Solving Faith Community Hospital's Organizational Crisis

Overview of Core Problems

Three areas appear to encompass the problems faced by Faith Community Hospital: organizational processes, ethics issues, and communication systems. All three have contributed to the difficulties — both financial and otherwise — that the hospital currently faces. These issues interrelate, meaning that problems in one area affect the others as well.

The root of the problem appears to lie in communication. Organizational processes and ethical issues are not being discussed in a unifying manner. The mission statement of the hospital has been printed on its business cards, but this has proven ineffective in carrying out the mission as stated. The problem is therefore one of interpretation and the method of communication. Because so many professionals work at the hospital, a wide variety of often conflicting principles and ethics come into play.

As a result, each individual appears to follow his or her own ethical views when dealing with healthcare situations, without a common guiding principle. The problem then becomes one of organizational processes. There is a lack of organizational unity and stability stemming directly from the absence of proper communication. The mission statement is an ethical principle that is being interpreted differently by each individual, according to personally held beliefs and practices.

This situation detracts from the goals and objectives of the hospital, which is to provide the best possible healthcare for the community it serves, guided by a set of spiritual values. That goal is supported by many dedicated staff members doing their best to work in the interest of both the hospital and its patients, along with their families.

The effects of these problems, however, create conflict — often between patients' family members and hospital staff. Threats of lawsuits further damage the hospital's reputation and may result in lower-quality care for patients, as well as a loss of public trust. The problems also affect staff directly: working in an already stressful environment is made worse by conflicts among colleagues over how best to interpret the mission statement. Finally, the lack of proper organizational practices results in financial problems that are difficult to pinpoint, as there appear to be many inconsistent approaches to managing patient care across the institution.

The focus of any solution should therefore be to eliminate uncertainty for staff members, patients, and their families alike.

Possible Solutions

In devising solutions to the above problems, it is important to ensure that proposed changes do not exacerbate the difficulties already present — especially in terms of finances. Since the problem appears to be rooted in a lack of a unified approach to healthcare, that issue should be addressed first.

At the outset, one priority should be revisiting the mission statement. It should be discussed in terms of its exact meaning and the philosophy behind it. A memorandum should then be drafted to document what is understood by the underlying principles behind the mission statement's language. A unified set of principles should be reached, according to which healthcare is provided. This memorandum should be adhered to by all staff members and should also be given to patients and their families to ensure that life-saving actions by hospital staff cannot become the basis for legal action.

The communication process should then be organized in a way that is inclusive of everyone involved in the hospital and its model of care. Communication should also be actively encouraged: staff members should be made to feel comfortable sharing thoughts, inputs, and concerns about the hospital's guiding principles. A committee could be established to facilitate this process and help management handle the workload. All questions of interpretation and decision-making should be directed to this committee and then cleared by management. In this way, communication channels can remain open while greater clarity is achieved regarding the principles that staff are expected to follow.

In terms of financial problems, all costs incurred by patient care should be channeled through a single entity — such as a financial committee. In this way, the exact costs of care can be determined and strategies devised to save both money and lives.

Organizational processes can be improved by consulting all staff members for possible solutions to organizational problems. This could be done through a questionnaire or an interview. Time constraints should be kept in mind with both approaches. A questionnaire may allow for more thorough analysis while also taking less time, since it can be distributed to any number of people simultaneously. Responses can then be reviewed by a committee to identify the best solutions to organizational challenges.

All of the above can be implemented and monitored for effectiveness on a continuous basis. A suggestion box for staff members, patients, and family members is another practical mechanism that can complement all of the above and can be reviewed at weekly or bi-weekly intervals.

A single committee composed of various experts could be established to address all of the issues and facilitate communication between staff and management. It would also serve a clarifying function in terms of the principles that should be followed throughout the hospital.

Regarding individually held ethics, staff members could be asked to draft memorandums describing their own most deeply held convictions about healthcare. These should then be incorporated into the development of the general memorandum of ethics and principles to be applied uniformly throughout the hospital.

At present, it appears that each individual is conducting his or her work according to personally held principles without any overarching guidance. This is why the structure of patient care appears to be in a disorganized state. This can be addressed by referring all complex or high-stakes cases to management, while the committee handles less complicated ones. When decisions are made through this framework, organizational processes will also improve, reducing the incentive for patients to pursue legal action against the hospital.