If it Ain't Broke, Fix it!: Beth Israel Hospital

Abstract

The case takes place in Beth Israel Hospital, an institution with highly progressive top management, and details a hospital's transition from the primary nursing model of patient care to an integrated clinical practice model. Beth Israel Hospital was required to minimize costs by increasing competition for managed care, the hospital is forced to discharge 127 nurses. This case contains important lessons in dealing with the discomfort and loss associated with a hospital's efforts to reduce its budget. Students gain familiarity with redefining the role of the professional nurse in caring for patients across the continuum of care. They are introduced to the concept of "care teams". A special emphasis is placed on breaking down barriers between inpatient and outpatient settings resulting in a more seamless experience for the patient. The case includes valuable lessons in turf issues arising amidst an interdisciplinary care team. Students are introduced to the concept of a Learning Center, in which patients are taught how to care for themselves after returning home, and are made aware of the importance of an interdisciplinary approach believed necessary to enhance patient care. Lastly, this case also addresses the special care required in dealing with HIV patients. This case can be used for courses relating to organizational culture and change management specifically in health care administration graduate courses.

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