Introduction
Dr. Karen Buhr, PhD is the newly appointed Chief Operating Officer of Bellevue Hospital; a large, a not-for-profit hospital located in New York City. After two weeks of working in the public sector, she misses the benefits of a seemingly endless cash flow available when working in a world renowned, private academic hospital. Bellevue Hospital has been in deficit for the past two years and patient satisfaction regarding care is at an all-time low. Her first task is to develop and implement cost saving measures for the clinical services provided. She has met with clinical and administrative leaders to identify potential savings and other opportunities for improvement. However, she has hit a road block. How
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Historically, Bellevue is a pioneer in the realms of public health, medical science and education. The hospital is home to the nation’s first maternity ward, nursing school, ambulance service and the more recent establishment of the first cardiac catheterization laboratory, dedicated unit for alcoholics and first cardiopulmonary laboratory. Originally founded in an unsettled section of Manhattan two miles north of Wall Street, the hospital began as a six bed infirmary used to quarantine the sick. Today, the hospital comprises of a 25-story facility consisting of 861 general medical and 339 psychiatric beds.
Bellevue’s mission statement is, “To provide high-quality, comprehensive health services to all New Yorkers, regardless of the ability to pay” (nyc.gov). The vision statement for Bellevue is, “To be a patient-centered, acute care facility in support of primary care initiatives” (nyc.gov). In order to fulfill both the mission and vision statements, the Health and Hospital’s Corporation has established the “Six Guiding Principles” upon which each staff member is to base their actions upon: keep patients first, keep everyone safe, work together, pursue excellence, manage resources, and keep learning. (nyc.gov)
Bellevue is the major safety net provider to New York City areas including Southern Manhattan, Northern Brooklyn, and Western Queens. The age range of the patients served is evenly distributed. Hispanics and blacks
In 1997 University of California, San Francisco (UCSF) merged its two public hospitals with Stanford’s two private hospitals. The two separate entities merged together to create a not-for-profit organization titled UCSF Stanford Health Care. The merger between the health systems at UCSF and Stanford seemed like a good idea due to the similar missions, proximity of institutions, increased financial pressure with cutbacks in Medicare reimbursements followed by a dramatic increase in managed care organizations. The first year UCSF Stanford Health Care produced a profit of $22 million, however three years later the health system had lost a total of $176 million (“UCSF-Stanford Merger,” n.d.). The first part of this paper will address reasons
Since most specialty procedures are inpatient services, EMC’s inpatient occupancy rate suffers. The occupancy rate for Emanuel Medical Center – fifty percent – is far below that of its competitors and industry benchmarks. To accompany this, EMC (on average) receives a lower reimbursement for in-patient Medicare services per patient seen in comparison to its competitors. A result such as this is correlated with directly to the fewer amount of specialty services that EMC offers. In order for Emanuel Medical Center to be able to compete with other hospitals in its service area, it is imperative that EMC evaluates what services they currently offer and are capable to offer in the future to add value to the hospital, increase its revenue stream, and expand its patient mix. Currently, Emanuel Medical Center has not succumbed to its increasing financial pressurealthough EMC has had a negative operating income for five straight years. A negative operating income places EMC at a disadvantage because it limits the hospitals ability to renovate its aging building or hire new specialists to offer revenue enhancing procedures. EMC’s competitors, on the other hand, have large sources of revenue due to their mergers with large healthcare networks such as Catholic Healthcare West. Another competitor, Kaiser Permanente Modesto Medical Center, has extremely large financial resources due to the fact
This week’s case looks at the critical situation occurring at Riverview Regional Medical Center located in Etowah County, Alabama. The medical center, located near a strong competitor, is run by a veteran in the hospital management market, Mr Matt Hayes. Hayes is actively in the process of developing new ideas and revolutionary steps in an attempt to remain competitive in the market and regain profitability. The overall performance of Riverview Regional Medical Center appears to have decreased throughout multiple departments except outpatient surgical procedures, outpatient CT imagining, MRI imagining and inpatient MRI scans.
Bellevue hospital has changed since the 1980’s to now with the result of new ethical and legal laws and regulations put into place to protect the organization, patients and staff.
