Health Care Management Scenario: Women’s Health Center

Health Care Management Scenario: Women’s Health Center
(Title Slide)
Welcome to your new job as a Clinical Manager of the Women’s Health Center!
As part of your position here at Cordola Community Hospital, you will focus on helping us to address
several management issues that have been identified as high priority.
Today we will talk about an initiative that I would like you to develop over the next several months. This
initiative will provide an opportunity to apply your management skills to a department in need of your
leadership and guidance.
(Overview)
Cordola Community Hospital (CCH) was founded in 1910 as a short-term, general, acute-care non-profit
hospital. The hospital was originally built as a 30-bed facility and has slowly grown to 145 beds with
numerous outpatient services, including the Women’s Health Center that you now oversee.
Recently, CCH merged with St. Jerome’s Catholic Hospital located in the same community, acquiring the
facilities and staff as part of the merger. The Catholic Diocese vacated as part of the merger agreement.
St. Jerome’s Catholic Hospital was founded in 1890 and the charter is written based on Catholic values.
The merger agreement states that the use of the facilities must honor the charter for ten years after the
Dioceses vacates the buildings.
Both facilities are licensed by the state and incorporated as a 501(c)3 nonprofit corporation. Both are also
accredited by the Joint Commission, and approved by the American College of Surgeons. Both hospitals
accept Medicaid, Medicare, and several private insurances.
The Cordola community has a primarily Irish and Polish immigrant heritage. This creates a strongly
Christian-based culture within the community. Recently, the community became a Syrian refugee
sanctuary city, successfully placing 4 refugee families in the community, 9 adults and 12 children, this
year. There is a strong neighborhood watch program, and people look out for one another in the
community. We have a good public transportation system; CCH is on a main bus route.
Let me share a bit about the two women’s health centers you will be working with.
The Women’s Health Center at CCH, commonly referred to as the WHC, works closely with both inpatient and outpatient services at the hospital. WHC staff are employed by the hospital. The WHC is
located within the main hospital building, off the main hallway near the Emergency Department.
WHC’s services include annual wellness exams, contraceptive counseling and services, hormone
replacement therapy, minimally invasive surgery, and care for women who are pregnant, giving birth, or in
the postpartum period, to name just a few. Walk-in services include mammograms, bone-density scans,
ultrasounds, and blood work. Patients must walk to other areas of the hospital for these services.
The St. Jerome’s Women’s Services, commonly referred to as SJW, is a separate building from the main
hospital. The program prides itself on offering person-centered care for the well-being of all women in
their care. The environment is intended to be peaceful, serene, and comfortable for anyone walking in.
SJW has a specially designed entrance where the color scheme and flow of the rooms create a calming
atmosphere.
Services are provided on an outpatient basis only and include cancer treatment, minimally invasive
surgery, natural family planning, gynecology, pregnancy, infertility, physical therapy, pregnancy loss
counseling, midwifery, and more. Health education classes on topics like healthy living, menopause, and
bone health are offered to the public.
As Cordola’s new Women’s Health Center manager, we will look to you for guidance in combining these
very different programs into one that best serves the community. I want you to propose strategies,
interventions, or solutions to help us do this.
Let’s talk about some of the pressing concerns.
(Administrator’s Challenge: Conflicting Charters)
As I mentioned earlier, SJW is in the preliminary stages of merging with the Women’s Health Center at
CCH. St. Jerome’s has state-of-the-art equipment and services for providing women’s health services.
Its charter is steeped in faith-based values. While the community hospital charter allows for women’s
health services well beyond the scope of St. Jerome’s, Cordola’s WHC struggles with dated equipment
and aging facilities and décor. The previous manager was advocating for a designated entrance away
from emergency and acute care admissions to create a more relaxing and welcoming environment for
WHC patients.
We would like a plan for tapping into the resources that St. Jerome’s facility brings, while continuing to
offer the family planning services that our public hospital offers. We want to maximize the strengths of
both women’s centers.
We recognize that staff and administrators may have differing work cultures. Respect for the work
cultures of both facilities should be considered.
(Human Resources Challenge: Merging Professional Staff)
As we have discussed, staff from St. Jerome’s will now be employed by CCH. From a human resources
perspective, we need a plan. Salaries, job descriptions, and reporting structure may change. As you
consider strategies, remember that SJW is a freestanding program and provides lab, radiology, and
physical therapy as ancillary services, whereas WHC relies on internal hospital departments to provide
these services. The physician groups are largely the same across facilities with only a few exceptions.
Physicians all have external contracts.
(Budgeting Challenge: Changing Reimbursement Structure)
SJW is subsidized through the Roman Catholic Archdiocese and four local Roman Catholic churches.
Apart from these subsidies, their patient base is financially similar to CCH in terms of Medicare, Medicaid,
and private insurances. There are several differences, however. The birthing center at St. Jerome’s is
reputed in the community to be a more desirable facility, so more private-insured births occur there. CCH
attracts more Medicaid recipients to their birthing center. St. Jerome’s is located closer to downtown and
a low-income senior apartment complex. Consequently, St. Jerome’s attracts a higher rate of Medicare
patients than CCH.
(Resource Allocation Challenge: Sharing Resources with Acute Care)
Receiving ancillary services from internal hospital departments has caused some frustration on the part of
WHC’s staff and patients. Waiting times are an issue. Patients must walk to various services within the
hospital, often navigating a maze of corridors, only to sit in a waiting room for long periods.
All WHC patient registrations are done by the WHC staff, to maximize patient privacy. The process has
been confusing. Patients are sent to wrong departments. Required information is missing. Authorization
for services is not consistently verified. Registration staff in other departments resent having to correct
what they perceive to be basic registration errors.
Sensitivity to WHC patient needs is increasingly an issue. Department staff are often not sensitive to the
specific needs of WHC patients. Many WHC patients are employed women who value expediency and
privacy within this tight-knit community. They often complain about long waiting times. They also
frequently report being asked to repeat health information in open areas where other patients in the
waiting room can overhear.
(Your Charge)
As you can see, there are a number of pressing management concerns to be addressed at CCH. The
executive leadership team has expressed two overarching priorities: (1) creating a sound transition plan
for merging of the two Women’s Health Centers, and (2) addressing the challenges of sharing resources
across departments at CCH. Let’s tackle these problems one at a time.
Because of your extensive knowledge of change theories and strategic planning, I want you to formulate
evidence-based strategies to recommend a transition plan to merge staffing and services at the two
women’s health centers.
(Your Portfolio)
I am going to give you a folder of resources to get you started in your work. This folder includes articles,
reports, and other resources. It’s just a beginning, though. You will find many gaps in the information and
will need to research additional resources to help you address this problem in an evidence-based
manner.
To begin, please review the information very carefully. Identify the resources in the folder that will allow
you to address the problem. Then figure out what you still need to develop a transition plan. Locate the
information and evidence-based practice data that you need and, based on your research, provide me
with a case analysis specific to your charge.
I will ask for several written reports to keep me apprised of your work.
Please visit the Case Analysis Project at a Glance document to learn more about my expectations for
your case analysis and proposal to address the target issue.