New L D S Apostle Quentin L
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Quentin L. Cook, a lawyer who later became an LDS Apostle, privatized Marin General Hospital in 1985 through a lease agreement that transferred millions in public assets to a private corporation. This greatly enriched Cook and the hospital administrators. The lease lacked protections for the public and allowed profits to be siphoned away. It gave Sutter Health control until 2015 without ensuring the hospital's return to public ownership. Voters and courts failed to remedy the situation, representing one of Marin's largest thefts of public property.
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An Overworked CEOThere are certain days when life seems unbearab.docx
An Overworked CEO
There are certain days when life seems unbearable. For Max Michael, MD, it had been one of those days. He had the difficult responsibility of balancing costs with access to care, of rationing procedures with policy, and of juggling personnel with budgets, performance, and demand. Dr. Michael, a former chief of staff at the hospital and now its chief executive officer (CEO), had spent the better part of his day fighting a losing battle in an understaffed, understocked, overflowing outpatient clinic. It was there, on the front lines, where he had first encountered the nature of the health care problem and developed his vision for its solution. As Dr. Michael left the clinic that evening, he mulled over a looming decision he was going to have to make. It was his last patient that reminded him of the importance of that decision.
692
693
Martha James Spent Her Day at Cooper Green Hospital
It was the second day in a row that Martha James missed work because she was running a fever and ached all over. She dared not miss another day for fear of losing the job she had with a small local business that paid above minimum wage but offered no health insurance. Her husband also was employed full time but did not receive any insurance benefits. Money was very tight for the couple and their two children, yet, based on federal guidelines, they were not eligible for financial assistance from the Aid to Families and Dependent Children (AFDC) welfare program; nor were they eligible for state Medicaid benefits. With no money to spare, the cost of a visit to a physician's office was a luxury Martha felt she could not afford. She did the only thing she knew to do: she headed for the emergency room at Cooper Green Hospital.
It was nearly 9:00 A.M. when Martha arrived after a 45-minute bus ride. She waited for more than two hours before her name was finally called. The nurse asked her about her symptoms. Barely even looking up, the nurse said Martha would have to be seen over at the Outpatient Clinic because her case was not truly an “emergency.” She was told to sign in at the Clinic desk and they would try to “work her in.”
After more than four hours of sitting in the overcrowded waiting room, Martha finally heard her name called again. The doctor who took her case was a silver-haired man with sharp eyes and a concerned demeanor. Dr. Michael quickly determined the problem: a respiratory tract infection that had been “going around” for weeks. When asked, she admitted she had been coughing for more than a week, but had hoped the severe cough would go away on its own. “Besides,” she said, “I can't afford to take a day off work to go to the doctor for just a cold.”
“The problem,” Dr. Michael explained, “is the infection is now affecting your lungs, which requires more intensive treatment than if you had come for help a week ago.”
Glancing at her chart, he realized she lived near Lawson State College, the location of one of the hospital's Community Care.
Hospital SystemFor this Dropbox assignment, please read pages .docx
Hospital System
For this Dropbox assignment, please read pages 692-716 (Case 14) of the course textbook Strategic Management in Health Care Organizations. In these pages, the Jefferson Hospital System (JHS) is described.
JHS consists of a full-service, acute-care hospital (Cooper Green Hospital), specialty outpatient clinics (Jefferson Outpatient Care), and six satellite, primary care clinics (the Community Care Plan).
With these components, JHS provides a full spectrum of medical care and a choice of two affordable payment options for what is considered to be an underserved population.
Create a 2- to 3-page report in Microsoft Word document that answers the following questions.
· Why do you think the components of this system are underutilized? (Please note that this is not just a problem of poor marketing and communication.)
· What would you do to increase the utilization of these services and attract a greater mix of paying patients? State at least four steps or actions you would take for this.
Support your responses with examples.
Cite any sources in APA format.
Assignment Grading Criteria
Maximum Points
Analyzed the components of the medical system at JHS that were underutilized.
Explained why the components of the medical system were underutilized.
Summarized the steps to increase the utilization of services and attract a greater mix of paying patients at JHS.
Notes from Class
As Dr. Michael entered his office, Martha James was still on his mind. It had been nearly four years since he launched the Community Care Plan, but in many ways it was still struggling. In his heart, he still believed it was a good model to provide access to preventive and routine medical services to the population traditionally served by Cooper Green Hospital: the poor and uninsured of Jefferson County. It placed small outpatient clinics within local neighborhoods.
They were staffed by physician assistants or nurse practitioners, who were supervised by a physician. For a quarterly fee, members could receive routine medical care at the CCP clinics. When needed, they also received care from specialists, and even inpatient hospital care at Cooper Green.
To Dr. Michael it made perfect sense; the CCP offered better access to services, less waiting time, less travel time, and a better atmosphere.
But the numbers did not agree. Although some of the CCP clinics established a reasonably sized patient base, others were struggling to attract members. If Martha James had been a CCP member, she could have been seen and received treatment before the infection had migrated to her lungs and she would not have had such a long waiting time. “For her, and thousands more like her,” Dr. Michael thought, “it's important to keep the CCP running–if at all possible.” But few people knew about the CCP and even fewer had joined.
