Overview statement
The case study discusses the question of necessity and existing opportunities for introducing new strategies and health care reforms in order to keep the Cooper Green Hospital open. However, the clinic faced numerous problems with providing services and diligent treatment to their patients. First of all, the healthcare establishment failed to provide a high standard treatment for patient because of overstaffed and outpatient clinic. Secondly, the hospital also had problems with health care insurance of their patients because the existing reforms do not allow middle-class patients to afford expensive medication provided by the Community Care Plan clinics. In this regard, Dr. Michael decided to implement Community Care Plan and introduce a high quality treatment at an affordable price.
Dr. Michael’ decision to introduce health care reforms, however, faced numerous challenges and one of them was inability of health care system to quickly adjust to changes. Being of the safety net providers, Cooper Greene Hospital encountered challenges in reimbursing the cost of uncompensated care. Besides, there were a lot of limitations imposed by local regulations being reluctant to introduced changes to the firmly established system of non-physicians providers.
Background statement
The former Cooper Green House hospital is working under the tutelage of a CEO Dr Michael who was formerly chief of staff of the same. Dr. Michael assumed office in the year 1992 after a promotion. Dr. Michael has for the recent past experienced unabated headache over the growing numbers of inpatients and out-patients in the hospital. He is also faced with overstretched facilities coupled with understaffed personnel.
The hospital has been under pressure for a long time to deliver quality services to the inflating population of the locals and this leads to increase in costs of operations. This forced the hospital to effect cost reduction strategies which included retrenching of staff among others. One day while on duty; Dr Michael met a patient diagnosed with respiratory tract infection which had become severe due to laxity by the patient to receive treatment. Upon scrutinizing the patient, Dr Michael realized that the patient lacks knowledge of the functions of the existing community care clinics. Otherwise, the treatment would have been sought long before at its early stage. It then dawned to Dr Michael that patients’ awareness of the functions of the existing Community Care Plan (CCP) was essential.
Dr Michael initiated the revolution of Cooper Green Hospital to Jefferson Health System (JHS) which executed its roles under two plans. Health first and Community Care Plan (CCP) with the former established on the basis of financial strength of the locals, and the later addressing the need for affordable and accessible medication under prepaid membership plan. Dr Michael wanted to make CGH the hospital of the choice in terms of quality services and cost effectiveness.
Community Care Plan is a program launched under a five-year funding program to put to rest the problems haunting Dr Michael. The Community Care Plan did set up clinics within the vicinity so as to enhance an easy access to medical care and treatment. What a patient ought to do is to register with the CCP at a fee which is paid on quarterly basis. Upon submission of a quarter registration fee, a patient is liable to receive regular medical care at the Community Care Plan clinics. The CCP offered services at the patients’ disposal thereby minimizing time wastage and fatigue with respect to the patients.
The Community Care Plan program funding was, however, limited to half a decade and the period was elapsing. This added to Dr Michael’s long list of predicaments and he was consequently torn between expanding this program and terminating the same.
Role identification
Taking the role of a consultant I will try to seize this situation outright through providing Dr. Michael with viable recommendation on introducing his Community Care Plan and on overcoming the existing challenges.
Major problem and secondary issues
As it has been briefly mentioned, Dr Michael attempts to implement the CCP program were encourtered with serious gaps in health care system. First of all, most of health care providers were restricted to nonphysian health careo deliver. Due to the fact that Cooper Green Hospital was one of the safety net providers in the United States, its main source of profit were coming mostly from unisured and poor patients.
Additionally, safety net provides were insufficiently funding by the government and local regulations that gave priority with nonphysician funding. According to the serveys presented in the case, the Cooper Green Hospital counted more than one thirhg of uninsured patients and poor residents. 48. 000 resident were not provided with proper treatement because they did not have healthcare insurance. More importantly, the servey revealed that the community identified “crime, low-income, housing and drugs as the highest priority isseus” (Swayne, 2007, p. 208).
