Quality management in a workplace

You are the manager of a department that provides hands-on service to both in-patients and outpatients of a large urban health care facility. One of your employees, a senior therapist named William, has been taking an increased amount of your time and attention in ways that have filled you with growing concern. William has been in the department nearly 10 years, which is two years longer than you, and at one time he seemed to have had ambitions to run the department. You feel that you have been watching William's overall reliability and effectiveness decline for the last couple of years.

Specifically:
1. William's performance has been noticeably deteriorating. He now arrives to work chronically late, although for years tardiness was not a problem. He is slow to start, takes numerous breaks, overstays his lunch period, and seems not interested in his patients.
2. Two other employees have told you confidentially that they feel William has become alcoholic; however, even remaining alert to this possibility you have detected no signs of his being under the influence or actively using alcohol at work.
3. On several occasions he has been absent from work without notification, claiming sudden illness after the fact. This has fostered ill feelings among other staff because of the last-minute staffing changes he's caused.
4. You have discussed William's sagging performance with him every three or four weeks for the past six months. William denies any change in attitude or performance, and concerning his absences he says only that his 'allergies are more troublesome than they used to be.'

What are you going to do? Your assignment is to:
a. Develop at least four alternative courses of action
b. Assess each action plan in terms of whether it is likely to solve the problem
c. Describe how you would follow-up on implementation of your plan
d. Show how your actions would be related to departmental policy, risk management protocols, quality assurance and quality improvement program in place.