The five-year funding that enabled the hospital to launch the CCP was about to run out. Dr. Michael knew he was facing a critical decision: .
6 9 2C A S E Cooper Green Hospital and the Com.docx
6 9 2
C A S E
Cooper Green
Hospital and the
Community
Care Plan
This case was written by Alice Adams and Peter M. Ginter, University of Alabama
at Birmingham, and Linda E. Swayne, The University of North Carolina at Charlotte.
It is intended as a basis for classroom discussion rather than to illustrate either
effective or ineffective handling of an administrative situation. Used with permis-
sion from Alice Adams.
14
An Overworked CEO
There are certain days when life seems unbearable. For Max
Michael, MD, it had been one of those days. He had the difficult
responsibility of balancing costs with access to care, of rationing
procedures with policy, and of juggling personnel with budgets,
performance, and demand. Dr. Michael, a former chief of staff at
the hospital and now its chief executive officer (CEO), had spent
the better part of his day fighting a losing battle in an understaffed,
understocked, overflowing outpatient clinic. It was there, on the
front lines, where he had first encountered the nature of the health
care problem and developed his vision for its solution. As Dr.
Michael left the clinic that evening, he mulled over a looming
decision he was going to have to make. It was his last patient that
reminded him of the importance of that decision.
both14.indd 692both14.indd 692 11/11/08 12:13:14 PM11/11/08 12:13:14 PM
6 9 36 9 3
Martha James Spent Her Day at Cooper Green Hospital
It was the second day in a row that Martha James missed work because she was run-
ning a fever and ached all over. She dared not miss another day for fear of losing the
job she had with a small local business that paid above minimum wage but offered
no health insurance. Her husband also was employed full time but did not receive
any insurance benefits. Money was very tight for the couple and their two children,
yet, based on federal guidelines, they were not eligible for financial assistance from
the Aid to Families and Dependent Children (AFDC) welfare program; nor were they
eligible for state Medicaid benefits. With no money to spare, the cost of a visit to a
physician’s office was a luxury Martha felt she could not afford. She did the only thing
she knew to do: she headed for the emergency room at Cooper Green Hospital.
It was nearly 9:00 A.M. when Martha arrived after a 45-minute bus ride. She waited
for more than two hours before her name was finally called. The nurse asked her
about her symptoms. Barely even looking up, the nurse said Martha would have to
be seen over at the Outpatient Clinic because her case was not truly an “emergency.”
She was told to sign in at the Clinic desk and they would try to “work her in.”
After more than four hours of sitting in the overcrowded waiting room, Martha
finally heard her name called again. The doctor who took her case was a silver-
haired man with sharp eyes and a concerned demeanor. Dr. Michael quickly
determined the problem: a respiratory tract infection.
CASE 14 Cooper Green Hospital and the Community Care PlanAn Ov.docx
CASE 14 Cooper Green Hospital and the Community Care Plan*
An Overworked CEO
There are certain days when life seems unbearable. For Max Michael, MD, it had been one of those days. He had the difficult responsibility of balancing costs with access to care, of rationing procedures with policy, and of juggling personnel with budgets, performance, and demand. Dr. Michael, a former chief of staff at the hospital and now its chief executive officer (CEO), had spent the better part of his day fighting a losing battle in an understaffed, understocked, overflowing outpatient clinic. It was there, on the front lines, where he had first encountered the nature of the health care problem and developed his vision for its solution. As Dr. Michael left the clinic that evening, he mulled over a looming decision he was going to have to make. It was his last patient that reminded him of the importance of that decision.
Martha James Spent Her Day at Cooper Green Hospital
It was the second day in a row that Martha James missed work because she was running a fever and ached all over. She dared not miss another day for fear of losing the job she had with a small local business that paid above minimum wage but offered no health insurance. Her husband also was employed full time but did not receive any insurance benefits. Money was very tight for the couple and their two children, yet, based on federal guidelines, they were not eligible for financial assistance from the Aid to Families and Dependent Children (AFDC) welfare program; nor were they eligible for state Medicaid benefits. With no money to spare, the cost of a visit to a physician's office was a luxury Martha felt she could not afford. She did the only thing she knew to do: she headed for the emergency room at Cooper Green Hospital.
It was nearly 9:00 A.M. when Martha arrived after a 45-minute bus ride. She waited for more than two hours before her name was finally called. The nurse asked her about her symptoms. Barely even looking up, the nurse said Martha would have to be seen over at the Outpatient Clinic because her case was not truly an “emergency.” She was told to sign in at the Clinic desk and they would try to “work her in.”
After more than four hours of sitting in the overcrowded waiting room, Martha finally heard her name called again. The doctor who took her case was a silver-haired man with sharp eyes and a concerned demeanor. Dr. Michael quickly determined the problem: a respiratory tract infection that had been “going around” for weeks. When asked, she admitted she had been coughing for more than a week, but had hoped the severe cough would go away on its own. “Besides,” she said, “I can't afford to take a day off work to go to the doctor for just a cold.”
