Faith Community Hospital case has been analyzed using a SWOT analysis in order to identify the pertinent issue and define the problems the organization faces currently. The SWOT analysis was also done with a view to developing solutions that take into consideration environmental factors, especially the interests of various stakeholder groups
Refer Appendix 1). However, prior to discussing the conclusions drawn from the SWOT analysis, it would be important to briefly introduce the organization itself.
Faith Community Hospital is a not-for-profit organization established with the aim of promoting the health and well-being of the people in the communities it serves. While there may be several similar organizations in the health care industry, it is important to note that Faith Community Hospital is an organization that has been built on a foundation of spiritual values. Indeed, the hospital's spiritual heritage and values is the single-most important "point of commonality" among its Board and staff members, besides the organization's purpose of restoring the health and well-being of patients (Case Study, p. 2). However, inferring from the CEO's briefing on Faith's current problems, it appears that the organization's emphasis on its spiritual heritage and values is leading to some amount of conflict with the ethics of the medical profession, regulatory requirements, compliance with managed care and insurance providers, and the hospital's own operating procedures. In fact, a close examination of the conflicts faced reveals a common underlying pertinent issue.
Pertinent Issue: The commitment of Faith Community Hospital to its spiritual heritage and values is apparent in the very manner in which this has been upfronted in the mission statement of the organization. While this indicates a clear set of organizational values and a strong culture, it also implies that Faith Community Hospital is an organization with a culture that is committed to not just its task but to the very idea of the organization. Unfortunately, this commitment to the idea of the organization has led to stakeholders who are more committed to the process rather than the product of organizational action, which really should be focused on the health outcomes of the patients treated. Indeed, it is this factor that has likely led to the existing conflicts between "ethics, laws, beliefs, oaths, etc." (Case Study, p. 2) In fact, the commitment to adhere to the spiritual and moral values of patients and staff has also led to several other problems especially in the area of financial management. Indeed, the SWOT analysis (Refer Appendix 1) clearly reveals the following problems, which Faith Community Hospital must address if it is to assure its continued survival and, indeed, grow its reputation and capacity to serve its communities.
Widely varying interpretations of the mission statement has led to an ambiguity in organizational goals. For instance, in any situation where there is a conflict between a staff member or patient's religious beliefs and hospital procedures or medical ethics and laws, the organization's mission is interpreted in a manner that results in spiritual values gaining precedence over established policies or procedures. Indeed, the confusion is amply clear in the anecdotes cited by the CEO of staff members who refuse to provide certain medical services and initiate or ignore 'Do Not Resuscitate' directives in direct contravention of hospital procedures. Thus, it is clear that the hospital needs to review its stated goals and, if necessary, reframe these in order to eliminate all ambiguity.
An over-emphasis on spiritual heritage and values in the organization's culture is leading to the hospital running the risk of inviting action from governmental agencies, health care and insurance providers. This is evident in the cited case of Child Custody Services feeling the need to take custody of a child in the hospital's neo-natal ward and threatening to take action for failure to provide the right services. Similarly, the differing values and styles of decision making of doctors have also led to health care givers, from managed care to capitation, experiencing a tremendous loss of power. This could create more problems for the organization especially when it comes to decisions concerning the patient's "right to die," or refusals to treat uninsured patients. The former can lead to legal suits being filed while the latter could result in negative media coverage especially since it involves a hospital known for its spiritual heritage. As such, it is key that Faith Community Hospital take the necessary steps to clearly establish policies and procedures that are adhered to if it is to avoid regulatory or legal action and if it is to manage its relationships with health care givers and the media well.
Lack of financial controls in operational procedures is evident in the highly democratic and decentralized form of decision-making. If stringent financial controls were in place, it is unlikely that the hospital pharmacist could fill uninsured prescriptions or that doctors could decide to treat patients pro bono as per the dictates of their conscience, without authorization. Indeed, the hospital runs the risk of not being reimbursed even in the case of insured patients if it continues to allow its doctors the leeway to take their own decisions as is apparent in the example of the doctor continuously ordering tests even for terminally ill patients. In fact, it is not surprising that the hospital is facing a situation of rising costs per patient per day (from $217 to $240) given the seeming lack of financial controls. Thus, it is clear that Faith Community Hospital needs to take a hard look at its financial management policies and procedures if it is to be able to avoid a situation where it is forced into cost cutting measures, which could result in a loss in quality of the health care services provided.
All the preceding problems indicate a lack of communication between management and staff as well. Indeed, this inference is confirmed by the fact that the CEO is planning the first all- staff meeting in 10 years! There also seems to be a communication problem between staff members judging from the incidents of decisions being taken in spite of orders existing to the contrary. This could either be due to the absence of clearly defined organizational goals, policies, and procedures or a failure to communicate properly even where such goals or policies do exist. As such, organizational communication issues need to be addressed as well in order to ensure that proposed solutions and changes are well accepted and implemented.
Alternatives: The analysis thus far leads to two possible alternative strategies.
Alternative 1: Given the conflicts caused by Faith Community Hospital's emphasis on its spiritual heritage and values, consider a change in focus to only providing a range of quality health care services that will lead to restoring patients' health and well-being. Such a route will eliminate all conflicts caused by widely varying religious and personal values and facilitate adherence to clearly stated organizational goals and values. However, the disadvantage in this solution will be a loss of a key strength that has allowed the organization to historically attract believers across its stakeholder segments. Further, it is likely that Faith Community Hospital will also lose the competitive edge that its spiritual values has, and can still, provide. The other risk inherent in adopting such a strategy is that Faith may lose the confidence and goodwill of the communities it serves besides losing its backing from charitable trusts. Thus, such a route is too risky to follow especially since Faith Community Hospital is a not-for-profit organization.
Alternative 2: Achieve a balance between the practical need to manage the business side of affairs and fulfilling the spiritual needs of the stakeholders the hospital serves. Such a balance, if achieved successfully, can not only resolve the hospital's current problems in the areas of ethics, regulatory obligations, and finance but serve to build its reputation and standing in the market as well (Refer SWOT Analysis). However, achieving such a balance will not be easy and much would depend on the management's ability to bring about a buy-in from all its stakeholders on the proposed modifications and additions to its organizational goals, policies and procedures. To start with, all stakeholder segments would have to agree that the hospital's priorities must necessarily lie in safeguarding the interests of the patient's health rather than in fulfilling spiritual or religious beliefs. Achieving a balance may be a difficult task, but it is not an impossible one providing the following recommendations are implemented and managed well.
Develop and clearly communicate quantifiable organizational goals in health care outcomes and patient safety, and the place and role for spiritual values. In fact, a good starting point may be to rewrite the existing mission statement to bring about the necessary balance between safeguarding a patient's health interests and spiritual values. For instance, the mission statement could be reworded to read, "Our primary objective is to promote the health, well-being, and safety of the people in the communities we serve through a comprehensive continuum of quality health care services. It is…