WHAT IS THAT BEHAVIOR YOU THINK HAS OCCURED OR DEEM TO OCCUR?

WHAT IS YOUR REACTION? WHAT IS YOUR LEARNING OUTCOME? WHAT IS THAT BEHAVIOR YOU THINK HAS OCCURED OR DEEM TO OCCUR? WHAT IS THE RESULT OF THIS CASE IN YOUR CONTINUANCE OF BEHAVIOR?
“You were recently hired in a boundary-spanning role for the global unit of an educational and professional publishing company. The company is headquartered in New York (where you work) and has divisions in multiple countries. Each division is responsible for translating, manufacturing, marketing, and selling a set of books in its country. Your responsibilities include interfacing with managers in each of the divisions in your region (Central and South America), overseeing their budgeting and financial reporting to headquarters, and leading a virtual team consisting of the top managers in charge of each of the divisions in your region. The virtual team’s mission is to promote global learning, explore new potential opportunities and markets, and address ongoing problems. You communicate directly with division managers via telephone and email, as well as written reports, memos, and faxes. When virtual team meetings are convened, video-conferencing is often used.”“After your first few virtual team meetings, you noticed that the managers seemed to be reticent about speaking up. Interestingly enough, when each manager communicates with you individually, primarily in telephone conversations and e-mails, she or he tends to be forthcoming and frank, and you feel you have a good rapport with each of them. How-ever, getting the managers to communicate with one another as a virtual team has been a real challenge. At the last meeting you tried to prompt some of the managers to raise issues relevant to the agenda that you knew were on their minds from your individual conversations with them. Surprisingly, the managers skillfully avoided informing their teammates about the heart of the issues in question. You are confused and troubled. Although you feel your other responsibilities are going well, you know your virtual team is not operating like a team at all; and no matter what you try, discussions in virtual team meetings are forced and generally unproductive. What are you going to do to address this problem? ”
” A visit to the doctor may mean seeing someone else instead. An increasing number of practices are scrapping the traditional one-on-one doctor–patient relationship. Instead, patients are receiving care from a group of health professionals who divide up responsibilities that once would have largely been handled by the doctor in charge. While the supervising doctor still directly oversees patient care, other medical professionals—nurse practitioners, physician assistants and clinical pharmacists—are performing more functions. These include adjusting medication dosage, ensuring that patients receive tests and helping them to manage chronic diseases. “I can’t possibly do everything that needs to be done for our patients as a single human being,” says Kirsten Meisinger, supervising physician for a team of between 9 and 11 medical professionals at the Union Square Family Health Center in Somerville, Mass., one of 15 primary-care centers run by Harvard Medical School-affiliated Cambridge Health Alliance. For example, Dr. Meisinger says she may see a diabetic patient once every three months. But nurses on her team generally see the patient more frequently and for longer visits. And patients are likely to feel more comfortable telling a nurse than a doctor if, for instance, they haven’t been taking their medication, she says. The new approach, called team-based care, comes amid a shortage in many parts of the U.S. of primary-care physicians, a situation expected to worsen as the number of new patients obtaining insurance under the federal Affordable Care Act rises. Pervasive chronic diseases such as diabetes also are straining the health-care system. “In many primary-care practices today, physicians are doing a great deal of work that could be done by oth-ers on the team,” says Don Goldmann, chief medical officer of the Institute for Healthcare Improvement, in Cam-bridge, Mass., a nonprofit that works with medical practices to improve delivery of health care. Dr. Goldmann expects that within 10 years team-based care “will be the norm.” Team-based care is also becom-ing more common as large health-care providers increasingly purchase private physician practices and shift from traditional fee-for-service pay-ments to other models, such as those that provide fixed payments to care for patients over a set time”