This case analysis will provide an overview and analysis of Washington Mercy Hospital, and its attempts to settle the dispute over its system performance between the general hospital and DCS, a software development and systems integration firm that specializes in the medical field. First of all, we will provide a history and overview of the hospital as the operational background of the medical services facility. This essay will provide adequate particulars and vital information on the hospital’s operational requirements and the solution regarding the role information systems plays in the operations of the facility. Additionally, we will provide an analysis of the problems and dispute that arose between the two parties as well as the problems that were encountered following the introduction of the information system. This part will comprise of three sections including; managerial and organizational problems, technical problems, and behavioral problems. The final part will identify and assess alternative solutions to the problems encountered. In conclusion, a solution will be selected and an appropriate justification will be provided, as well, a plan for its implementation.
Organization History and Overview
Washington Mercy is an acute care, no-profit, full service medical care facility located in the suburban area on the outskirts of Washington that offers comprehensive surgical, medical, pediatric, and obstetric services. Even though, the hospital is a level III Trauma Center between Jefferson City and St. Louis. Washington Mercy is committed to the provision of quality healthcare services to an area of more than 150,000 residents. The facility houses 233 physicians and more than 800 co-workers.
Washington Mercy hospital was founded in 1926 and served the residents of Gasconade, Franklin, Crawford, and Warren counties. The facility came under the sponsorship of Mercy in 1976 and is a full member of Mercy Health.
Over the last few years, the organization has witnessed a drop in inpatient utilization. This was mainly caused by fluctuations in the demand for inpatient services to outpatient services. Additionally, changes in Medicaid, Medicare and insurance companies’ payment policies have created more competition to the hospital. However, the hospital had a solution to these challenges through the establishment of the Ambulatory surgery center. The center is set up to make patient’s visit as brief as possible.
The implementation of this strategy was effective. However, the several problems were encountered in operations, including the information system that the organization had in place to operate the hospital. Moreover, the source of the challenges was rooted in several areas beyond simply implementing a new system. These challenges include technical, managerial, and behavioral problems within the organization.
Managerial, Technical and Behavioral Problems
There were several problems in the organization that became exacerbated after the hospital began to achieve improvement in its operational activities. The running of the information system was the central problem as its response times at the users’ network computer workstations were consistently below what was promised. However, several other problems became clear as the director and administration attempted to implement the new system. The first of the problems included lack of adequate planning and implementation by Ed Grant, the hospital’s director of Information systems. First of all, Ed Grant was not adequately qualified to occupy such an important position as the director. His only computer knowledge was basic. This created a major impediment during the implementation of the system as he was not qualified to assess the appropriate and agreed upon specifications the organization needed. Mr. Grant oversaw the implementation of the system and was subsequently rewarded with a permanent senior managerial position. No strategy or subsequent plans were developed after that for assessment of the system before a considerable amount of time had elapsed. A lack of planning and communication by the systems manager created other problems after the system was already installed and implemented.
The second problem associated with the system was the technical challenges. A technical problem was encountered because the system that Grant selected did not meet the response specifications necessary for the hospital operations or its potential for future growth. For instance, the system that the hospital required would need to support network capabilities for several departments as well as serve thousands of new customers daily, thereby, reducing the amount of time spent by in-patient visitors. Additionally, the system was needed to perform tasks of communication with insurance providers, scheduling medical procedures and billing. Moreover, it would also need to support the current data base of customer to enter into the system for the system to play an effective role to improve the organization. However, Mr. Grant did not feel that the blame should be forwarded towards him as he lays blame on the hospital’s administration in spending two years profit on a system that failed to perform perfectly. The hospital invested a great deal of money in a system that failed to sufficiently meet the organization’s operational demands. This second problem created an unnecessary challenge to effective implementation even if the first problem did not exist.
The final set of challenges that were realized by Grant and the hospital administration were behavioral. Behavioral problems were as a consequence of the change in routine and operational processes that had to change with the implementation of the new system. This created an adjustment in the roles of staff and the general organization culture. These had clearly been in place since the inception of the hospital and persevered unchanged for many years. For instance, the manual system that employees traditionally used were intended to be overhauled. This change was regarded as largely unnecessary and wasteful by many in the organization, including Mr. Grant who criticized the organization’s decision to spend over one million dollars on a new system that did not work perfectly. As a consequence, organizational politics about the use of hospital’s resources created conflicts within the organization. As other projects viewed as more fruitful by others received. The ability of the administration and competence of DCs recommendations were scrutinized. This behavioral issue was compounded by the aforementioned lack of planning on the implementation of the system.
