Executive Decision

A hospital is a difficult place to run because there so many aspects to manage. There are many types of doctors and nurses, and so many departments in this type of facility. The patients come in a wide variety of different ailments, needs, colors, sizes, personalities, and beliefs. Not to mention, with all of the equipment, devices, and people coming and going a hospital can seem like a small town in itself. That is why it will take a group effort, open communication, and positive reinforcement to keep it running smoothly. I will address this case study by identifying each problem, advise an adequate solution for each problem, and give a reason for each solution.

The first problem starts from the top where the stakeholder groups have different interpretations of the mission statement. This makes it difficult to determine how many of our stakeholders realize or understand the differences between ethics, laws, beliefs, oaths, etc. The American Heritage dictionary expounds on ethics as being the study of general nature of morals and of specific moral choices. In like manner, the definition of laws is rules of conduct established by custom, agreement, or authority. Beliefs are also explained to be a conviction or opinion. Lastly, oaths are formal promises to fulfill a pledge often calling on God as a witness. If they do understand, how many accept the fact that we draw our value lines at diverse junctures when it comes to applying these ground rules? This problem could be cleared up by having the CEO calling a meeting of the stakeholder groups and discuss the mission statement, distinguish the definitions of policy according what benefits the hospital, not one's own interpretation of how they apply as a commencement to getting everyone on the same page. It is important that everyone is working together respectfully and the CEO has their support.

Some patients refuse to take certain medical services, and some staff members refuse to provide certain services. In both cases, they feel that medical intervention can go too far into conflict with their religious beliefs or personal moral convictions. The hospital can not make patients take medical services, but we can control the employees. The patients will be advised to take the recommended medical service and if they refuse it will be their choice. No employee should be allowed to act upon his or her own beliefs. Instead, at a formal meeting addressing all problems, there should be a base definition of these beliefs that simply state a common rule all can follow with a gray area if needed. None the less, a job is to be done according to hospital rules and regulations. Following the proper chain of command should put perspectives in order whether or not in agreement. Employees refusing to do their jobs will be subject to termination. This should allow the staff to evaluate their position and help to eliminate this problem.

Child Protective Services (CPS) is in the process of taking custody of a baby and threatening to file charges against the hospital because of the way they provided services or failed to provide services. This is happening despite the hospital being in agreement with the parent's wishes. In America, anybody can sue over any circumstance, so unfortunately this type of offensive reaction is inevitable. The best action the CEO can do is address the situation with a meeting including all of the department heads and make sure every doctor and nurse have all of the appropriate paper work signed before any procedure is done. In addition to that all doctors and nurses should double check with an appropriate signature of the doctor in charge with a witness before implementation of the procedure. This should only take a few minutes and could cut down the number of wrong site surgeries and potential law suits.

Staff members in the Intensive Care Unit (ICU) initiated Do Not Resuscitate (DNR) directives even though there were no written orders to do so. And the hospital has staff members who do not follow DNR directives even though they were in place. Then the hospital has some sincere, qualified staff members that are driven by their personal directives that say, 'we have to do all that we can.' First the CEO needs to have forms signed by all staff members stating the hospital's policy and if they do not follow by them they will be terminated and the hospital will press charges. It needs to be clear how important these rules are and that the hospital will not tolerate staff members not following them, because they are too important.

Poor communication between patients, doctors, nurses, and filing proper forms is leading to chaotic situations for the hospital, which also is causing communication breakdown to the CEO which may cause the stakeholders to decide to shut down Faith or cut back on certain services or jobs. The CEO needs to implement a Root Cause Analysis (RCA) to get to the root of why there is poor communication between the patients, doctors, and nurses. A RCA is a problem solving method used to identify the root cause of problems or events. Once the root problems are identified then the CEO and the department heads can come up with ways to avoid the problems in the future. This will save time and money.

The CEO does not know how the doctors are responding to all of the problems because there are various interpretations of the Hippocratic Oath and different opinions regarding a patient's right to die. The CEO believes the doctors are experiencing a loss of power because of managed care and capitation. The CEO needs to know how the doctors in the hospital are responding to all of the problems and he can do this by having an open door policy for the doctors to come

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