Ann Tucker, MSN, is the patient director of the palliative care unit at Community Medical Center, a large urban hospital. The palliative care unit has 20 beds and is one of 20 patient care units at the medical center. During budget time, Pat Ward, the director of nursing, tells Ann that the chief financial officer has suggested closing the palliative care unit, which is losing a small amount of money, and switching the unit to general medical care. Ann is busy with clinical work and family matters and does not have time to challenge the financial figures, but she has discussed the issue with Mary Wright, one of the oncology nurses. The following are summaries of Ann's and Mary's views:

Ann's View

Management isn't asking the right question. The question ought to be, "What can the hospital do to provide the best care and the best experience to patients requiring palliative care?" The follow-up question is, "How can the hospital

find the resources to provide that best available care?" Ann does not find Pat Ward to be a forceful nursing leader, but rather

someone "who goes along to get along." Ann has mixed feelings about taking the matter up with Dr. Paul Richards, the chief of oncology. Dr. Richards is a fiery leader and supports palliative care, but he has limited leverage with Bob Fox, the CEO, unless he is talking strictly about quality of care (relative to established evidence-based guidelines).

Mary's View

Mary agrees with Ann's diagnosis, and she also agrees that Ann's existing responsibilities don't allow her to do anything more than writing this up. Mary suggests that Ann reach out to and meet with Sam Gold, the hospital's chief operating officer, to document the problem and ask him to investigate further. She also thinks Ann should recommend that the hospital hold up any definitive action, since there is no financial crisis, and reconsider the issue in the next budget year. Finally, Mary suggests getting the families of patients particularly one or two members of the hospital boardinvolved in pressing the issue to preserve the palliative care unit. Mary says, "It's the right thing to

do, you have job security, and it's the right thing for patient care."

1. What is the management challenge for Community Medical Center?
2. What evidence would Sam Gold need to evaluate the alternatives he might pursue?
3. What has to happen for Ann to get a fair hearing for her justifiable concerns?

Answer rating: 100% (QA)

The management challenge for Community Medical Center is to determine the future of the palliative care unit and make a decision that aligns with prov... View the full answer