MBAX 6007 Week 9 High-Impact Remedy Analysis Example

Why Sign-On Bonuses Widen Hearthside's Caregiver Swing: Four Remedies Tested in One Model, Three Outcomes Each and Two System Archetypes That Explain the Results

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Walden University

MBAX 6007: Complexity and Systems Thinking Dynamics

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Month Day, Year

Why Sign-On Bonuses Widen Hearthside's Caregiver Swing: Four Remedies Tested in One Model, Three Outcomes Each and Two System Archetypes That Explain the Results

Four Candidates, One Model

Hearthside Home Care's leaders, managing the made-up home-health agency studied all term, have a favorite remedy for staffing shortages: sign-on bonuses. This analysis tests that remedy against three others in the course model, extended since Week 5 so that quits rise in both phases of the cycle: in a surplus, when short hours push aides to steadier jobs, and in a shortage, when overtime builds fatigue. Half of any shortage is covered by overtime and half goes unfilled. The four candidates are sign-on bonuses, which raise hiring by 30 percent whenever the rule calls for hiring; an overtime cap, which ends overtime and so removes fatigue-driven quits but leaves more visits unfilled; a guaranteed floor of weekly hours for active aides, which removes short-hours quits but means paying for idle time; and a hiring rule that counts aides already in screening and training. Each was run for 36 months from the same starting point, 100 aides against a need of 120.

Three Outcomes, Not One

Each run is judged on three outcomes, reported separately because a remedy can improve one while worsening another. Swing is the distance from the roster's first peak to its following low point. Shortage depth is how far below need that low point falls. Unfilled need is the total aide-months of demand that neither the roster nor overtime covered across the 36 months.

Table 1

Results for Four Candidate Remedies

Composite organization; illustrative runs of the extended course model.

Fixes That Fail

Bonuses look like a success on one measure: unfilled need falls from 90 to 74 aide-months, because more applicants enter the pipeline early. But the swing widens by about a third, from 26 aides to 35, and the peak rises to about 146 aides against a need of 120. Bonuses pour applicants into a pipeline that is already full, so the overshoot that follows is larger, the surplus is longer and more aides face short hours. Senge (1990) described this pattern as fixes that fail: a quick fix relieves the symptom now and, after a delay, makes the problem return worse. The archetype diagram shows a balancing loop, bonuses reduce the shortage, and a reinforcing side effect, the larger overshoot that drives short-hours quits and sets up the next shortage.

Shifting the Burden

The overtime cap tells a different story. Ending overtime removes fatigue-driven quits, which narrows the swing slightly, to about 23 aides. But unfilled need rises sharply, from 90 to 140 aide-months, because visits that overtime used to cover now go unserved. That result exposes how Hearthside came to depend on overtime. Senge (1990) called this archetype shifting the burden: a symptomatic solution, overtime, relieves each shortage and over time erodes the fundamental solution, retention, since fatigue drives aides out. The agency cannot simply cap overtime without something else carrying the load. Repenning and Sterman (2001) found the same dynamic in manufacturing, where working harder to meet short-term targets steadily eroded the capability needed to improve.

The Hours Floor

Guaranteeing aides a floor of weekly hours is attractive on fairness grounds, and it does keep aides in surpluses. But in the model it widens the swing slightly, to about 29 aides, and deepens the following shortage, for the same reason higher wages did in last week's scenario: with fewer quits in a surplus, the roster drains more slowly, the hiring rule stays switched off longer and the agency enters the next shortage with an empty pipeline. It also means paying for idle hours throughout each surplus. A floor may still be worth adopting later for retention reasons, but only once the hiring rule no longer creates large surpluses to pay for.

The Pipeline-Aware Rule

The rule that counts aides already in screening and training nearly eliminates the swing: the roster rises to about 121, settles near 120 and stays there, with a low point only 0.2 percent below need. Unfilled need falls to 59 aide-months, the best of the five runs. The change attacks the structural cause found in the delay analysis, a hiring decision that ignores its own supply line. Sterman (2000) treats attention to the supply line as a powerful stabilizer for systems with long delays, and the result here is consistent with that.

Limits and Recommendation

The model is small and its parameters illustrative, so the size of each effect should not be taken literally. The ranking, however, is robust across the runs tried: the pipeline-aware rule does best on all three outcomes, and bonuses do worst on swing. Hearthside should adopt the pipeline-aware rule first and treat overtime as a short-term buffer to be reduced gradually as the swing narrows, rather than capped at once.

References

Repenning, N. P., & Sterman, J. D. (2001). Nobody ever gets credit for fixing problems that never happened: Creating and sustaining process improvement. California Management Review, 43(4), 64-88. https://doi.org/10.2307/41166101

Senge, P. M. (1990). The fifth discipline: The art and practice of the learning organization. Doubleday.

Sterman, J. D. (2000). Business dynamics: Systems thinking and modeling for a complex world. Irwin/McGraw-Hill.