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RUNNING HEAD: Problem solving (4)
Problem solving (4)
1
Problem solving (4)
Name
University
Date
According to Min Basadur, there are eight steps of solving
problems in a process, these steps are designed to address
problems in the best way that illustrates innovativeness and
resilience at all time. This analysis is based on Natalie
MacLachlan’s experience in finding a job after graduating from
university. The chapter illustrates expectations and experiences
that job seekers face when they get to new places of work.
Basadur methodology helps in guiding one to learn to adapt to
changes in work places or at times of adversity. The steps
Basadur considered are:
Step 1: Problem finding.
This step obtains meaning by following SWOT (Strengths,
Weaknesses, Opportunities and Threats) analysis. Natalie knew
her potential to produce good results from her days in school
where she would score highly in her exams and her ability to
work swiftly with others.
Weaknesses are important to note because they help one to
know their vulnerability and mitigate where they can. Natalie
planned for a good engagement at work upon graduation but to
her surprise, her supervisor made a sentiment to her the one has
to do things he shouldn’t do after she complained about her job.
Natalie observed she must have behaved unconventionally that
her superiors concluded that she was a slacker employee.
At the time Natalie was in college, Hospitals Software
Solution
s (HSS) was developed by Ottawa software engineering students
to solve challenges in hospitals which had not integrated
technology into their operations. The students saw a huge
opportunity because many hospitals used paperwork to store
information which technology would go a long way in helping
them to do it. Natalie’s willingness to work on behalf of
communities in London and Ottawa poised her to find
opportunities to work even when there is least monetary returns.
Threats are crucial in knowing an impending danger that if not
averted will damage good ventures. Natalie observed that her
poor performance in her first job posed a threat to her
productivity because of little motivation that infected her spirit.
HSS upon realizing imminent threat from its competitors
decided to buy and integrate them into itself.
Step 2: Fact finding.
· HSS was formed by a team of ten software engineering
students to address problems of data storage in hospitals.
· During Natalie’s interview, upon responding to questions and
information about herself to the panel, the company’s
management in unison observed that she was perfectly fit to
serve as the company’s project manager.
· Natalie was called to be informed that HSS had confirmed her
appointment into the position of project manager.
· Provisional budget cuts by the government forced hospitals to
innovate ways to serve patients effectively within their limits.
· Many hospitals in Ontario were still using paperwork to store
their information.
· HSS saw a huge opportunity in hospitals in Ontario because of
the old ways of data storage.
· HSS founders worked so hard and made huge sacrifices to
ensure that the company rose.
· Chow, a senior employee was resistant to use of technology in
the company to sort data.
Step 3: Problem defining.
Natalie received a call later from Densmore informing her that a
new offer was being made to her instead of project manager.
She was offered Customer Care Team Lead, which was a new
newly created position. She didn’t like the change because there
was no clear job description to it. Though Densmore insisted
that the job was more prestigious than the earlier one, she
accepted the offer partially with a condition that a clear job
description would be provided in two weeks. On arriving at the
workplace, she was dealt a major blow when she was told that
she would have to do data entry and database cleanup tasks
because there was no one to train her for the appointed job.
Step 4: Idea finding.
This is a way of creating means to solve problems, ideas
developed included:
· Natalie went to Chow to inquire on clarity of her job.
· Natalie devised new ways of saving time in her data entry to
reduce redundant data from the system.
· Natalie sought feedback from Chow to help in evaluating her
performance.
Step 5: Evaluating and selecting.
This step provides that the selected ideas are put into practice.
Natalie evaluated the procedural way of entering data manually
and established that it was a redundant way that caused all the
mess that accumulated workloads for weeks. She realized that
Chow was not happy with her performance in completing her
duties in time from colleagues so she decided to work on her on
ways and check figures under the help of existing program.
Step 6: Action planning.
This a way in which certain steps are developed that will lead to
successful implementation of a solution. Natalie was very
frustrated by Chow’s lack of appreciation to her efforts to work
faster, she noted that since her work didn’t require that she
collaborates with others, she began to work from home where
there were fewer distractions. She made the decision knowing
that Chow was too busy to spend time with neither her nor the
programming team.
Step 7: Gaining acceptance.
The idea in this step is that best ways of doing work can
sometimes be resisted by those not willing to embrace change.
Natalie worked so hard to beat timelines and deliver worthy
results by embracing technology usage to sort out information
faster and accurately but Chow was unwilling to support her
innovativeness. He instead frustrated her efforts by referring her
back to old redundant ways. Natalie decided to keep quiet and
work from home in the best way that she knew was fit for her
responsibilities.
Step 8: Taking action.
This step provides that deeds are done according to the steps
provided by action plan and continually evaluating and adopting
new insights that would help in ensuring that solutions are
implemented successfully. Natalie came to realize that serious
action needed to be done by the company if it were to grow. She
found no room for productive conversation with neither Chow
nor Worthington. She considered talking to the president of the
company because she wanted to make a change in the company.
Her own observation and that of her colleagues agreed that the
company’s president was an easy man to talk to and always
wanted to do everything that would be done to improve the
company. The chapter concludes with Natalie’s determination to
act without doing other mistakes and to get herself out of
blame.
In conclusion, Natalie found herself at the center of a
disfunctioning system that didn’t appreciate individual efforts
to improve the company’s productivity. Chow showed envy by
frustrating her good performance in data entry, even when faced
with a challenge in the system, he attributed all mess to Natalie.
It’s evident at the end of the chapter that Natalie was going to
make a choice for the good interest of the company.
References
Kurt, D. Tracy, J.F, & Robert, C.M (2017). Case in Health
Services Management. Health professional press.
Disaster management discussion Board Questions
1. Week 1 Discussion Forum
This week, explain the various responsibilities and services of
FEMA when a disaster occurs in the United States. Do some
research on past disasters, and describe how FEMA supported
the community and disaster efforts. Address 2-3 of the
following.
How did FEMA help people prepare for the disaster?
What services did FEMA provide to the community?
Who else participated in the disaster relief efforts?
How much monetary damage was caused by the disaster? Or,
how much did FEMA spend in relief?
What was public perception of FEMA and the response they
provided?
Provide links to your sources for others to reference.
Support your answer with evidence from the disasters that you
researched.
