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Critical Thinking Case Study

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Autor:  anton  24 November 2010
Tags:  Critical,  Thinking
Words: 2365   |   Pages: 10
Views: 433

Introduction

Just starting a new position as executive assistant, working directly for the CEO of Faith Community Hospital I receive

my first assignment as executive assistant. I am charged with solving specific problems, delivering the solutions and describing my rationale for my proposed solutions, my boss, the CEO of the Faith Community Hospital is requiring the information next Monday. In my following report I will take steps to identify the problems and to solve each of the problems described using the critical thinking skills I have learned at the University of Phoenix. I will be using my decision making skills along with a brainstorming technique to help me solve these problems. The two problems that I have identified are as follows: The first problem I have identified to solve is the moral and ethical differences our practitioners have towards administering care to patients resulting in different levels of care provided by different practitioners. The second problem that I have identified is our increased costs per patient. I need to brainstorm what we can do to reduce or avoid the potential continuing increased costs.

Critical Thinking Case Study

To begin, I need to study the problems thoroughly and efficiently. Then I will need to isolate each of the problems that the CEO and I discussed in the meeting. I will need to analyze each problem and evaluate alternatives for each problem. After that is done, I will make recommendations with corrective actions prepared for the CEO by Monday.

In my CEO’s assignment I have identified the two separate problems and I will be evaluating them each independently.

Problem #1

First, I have to identify the problem. The hospital and regulators are seeing inconsistent decisions that are implemented for the patients based on the particular doctors' or nurses morals, and ethical beliefs. As the CEO said "On one hand, we have particular patients who refuse to take certain medical services, and on the other hand, particular staff members who refuse to provide certain services." The doctors are not following any set standards for issuing care for our patients. This problem needs to be immediately rectified.

To solve this issue I need to break down the problem into its different elements. I have identified the problem, now I have to define the goals.

Goals

The goals that we need to accomplish are to have each practitioner administer consistent care for our patients regardless of personal morals and ethics. We also need to make sure that no patient is refused care, regardless of the doctors' beliefs, medical coverage or lack of coverage. Now that goals have been identified we need determine what effect this problem is having on our patient service level.

Effects of the Problem

We have four separate effects of our problem. The first effect is the negative media coverage that hospitals are receiving due to inconsistent care. This is a problem that is connected to our own doctors' and nurse ethical, personal and moral beliefs. This a major factor that hospital are allow 100,000 patients die each year from care related issues in our nation's hospitals.

Second, if we are refusing care to patients due to lack of medical insurance, we are in violation of non-profit laws requiring lifesaving care to all patients. This could result in criminal charges against board members and individual practitioners. This could also result in negative media coverage of hospital policies.

A third effect of the problem is that outside agencies may become more involve in day-to-day operations of the hospital by enforcing federal standards of healthcare. They will become harder to work with. Negative media attention could also force agencies such as Child protective Services (CPS) to not bring their cases to our hospital if they and the public think that we will not treat patients to their liking or direction. We currently have a case where "Child Protective Services is in the process of taking custody of a baby and threatening to file charges against us because of the way we provided services or, as they allege, failed to provide services.

The fourth effect of the problem I have identified is the possibility of each patient receiving care that is different, depending on which doctor or nurse is assigned to the patient. Each patient needs to have the same treatment and care from any and all of our doctors and nurses, regardless of the doctors and nurses ethical and moral beliefs. This directly affects patient costs and mortality rates,

The next step to solving our problem is to examine solutions to the the problem.

Alternative solution

I have brainstormed three possible solutions to our problem. The first is to create standard operating procedures (SOP's) for all of our nurses, doctors and administrators to follow. SOP are a nationwide standard for hospitals and most healthcare institutions. A panel of doctors, nurses, administrators, and lawyers must create SOP’s. A member of the board should provide oversight to the group to keep all practitioners on track and make sure that they keeping with the hospitals general principals, patients interests, and keep with the medical boards guidelines. These SOP's must be worded so that all doctors, nurses, and adminstrators in our hospital understands exactly what care must be provided to patients every individual patient case.

The next possible solution to our problem is to launch a advertising campaign to emphasize the quality of care provided in Faith Hospital. We can use some or all of the available media outlets for our promotional campaign. Our campaign must counter the newscasts that hospitals are dangerous, emphasizing caring quality care in our hospital.

The third solution that I have brainstormed is terminating employees who are not following the law. If the hospital can control the hiring practices, we can hire people that are closely match our hospital’s ethical and moral beliefs. This would make our care that the hospital disburses to our patients more consistent. It would also make for an environment that would be better to work in for the doctors and nurses. Everybody would be on the same mindset as far as practices and procedures.

Now that I have framed our possible solutions, we have to evaluate the impacts of our alternative solutions. I will evaluate all of the possibilities of each solution and see which solution will work the best for our situation.

Impacts of Alternatives

Solution #1 (standard operating procedures)

Doctors and nurses reject the changes by management and quit. They may not feel that they can adjust their methods of treatment just to satisfy a procedure. While losing some employees would increase workload temporary I will greatly decrease the liability of the hospital. The proposed procedures will not cover all of the possible scenarios that the doctor or nurse may encounter, but will provide advanced directions and guidelines to ensure patient care.

Solution #2 (advertising campaign)

The media campaign will cost a lot of money that we do to our financial situation do not have to spare. This will be discussed in the next problem I have to figure out.