“The problem,” Dr. Michael explained, “is the infection is now affecting your lungs, which requires more intensive treatment than if you had come for help a week ago.”
Glancing at her chart, he realized she lived near Lawson State College, ...
Review the Southeast Medical Center case study found on page 92 of.docx
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources. Write a three- to five-page paper (excluding title and reference pages) with your selected recommendations and justifications. The paper must be in APA format.
Southeast Medical Center Case Study
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources
In-Depth Case Study: Southeast Medical Center
The following case study involving a large organized delivery system exemplifies many of the issues described earlier in this chapter.
History and Evolution
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Review the Southeast Medical Center case study found on page 92 of.docx
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History and Evolution
Southeast Medical Center (SMC; a pseudonym) was established as a public hospital in the 1920s, just before the Depression. Located in the Southeast, a $1 million bond financed the 250-bed facility. Major expansion projects in the 1950s increased the hospital’s size to 600 beds. Formal affiliation with the local university’s College of Medicine residency program in the 1970s further expanded capacity. Thus, SMC became a public academic health center and subsequently assumed multiple missions of patient care, teaching, and research. Capital improvement programs were conducted during the 1970s, and in 1982, a massive renovation and construction project ($160 million) added 550 beds to the facility. In the 1980s, a 59-bed freestanding rehabilitation center was opened adjacent to the hospital, and a physicians’ office building was constructed next to the hospital. Medical helicopters were also acquired in 1989, expanding SMC’s trauma services. In addition to serving as a regional provider for trauma, SMC also furnishes burn, neonatal, and transplant care for the region.
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For your Dropbox assignment, read the following article on pages 803-816, Case 19 from your course textbook Strategic Management in Health Care Organizations.
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· Why is the hospital considering this additional service?
· Does the hospital and community really need this service? Why or why not?
· What should be the most important characteristics of a hospital in which one would want to have an open heart surgery?
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Support your responses with examples.
Cite any sources in APA format.
CASE 19 The Case for Open Heart Surgery at Cabarrus Memorial Hospital*
Situation
It was a clear, crisp October morning in Concord, North Carolina. The board of trustees of Cabarrus Memorial Hospital gathered in the windowless, walnut paneled boardroom for its monthly meeting (see Exhibit 19/1 for board members). Board chairman George Batte opened the meeting saying, “Because we do not have an open heart surgery program, patients needing open heart surgery or coronary angioplasty have to be transferred to another hospital, causing inconvenience to the patient's families and risks from delayed treatment. There are several questions we have to answer in addressing this issue. Should we add open heart surgery to the mix of cardiac services we offer? Does the hospital's existing service area provide adequate patient volumes to support the program? What role should the Duke University Medical Center play in the proposed program? Willwe be able to obtain the required certificate of need [CON] from the State of North Carolina's Department of Health and Human Services? Will there be opposition to the CON from surrounding hospitals? What costs are likely to be incurred in the required renovation, construction, medical equipment, and staffing?”
Exhibit 19/1: CMH Board of Trustees
Mr. George A. Batte, Jr., Chairman (Retired Manufacturing Executive)
Mr. L. D. Coltrane, III, Vice Chairman (Telephone Company President)
Mr. Robert L. Wall (President, Cabarrus Memorial Hospital)
Mr. Dan Gray, Secretary (Executive Director, Charitable Foundation)
Mr. Durwood Bost, CPA (Retired Manufacturing Executive)
Mr. S. W. Colerider, Jr. (Retired Manufacturing Executive)
Mr. Gene Verble (Merchant and Retired Major League Baseball Player)
Mrs. Margaret C. West (Civic Leader)
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Overview
Hospital A: Porter Regional Medical Center (PRMC)
Located on the east side of town, Porter Regional Medical Center (PRMC) was a for-profit hospital, consisting of 110 hospital beds, 8 of which were reserved for transitional care. PRMC was a privately owned facility. Mountain Health Care (MHC), a large healthcare organization in the Rocky Mountain region, owned the facility. Built in 1990, the facility was designed to efficiently handle patient flow from the emergency room to the pharmacy and to be a point of referral for more complicated patient conditions. PRMC services consisted of general and same-day surgery and full-service rehabilitation and radiology departments. Other services included a kidney dialysis center, on-site retail pharmacy, a regional Red Cross blood bank, 24-hour laboratory, home health, Infusion/Home IV, and a women’s center, including obstetrics and numerous other amenities.
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1IN T R O D U C T I O NThis comprehensive case study ser.docx
1
IN T R O D U C T I O N
This comprehensive case study serves as a basis for the exercises included throughout the
book.
Coastal Medical Center (CMC) is a licensed, 450-bed regional referral hospital
providing a full range of services. The primary service area is a coastal city and three coun-
ties, with a total population greater than 995,000, located in the Sunbelt. This tricounty
area has had one of the fastest population growth rates in the country for the past five
years. According to the local health planning council, the tricounty population is projected
to increase by 15 percent from 2015 to 2020. Appendix A, at the end of this case study,
provides detailed population statistics for the city and tricounty area.
