...Virginia Mason Medical Center Case study Question 1 How could TPS be used to solve the problems that Kaplan was facing at VMMC? VMMC was facing several critical issues when Kaplan assumed leadership of the organization: * High number of competitors in same geographic area * Lost substantial amount of money for the first time * Low morale among staff While Kaplan had implemented some changes to cut costs, he really needed to identify systematic ways to improve the quality of service and differentiate VMMC from its competitors. This is where TPS would prove valuable. Instead of being just another approach by management to create a more cost effective organization, TPS focuses on creating a culture of teamwork with the ultimate goal of delivering the highest quality service possible to the customer. And as a result of this focus on improvement, eventually costs are reduced. And lastly, TPS involves employees in the process and shifts the focus of management to the role of facilitator. Ideally these changes would undo some of the damage from past strategic innovations at VMMC and increase the staff morale. Why does TPS work at VMMC, while other similar approaches, i.e. TQM, have failed? The healthcare industry presents an interesting challenge: the relationship between the hospital and the physicians who work there. Historically the VMMC had a very difficult relationship with its physicians because they felt entitled to do what they wanted while it was...
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...Chapter I Introduction Recently, we have been given the opportunity to know more about Davao Medical Hospital, which has been greatly of interest to us. The Hospital has become part of our lives for more than four years now. We spend 24 hours every week in Davao Medical Hospital for our duties. That is why today, and for a few days more, We as a group are indeed very grateful that upon the day we shall bid goodbye to Ateneo de Davao University, the institution who have inculcated us with good values and quality education and also become part of our lives for many years have given us the opportunity to know more the history of Davao Medical Hospital. This document aims to describe the in- depth information, history and other factors that have been utilized to the emergence of Davao Medical Hospital. The resources came from our orientation and meeting with Mrs. Vilma Comoda, R.N, MAN and the interviews and the written documents we have read. HISTORY OF THE DAVAO GENERAL HOSPITAL 1917 – Enacted by the Philippine Legislative as Davao Public Hospital with a 25 bed capacity. The Davao General Hospital at Davao City, way back in the year 1918, a just a Sick Ward set up by the District Engineer’s Office in Davao for the care and treatment of the sick laborer’s known as “Sakadas”, who were the brought in to help the development of Davao. In 1919, by virtue of Special Act of the Philippine Legislation which was passed in 1917, to establish...
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...Communication Barriers at Duke Medical Center Introduction: Effective communication requires messages to be conveyed clearly to the appropriate parties, but along the way there are many communication barriers that can create misunderstandings and misinterpretations of the intended message (Burns et al., 2012). Such misunderstandings and misinterpretations are apparent in the case of Jesica Santillon. This case study will identify the social and cultural barriers that may have made it difficult for the doctors to communicate with Jessica’s family. This case study will also offer recommendations on modification of the transplant process to ensure that misunderstandings are eliminated or minimized; and lastly it will propose some general communication strategies to manage communication with each group involved in this tragic case. Communication Barriers There may have been many communication barriers that hindered the doctors from effectively communicating with Jesica’s family. We will discuss some social and cultural communication barriers between the physicians and Jesica’s family: The language differences may have been a leading obstacle to effective communication between the physicians and the family, The family recently migrated to the United States seeking treatment for Jesica's condition and were not fluent in the English language. Health literacy may have also induced the communication barrier between the physicians and...
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...13 CASE Emanuel Medical Center: Crisis in the Health Care Industry The Haley Eckman Story On Friday, four-year-old Haley Eckman stayed home from school because of a slight fever. She complained that she was feeling very tired. That night, Haley’s temperature increased to 104°F. At 3:15 A.M., Mr. and Mrs. Eckman took Haley to the emergency department (ED) of Emanuel Medical Center (EMC) in Turlock, California. They registered at the admissions desk and waited for someone to see them. After what seemed like forever to the Eckmans, a triage nurse came out to evaluate Haley. He asked several questions, but failed to take her temperature – a routine procedure in that situation. He then disappeared, leaving the Eckmans to wait yet again. While they waited, Haley vomited. She said she felt very weak. The family asked if Haley could lie down in a bed while they waited to see a doctor. A staff member told them that there were no available This case study was prepared by Randall Harris, Kevin Vogt, and Armand Gilinsky as a basis for class discussion rather than to illustrate either effective or ineffective handling of an administrative situation. © 2004 by Randall Harris, Kevin Vogt, and Armand Gilinsky. Used with permission from Randy Harris. both13.indd 670 11/11/08 12:04:27 PM MORE PROBLEMS THAN THE ED 671 beds, and that they would have to wait. The Eckmans saw several empty beds across the hall from where they sat as the staff member said...
