Washington Mercy Hospital Current Situation - Essay Example

BACKGROUND Washington Mercy is a not-for-profit and full service hospital in Washington, D. C. with a registered 450-bed capa It offers, medical, surgical, pediatric, obstetric, and nursery services, for both admitted and out patients. In addition, they have an emergency room, a senior health clinic, and a wide range of full diagnostic testing. The hospital is still expanding, with the ambulatory surgery center as its latest addition. This paper focuses on the hospital’s Information Systems (IS), which converted to a more advanced one only recently. However, these changes did not result to expected performance. Although the best solution to this problem had already been identified, who will bear the cost of solving the problem is now the main issue at hand. CURRENT SITUATION: PROBLEMS AND SOLUTIONS Managerial and Organizational Planning Previously, the hospital operated using a six-year old computer system, which provided general accounting, patient accounting and patient registration. However, the the dissatisfaction of the hospital staff with regards to the performance of their old computer system motivated the change to a new IS. Unfortunately, no objectives were set by the hospital to guide each step the directors, the committees, staff, and others would take. Organizing 1. Washington Mercy Hospital Board of Directors The board of directors seemed to be the one overseeing the steps toward a new IS, from determining the specifications needed, choosing the networking company, and assessing the new IS’s performance, since it was the one that provided the funding for those activities. It was the one that appointed a Director of Information Systems to oversee the installation and use of a patient information system, and mandated the senior managers to conduct a poll among medical staff regarding the performance of the old information system and the desirable features of a new system. However, aside from appointing people and funding the project, the board was detached from the decision-making regarding the project. 2. Director of Information Systems The DIS was the one who prepared the RFP to be shown to potential bidders, oversaw the selection of networking company, and monitored the installation of the networking system. He also seemed to have been the one to set the 3 sec. response time stipulated in the MOA. The basis of this was not provided. No moment during the preparation of RFP to the signing of MOA was the building of ambulatory surgery department ever mentioned. He also did not indicate in the MOA the need of the networking company to provide IS to give room for growth. More importantly, the actual visits were almost a quarter more than the projected values he provided to the hospital. His educational background is unrelated to his position, as he graduated with a degree of BS Civil Engineering from Georgia Tech. However, he supplements his computer knowledge by attending one-day seminars, community college courses, and in-house training. Despite the lack of expertise, he was the one who gave a presentation to the hospital’s executive committee and board of directors regarding the current state of the art for hospital IS. After its installation, he currently manages IS operations, again, despite the fact that he does not have the training extensive enough for the job. 3. DCS, Inc. DCS, Inc. is the outsourced networking company tapped by Washington Mercy to install the Patient Information System. It has signed a MOA with Washington Mercy to provide the hardware and software of the Patient Information System capable of providing specified outputs. It coordinates with Washington Mercy through its Vice President of Systems Integration, Dave Caron, overseeing installation director, Jeff Baker, and a team of networking engineers. Upon being informed of having to add 12 more computer units to provide for the services of the newly opened department, they underestimated the capacity of their server to handle the activity within the agreed response time. When problems in response time arouse, DCS, Inc suggested quick-fix solutions, doing certain services during the evening and hiring a staff to do it, as well as adding RAM and disk drive to the server, that did not end up solving the problem. The company could have reviewed the suggestion further, since it shows that the solutions suggested only resulted to about 10% improvement in response time. Technical Hardware and Software The hospital previously operated using a six-year old computer system. Maintenance of its hardware became chronic and expensive. These were among the reasons why a new information system was put in place. The new system was true to its promise, with initial response times at 2.9 sec, just making the limit set in the MOA. However, as shown, it does not provide much room for more activity without increasing the response times. Behavioral Very apparent during the interviews that there are conflicting testimonies between the two parties, such as whether or not DCS, Inc. suggested the ambulatory surgery center be closed or not. There seem to be pointing fingers between Washington Mercy and DCS, Inc. With the problem already present, the two sides responded differently. Although DCS, Inc. was accommodating with the idea of cooperation with the hospital in improving IS performance despite fulfilling its own side of the MOA, the hospital’s representative was adamant in saving the hospital some money. Because of such disagreements in their motivations, an intervening party is necessary. ALTERNATIVE SOLUTIONS With all information from both parties in consideration, the problem seems to be, who will shoulder the expenses of improving the IS response time. Through expert opinion from DCS, Inc., replacement of server into a larger, faster and more expensive one would be the solution for poor response times. This means two sets of server and associated cabling and hardware are to be bought for this project, while using just one. The following are the possible solutions by which the problem can be solved amicably. Who pays for the new server? Who pays for the old server? 1 Hospital Hospital 2 DCS, Inc. DCS, Inc. 3 Hospital DCS, Inc. 4 DCS, Inc. Hospital EVALUATION OF ALTERNATE SOLUTIONS Of course, the first two are not plausible, because they are unfair to any of the two parties. But before identifying which of the remaining two is the best, let it be put into writing that 1) DCS, Inc. has met the demands of the MOA, despite the fact that 2) the hospital provided compromising information in the contract. In addition, 3) the new server is more expensive than the old server. Because of this, it is only just that the third option be chosen, and a new MOA be made for it. It may also be best if the board of directors and/or executive committee are included in the proceedings. Moreover, it might be best if DCS, Inc. sells the old server, and the proceedings of this sale be deducted to the cost of the installation of the new server. However, it should be noted that if the new server chosen by DCS, Inc. will not meet the three-second response time requirement, then it is the networking’s responsibility to replace it, with no additional cost to the hospital. STEPS FOR IMPLEMENTATION Steps Time needed Resources required 1 Planning and signing of a new MOA 3 hours intervening party DIS board of directors executive committee 2 The hospital and DCS, Inc. find a buyer for the old server 1 week DCS, Inc. DIS 3 The DCS, Inc. finds a new server DCS, Inc. 4 DCS, Inc. replaces the old server with a new one 2 days 5 Monitoring of the performance 1 month DCS, Inc. DIS CONCLUSION A shared responsibility is advocated in solving the problem of who bears the cost of changing the server. This lessens the loss, if any, to both parties, while achieving the objective of this whole activity. The principles of just and efficiency were important in determining the best solution for the problem. Read More