The population growth rate for households (families) has been 1 to 2 percentage
points higher than the overall population growth. The growth rate of the population under
age 44 shows a young and growing community. Per capita (i.e., per person) income in the
tricounty area is high and increasing. As the population of the tricounty area increases, the
need for healthcare services is anticipated to increase. The area’s economy is largely supported
by manufacturing, with service companies and agriculture accounting for another 35 percent.
Unemployment is typically 6 percent. The overall poverty rate is 12.4 percent. A recent study
revealed that 40,000 city residents are below 125 percent of the established federal poverty level.
HE A LT H C A R E CO S T S
Healthcare costs in the region are high in comparison to healthcare costs in most other
areas in the state. In response to what they feel are excessively high healthcare costs, county
C O A S TA L M E D I C A L C E N T E R
C O M P R E H E N S I V E C A S E
S T U D Y
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2 E s s e n t i a l s o f S t r a t e g i c P l a n n i n g i n H e a l t h c a r e
businesses recently formed a business coalition, hired a full-time executive, and publicly
stated their intent to achieve reduction in healthcare costs. The local press has expressed its
concern about the high cost of healthcare in the local community and consistently bashes
the area’s hospitals and physicians. The coalition refused to allow the three major medical
centers in the area to join, despite the fact that each is a major employer.
TH E CO M P E T I T I O N
CMC has two major competitors. Johnson Medical Center (JMC) is the larger of a two-
hospital for-profit healthcare system, and Lutheran Medical Center (LMC) is the larger of
a two-hospital, faith-based not-for-profit healthcare system.
JMC is located less than two miles from CMC and is a 430-bed tertiary care facility.
JMC owns four nursing homes, two assisted living facilities, a durable medical equipment
company, a wellness center, an ambulance service, and an industrial medic.
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An Overworked CEOThere are certain days when life seems unbearab.docx
An Overworked CEO
There are certain days when life seems unbearable. For Max Michael, MD, it had been one of those days. He had the difficult responsibility of balancing costs with access to care, of rationing procedures with policy, and of juggling personnel with budgets, performance, and demand. Dr. Michael, a former chief of staff at the hospital and now its chief executive officer (CEO), had spent the better part of his day fighting a losing battle in an understaffed, understocked, overflowing outpatient clinic. It was there, on the front lines, where he had first encountered the nature of the health care problem and developed his vision for its solution. As Dr. Michael left the clinic that evening, he mulled over a looming decision he was going to have to make. It was his last patient that reminded him of the importance of that decision.
692
693
Martha James Spent Her Day at Cooper Green Hospital
It was the second day in a row that Martha James missed work because she was running a fever and ached all over. She dared not miss another day for fear of losing the job she had with a small local business that paid above minimum wage but offered no health insurance. Her husband also was employed full time but did not receive any insurance benefits. Money was very tight for the couple and their two children, yet, based on federal guidelines, they were not eligible for financial assistance from the Aid to Families and Dependent Children (AFDC) welfare program; nor were they eligible for state Medicaid benefits. With no money to spare, the cost of a visit to a physician's office was a luxury Martha felt she could not afford. She did the only thing she knew to do: she headed for the emergency room at Cooper Green Hospital.
It was nearly 9:00 A.M. when Martha arrived after a 45-minute bus ride. She waited for more than two hours before her name was finally called. The nurse asked her about her symptoms. Barely even looking up, the nurse said Martha would have to be seen over at the Outpatient Clinic because her case was not truly an “emergency.” She was told to sign in at the Clinic desk and they would try to “work her in.”
After more than four hours of sitting in the overcrowded waiting room, Martha finally heard her name called again. The doctor who took her case was a silver-haired man with sharp eyes and a concerned demeanor. Dr. Michael quickly determined the problem: a respiratory tract infection that had been “going around” for weeks. When asked, she admitted she had been coughing for more than a week, but had hoped the severe cough would go away on its own. “Besides,” she said, “I can't afford to take a day off work to go to the doctor for just a cold.”
“The problem,” Dr. Michael explained, “is the infection is now affecting your lungs, which requires more intensive treatment than if you had come for help a week ago.”
Glancing at her chart, he realized she lived near Lawson State College, the location of one of the hospital's Community Care.
Hospital SystemFor this Dropbox assignment, please read pages .docx
Hospital System
For this Dropbox assignment, please read pages 692-716 (Case 14) of the course textbook Strategic Management in Health Care Organizations. In these pages, the Jefferson Hospital System (JHS) is described.
JHS consists of a full-service, acute-care hospital (Cooper Green Hospital), specialty outpatient clinics (Jefferson Outpatient Care), and six satellite, primary care clinics (the Community Care Plan).
With these components, JHS provides a full spectrum of medical care and a choice of two affordable payment options for what is considered to be an underserved population.
Create a 2- to 3-page report in Microsoft Word document that answers the following questions.
· Why do you think the components of this system are underutilized? (Please note that this is not just a problem of poor marketing and communication.)
· What would you do to increase the utilization of these services and attract a greater mix of paying patients? State at least four steps or actions you would take for this.
Support your responses with examples.
Cite any sources in APA format.
