The group will take the view of the provost. The provost being the head of both the medical school and teaching hospital is the most influential person and is in the best position to initiate decisions in solving the gap and inconsistencies between the two institutions.
The case also indicated that the top management is the only one common among the two institutions so to address the problem occurring among the medical school and the hospital. The events that have transcribed in the renal unit should have been prevented also if the problem have already been addressed by the top management in the first place.
Why not the executive committee?
It is because their scope is only the medical school. We are looking at the holistic view of the two institutions. They may be the one formulating the solutions to be implemented but it is still the provost who is approached before plans are made into action.
Although it was frequently stated in the case that the executive committee were the one implementing mostly the changes (Conrad replacing Uric in particular), the group would still take the point of view of the provost. We believe that renal unit’s dilemma is not the main problem in this case. It may just be a representation of what is happening within the whole organization. Other units may also be going through the same situation as what the renal unit is experiencing.
Things took a turn for the Renal Unit and the Teaching Hospital when Dr. Uric discovered a fluid that was absorbed much faster than water at the cellular level which showed to be a good fluid to extend the life of cut flowers. A large nursery-supply manufacturer was the only institution interested in the fluid. They bought the technology, named it Flower Life, and began making millions.
The National Institutes of Health filed suit and everything went to press. The Teaching Hospital faculty became concerned about the reputation of the school. Dr. Uric was offered the position of new Research Chair in Medicine to establish his respectability in medical research and with the faculty to help back his case on Flower Life.
Dr. George Conrad was placed as the new head of the renal unit. Serious personnel problems arose in the dialysis unit within a span of three months and some bad press hit the unit and the Teaching Hospital. Dr. Uric’s research became stale, and so was his disposition. He failed to turn in a grant progress report on time and the funding agency canceled the remainder of his funding.
The Dean and the Executive Committee immediately put Dr. Uric back as head of the renal unit.
But the Teaching Hospital was already in a swarm of problems by then, aside from the problems it had before Flower Life.
RELEVANT CASE FACTS
The Teaching Hospital is a regional medical center having over 1,000 beds and is considered a reasonably prestigious medical facility.
Organizational Structure and Financial Arrangements
The following figure shows the organizational structure of the Teaching Hospital.
Organizational Structure of the Teaching Hospital
At the Teaching Hospital, hospital personnel worked directly under the physicians and nurses from the medical school faculty. Assistant hospital directors were in charge of most administrative matters (administration of wage and benefit programs) and Department heads supervised departmental activities, evaluated employees, and recommended raises and promotions.
The integration of medical school faculty into hospital functions showed some inconsistencies where the dual reporting relationship left the employees in a situation of very divided responsibilities.
There was also an unusual nature of the financial arrangements at the Teaching Hospital: * Physicians as faculty members received salaries
* Physicians as doctors did not receive money for patient services * Patients were billed for professional services which went to the...