Case Study Of The Unhealthy Hospital

A seminal 1963 article has been credited for giving rise to the concept of health economics, and its establishment as a discipline. It focuses on issues that are related to scarcity in the allocation of health and health care. Amid growing concerns for health care and global health reform it has been recognized that health finances are finite, a view substantiated by Basch (1999), and that neither developed nor developing countries are immune to the scarcity of resources that plagues our health care system. Levine (2005) argues that the problems in health care systems have been hampered by chronic financing shortfalls, compounded by weak management and crippled by rigid budgeting. Against this backdrop the case of Bruce Hudson, Seven Seas Memorial Hospital is not so farfetched.

Robert et al. (2004), underwriters of many health policies in developing countries, put forward the argument that the elements of any form of systematic policy cycle, first seeks to define the problem, form a diagnosis to policy development, political decision making, implementation and evaluation. From the given case study it is clearly identified that the operating policies need to be revised, a decision needs to be made on how the new operating policies will be developed, how much political influence will be incorporated into it and how will these policies be evaluated.

With the ever increasing demand for improved efficiency in the health care sector there has been the ever increasing need to revise and change hospital structures. That has included the use of strategies such as mergers and downsizing, as modifications are made to cut down on expenditure. The difficulties of Bruce Hudson, in the given scenario, are not unlike the challenges that Hospital administrators face in developing countries. They grapple with limited finances and are often faced with the difficult decision of restructuring staff. Fulop et al. (2002) and Braithwaite et al. (2005) argue that in such cases as administrators seek to contain cost and cut down on over heads, there is increased emphasis on redefining job roles to ensure the delivery of health care in a more cost effective way. They go on to argue that there is very little evidence to suggest that restructuring actually improves efficiency or programme outcomes.

Hospital administrators face the difficult task of how to restructure and not affect quality. It is recognized that nurses are the largest component of the health care workforce and as a direct result they would be the largest operating expenditure. Attempts to cut back on labour costs could mean a cut back on the number of nurses operating within the facility. While the case study goes on to note that Mr. Hudson is not new to effectively running an operation with less than the current number of staff at Seven Seas Memorial Hospital, Kearin et al. (2006) cites in their work the view of Akien et al. (2002) who put forward the view that patient outcomes are linked to appropriate nurse-patient ratios and the proportion of registered nurses operating within the health care facility. As Di Frances (2002) indicated, the downside to downsizing is the fact that as a process it creates distrust and low morale among staff, not an environment to promote efficiency and greater work outcomes. While Mr. Hudson may want to expand roles and employ the use of organizational report cards to monitor performance, as a result of improving quality of care, retrenchment may not, according to the aforementioned arguments, be the best way of dealing with the problems or securing the future of Seven Seas Memorial. While with continued financial constraints it may inevitably come down to re-engineering or downsizing the work force, the potential negative impacts needed to be assiduously guarded against.

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