These competitors include the two large hospitals in the region, several freestanding physician-owned centers offering urgent care, ambulatory surgical services and imaging as well as the small psychiatric care facility which offers inpatient drug and alcohol detoxification and rehabilitation. The university hospital which is 75 miles distant of MacMillan is also a stakeholder since they receive complex cases which are referred from MacMillan Hospital. They hospital-based physicians who MacMillan has contracts with are also stakeholders in this case. These physicians provide anesthesiology, emergency medicine, cardiology, medical imaging (radiology), and clinical and anatomical laboratory services. The Joint Commission on Accreditation of Health-Care Organizations which has numerously accredited MacMillan Hospital is also a stakeholder. The status provided by this commission helps MacMillan receive reimbursement for Medicare and Medicaid patients who account for a third of admissions at the hospital. The 21-member board of trustees who are trustees of the trust which was originally established by Abner MacMillan is also a stakeholder in the organization. This is because they make crucial decisions about the hospital such as the decision to change the name from the name of the city in which it was located to be named after Abner MacMillan after his death. The professional staff organization (PSO), hospital administration such as the chief executive, vice president for clinical services, and vice president for medical affairs are also stakeholders in the organization. The chief of medical imaging and the chief radiographic technologist are also stakeholders in the organization. The members of staff of the medical imaging department who were under Dr. Goodview are also stakeholders in the case. The vice president for support services who provide maintenance for the hospitals departments is also a stakeholder. Ms. Tendo who had had her mammogram mistakenly read was also a stakeholder since she deserved to receive quality medical imaging services from the hospital and Dr. Goodview. Explanation or analysis

Both Dr. Goodview and the hospital management were at fault and had a part to play in ensuring the medical imaging department performed according to expectations and the relevant professional standards. The hospital administration team should have ensured any conflicts...

Goodview and the hospital administration were addressed immediately. In addition to this, before renewing the contract given to Good Views Medical Imaging, the hospital administration should have reviewed the performance of Dr. Goodview and his company and ensured that the physician was performing to the required standards before renewal of the contract. Lack of monitoring of the quality of services provided and lack of strategic decision making regarding the performance of the medical imaging department led to these issues in the department which could have been easily prevented by the hospital administration.
Reviewer's commentary

The issues in this case study could have easily been prevented through the hospital administration taking responsibility of the performance of each of the hospital's departments including the medical imaging department. This would have meant the vice president of clinical services taking charge of the department and ensuring that the concerns that had been raised about the department were addressed in the right manner. First is that the vice president of clinical services should have taken active interest in the issues that were raised by Sally Lebeau about the department and raised this concern with the chief executive and the board members. This would have led to board policies being instituted towards the improvement of quality in the department thus reducing the chances of these lawsuits arising. The chief executive of MacMillan hospital should also have let Dr. Goodview know that there was a managerial hierarchy which the latter was meant to follow. This meant that any issues in the medical imaging department should have first been handled by the vice president for clinical services who was directly responsible for the department and its performance and only when the vice president of clinical services was unable to resolve the issues is when the issues should be taken to the next person in the ladder who is the vice president of medical affairs then the chief executive. Since the hospital had not found a suitable candidate to fill the vacant vice president of medical affairs, a qualified person should have been given this office to hold temporarily while the organization worked on finding a permanent replacement. This would have ensured the office runs as it is supposed to and that there is no managerial gap.