Assignment Grading Criteria
Maximum Points
Analyzed the components of the medical system at JHS that were underutilized.
Explained why the components of the medical system were underutilized.
Summarized the steps to increase the utilization of services and attract a greater mix of paying patients at JHS.
Notes from Class
As Dr. Michael entered his office, Martha James was still on his mind. It had been nearly four years since he launched the Community Care Plan, but in many ways it was still struggling. In his heart, he still believed it was a good model to provide access to preventive and routine medical services to the population traditionally served by Cooper Green Hospital: the poor and uninsured of Jefferson County. It placed small outpatient clinics within local neighborhoods.
They were staffed by physician assistants or nurse practitioners, who were supervised by a physician. For a quarterly fee, members could receive routine medical care at the CCP clinics. When needed, they also received care from specialists, and even inpatient hospital care at Cooper Green.
To Dr. Michael it made perfect sense; the CCP offered better access to services, less waiting time, less travel time, and a better atmosphere.
But the numbers did not agree. Although some of the CCP clinics established a reasonably sized patient base, others were struggling to attract members. If Martha James had been a CCP member, she could have been seen and received treatment before the infection had migrated to her lungs and she would not have had such a long waiting time. “For her, and thousands more like her,” Dr. Michael thought, “it's important to keep the CCP running–if at all possible.” But few people knew about the CCP and even fewer had joined.
The five-year funding that enabled the hospital to launch the CCP was about to run out. Dr. Michael knew he was facing a critical decision: .
6 9 2C A S E Cooper Green Hospital and the Com.docx
6 9 2
C A S E
Cooper Green
Hospital and the
Community
Care Plan
This case was written by Alice Adams and Peter M. Ginter, University of Alabama
at Birmingham, and Linda E. Swayne, The University of North Carolina at Charlotte.
It is intended as a basis for classroom discussion rather than to illustrate either
effective or ineffective handling of an administrative situation. Used with permis-
sion from Alice Adams.
14
An Overworked CEO
There are certain days when life seems unbearable. For Max
Michael, MD, it had been one of those days. He had the difficult
responsibility of balancing costs with access to care, of rationing
procedures with policy, and of juggling personnel with budgets,
performance, and demand. Dr. Michael, a former chief of staff at
the hospital and now its chief executive officer (CEO), had spent
the better part of his day fighting a losing battle in an understaffed,
understocked, overflowing outpatient clinic. It was there, on the
front lines, where he had first encountered the nature of the health
care problem and developed his vision for its solution. As Dr.
Michael left the clinic that evening, he mulled over a looming
decision he was going to have to make. It was his last patient that
reminded him of the importance of that decision.
both14.indd 692both14.indd 692 11/11/08 12:13:14 PM11/11/08 12:13:14 PM
6 9 36 9 3
Martha James Spent Her Day at Cooper Green Hospital
It was the second day in a row that Martha James missed work because she was run-
ning a fever and ached all over. She dared not miss another day for fear of losing the
job she had with a small local business that paid above minimum wage but offered
no health insurance. Her husband also was employed full time but did not receive
any insurance benefits. Money was very tight for the couple and their two children,
yet, based on federal guidelines, they were not eligible for financial assistance from
the Aid to Families and Dependent Children (AFDC) welfare program; nor were they
eligible for state Medicaid benefits. With no money to spare, the cost of a visit to a
physician’s office was a luxury Martha felt she could not afford. She did the only thing
she knew to do: she headed for the emergency room at Cooper Green Hospital.
It was nearly 9:00 A.M. when Martha arrived after a 45-minute bus ride. She waited
for more than two hours before her name was finally called. The nurse asked her
about her symptoms. Barely even looking up, the nurse said Martha would have to
be seen over at the Outpatient Clinic because her case was not truly an “emergency.”
She was told to sign in at the Clinic desk and they would try to “work her in.”
After more than four hours of sitting in the overcrowded waiting room, Martha
finally heard her name called again. The doctor who took her case was a silver-
haired man with sharp eyes and a concerned demeanor. Dr. Michael quickly
determined the problem: a respiratory tract infection.
CASE 14 Cooper Green Hospital and the Community Care PlanAn Ov.docx
CASE 14 Cooper Green Hospital and the Community Care Plan*
An Overworked CEO
There are certain days when life seems unbearable. For Max Michael, MD, it had been one of those days. He had the difficult responsibility of balancing costs with access to care, of rationing procedures with policy, and of juggling personnel with budgets, performance, and demand. Dr. Michael, a former chief of staff at the hospital and now its chief executive officer (CEO), had spent the better part of his day fighting a losing battle in an understaffed, understocked, overflowing outpatient clinic. It was there, on the front lines, where he had first encountered the nature of the health care problem and developed his vision for its solution. As Dr. Michael left the clinic that evening, he mulled over a looming decision he was going to have to make. It was his last patient that reminded him of the importance of that decision.