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...Introduction This paper strives to answer questions based on the case study “Emanuel Medical Center: Crisis in the Health Care Industry”. As excerpted directly from the case study, Mr. Robert Moen, Emanuel Medical Center (EMC) president and CEO, was experiencing a number of challenges in 2002. The medical center faced numerous challenges in its external and internal environment. First, EMC garnered an onslaught of negative attention for the “Haley Eckman incident” in which a young man, who happened to be a gang member, died within view of EMC’s Emergency Department (ED) medical personnel rendered no care and watched. The emergency department at EMC was also experiencing greater pressure to deliver services in an increasingly difficult health care environment, particularly after the federal Emergency Medical Treatment and Active Labor Act (EMTALA) was enacted; legislation that required access to emergency medical care for all, regardless of one’s ability to pay. Additionally, larger, for-profit managed care facilities were making substantial advances into EMC’s service area. Internally, the cost of operating the ED had increased significantly and patient traffic had vastly exceeded the capacity for which the ED had been designed. In addition, reimbursements for services from health maintenance organizations (HMO) and government programs had been drastically reduced. At the same time that other regulatory burdens had increased, EMC began to experience labor shortages...
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...There are several apparent conflicting cultures at Hillwood. One obvious competing culture at Hillwood is that the administrators and staff do not have mutual values. For one, the chief medical officer main concern is saving lives. On the other hand, the medical board is more concerned with the cost associated with running the medical center. The staff is concerned with other issues such as their working conditions. These conditions include supervisors, having the latest technology, and supplies. If everyone working at Hillwood would sit back and look at the entire picture, they would see that all of these competing values have equal value and go hand in hand with one another. Saving lives is essential and should be done in the most resourceful way to include treating the staff fairly. This can be accomplished if everyone works as team and has one common goal. Based on the information provided in the case study, everyone has different values and due to this everyone is at odds with one another. An example of this is when Dr. Garcia explodes and states, "You administrators are never available when we need you. Your only concern is holding down costs. We're talking about human lives here." Dr. Garcia is concerned with saving human lives but his words are actually expressing his dissatisfaction with the administration staff. In addition, Dr. Garcia wants to blame the administrators on staff when he needs to be confronting Dr. Chambers about his alleged drinking problem...
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...1. The key problem in the Lab Central Receiving Area at Massachusetts Medical Center is poor specimen turnaround in the CRA. Delaying STAT tests can impair the care of sick patients also, it can cause specimen spoilage and the specimen will have to be recollected. 2. Average Daily Demand Formula = Add up all of the totals and divide by 7 days a week ADD = 672 specimen + 1322 specimen + 1622 specimen + 1639 specimen + 1582 specimen + 1519 specimen + 683 specimen = 9,039 specimen DIVIDED BY 7 Days a week = 1,291.29 specimen per day 3. Average Hourly Demand divided by 24 hours in a day AHD = 1291.29 specimen per day DIVIDED BY 24 hours per day = 53.80 specimen per hour 4. A. Once the specimens arrive at the lab, they are processed. Depending on what kind of specimen test they are undergoing determines which process of the two they will be put through. B. As shown above the all specimens are unwrapped, and then they undergo which ever process they are being tested under. For each of the two processes after the unwrapping they are typed up and then labeled. C. After the process at the LCRA is complete the specimens are delivered to the lab. 5. The bottlenecking occurs in the CRA in the typing processes. It takes a much longer time for the typing process to be complete. With a more efficient typing...