2. Week 2 Discussion Forum
Watch the videos and answer the questions that follow.
1. https://www.youtube.com/embed/zP4rgvu4xDE?rel=0
2. https://www.youtube.com/embed/e7ho6z32yyo?rel=0
Earthquakes (Video 2:56)
3. https://www.youtube.com/embed/dJBS94GVyuo?rel=0
Tsunamis (Video 3:28)
4. https://www.youtube.com/embed/5hghT1W33cY?rel=0
Wildfires (Video 3:12)
Choose one of the natural disasters represented in the videos
above and answer the following:
What are some of the nursing implications of this disaster?
What diseases do you need be concerned about and how would
you protect yourself and others? Be specific.
Support your answer with evidence from scholarly sources.
3. Week 3 Discussion Forum
For this week’s discussion, you are asked to research a
bioterrorist incident. Begin by reviewing the Media Focus video
on bioterrorism in Week 3 of the Content and Activities, then
explore the Internet.
Give an example and details from national/international news of
a bioterrorist attack.
Address all of the following in your post:
· What was the classification of biological agent used in the
attack?
· Discuss the implications of the biological agent.
· Discuss the therapy for the biological agent.
· What are the decontamination procedures for the biological
agent used in the attack?
· Define the appropriate level of PPE required for this type of
biological agent?
· In your post, provide the name of the incident you have
chosen, and support your answers with evidence/examples.
Please provide a working link and a citation for your source(s).
Support your answer with evidence from scholarly sources.
4. Week 4 Discussion Forum
For this week's discussion, we will be looking at local or
national response protocols that were initiated during a critical
incident, and you will choose your topic!
Search reputable local and national media for a man-made
disaster to discuss.
Search for critical instances such as: hostage situations, mass
shootings, multiple-vehicle or mass transit accidents with
multiple critical injuries, and disease outbreaks.
In your initial post, describe the incident and address the
following:
· Determine the incident type and explain your reasoning.
· What resources were deployed for this incident?
· What protocols were implemented successfully, and which
were unsuccessful?
· Discuss way to improve the response to this type of incident in
the future.
Support your answer with evidence. Please provide a working
link to your story source.
5. Week 5 Discussion Forum
We have already discussed weather related natural disasters and
bioterrorism, and now we will focus on other types of disasters.
For this week’s discussion, you are asked to research a
technological or human induced disaster.
(This not the same as in Weeks 3 and 4 where you might have
discussed hostage situations, mass shootings, multiple-vehicle
or mass transit accidents with multiple critical injuries,
bioterrorism, and disease outbreaks.) Here you want to look at
situations such as radiological, nuclear accidents, technological
disasters (electromagnetic pulse), and hazardous material spills.
In your post, provide the name of the incident you have chosen,
and support your answers with evidence/examples. Please
provide a working link and a citation for your source(s).
Select 2 of the items below to discuss:
· At what point does a technological or man-made event become
labeled a disaster?
· Name and explain the impact categories associated with your
disaster.
· How well do you think the United States is prepared for a
disaster like the one you selected?
· Discuss the factors that can influence the effects a disaster
may have on a community or region.
· What nursing interventions would be a priority for these
victims?
· What community resources should be provided to the victims
for follow up needs?
· Support your answer with evidence from scholarly sources.
6. Week 6 Discussion Forum
This week, read the journal article "Challenges and Resources
for Participating in a Hurricane Sandy Hospital Evacuation" and
complete the activity below.
https://learn-us-east-1-prod-fleet01-xythos.s3.us-east-
1.amazonaws.com/5c12b64692d5f/4172331?response-content-
disposition=inline%3B%20filename%2A%3DUTF-
8%27%27Hurricane%2520Sandy%2520Article-
Week%25206.pdf&response-content-
type=application%2Fpdf&X-Amz-Algorithm=AWS4-HMAC-
SHA256&X-Amz-Date=20200330T202359Z&X-Amz-
SignedHeaders=host&X-Amz-Expires=21600&X-Amz-
Credential=AKIAZH6WM4PLTYPZRQMY%2F20200330%2Fus
-east-1%2Fs3%2Faws4_request&X-Amz-
Signature=efcce76e24e6c915a990e430bad1cc751b7080e60e648f
11836831798ee63d26
After completing the activity, discuss your role as a nurse in
disaster preparedness and response. Describe your current
patient population and discuss the challenges you might face in
carrying out your responsibilities in a disaster.
How could you gain more hands-on training to supplement your
academic study of disaster management? How could you feel
more prepared? Discuss different training options that you
could participate in (e.g., CERT training).
Support your answer with evidence from scholarly sources.
7. Week 7 Discussion Forum
This week you will put together your 72-hour disaster home "go
bag" and evaluate your preparedness.
Here are the steps for your initial post:
1. Use the lists available at the Ready.gov website, FEMA, or
the Red Cross website to gather items for your 72-hour home go
bag. Add additional items that you think will be useful and
essential for your family. (You are not required to purchase
items, but you may if you choose.)
https://www.ready.gov/kit
https://www.fema.gov/media-library/assets/documents/90354
https://www.redcross.org/get-help/how-to-prepare-for-
emergencies.html
2. Post a picture of all of the items you have gathered for your
go bag. For the sake of personal and family privacy, keep
personal/private items out of the photograph; you may list them
(e.g., prescription medications).
You must take and submit a picture of your own items! You
may not post a picture from the internet or any other source.
· Along with your photo, include the following information:
· A discussion of the items in your home go bag - what is
present and what is missing.
· A brief explanation of the demographic considerations and
potential disaster hazards in your area and why you included
certain items.
· Your family, pets, and living situation considerations and why
you included certain items.
· Are you prepared to help others in your community in the
event of a disaster?
· Support your answers with evidence from scholarly sources.
