Running head: APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 1

An Appreciative Inquiry of Friendly Faces Senior Care

Friendly Faces Senior Care

Kristina Alexander, Heather Cantu, Whitney Green, and Jonathan James

Course EHRD 625

Dr. Latoya Morris

Texas A&M University

December 1, 2019
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Executive Summary

Small businesses and organizations typically do not lend resources nor consideration to

organizational development (OD) practices or interventions that could support their objectives.

Such organizations are often so immersed in the day-to-day responsibilities or operational tasks

that detailed strategic evaluation, data analysis, and recommended courses of action from outside

agencies are not frequently executed. However, objective students of organizational development

could serve as cost-effective resources for small organizations to determine strategic

organizational interventions.

This report was developed as part of a graduate-level course in organizational

development and documents the efforts of ‘Team Aggies’ to provide supporting consulting

services to a small senior care agency known as Friendly Faces Senior Care, also referred to as

Friendly Faces. Team Aggies utilized Appreciative Inquiry (AI) as a model for engaging

Friendly Faces, and initiated employee interviews and surveys for data collection efforts. Data

collection and analysis revealed employee perceptions concerning the organization, in areas such

as engagement, training, development, and opportunities for innovation among others. Using this

data in conjunction with gathered knowledge on the characteristics and current state of the senior

care industry, Team Aggies was able to recommended interventions for Friendly Faces, as well

as describe their support for prioritization of pending organizational initiatives.

This report could potentially be of value to those interested in the execution of

Appreciative Inquiry based research in small organizations or to those interested in considering

strategic organizational development initiatives for home care companies in the senior care

industry.
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Organizational Context

Friendly Faces Senior Care is an in-home senior care agency that provides professional

caregiving services to elderly and incapacitated individuals (Friendly Faces, 2019). The

organization was established in 2010 in Houston, Texas, and serves the city of Houston and

surrounding towns and counties. Various common misconceptions exist concerning in-home

senior care. For example, upon hearing of similar agencies and services, many think of home

health or nursing facility extensions. However, the services offered by Friendly Faces and other

agencies involve non-medical care such as assistance with bathing and grooming, meal

preparation, light housekeeping, transportation, fall prevention, laundry service, engagement for

Alzheimer and dementia patients, and a host of other support-related services (Friendly Faces,

2019). Caregivers may provide reminders for clients to take prescribed medication, however they

do not administer medication nor do they function as registered nurses or licensed vocational

nurses. Although some clients reside in assisted-living facilities or in skilled-nursing facilities,

the majority of clients reside in their own home due to their preference, or that of their immediate

family.

The organization was founded by Qiana Joi James, a native Houstonian, who saw the

opportunity to address specific client needs within the home care industry (Friendly Faces,

2019). James sought to establish an agency independent of franchise requirements or restrictions,

so that she could specifically ensure a high quality of care was provided for clients of Friendly

Faces. On a personal level, she was especially empathetic and attentive to the needs of the

elderly because of her personal experiences with her late grandmother and surviving step-father,

who both experienced the debilitating effects and declining health that comes from Alzheimer’s

and dementia. This personal experience with her family members instilled in her a belief that
APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 4

seniors should be able to experience high-quality care in the comfort and familiar surroundings

of their own home, to the extent that their individual and health circumstances will allow

(Friendly Faces, 2019).

The combination of quality caregiving and supportive staff with James’ personal and

professional experience has allowed Friendly Faces to grow to include approximately 150

employees including both caregiving and administrative staff, with an annual revenue of

approximately $1.2 million. The organization has received recognition in the industry for the

quality of its service, and in 2019, the Greater Houston Black Chamber awarded Friendly Faces

with the Pinnacle Award, which recognizes organizations for business achievement and for

having a positive impact in the industries and communities in which they operate.

It is important to note in the context of the organization that Friendly Faces is a small

business that operates in a specific subset of the senior care industry. Clients pay for services

either privately or through the utilization of long-term care insurance – Medicare or Medicaid

cannot be applied towards services form the organization. The organization regularly has to refer

potential clients to other companies that offer services outside of the scope of Friendly Faces,

including hospice, home health, or skilled nursing facilities. The senior care industry as a whole

has exploded due to an aging populace, which has caused some concerns about the ability for the

needs of the population to be met (Anikeeff, 1999). The lack of professionally-qualified

caregivers presents continued challenges related to talent acquisition and client satisfaction. A

benchmarking study of the industry conducted by Home Care Pulse revealed that amongst

agencies caregiver shortage is considered the top threat facing their industry (Home Care Pulse,

2016). Friendly Faces has confirmed the challenges experienced by the industry, by relating that
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out of approximately ten candidates for caregiving positions, only one is considered qualified to

take on the role of a caregiver and receive client assignments.

