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Critical Thinking Case Study

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Critical Thinking Case Study

"I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant:

To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but no one else.

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art. I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.

Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves. What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.

If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot." (Translation from the Greek by Ludwig Edelstein. From The Hippocratic Oath: Text, Translation, and Interpretation, by Ludwig Edelstein. Baltimore: Johns Hopkins Press, 1943.)

This case study is based on the University of Phoenix Material "Let It Pour: My First Assignment as Executive Assistant". This case study will identify the problems and their impact, possible solutions and their impact and finally, a clear solution and its feasibility. The problems that found have been divided into three categories, Organizational, Ethical, and Communication.

Pat is the CEO of Faith Community Hospital (FCH). He is faced with a mired of problems that seem to be pulling him in 20 different directions at the same time. At his level, he is very much overwhelmed as to where to begin, and how to handle each situation. Each problem has its own set of consequences that Pat would like to avoid at all cost. He ultimate goal is to bring some type of resolution to these problems while at the same time, satisfy all the needs and concerns of all parties involved, i.e. patients, board members and the community.

Organizational issues are the first key problem area. FCH like most hospitals has many departments, however, when a department begins to run itself as if autonomous to FCH that will pose problem. Pharmacist filling uninsured prescriptions on a payment plan type system and counselors doing pro-bono work that is unauthorized. This in fact will give patients a false sense of comfort and thinking that this is common FCH practice. The fact that the diversity of the board members who all have their own interpretation of the laws, ethics and belief system, this hinders the overall performance of FCH if the board of directors are all not on the same page.

The regulatory agencies, insurance companies, and managed care companies how they indirectly control the rendering of healthcare from a financial aspect. All these companies have a vested interest in those who seek healthcare. These companies charge its customers increasing high premiums, while only reimbursing the doctor a percentage of the billable amount. At the same time, the insurance company or managed care organization profits for it all. In essence the cost of the treatment does not always fit the scope of the treatment, for example, if hospitalized, two aspirin may cost you $10. These financial implications adversely affect the performance of FCH. While looking at financial information, FCH cost do not flex proportionally with the number of patients that are treated. If the current trend continues then the fixed cost of FCH, which is about 28%, will have to be reduced by 15% just for FCH to break even. This cut in fixed cost may result is discontinuing certain services or a reduction in force either way the patient or the FCH loose.

There are two solutions to these organizational problems. In relation to staff and its autonomous practices, FCH management needs to be more proactive in the enforcement and compliance of its policies and procedures in the nature of doing business as a hospital. A tough pill to swallow, (no pun intended), is understanding that while providing medical services FCH is still a business that has monthly, quarterly, and annual financial responsibilities that is must meet in order to stay in business. Stressing that interdepartmental autonomous behavior negates the FCH business plan. This needs to be disseminated from upper-management so that there is a clear understanding of the big picture by all those staff members that are involved. This in-turn let's FCH conduct business in a professional manner, patients are fully aware of what is expected of them financially "payment is due when services are rendered".

Realizing that the FCH board members are composed of a diverse group of people, there still needs to be cohesive thought process when it comes to the administration of FCH. Keeping in mind that groupthink is not what we are looking for. FCH board members, keeping in mind its financial concerns as well its role in serving the community. FCH should offer more services such as Emergency services; this will directly affect its patient count and patient days, which directly influences FCH's P&L in a positive direction. Insuring that by offering more services the quality of rendering healthcare is not jeopardized, by overworking current staff. Also keeping in mind that by exercising "Lean Management" where FCH over head is kept at an efficient yet optimal level, minimizing waste of staff which relates to waste of money.

A back end problem for Pat is Healthcare reform. One CEO cannot make that much of a difference on the local level. Pat should not focus on reforming healthcare but reforming the healthcare fight. This will keep him focused on find ways



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