Healthcare Case Study
Liberty also invested in education and information about “home treatment” to aid minor Illnesses and injuries to begin treatment without the need of a physician. However, although Liberty had managed to successfully survive with this structure, the medical setting and patient satisfaction had begun to negatively impact ELM both internally and externally. Among the internal factors ELM currently faced was the recruiting of new physicians.
Before Dry. Townsend was appointed as the new CEO of the organization, a few changes In policy caused a decline in the comparability of the ELM physicians.
These changes shifted the way in which health care was delivered to a team based system that heavily relied on Naps, Pat’s, health educators and support staff which meant less Physician-patient interaction. This new policy also brought about a change In the way physicians were being compensated. With the new policy in place, physicians were given two options; they were required to either increase their workweek by half a day with no pay increase or they could have accepted a decrease in their current salary.
These policy changes obviously created a negative Impact on the physicians of the organization, which demonstrated hat the exposure staff was “Isolated” from the realities of the dally medical practices. Another internal issue affecting the organization was its communication. Many physician were beginning to feel excluded from the decision making process when issues worsened regarding physician-patient relationships, In which there was a decrease In morale amongst the physicians and staff, attending meetings, tensions between labor management arose, and the deficiency of service orientation among the staff.
Liberty experiences external/competitive issues as well. ELM was located in Pennsylvania, where health care premiums are 15% below the rest of the nation. During the 1992 recession, employers sought strategies for managing health care costs for their employees.
Some employers reduced their healthcare costs by restricting benefits or increasing the employees’ co-payments, meaning that Liberties price advantage was almost non-existent. Another external Issue Liberty faced the challenge of satisfying many of their “new” patients.
Although Liberty had succeeded in being a physician-centered organization, many patients did not see this as satisfactory. All of the offices and staff were owned by ELM enabling physicians to private practice. Although many enjoyed this, patients weren’t as satisfied when they were required to wait long periods of time being seen by a physician or being scheduled to see a physician.
Therefore, some patients would rather Walt one or two hours to see a physician in private practice rather than a week or two to be attended. OFF Littered also Tacit ten canalling AT winter AT not teen could nave implemental t physician-centered approach to medicine while remaining competitive in the new health care world. Liberty competitors have successfully driven costs down by utilizing gatekeepers, which provided financial incentives for physicians to restrict care or choose low cost treatments. 2. Identify and briefly discuss at least 4 major managerial challenges facing Dry.
Townsend at ELM. Staffing: Due to the changes in their policy, the overall satisfaction of the ELM physicians have declined and it has become more difficult to recruit physicians for the organization.
Therefore, Dry. Townsend will have to find a way to retain his current physicians and attract new physicians to be employed within the organization. Leading: As the new CEO of ELM, Dry. Townsend will be in charge of mandating employees.
Dry. Townsend will need to be authoritative, but in doing so, he must motivate his employees, both physicians and staff by example and aiding them with any problems/challenges that arise within staff, and the organizational as a whole. Strategic Planning: Due to the current issues, both internally and externally, the organization is facing, Dry.
Townsend is challenged to prepare an action plan to implement the proposed strategy needed to restore the organization back to financial health and improve the morale among the physicians and support staff. Another course of planning Dry.
Townsend will challenge is the organizations old structure into a way that all patients will be satisfied. Financial Management: Since the broader healthcare environment was undergoing great changes, Liberty price advantage was deteriorating, as was their level of service. Hence the need retain their price advantage and complete on quality and service.
Customer Service: Because of the size ELM holds, many patients in the communities it served had “horror stories”. Patients who did not have a sever case at the time would have to wait long periods of time before they can be seen and attended by a hysteria, and would see any physician that would be available enabling the physician-patient relationship many patients like to build for trust.
3. Based on the managerial challenges you identified what should Downtrend’s top 2 priorities be during his first 90 days? Be specific. During his first 90 days as the new CEO to ELM, Dry.
Townsend should put emphasis on both, internal and external, issues the organization is facing. He should conduct the necessary research to gain a better understanding of what are the top internal issues as well as the top external issues, while also facing any problems that may arise.
