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Health care management is a complex and challenging endeavor. A good health care manager realizes the role which reporting staff plays in enhancing the quality of medical and administrative performance within the hospital. A good health care manager also knows how important the reporting staff is for his (her) success. All issues affecting today’s hospitals, including nursing shortage, low professional standards and competences, poor workload planning and pay gaps, are secondary. Primary are the issues and gaps in health care management.
The case of Mercy Hospital exposes the major deficiencies in health care management and communication. Not nursing shortage or pay gaps but problematic relations and poor communication are at the heart of all difficulties faced by Mercy Hospital. This being said, and taking into account numerous areas for improvement at Mercy Hospital, the main task is to help Helen Swenson establish herself as a health care manager, develop a common strategic vision for the entire hospital, and build strong formal and informal support with the intent of creating a novel, effective, and reputable nursing environment.
That Mercy Hospital is often compared to a leper colony is not accidental: for many years, numerous planning, organizational, staff, financial, and image problems have plagued the hospital. Many of these problems continue to persist. The hospital’s nursing service is, probably, in the most difficult situation (Allen & Gilmore, 1993). The shortage of nurses does not allow for the provision of quality medical services to patients (Allen & Gilmore, 1993). Added to this is the lack of competences and advanced skills in the nurses currently working for Mercy Hospital (Allen & Gilmore, 1993).
Health care managers have no resources or opportunities to enhance their hiring and workload planning procedures, mainly because Mercy Hospital has a bad reputation among potential hirees and because full information regarding workload needs and opportunities at Mercy Hospital is not available to management (Allen & Gilmore, 1993). The hospital does not implement any educational activities for nurses, and nurses are simply unaware of any innovations and developments in clinical research (Allen & Gilmore, 1993).
With low professional standards, nurses have no incentives to improve their performance: patients are left unattended, and the absence of sound control systems in place does not allow monitoring and judging nurses’ performance (Allen & Gilmore, 1993). Helen Swenson’s transformational leadership and spirit do not seem to fit in the existing organizational conditions at the hospital. Payment discrepancies add complexity to the situation. However, these are secondary problems. At the heart of Mercy Hospital’s difficulties are poor relations among health care managers, the absence of effective communication channels, the lack of an explicit strategic vision, and the general resistance to innovations and change.
As a health care manager, Helen Swenson has undertaken one of the most responsible missions – delivering superior quality health care. In this critical endeavor, she needs both formal and informal support. According to Lombardi (2001), “the organization has many methods of supporting you and helping you attain success as a health care manager” (p.3). First, there should be an informal system of support that includes managers and supervisors, as well as colleagues and subordinates.
Second, there should be a formal system of support that usually operates through leadership education and management development programs (Lombardi, 2001). Neither has ever been developed at Mercy Hospital. Swenson’s managers, supervisors, and colleagues provide no informal support. On the contrary, their resistance to Swenson’s leadership impedes the implementation of promising change strategies. In the absence of leadership education programs, Helen Swenson does not have any chance to implement the proposed change initiatives. The lack of understanding among other health managers further complicates the situation.
Another problem is that the system of health care management at Mercy Hospital lacks clear performance parameters and does not have effective communication channels. Lombardi (2001) writes that the first challenge faced by a newly appointed health care manager is to implement a communication system that will encourage all staff members to share their knowledge and concerns freely. Only then can Helen Swenson decide whether her leadership style fits in the conditions of nursing care provision at Mercy Hospital and adjust her leadership principles to meet the organizational, administrative, and care demands set by the hospital.
Based on everything said earlier, the main areas of improvement include management relations and communication. Helen Swenson and her direct supervisor should hold a general meeting with all health care managers, with the goal of establishing a strategic vision, setting the basic standards of performance, and creating a system of communication channels.
Also, the lines of responsibility and chains of command need to be established. Simply stated, health care managers need a clear view of their own and others’ responsibilities and a better understanding of how, when, and to whom they report their achievements, ideas, and problems. Only then the managers can proceed with the analysis and solution of the major problems affecting Mercy Hospital. Without a clear vision, effective communication, and continued collaboration, the hospital will never succeed in improving its reputation among patients and professional nurses.
Conclusion
The situation at Mercy Hospital is very complicated. Helen Swenson fails to establish her vision and motivate other managers to work collectively towards a common goal. The most serious are communication problems: managers cannot find a common language and work together to solve the most acute organizational and planning problems. Today, health managers at Mercy Hospital need to establish a clear vision of their responsibilities and an effective network of communication channels, to provide all health care managers with formal and informal support.
References
Allen, W.R. & Gilmore, H.L. (1993). Mercy Hospital. In W.R. Allen and H.L. Gilmore (eds), What managers do, NY: American Management Association, 211-228.
Lombardi, D.N. (2001). Handbook for the new health care manager: Practical strategies for the real world. John Wiley & Sons.
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