The Teaching Hospital

THE TEACHING HOSPITAL

TABLE OF CONTENTS                                                                      PAGE

I. POINT OF VIEW                . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        3

II. SYNOPSIS                        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        3

III. ANALYSIS OF THE CASE SITUATION    . . . . . . . . . . . . . . . . . . . . . . . . .        3

A. Company Analysis     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        3

B. Relevant Case Facts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        5

IV. PROBLEM ANALYSIS                . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        6        

V. PROBLEM STATEMENT        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        7

VI. SWOT ANALYSIS        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          7

A. STRENGTHS        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        7

B. WEAKNESSES        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          8

C. OPPORTUNITIES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         8

D. THREATS        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         8

VII. FORMULATION OF EVALUATION OF

ALTERNATIVE SOLUTION TO THE PROBLEM        . . . . . . . . . . . . . . . . .        8

VIII. DECISION / RECOMMENDATION         . . . . . . . . . . . . . . . . . . . . . . . . . . . .        12

IX. IMPLEMENTATION        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         13

X. CONTINGENCY                . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        13

XI. OB CONCEPTS REFLECTED IN THIS CASE        . . . . . . . . . . . . . . . . . . . . . . .        13

I.POINT OF VIEW

                In this case, our group deemed to use the point of view of the Provost – who is in the top of the two institutions – the Teaching Hospital and the Medical School. Provost should be the one who presides with regards to the institutions’ development.

II. SYNOPSIS

                Renal Medical Unit at a large university medical school and teaching hospital was considered a reasonably prestigious medical facility.  There was a steady undercurrent hostility and competition between the two institutions.  The unusual nature of financial arrangements, serious lack of coordination in the integration of medical school facilty into hospital functions, is some of the predicaments.

The National Institutes of Health (NIH) supported Dr. Uric with several federal grants to do research on kidney transplantation. In the research Dr. Uric discovered a fluid that could keep the cut stem end from closing.

According to the grant agreement, Uric reported his discovery to NIH. NIH officials did not want it. Uric sold the fluid to a big nursery-supply manufacturer, the firm named it Flower Life, and began mass-producing. NIH regretted and filed suit at a sudden, the story was widely spread across the nation on newspapers.

The faculty concerned the story would make a bad influence on the reputation of the school, and Uric was moved to another new unit.

From here, several drawbacks arise.

III. ANALYSIS OF THE CASE SITUATION

                Upon discussing the case, we have gotten a clear picture of the essential contents of the study.  Each analysis has the relevant theory and course concepts.

A.  COMPANY ANALYSIS

                This incorporates basic company information; moreover, it looks into the company’s goods and services.

• The teaching hospital had over 1,000 beds and was considered a reasonably prestigious medical facility.
• The two institutions, a state school and a state-supported hospital, had only one top official in common – the provost.
• The physical plant, designed in the shape of an H, paralleled and accentuated the organizational structure.
• The Renal Medicine Unit at the teaching hospital, like many other renal units, received what might be termed“stepchild”treatment, banished to a subbasement where most of the other faculty and staff could avoid the painful realities of chronic kidney patients.

Teaching Hospital

• Ran east-west, eight stories high on the south
• Received what might be termed“stepchild”treatment, banished to a subbasement where most of the other faculty and staff could avoid the painful realities of chronic kidney patients.
• State-supported hospital.

Medical School

• Ran east-west, ten floors high on the north side
• State school

                Concurrently, in this case, we define the context, introduced the key players, cite significant events, which have bearing on how the case unfolds.   Hence we present the:

B.  RELEVANT CASE FACTS

        People involved:

• Dr. Robert Uric

• He is the head of the renal unit, was very courteous to his unit. He shares monies with the hospital employees in his units whenever ppossible.
• He treats the hospital renal unit as his home and favorite child.
• For a research physician, he was completely too involved with his patients. And crying when his patients died – most uunprofessional.
• After all, Dr. Uric was still a fine director of renal medicine and a remarkable teacher.

• Dr. George Conrad

• He was born and raised in very poor surroundings
• He had a reputation of being a Hard-nosed.
• He had gone to medical school at a smaller university and had been very happy to get an internship and residency at a large teaching hospital.
• He isan extremely bright and an extraordinary dedicated young man based on his grades and aptitude tests.
• As per on thereference letters, it reveals that he is inflexible and rather ruthless.
• He had an image of the physician as being wise, aloof, self-controlled, and as close to infallible as a person can get.

        Significant Events:

• Dr. Uric’s involved in different issues such as:

• Given a ticket for speeding down one of the steep campus hills on his bicycle
• Friday afternoon parties stimulated with grain alcohol and fruit punch
• Monthly roasted rabbit – the experimental animals were put on death painlessly whenever the transplants were not successful. And the barbeques it over a pair of Bunsen burners.

• Dr. Uric discovered a fluid that absorbed much faster than water at the cellular level.
• National Institutes of Health (NIH) did not acceptDr. Uric's as he reported his discovery to NIH which required by the grant agreement.
• He offered the fluid with the University since they have the ownership of the discovery of Dr. Uric but they refused to accept it and said he could keep it.
• Since Dr. Uric is not a kind of man who easily discouraged, he offered his discovery to a large nursery-supply manufacturer.
• The firm bought the fluid, named it "Flower Life" and began making millions.
• NIH had a changed of heart and filed a suit.
• The committee establishes a new research chair in medicine and offered it to Dr. Uric. He refused to accept it first but he realized that he would have to help out by surrounding himself with an air of respectability.
• Dr. George Conrad was placed in charge of the dialysis unit.

IV. PROBLEM ANALYSIS

                Each analysis of the problem should be supported by facts given in the case.  Here, it is important to search for the underlying problems.

• There has been a steady undercurrent of hostility and competition between the hospital and medical school.
• A large part of the problem was the unusual nature of the financial arrangements.
• Patients were billed for professional services, but the revenues went into departmental funds which were disbursed at the discretion of the department chair.
• Grant monies further complicated the situation.  Hospital employees were civil service workers, strictly regulated by job classifications and wage scales; no exceptions were made. The medical school faculty, however, could frequently use grant money to supplement state salary scale, to hire people outright at higher salaries, or to provide nonsalary perquisites.
• Because of the financial flexibility, working conditions were also frequently better on the medical school side, and medical school staff had money for more equipment, more travel, and even more parties.
• The inconsistencies between the operations of the hospital and those of the medical school were highlighted by the integration of medical school faculty into hospital functions.
• Situation was aggravated by the reports of technicians.
• The dual reporting relationship left the employees in a situation of very divided responsibilities.
• The hospital personnel complained that physicians were prima donnas, who considered themselves the next best thing to being divine.
• U ric and his peculiarities were no longer a private joke, and the faculty became concerned about the reputation of the school.
• Serious personnel problems arose in the dialysis unit, with increased absences and constant grievances about impossible working conditions.
• While these complaints were pouring into the hospital personnel office through grievance procedures, few or no messages were coming through to the executive committee or the dean.
• By the end of the first month the turnovers had started.  Dr. Conrad did not believe in becoming involved with patients on a personal basis, and he appeared to feel the same way about subordinates. Interns on rotation through renal medicine complained bitterly about Conrad’s attitude toward and treatment of them; the roster of residents applying to the service dropped dramatically.

V. PROBLEM STATEMENT

                So as we epmphasize the predicament, we have come up with a problem statement: “What should management do to have an efficient network of communication within the organizational structure? How can the hospital personnel be effectively motivated?”