Chapter 5 Case Study

ComplexandDiverseWorkforce;MotivationandInfluence

Directions: Read the case and respond to the questions below. Your response must be detailed and provide evidence to support your response. Follow APA guidelines and use proper in-text citations and references.

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After we won the Certificate of Need against the for-profit hospital corporation, we proceeded with our planned $30 million(thiswouldbeequalto$50millionormoretoday)expansion,includinganewobstetricalcenter.Constructionwasprojectedtotake2years.However,weexperienced11laborstrikesduringtheproject.Pluswehadaverybadwinterwithhistoriclevelsof snow. It literally snowed for 3 days at one time and kept us in a lock-down situation for the hospital. And so, the projectwasdelayedforayear,andittookus3yearstoexpandthefacility.

After all that, we discovered that we had a problem in our newly constructed newborn nursery. We had an unusually highrateofjaundiceamongournewbornbabies.Backatthistime,thejaundiceratewasbetween2and3%andwewererunningbetween24and26%.Rumorshadstartedtocirculateinthecommunitythatbabieswereactuallydyinginournewbornnurs-ery. That certainly was not true, but the jaundice rate was quite troubling. It was a serious problem. We reviewed everythingtrying to determine what was causing this raised jaundice rate. We reviewed all the levels of lead in the paint, we reviewedthetiles,andwereviewedallofthewoodwork.Webrokedowneverythingandstillcouldnotfigureoutwhatwascausingtheelevated jaundice rate. At that point, we were faced with a decision of whether we should close our obstetrical center untilthejaundiceratecouldbereduced.Forahospitaltoclosedownitsnewbornobstetricalcenterandnurserywouldpresenta major problem. The high jaundice rate was threatening our hospital's reputation, our market share, and the millions ofdollarswehadjustinvestedinexpansion.

The problem had persisted for several months, and we were near closing of the obstetrical center. I called the Centers forDiseaseControlandPrevention(CDC)inAtlantaandaskedthemforhelp.Jaundiceisnotacommunicabledisease,andthe CDC generally doesn't get involved unless it is a communicable disease, but they had such an interest in this puzzlingsituationthattheysenttwoexpertstoinvestigate.Amazingly,theydiscoveredtheproblemwithinjust2weeks.Thesourceof the problem actually was the type of detergent we had been using to launder the bedding. Our Director of Laundry hadbeen under pressure to reduce his costs and had switched to a cheaper detergent. When we changed back to our originaldetergent, the jaundice rate immediately dropped back to a 2 to 3% rate. This solution allowed us to keep the obstetricalcenter and nursery open and eliminated any rumors that babies were dying in our newborn nursery. We had succeeded inprotectingourpatients,ourreputation,aswellasourobstetricalservice,andinvestmentinthefacility.

Questions:

1. Wouldyouhaveclosedthenewbornnurseryunituntilyouhadfoundthecauseofthehighjaundice rate?Explainwhyorwhynot.

2. WhatwouldyoudowiththeDirectorofLaundryasfarashiscontinued employment?

3. WouldyouhaveinvolvedyourOB-GYNinthedecisiontokeepthenewbornnurseryopen?Explainyouranswer.