Case Study: Outcomes Management

Midwest Medical Center is composed of a 475-bed hospital, a 120-bed long-term care facility and a visiting nurse agency. The medical staff is an older, conservative group wary of change. The employees pride themselves on being part of their local hospital, but have recently become disturbed at the changes occurring in their health system.
Recently, the government, health insurance companies, and the state hospital association have started publishing quality outcomes for the hospitals in the state. The publishing of this information has caused hospitals around the state to recognize that change must occur in the provision of patient care to ensure their hospitals meet the highest standards. Some of the issues facing Midwest Medical Center include:
There are 14 other hospitals in the county.
The competitive environment is enabling insurance companies to force patients to use hospitals with low rates.
The hospital’s average length of stay and average cost per discharge are significantly higher than those of other hospitals in area.
Many of the physicians are close to retirement and see little reason to change their ways of practicing at this stage of their life.
Employee morale is low as a result of cost-cutting, layoffs, and no raises.

Action Items
Read the case carefully and take notes on the elements that might help with your case study.

As the hospital goes about implementing a quality outcomes improvement system, it encounters the following issues. Compose a four- to six-page, double-spaced paper including the following elements:
1. Employees have the feeling that eliminating “wasted work” and improving processes is a fancy way of eliminating more jobs. Identify strategies to overcome this impression.

2. Managers feel this is the management philosophy “of the week.” Identify and describe effective means to overcome this barrier.
3. Physicians see quality outcomes improvement systems as cookbook medicine imposed upon them by the nursing department. Describe ways to get them to buy into this process.
4. Identify organizational strategies that the hospital should adopt to make the institution more viable in the marketplace.
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