Additional Resources
https://www.nytimes.com/2017/07/03/smarter-living/packing-
emergency-kit-disaster.html
https://www.mysafela.org/survival-kit/
8. Week 8 Discussion Forum
Review the American Nurses Association (ANA) Code of Ethics
https://learn-us-east-1-prod-fleet01-xythos.s3.us-east-
1.amazonaws.com/5c12b64692d5f/4297897?response-content-
disposition=inline%3B%20filename%2A%3DUTF-
8%27%27Code%2520for%2520Ethics%2520for%2520Nurses%2
520with%2520Interpretive%2520Statements_2015.pdf&respons
e-content-type=application%2Fpdf&X-Amz-Algorithm=AWS4-
HMAC-SHA256&X-Amz-Date=20200330T203100Z&X-Amz-
SignedHeaders=host&X-Amz-Expires=21600&X-Amz-
Credential=AKIAZH6WM4PLTYPZRQMY%2F20200330%2Fus
-east-1%2Fs3%2Faws4_request&X-Amz-
Signature=b58ad11e14923565b55c2149fda5831d5e9bdd6ae977b
839cc11f79fe5c74da9
Address the questions below in your discussion post this week:
· Does the law require you to respond in disaster situations?
· Do RNs have a contractual responsibility to respond in
disaster situations?
· Are you familiar with the laws in your state?
Support your answers with evidence from scholarly sources.
9. Week 9 Discussion Forum
For this week's discussion, click on the Additional Resources
folder located on the main menu. Scroll down to Week 9
Resources.
https://emergency.cdc.gov/coping/index.asp
Choose one of the websites to visit and explore. Choose a
subject/topic that you find most interesting. Provide a link to
the website and the source citation in your post.
Address all of the following:
· Why did you select this resource/site? Why do you find the
subject/topic interesting?
· What is the one thing you want others to know about this
subject/topic that is found on the website?
· What information had the greatest impact on you? Explain.
Support your answers with evidence from the site that you
visited and provide a citation for that website
2
3
Health Professions Press, Inc.
Post Office Box 10624
Baltimore, Maryland 21285-0624
www.healthpropress.com
Copyright © 2017 by Health Professions Press, Inc.
All rights reserved.
Manufactured in the United States of America by Versa Press,
East Peoria, Illinois.
Cover and interior designs by Erin Geoghegan.
Typeset by Absolute Service, Inc., Towson, MD.
This casebook can be used alone or in conjunction with other
texts. To help
instructors use the cases most effectively in the classroom, the
editors have
prepared an instructor’s guide, Instructor’s Manual for Cases in
Health Services
Management, available to faculty as a downloadable PDF file
from Health
Professions Press (see website and address above or call 1-888-
337-8808 or 1-410-
337-9585). Cases in Health Services Management can also be
used in conjunction
with the textbook, Managing Health Services Organizations and
Systems, also
published by Health Professions Press.
The cases presented in this volume are based on the case
authors’ field research in
a specific organization or are composite cases based on
experiences with several
organizations. In most instances, the names of organizations and
individuals and
identifying details have been changed. Cases are intended to
stimulate discussion
and analysis and are not meant to reflect positively or
negatively on actual persons
or organizations.
Library of Congress Cataloging-in-Publication Data
Names: Darr, Kurt, editor. | Farnsworth, Tracy J., editor. |
Myrtle, Robert C.,
editor.
Title: Cases in health services management / edited by Kurt
Darr, Tracy J.
Farnsworth, Robert C. Myrtle.
Description: Sixth edition. | Baltimore : Health Professions
Press, Inc., [2017] |
Preceded by: Cases in health services management / edited by
Jonathon S.
Rakich, Beaufort B. Longest, Kurt Darr. 5th ed. c2010. |
Includes bibliographical
4
http://www.healthpropress.com
references. | Description based on print version record and CIP
data provided by
publisher; resource not viewed.
Identifiers: LCCN 2017008811 (print) | LCCN 2017010156
(ebook) | ISBN
9781938870736 (epub) | ISBN 9781938870620 (pbk.)
Subjects: | MESH: Hospital Administration | Health Services
Administration |
Total Quality Management | Organizational Case Studies |
United States
Classification: LCC RA971 (ebook) | LCC RA971 (print) | NLM
WX 150 | DDC
362.10973—dc23
LC record available at https://lccn.loc.gov/2017008811
British Library Cataloguing-in-Publication data are available
from the British
Library.
5
https://www.lccn.loc.gov/2017008811
To the Alumni of the GWU MHA Program
(Dedication of Dr. Darr)
To my wife, Michelle;
parents Karl and Jackie;
and children, Lindsey (Dan), Taylor (Jill), Rachel (Steven), and
Dallin
(Dedication of Dr. Farnsworth)
To my students, who made this work possible
(Dedication of Dr. Myrtle)
6
Additional titles on healthcare management and
administration
Managing Health Services Organizations and Systems (Sixth
Edition)
Ethics in Health Services Management (Sixth Edition)
Climbing the Healthcare Management Ladder: Career Advice
from
the Top on How to Succeed
Superior Productivity in Healthcare Organizations: How to Get
It,
How to Keep It (Second Edition)
Becoming an Effective Leader in Healthcare Management: The
12
Essential Skills (Second Edition)
7
http://www.amazon.com/dp/B00J8UH3LW?tag=inscdigi04-20
https://www.amazon.com/Ethics-Health-Services-Management-
Sixth-
ebook/dp/B07JMLX52C/ref=sr_1_1_twi_kin_1?ie=UTF8&qid=1
545241676&sr=8-1&keywords=9781938870811
https://www.amazon.com/Climbing-Healthcare-Management-
Ladder-Succeed-
ebook/dp/B00X4G501Q/ref=sr_1_1_twi_kin_1?ie=UTF8&qid=1
545845644&sr=8-1&keywords=9781938870194
https://www.amazon.com/s/ref=nb_sb_noss?url=search-
alias%3Daps&field-keywords=9781938870590
https://www.amazon.com/Becoming-Effective-Leader-
Healthcare-Management-
ebook/dp/B0767Q2FHY/ref=sr_1_1_twi_kin_1?ie=UTF8&qid=1
545846357&sr=8-1&keywords=9781938870750
Contents
About the Editors
Contributors
Preface
Acknowledgments
Introduction
PART I POLICY ENVIRONMENT OF HEALTH SERVICES
DELIVERY
1 Carilion Clinic
Alexandra Piriz Mookerjee and Kurt Darr
Led by a new CEO, the efforts of a mid-Atlantic acute care
hospital
to develop a vertically integrated, clinic-driven health services
system
result in allegations of antitrust, excessive healthcare costs,
disruption
of physician referral patterns, and use of harsh collection
practices,
all of which cause a negative reaction in its service area.
