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

Copyright ©2010 by Health Professions Press. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the author.

Preface

Like its predecessors, the fifth edition of Cases in Health Services Management describes management problems and issues in a variety of healthcare settings. The primary criterion used for selecting the cases was that each
had to be rich in applied lessons. The result is a comprehensive set of health services management cases in one volume, 36% of them new. Selection was tempered by the editors’ 90 years of combined experience teaching with the case method.

The cases in this edition are of various lengths and complexities and are grouped into six parts. Of the 28 cases, 10 are new. One carryover case, Hartland Memorial Hospital, has been completely revised. Cases that have stood the test of time are retained in this edition. Almost half of the cases feature settings outside acute care hospitals, including long-term care facilities, health networks, a continuing care retirement community, an emergency department, a hospital burn unit, a pharmaceutical company, a city health department, a home health agency, and a software company. Part I is new and focuses on public policy and the environment of health services delivery.

Acute care hospital cases include a range of sizes, types, ownerships, and geographic locations, including rural and inner-city settings. One hospital case is set in a multi-institutional system; another applies the principles of continuous quality improvement. An in-box exercise set in a hospital simulates the time pressures and importance of prioritizing issues that confront managers.

Depending on depth of analysis and the amount of time available for out-of-class preparation, most cases can be addressed adequately in one or two class hours. A few 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 from the 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 health services management programs. 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 the cases informative as they hone analytical and problem-solving skills. These cases can also be used 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 management activities.)

By their nature, cases present events, situations, problems, and issues. It is the dynamics of the analysis, especially the group discussion, that make the case method such a powerful and rich tool for learning. Therefore, users are urged to review the Introduction, which 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. In all instances authors of the cases have prepared well-written, factual situations that are 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 organized in five parts:

Part I: Public Policy and the Environment of Health Services Delivery (five cases)
Part II: Strategic Management (six cases)
Part III: Management, Medical Staff, and Governing Body (six cases)
Part IV: Resource Utilization and Control (five cases)
Part V: Human Resource Management and Organizational Dynamics (six cases)
Part VI: includes 10 ethics incidents that sensitize and educate students about the administrative and clinical issues that managers confront.

The synopsis of each case in the table of contents identifies the organizational setting, dominant 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 taken on increased importance. This collection of cases, combined with a solid academic grounding in health services and management disciplines, will be of great aid in preparing students for situations they are certain to encounter as health services managers.

The core task of teaching others to manage effectively in the health services field is to provide 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 those in this volume
can make an important contribution to that end.

TEXTBOOK SUPPLEMENT AND INSTRUCTOR’S MANUAL

A useful supplement for students and instructors using the case method is Managing Health Services Organizations and Systems, Fifth Edition, published by Health Professions Press. This textbook will ground students in the healthcare system and give them the management knowledge necessary for case analysis.
Chapter 6, "Managerial Problem Solving and Decision
Making," is especially helpful in preparing to use the case method. An Instructor’s Manual, available on CD-ROM from Health Professions Press, accompanies Cases in Health Services Management, Fifth
Edition. It contains the teaching notes that have been prepared by the authors of the cases. It is available without charge to instructors who adopt the casebook.

The Instructor’s Manual also contains follow-up case supplements to the following four cases in the casebook:

1. Governance Challenges at Good Hands Healthcare (B, C, and D) — follow up to case #12
2. Hartland Memorial Hospital (Part 2: Organizational Diagnosis and Social-Networking Exercise) — follow up to case #14
3. West Florida Regional Medical Center (B) — follow up to case #21.
4. Hospital Software Solutions (B) — follow up to case #24.
Instructors who use the follow-up cases are invited to reproduce them for classroom use.