whether another approach would be better in this situation.
Using the Big 5 personality domains from Chapter 4, identify any issues or problems in her leadership approach (define the Big 5 domains and give examples to support your analysis). Does the case reveal any other aspects of Ms. Harper’s personality that might impact her leadership style?
What conclusions can you draw from this case about leading with fear versus leading with love (Chapter 5)?
The Leadership Experience, 7th Edition by Richard L. Daft