The strategic actions of Friendly Faces in recent years have been focused on the

marketing aspect of the organization to allow brand recognition and sales to support further

growth. However, since talent acquisition and retention are such critical components of operation

for Friendly Faces, the organization believes it would be in its best interest to examine its

practices regarding the engagement of its employees as well as the perspectives and experiences

of those employees while working for the company. This provides an excellent opportunity for

organizational development analysis and initiatives that could provide a positive impact in

support of the further growth of the organization.

Team Aggies’ Approach

After receiving instructor approval for this project, Team Aggies followed a detailed

study plan while working with Friendly Faces. This section of the report provides an explanation

of the project design process and communication-style with the target organization and shares

our values and assumptions about Friendly Faces Senior Care and its employees. It is important

to note that Team Aggies based the foundation of this project upon the 5D Model of AI. We

believe that focusing on the positive aspects Friendly Faces Senior Care and building upon that

base is a refreshing way to provoke ideas for improvement in processes and procedures within

the organization (Rothwell, 2015).

As mentioned above, the initial task for the project was to set communication

expectations with Friendly Faces Senior Care. Qiana James served as Team Aggies’ main point

of contact throughout the project. Team Aggies selected a group spokesperson to be our main

point of contact throughout the project, as well. After making initial contact with the target
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organization and receiving their approval to move forward with the consultation project, Team

Aggies began the design process.

The assessment of the organization takes place in two phases. In Phase 1, four employees

of Friendly Faces Senior Care were selected to be interviewed by Team Aggies based on their

length of tenure and positioning within the organization by the spokesperson and the business-

owner. Unfortunately, as will be explained in a later section of this report, only three interviews

were able to be completed. In Phase 2, 158 surveys were sent out via Google Forms to all ‘front-

line’ employees of Friendly Faces to gain insight into their perspectives when compared to those

of the interviewees. The two groups hold different responsibility-levels within Friendly Faces

Senior Care. Prior to conducting interviews and distributing surveys, Team Aggies received

approval on both sets of questions from the course instructor.

Since Team Aggies used the 5D Model of AI as the foundation for this project, there are

five phases of inquiry involved as described below:

1. Phase 1 - Define: Using information from the course and from the business owner, Team

Aggies identified potential areas of difficulty in terms of business operation for the target

organization.

2. Phase 2 - Discover: Team Aggies developed interview and survey questions keeping

these areas in mind. Due to the fact that we are conducting an AI, it was important to

keep the focus on the positives of the organization when developing said questions.

3. Phase 3 - Dream: Team Aggies identified innovative solutions shared in the interviews

combined with information inferred from the survey responses to apply to areas of

struggle for Friendly Faces Senior Care.

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4. Phase 4 - Design: These suggestions were compiled and a list of resources were provided

to the target organization for items from the Dream Phase to be realized at a macro-level.

5. Phase 5 - Deliver: The findings were reported back to the business-owner. We believe

that with a list of suggestions, Friendly Faces Senior Care senior management team can

select innovative solutions that work best for their team/organization.

Next, there were several assumptions made about the target organization going into this

project based on communication between the business-owner and Team Aggies’ spokesperson.

These assumptions influenced the direction of this project to a certain degree. As previously

mentioned, employee turnover and retention are constant areas of struggle in the senior care

industry. Team Aggies put a heavy emphasis on these items in the survey questions due to the

fact that it was directed at front-line employees.

Finally, our main set of values in this project surrounded the philosophy of the 5D Model

of AI. More often than not, employee engagement surveys and their counterparts focus on what

is ‘wrong’ with an organization. Since we were using AI as our foundation for this project, we

chose to focus on the positive aspects of the organization when constructing our questions and

when communicating with employees and leadership. In other words, Team Aggies wanted to

focus on what was going well within the organization and how to use those areas as fuel to

inspire innovative solutions in challenging areas of business operations.

Theoretical Framework and Assumptions

This section of the paper explores the chosen AI model in more depth and provides the

rationale for choosing such an approach. One item that needs to be made clear to Friendly Faces

Senior Care is that after an AI initiative takes place, “... the process creates awareness for the

power of positivity within the organization’s system. When sustained over time, these effects can
APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 8

have substantial impact on the organizational system” (Wiley, 2013, p. 146). In other words, the

AI line of thinking can be a catalyst for a culture-shift within an organization, but only if the

positive outlook is maintained by management. To begin this section, we will summarize the AI

theoretical framework as a whole with Boyd and Bright’s (2007) definition:

“Appreciative inquiry eschews a problem-focused reactionary methodology, and instead

attempts to build upon current system strengths that lead the system to a greater potential.

It seeks to prevent the system from incurring future problems by envisioning and

implementing changes at the present time that would ward off or prevent future negative

states from occurring to the organization or social system. In relation to the reflective

process, AI helps prevent excessive negative thought patterns and energy that could

thwart the group’s ability to reach desired outcomes and social changes” (p. 1033).

Unlike many organizational development (OD) frameworks, “AI seeks to leverage what

is working well and further develop the positive aspects of the organization and its people”

(Rothwell, 2015, p. 27).

