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NUHCA620GracelandMemorialHospitalCaseStudy1.docx

CASE : TAKING CARE OF BUSINESS AT GRACELAND MEMORIAL HOSPITAL BACKGROUND AND CASE OVERVIEW

Graceland Memorial Hospital is a not-for-profit, community hospital located in a medium-sized urban area in the Midwest. The only other hospital that serves this community is a large, tertiary care teaching hospital affiliated with a major university medical center. When Jack Prestwood, vice president of Human Resources at Graceland, read the current Occupational Safety and Health Administration (OSHA) regulations, he knew that he needed to comply with them. Under the newly formed OSHA regulations, Graceland is required to enforce the correct usage of respiratory masks and conduct respiratory fit-testing to prevent the transmission of communicable

diseases. In the past, Graceland employees who had frequent contact with patients who suffered from airborne communicable diseases were not fitted for a correctly sized respiratory mask. Therefore, to prevent large OSHA fines for noncompliance with the new regulations, Graceland’s administration concluded that it must update its own regulations.

ORGANIZATIONAL PROBLEM

Mr. Prestwood called Janet Bowers, director of Employee Health, into his office one morning to ask, “Janet, are you familiar with the new OSHA regulations for respiratory mask fit-testing?”“I certainly am, Jack,” replied Ms. Bowers. “After reading about the OSHA update in Employee Health Weekly, I called our two health equipment supply companies yesterday afternoon to get an idea of the costs involved with mask fit-testing. I knew that I would need the information sooner or later since the hospital will obviously have to comply with the new regulations.”“Sounds great, Janet. What did you find out?”

asked Mr. Prestwood.“It seems that both companies will give us a discount for a large order of the masks. They will also provide training to Employee Health and Infection Control staff for proper use of the new masks,” Ms. Bowers continued.“It looks like you’ve done your homework, Janet. Let’s schedule a meeting with the Infection Control staff about this,” Mr. Prestwood suggested. Mr. Prestwood arranged the meeting the next day with Ms. Bowers and Erika Tompson, the director of Infection Control, to discuss the updated OSHA regulations and the proposed compliance change. To Mr.

Prestwood and Ms. Bowers’ surprise, Ms. Tompson objected to implementing the change.“Why should we have to undergo such a major policy change since the other hospitals in the area are not making any changes in their infection control policies?” Ms. Tompson complained. “That’s only going to require more work for my staff and for me.

I really don’t think that the change is worth the cost of its implementation. I recommend that we keep things as they are. Te current policies have worked just fine for the past couple of years. If other hospitals begin to make the change, then maybe we could decide to update our policies.” After the meeting with Ms. Tompson, Mr. Prestwood was very frustrated. As a vice president, he had a legal and moral obligation to implement changes for compliance. Although few hospitals had begun to implement the new safety measures within their Infection Control departments, he was concerned about the potential risk of following in their footsteps. Graceland had always been known as a leader, but now he was thinking of dragging behind with the pack. But there could be fines to pay; after all, the new guidelines were the law, and if there was an accident, the consequences could be worse! He did not understand why Ms. Tompson’s response to the situation was different from others in the past. To find a solution to the dispute, Mr.

Prestwood arranged another meeting with Ms. Bowers and Ms. Tompson, but this time he also invited Margaret Ridell, vice president of Medical Staff Affairs, and two doctors on the medical staff. All, except for Ms. Tompson, agreed with Mr. Prestwood’s recommendation. Ms. Tompson, who represented the aggregate view of Infection Control, still would not voice her support for the policy change. After two hours of

intense discussion, no clear resolution had been reached. Mr. Prestwood decided that he would have to look at other avenues by which to get the new fit-testing requirement in place.