Case 1: Labor, Delivery, Recovery, Post Partum (LDRP) Staffing Situation
1. Problem Identification
Problems, Issues and Challenges Overworked nurses Distressed obstetricians Insufficient funds Lack of consultation Complaints not handled in time Handling complaints Consulting all the people involved Proper delegation of tasks Issues uncontrollable by the manager Insufficient funds Issues controllable by the manager
The major problems in the LDRP are lack of funds and proper delegation of tasks. The nursing assistants are given many responsibilities by the registered nurses, some of which are not patient-related. Though the obstetricians do not mind, the nursing assistants are not asked how they feel about the arrangement. In an attempt to reduce the costs of maintaining all the staff, the unit manager does not consult the other members of staff and does not ask for their opinion. This causes major problems later because the people that are left are not enough to do all the work required. The registered nurses take on additional tasks and the level of efficiency reduces. This causes distress to the registered nurses and the obstetricians. It takes a long time for the managers to respond and provide solutions to the complaints brought forward.
3. Potential Solutions
There is a managerial problem in the community hospital and the management has to come up with solutions, if work is to be done efficiently. Funds seem to be a major issue at the hospital. If they can find ways to find the required funds, then they can hire more people to handle all the tasks in the hospital. One of the potential solutions is to find a way to come up with the required funds. Being a community hospital, it usually depends on private donations and federal grants so that it can continue running (Greenwald, 2010). Another potential solution is to train all the different managers. The unit manager did not consult the others when making his decision and the CEO took a long time to respond to the complaints raised by the obstetricians.
There seems to be a communication problem at the hospital. The management should inform all the employees about the changes they intend to make before making them (Wheeler & Grice, 2000). Communication is both verbal and non-verbal and the CEO’s decision to be silent to the obstetricians was communicating a negative message to them (Huber, 2006). The staff should be allowed to contribute to the discussion and their ideas should be considered. Some of the reasons why transformations fail include under-communication, not recognizing any potential challenges and lack of careful planning (Jones, 2007). Another potential solution is developing a more lenient management structure. The bureaucratic management in hospitals has many limitations because it is cumbersome and decision-making is slow. Excessive administration is also a major problem in this sort of structure (Parkin, 2009). Though the registered nurses were overworked, they did not communicate to the CEO. It was only after the obstetricians noted the level of inefficiency that they took the action of addressing the CEO.
4. The solution
The solution is that the hospital needs to develop its communication skills and enhance consultation. This is because before making a decision, all the staff members who will be affected by that decision ought to be consulted.
Case 2: What is a Manager to do?
1. Problem Identification
Problems, Issues and Challenges A political organizational kind of structure Mismanagement and abuse of staff Reluctance and unwillingness to change Lack of transparency in money management Lack of co-operation from some members of staff Corruption from the governing body members Issues controllable by the manager Mismanagement and abuse of staff Reluctance and unwillingness to change Lack of co-operation from some members of staff Issues uncontrollable by the manager A political organizational kind of structure Corruption from the governing body members Lack of transparency in money management
The health service provider has many managerial and legal problems. There is rampant corruption, misuse of resources and lack of transparency. The governing body has made sure that everybody else remains powerless and voiceless. They clearly demonstrated this when they fired someone who had dared to speak against what they were doing. They abuse their power by using the maintenance staff to do their private chores. The staff could use their services at the office instead of mowing lawns at private residence. The governing body is also acquiring profit using illegal means.
3. Potential Solutions
The Operations Restore Trust was established in 1995 to investigate fraud cases and enforce rules to deal with fraud and abuse. Some of the activities of the ORT include sensitizing the community about fraudulent activities in the healthcare center, investigating any fraud cases and conducting financial audits (Buchbinder, 2007). A possible solution would be to report all that is happening to the relevant authorities. Since Rime is a member of the managerial staff, she is in a position to complain about the misuse of the maintenance staff. Corruption increases the cost of health care in the end and the society suffers because of this. It is also frustrates and discourages the rest of the staff members (Gruen & Howarth, 2005). Transparency is one of the most effective methods of dealing with corruption. Another method would be developing an electronic system, which will ensure that everything that enters in the hospital is accounted for. This would make it hard for the officials to steal the equipments (Carrin et al, 2009). She could also encourage her fellow colleagues to be more co-operative.
Another possible solution would be to motivate the employees and her colleagues at the same level to be more positive towards change. This will in turn enable them to speak out against the injustices at the workplace. She could also take the issue of misusing the maintenance staff to the labor department. There is much conflict between some members of staff and the governing body and it can only be resolved through communication. In cases of conflict, the parties can decide to negotiate about the issue at hand and come up with a solution where both will be content. One side can decide to persuade the other to agree with them. This is what Rime will have to do with her colleagues so that they can agree with her. The parties could also bargain, where in this case something is exchanged with another. The governing body might not like the idea of getting rid of the maintenance staff in their homes. The other managers can bargain with them to help in paying them (Huber, 2006).
4. The Solution
In cases such as this, the best and most feasible solution would be to let the law deal with the governing body. All cases of fraud and mismanagement of staff should be reported to the relevant authorities since what the governing body is doing is illegal. At the lower level, she should mobilize the staff and motivate them to speak out. She is in a position to advocate for change and one of the first things they should consider is the structure and formality of the organization.
Case 3: The Admitting Department
The ability for May process more patients than was required can be seen as a positive and negative attribute. It could be that a clerk is highly efficient and therefore does his or her work in minimal time. On the other hand, he or she could have been in a hurry to process many patients so that they could have some extra time to do other things. In this case, the patient’s healthcare is compromised since there is lack of efficiency. York should ensure that the time allocated to each client is appropriate and that a person exceeding the expectations is indeed efficient. In contrast, York should consult June due to lagging behind schedule in order to find out whether any potential hindrances to work are being experienced.
Buchbinder, S. B., & Shanks, H. N. (2007). Introduction to health care management. Sudbury, MA: Jones & Bartlett Learning.
Carrin, G., Buse, K., Heggenhougen, K., & Quah, R. S. (2009). Health systems policy, finance and organization. Durham, NC: Academic Press.
Davies, H., & Tavakoli, M. (2004). Health care policy, performance and finance: Strategic issues in heath care management. United Kingdom: Ashgate Publishing Ltd.
Greenwald, P. H. (2010). Health care in the United States. Boston, MA: John Wiley and Sons.
Gruen, R. & Howarth, A. (2005). Financial management in health services. New York, NY: McGraw Hill International.
Huber, D. (2006). Leadership and nursing care management. Shreveport, LA: Elsevier Health Sciences.
Jones, R. (2007). Key topics in healthcare management. United Kingdom: Radcliffe Publishing.
Parkin, P. (2009). Managing change in healthcare: Using action research. Thousands Oaks, CA: SAGE Publications Ltd.
Scott, R., & Petrosino, C. (2007). Physical therapy management. Shreveport, LA: Elsevier Health Sciences.
Wheeler, N., & Grice, D. (2000). Management in healthcare. Nashville, TN: Nelson Thomas.