As previously mentioned, a large part of the AI framework is the way questions are asked

and the way that communication takes place. As an example, when an organization is

approached with a list of what it is doing incorrectly, the natural response is to become defensive

(Rothwell, 2015). This defensiveness can cause organization leaders to shut down and not be

receptive to advice from organizational development professionals. In this project, Team Aggies

wanted to avoid this type of interaction with the target organization.

While working with Friendly Faces Senior Care, Team Aggies saw its fair-share of

positive organizational attributes. The organization possessed several of the qualities outlined in

Jennings (2012), which is no small feat. Leadership was transparent with our team throughout
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the process and remained open to the evaluation. The company also possesses a strong work

ethic from top to bottom. The caregiving industry is not for the faint of heart, and Friendly Faces

Senior Care goes above and beyond the call of duty for their clients. They believe that everyone

deserves excellent care regardless of their abilities and does their best to meet these goals.

While referencing the caregiving field, Gain’s (2019) article explored AI being used in

palliative care. While it is not exactly the same, parallels can be drawn between the two client

populations. Gain found that their participants were eager to focus on the positives in their

environments. Gain stated that they typically find that these groups of people, “... rarely dwell on

the things that are missing, but totally focus on the good points and the things that they want to

see more of in their community” (Gain, 2019, p. 76). We inferred that this may have to do with

the attitude one has to have when working in such a stressful, highly-emotional environment.

Due to this, we resolved that the AI framework would be an excellent match for our target

organization, given their field of expertise.

Assuming that AI uses a form of problem-solving that is atypical to most people

(focusing on the positive, focusing on what is already going well within an organization, etc.),

after taking part in an AI inquiry, an employee’s identity within an organization may realign

(Priest, Kaufman, Brunton, & Seibel, 2013). Many of our interview and survey questions focus

on how employees fit within Friendly Faces Senior Care at a macro-level. This sort of focus can

help ignite employees’ sense of belonging within the organization and reaffirm their commitment

to the organization’s vision and mission as a whole. Under this assumption, Team Aggies

recommends that Friendly Faces Senior Care to have either a follow-up meeting regarding the

results of this project’s analysis, or at least distribute information to employees surrounding this

study and topic.

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Additionally, a big part of our design philosophy operated under the assumption of

inclusion. Friendly Faces Senior Care leadership wanted all levels of employees to be involved

in the evaluation process. This is part of the reason that Team Aggies selected AI as our

theoretical framework. AI is seen as a “...a collaborative and participative process; generates

inclusion and enhances the energy levels of an organization. Appreciative Inquiry approaches

change as a continuous journey, rather than a one-time event” (Sharma, 2008, p. 27). By

including both entry-level and managerial-level employees, we hope that the target organization

gets a full picture of the organization in this report. Team Aggies entered into this study with the

understanding that Friendly Faces Senior Care has committed itself to continuous improvement

ideals and uses the innovative ideas from their employees to gain momentum in their field.

Interestingly, Johnson and Leavitt (2001) found that the participants that took part in AI

research had an overwhelmingly positive experience and linked similar studies to their analysis.

Through our literature review as discussed above, Team Aggies found that this type of

experience is typical of AI because of the positive attitude focus that takes place during all

communication. Other organizational development practices have management team members

focus on the negatives of their organization, which can potentially be disheartening. Team

Aggies believes that the innovative suggestions we received from the target organization’s

employees were a direct result of focusing on what the organization was already doing well in

terms of business operations.

Diagnostic Methods

In this section of the report, the methods and processes related to data collection are

explored in more detail. Our interviews consisted of three participants of the office staff that

have been with the company for several years. Our rationale for choosing this type of participant
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was due to the fact that they have seen how the business has evolved over time, they are familiar

with the inner-workings of the business, and their agendas allowed for the most flexibility for

interview-scheduling. Organizational leadership helped us gain approval from the individuals to

conduct the interviews and to schedule time with them. While initially we were given approval to

interview four employees, due to circumstances discussed in a later section of this report, we

were only able to secure three interviews. The surveys, however, were more easily accessible

and thus were disseminated to 158 caregiver employees (or ‘front-line’ staff) via an email with a

Google Forms link. This method was chosen as most people are familiar with and trust Google.

We hypothesized that they may be less likely to dismiss such an email as spam if it came through

a reputable brand. We also requested that these staff members be given advance notice of the

incoming surveys from Friendly Faces leadership, which was done via email prior to the survey

link being sent out.

As mentioned before, after communicating with Friendly Faces Senior Care initially, we

operated under the assumption that they wanted to include the opinions of all levels of staff in

this final report. Since we were already using AI as a theoretical framework, this philosophy

aligned nicely with our project design. The interview and survey questions were constructed both

while keeping the AI theoretical framework in mind and our research question in mind: ‘how can

Friendly Faces Senior Care develop and implement innovative solutions that captivate employee

engagement while increasing sales and market share?’ The survey was created using a Five-Point

Likert Scale that ranged from 1-strongly disagree to 5-strongly agree. Our goal in focusing on

this research question in particular was to inspire innovation from employees, which could then

be translated into actionable items for the business-owner and other leadership to implement

within the organization.