2 Flu Vaccine
Mary K. Feeney and Abigail Peterman
Flu vaccine shortages in 2004–2005 caused by a major
manufacturer’s problems with quality control result in federal
and
state efforts to secure supplies of the vaccine and raise public
policy
and resource-allocation issues that users can role-play in three
scenarios.
3 Merck’s Crixivan
Kimberly A. Rucker, Nora G. Albert, and Kurt Darr
A pharmaceutical manufacturer encounters significant negative
stakeholder reaction to its introduction of a new medication for
the
human immunodeficiency virus despite having met expectations
for
clinical rigor and carefully assessing stakeholders and the
external
environment.
8
4 Pineridge Quality Alliance: A Case Study in Clinical
Integration
and Population Health
Tracy J. Farnsworth
A new CEO urges his board to move toward becoming an
accountable care organization and promoting regional
population
health, which demands choosing among three common
approaches to
navigating the challenges and opportunities of developing a
clinically
integrated network.
5 Hawaii Health Systems Corporation: The Politics of Public
Health Systems Governance
Earl G. Greenia
A healthcare executive facing continual public policy
restructuring of
Hawaii’s Health Systems Corporation must develop strategic
options
for his board to consider in response to this environmental
uncertainty.
PART II STRATEGIC MANAGEMENT
6 Riviera Medical Center
Michael J. King and Robert C. Myrtle
The CEO of a 350-bed hospital explores strategic alternatives to
enhance its financial situation and reputation by asking the
hospital
board to approve a worksite wellness program to be marketed to
area
companies to improve workers’ health and decrease employers’
healthcare costs.
7 Edgewood Lake Hospital: Leadership in a Rural Healthcare
Facility During Challenging Economic Times
Brent C. Pottenger, Douglas Archer, Stephen Cheung, and
Robert C.
Myrtle
The new CEO of a 30-bed, not-for-profit rural hospital faces a
turnaround situation to make the hospital profitable after 3
years of
losses. Problems include challenging payer mix, employee
overstaffing, and difficulty recruiting physicians.
8 Klamath Care: Targeting and Managing Growth and
Company-
Wide Development
Tracy J. Farnsworth, Leigh W. Cellucci, and Carla Wiggins
9
The CEO of a growing system of urgent care centers recounts
the
organization’s development over a decade while considering
strategies and options for future growth in an increasingly
crowded
marketplace with an analysis that uses financial, market share,
and
demographic data.
9 Hospital Consolidation
Tracy J. Farnsworth
This case focuses on the relationship healthcare providers have
with
their local and regional markets and the need to balance
organization
and community interests when making decisions that affect the
healthcare marketplace.
10 Service Area Management
Tracy J. Farnsworth
Users are challenged to analyze, prioritize, and use disparate
information common to a dynamic and competitive healthcare
marketplace as part of an organization’s strategic planning and
marketing processes.
11 Western Healthcare Systems: A Healthcare Delivery
Continuum
Robert C. Myrtle
Western Healthcare Systems was creating an integrated delivery
system when an opportunity to acquire a large multispecialty
group
arose, but it may be imprudent to proceed because of hospital
and
multispecialty group physician resistance.
PART III ORGANIZATIONAL MANAGEMENT
12 Hartland Memorial Hospital: Part 1, In-Box and
Prioritization
Exercise
Kent V. Rondeau, John E. Paul, and Jonathon S. Rakich
The VP for nursing services of a 285-bed for-profit hospital
must
decide what actions to take regarding her in-box, which
includes e-
mail, correspondence, and phone messages that communicate
various
challenges, such as two angry nurses, a wandering patient, staff
shortages, and increasing numbers of OR infections.
Emphasizes
priority setting, decision making, and delegation.
13 Bad Image Radiology Department
10
Kurt Darr
Management of a community hospital is unwilling to recognize
and
address major problems in its radiology department, which is
directed
by a radiologist whose disruptive behavior and preoccupation
with
income and stock market speculation have diminished the
quality of
radiograph readings with tragic results.
14 Westmount Nursing Homes: Implementing a Continuous
Quality
Improvement Initiative
Kent V. Rondeau
The future of a total quality management initiative is threatened
when
the CEO has to overcome more than the expected barriers and
pitfalls
in a chain of seven nursing homes and the initiative becomes
entangled in negotiations with the union representing nurses.
15 District Hospital: A Lesson in Governance
Cynthia Mahood Levin and Kurt Darr
A tax district community hospital has major problems with its
governance structure because of historical animosities among
internal
stakeholders, medical staff politics, weak and ambivalent senior
management, and a disruptive member of the medical staff who
has
ambitions to attain major power in the hospital.
16 Restructuring Decision Making at Holy Family Hospital:
Overcoming Resistance to a Shared Governance Program
Kent V. Rondeau
A change initiative introduced to democratize decision making
and
improve clinical care in a healthcare organization is met with
staff
suspicion, derision, and resistance.
PART IV ORGANIZATIONAL EFFECTIVENESS
17 Attica Memorial Hospital: The Ingelson Burn Center
Bonnie Eng-Suess and Robert C. Myrtle
After the merger of two hospitals, planning must include how to
consolidate duplicated services and realign units, including a
burn
center, while considering the center’s financing and community
and
organizational impact.
11
18 Pediatric Dental Care Center
Eleanor Lin
A not-for-profit pediatric dental care center that has struggled
financially for years as it serves a Medicaid population is
offered the
opportunity to become part of a federally qualified health
center, but
to do so requires expanding services and significantly changing
its
governance structure.
19 Radical Innovation on the Idaho Frontier: Bengal
Telepharmacy
Julie Frischmann, Neil Tocher, and Alexander R. Bolinger
Efforts to provide pharmacy services in a rural community are
successful because of creative thinking, perseverance, political
deal
making, and using telepharmacy in a unique and effective way.
20 Structure and Funding of Hospitalist Programs
John E. Paul and Gillian Gilson Watson
An academic medical center must decide how to structure and
fund
hospitalist services in the context of its relationship with an
affiliated
school of medicine; the history and content of hospitalist
functions;
and other revenue that might be derived from hospitalist
services,
even while considering several alternate strategies.
