Forsaken Memorial Health System (evaluating the governance system)

Forsaken Memorial Health System (evaluating the governance system)

This case can be used after students read chapters 3 and 4.
You’ve taken a position with a consulting company. You are trying to act like you are worth what the company pays you and maybe even what they bill the client for your work. Your firm’s engagement is to develop an evaluation of Forsaken Memorial Health System (FMH), a hospital trying to become a healthcare system. FMH is one of two hospitals serving a community of 300,000 in the Midwest. FMH wants to remain independent, but its record to date on strategy, planning, cost control, and even quality is only mediocre. The partner at your consulting company asks you to develop a list of questions or topics the firm must review about the governing board and the CEO. He says:
Put down everything we ought to check using interviews, bylaws, and minutes, in a way that we can organize a final report. This includes membership, relation to community, and ability to handle issues. Don’t forget the possibility that we may have to tell FMH to find a strong partner, but if we do that we’ll need to have a convincing justification. I think we’ll list what they need in the way of capabilities, show what they’ve got, and let them wrestle with the gap.
The ‘needs’ must be convincing—if they look too cookbook, the client won’t believe them, and our rapport with them will be lost. The list I’m asking you to prepare isn’t Mickey Mouse, so include a justification for the questions. You might want to summarize the questions on a one-page table. The justification should be four pages or less.
“Would it be smart to use the Well-Managed Health Care Organization as a guide?” you ask. “I guess so,” he replies. “It’s a well-regarded text, but remember this place is accredited. It meets the basics. No sense in asking, ‘Do they appoint a CEO?’ because it’s obvious. Focus in on the critical questions, the ones that are likely to make a difference. Like, ‘Is the executive staff prepared for the challenges ahead?’ or ‘Do they have a board and CEO evaluation system that keeps them competitive?’
“Also,” he says, “textbooks aren’t very dynamic. If this place is going to make it, it will have to have its share of support from the community movers and shakers, including the medical staff leadership. We might think about who the heavy hitters are in the community, what they are thinking about, and how well the FMH board is linked in to that thinking.”
© 2006 John R. Griffith and Kenneth R. White 6
Instructor’s Manual Cases and Longer Exercises The Well-Managed Healthcare Organization, 6ed
Designing Accountability (basic management for a small clinic)
This case can be used after students read Chapter 4.
A small primary care clinic has 69 employees, representing 9 different clinical professions and 12 other skills, as shown in Figure 1 below. It operates two sites, one of which is bigger and contains the specialists, diagnostic, and patient services. It also contracts for a variety of services, such as repair and maintenance, referral specialists, and advanced diagnostic services.
You are the manager; you report to the owners who are four of the family practitioners and their wives. Two of the wives still work at the clinic as registered nurses.
Figure 1. Associates of Primary Care Clinic
(Number of persons in parenthesis)
Clinical Professions (24)
Other Skills (45)
Family practice (5)
Manager (1)
Obstetrics (1)
Bookkeeper (1)
Surgery (1)
Data processor (3)
Registered nurses (8)
Patient admission and registration (10)
Licensed practical nurses (2)
Clerical (6)
Lab technicians (3)
Nurse aides (5)
X-ray technician (2)
Lab aides (5)
Physical therapist (1)
X-ray aides (5)
Pharmacist (1)
Therapy aides (4)
Pharmacy aides (1)
Medical record technician (1)
Plant maintenance (3)
1. What are some possibilities for accountability units?
2. What would be a good mission statement?
3. How would you report the organization’s performance to the owners?
4. How would you approach the following decisions?
a. new clinical hires,
b. nonclinical hires,
c. expansion, and
d. annual plan approval
5. How would you evaluate the success of your efforts?
6. What would you ask for in an employment contract? © 2006 John R. Griffith and Kenneth R. White 7
Instructor’s Manual Cases and Longer Exercises The Well-Managed Healthcare Organization, 6ed
Ambulatory Clinic Management (a growing medical group)
The clinic did just great under your leadership, especially after you signed up with “Healthy Life,” a preferred-provider health insurer that now provides 60 percent of the clinic’s business. It now has 20 doctors representing primary care, obstetrics, general surgery, orthopedics, cardiology, and psychiatry.
Healthy Life now insists that your group share the risk for both quality and economy of care. They wish you to develop policies for each of the following areas and pursue NCQA accreditation:
• Staff size, credentialing, recruitment, and planning
• Continuing education
• Maintenance of quality and economy of care
• Preventive services for Healthy Life commercial (under 65) and Medicare HMO patients
Prepare a plan for the owners that will allow the organization to meet NCQA standards
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