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Team Aggies then analyzed the survey responses via spreadsheet using a color-coding

system. By doing this, we avoided as much negative commentary as possible in our analyses.

Team Aggies also carefully redirected conversations away from negative commentary during the

interview process by refocusing on the questions at-hand. Answers in the interviews were then

compared to identify top themes and commonalities among the responses. The interview

response themes were then compared to the coinciding survey question responses. For our

purposes, the mean response was used for analysis and comparison.

Findings

After reviewing interview responses and survey responses, the following four thematic

areas were identified as being of interest: organizational culture, employee engagement

(specifically of new employees), innovation in the workplace, and suggestions for improvement.

In this section, general qualitative themes will be discussed. More quantitative results are

identified and discussed later in this report. For reference throughout both proceeding sections,

13 complete survey responses and 3 interview responses were collected.

The first thematic element discovered was in regard to the organizational culture of

Friendly Faces. Two of three interviewees noted the friendliness of the organization as a whole

as well as individual employees. Two of three interviewees (not the previous pairing) discussed

feeling appreciated, valued, and like they were making a difference through their work. One

interviewee stated that leadership at Friendly Faces, “makes [employees] feel good about what

they’re doing”. Three survey questions were aligned with this theme, and each question had a

positive response. These survey items were: I believe that Friendly Faces values me and my

contribution to the organization; I believe Friendly Faces truly cares about their customers and

caregivers; and In my opinion, Friendly Faces communicates effectively.

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The second theme that Team Aggies focused on was employee engagement specific to

new employees. The general consensus among the interviewees was that new employees are

typically well-engaged through extensive group training in the first few weeks of employment.

There are also plans in place to introduce a mentorship program for new employees beginning in

2020. This program is intended to help with employee engagement, retention, and to build a

better connection with new employees. Retention of employees was mentioned by multiple

interviewees at various intervals during interviews. The survey item identified along with this

theme yielded positive survey responses as well: I believe that Friendly Faces encourages

employees to remain engaged in their work as both as new employees and in the long term.

Team Aggies also found a theme centered on innovation in the workplace. While each of

the three interviewees had different answers due to their various job positions, they all responded

positively that they were able to use innovation in their jobs in some way. One respondent stated

that they were able to be innovative by “using [their] creativity”. Another said, “I’ll have

conversations with others to work out new processes”. The final interviewee said that Friendly

Faces leadership “thanks the employee for their feedback” and that the organization management

is working to establish a more official means of capturing positive innovation suggestions. The

survey item on innovation brought about another positive result: I believe that Friendly Faces

encourages employees to be innovative and solve problems in their work.

The innovation theme also lends itself to the final theme to be discussed here: suggestions

for improvement. When asked how suggestions would be made, all three interviewees said that

the process is just to pick up the phone and call leadership to have a conversation, whether the

suggestion is from an employee or a client. “The process now is informal and retroactive”,

according to one respondent. However, they also stated that plans are in the works to formalize
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the process and to communicate the changes to employees. The following two survey items

specifically addressed this theme with neutral to positive results: On the scale below, how likely

are you to make a suggestion to management about an improvement in the processes or

procedures at Friendly Faces?; and On the scale below, how likely is it that your suggestion for

improvement in the processes or procedures at Friendly Faces would be implemented?

Analysis of Findings

Throughout this study, Team Aggies has focused on Appreciative Inquiry. Our survey

and interview design reflected this. We received 13 complete survey responses along with 3

complete interview responses. Our questions were worded carefully to encourage positive and

appreciative answers. Our assessment used a Five-Point Likert Scale labeled at the following

intervals: 1-strongly disagree, 2-disagree, 3-neutral (neither agree nor disagree), 4-agree, 5-

strongly agree. In alignment with our design, all of our survey questions had a Mean Score of at

least 3-neither agree nor disagree. In fact, the four lowest scores were still over the halfway mark

between 3-neither agree nor disagree and 4-agree. The majority of survey questions were higher

scoring being at 4-agree or between 4-agree and 5-strongly agree. This in itself was encouraging

for our team when reviewing our survey results (Table 1).

Table 1. Mean, Median, and Mode of Survey Responses (on a Five-Point Likert Scale)

Question Mean Median Mode

On the scale below, how likely are you to make a 3.77 4 4&5
suggestion to management about an improvement in the
processes or procedures at Friendly Faces?

On the scale below, how likely is it that your suggestion for 3.54 4 4
improvement in the processes or procedures at Friendly
Faces would be implemented?
APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 15

I am aware of the mission or core values of Friendly Faces. 4.69 5 5

In my opinion, Friendly Faces communicates effectively. 4.56 5 5

I feel I have career growth opportunities at Friendly Faces. 3.85 5 5

I would recommend Friendly Faces as a great place to 4.46 5 5

work.

I understand how my role contributes to the overall success 4.62 5 5

of the organization.

I believe that Friendly Faces values me and my 3.85 4 4

contribution to the organization.