In gaining a thorough understanding of the organization’s issues, Dry. Townsend will be able to implement a strategy to restore the organizations financial health, as well as improve its environment between the staff and physicians and improve on providing better customer service.
One of his top priories should be to develop a better model to serve the organizations patients in a way that every patient that is served by the organization is satisfied. Dry. Townsend should restructure the organization to ensure that the executives do not implement policies that will conflict with the physicians’ interest.
There should be constant communication with physicians, support and administrative staff, which would improve the morale of the internal environment. In regards to the organizations financial health, it will definitely take more than 90 days to resolve these issues.
However, it should also be a priority because the organization needs to be financially stable to continue operating and serving the community. 4. Evolve Dry.
Loneness on ten steps en wall need to take to Implement ten new strategy. How should he manage the process of change? Outline a short plan for him to use. Firstly, Dry. Townsend will need to review the organization’s mission statement and determine if it has to be revised in order to comply with his strategy. Making revisions to the mission statement and the values of the organization will help Dry.
Townsend in informing the physicians and staff of the new objectives stated for the organization, in which they would have to follow through. He can also inform them before the revision of the statement is finalized to keep open communication with the staff, making them feel as part of the organization. After the revision of the mission statement, Dry. Townsend can set goals for the new strategy. These goals can be assured in forms of surveys, to both staff members and patients in order to determine whether the new strategy if functioning as desired.
The implementation of the new strategy may also involve training in order to properly educate the organization as a whole as to what the new objectives for the organization will be.
Advise Dry. Townsend as to the questions he should expect the board to ask when he presents his recommendation for the new strategy. Cite at least 5 questions specific to his recommendation. Due to the long, successful history of ELM, Dry. Townsend should expect many challenging questions regarding his new strategy for the organization.
Some of the questions he may expect could include: 1 .
How capable are we in changing the 60-year-old tradition of providing low costs to now serve our patients based on quality and insurance? 2. What would happen if physicians are reluctant to give up their autonomy? 3. How can you ensure that patients who have been served by ELM for a long period of time will continue with our services despite the changes that are taking place? 4. Since we are experiencing a financial issue at the moment, how much will this new strategy cost the organization?
Do we have sufficient funds to invest in your recommendation? 5. Due to the risks that the implementation of changing from a low cost organization to an organization based on quality and service, would you be able to provide an alternative recommendation, in the case of it being unsuccessful? 5.
Advise Dry. Townsend what kind of resistance will ELM likely face from its physicians in requiring the use of evidence-based protocols and measuring physician quality. Cite at least 4 objections by the physicians he should reasonable expect to hear.
ELM has a history of high quality service, mainly due to the freedom exercised by physicians and the policies that permits the efficient provider action. In an attempt to increase service and quality, Dry.
Townsend must contemplate the implementation of evidence-based protocol in hopes of satisfying patient’s desire to a more personable experience by adapting the protocols utilized by its competitors. This may cause resistance among the physicians, in which Dry. Townsend should expect to hear objections such as: 1.
If limitations are placed on our discretion, the high standard of quality the hospital is historically known for will diminish. 2. Transitioning into a system that is more providing personal physicians for patients will increase our workload tremendously.
3. If indeed, a personal physician system is implemented, patients will seek unnecessary treatment from their physicians which will also overwhelm the scheduling of patients and affect the healthcare enema Dye tense won actually need urgent care 6. Want can Alms management do to facilitate acceptance of these programs? I. E. , how can you get “buy-in” from the clinicians? ) Identify at least 3 actions that can be taken.
Due to the occurring changes in the healthcare environment, hospitals, as well as insurance companies, must make modifications to their structure in order to meet the patients’ needs and keep up with hangers in the broader market. Adapting to these changes may become a difficult task to a majority of the organization, especially its providers of whom provide the majority of the services the organization offer.
However, the organization must find the balance between the demands and needs of its internal and external environment. A few actions Dry. Townsend can implement to facilitate the acceptance of the changes and programs to physicians could be: 1 .
Assigning competent physicians to act as leaders. The chosen physicians lead other physicians in learning ND training of new changes taking place within the organization. There can also be a reward involved to physicians and staff, which should be determined depending on the outcome of the new programs. 2. Keeping open communication to all staff.
