IUSB Healthcare System - Essay Example

1a. At IUSBs annual board retreat the trustees are displeased with the high rates of readmissions. Provide a report to the board offering potential reasons for the readmissions and your plan to correct, consider the diverse population and the role of home care, skilled nursing, and the medical group. Due to the fact that IUSB is a designated state hospital and serves as the safety net hospital, there are a high number of patients that are treated by our professionals each and every day that oftentimes have not had the same benefit of proper healthcare instruction and knowledge as others take for granted. Due to this and other factors, we have experienced a higher than average re-admission rate. This however is at least partly correctable by relying on the skills and expertise of our healthcare professionals to work to engage these patients and provide a higher level of instruction as to provide such instruction to these patients. Due to the fact that our hospital is comprised of home care, skilled nursing home, and a medical group, we have the skill set required to provide the needs based outreach that is necessary to reduce the problem. On an aside, our bi-lingual services should undergo a review to ascertain that they are able to provide the full level of proficiency that is required and that each and every patient that our hospital is treating understands the necessary steps that he/she should take in order to tend to their own health and the healthcare of their loved ones. 1b. The board chair inquires why there is a negative variance of actual compared to budget for profitable heart cases and negative variance for ER and trauma cases. With regard to heart cases, what data will be analyzed to justify the allocation of resources to enhance the heart program to compete, and what resources (human and capital) are needed to enhance the program? With respect to augmenting the budget for the heart care program, this is seen as tantamount to a necessity as IUSB now has to compete with a new hospital within a 15 mile range. This new hospital’s main selling point is its advanced heart care unit. As such, in order to retain a competitive advantage with respect to this specialized skill, it is necessary to expend the money in order to capture lost market share. With respect to the data that will be analyzed in order to draw inference on the total amount of money that should be expended and human capital required to staff the up fit, previous records relating to total number of heart care patients will be analyzed (tracking population growth alongside this) to infer what total percentage loss has been realized as a result of the patient draw that the new hospital has affected. 1c. Explain to the board potential reasons why ER and trauma visits are lost to other hospitals, and what corrective actions can be executed. Consider the high number of ASCs along with other info provided above. The high number of ASCs (conditions are illnesses that can often be managed effectively on an outpatient basis and generally do not result in hospitalization if managed properly) has meant that fewer emergency/trauma cases are being transferred into our ER and trauma wards. Concurrently, the excessively high wait times that currently exist encourages individuals with non life threatening emergency needs to seek out alternate hospitals. Additionally, if our hospital is to remain competitive, it must diligently work to reduce the waiting period that incoming patients are faced with. In this way, buying back consumer trust is an uphill battle that will take time coupled with an aggressive marketing campaign to re-introduce the customer with the new face of the hospital. 2. IUSB Healthcare Systems medical group is looking to recruit additional cardio thoracic surgeons. There is currently one (i.e. the heart program is relatively new). What are the implications of recruiting 5 additional CT surgeons, as it relates to both the 1 employed surgeon and the hospital? The first implication relates to how the 1 currently employed surgeon will view such an action. He/she will doubtless be disheartened at least a little bit that they are no longer the one house heart specialist; however, the broader implication of this deals with the fact that previously the hospital had a cardio specialist and now they will be in the process of building a legitimate cardiac program. Such a move will not be inexpensive, but as already related, it is a necessary move that must be made in order to retain and gain market share that has been lost due to the new hospital that has been opened. Furthermore, this move will have the additional effect of building capacity. As such, a firm and legitimate price tag cannot be placed on this since the rewards and benefits of this increased capacity will likely be reaped for many years to come. 3. One of the medical practices has a payer mix of 50% Medicaid, 15% Medicare, 10% Self-pay, and the rest Commercial. Most of these patients are at or below the federal poverty level (FPL) and have high rates of chronic diseases that are uncontrolled or unmanaged. What type of care setting can be established to serve these patients to lessen the financial burden to the hospital? What factors should this be addressed to improve outcomes (i.e. disease management) once this entity is operational? And what can be implemented to improve utilization and reduce no show rates? One of the most powerful means towards improving the health care setting in the community, reducing the rates of chronic and uncontrolled/unmanaged disease is by working to fund and promote outreach which seeks to educate the community. Although this outreach is expensive, there exist a number of grants from the USDHHS as well as other state and local funds. Furthermore, in an effort not to clog the emergency room with such cases, a secondary clinic for non-emergency non-insured patients can be staffed for what would likely be a nominal amount of the money that is saved from the fact that the ER would no longer be overburdened with such cases. 4. Back in the good old days there were 5 safety net hospitals in the area, they shared the burden of proving care to the uninsured. Explain how these hospitals were able to sustain early on and why only 1 remains. Many of the nation’s safety net hospitals have closed due to the fact that these public hospitals are dependent on Medicaid to help to cover the cost of providing care to the un and under-insured people that make use of such facilities. However, as federal and state budgets are actively cutting subsidies to programs such as Medicaid, the funding levels have dropped and so have the ability of the safety net hospitals to continue to provide the same level of care to those individuals that they are tasked with serving. 5. There is conflict among many stakeholders and a negative culture at IUSB hospital. How can individual agendas of each stakeholder influence this conflict? Managing the multitude of shareholder interests is one of the most difficult tasks that IUSB will face. As such, key shareholders may have very specific agendas that they may use to bend the future of IUSB to their will. Such agenda’s should not be dismissed out of hand because they will not all be necessarily bad for the future of the hospital; rather, they should all be weighed and counted to determine if they are in the best interests of the hospital, the patients, and the community. If this is not the case then they should be dismissed and alternate positions should be entertained. Likewise, seeking to refocus the negative culture of IUSB as it relates to the shareholders will be a primary task of any manager/facilitator as the hospital is unlikely to experience any positive change. Read More