Martha James Spent Her Day at Cooper Green Hospital
It was the second day in a row that Martha James missed work because she was running a fever and ached all over. She dared not miss another day for fear of losing the job she had with a small local business that paid above minimum wage but offered no health insurance. Her husband also was employed full time but did not receive any insurance benefits. Money was very tight for the couple and their two children, yet, based on federal guidelines, they were not eligible for financial assistance from the Aid to Families and Dependent Children (AFDC) welfare program; nor were they eligible for state Medicaid benefits. With no money to spare, the cost of a visit to a physician's office was a luxury Martha felt she could not afford. She did the only thing she knew to do: she headed for the emergency room at Cooper Green Hospital.
It was nearly 9:00 A.M. when Martha arrived after a 45-minute bus ride. She waited for more than two hours before her name was finally called. The nurse asked her about her symptoms. Barely even looking up, the nurse said Martha would have to be seen over at the Outpatient Clinic because her case was not truly an “emergency.” She was told to sign in at the Clinic desk and they would try to “work her in.”
After more than four hours of sitting in the overcrowded waiting room, Martha finally heard her name called again. The doctor who took her case was a silver-haired man with sharp eyes and a concerned demeanor. Dr. Michael quickly determined the problem: a respiratory tract infection that had been “going around” for weeks. When asked, she admitted she had been coughing for more than a week, but had hoped the severe cough would go away on its own. “Besides,” she said, “I can't afford to take a day off work to go to the doctor for just a cold.”
“The problem,” Dr. Michael explained, “is the infection is now affecting your lungs, which requires more intensive treatment than if you had come for help a week ago.”
Glancing at her chart, he realized she lived near Lawson State College, ...
Review the Southeast Medical Center case study found on page 92 of.docx
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources. Write a three- to five-page paper (excluding title and reference pages) with your selected recommendations and justifications. The paper must be in APA format.
Southeast Medical Center Case Study
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources
In-Depth Case Study: Southeast Medical Center
The following case study involving a large organized delivery system exemplifies many of the issues described earlier in this chapter.
History and Evolution
Southeast Medical Center (SMC; a pseudonym) was established as a public hospital in the 1920s, just before the Depression. Located in the Southeast, a $1 million bond financed the 250-bed facility. Major expansion projects in the 1950s increased the hospital’s size to 600 beds. Formal affiliation with the local university’s College of Medicine residency program in the 1970s further expanded capacity. Thus, SMC became a public academic health center and subsequently assumed multiple missions of patient care, teaching, and research. Capital improvement programs were conducted during the 1970s, and in 1982, a massive renovation and construction project ($160 million) added 550 beds to the facility. In the 1980s, a 59-bed freestanding rehabilitation center was opened adjacent to the hospital, and a physicians’ office building was constructed next to the hospital. Medical helicopters were also acquired in 1989, expanding SMC’s trauma services. In addition to serving as a regional provider for trauma, SMC also furnishes burn, neonatal, and transplant care for the region.
Responsibility for governance of SMC has shifted over the years. In the early years of operation, a hospital board ran SMC. In the 1940s, the city was given direct control over the hospital. In the 1980s, the state legislature created a public hospital authority (to be appointed by the county commission) to govern the hospital. In the 1990s, the hospital’s board of trustees voted to turn operations of the hospital over to a private, not-for-profit corporation (501c-3), the SMC Corporation. However, oversight for charity care remained with the county’s hospital authority. The SMC Corporation is directed by a 15-member board of directors and essentially manages the organized delivery system through a lease arrangement with the county hospital authority.
Today, SMC is a private, not-for-profit academic health center that is accredited by JCAHO. It also serves as the ...
Review the Southeast Medical Center case study found on page 92 of.docx
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources. Write a three- to five-page paper (excluding title and reference pages) with your selected recommendations and justifications. The paper must be in APA format.
Southeast Medical Center Case Study
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources
In-Depth Case Study: Southeast Medical Center
The following case study involving a large organized delivery system exemplifies many of the issues described earlier in this chapter.
History and Evolution
Southeast Medical Center (SMC; a pseudonym) was established as a public hospital in the 1920s, just before the Depression. Located in the Southeast, a $1 million bond financed the 250-bed facility. Major expansion projects in the 1950s increased the hospital’s size to 600 beds. Formal affiliation with the local university’s College of Medicine residency program in the 1970s further expanded capacity. Thus, SMC became a public academic health center and subsequently assumed multiple missions of patient care, teaching, and research. Capital improvement programs were conducted during the 1970s, and in 1982, a massive renovation and construction project ($160 million) added 550 beds to the facility. In the 1980s, a 59-bed freestanding rehabilitation center was opened adjacent to the hospital, and a physicians’ office building was constructed next to the hospital. Medical helicopters were also acquired in 1989, expanding SMC’s trauma services. In addition to serving as a regional provider for trauma, SMC also furnishes burn, neonatal, and transplant care for the region.
Responsibility for governance of SMC has shifted over the years. In the early years of operation, a hospital board ran SMC. In the 1940s, the city was given direct control over the hospital. In the 1980s, the state legislature created a public hospital authority (to be appointed by the county commission) to govern the hospital. In the 1990s, the hospital’s board of trustees voted to turn operations of the hospital over to a private, not-for-profit corporation (501c-3), the SMC Corporation. However, oversight for charity care remained with the county’s hospital authority. The SMC Corporation is directed by a 15-member board of directors and essentially manages the organized delivery system through a lease arrangement with the county hospital authority.