Working for Friendly Faces is a better experience than 4.46 5 5

working for other agencies in the industry.

I believe Friendly Faces truly cares about their customers 4.38 5 5

and caregivers.

I have been provided with the tools and training necessary 3.69 4 4&5
to successfully complete my caregiving responsibilities for
clients of Friendly Faces.

I believe that Friendly Faces encourages employees to be 4.08 4 5

innovative and solve problems in their work.

I believe that Friendly Faces encourages employees to 4 4 5

remain engaged in their work as both as new employees
and in the long term.

The following items mean response scores were found to range from 3-neither agree nor

disagree to 4-agree:

● On the scale below, how likely is it that your suggestion for improvement in the

processes or procedures at Friendly Faces would be implemented?

● I feel I have career growth opportunities at Friendly Faces.

● I believe that Friendly Faces values me and my contribution to the organization.

● I have been provided with the tools and training necessary to successfully

complete my caregiving responsibilities for clients of Friendly Faces.

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The remainder of survey items had means ranging from 4-agree to 5-strongly agree.

When considered with the team’s Appreciative Inquiry approach, these results were

encouraging denoting that in the view of the employees, Friendly Faces is doing well in the

identified areas. This also aligned with the positive thematic elements of our results. It should be

noted, however, that among the completed survey answers, there was one outlier that responded

at times drastically differently than the rest of the sample. However, due to the extremely small

sample size, we elected to leave the outlier in the data analysis. We did not feel comfortable

removing it when we work working with such a small response rate.

Team Aggies was, however, concerned regarding the low response rate on both our

interviews and the survey. While internal surveys typically receive between 30 and 40 percent in

response rate, our survey only received full responses from 13 individuals while the survey was

sent to 158 employees. This resulted in a response rate of 8.23 percent—lower than the average

10 to 15 percent response rate of external surveys (Survey Gizmo, 2019).

Team Aggies included strategies in our survey which are typically inviting for potential

respondents. Our team strictly followed survey conditions as described in Bosnjak and Tuten

(2001) including a free-flow design to lead respondents from question to question. Questions

were also each listed in their own section (Bosnjak & Tuten, 2001). However, even when all

recommended steps are taken to build a positive and useful survey, external threats may decrease

its impact in a study including the possibility of a survey sent via email, as was the case, being

filtered to a junk or spam folder in a user’s email mailbox (Bosnjak & Tuten, 2001) (Dillman,

1991).

While we had 13 completed responses, Team Aggies also received one incomplete

survey response. According to Bosnjak and Tuten (2001), there are three types of survey
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respondents. Team Aggies can definitively say that we encountered two of the three. The most

desired response type is a complete response, of which we received the previously stated 13.

This category of responder answers every item within the survey. There are two types of non-

responders discussed in the article. The first is unit non-response. These respondents open the

survey before deciding not to complete any of the items provided. While some survey formats

can track these types of responders, unfortunately the platform used in the study did not make

this possible. However, the next responder category is item non-response. Team Aggies’

Response #14 fit this characterization, answering only 1 of the 13 survey items. Item non-

response is the act of leaving one or more items unanswered yet submitting the survey anyway

(Bosnjak & Tuten, 2001).

While surveys sent via email are often successful, our low response rate of 8.23 percent

made data analysis difficult (Sproull, 1986). The most that we can do is to provide the themes we

observed when comparing the survey responses with the three interviews we were able to

complete. Aside from the themes presented in this report, Team Aggies also sought to determine

possible explanations for the lack of response to the surveys, as well as interviews. In accordance

with the low response rate, Team Aggies initially had four individuals from Friendly Faces agree

to take part in an interview. However, only three individuals were interviewed. One intended

interviewee declined multiple attempts to be reached to conduct the interview despite agreeing

ahead of time.

Identification of Organizational Issues

Team Aggies conducted a SWOT analysis in order to review the organization. The

strengths of Friendly Faces included a friendly, warm and caring culture. This organization

strives to provide schedule flexibility and higher pay in order to address the previously
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mentioned industry challenges of caregiver shortage and high employee turnover. Friendly Faces

currently has a competitive advantage paying on average $1 to $2 more per hour compared to

similar agencies.

Weaknesses included lack of owner capacity to focus on the strategy and growth of the

company. The owner self-identified the current focus areas are processes, procedures and

organizational leadership. Friendly Faces plans to hire an Executive Director in 2020 to handle

the day to day operations. This individual has been identified and comes from a competitor with

experience in other business lines. This will allow the owner to focus on the strategic directions

of the organization, as well as focus on hiring and training caregivers. The additional emphasis

placed on interviewing, hiring and training dedicated caregivers is critical to the client

experience. Currently, the organization has experienced one out of ten interviews meeting the

expected level of talent for the position. In relation to improving processes and procedures, an

EOS (Entrepreneurial Operating System) tool will be introduced in 2020. The EOS provides a

holistic organizational review of six key components including vision, data, process, traction,

issues and people (Worldwide, n.d.)

