Harvard University Case 15 District Hospital a Lesson in Governance

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Case 15 District Hospital A Lesson in Governance

Cynthia Mahood Levin Healthcare Consultant, Palo Alto, CA

Kurt Darr The George Washington University, Washington, D.C.

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Barclay Memorial Hospital (BMH) has enjoyed a reputation for excellent medical care in an affluent community for over 70 years. In the mid-1940s, its community was mainly agricultural, but urbanization was beginning. Hospitals in the region were operating at capacity. Community members and physicians proposed a solution to the problem of overcrowding at local hospitals: form a hospital district supported by the community through a tax. Voters approved the hospital district in 1945 by a 5 to 1 margin. The first decision was to select a 15-acre campus. In 1947, voters approved an $8 million bond issue to finance construction and operation of a 275-bed hospital. The tax district spans seven townships that elect five district community members to a governing board for the district hospital’s four entities, which include the hospital, joint ventures that operate an urgent care center and a hospice, and the hospital foundation.

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HAD509 Written Case Analysis Content and Format [Adapted from: Simendinger, E. (2003). In Search of a Course Design and Teaching Methods to Improve Critical Thinking. Journal of Health Administration Education, 20(3), 197-213.] Do each case analysis without discussing it with other HAD 509 students prior to the due date. For each case, write the following information and number it 1 though 8 and use section headings: 1. Your name. 2. The case number, case title, and class date. 3. A summary of the case. [1 paragraph] This will require you to read the case several times. Do not just copy sentences from the case. Instead, express in your own words the essence of the case. 4. A list of what you think are the 10-15 most important facts/factors in the case [1-2 pages]. 5. The most important health administration problem/issue to be solved in the case. [1 sentence]. List other secondary problems in the case [1-2 pages]. 6. Your recommended solution for the case (a.-d. below). Make clear specific realistic recommendations. There must be a clear logical sequence to your thoughts and recommendations. [45 pages] a. At least three possible realistic alternative solutions for the most important problem (stated above for 5). b. Criteria to evaluate possible alternative solutions. For example: acceptability to stakeholders, needed resources, legality, timing, cost-effectiveness, ability to implement, side effects, qualifications, statistical data, financial data, ethical considerations, fit with case facts, likelihood of actually solving the problem, etc. c. Evaluation of the possible alternative solutions (6a) using the criteria (6b). d. Your recommended solution for the problem, based on 6a, 6b, and 6c. Justify your recommendation. 7. Specific MHA tools, methods, techniques, principles, theories, models, etc. from MHA courses that you used for this case. List specific tools (e.g., cost-benefit analysis, market segmentation, etc.). Do not list general subjects (e.g., finance, leadership) [1-2 pages]. 8. Answer any case study questions that accompany the case. If a case question is answered by what you already wrote for 3-7 above, then just note which part of your case analysis provides the answer. Submit your written reports by 11:55 pm on the Sunday of each week.
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Tags: case study government ethics Governance Compliance Barclay Memorial Hospital BMH

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Explanation & Answer

Attached.

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Running head: CASE STUDY 15

Case Study 15

Lesson in Governance
Student’s Name

Institutional Affiliation

Date

CASE STUDY 15

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Summary

The case study of Barclay Memorial Hospital focuses on the effects of poor management
despite the hospital receiving assistance from the state. BMH becomes a tax district hospital after
the voters agreed renovation to be carried out using the tax money from the district. The CEO
strategizes to join the Valley Physician group, which required some legal changes. The changes
caused financial struggle due to lack of good leadership, which led to the election of the district
Schilling as the new CEO. The performance of BMH improved with several renovations that
make it one of the market healthcare in the region. Some issues arose when Harvey, an
orthopedic surgeon, was elected by the board as the CEO. Harvey takes advantage of his position
and barely adheres to the medical schedule causing delayed treatment and idleness. The board
members have several issues and emotional complications that are significantly affecting the
performance of the hospital (Darr,2005). The CEO had achieved his strategic plan of stabilizing
BMH when his health deteriorated. A new board team was elected, but the CEO caused a
negative impact on the management, forcing Shrilling to resign.

Most Important Factors

The essential factors in the Case study focus on improving the financial performance of
Barclays Memorial Hospital by correcting the leadership system. Most of the challenges
affecting Barclays Memorial Hospital are the different weaknesses expressed by board members.
The challenges make it difficult for the former CEO Shrilling, to maintain his achieved dreams.
Some of the most important factors are;

CASE STUDY 15
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The management process of the Barclays Memorial Hospital that significantly
affect the progress and financial stability of the healthcare.

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The weaknesses expressed by the members of the executive board as a hindrance
to achieving a stable medical state.

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The process employed by the CEO in the management of chief medical staff to
avoid poor medical services.

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The re-organization of the board as a strategic way to improve the management
process and aid in the implementation of the plans by the CEO.

▪

The loss of support from the rest of the board members on introducing strategies
and plans to improve the departments.

▪

The factors were leading to the resignation of the CEO Shrilling and the expected
effects on the management of Barclays Memorial Hospital.

▪

The market position of Barclays Memorial Hospital based on the types of services
before and after the election of Schilling as the CEO (Darr,2005.

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The failure to implement plans made on the different essential units, mainly the
cardiovascular and the oncology.

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The compensation for ER on-call panel despite the plan of the former CEO to
have it as a compulsory process for all physicians.

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The abstraction of the preparation for the Joint Commission based on the flow of
communication.
Health Administration Problems

The main problem faced by Barclays Memorial Hospital is the lack of leadership qualities
among the board members. The board members comprising of the physicians lack leadership

CASE STUDY 15

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qualities essential in fulfilling the mission of the hospital. The first fall of the hospital after the
BM...