Sample Healthcare Case Study on St. Rita’s Hospital
In Canada, hospitals are allocated healthcare funding. Hospitals that offer mental health care services receive sufficient funding owing to the clauses in the Canada Health Act. Hospitals that provide mental health services need to allocate money for the expenditure incurred while extending healthcare to the patients because the government provides funding on a yearly basis. The integrated vice-president of St. Rita’s Hospital in Canada, Katie Johnson, is tasked with laying off at least 33 of the hospital’s unionized nurses. It will accommodate the requirements of certain advanced methods of mental illness treatment, which calls for changes in the staffing ratio. Katie is faced with the task of implementing the layoff in a way that does not attract union protests and does not affect the image of the hospital. Also, she would need to maintain a good relationship with the new union president, Debbie, who tasked her with the layoff.
As the sole provider of in-patient mental health care within the region, St. Ritas receives a funding to suffice 85-90% occupancy of beds on its Mental Health Program (MHP). The occupancy rate, however, has deteriorated with time due to decreased need for hospitalization of mental health patients. Occupancy rate decreased because of availability of treatment models that supported out-patient treatment. Also, in-patient care became more specialized than the custodial methods that the hospital used. The treatment included active clinical intervention and psycho-social rehabilitation, which ensured that patients do not spend much time in the hospital. Therefore, it was a requirement that the hospital reduces the staff. The new treatment model required at least one Registered Practical Nurse (RPN) for every two Registered Nurses (RNs), which differs from the old model that required, in total, 75 RPNs and 25 RNs. I agree that with a decrease in the occupancy rate, the hospital funding will also reduce. However, laying off 33 nurses would not be enough. Katie was right to observe that it would be the first inevitable change the hospital’s staffing would undergo.
The layoff of nurses could be controversial, but I believe it is necessary because most of the beds in the Mental Health Patient (MHP) remain empty. Since the hospital funding was also cut to accommodate “right-sizing”, the hospital would not be in a position to pay nurses since the workload had reduced. Salary payments worth $1.2 million would be saved, hence facilitating the hospital with funds for other projects. I concur with Katie’s argument that the layoff would not affect the quality of care, access or workload for other hospital employees despite the obvious controversial issues.
Since nurses at the hospital were represented by the Ontario Public Workers Union (OPW), Katie would face a big and controversial issue with the president of the union regarding the layoff. Therefore, Stan Walters should defend the contract that the nurses signed with the hospital saying that they would be given at least a five-months notice before any final decision in staffing change is made. Katie is trying to build a good relationship with the union President (Debbie). She is also trying to facilitate easy future layoffs with the OPW. It is something that I believe she cannot achieve since both parties would want layoffs to be executed within their interests. Therefore, the dismissal could be a controversial issue that could lead to protests from the OPW, which often opposes changes in staffing.