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...Case Study 9 Boston Medical Center 1.) What is the marginal cost estimate of the Phase 4 hospital services, assuming that 60 percent of the designated costs are fixed and the remaining costs are variable? * The Marginal cost estimate is $ 71,468 2.) What is the ‘relevant range’ for the cost structure? In other words, at what volume might you expect the fixed and variable costs to change appreciably? * The current amount of patients treated for liver transplant volume totaled 120 patients annually, with a reimbursement rate of $140,000, providing the hospital with the ability to handle 30 more patients before the fixed costs would increase. 120 +30= 150. This means that the hospital can sufficiently handle a capacity of 150 patients, but after 150 at 151 the expected fixed and variable costs will change appreciably. * The total average cost $140,000 for 19 days of average length of stay- per diem of $6,000 a day this can be reduced by almost $12,000 dollars by decreasing LOS by 2 days. 3.) What fixed cost proportion is implied if the price for Phase 4 hospital services is set at $90,000? HINTS: This is an iterative process, arrived at by trying different fixed cost percentages in the template. Also, remember that the Center’s price at this point is based on the marginal (variable) cost. * 37 % is the fixed portion that if implied for phase 4 hospital services would set services at approximately $90,0000, * 37 percent is $89,997 being the closest percentage...
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...Case Study 9 Boston Medical Center 1.) What is the marginal cost estimate of the Phase 4 hospital services, assuming that 60 percent of the designated costs are fixed and the remaining costs are variable? * The Marginal cost estimate is $ 71,468 2.) What is the ‘relevant range’ for the cost structure? In other words, at what volume might you expect the fixed and variable costs to change appreciably? * The current amount of patients treated for liver transplant volume totaled 120 patients annually, with a reimbursement rate of $140,000, providing the hospital with the ability to handle 30 more patients before the fixed costs would increase. 120 +30= 150. This means that the hospital can sufficiently handle a capacity of 150 patients, but after 150 at 151 the expected fixed and variable costs will change appreciably. * The total average cost $140,000 for 19 days of average length of stay- per diem of $6,000 a day this can be reduced by almost $12,000 dollars by decreasing LOS by 2 days. 3.) What fixed cost proportion is implied if the price for Phase 4 hospital services is set at $90,000? HINTS: This is an iterative process, arrived at by trying different fixed cost percentages in the template. Also, remember that the Center’s price at this point is based on the marginal (variable) cost. * 37 % is the fixed portion that if implied for phase 4 hospital services would set services at approximately $90,0000, * 37 percent is $89,997...
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...mission should be revised. The Medical Center is in an older urban area with smaller shops and businesses. The community is trending towards a predominantly elder population. There has also been a decline in compliance with T.J.C. standards. Staffing supports new program development and the physician staff is in abundant supply. There are also major issues that need to be addressed, such as shortages in clinical staff, non-interfacing information technology systems, antiquated facilities and infrastructure, and a shift to its financial mix. Careful assessment of the aging person's perception of his or her health, health practices, and knowledge of safety factors affecting their own health is an important part of primary care in all settings. A strategic plan to handle the aging population must be addressed and plans implemented to meet the challenges and needs that the aging population would present. One of the major issues confronting the Community South Medical Center are the shortage of clinical staff including registered nurses, respiratory therapists, and medical technologists The strengths, (arrived through SWOT analysis),of Community South Medical Center is that it has comprehensive health services including acute care, residential care, independent living, in-home nursing, hospice, neonatal, and pediatric services, advanced cardiac services, a major trauma center, a center of excellence for pulmonary services, and a neurosurgery center. (Instructor. 2012) Expansion...
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...Case #1 Medical Center of Southern Indiana History The Medical Center of Southern Indiana was the brainchild of two community members in 1973, originally named North Clark Community Hospital (NCCH). Many years after the initial conception of the NCCH, and numerous positional changes throughout the corporate structure, “North Clark Community Hospital opened its doors in September 1976,” (Rakich, Longest, & Darr, 2010). Unfortunately, NCCH only experienced difficult times for the next nine years, daily loss of profit due to unoccupied treatment beds and unused facilities, and lack of competitive advantage in the market to aid in the marketing of the hospital to increase profits eventually lead to the sale of the hospital in 1985 for $15 million to Hospital Corporation of America (HCA). HCA began reorganizing and transforming the entire structure of the hospital, these changes provoked renowned community support, to which HCA sold the hospital six years later to the City of Charleston for a drastically lower price of $2 million, thus NCCH name was changed to the Medical Center of Southern Indiana (MCSI). Internal Strengths and Weaknesses MCSI has employed very intelligent staff members, this workforce has been maintained properly creating a very low employee turnover rate of 11%, which is one of MCSI’s internal strengths. The second internal strength would be MCSI’s management of finances. MCSI internal weaknesses consist of the history attached to the hospital and its failures...
