Cases in Health Services Management Fourth Edition By Jonathon S. Rakich, Ph.D., Beaufort B. Longest, Jr., Ph.D., & Kurt Darr, J.D., Sc.D.

Excerpted from the Preface of Cases in Health Services Management, Fourth Edition, edited by Jonathon S. Rakich, Ph.D., Beaufort B. Longest, Jr., Ph.D., FACHE, and Kurt Darr, J.D., Sc.D., FACHE.

Copyright © 2004 by Jonathon S. Rakich, Beaufort B. Longest, & Kurt Darr. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the editors.

Preface

Like its predecessors, the fourth edition of Cases in Health Services Management describes management issues and problems in a variety of settings. The cases included were selected and grouped into four parts in order to provide a comprehensive set of health services management cases in one volume. The primary criterion was that each case be rich in applied lessons. Selection was tempered by the editors’ 90 years of combined experience in teaching with the case method.

This edition reflects the dramatic shifts that have occurred in how and where health services are delivered. Of the 28 cases, more than half (16) are new. Classic cases that have stood the test of time have been retained in this edition. Almost half of the cases feature nonhospital settings, including long-term care facilities, an HMO, several health networks, a continuing care retirement community, an emergency department, relocation of a hospital burn unit, a pharmaceutical company’s distribution of a new AIDS drug, a city health department, and a home health agency. Two of the new cases are set within the Canadian health care system.

The range of acute care hospitals includes a variety of sizes; types; ownerships; and geographic locations, including rural and inner-city hospitals. There is also a case set in a multi-institutional  system. The principles and applications of continuous quality improvement are reflected in another case. An in-basket exercise simulates the time pressures and the importance of prioritizing that may confront managers. Vignettes in administrative and clinical ethics sensitize and educate readers about ethical issues that managers face.

Depending on the depth of analysis and the amount of time available for out-of-class preparation, most cases can be addressed adequately in 1 or 2 class hours. A few of the cases are short and present single issues. Most, however, are integrative and complex, and involve multiple problems and issues. Analyses will require applying several discrete disciplines and knowledge areas. Users must synthesize and apply knowledge, skills, and experience gleaned from social–behavioral sciences; administrative and clinical ethics; individual, social, and environmental determinants of health; management and administration (e.g., strategic planning and policy formulation, marketing, organizational and administrative relationships, problem solving, resource allocation and utilization, control, financial management, human resources management); and health services organization, financing, and delivery.

The primary audience for this book is students in programs educating health services managers. Cases are especially effective in integrating the curriculum, and many students will use this book in a capstone course. Case analysis bridges theory and practice. In this regard, new and experienced managers will find these cases informative as they  hone analytical and problem-solving skills. These cases are also useful in continuing professional development seminars for practicing managers. (A broad definition of managers is appropriate here because department heads and mid- and senior-level managers perform similar generic activities.)

By their nature, cases present events, situations, problems, and issues. It is the dynamics of the analysis, especially group discussion, that make the case method such a powerful and rich learning tool. Therefore, users are urged to review the introductory material that describes the case method and case analysis.

The cases included in this volume are intended to stimulate class discussion and analysis. In most instances, the names of organizations and individuals are disguised. The authors of these cases have prepared well-written factual situations based on field research in a specific organization or a composite case based on experience with several organizations. None of these cases is meant to reflect positively or negatively on actual persons or organizations or to depict either effective or ineffective handling of administrative situations.

The 28 cases are grouped into four parts:

Part I: Strategic Management (six cases)

Part II: Administration, Medical Staff, and Governing Body (eight cases)

Part III: Resource Utilization and Control (seven cases)

Part IV: Human Resource Management and Organizational Dynamics (seven cases)

The table of contents includes a synopsis of each case, which identifies the organizational setting and predominant themes and issues.

As experiential learning in health services management education has given way to more discipline-based didactic education and as younger, less experienced students have entered graduate programs, cases that apply didactic work have become more important. No case study can replace experience, but this collection, combined with a solid academic grounding in health services and management disciplines, will greatly aid in preparing students for situations they are certain to encounter as health services managers.

The core task in teaching others to manage effectively in the health services field is to provide them with the insight to identify and define problems and the judgment to apply the skills and methods needed to solve them. With instructor or seminar leader guidance, cases such as the ones in this volume are an important means to that end.

To assist in the task of teaching by the case method, students and teachers may find the editors’ textbook Managing Health Services Organizations and Systems, published by Health Professions Press, a useful supplement. It can provide a solid grounding in the health care system and many of the managerial topics applicable to issues presented in the cases.

To assist instructors, the editors have compiled an Instructor’s Manual, available on CD-ROM from Health Professions Press, to accompany Cases in Health Services Management. It contains teaching notes for each case that have been prepared by the case authors. It is available to instructors who adopt the casebook.