Today, SMC is a private, not-for-profit academic health center that is accredited by JCAHO. It also serves as the ...
Crisis At Weems Hospital
This is a recap of recent events involving the Board of County Commissioners and Weems Hospital.
Assignment 2 Dropbox AssignmentOpen Heart Surgery.docx
Assignment 2: Dropbox Assignment
Open Heart Surgery
For your Dropbox assignment, read the following article on pages 803-816, Case 19 from your course textbook Strategic Management in Health Care Organizations.
"The Case for Open Heart Surgery at Cabarrus."
Based on your reading of the above article, create a 4- to 5-page report in Microsoft Word document that covers the following questions:
· Why is the hospital considering this additional service?
· Does the hospital and community really need this service? Why or why not?
· What should be the most important characteristics of a hospital in which one would want to have an open heart surgery?
· Is it financially viable for a hospital to offer this service? What costs and revenues would you predict to know the viability? Would any revenues cover the costs of offering this service?
In addition to the above, state any three instances that could go wrong if this service is offered.
Support your responses with examples.
Cite any sources in APA format.
CASE 19 The Case for Open Heart Surgery at Cabarrus Memorial Hospital*
Situation
It was a clear, crisp October morning in Concord, North Carolina. The board of trustees of Cabarrus Memorial Hospital gathered in the windowless, walnut paneled boardroom for its monthly meeting (see Exhibit 19/1 for board members). Board chairman George Batte opened the meeting saying, “Because we do not have an open heart surgery program, patients needing open heart surgery or coronary angioplasty have to be transferred to another hospital, causing inconvenience to the patient's families and risks from delayed treatment. There are several questions we have to answer in addressing this issue. Should we add open heart surgery to the mix of cardiac services we offer? Does the hospital's existing service area provide adequate patient volumes to support the program? What role should the Duke University Medical Center play in the proposed program? Willwe be able to obtain the required certificate of need [CON] from the State of North Carolina's Department of Health and Human Services? Will there be opposition to the CON from surrounding hospitals? What costs are likely to be incurred in the required renovation, construction, medical equipment, and staffing?”
Exhibit 19/1: CMH Board of Trustees
Mr. George A. Batte, Jr., Chairman (Retired Manufacturing Executive)
Mr. L. D. Coltrane, III, Vice Chairman (Telephone Company President)
Mr. Robert L. Wall (President, Cabarrus Memorial Hospital)
Mr. Dan Gray, Secretary (Executive Director, Charitable Foundation)
Mr. Durwood Bost, CPA (Retired Manufacturing Executive)
Mr. S. W. Colerider, Jr. (Retired Manufacturing Executive)
Mr. Gene Verble (Merchant and Retired Major League Baseball Player)
Mrs. Margaret C. West (Civic Leader)
He continued, “As you all know, one of the factors pressing a quick decision is the desire of Dr. R. S. “Chris” Christy to return to the staff of the hospital after completing his fellowship in cardiovascul ...
The NHS in the past, Eldergill
Summary of the organisation of the NHS from 1948 to 2003. Reproduced because recent reorganisations of NHS services often seem to be made in ignorance of the past and/or to replicate previous mistakes.
Case Study - The Merger of Two Competing Hospitals This case hig.docx
Case Study - The Merger of Two Competing Hospitals
This case highlights the process of merging two fully accredited hospitals, both of which have a full complement of state-of-the-art diagnostic technology, including MRI and CAT scanners, 24-hour physician-staffed emergency care centers, and specialized women’s centers. Both of these facilities are located in a community of 60,000 in the southeastern part of Idaho.
The success of the merger hinges on the timely resolution of several issues that the executive staff implemented, mutually enhancing solutions in the areas of: (1) leadership, (2) culture adaptation, (3) human resource management, (4) staffing, and (5) benefit issues.
Overview
Hospital A: Porter Regional Medical Center (PRMC)
Located on the east side of town, Porter Regional Medical Center (PRMC) was a for-profit hospital, consisting of 110 hospital beds, 8 of which were reserved for transitional care. PRMC was a privately owned facility. Mountain Health Care (MHC), a large healthcare organization in the Rocky Mountain region, owned the facility. Built in 1990, the facility was designed to efficiently handle patient flow from the emergency room to the pharmacy and to be a point of referral for more complicated patient conditions. PRMC services consisted of general and same-day surgery and full-service rehabilitation and radiology departments. Other services included a kidney dialysis center, on-site retail pharmacy, a regional Red Cross blood bank, 24-hour laboratory, home health, Infusion/Home IV, and a women’s center, including obstetrics and numerous other amenities.
Other assets owned by PRMC were the adjacent medical office buildings, a day care center, the land on which an assisted living center was located adjacent to the hospital, and the sports medicine complex adjacent to the state university’s arena. These assets represented 188,000 square feet of facility space housed on 63 acres. The hospital employed 450 personnel.
Last year, the hospital’s operating budget was $34 million. However, in the same year, the hospital experienced a $1 million loss, and a projected $500,000 loss was anticipated for the following year. After three years of red ink, PRMC decided to liquidate.