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...February 20, 2012 MEMORANDUM FROM: Graduate Student TO: Important Executive SUBJECT: The Case of Holy Medical Center Mr./Mrs. Executive, I am writing to you today to discuss the case of Holy Medical Center. In my review of this case a number of questions have come up that need to be addressed. Question 1 - Why did Dwane Hopkins fail as a clinic manager? Dwane Hopkins was hired to head Holy Doctors Medical Group. This new medical service organization (MSO) started out by bringing together six primary care physicians to form the initial part of this primary care network. However, it was hoped that in the long ran the practice would eventually support twenty more physicians. Their sponsor, Holy Medical Center, supplied the founding and income guarantee. Mr. Hopkins was hired at the time of hospital downsizing. He was someone the administration could spare to head this project. In addition, Mr. Hopkins had the backing of the COO who felt that Mr. Hopkins possessed good organizational skills. Unfortunately, Mr. Hopkins was never comfortable working with doctors and conflicts soon emerged over procedural and policy issues. In addition, Mr. Hopkins failed to provide the physicians with the feedback on the financial status of the practice. Mr. Hopkins was discharged from his managerial position because after eight months he has failed to make progress concerning both consolidation of the practice as well as physician recruitment. Question 2 - Was the hospital...
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...Orangeburg Regional Medical Center HCS 235 January 16, 2012 Maria Cabanillas Orangeburg Regional Medical Center has been serving the residents in Orangeburg County over thirty years. Over the years they have added more square footage, open the doors for new wings and job opportunities. Not only that it provided close services for the patients, they no longer had to make a seventy mile drive to have a specific service done, it was now done locally. With a great staff and some state of the art equipment this makes this hospital one the best in the area. They even have a website where you can find the many different service they offer on www.trmchealth.org. Besides emergency care, Orangeburg Regional Medical Center provides a large range of services to the community. They offer an admitting/outpatient wing that allow the service into one area allowing space for Same Day Surgery, which was needed to accommodate the increase in outpatient surgery. They offer some many other services like 15-bed psychiatric unit, pediatric unit, Cancer Center for cancer patients with chemotherapy and radiation therapy. They also offer Breast Health Center, Dialysis Access Institute, Radiology Department, Vascular Center, 20-bed Rehabilitation Unit, and Health Plex for outpatient rehabilitation and wellness, endoscopy, community outreach, EKG, neurology, nursing units, pharmacy, sleep lab, wound center, volunteer service, public relation, occupational therapy, joint center, and Biomedical...
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...2010 8/24/09 by FACHE RIO GRANDE MEDICAL CENTER Cost Allocation Concepts This case focuses on cost allocation concepts, specifically the fairness and incentives created by a new allocation system applied to a department that is moving to a new, stand-alone facility. The primary thrust of the case is qualitative rather than quantitative, but this model can be used to compare results under alternative allocation schemes. The model consists of a complete base case analysis--no changes need to be made to the existing MODEL-GENERATED DATA section. However, in the student version all values in the INPUT DATA section have been replaced with zeros. Thus, students must enter the appropriate values into the red cells that currently contain a zero or hyphen. When this is done, any error cells will be corrected and the base case solution will appear. Note that the model does not contain any uncertainty analyses, so students will have to create their own if required by the case. Furthermore, students must create their own graphics output (charts) as needed to present their results. INPUT DATA: KEY OUTPUT: Dialysis Center Data: Dialysis Ctr Outpatient Ctr Total Total revenues $- ...
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...What were the objectives in changing to the new 4/40 work week The objectives in changing to the new 4/40 work week were to have the clinic be innovative in its personnel policies, allowing full time employees a three-day weekend, reducing the number of computed to and from work each week. Evaluate the work of the task force from a managerial perspective. From the results presented by the task force, the research has shown that alternative schedules didn't necessarily reduce work-family conflict, although having a decrease in employee absenteeism. There are many generalizations that can be made from this study and considerations need to be taken as to whether these generalizations are reflected in other employees. The data collected provides possible explanations as to the conclusions of the study but it is believed that the study doesn't offer the whole picture. The use of a survey provides low precision is control and measurement and realistic context. Evaluate the work of the task force as a field research study. Workers enjoyed the commute time and expense savings associated with the 4/40 work week. The answers to the research question might be biased because some of the members of the task force made their opinions known, which could have influenced the opinions of other employees. The research questions were relevant and worth answering and were worded in way that were answerable. Most data...
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