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Sample Critical
Thinking Term Paper - The Case Study of Faith Community Hospital
PART A
Description Of The Problems Appearing In The Case
I. Mission Statement
The mission statement of the hospital is too general to
be perceived much too differently be those concerned
i.e. the stakeholders. There can be many interpretations
of this statement and needs to be revised towards more
specific targets.
II. Medical Errors
Another looming problem or issue that seems to be
hanging over Faith Community Hospital and needs to be
addressed is the medical errors which, according to a
headline, cause tens of thousands of deaths each year,
close to 100,000 in hospitals alone. Studies have shown
that the clinicians use alcohol and drug, which is one
of the reasons for medical errors. Pope, Tabachnick, and
Keith-Spiegal (1987; see also Pope & Vasquez, 1998), for
example, found that 5.9% of psychologists acknowledged
conducting therapy sessions while under the influence of
alcohol.
III. Diversity of Organizational Structure
The hospital’s organizational structure is too diverse
at the controlling body that hinders smooth running and
flexible decision-making. The Board of Directors of the
Faith Foundation is very diverse in thinking and
decision-making abilities. A wide variety of
believers--Board of Directors, staff, patients and their
families, as well as others believe to be someone with
responsibility to the smooth and effective running of
the hospital based on their community belongingness.
IV. Refusal of Certain Medical Services by Patients
It has been observed that particular patients refuse to
take certain medical services on different grounds based
on their own notions of hygiene, ethics, religious
beliefs and health care ideas or personal moral
convictions.
V. Refusal by Staff for Providing Certain Services
Particular staff members refuse to provide certain
services to certain or all patients. This again poses
problems when there is a personal demand on a staff and
can lead to conflicts between the patients and the staff
members concerned.
VI. Failure to Provide Certain Services / Massive
Service Demands by Patients
The hospital seems to be failing its customer or
patients’ demands. It is not coming up to their
expectations for the provision of certain services. For
example, in it’s Neo-Natal Ward, where Child Protective
Services is in the process of taking custody of the
baby.
Faith Hospital’s patients expect very high service and
demands extensive treatments. Yet the costs are on the
rise that is making it very difficult to increase the
services as per demands.
VII. Resuscitation
There seems to be communication vagueness about DNR
practice in the hospital even at the desire and support
of the families concerned, if any. Some of the members
are practicing it and some are not. There is no written
overall policy in this regard.
VIII. Doctors’ Loss of Power Feelings
Doctors are facing a dilemma of loss of power. They no
more seem to be able to exert pressure and dominate the
patients. More than this some of the pharmacists are
filling uninsured prescriptions by accepting payment in
installments.
IX. Pro Bono Treatment by Some Counselors - Unauthorized
Again there is a failure of clear communication and its
effective monitoring and control of action by those
concerned. Some counselors either treat the patients
unauthorized yet some refuse to confirm insurance
coverage first.
X. Increasing Costs per patient per day
Costs per patient per day have increased by 10.6 %
compared to the last year. There can be two underlying
structural problems for such an increase in costs. The
hospital may be running a less efficient operation or
the quality may be overemphasized and may be studied to
find a link between costs and the quality.
XI. Alternatives for CEO’s Time
CEO is a major decision maker as well as a visionary and
a thinker. His time is very much valuable and one of the
most important as well as expensive asset and fixed cost
of the hospital. Therefore, he should be clear in his
mind as to what are his responsibilities and his time
should be uniquely used. The main problematic questions
about CEO’s attention are:
Where should he be spending most of his time and energy,
not to mention other resources?
Should he fight for healthcare reform or reform the
healthcare fight?
Part B
Appropriate Solution (S) With Their Rationale
Following are the proposed solutions with rationale to
the problems discussed in Part A.
I. Mission Statement
In my opinion the problem statement should identify the
community to whom it will specifically serve as well as
chose a specific niche area for itself where it will
create an asset base and spin its expertise such as
maternity, child care, skin disease, bones treatment or
any other specific area of treatment. It does not mean
that the hospital will not treat others but there should
be a specific area.
Changed mission statement is as follows:
“With the foundation and commitment of our spiritual
heritage and values, our mission is to promote the
health and well-being of the people in our community.
Our goal is to meet all medical demands of a family
ranging from maternity to child care and old age
problems.”
II. Medical Errors
The management needs to tighten its control over the
training and check and counterchecks over medical
prescriptions. A comprehensive system of patient record
and management needs to be made. Medical errors arise
out of neglect or in-competencies of doctors or nurses
or other staff members of a hospital. The Management of
Faith Hospital needs to make sure that the staff is
continuously trained and should not be under stressed
working conditions, which may lead to such medical
errors.