21 Appian Health Systems
Robert C. Myrtle
A negotiation simulation allows participants to assume union
and
hospital roles to work toward an acceptable collective
bargaining
agreement.
22 Evolution of the Healthy Communities Initiatives
Barry Ross
Several years after initiating healthcare services for diverse,
underserved communities, hospital leadership is planning how
to take
its activities to a level with greater impact and sustainability.
PART V LEADERSHIP CHALLENGES
23 Hospital Software
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  • 1. RUNNING HEAD: Problem solving (4) Problem solving (4) 1 Problem solving (4) Name University Date According to Min Basadur, there are eight steps of solving problems in a process, these steps are designed to address problems in the best way that illustrates innovativeness and resilience at all time. This analysis is based on Natalie MacLachlan’s experience in finding a job after graduating from university. The chapter illustrates expectations and experiences that job seekers face when they get to new places of work. Basadur methodology helps in guiding one to learn to adapt to changes in work places or at times of adversity. The steps Basadur considered are: Step 1: Problem finding. This step obtains meaning by following SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis. Natalie knew her potential to produce good results from her days in school where she would score highly in her exams and her ability to work swiftly with others. Weaknesses are important to note because they help one to know their vulnerability and mitigate where they can. Natalie planned for a good engagement at work upon graduation but to her surprise, her supervisor made a sentiment to her the one has to do things he shouldn’t do after she complained about her job. Natalie observed she must have behaved unconventionally that
  • 2. her superiors concluded that she was a slacker employee. At the time Natalie was in college, Hospitals Software Solution s (HSS) was developed by Ottawa software engineering students to solve challenges in hospitals which had not integrated technology into their operations. The students saw a huge opportunity because many hospitals used paperwork to store information which technology would go a long way in helping them to do it. Natalie’s willingness to work on behalf of communities in London and Ottawa poised her to find opportunities to work even when there is least monetary returns. Threats are crucial in knowing an impending danger that if not averted will damage good ventures. Natalie observed that her poor performance in her first job posed a threat to her productivity because of little motivation that infected her spirit. HSS upon realizing imminent threat from its competitors decided to buy and integrate them into itself. Step 2: Fact finding. · HSS was formed by a team of ten software engineering students to address problems of data storage in hospitals. · During Natalie’s interview, upon responding to questions and information about herself to the panel, the company’s management in unison observed that she was perfectly fit to
  • 3. serve as the company’s project manager. · Natalie was called to be informed that HSS had confirmed her appointment into the position of project manager. · Provisional budget cuts by the government forced hospitals to innovate ways to serve patients effectively within their limits. · Many hospitals in Ontario were still using paperwork to store their information. · HSS saw a huge opportunity in hospitals in Ontario because of the old ways of data storage. · HSS founders worked so hard and made huge sacrifices to ensure that the company rose. · Chow, a senior employee was resistant to use of technology in the company to sort data. Step 3: Problem defining. Natalie received a call later from Densmore informing her that a new offer was being made to her instead of project manager. She was offered Customer Care Team Lead, which was a new newly created position. She didn’t like the change because there was no clear job description to it. Though Densmore insisted that the job was more prestigious than the earlier one, she
  • 4. accepted the offer partially with a condition that a clear job description would be provided in two weeks. On arriving at the workplace, she was dealt a major blow when she was told that she would have to do data entry and database cleanup tasks because there was no one to train her for the appointed job. Step 4: Idea finding. This is a way of creating means to solve problems, ideas developed included: · Natalie went to Chow to inquire on clarity of her job. · Natalie devised new ways of saving time in her data entry to reduce redundant data from the system. · Natalie sought feedback from Chow to help in evaluating her performance. Step 5: Evaluating and selecting. This step provides that the selected ideas are put into practice. Natalie evaluated the procedural way of entering data manually and established that it was a redundant way that caused all the mess that accumulated workloads for weeks. She realized that Chow was not happy with her performance in completing her duties in time from colleagues so she decided to work on her on ways and check figures under the help of existing program. Step 6: Action planning.
  • 5. This a way in which certain steps are developed that will lead to successful implementation of a solution. Natalie was very frustrated by Chow’s lack of appreciation to her efforts to work faster, she noted that since her work didn’t require that she collaborates with others, she began to work from home where there were fewer distractions. She made the decision knowing that Chow was too busy to spend time with neither her nor the programming team. Step 7: Gaining acceptance. The idea in this step is that best ways of doing work can sometimes be resisted by those not willing to embrace change. Natalie worked so hard to beat timelines and deliver worthy results by embracing technology usage to sort out information faster and accurately but Chow was unwilling to support her innovativeness. He instead frustrated her efforts by referring her back to old redundant ways. Natalie decided to keep quiet and work from home in the best way that she knew was fit for her responsibilities. Step 8: Taking action. This step provides that deeds are done according to the steps provided by action plan and continually evaluating and adopting new insights that would help in ensuring that solutions are implemented successfully. Natalie came to realize that serious
  • 6. action needed to be done by the company if it were to grow. She found no room for productive conversation with neither Chow nor Worthington. She considered talking to the president of the company because she wanted to make a change in the company. Her own observation and that of her colleagues agreed that the company’s president was an easy man to talk to and always wanted to do everything that would be done to improve the company. The chapter concludes with Natalie’s determination to act without doing other mistakes and to get herself out of blame. In conclusion, Natalie found herself at the center of a disfunctioning system that didn’t appreciate individual efforts to improve the company’s productivity. Chow showed envy by frustrating her good performance in data entry, even when faced with a challenge in the system, he attributed all mess to Natalie. It’s evident at the end of the chapter that Natalie was going to make a choice for the good interest of the company. References Kurt, D. Tracy, J.F, & Robert, C.M (2017). Case in Health Services Management. Health professional press. Disaster management discussion Board Questions 1. Week 1 Discussion Forum This week, explain the various responsibilities and services of
  • 7. FEMA when a disaster occurs in the United States. Do some research on past disasters, and describe how FEMA supported the community and disaster efforts. Address 2-3 of the following. How did FEMA help people prepare for the disaster? What services did FEMA provide to the community? Who else participated in the disaster relief efforts? How much monetary damage was caused by the disaster? Or, how much did FEMA spend in relief? What was public perception of FEMA and the response they provided? Provide links to your sources for others to reference. Support your answer with evidence from the disasters that you researched. 2. Week 2 Discussion Forum Watch the videos and answer the questions that follow. 1. https://www.youtube.com/embed/zP4rgvu4xDE?rel=0 2. https://www.youtube.com/embed/e7ho6z32yyo?rel=0 Earthquakes (Video 2:56) 3. https://www.youtube.com/embed/dJBS94GVyuo?rel=0 Tsunamis (Video 3:28) 4. https://www.youtube.com/embed/5hghT1W33cY?rel=0 Wildfires (Video 3:12) Choose one of the natural disasters represented in the videos
  • 8. above and answer the following: What are some of the nursing implications of this disaster? What diseases do you need be concerned about and how would you protect yourself and others? Be specific. Support your answer with evidence from scholarly sources. 3. Week 3 Discussion Forum For this week’s discussion, you are asked to research a bioterrorist incident. Begin by reviewing the Media Focus video on bioterrorism in Week 3 of the Content and Activities, then explore the Internet. Give an example and details from national/international news of a bioterrorist attack. Address all of the following in your post: · What was the classification of biological agent used in the attack? · Discuss the implications of the biological agent. · Discuss the therapy for the biological agent. · What are the decontamination procedures for the biological agent used in the attack? · Define the appropriate level of PPE required for this type of biological agent? · In your post, provide the name of the incident you have chosen, and support your answers with evidence/examples.
