City Hospital has a pediatrics department with 35 beds. For the past several years, the occupancy has varied between 40% and 60%. There is a definite downward trend, but it appears to be stabilizing at about 45% occupancy. The low occupancy has caused a financial strain. Other area hospitals are experiencing similar situations. As a result, several hospitals have proposed forming a community task force to study the situation and determine whether one or more pediatric departments should be closed, thereby increasing occupancy for those remaining. It is hoped that this will reduce cost and increase quality.

Although this proposal may benefit the community as a whole, it raises questions for City Hospital. Among them is the effect on two objectives: to provide a full range of high-quality services and to offer a full range of graduate medical education, including residencies in pediatrics.

a) What effect would the retrenchment strategy have on City Hospitals objectives?

b) Identify the stakeholders who influence the decision.

c) Are there other strategies that City Hospital can consider?

d) Argue against the closure. What reasons support your position?