The advertising campaign could be seen as a shallow act to counter improve a non-profits perception in the media. When the public could think that the money we are spending on marketing could be better spent on patients or new equipment.

Solution #3 (employee replacement)

Replacing employees who do not know what they are doing is wrong would take too long to find quality people that are closely matched ethically and morally. This is also expensive process. We can't fire employee because we did not properly train them. I would lead to employment lawsuits.

The solution recommendation

Now that I have analyzed the possible solutions, I have made the decision to use solution #1. We need to create standard operating procedures for our doctors and nurses to follow so we can provide consistent high quality care foe every one of our patients. SOP’s might be difficult to accept but it will be eventually accepted.

I now have to explain my rationale for my proposed solution, I am sure that the CEO will want to have some excellent reasons behind my decision.

I have decided to implement standard operating procedures (SOP's) for our hospital so there is no confusion at all on what an employee is supposed to do in most scenarios that may arise regarding the care of our patients.

Benefits of this solution

Patients will know what they can expect as far as quality consistent treatment that does not depend on getting assigned to a particular doctor or nurse. This will make the patient feel better about choosing our hospital for their medical needs. The patients can feel comfortable with any off the staff that they have treat them. They don't have to worry about the doctor or nurse altering on care based on their personal beliefs.

A group of doctors, nurses, hospital administration, and lawyers must write the procedures to make sure that the morals and ethics of the hospitals mission statement are not compromised.

Problem #2

For the second problem I am going to use the same problem solving technique as I did for problem #1, brainstorming. First I have identified the problem. We are having budget problems. We are experiencing the rising cost of care per patient, and we are also experiencing a decrease in patients in our hospital. Now that we have identified our problem I will go through the decision making process to solve this problem.

Goals

The goals that the hospital needs to accomplish to remedy this problem are the need to reduce our fixed costs by 15% just to break even from a budget standpoint and also need to increase patient count. We need to increase annual patient days for the year. More patients and more annual patient days equal more full rooms and more revenue for the hospital. Now that I have identified the hospital’s goals for our second issue we need to evaluate the effects of our problem.

Effects of the Problem

The effects of our problem will be devastating if the hospital does not act quickly. We must make sound factual decisions, but the hospital needs to act quickly upon them in a timely manner if we are to solve the problem. If we do not increase our patients and patient days we will not be able to stay operating as a financially viable business. We are a non-profit organization, but we still have to bring in a certain amount of revenue to keep the hospital operational and the doors open for business. If we cannot increase our revenue we may have to cut employees’ salaries. We may even have to layoff part of our workforce. The fewer doctors we have the less patients we can treat, which translates into less revenue for the hospital. Another possible effect of the problem could be the reduction in patient care. If we have to cut back on staff then the patients do not have a wide variety of experienced doctors that they need to make them well. They also can not take the diagnostic test that provide much needed income for the hospital

Two causes are apparent. Our cost per patient is rising. We are experiencing a decline in patients which translates to a decrease in annual patient days.

Alternatives

I have decided to look at four possible solutions to our problem. The first possible solution to our problem is that the hospital may have to reduce fixed costs and increase income. Another possible solution is to increase our patient load, which will increase our annual patient days. A third possible solution is to increase the costs of our services provided to the patient. A fourth possible is a combination of two other possible solutions. I think that we could reduce our fixed costs, increase our income and increase the cost of service in which is passed on to the patient and the insurance companies.

Impacts of Alternatives

Solution #1 (reduce fixed costs and increase income)

Implementing SOP’s will result in a reduction of duplicated efforts. It will also allow doctors to prescribe consistent diagnostic testing of patient increasing revenue. Fixed costs also include doctors and nurses salaries. We may have to reduce duplicated employees to reduce fixed costs.

Solution #2 (increase patient intake)

Increasing patients is something we have limited control over. We can not control who gets sick or who is healthy we can only influence their decision on where they go. We can advertise how we do business in the health care industry to help potential patients decide to come to our hospital instead of other hospitals.

Solution #3 (increase costs to patients and insurance companies)

If we increase the patient care billable costs we can make more money off of the same services and not have to compromise our fixed costs.

We might be able to negotiate increases with insurance. Since many patients have insurance increases may not scare away potential patients.

Solution #4 (combination of reduce fixed costs and increase costs to insurance and patients)

We can slightly increase our costs for service and make up the rest in a slight cut in fixed costs and increased income.

Increases should be minimal enough that the insurance companies will agree to the new charges for services rendered.

Now that I have analyzed all of the possible solutions, I have to make a decision on which solution has the most positive effect for our hospital. I feel that solution #4 has the greatest change of success and will handle our budgeting crisis. If we can increase costs to the patient/insurance companies and then decrease our fixed costs while increasing income through use of SOP’s we will be able to keep providing our first class care to all of our patients.

Benefits of this solution

We can increase our costs to the insurance companies and patients; this will increase our revenue for the hospital.

We can reduce our fixed costs to lower our overhead by using SOP’s and reduce the amount of money we are losing.

Now that I have identified the problems, proposed solutions and explained my rationale using my skills learned in my critical thinking class at University of Phoenix, I am ready to review and discuss the solutions that I have proposed with the CEO.

.

References

Bassham et al. (2002). Critical Thinking. New York: Irwin/McGraw-Hill Companies. Retrieved February

14, 2006, from University of Phoenix, Resource, MGT/350 Critical Thinking: Strategies in Decision Making Web site: https://ecampus.phoenix.edu/secure/resource/resource.asp



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