Opportunities identified for the organization include proactive client training,

implementing a formal suggestion process and mentorship program. The organization plans to

increase initial client training on utilizing the family portal online, as well as schedule regular

touchpoints to stay engaged and connected. In relation to a suggestion process, the owner

currently fosters an open communication policy welcoming caregiver suggestions. Additionally,

as we will further discuss in the following sections, a mentorship program is planned to roll-out

in 2020 to address this opportunity.

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Threats for the organization are related to the highly stressful, emotional and turbulent

industry. As previously mentioned, the industry is characterized by a highly competitive

landscape, varying levels of caregiver talent, high-turnover and low retention rates. Focus on

these areas is critical to the sustainability and growth of the organization.

Assessment of the Organization’s Organizational Development Practices

When considering the organizational development practices of Friendly Faces and

measuring those practices against the data received in our collection efforts, we find that there

are some areas in which the organization is effective and others in which there is an opportunity

for improvement. There are also notable barriers that the organization has to overcome when

addressing organizational development needs. Challenges exist at both the individual and

organizational level, which provide opportunities for the organization to strategically address its

organizational development strategy as it seeks to continue its growth.

Individual level interventions will allow Friendly Faces to further develop the skills and

capability of its existing employees, which can in turn maximize the performance of the agency

(Rothwell, 2015). In fairness to the agency, it has already implemented some individual level

interventions to develop the skills and capabilities of its employees. One example is the training

provided to caregivers upon hiring with the agency. Caregivers are enrolled in a series of

educational certificate courses produced by the Institute for Professional Care Education

(IPCed). These courses cover a variety of care topics including dementia, diabetes, multiple

sclerosis, post hospital, end of life, home health aide, general caregiving, and others. Such

certification courses provide a foundation of knowledge and capability for all caregivers when

providing services to clients of Friendly Faces, and in many cases, increases their professional

caregiving skills. This is important because caregivers hired into the organization come with
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varying levels and depth of experience, and it is important to establish a baseline of capability

amongst the frontline personnel.

A second example of training as an individual level intervention is the Hurricane

Marketing training that was mentioned during the interview process. This marketing training

focuses on developing the sales and marketing skills of employees specifically for the home care

industry, so that stronger connections can be developed with referral sources, which will in turn

result in more referrals and clients for the agency. Employees who have experienced this training

have credited it with enhancing their skills and contributing to the growth of the organization.

However, there also exist opportunities for the organization to be more effective through

individual interventions. One of the interviews also revealed a desire to receive further training

so that they could answer detailed questions from potential or existing clients concerning

caregiving standards and practices. Although the interviewee in question frequently takes

incoming phone calls, their role is one of primarily an administrative nature, so they did not

regularly deal with the operational or frontline details that would provide them with the insight to

answer such questions. In their view, being empowered to address such situations would allow

the clients to receive an answer more efficiently, instead of having to wait on the business-owner

or another staff member to follow up with the client. Further training or cross training employees

would address this area.

Another opportunity for an individual intervention that was noted by James as planned

for 2020, is the establishment of the previously mentioned mentorship program. James feels that

such a program will establish stronger connections with new employees, and lead to more

retention. This perception is actually supported by organizational development principles, in that

mentoring has been characterized as establishing an ongoing relationship, as well as connecting

APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 21

with individual growth and learning (Rothwell, 2015). Since the shortage of qualified caregivers

previously mentioned impacts Friendly Faces just like every other agency in the industry, a

mentorship program can assist the agency in addressing this barrier and provide an experience

for its employees that is not offered by its competitors.

In regards to organizational level interventions, our assessment of Friendly Faces once

again reveals areas in which the agency is making an effort to engage in some productive

organizational development initiatives, and others in which the agency could potentially address.

For example, the agency already engages in forms of survey guided development that is solicited

from caregivers as well as clients. Such an intervention is a common method of collecting data

and using it to establish an action plan to address areas that the survey reveals need attention

(Rothwell, 2015). As James expressed in her interview, she values the feedback of employees

and wants to capture any innovative or new suggestions they may have.

The agency will also engage in restructuring processes or workflows as necessary, to

accommodate the growth and changes that it has experienced. One interviewee noted that

although the adjustment of processes used to take place via an individual direct conversation

with James, because of the involvement of more staff, there has to be thorough communication

with others to ensure consistency and continuity of business processes. It is recommended that

the organization is vigilant in documenting all business processes and procedures, as well as

adjustments (Rothwell, 2015).

Another organizational development intervention we previously mentioned that Friendly

Faces has on the horizon is an organizational redesign of sorts. This is the hiring of an Executive

Director in 2020. This new hire will focus on addressing operational and business processes gaps

within the organization, as well as implement the previously mentioned mentorship program and
APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 22

a caregiver recognition program. The responsibilities of this new role will free James up so that

she can focus more on the growth of the larger footprint of the organization, and less on day-to-

day issues that may arise.

