IntroductionMembership Services (MSD) at Kaiser Permanente was a modest department of sixty employees. However, in recent years the department has doubled in size, creating little departmental reorganization. In addition to increased department staffing, several challenges have emerged. The changes included the primary job function, as well as the introduction of new network system software that slowed down processes in other departments. These departments included Claims (which pays bills for service providers outside the Kaiser Permanente network) and Corporate Patient Services (which sends bills to members for services received within Kaiser Permanente). Due to the unexpected challenges created by the system upgrade, it was decided that MSD would process calls for both affected departments. Unfortunately, this created a catastrophic event where MSD received numerous phone calls from distraught members, who had received invoices a year after the service was provided. Average Monday call volume increased from 1,800 to 2,600 calls per day. The average time to handle each call also increased: from an acceptable standard of 5.6 minutes to an unfavorable 7.2 minutes. The department continued to be inundated with these types of calls for the two years that these changes went into effect. The Claims and Patient Business Services departments have made great strides in getting back on track with these changes, which has provided much-needed relief to the MSD. However, MSD still grapples with some issues, such as high absenteeism and low morale, which make it difficult to balance available staff with the inbound call load. There are also some factions who often find themselves socializing in other people's cubicles or going to the lobby to answer personal phone calls. Finally, there were also difficulties within the management team due to past and future management styles within the department. Data Collection/Observation Information and facts related to “Organizational Culture” were gathered through a personal interview with Erica Mettert (a 15/85 team and supervisor of membership services at Kaiser Permanente). Information and facts regarding potential concerns and/or problems within the department were obtained through personal interviews with current and former Membership Services staff members. Ms. Mettert has a six-year tenure at Kaiser Permanente, four of those years at MSD.1. Interviews Interviewees ranged in responsibilities, from supervisors to call center representatives to former employees, and were conducted via telephone, email and face-to-face.