Question

Read the case entitled "Keep the Community Health Center's Doors Open" on pages 543-544 and answer the following:

1. What are the consequences of a community health center closure for both patients and the community?
2. What strategies could the executive director employ to address the health center's financial challenges, and to improve recruitment and retention rates of employees?

Answer 1

1.The closing of hospitals has exacerbated challenges for older adults in accessing healthcare, especially those living in economically underserved settings. Through focus groups and a community-engaged approach, our study examined and documented the emergent health needs of older adults following the closing of a local hospital in an economically disadvantaged community. Focus groups were reconvened to assess progress and health needs over time. Analyses of the focus groups (n=37, mean age 77, 84% female) illustrated the impact of the closure and the emergence of the following dominant themes: perceptions of the hospital system, including feelings of abandonment and social isolation; transportation challenges in accessing health care resources; and lack of knowledge and literacy regarding available health care and obtaining health services. The major thematic elements regarding the impact on the community and challenges to obtaining care is their psychological association towards the care centres. In addition to feelings of injustice and powerlessness, residents will have a lack of knowledge about where to go for health care and where avoiding seeking care. Health care services and efficient transportation to health care providers were identified as critical needs in the community. These strong negative emotions can become a barrier to future understanding of resources and to patient adaptation to alternative ways to meet their needs. The various non-health roles of a community hospital should be taken into account so these roles can be continued by outreach programs if a closure occurs.

2.

Strategies to help facility in Healthcare setup to achieve performance improvement and sustainable results at their hospitals.

1. Use data to establish in which areas (and in what manner) suitable modifications to staffing should be made to increase efficiency and decrease expenses. Regulators to consider include staffing to demand, skill-mix changes, and capacity utilization.
2. Assess the current organizational structure to pinpoint circumstances where tiers of management and supervisory jobs can be reduced. Start by putting together a plan to reorganize the entire leadership structure in effect to focus on impending operational and tactical challenges as well, instead of simply cutting positions.
3. Consider engaging the services of professionals who—together with department managers—can distinguish and create concepts for better operations and lower costs. Providing decision makers with training, tools, and support to effectively oversee their divisions and promptly respond to serious matters can make a significant, positive impact on a facility’s bottom line.
4. Optimize core processes. Core practices, from patient flow to emergency department operations, are essential to staff accountability, effective communication and teamwork between departments, and physician engagement. Using “a nonbiased, data-driven approach to identify key areas for improvement and allow all stakeholders the opportunity to objectively assess their current role and realize how they may be contributing to inefficiencies” allows for a productive environment, according to Wipfli, LLP partner David Kim.
5. Review supply chain management costs and expenditures unrelated to labor to determine further opportunities for reductions. This approach can improve quality, too. Areas to evaluate include medical/surgical supplies, purchased goods and services, and floor stock.

References:

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