Question

Broad Overall Problems in the hospital:

Unnecessary Costs:

Unnecessary costs is an issue within the hospital for a couple different reasons. First, since the MAR was not kept where it should have been when the patients got medication, this could cause issues of not knowing whether a patient received medication already. Which could result in another dose, meaning more costs for the hospital. The hospital needs to strive to keep the costs of care as low as possible as well as cut out medically unnecessary things such as sending placentas to the pathology lab for testing. By making changes to “the way they’ve always done things,” it will be easier to make the hospital more revenue and more efficient.

Communication Errors:

Often times, nurses wouldn’t have the time to chart in the MAR when the medication was administered. This is an issue because it can cause disconnect when there may be a shift change, that could result in an additional dose of medication, causing the quality of care for the patient to decrease. While the nurses are not the only people within the hospital to have charting errors, ancillary services also had issues with charting. They would lose reports or not get the charts on time, which caused issues for the hospital as well as the physicians. The physicians wouldn’t be able to discharge the patients in a timely manner, which would result in less revenue for the hospital itself.

OB Department Against Change:

There was a lot of competition within Pensacola for new families. After the hospital understood what these patients wanted, a family centered birth experience, the hospital worked to change the way that they delivered their care to these patients. There were many positions in support of these new changes, however, nursing staff and nursing management, especially the OB supervisor were set against this. Instead, they wanted to keep practicing how they’ve been doing it within the OB department. There were many nurses that no longer work in the OB department because of this change.

Specific problems in the hospital:

The shift from prescribing antibiotics:

The shift from prescribing antibiotics in the recommended ways to use the local prescribing patterns. The shift in prescribing antibiotics was caused to cut the costs which resulted in saving $200.000 annually. Management should have considered their cost-cutting plans without ignoring patients’ safety, and outcomes. This problem caused in delaying patients from receiving their prescribed antibiotics for days. It is concerning because of the lack of quality was shown from the hospital in delivering their services focusing on cutting the costs and not considering about the patients’ conditions.

Not involving fathers in the birth process:

This problem showed a weak part of the hospital’s system in not making their system to be designed as patient-center care. Instead, the system was built based on rules that they had to follow. The system should have been built to be based on the customers’ needs and should have targeted their satisfaction. It is concerning because the healthcare delivery system should be delivered as patient centered.

Labor Delivery Recovery Postpartum implementation:

The hospital’s management implemented the LDRP concept too fast. The nursing management did not like the idea of the implementation. However, the hospital kept the process going which resulted in retainment and resignation over the staff. The LDRP caused unclear charging structure, and duplicated and missing charges. It is concerning because the hospital’s management did not take the necessary steps by evaluating the structure before implementing the concept.

1. Based on the broad overall problems and specific problems in this hospital, discuss your recommendations for continued improvement and success.

Answer 1

I suggest following recommendations should be improved for success of hospital:

1. Hospital should not charge unnecessarily.
2. All the charges should be reasonable and should be briefed in the reciept.
3. Nurses should timely chart on the Medication Administration Record (MAR) .
4. Medication administration record helps to know that when and what medicine the patient have eaten, It will be easier for doctor to make any changes in medicines if required.
5. If the medication administration record is not prepared then it will be difficult for the hospital to charge the exact amount from the patient.
6. Labour room should be properly cleaned.
7. Patient room should be properly clean and hygienic.
8. Hospital should know that which patient has to be shifted in VIP room. According to patients family demand.
9. Hospital should not only focus on earning money. They should take care of their staff members.
10. Labour, Delivery ,Recovery Postpartum (LDRP) Concept should not be too fast. As the nurses also needs time to take rest.
11. LDRP Just should be reasonable and properly described in money receipt structure.
12. If the going to be born babies father wishes to be there in Labour room then there should be procedure for him also to be there with his wife.
13. Hospital should follow the slogan "Depend on US for life".