Management should reduce their staffs’ uncertainties by informing them of all decisions that have been agreed upon. In providing constant communication, management will be instilling trust in their staff, in which they would feel they are being heard and their voice counts. 3. Management should also allow their staff to be present in their organization. By this, management should address their negative aspects of the changes being implemented and possibly provide any alternatives for these fears, or explain in detail as to why these changes will be beneficial for the organization.
One of the concerns is the incentive that will be provided to the physicians. How will these changes affect them, and if they do affect them negatively, what positive incentives will be provided to them? * Physicians may also feel as though their time is being used improperly, and their workload will double due to the increased number of patients they will be seeing. * Also the Hessians may feel as though the quality of care is not its best due to the high flow of new patients, and protocols they must follow 7. Dry.
Townsend asks you to develop a formal quality improvement for the medical group. Briefly describe the steps you would recommend to implement the program.
To identify any course of action, whether positive or negative, there must be a review system in place, in which any action can be documented and analyzed. This system will serve as an ongoing monitoring and evaluating tool for organization in terms of improving the organizations quality, both clinically and operationally. A few steps in developing a formal quality improvement system include: 4.
Identifying the organizations current model: Identifying Alms current model to handle cases they deal with on a daily basis will help in finding the root cause of these problems, and how they can be approached at differently. For example, although long term members of ELM are used to, and happy with the way the organization is structured, side effect have shown that new comers don’t seem to be as content.
5. Relate outcomes in terms of procedures and patients: Once the approach to handle these situations is identified, he organizations management can relate the outcomes of procedures and patients.
This may be done by the use of electronic records, which will also help in obtaining statistical analysis. 6. How much will it cost? : Once the organizations management nave Intentional ten course AT octagons Tanat teen wall take, teen may run a Atlanta analysis in order to determine which quality improvement model/approach will best suit their organization and be within their budget.
8. What key financial management and control functions should Dry. Townsend ensure are in place at ELM? Describe them briefly. As the CEO of ELM, Dry.
Townsend should work towards creating an accountability measurement that will include budgeting, managing and controlling of funds, and measuring the organizations performance. In working towards budgeting, Dry.
Townsend can aid in determining the needs of each department financially and be able to allocate the appropriate funds to them, while also monitoring their use of financial resources. Dry. Townsend should also ensure that any activities that are associated or affect the organization are being managed and controlled appropriately, which can be assessed through analysis of ratios, timed reports, profits, etc. Lastly, Dry.
Townsend should be able to measure the finances of the organization by measuring inputs, outputs and outcomes and be able to determine corrective action if necessary. 9.
Assume the goal of being the leader in quality health care requires ELM to implement a system of electronic health records (ERR). Advise Townsend as to the managerial challenges that should be anticipated with an adoption of the new information system. Cite at least 3 challenges. The implementation of a new information system can be extremely complicated and time- consuming, not only for the decision makers of the organization, but for their staff as ell.
One major challenge that organizations face with Errs is establishing security.
With an electronic records system, every staff member of the organization will have access to countless data. Therefore, the organization will need to establish policies and procedures regarding handling all of the sensitive data staff now have access to. Another security issue includes creating a firewall in order to prevent hackers from accessing the patients’ data. A second challenge that may occur with establishing an electronic records system is training.
It will be challenging enough to establish raining schedules in which all required staff members who will use the system receive their appropriate training.
During the training on how to use the ERR, staff will also need to be trained on HAIFA in order to ensure that they fully understand the privacy requirements that come along with the electronic records system. Lastly, it can be a major challenge to convert all of the organization’s paper medical records to electronic medical records. Management of the organization will have to decide who will be in charge of transmitting all of the paper records into the new electronic yester.
Will they train staff on how this will be done, or will they hire new staff members for the task? With either decision, it will be costly for the organization because if they choose to have their own staff members transmit the records; they will have to train them properly and will also be taking them away from their current responsibilities. On the other hand, if they choose to recruit externally, they will have to provide these new hires with new hire training, which will add costs to the organization, including salaries and benefits, aside from the cost of the software itself.