III. Diversity of Organizational Structure
CEO will need to strike a balance among the diversity of
stakeholders through his leadership qualities. CEO will
have to take step and assume greater responsibilities of
creating an agreement based on logical reasoning. There
may be a team exercise sometimes in some shape done by
the Board of Directors or any other social gathering
such as a tea party whereby they would mix up and lessen
their diversity. CEO needs to emphasize the common
ground of the members i.e. purpose, values, and survival
of Faith Hospital.
IV. Refusal of Certain Medical Services by Patients and
V. Refusal by Staff for Providing Certain Services
There is one solution to both the problems mentioned
above. The hospital management needs to organize a
conference or a discussion to sort out differences in
opinions of patients and agree on specific treatment
practices by which all patients would have to abide.
There is an urgent need for a written down patient as
well as nurse policy and other terms of treatment and
service. CEO may also notify all staff of the company’s
strict policy of adherence and compulsory provision of
certain services by all staff members without
exceptions.
VI. Failure to Provide Certain Services / Massive
Service Demands by Patients
A survey based on a questionnaire needs to be made with
the patients. The questionnaire will contain questions
on what facilities do the patients want and what not.
Which of the services offered is considered to be
counter religious beliefs. A review of services at
competitor hospitals needs to be made. Then needs
to be a restructuring of costs and same resources would
have to find alternate uses as well. There can be no
increase in resources since the hospital is already
facing rising costs.
VII. Resuscitation
Again this is a problem of communication being unclear.
The hospital would have to decide whether to stay on DNR
or to have a policy of doing their best to save a life.
The ethics differ in this case where some people
consider it ethical to relieve someone of his troubles
by not resuscitating him and yet others feel it their
utmost duty to do all they can to save a life.
Woodstock (1995) has discussed, “Individual health care
providers should do whatever they can for their
patients, consistent with obligations to other patients
and necessary institutional and resource constraints. It
is unethical for a provider to exploit the vulnerability
of the patient in order to enhance his or her own income
or profits.”
VIII. Doctors’ Loss of Power Feelings
Pharmacists need to be stopped from giving uninsured
prescriptions on installments. This is to be done
because other pharmacists and the hospital’s reputation
are affected by such uninsured prescriptions.
IX. Pro Bono Treatment by Some Counselors - Unauthorized
Hospital should stop counselors who treat patients
unauthorized and support a general subsidy to those who
are needy at the management level.
X. Increasing Costs per
patient per day
The hospital can collaborate with insurance companies
and the regulators--HMOs, PPOs, and other TLAs such as
AMA, AHA, HHS, etc. There is a need to collaborate in
order to save money and thus stop rising costs as well
as increase the number of services at the same time. I
believe the hospital should try to get support from
donor agencies and should not cut short its service
quality. There was a 7% decrease in patient population.
Roughly 28% of our costs are fixed costs -- costs that
do not vary with the fluctuating patient population.
XI. Alternatives for CEO’s Time
I believe that the CEO should concentrate on the broad
policy making and act on the strategy of dissolving the
various disagreements arising out of the diversity of
Board of Directors and other stakeholders. Moreover, CEO
should propagate a feeling of friendliness and sympathy
and should initiate such activities within the walls of
the hospital, which would arise awareness of need to
share common beliefs and values among the staff as well
as between the staff and the patients.
The CEO should communicate the organization’s commitment
to ethical decision making through its mission and value
statements, develop flexible organizational mechanisms
to deal with different concerns—medical, social,
financial, promote organizational mechanisms that allow
for diverse input, evaluate and reevaluate processes for
addressing different issues and promote decision making
that results in the appropriate use of power and
protection of human rights.
References
Pope, K. S., Tabachnick, B. G. & Keith-Spiegel, P.
(1987).
Ethics of practice: The beliefs and behaviors of
psychologists a Therapists, American Psychologist, 42,
993-1006,
Pope, K.S., & Vasquez, M.J.T. (1998). Ethics in
psychotherapy and counseling: A practical guide, Second
edition. (San Francisco, CA: Jossey-Bass),
American College of Healthcare Executives and American
Hospital Association, Evaluating the Performance of the
Hospital CEO in a Total Quality Management Environment
(Chicago: American College of Healthcare Executives,
1993),
Ethical Considerations in the Business Aspects of Health
Care Woodstock Theological Center Seminar in Business
Ethics
Georgetown University Press, 1995,
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