Ellen Zane had her work cut out for her at Tufts-NEMC. The Tufts University affiliated teaching and research hospital had long been on the decline. It was mired in financial difficulty, was falling behind other teaching and research AMCs, and was not effectively serving its local community. Beginning on the day she accepted her position as CEO, Ellen Zane started on a path of reform. Upon learning that the hospital only had 10 months of cash on hand, she began brainstorming on how to make the hospital financially viable, starting by meeting payroll needs first. She discovered that Tufts-NEMC was being drastically underpaid and began looking for solutions to the problem of reimbursements. One of the more
In the Harvard Business School case study of Intermountain Health Care (IHC), we learned about the efforts made by IHC to adopt a new strategy for managing health care delivery that is focused on improving care quality while simultaneously saving money. Beginning in 1986 as a series of experiments tying cost outcomes to traditional clinical trials, IHC’s approach to delivering care became known as “Clinical Integration” which “referred to both an organizational structure and a set of tools” (Bohmer, 2002). The organizational structure required a departure from the traditional administrative management model to one that “involved administrative and medical
The health care system in the United States is known for being one of the most costly systems in the world. In 2010 the Affordable Care Act, (ACA) was implemented with the hopes of reshaping the system and decreasing the healthcare cost, (Mason, Gardner, Outlaw, O’Grady, 2016). . Somewhere along the way our country made healthcare a business. Understandings our country healthcare finances can be quit complex. In order to be successful the Chief Nursing Officer, (CNO), business owners and directors must understand the business principles. These individuals are placed in leadership role and therefore must have the characteristics of a leader, (Huber, 2014)
When I just looked at the title of this book “If Disney Ran Your Hospital 9 1/2 Things You Would Do Differently”, I was pretty skeptical. “No way. A hospital is neither a fun place nor entertainment. We deal with lives. Responsibility is huge.” But, Mr. Fred Lee, the author of this book, was very well aware of that. He hit every single point I wanted to argue. Going to read the book, a lot of relevant memories came up in my mind since I had worked for a hospital for a long time. I was convinced that Disney’s approach to quality improvement is applicable to hospital management. Out of 9 1/2 things, I would like to talk about three actions that left marks on me with my experience: service vs. experience, rewards to motivate people and closing the gap between knowing and doing.
This hospital is a 65-bed rural hospital but it is the job of every hospital to give the best patient care possible. With a
Without strategic planning, several things can go wrong including missing out on great opportunities. Strategic planning is an organization’s outline to help achieve its purpose. Although strategic planning begins at the top of the pyramid, it is more effective when it is carry out as a whole among other in the organization. Having a good internal control system in place protects an organization from high risk, fraud, and more. Jackson Memorial Hospital has several weaknesses which are similar to its competitors and other health care organizations. For instance, Mount Sinai Medical Center one of Jackson Memorial’s competitors, encountered lack of strategic planning that led to many issues such as with readmissions, surgical complications,
Patients want and expect to receive high quality care. Nurses want to provide the best care possible to their patients and like everybody else; want a pleasing job environment. Hospitals, on the other hand, are expected to provide a safe environment to patients, have enough nursing staff and remain profitable (Keller, Dulle, Kwiecinski, Altimier & Owens, 2013). The ultimate goal is to improve quality of care and patient safety across the United States; therefore, all the different interests of these major stakeholders should be taken into
The healthcare system in America started as a predominantly volunteer system where patients were required to pay little to nothing for treatment. Since it began, the healthcare industry has seen tremendous changes that have transformed it into a business entity which has operations like financial management, strategic planning and functional specialties to keep the industry viable. The industry is one of the largest in the country employing 15 million people with a projected increase of jobs with 3 million jobs annually. As the healthcare industry continues growing, services and personnel are changing, and various dynamics are coming into play to accommodate changes (Smith, Saunders, Stuckhardt, & McGinnis, 2013).
Here at Superior Hospital, our foresight for the future is clear-cut in that we strive to become an elite hospital. This new strategic plan guides our organization each step of the way. The last year has been insightful as we’ve acquired and secured a deeper understanding of what it takes to flourish in the healthcare industry in the years to come. Our strategic plan has been constructed based on what we have learned and will direct our success. While this plan is our turn north star, it is influenced by our vision that has driven us since inception -To be the healthcare provider of choice for patients, families, employees, physicians, and shareholders by providing high quality, cost effective care in the areas we serve. This plan will afford
Fixing problems that face health care in many health facilities demand a system wide set of solutions. The systems used in these facilities must be assessed and redesigned to identify factors that will aid in the achievement of the set goals. The enormous task of achieving the goals should be undertaken collaboratively by all the key stakeholders, who include, health care professionals, planners and policy makers, administrators, payers, and patients and their families. These partnerships must begin with a common understanding of the problems together with a shared commitment to cooperate and work together to eliminate the problems. With this knowledge, therefore, an action plan for redesigning the health care system can be developed and later implemented. For a successful health care service to be realized, there are various factors which should be employed and which are not found in the traditional business setting. These include unique economic processes, proper regulatory requirements and the perfect quality indicators. This creates a need for every leader within the healthcare industry to create or develop unique skill sets that will harmonize both organizational leadership and the inter-professional team development. It is, therefore, important to understand the comprehensive approach to the management of patient care and also how the concepts of team development and organizational leadership support healthcare leaders in creation of a patient-centric
As performance improvement goals are reached, new financial opportunities are analyzed to help the governance board make financial arrangements. Additionally, a finance system provides an arc of safety “to protect assets and resources from theft, waste, loss and distortion” (White and Griffith 415). With this knowledge, it is important for each department to account for their expenses to keep the HCO in the positive financially. This takes time and effort to research, analyze, and forecast where funds should be allocated in the present and future. All stakeholders, including clinical professions, Chief Executive Officers (CEO), Chief Operating Officer (COO), and Chief Financial Officer (CFO), administration, governance board, and community play a role in balancing the financial