Hospital B: Banner Regional Medical Center (BRMC) and Turner Geriatric Center
Built in 1951, Banner Regional Medical Center (BRMC), a county-owned hospital, was located on the west side of town. The hospital structure included 154 inpatient beds and a geriatric healthcare center that consisted of 100-106 beds, 15 transitional care beds, and 7 rehabilitation beds. A medical office building with a parking structure was located adjacent to the hospital. The campus consisted of 561,366 square feet of building space, housed on 6 acres. The hospital’s operating budget for last year was $79 million. BRMC had a reserve fund of $20 million earmarked for major renovations to the existing facility’s emergency room and intensive care unit. BRMC’s servi ...
Everybody In! Newsletter - March 2015
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1IN T R O D U C T I O NThis comprehensive case study ser.docx
1
IN T R O D U C T I O N
This comprehensive case study serves as a basis for the exercises included throughout the
book.
Coastal Medical Center (CMC) is a licensed, 450-bed regional referral hospital
providing a full range of services. The primary service area is a coastal city and three coun-
ties, with a total population greater than 995,000, located in the Sunbelt. This tricounty
area has had one of the fastest population growth rates in the country for the past five
years. According to the local health planning council, the tricounty population is projected
to increase by 15 percent from 2015 to 2020. Appendix A, at the end of this case study,
provides detailed population statistics for the city and tricounty area.
The population growth rate for households (families) has been 1 to 2 percentage
points higher than the overall population growth. The growth rate of the population under
age 44 shows a young and growing community. Per capita (i.e., per person) income in the
tricounty area is high and increasing. As the population of the tricounty area increases, the
need for healthcare services is anticipated to increase. The area’s economy is largely supported
by manufacturing, with service companies and agriculture accounting for another 35 percent.
Unemployment is typically 6 percent. The overall poverty rate is 12.4 percent. A recent study
revealed that 40,000 city residents are below 125 percent of the established federal poverty level.
HE A LT H C A R E CO S T S
Healthcare costs in the region are high in comparison to healthcare costs in most other
areas in the state. In response to what they feel are excessively high healthcare costs, county
C O A S TA L M E D I C A L C E N T E R
C O M P R E H E N S I V E C A S E
S T U D Y
00_Harrison (2302).indb 1 2/18/16 4:12 PM10/12/2018 - RS0000000000000000000000574903 (Baylee Soper) - Essentials of Strategic Planning
in Healthcare
2 E s s e n t i a l s o f S t r a t e g i c P l a n n i n g i n H e a l t h c a r e
businesses recently formed a business coalition, hired a full-time executive, and publicly
stated their intent to achieve reduction in healthcare costs. The local press has expressed its
concern about the high cost of healthcare in the local community and consistently bashes
the area’s hospitals and physicians. The coalition refused to allow the three major medical
centers in the area to join, despite the fact that each is a major employer.
TH E CO M P E T I T I O N
CMC has two major competitors. Johnson Medical Center (JMC) is the larger of a two-
hospital for-profit healthcare system, and Lutheran Medical Center (LMC) is the larger of
a two-hospital, faith-based not-for-profit healthcare system.
JMC is located less than two miles from CMC and is a 430-bed tertiary care facility.
JMC owns four nursing homes, two assisted living facilities, a durable medical equipment
company, a wellness center, an ambulance service, and an industrial medic.
Similar to New L D S Apostle Quentin L (20)
An Overworked CEOThere are certain days when life seems unbearab.docx
An Overworked CEOThere are certain days when life seems unbearab.docx
Hospital SystemFor this Dropbox assignment, please read pages .docx
Hospital SystemFor this Dropbox assignment, please read pages .docx
6 9 2C A S E Cooper Green Hospital and the Com.docx
6 9 2C A S E Cooper Green Hospital and the Com.docx
CASE 14 Cooper Green Hospital and the Community Care PlanAn Ov.docx
CASE 14 Cooper Green Hospital and the Community Care PlanAn Ov.docx
Review the Southeast Medical Center case study found on page 92 of.docx
Review the Southeast Medical Center case study found on page 92 of.docx
Review the Southeast Medical Center case study found on page 92 of.docx
Review the Southeast Medical Center case study found on page 92 of.docx
Assignment 2 Dropbox AssignmentOpen Heart Surgery.docx
Assignment 2 Dropbox AssignmentOpen Heart Surgery.docx
Case Study - The Merger of Two Competing Hospitals This case hig.docx
Case Study - The Merger of Two Competing Hospitals This case hig.docx
INHERITED SIT_BEFORE PIC-DOJ PRESS RELEASE MAXIM SETTLEMENT SEPT 2011
INHERITED SIT_BEFORE PIC-DOJ PRESS RELEASE MAXIM SETTLEMENT SEPT 2011
1IN T R O D U C T I O NThis comprehensive case study ser.docx
1IN T R O D U C T I O NThis comprehensive case study ser.docx
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It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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The Normal Electrocardiogram - Part I of II
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journey
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Physiology of Chemical Sensation of smell.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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