Health
Service Systems
Week
8 â Final
1. (TCO A) You are the newly hired Chief Knowledge
Officer (CKO) for a mid-size hospital in a semiurban area of the country. Your first task is to develop the
organizationâs strategic plan that will shape the development of a
comprehensive network of services for their community.
The organization provides the usual
array of inpatient services expected in a moderate-sized community
hospital. A local nursing home and
retirement community is for sale, and the organization is considering the
purchase of that agency. Several physician
practices are also interested in alliances with the hospital. There is a local county health department
that provides some clinic services, primarily for the uninsured.
Youâve been asked to give a presentation
to the board of directors on options to restructure the local delivery of
healthcare services. The hospitalâs
president has asked you to focus your presentation on the common elements a
comprehensive delivery system attempts to accomplish and to highlight
innovative methods of restructuring. The
presentation will lay out the requirements of an integrated healthcare delivery
system. (Points: 25)
2. (TCO B) You are the newly-hired Vice President of
Human Resources for the Bayside Community Health System. Youâve been on the job for just 3 months and
have considerable experience in human resource functions. You have responsibility for all of the usual
human resources functions, including the recruitment process, the training and
development functions, and the retention plan.
In addition, you have the additional departments of volunteers and the
hospital chaplain services.
Youâve identified a number of serious
organizational issues that are impacting the hospital. Turnover is high, there are many vacant
positions, and the organization has a very high number of positions that are
considered hard-to-fill positions because of national workforce shortages in
nursing, pharmacy, and radiology.
The board of directors and the president
know that they have serious human resource issues that will have to change in
order for them to compete in the local healthcare market as an employer-of-choice. As in any healthcare organization, fiscal
resources are limited, but the board is firmly committed to investing in a well
developed human resources plan to decrease turnover and stem the ever-growing turnover
and vacancy rates. The president has
asked you to attend the next board of directors meeting to share your plan for
addressing these serious issues. What
will you tell them in your presentation to address the retention and
recruitment problems? (Points: 5)
3. (TCO C) Some physicians and for-profit healthcare
organizations in your area are refusing to treat Medicare and Medicaid patients
for a variety of reasons. These
controversial decisions present not only a major breakdown in the healthcare delivery
system but also in the financing of healthcare for many individuals across the
nation. Delineate at least three reasons
that physicians have for refusing to participate in these governmental
programs, as well as the impact this practice has on other areas of the
healthcare delivery system.
(Points: 25)
4. (TCO D) As the executive director of a managed care
company, you have been invited by Congress to consult about national healthcare
reform. Public outcry for changes in
managed care practices is ongoing.
Congress is calling for reform, and medical providers are extremely
frustrated with how you restrict care and offer low reimbursements.
Congress has
asked you to discuss how the managed care industry can be overhauled to provide
a more customer-responsive product and to control national healthcare costs.
What are the
high-priority issues that will need to be discussed to overhaul the managed
care industry? What stakeholders must be
considered in the planning process?
(Points: 20)
5. (TCO E) You are the VP for human resources and have
been given the assignment to come up with a new healthcare benefits plan that
will improve healthcare services for your employees and control costs. The health plan currently covers services
provided in healthcare services. You
employ approximately 1,800 employees and already determined in this new plan,
you want to provide traditional healthcare services and further develop a more
preventative and wellness focus. Your
goal is to improve the health of your employees, thereby saving monies in your
illness coverage as well as nonproductive time in sick days.
You are meeting with the president of
the health system this afternoon. What
will you say to him or her?
(Points: 25)
6. (TCO F) You are the newly hired hospital
administrator for Healthcare-U.S. System, a national system of tertiary
hospitals located throughout the U.S.
Your organization has just approved new monies for developing new
quality management initiatives. The
individual hospitals have implemented their own quality management programs. Some of these programs have produced stellar
results and high levels of patient satisfaction, although others have had much
less success.
Your focus as the newly hired
administrator is to develop a corporate quality improvement program that will
be standard throughout the companyâs hospitals.
The quality improvement plan must be responsive to any local needs or
issues. How will you craft that plan? What will you include in your plan? Include some specific examples of what you
might measure. How will you get to
buy-in from your individual organizations that already have their own plan?
7. (TCO G) Youâve just been hired as the Chief Operating
Officer (COO) for a new orthopedic physician practice. The new practice was created by two
previously independent practice groups that had fines for governmental
regulatory violations, as well as suspected fraudulent billing practices. You just received a subpoena to appear in
court and testify as to your role in the organization and knowledge of billing
practices.
All you know is that the clinic has
recently purchased a new electronic billing and medical records system that is
HIPAA-Compliant. One goal of this
electronic system is to address all areas of compliance and to clean up any
issues from the past. It is also
intended to position the new organization as an organization with an impeccable
reputation for compliance. Articulate
your vision for this plan and components that are required for its success. How will you justify the expense associated
with your plan? Keep in mind that you
have a newly formed organization and differing organizational cultures. (Points:
40)