  • 9. Please provide a working link and a citation for your source(s). Support your answer with evidence from scholarly sources. 4. Week 4 Discussion Forum For this week's discussion, we will be looking at local or national response protocols that were initiated during a critical incident, and you will choose your topic! Search reputable local and national media for a man-made disaster to discuss. Search for critical instances such as: hostage situations, mass shootings, multiple-vehicle or mass transit accidents with multiple critical injuries, and disease outbreaks. In your initial post, describe the incident and address the following: · Determine the incident type and explain your reasoning. · What resources were deployed for this incident? · What protocols were implemented successfully, and which were unsuccessful? · Discuss way to improve the response to this type of incident in the future. Support your answer with evidence. Please provide a working
  • 10. link to your story source. 5. Week 5 Discussion Forum We have already discussed weather related natural disasters and bioterrorism, and now we will focus on other types of disasters. For this week’s discussion, you are asked to research a technological or human induced disaster. (This not the same as in Weeks 3 and 4 where you might have discussed hostage situations, mass shootings, multiple-vehicle or mass transit accidents with multiple critical injuries, bioterrorism, and disease outbreaks.) Here you want to look at situations such as radiological, nuclear accidents, technological disasters (electromagnetic pulse), and hazardous material spills. In your post, provide the name of the incident you have chosen, and support your answers with evidence/examples. Please provide a working link and a citation for your source(s). Select 2 of the items below to discuss: · At what point does a technological or man-made event become labeled a disaster? · Name and explain the impact categories associated with your
  • 11. disaster. · How well do you think the United States is prepared for a disaster like the one you selected? · Discuss the factors that can influence the effects a disaster may have on a community or region. · What nursing interventions would be a priority for these victims? · What community resources should be provided to the victims for follow up needs? · Support your answer with evidence from scholarly sources. 6. Week 6 Discussion Forum This week, read the journal article "Challenges and Resources for Participating in a Hurricane Sandy Hospital Evacuation" and complete the activity below. https://learn-us-east-1-prod-fleet01-xythos.s3.us-east- 1.amazonaws.com/5c12b64692d5f/4172331?response-content- disposition=inline%3B%20filename%2A%3DUTF- 8%27%27Hurricane%2520Sandy%2520Article- Week%25206.pdf&response-content- type=application%2Fpdf&X-Amz-Algorithm=AWS4-HMAC- SHA256&X-Amz-Date=20200330T202359Z&X-Amz- SignedHeaders=host&X-Amz-Expires=21600&X-Amz- Credential=AKIAZH6WM4PLTYPZRQMY%2F20200330%2Fus -east-1%2Fs3%2Faws4_request&X-Amz-
  • 12. Signature=efcce76e24e6c915a990e430bad1cc751b7080e60e648f 11836831798ee63d26 After completing the activity, discuss your role as a nurse in disaster preparedness and response. Describe your current patient population and discuss the challenges you might face in carrying out your responsibilities in a disaster. How could you gain more hands-on training to supplement your academic study of disaster management? How could you feel more prepared? Discuss different training options that you could participate in (e.g., CERT training). Support your answer with evidence from scholarly sources. 7. Week 7 Discussion Forum This week you will put together your 72-hour disaster home "go bag" and evaluate your preparedness. Here are the steps for your initial post: 1. Use the lists available at the Ready.gov website, FEMA, or the Red Cross website to gather items for your 72-hour home go bag. Add additional items that you think will be useful and essential for your family. (You are not required to purchase items, but you may if you choose.) https://www.ready.gov/kit https://www.fema.gov/media-library/assets/documents/90354 https://www.redcross.org/get-help/how-to-prepare-for-
  • 13. emergencies.html 2. Post a picture of all of the items you have gathered for your go bag. For the sake of personal and family privacy, keep personal/private items out of the photograph; you may list them (e.g., prescription medications). You must take and submit a picture of your own items! You may not post a picture from the internet or any other source. · Along with your photo, include the following information: · A discussion of the items in your home go bag - what is present and what is missing. · A brief explanation of the demographic considerations and potential disaster hazards in your area and why you included certain items. · Your family, pets, and living situation considerations and why you included certain items. · Are you prepared to help others in your community in the event of a disaster? · Support your answers with evidence from scholarly sources. Additional Resources https://www.nytimes.com/2017/07/03/smarter-living/packing- emergency-kit-disaster.html https://www.mysafela.org/survival-kit/ 8. Week 8 Discussion Forum
  • 14. Review the American Nurses Association (ANA) Code of Ethics https://learn-us-east-1-prod-fleet01-xythos.s3.us-east- 1.amazonaws.com/5c12b64692d5f/4297897?response-content- disposition=inline%3B%20filename%2A%3DUTF- 8%27%27Code%2520for%2520Ethics%2520for%2520Nurses%2 520with%2520Interpretive%2520Statements_2015.pdf&respons e-content-type=application%2Fpdf&X-Amz-Algorithm=AWS4- HMAC-SHA256&X-Amz-Date=20200330T203100Z&X-Amz- SignedHeaders=host&X-Amz-Expires=21600&X-Amz- Credential=AKIAZH6WM4PLTYPZRQMY%2F20200330%2Fus -east-1%2Fs3%2Faws4_request&X-Amz- Signature=b58ad11e14923565b55c2149fda5831d5e9bdd6ae977b 839cc11f79fe5c74da9 Address the questions below in your discussion post this week: · Does the law require you to respond in disaster situations? · Do RNs have a contractual responsibility to respond in disaster situations? · Are you familiar with the laws in your state? Support your answers with evidence from scholarly sources. 9. Week 9 Discussion Forum For this week's discussion, click on the Additional Resources