Another challenge that Dr. Michael encountered is the demographic problem and its correlation with the quality of medical treatment and medication delivery. Despite the growth of population, the ration of eligibles remain almost the same. Therefore, there was not and shifts in enforcing and introducing healthcare insurance. According to the presented exhibits, along with the populationg of more thant 4 million people, there were only 637 thousand who were eligible for helth care insureance (Swayne, 2007, p. 206).
With regard to the above-desribed complicated situation, Dr. Michael’s first steps of the program fulfillment faced the numerous problems, including the lack of cooperation between the members, which were slowly developped. In addition, there problems in coordinating between CCP functions and those of CGH. As a result, the presentation of employees’ problems and concens were gaining more complex issues. At the same time the manegial staff of the hospital was still considered as a model of successful cooperation and teem work. Therefore, the developnent of efficient communication channels presented the main problem.
Finally, the CGH hospital faced the problem of technical advamcnent. The modernization of CCP equipment was essential because it had to eqaully communicate and cooperate with CGH being more technologically advanced.
Organisations strength and weaknesses
Cooper Green Hospital was formed to address health issues of the poor Jefferson county community. CGH had this in mind: provision of affordable and accessible medical care as well as quality services especially to the poor individuals. CGH wanted to be a hospital of ‘last resort’ according to Dr Michael. Irrespective of the patient’s ability to meet his /her medical bills, he/she is liable to quality medication. This made the hospital to be one of a kind and attracted many patients culminating to high operational costs.
CGH under the management of Dr. Micheal boasts a great deal of resources. Behind Dr Micheal there was a dedicated team of a of a few physicians, “assistant physicians, certified nurse midwives, nurse anesthetists and clinical nurse specialists” (Ginter, 2007).
The CGH hospital also enjoys benefits from the policies set by the federal government e.g. Medicaid which funds the state run programs. There is also the ‘Balanced budget act’ which compensates for the medical care for patients’ who are under the age of 19 years. CGH hospital enjoys medicare established under ‘Social Security Act’. “The medicare was established in 1965 to ensure medical coverage for the aged and disabled” (Jills, 2004). The Alabama environs is also greatly diversified in terms of economy. It was “once known as centre of the steel-making industry, Jerfferson County, Alabama, boasted a diversifiied economy by the 1990s” (Duncans, 2007).
Cooper Green Hospital sits on a gold mine environment since it has a rich vicinity in terms of economy. The few affluent citizens of the county can help boost the funding of the program which is on the threshold of collapse. The poppulation of the Jefferson County is a big incentive to the CCP program which can enhance it run independendly. However, these opportunities cannot be realised if the issues of insecurity and housing cannot be delt with absolutely. Most Alabama residents lacked health insurance cover and when inquired, the low-income residents overwhemingly listed crime, violence,and drugs as their priority issues (Dubay, 2000, p. 256). If these issues are not properly tackled, the hospitall will have to terminate the process of program fulfilement. It will fail to meet it’s expectations and hence collapse.
Alternative course of action
The hospital is in a crossroad. It is supposed to ensure an easy access to cheap medical care for the growing number of the Jefferson County residents. Under the ‘Managed Care Policy’ watchdog, Dr Micheal must “cut down health care cost” (Baker, 2007). This reduction in health care costs has a negative effect on the program since the poppulation is rising. Dr Micheal has an option of maintaining the existing CCP clinics but then he must bear in mind the poppulation growth index.
The method that I would use to evaluate the best option to be applied by the CEO will therefore be ethical analysis. As stated by Moberg, “the current management focusses on the value of outcome rather than on the value of the means chosen” (Moberg, 2001). Therefore, it follows what is essential to focuss on the results. I will bias my analysis towards utiliterian theory model of approach. In a nut shell, this theory “holds that actions and plans should be judged by their consequences” (Sidgwick, 2004).
According to Sidgwick again, decision architects should weigh their options and find the best way to satisfy the majority. I also believe the utiliterian theory option is the best suited for this situation because it “encorages entrepreneurship, innovation and productivity” (Moberg, 2001). Just like a perfect competition, in utiliterian theory, the final decision is a compound of individual decisions. According to Moberg, utiliterian theory “facilitates calculative shortcuts” (Moberg, 2001).