Alternate Solutions and Evaluation
The next step that needs to be made at Washington Mercy Hospital is to determine the next course of action. At the time of the case, there was significant conflict due to the effective nonperformance of the response time. Therefore, Grant needed to formulate a strategy to move the process forward with alternate solutions. Next, he would need to evaluate their likelihood to solve the problems that were identified.
There are seemingly three potential solutions to the IT problem. First, the hospital could revert to the old method and abandon the full implementation of the system. Second, Grant could attempt to move forward with the full scale implementation of the system as originally planned. Third, he could attempt to incrementally phase-in the new system while simultaneously moving the old system to obsolescence within the hospital.
The first option to abort the system would be a quick way to resolve the challenge. However, it would not solve the problem permanently. For example, the out-patient department has outgrown the effectiveness of the old system. Additionally, this alternative will lead to a long and public litigation between the hospital and DCS, one that they openly want to avoid. Additionally, the billing, cash flow, patient data, and insurance carrier communication problems would persist and eventually become worse and unmanageable with the existing system. As a result, it can be concluded that a new information system is needed regardless of whether or not behavioral problems exist.
Secondly, the full scale implementation of the new system through swapping the current server with a larger one. This alternative is conditional to a binding agreement between the two parties who have to bear jointly the cost of acquisition of the new servers. The hospital’s operations consist of culture, routines, and politics that are too embedded into its operations that it would be difficult to achieve a consensus and allow Grant to implement this proposal. Furthermore, the technological capabilities of the system are not adequate to cater for all the hospital’s future needs.
The best solution for Washington Mercy is to phase-in incrementally the new server system into the current system. This will minimize all of the problems identified and maximize the potential of the system’s capabilities. There would be two steps to this process. The first is identifying personnel and processes to adopt and implement using the new server system. The second step is to identify personnel and processes to remain exempt from using the new system and remain on the available system. Each step could have a time frame for implementation of the new and obsolescence of the old system. Furthermore, an incremental implementation could take advantage of the strengths of each team members while minimizing the objections of those strongly opposed to its implementation. For example, administration and cash flow can be dramatically hindered by the use of an antiquated and slow system. There is a new secretary that is not opposed to computers as well as a long time administrator that is accepting of the new system. As a result, this is an area of the organization that would benefit dramatically from the new system’s implementation. Receivables are difficult to manage. This is also the area that has the least resistance to change. Additionally, they are a group that would not display the behavioral problems that create challenges to its implementation. The doctors and nurses are the groups that should support the implementation of the new server system. This group creates a behavioral problem, because they are entrenched in the old routines and processes of the organization. In addition, the doctors’ and nurses’ medical charting and data base requirements will eventually create a problem for the system as the clinic expands. Therefore, their resistance can be overcome by allowing them to use the manual system for medical related operations.
An implementation of the new server system will be the hospital’s best chance to improve the response time of the information system as well as serve the needs of the hospital’s operations. Identifying the proper people and processes to use the system while simultaneously identifying people and processes to remain exempt has the best potential of all available options to be effective at implementing the system and improving the short term efficiency of the organization. The administrative staff will effectively implement the system to increase efficiency. By contrast, the practitioners can remain attached to their antiquated system that has served the hospital well to this point. This strategy will minimize behavioral conflicts while maximizing the potential of the system. It also provides an authentic strategy instead of simply buying system and hope, so it is perfectly operational.
Considering the nature of operations in the hospital, and the number of patients the facility serves daily, the implementation of the process should be hastened in order to avoid any back log in work and records. It is estimated that the implementation process of the new server system should be take one week since all the intensive tasks of the network connection and systems analysis has already taken place. The server and network computers will be delivered to the facility and re-installed. Since no follow up activities such as re-training hospital staff will be conducted, the whole process is expected to last no more than 14 working days. Additionally, since a limited level of supplementary resource implementation will not be required for the implementation of the new server, the time limit is estimated to remain the same.
The implementation of the new server system should have been conducted in a more stringent and effective way. The director of operations and information systems implementation should be in highly qualified individual with the ability to assess correctly the response of a system before a complete implementation is carried out. Secondly, the hospital should keep the old system as a backup system in the event the current system experiences difficulties in the future. The new system has the potential to handle the hospital operations effectively, which accommodate the ability to growth in the future. As long as the organization maintains the system effectively, this goal will be achieved.
|Milestones in Media Communications|