  • 15. folder located on the main menu. Scroll down to Week 9 Resources. https://emergency.cdc.gov/coping/index.asp Choose one of the websites to visit and explore. Choose a subject/topic that you find most interesting. Provide a link to the website and the source citation in your post. Address all of the following: · Why did you select this resource/site? Why do you find the subject/topic interesting? · What is the one thing you want others to know about this subject/topic that is found on the website? · What information had the greatest impact on you? Explain. Support your answers with evidence from the site that you visited and provide a citation for that website
  • 16. 2 3 Health Professions Press, Inc. Post Office Box 10624 Baltimore, Maryland 21285-0624 www.healthpropress.com Copyright © 2017 by Health Professions Press, Inc. All rights reserved. Manufactured in the United States of America by Versa Press, East Peoria, Illinois. Cover and interior designs by Erin Geoghegan. Typeset by Absolute Service, Inc., Towson, MD. This casebook can be used alone or in conjunction with other texts. To help instructors use the cases most effectively in the classroom, the
  • 17. editors have prepared an instructor’s guide, Instructor’s Manual for Cases in Health Services Management, available to faculty as a downloadable PDF file from Health Professions Press (see website and address above or call 1-888- 337-8808 or 1-410- 337-9585). Cases in Health Services Management can also be used in conjunction with the textbook, Managing Health Services Organizations and Systems, also published by Health Professions Press. The cases presented in this volume are based on the case authors’ field research in a specific organization or are composite cases based on experiences with several organizations. In most instances, the names of organizations and individuals and identifying details have been changed. Cases are intended to stimulate discussion and analysis and are not meant to reflect positively or negatively on actual persons or organizations.
  • 18. Library of Congress Cataloging-in-Publication Data Names: Darr, Kurt, editor. | Farnsworth, Tracy J., editor. | Myrtle, Robert C., editor. Title: Cases in health services management / edited by Kurt Darr, Tracy J. Farnsworth, Robert C. Myrtle. Description: Sixth edition. | Baltimore : Health Professions Press, Inc., [2017] | Preceded by: Cases in health services management / edited by Jonathon S. Rakich, Beaufort B. Longest, Kurt Darr. 5th ed. c2010. | Includes bibliographical 4 http://www.healthpropress.com references. | Description based on print version record and CIP data provided by publisher; resource not viewed.
  • 19. Identifiers: LCCN 2017008811 (print) | LCCN 2017010156 (ebook) | ISBN 9781938870736 (epub) | ISBN 9781938870620 (pbk.) Subjects: | MESH: Hospital Administration | Health Services Administration | Total Quality Management | Organizational Case Studies | United States Classification: LCC RA971 (ebook) | LCC RA971 (print) | NLM WX 150 | DDC 362.10973—dc23 LC record available at https://lccn.loc.gov/2017008811 British Library Cataloguing-in-Publication data are available from the British Library. 5 https://www.lccn.loc.gov/2017008811
  • 20. To the Alumni of the GWU MHA Program (Dedication of Dr. Darr) To my wife, Michelle; parents Karl and Jackie; and children, Lindsey (Dan), Taylor (Jill), Rachel (Steven), and Dallin (Dedication of Dr. Farnsworth) To my students, who made this work possible (Dedication of Dr. Myrtle) 6 Additional titles on healthcare management and administration Managing Health Services Organizations and Systems (Sixth Edition) Ethics in Health Services Management (Sixth Edition)
  • 21. Climbing the Healthcare Management Ladder: Career Advice from the Top on How to Succeed Superior Productivity in Healthcare Organizations: How to Get It, How to Keep It (Second Edition) Becoming an Effective Leader in Healthcare Management: The 12 Essential Skills (Second Edition) 7 http://www.amazon.com/dp/B00J8UH3LW?tag=inscdigi04-20 https://www.amazon.com/Ethics-Health-Services-Management- Sixth- ebook/dp/B07JMLX52C/ref=sr_1_1_twi_kin_1?ie=UTF8&qid=1 545241676&sr=8-1&keywords=9781938870811 https://www.amazon.com/Climbing-Healthcare-Management- Ladder-Succeed- ebook/dp/B00X4G501Q/ref=sr_1_1_twi_kin_1?ie=UTF8&qid=1 545845644&sr=8-1&keywords=9781938870194 https://www.amazon.com/s/ref=nb_sb_noss?url=search-
  • 22. alias%3Daps&field-keywords=9781938870590 https://www.amazon.com/Becoming-Effective-Leader- Healthcare-Management- ebook/dp/B0767Q2FHY/ref=sr_1_1_twi_kin_1?ie=UTF8&qid=1 545846357&sr=8-1&keywords=9781938870750 Contents About the Editors Contributors Preface Acknowledgments Introduction PART I POLICY ENVIRONMENT OF HEALTH SERVICES DELIVERY 1 Carilion Clinic Alexandra Piriz Mookerjee and Kurt Darr Led by a new CEO, the efforts of a mid-Atlantic acute care hospital to develop a vertically integrated, clinic-driven health services system result in allegations of antitrust, excessive healthcare costs,
  • 23. disruption of physician referral patterns, and use of harsh collection practices, all of which cause a negative reaction in its service area. 2 Flu Vaccine Mary K. Feeney and Abigail Peterman Flu vaccine shortages in 2004–2005 caused by a major manufacturer’s problems with quality control result in federal and state efforts to secure supplies of the vaccine and raise public policy and resource-allocation issues that users can role-play in three scenarios. 3 Merck’s Crixivan Kimberly A. Rucker, Nora G. Albert, and Kurt Darr A pharmaceutical manufacturer encounters significant negative stakeholder reaction to its introduction of a new medication for the human immunodeficiency virus despite having met expectations for clinical rigor and carefully assessing stakeholders and the external environment.
