Great west hospital system-not-for-profit healthcare system

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Reference no: EM132215540

The Case

South Street Hospital (SSH) is one of 12 hospitals in the Great West Hospital System, a not-for-profit healthcare system. SSH serves a largely blue-collar and elderly population. This patient-centric hospital prides itself on high patient satisfaction scores and good financial management.

Dr. Canton is a busy colorectal surgeon who has brought hundreds of cases to SSH in the past year. The day before one of his patients, Mr. Gutsey, was scheduled for an extensive bowel resection, Dr. Canton’s office received an irate phone call from the patient stating that he was not having the surgery “because a woman from SSH called and demanded he bring money to the admitting center.” Shocked, Dr. Canton personally called the patient to find out what happened.

Mr. Gutsy stated that a woman “insisted that I bring cash or credit cards with me to pay my copayment. I have Medicare and other insurance. There are no copays. The more I tried to explain that to the woman, the nastier she became.”

Dr. Canton apologized and asked if Mr. Gutsy was able to recall the woman’s name

“No, she didn’t give me a name, but she sure gave me attitude.” Despite Dr. Canton’s best efforts, the patient said he wasn’t going anywhere that made these types of demands.

Dr. Canton complained to the chairman of surgery, Dr. Kutup, who in turn called the head of SSH pre-admission, Mrs. Mintz. She was appalled and said, “No one makes those calls from this hospital. Great West has a corporate call center for all 12 hospitals in the system. They’re supposed to be following a script.” Mrs. Mintz told Dr. Kutup she’d look into it and get back to him ASAP.

A short time later, Dr. Kutup was scrubbing for his next case and related the story to an anesthesiologist, Dr. Gasser.

Dr. Gasser laughed and said, “Tell your patient they did the same thing to me - but they told me to bring $2,000 in cash to admissions. I almost asked them if they wanted it in unmarked bills.”

“Did you bring the money?” asked Dr. Kutup.

“No, I did not. I knew I had coverage, so I just agreed with the woman and ignored her," said Dr. Gasser.

“Well, you work here, you’re one of their physicians, and they told you that - which makes me think they’re doing this to everyone.” Dr. Canton shook his head. “Will you tell Mrs. Mintz about this with me?”

“Sure, just don’t ask me for my credit card or gold bullion.”

The next day, Drs. Kutup, Canton, and Gasser sat down with Mrs. Mintz.

“When I talked to Mr. Count de Money at headquarters, he said the call center used a script and they were “just following it.” Mrs. Mintz shook her head. “I tried to tell him that it wasn’t true, that they were harassing people and patients were complaining - but more will just vote with their feet and go elsewhere. He asked me if I thought the system should lose money on these deadbeats? I tried to reason with him, but he hung up on me! Great West talks a good game about how we’re a ‘team with 12 hospitals.’ He didn’t treat me like a member of the team. He was nasty - and he’s in charge of the call center!”

Dr. Canton said, “I have privileges at another hospital. If they don’t stop this, I’ll be taking my cases there.”

Dr. Kutup pointed at his colleague. “This guy is one of our busiest surgeons. SSH is going to lose a lot of business if something isn’t done about this.”

Instructions

In health care, you will often find yourself working on teams to solve a problem or accomplish a goal. After reading the case study, please answer the questions below in a 2-3 page report. Be sure to include at least one, well-developed paragraph, to answer each question.

What type of team should SSH form to address this problem? Who should be selected to be on this team? Provide a rationale for your choices.

Identify and delineate the top three issues that the team should address in its deliberations.

Since SSH is part of the larger hospital system, who should be the person designated to take the matter to corporate headquarters?

How should the team evaluate whether a change in corporate policy is needed? Who should take the lead on this evaluation?

Reference no: EM132215540

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