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Enebish Uuree

on 13 November 2014

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After the meeting...
Dawn was to fire 4 key people. She then gave their duties to six others who were at lower salaries, and put the hospital staff on notice that changes would be occurring at the hospital over the next several months.
3 weeks later, Dawn presented Nancy with an extensive list of ideas.

3 months productivity had jumped
Attention Hospital Staff
Dawn found that some of the most productive workers were using substandard procedures and poorly made products.
What about this issue?
She had been with PCA Health Care Hospitals for 3 years had been promoted to marketing director in the Miami area.
Dawn's job was to attract more patients to the HMO while helping keep costs down.

Dawn Prarie
Marketing director
1. Discuss PCA Health Care
Hospitals corporate culture and
its ethical implications.
2. What factors influence Dawn's
3. Discuss the issue of profit
versus nonprofit healthcare
4. If you were Dawn, what information would you like to have to help you make your decisions?
1. Discuss PCA Health Care Hospitals` corporate culture and its ethical implications.

It “may give the signal that the company wants only minimum ethical behaviour.” It also may target lower level employees and give insufficient guidance for the really hard ethical decisions.

It may identify minimum ethical standards. Health Care Hospitals have to stabilize the hospital make it a better place to care for patients and to work. “Educate, model ethical behaviour, and reward those who abide by organizational values and standards.”

2. What factors influence Dawn`s option?

Nancy is afraid of workers are not abide by standard and not hardworking. So it may influence hospital`s reputation and losing their clients.

As a result...
Nancy launched an aggressive plan to destabilize the nurses' union. Many nurses began work slowdown and were filing internal petitions. One floor manager suggested splitting up the staff into work teams.

At a meeting...
/Dawn and Nancy/
At Nancy's latest meeting
She told Dawn" We've decided to use your staff's segmentation strategy for the elderly market".
The implementation phase will start next month. I want you, Dawn, to be the lead person in developing a long-term strategy to break the unions in the hospital. Do whatever it takes.
Which is it going to be?
There are 4 types of elderly patients:
Healthy elderly
(Life expectancies are 10 or more years)
Fragile elderly
(2-7 years)
Dying elderly
(1-3 years)
Uninsured elderly

Nancy had explained the ramifications of the
Balanced Budget Act
and how it was affecting all HMOs.
3. Discuss the issue of for-profit versus non-profit healthcare facilities.

• A nonprofit hospital means the facility does not pay either state or local property taxes or federal income taxes because it is considered a charity, and proves certain community benefits in accord with state and federal guidelines.

• A for-profit, or investor-owned, hospital means the facility is either owned by private investors or is owned publicly by shareholders and is part of a company that issues shares of stock to raise revenue to expand the hospital activities. Depending on economic conditions, for-profit hospitals can have better access to capital than nonprofits that expand by issuing debt through tax-exempt bonds.

4. If you were Dawn, what information would you like to have to help you make your decisions?
• Reduce overtime. Reducing overtime is a great opportunity to help make improvements with lean that doesn't alienate people the way layoffs do. For example, instead of having nurses do it after, you can improve staff satisfaction while trimming down overtime, which results in both morale and cost savings. It's a win-win opportunity.
• Reduce length of stay. This certainly isn't about pushing patients home before they're ready. Reducing length of stay is done through preventing errors that would extend a stay or delay a discharge when patients are medically ready to go home. Because of miscommunication, poor planning, or when families or nursing homes aren't yet ready to take on the person being discharged, a four-day stay can suddenly turn into a five- or six-day stay. These process related things aren't medical issues, but they often extend length of stay which can cost millions.
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