  • 24. 8 4 Pineridge Quality Alliance: A Case Study in Clinical Integration and Population Health Tracy J. Farnsworth A new CEO urges his board to move toward becoming an accountable care organization and promoting regional population health, which demands choosing among three common approaches to navigating the challenges and opportunities of developing a clinically integrated network. 5 Hawaii Health Systems Corporation: The Politics of Public Health Systems Governance Earl G. Greenia A healthcare executive facing continual public policy restructuring of Hawaii’s Health Systems Corporation must develop strategic options
  • 25. for his board to consider in response to this environmental uncertainty. PART II STRATEGIC MANAGEMENT 6 Riviera Medical Center Michael J. King and Robert C. Myrtle The CEO of a 350-bed hospital explores strategic alternatives to enhance its financial situation and reputation by asking the hospital board to approve a worksite wellness program to be marketed to area companies to improve workers’ health and decrease employers’ healthcare costs. 7 Edgewood Lake Hospital: Leadership in a Rural Healthcare Facility During Challenging Economic Times Brent C. Pottenger, Douglas Archer, Stephen Cheung, and Robert C. Myrtle The new CEO of a 30-bed, not-for-profit rural hospital faces a turnaround situation to make the hospital profitable after 3 years of losses. Problems include challenging payer mix, employee overstaffing, and difficulty recruiting physicians.
  • 26. 8 Klamath Care: Targeting and Managing Growth and Company- Wide Development Tracy J. Farnsworth, Leigh W. Cellucci, and Carla Wiggins 9 The CEO of a growing system of urgent care centers recounts the organization’s development over a decade while considering strategies and options for future growth in an increasingly crowded marketplace with an analysis that uses financial, market share, and demographic data. 9 Hospital Consolidation Tracy J. Farnsworth This case focuses on the relationship healthcare providers have with their local and regional markets and the need to balance organization
  • 27. and community interests when making decisions that affect the healthcare marketplace. 10 Service Area Management Tracy J. Farnsworth Users are challenged to analyze, prioritize, and use disparate information common to a dynamic and competitive healthcare marketplace as part of an organization’s strategic planning and marketing processes. 11 Western Healthcare Systems: A Healthcare Delivery Continuum Robert C. Myrtle Western Healthcare Systems was creating an integrated delivery system when an opportunity to acquire a large multispecialty group arose, but it may be imprudent to proceed because of hospital and multispecialty group physician resistance. PART III ORGANIZATIONAL MANAGEMENT 12 Hartland Memorial Hospital: Part 1, In-Box and Prioritization Exercise
  • 28. Kent V. Rondeau, John E. Paul, and Jonathon S. Rakich The VP for nursing services of a 285-bed for-profit hospital must decide what actions to take regarding her in-box, which includes e- mail, correspondence, and phone messages that communicate various challenges, such as two angry nurses, a wandering patient, staff shortages, and increasing numbers of OR infections. Emphasizes priority setting, decision making, and delegation. 13 Bad Image Radiology Department 10 Kurt Darr Management of a community hospital is unwilling to recognize and address major problems in its radiology department, which is directed by a radiologist whose disruptive behavior and preoccupation with
  • 29. income and stock market speculation have diminished the quality of radiograph readings with tragic results. 14 Westmount Nursing Homes: Implementing a Continuous Quality Improvement Initiative Kent V. Rondeau The future of a total quality management initiative is threatened when the CEO has to overcome more than the expected barriers and pitfalls in a chain of seven nursing homes and the initiative becomes entangled in negotiations with the union representing nurses. 15 District Hospital: A Lesson in Governance Cynthia Mahood Levin and Kurt Darr A tax district community hospital has major problems with its governance structure because of historical animosities among internal stakeholders, medical staff politics, weak and ambivalent senior management, and a disruptive member of the medical staff who has ambitions to attain major power in the hospital.
  • 30. 16 Restructuring Decision Making at Holy Family Hospital: Overcoming Resistance to a Shared Governance Program Kent V. Rondeau A change initiative introduced to democratize decision making and improve clinical care in a healthcare organization is met with staff suspicion, derision, and resistance. PART IV ORGANIZATIONAL EFFECTIVENESS 17 Attica Memorial Hospital: The Ingelson Burn Center Bonnie Eng-Suess and Robert C. Myrtle After the merger of two hospitals, planning must include how to consolidate duplicated services and realign units, including a burn center, while considering the center’s financing and community and organizational impact. 11 18 Pediatric Dental Care Center
  • 31. Eleanor Lin A not-for-profit pediatric dental care center that has struggled financially for years as it serves a Medicaid population is offered the opportunity to become part of a federally qualified health center, but to do so requires expanding services and significantly changing its governance structure. 19 Radical Innovation on the Idaho Frontier: Bengal Telepharmacy Julie Frischmann, Neil Tocher, and Alexander R. Bolinger Efforts to provide pharmacy services in a rural community are successful because of creative thinking, perseverance, political deal making, and using telepharmacy in a unique and effective way. 20 Structure and Funding of Hospitalist Programs John E. Paul and Gillian Gilson Watson An academic medical center must decide how to structure and fund hospitalist services in the context of its relationship with an affiliated school of medicine; the history and content of hospitalist
  • 32. functions; and other revenue that might be derived from hospitalist services, even while considering several alternate strategies. 21 Appian Health Systems Robert C. Myrtle A negotiation simulation allows participants to assume union and hospital roles to work toward an acceptable collective bargaining agreement. 22 Evolution of the Healthy Communities Initiatives Barry Ross Several years after initiating healthcare services for diverse, underserved communities, hospital leadership is planning how to take its activities to a level with greater impact and sustainability. PART V LEADERSHIP CHALLENGES 23 Hospital Software