The District Hospital A Lesson in Governance

The District Hospital: A Lesson in Governance

How would she approach improving the financial position of the hospital?

She should adopt a comprehensive approach towards improving the financial position of the hospital. This is through solving rifts among employees, adoption of new marketing strategies, and harmonization of the existing strategy to operate effective and efficiently with the new ones.

How would she approach increasing the patient volumes?

She should focus on acquiring the support of all employees working towards expansion of the operations of the hospital. This will enhance efficiency in the service delivery as well as improvement of the image and reputation of the hospital.

Could she use the old strategic plan or would she need to develop a new one?

She has the opportunity to maximize the old strategic plan while gaining ground towards integration of new marketing mechanisms. This will offer an opportunity for improvement of the image and reputation of the organization.

Would the board support her decisions?

An effective approach would enable her to gain support of the board in relation to key decisions on transformation of the organization. She needs to prioritize the needs of the hospital in an effective manner to accommodate all personnel in the process.

Could she stop other hospital employees from unionizing?

I think she could not stop other hospital employees from unionizing, but could adopt and implement appropriate mechanisms towards working with the labor unions within the hospital.

How could she control the chief of staff’s divisiveness?

Transparency and constant interaction is essential in controlling the divisiveness among the employees. In addition, accessibility to vital information concerning the strategy of the organization would be ideal for management of the staff’s divisiveness (Ginter et al., 2013).

Could she focus the organization on completing its preparation for The Joint Commission?

She has the ability and capacity as the new CEO of the hospital to enhance the existing strategies towards the achievement of the goals and preparation for the joint commission.

How could she manage her board members and executive team into becoming effective leaders to assist her in turning the hospital around and perhaps making the hospital a market leader?

In order to manage her board members and executive, there is need for improved training and modification of roles and expectations. This is through execution of an extensive performance review, transparency in management of information, and generation of a teamwork feeling among the employees (Longest, 2008).

Most important, what priorities should be assigned to these problems?

She should focus on restructuring the image and reputation of the hospital among its competitors. This is through solving issues among employees for adoption and integration of an effective research process in the process of eliminating or providing solutions to the problems.

Question B: Case #19, The ER That Became the Emergency: Managing the Double Bind

Who are the key shareholders in this case?

In this case, there are various key shareholders aiming to provide an effective solution for the major problem arising between City Hospital and CMH Hospital. The key shareholders include health commissioners, local authority/government, CMH health centre, City Hospital, Chief Executive Officers of the local hospitals or health centers, and patients. The issues emanating from the case affect these individuals and entities in one way or another.

What are the critical issues? Support your answer

One of the critical issues emanating from this case is aspect of diversification of patients by City Hospital to CMH Hospital because of lack of sufficient facilities and resources. This issue is critical because it leads to development of an absurd situation for the CMH and its CEO. Another critical issue is the potential loss of financial resources in the next few months of operations. CMH health center focuses on the evaluation of ways of handling the issues relating to increase in the number of emergency patients through the ER doors. This is because of the development of political, economic, and ethical issues surrounding the case (Rakich et al., 2010).

What are the alternative courses of action? Support your answer

CMH might decide to take any of the potential alternatives or options towards addressing the crucial issues emanating from this case. Some of the alternative courses of action include accepting the financial proposal from the City Hospital, locking its ER doors from accepting excess patients from City Hospital, and maintaining the status quo. These alternatives have benefits and limitations to the key shareholders and stakeholders with reference to the critical issue (Rakich et al., 2010).

What are the potential positive and negative outcomes to consider for each of the alternatives?

In case of the first option (accepting the financial proposal from City Hospital), CMH health center will have the ability to address about 20 percent of the operation cost in relation to the increase in the number of patients through the ER doors. On the other hand, the institution will have to shoulder about 80 percent of the new costs of operations leading to massive losses in the next few months.

The second option (rejecting the financial offer and locking doors from accepting excess patients from City Hospital) would lead to key ethical issues. Some of the ethical issues include destruction of the image and reputation of the health center in the hospital and loss of consumers. Finally, maintenance of the status quo will force the organization to shoulder 100 percent of the cost of operations under the influence of the diversification process by City Hospital (Rakich et al., 2010).

What do you believe is the optimal course of action for Peterson to take? Support your answer

I believe Ralph Peterson should accept the financial proposal from City Hospital with an objective of applying for modification of the code information for the next period of three years. This is because other options would be detrimental to the organization’s financial resources, image, and reputation among consumers and other market operators.


Longest, B. B., & Darr, K. (2008). Managing health services organizations and systems. Baltimore: Health Professions Press.

Rakich, J. S., Longest, B. B., & Darr, K. (2010). Cases in health services management. Baltimore: Health Professions Press.

Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2013). Strategic management of health care organizations. San Francisco, CA: Jossey-Bass.

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