Critical Thinking Case Study
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Critical Thinking Case Study
Chris had just been promoted as an Executive Assistant for Pat the CEO, Chief Executive Officer, of Faith Community Hospital. Pat had given Chris her very first assignment on her first day of work as an executive assistant and that was to gather information so that Pat can present the issues to the board of directors. Faith Hospital is faced with issues that needed attention and the board of directors must be notified of the issues so that a solution can be remedy to help the hospital stay in business.
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Chris was to look at the different issues that Pat had informed of her during their first meet and capture only what were the essential issues for the board of directors to know. Some of the strategic overview that Pat requested was to be able to answer the following questions: "what's going on right now, what we can do about it, and what we should do about it" retrieved from Resource January 28, 2006.
Before Pat had informed Chris of the issues that the hospital faces, she was on top of the world even though it was Monday morning and raining. She was just engaged on Saturday will be graduating University of Phoenix on the following Saturday and will also be starting her new position as an executive assistant so there was nothing that can come her way that would let her down.
Framing the problem
The problem that Faith Hospital is dealing with is the decline of belief's and spiritual values towards the hospitals missions' statement. The hospitals mission states that the "mission is to promote the health and well-being of the people in the communities we serve through a comprehensive continuum of services provided in collaboration with the partners who share the same vision and values." retrieved from Resource January 28, 2006. According to Chris, there are fewer community members and partners that know what the hospital's missions are and there are others that have different views and interpretations of what the mission should be. With the different interpretations of the mission the hospital is constantly faced with diverse cases that requires a decision-making solution and techniques to handle.
Since the interpretation of the mission varies this attributes to one of the problem that the hospital is faced with such as: patient refusing medical services, do not resuscitate directives, how doctors are responding to the different scenarios and how certain government services and lawsuit affects the hospital. For example, some patients feel that they have the right to refuse certain medical services in which may be due to personal religious beliefs not to accept any medical surgery. On the other hand, there are staff members that refuse to provide certain medical services. This could be because some patients do not have insurance and that the staff is trying to help the hospital not lose any money if they do not provide services to non-insured patient. Another example would be the Do Not Resuscitate (DNR) directives. Some patients do not have their consent in written form so it is difficult for the hospital to abide with the patients wishes.
The doctor's responds to the hospital's mission in different scenarios in the medical services by abiding by their oath, which is to serve and provide services by putting the patients care first. This can also vary depending on the doctor, as some compassion about the patient and some are passionate about the patients right to die'. So basically the doctors needs to balance the hospital's mission statement-based on personal belief and how they interpret the mission.
On top of all this, the hospital also has to deal with different organizations such as the Child Protective Services. According to Pat, the hospital had a case in the "Neo-Natal ward, where the Child Protective Services is in the process of taking custody of the baby and threatening to file charges against us because of the way we provided services or, as they allege, failed to provide services" retrieved from Resource January 28, 2006.
Another that attributes to the problem is how the media represents the hospital on the headline news "that medical errors cause tens of thousands of deaths each year, close to 100,000 in hospitals alone. With that as the external panoramic view, let me paint the picture for you, from the inside", said Pat (Resource). This type of media coverage causes a decrease of the number of patients that the hospital serves every year. With the decrease of patient, that translates to the decrease of revenue for the hospital that affects the hospitals budget. Compare to the prior year the hospital lost 7% of the patient population. The hospital has 28% fixed cost yearly that is required to run the hospital business such as: paying the bills which most likely includes paying the employees, utilities equipment maintenance and serving the people.
Some of the data shows that the hospital needs to "hold steady at 7863 patients and 39,866 patient days" or the hospital will need to reduce fixed cost by 15%. The fixed cost cannot be reduced so if there is decrease in the patient admittance into the hospital for service then the less income the hospital receives. That means the hospital needs decide on cutting the cost on the fixed cost just to break even to keep the hospital running. Some of the tough decisions would be to reduce the hospital's headcount.
To help tackle the issues and problems, Faith hospital's board of director need to sit down and come up with ideas that will help the hospital resolve the issues.
Solution One that I come up to help resolve the problem of maintaining and identifying the hospitals mission clearly is to provide a clear and concise procedures and policies that can be implemented. The policies and procedure has to be learned by all staff so that they can be familiarized with what needs to be done when the staff is faced with various cases. It is very difficult and impossible to write down every single item that the staff must do on certain occasion, as the medical field is unpredictable and nearly impossible to memorize. Staff member should focus and concentrate on important issue and quality care for the patients. The hospital needs to also focus on abiding by law to stay in operation while making the policies and procedures. The hospital cannot refuse care for non-insured patient especially if the patient is faced with a life threatening injury. By refusing care, the hospital will be faced with lawsuits if the patient is to die or cost more harm and injuries. For example, if the DNR is not in a written form, there is no question by the staff members but to provide the medical service needed by the patient.
Solution two that I can think of is to take a survey of employees according to their personal beliefs of how a patient should be treated and keep this survey on the employees record to ensure that the policies and procedures are clearly understood by everyone. This survey will help the hospital track what percent of the employees understand the hospital's mission. If the percent of the survey falls below 95% from the mission statement then Faith hospital needs to re-train employees in regards to the policies and procedures of the hospital.
To help improve and increase the number of patients that come to Faith hospital, solution three would be for better marketing of the hospital. If the hospital is market properly to entice patients on why they should go to Faith hospital instead of others then this will help the flow of patients. Advertising through the media such as the quality of service that patient can receive at the hospital will be outstanding, patient commitments and the type community service that the hospital provides. By having more patients should help offset the fixed cost on operating the hospital.
Chris needs to outline what type of decision-making techniques the board of directors should use in tackling the issues at Faith hospital and that technique should be dimensional analysis. Dimensional Analysis techniques is a "checklist (Jensen, 1978) that relates to Five W's and H, and is of most use as an aide memoir for initial exploration of a problem or evaluating options, particularly those associated with human relations, rather than of a technical nature" retrieved on January 29, 2006, Dimensional Analysis. By identifying the five W's (Who, What, Where, When) and H (How), this should assist in finding one solution. I think the best solution is the putting the policies and procedures in place. In doing this, employees that serves the hospital will have a clear and concise knowledge of the hospitals mission statement. This will help alleviate the in concision that is happening at the hospital. The five W's and H can be represented by substantive dimension (Who?), spatial dimension (where?), temporal (When?), quantitative (How much?), and qualitative (How serious?). Some of the questions that can be asked are substantive dimension or what asks the question like "Is it necessary to change attitudes or practices?" Another is spatial dimension or who, asks the question such as " Recognize the exact area concerned".
After identifying problem and the effects of it to the hospital, now the Pat can present to the board of directors the solutions that are feasible and achievable. It is not going to be an easy task to get all the board in agreeable to the solution but will help identify all the problems that needs to be resolved and in peoples mind. If the issues are not dealt with, there is a chance that the hospital will lose more money by losing more patients. Without the patients coming into the hospital, the hospital will not be around to serve the community. Like any businesses, Faith has to earn money to be able to operate and serve customers. The solution that is identified to help with the problem will assist the hospital run a better business.
In conclusion, the hospital needs to let the community be aware of the quality service that Faith hospital provides and once the trust from the community comes in this should help balance the budget once the flow of patients start to increase. The board of directors has to come to an agreement on maintaining the mission of the hospital and its survival. Without the mission statement, the hospital's spiritual beliefs and values will fail to exist.