These advantages makes utiliterian option the best option for this scenario. As shown by Moberg, the main obstacle of the utiliterian theory is that: “it can result to unjust allocation of resources’ and is virtually impossible to assess the effects of a PBA” (Moberg, 2001).The other options at Dr Micheal’s disposal are; ‘Theory of rights’, which is not convenient with respect to this situation because it is based on the legal issues. However, the advantage of this theory is that “it specifies minimal level of satisfaction” ( Beck, 2006). Another option is ‘Theory of justice’ which is basically based on justice and hence irrelevant in this case.
Another cause of action is the provision of accountable management that would block commisioners in influencing unethical decisions at the hospital. The hospital books should again be provided to the public so that there can be proper accountability. This is so since the hospital runs partially on public funds.
Plan of action
According to utiliterian theory, the course of action to be taken should to forster the process of plan introduction. First of all, it should “adopt some ideological system that reduces ellaborate calculations of intrest to a series of utiliterian rules” (Mill, 2003). The second course of action to be taken by the CEO is that he should fomulate a framework of assessing the parties involved. The final action is for the CEO to “make bounderies on the utiliterian calculations” (Lyons, 2003). Under these guidelines the CEO will come up with a concreate decision since this option will enable him weigh the consequences of his actions in an appropriate way.
Evaluation
For the hospital to assess the reliability of its methods it should therefore carry out statisics on the impact of the program to the residents of Jeffersons county. The Ceo should assess the plan of action relative to it’s consequences and hence make a viable verdict. In order to evaluate such the profitability and viability of the clinic under consideration, it is necessary to analyze and evaluate such issues as utility, propriety, feasibility, and accuracy.
Hence, judging from these elements of assessmentn, Cooper Green Hospital and its Community Care plan can turn out to be efficient in case of having sufficient funding for constructing a solid and consistent, organizational infrastructure. Addition, it is also very important to introduce certain legal issues that will sustain the project development and provide a solid basis for changes in the shphere of health care development. What is more important is that, all health care reforms put forward by Dr. Michael should be accurate and consistent to present more opportunity for a successful accomplishment of the Community Care Plan.
Currently the hospital is about to be sold. It is said that the county does not need a county-owned-hospital, but instead it needs health care for the indegent. It is true that the hospital has been providing cheap health care for poor patients for a long time, but due to unaccountable management the hospital is down on its knees. Therefore the many clinics that are branched from this hospital cannot be run effectivily due to the problem of inavailability of resources.
Although incentives have been put in place to inject public funds in an attempt to revive the clinics and the hospital’s entire programs, lack of accountability has made patients pay twice as much for medical care. In a synopsis the hospital cannot easily recover from the its predicaments that are lack of stocks, being understaffed and a swarming outpatient clinic.
Refference List
Baker, L. (2007). Managed Care, Health Expenditures, and Medical Technology. Journal for Health Research and Policy Research 23 (3), 62-69.
Beck, G. (2006). Immanuel Kant’s Theory of Rights. London: Oxford University press.
Dubay, L. (2000). The uninsured and the affordability of health insurance cover. A journal for Health Affairs 15 (4), 254-293.
Duncans, J. (2007). Strategic management of health care management. New York, NY: Oxford university press.
Ginter, P. (2007). Health care management. London: McGraw Hill.
Jills, Q. (2004). The Color of Welfare: How racism undermined the war on poverty. New York, NY: Oxford University Press.
Lyons, D. (2003). The forms and the limits of utiliterianism. London: Oxford Clarendon Press.
Mill, J. (2003). Utiliterianism. New York, NY: Prentice hall.
Moberg, D. (2001) The Ethics of Organisational Politics. New York, NY: Oxford University Press.
Sedgwick’s, H. (2004). Methods of health Ethics. Journal of health ethics, 19 (2) 62-87.
Swayne, L. (2007). Cooper Green Hospital and Community Care plan. London: McGraw Hill.