However, it is worth noting that the agency does not possess an individual Human

Resources (HR) department. Most of the HR responsibilities or tasks are done in conjunction

with other roles, and primarily consist of talent acquisition or terminations. This is an emphasis

on Human Resource Management (HRM) activities, instead of Human Resource Development

(HRD) activities. Although initiatives previously mentioned could be managed by a training, OD

or HRD group, as of now they are executed by whatever resource is available. While such a

characteristic may be common amongst small businesses such as Friendly Faces, the lack of an

HR or OD practitioner could impact the quality of implementation of organizational

interventions, and present further challenges to the OD efforts of the agency.

Overall, our assessment of Friendly Faces organizational development practices yielded a

positive reaction. As mentioned, there were areas of progress as well as areas of opportunity.

However, when we consider the challenges facing the organization such as talent shortages and

limited resource availability, for a small business the organizational does make a concerted effort

to engage in productive organizational development practices.

Recommended Interventions

Team Aggies collected data through surveys and interviews to diagnose organizational

issues and recommend appropriate interventions for Friendly Faces. Our intervention strategy is

composed of three parts that are supported by the data and literature review. This section of the

report explores these three organizational development intervention strategies in detail,

highlighting both positive and negative consequences of their implementation. We will also note
APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 23

recommendations that Friendly Faces is already considering implementing that from our

perspective should be prioritized.

We recommend that Friendly Faces Senior Care follow the strategy of thinking big and

acting small, as referenced in Jennings (2012). This section will borrow from “The Quad”

analysis on the subject (Jennings, 2012, p. 209). Upon completing this analysis as outlined in the

book, we discovered that Friendly Faces is evaluated as having six out of ten categories in “The

Quad” of thinking big and acting small (Jennings, 2012, p. 209). This was determined by

reviewing interview and survey data, as well as our conversations with leadership. This means

there is room for improvement in this area. To intervene on this topic, we recommend that

Friendly Faces:

● “Keep their hands dirty” by increasing communication across different departments. This

could also include cross-training team members to be better allies to their colleagues that

work in different areas (Jennings, 2012, p. 215). This intervention strategy is selected due

to feedback regarding how the involvement of more staff has reduced communication

efficiency within the organization.

● “Have everyone think like their owner” in that there is a clear cultural model in place that

employees can reflect in their day-to-day interactions with each other and with clients

(Jennings, 2012, p. 217). We selected this strategy due to feedback from survey data

indicating that ‘front-line’ staff do not clearly see themselves as highly-valued as they

need to.

● “Build communities” by ensuring there are performance targets in place that employees

can both see concretely and believe in (Jennings, 2012, p. 220). These targets can be

communicated via onboarding and increase cultural buy-in from ‘front-line’ staff. This
APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 24

cultural inclusion can encourage employees to truly feel like they are making a difference

and thus increase morale/retention. This strategy was selected due to similar reasons as

the aforementioned strategy.

As with any intervention strategy though, there are possible negative implications to

changing the business strategy in these ways. First, inter-departmental role confusion might be a

side effect of cross-training. In other words, team members at Friendly Faces might be confused

by their individual duties and communication responsibilities if strong job descriptions are not in

place prior to cross-training. Work might be completed multiple times or inefficiently if Friendly

Faces does not stay ahead of this curve. Prior to cross-training, we recommend outlining exactly

which employees will be responsible for each task should someone be absent from work,

unreachable, etc.

Next, thinking like the owner in terms of cultural assimilation can be a positive, but there

needs to be a strong cultural image in place prior to implementing this. If there is any confusion

within leadership regarding which direction the company is heading or in their values, this

confusion will trickle down the ranks. This can impact client treatment and communication

across departments. We recommend that Friendly Faces establish a highly-visual set of values

and expectations regarding interactions prior to taking this path.

Finally, the goals that Friendly Faces sets for its employees to make them feel

established, increase morale and participation, as well as encourage growth should be realistic

and attainable. The goals should be concrete and specific to the employees’ individual roles.

Should Friendly Faces set unattainable goals or unclear goals, this could potentially plummet

employee morale.
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That being said, there were some interventions that we would nominate as

recommendations, however Friendly Faces is already giving consideration to them. In our view,

these actions should be noted as significant priorities in 2020. For example, first we considered

recommending that a formal process be implemented for caregivers to provide suggestions on

processes, procedures, and overall client care. This would include conducting research on the

best formal implementation tool or tools. We arrived at the consideration of this intervention

based on the survey results below, which show the three survey items with the lowest mean. We

recommend that these be addressed.

● How likely is it that your suggestion for improvement in the processes or procedures at

Friendly Faces would be implemented? 3.54 Mean

● I have been provided with the tools and training necessary to successfully complete my

caregiving responsibilities for clients of Friendly Faces. 3.69 Mean

● On the scale below, how likely are you to make a suggestion to management about an

improvement in the processes or procedures at Friendly Faces? 3.77 Mean

The goal of such an intervention would be for caregivers to be given and trained with

excellent tools and process training while still having a voice, increasing efficiency, providing an

outstanding customer experience, and feeling valued in the process. According to our

recommended path, caregivers would be trained on the formal process and feedback would be

provided on suggestions and implementation. This aligns with plans that Friendly Faces has

already developed, and they have begun considering websites and other potential tools to address

this area.

