The ER That Became The Emergency Case Study

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In the case of The ER that Became the Emergency, we are introduced to Ralph, a CEO at Community Memorial Hospital (CMH), and his financial officer, Bill. Here are the key findings from the information we were provided:
• CMH is a private not-for-profit hospital
• City Hospital is responsible for providing care to indigent people and receives money from the government to do so
Patient traffic has dramatically increased in the last 2.5 months for CMH
• Most new patients are indigent people who have been diverted from City Hospital
• CMH will lose anywhere between $700,000-$800,000 this month by providing care to those patients
• If things don’t change, CMH will have to shut their doors in 6 months
• Ralph has yet to find any outside help
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First, we must look at the stakeholders within the community and analyze what they have to lose if the situation gets worse. Then, we outline all possible courses of action Ralph can take as CEO of Community Memorial Hospital. Lastly, we must consider the pros and cons of each course before finally making a decision regarding the situation in the ER. Stakeholders in the community can be broken up into groups as such:
Hospitals & Staff
• CMH- Hospital could potentially close
• CMH CEO Ralph – Could lose job due to closure
• City Hospital – finances are at stake
• City Hospital’s CEO Jim – Could lose his job
• Surrounding Hospitals and their CEOs—Depending on the choice of Ralph these hospitals could lose more money
Patients
• Indigent Patients – May not be able to receive any care
• The surrounding community – The ER services are being over flowed with people and this could cause the community to be underserved.
City Officials
• The Mayor and City Commissioner of Middleville – They don’t want voters to think they don’t care about the indigent; they are trying to keep their images clean.
Understanding what Ralph and the rest of community have to lose we now must determine the different courses of
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CMH has been in the community a long time and they have a good establishment as of today. They could revaluate the restocking of materials in all areas of the hospital. Smaller batch delivery or rotating supplies quickly can reduce both the amount of space used in internal warehouses as well as cash tied-up in inventory. Ralph could also ask his employees to take a reduction in benefits in an attempt to retain his staff through this difficult financial time. Baptist Health System utilized this method during a financially difficult period. They cut costs by not adding to employees 401ks as well as cutting out raises for employees in an effort to not terminate staff. Ralph could reduce overtime for his hourly staff, making sure that processes such as charting are done during shifts not after. Ralph could also reduce length of stay for patients, instead of having them be there for 6 days we can have them out in 4 days. He can do this by signing deals with nursing homes or rehab centers to insure the process will go smoother when discharge rolls

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