Another intervention that the organization was already considering is designing and

delivering a comprehensive training onboarding program. This would involve new caregivers
APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 26

hired within the last year to receive a survey to assess the areas of training strengths and

improvement areas. A training checklist and formal onboarding program would be developed to

ensure consistency across caregivers and provide a thorough understanding of Friendly Faces

tools, processes, and procedures. Success checkpoints should this recommendation be taken,

would be designed at 30-, 60-, and 90-day increments to ensure knowledge comprehension and

progression.

Our consideration for this recommendation was based on interviews conducted with key

personnel who provided additional organizational insight. The data was varied and revealed the

need for focus on processes and procedures, as well as an emphasis on caregiver hiring and

training. Friendly Faces revealed to us that in addition to the formal suggestion process, an

Entrepreneurial Operating System (EOS) tool is being considered for implementation to further

assess the organization operations, processes, and procedures to provide further interventions.

From our perspective, these initiatives already under consideration should be implemented

effectively and in conjunction with the other recommendations described above concerning the

practice of concepts related to thinking big and acting small, as discussed by Jennings (2012).

Proposed Evaluation Plan

The recommended evaluation plan for the training onboarding program is based on

Kirkpatrick’s Four Levels of Evaluation. All four steps encompassing reaction, learning,

behavior, and results are recommended to be assessed at predetermined intervals (Rothwell,

2015, p. 60).

For the formal suggestion box, a quarterly review of the selected tool and engagement

level of employees will be assessed. The focus of the review will be to evaluate the
APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 27

recommendations and improvements made in processes, procedures, and overall client care.

Further interventions may be needed to increase participation and effectiveness.

The EOS tool is recommended to be implemented in 2020. The evaluation plan will

consist of an initial thorough review of the six components. Based on the findings discussed in

an earlier section, intervention recommendations will be provided. Evaluation time frames would

be determined at that time.

The final recommended evaluation will be on the effectiveness of hiring caring, talented,

and most of all, dedicated caregivers. An initial monthly review of the quality of talent hired will

be evaluated to assess culture and experience fit.

Conclusion

As we discussed, the four thematic areas identified were: organizational culture,

employee engagement (specifically of new employees), innovation in the workplace, and

suggestions for improvement. Our findings closely aligned the experiences and answers from the

3 interviewees with survey responses from the 13 respondents. Both produced varying-degrees

of positive results. Overall, Team Aggies found that Friendly Faces Senior Care is creating a

positive work space for employees on all levels.

In the search for understanding regarding the lack of survey responses, Pervaiz (1998)

discussed lack of organizational unity. Our survey discussed the culture of the organization as

well as engagement and innovation within that culture. Making sure that an organization’s

culture is aligned with innovation is highly important in organizational unity (Pervaiz, 1998). In

alignment with this, Sproull (1986) discussed the need for a culture to set a standard of fast and

efficient communication along with the encouragement of the individual’s desire to improve the
APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 28

organization (Sproull, 1986). While Team Aggies did not directly recognize a state of disunity in

Friendly Faces through the survey responses, interview responses were not clearly aligned. There

were differing opinions when it came to the organization’s culture and communication styles, but

overall, they were both perceived in a positive manner. However, continuing to focus on

unifying and uniting the individuals in an organization is a recommended endeavor (Sproull,

1986).

Team Aggies’ other recommendations as discussed previously include those related to

training and onboarding of new employees, ways to ensure that employees have an outlet and

formal process to voice their opinions and to feel heard, and a focus on “The Quad” of thinking

big and acting small (Jennings, 2012, p. 209).

APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 29

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Appendix A - Survey Sample

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APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 33
APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 34

Appendix B - Interview Questions

Interview Questions:

1. How would you describe the culture of Friendly Faces?

2. What are some of the advantages to working with Friendly Faces when compared to

other agencies in the industry?

APPRECIATIVE INQUIRY OF FRIENDLY FACES SENIOR CARE 35

3. How does Friendly Faces encourage engagement of new employees?

4. In what ways does Friendly Faces encourage employees to remain engaged in their work

long term?

5. In what ways does Friendly Faces encourage employees to be innovative in their work?

6. Are there any areas in which working at Friendly Faces has resulted in you learning new

professional skills or further developing existing skills? Are there any areas in which you

would like Friendly Faces to further develop your professional capability?

7. What keeps you motivated to excel at Friendly Faces?

8. How does Friendly Faces encourage engagement of clients?

9. What steps has Friendly Faces taken that have resulted in further growth or development

of the organization?

10. Let’s say you have a suggestion for improvement in the processes/procedures at Friendly

Faces. What changes or further steps would you take to grow the organization and the

business? How would you go about getting this improvement implemented?