FOR PERFECT PROF ONLY

4

Mod 1 Case

Mod 1 Case: Problem Identification

William S. Gates

TUI

Professor: Robert Grice

For this assignment you are to select a hospital for which you are familiar or have access to the needed information. This hospital will be the focus of the case and SLP assignments. For the module 1 case please submit a paper that:

1. Identifies a problem in hospital administration.

2. Describes the problem and discusses its importance.

I have been working for San Antonio Military Medical Center for the Past four years, and in that time frame I have noticed many flaws. This facility is considered to be the Flagship facility for the Department of Defense’s Health Care, but administratively speaking it could run smoother. The next few paragraphs will elaborate on how administrative practices with in the facility hinders care, morale, and patient perspective.

SAMMC is an integrated facility meaning that multiple services branches man this facility along with its contractor and civilian counterparts. Formerly known as Brooke Army Medical Center, San Antonio Military Medical Center is primarily manned by the United States Air Force Medical Services. The United States Army has since reduced its manning in the facility and has supplemented with contractor and civilian personnel. This all Came about in 2012 when the Base Realignment and Closure (BRAC) Merger took place; moving inpatient units at Wilford Hall Medical Center, now known as Wilford Hall Ambulatory Surgical Center to BAMC, now known as SAMMC. All inpatient units along with the staff both military and civilian were forced to move from Lackland AFB to Ft Sam Houston TX. SAMMC then took over inpatient care for Joint Base San Antonio and WHASC became a super clinic only utilizing outpatient care facilities.

Now on paper this was the best decision for the DoD financially, however the clash of culture would soon result in numerous complaints and morale issues within the facility that caused a riff throughout the hospital. Administratively the hospitals commanding officers were all Army initially, since 2012 only 3 Air Force Colonels have made their way into the Hospitals administrative command. One of the biggest issues facing the chain of command is its culture. The Army has harsher way of dealing with issues, and since they are in control of the day to day operations they have bumped heads with many of its Air Force counter parts.

There are 3 administrative commands that make up SAMMC, Troop Command (Army), 959 Medical group (Air Force), and Medical Command (Army). The hospitals administrative piece operates from Medical Command and there mission. They own the staffing portion or manning document for the makeup of the hospitals personnel. But since more than half of its staff is Air Force, and the 959 Medical group handles all administrative action for the members, the army has a hard time getting its mission done on paper by its Air Force Counterparts. For the most part like I have stated prior, this is all a clash of culture that has escalated into numerous negative climate survey’s indicating negative work atmosphere with poor leadership on all organizations involved. This administrative issues between the different organizations has stifled the morale of all units within the facility that it has raised the military separation rate fifty percent. In 2015, a whole page of information from climate surverys conducted by Air Force personnel found itself on the Chief of staff of the Air Forces desk.

Another issues that seems to hold up the hospital administratively is the amount of computer illiterate staff. The majority of the civilian personnel working in the facility is over the age of 40 and prior service that didn’t have computers when they initially came into military service. The rate that technology advances is greater than the rate the average baby boomer or 40 year old gets better at using a computer. The entire hospital runs on computers, from the machines that keep the patients alive to the programs that help order the supplies for the facility. If the government would just hire some younger staff with new fresh ideas, and get rid of old fat civilians who think they own the place the place would run a lot smoother. For example the Lt Col I sit in an office with ask me constantly how to do things in excel, outlook, and word.

San Antonio Military Medical Center will always be plagued with administrative challenges, mostly because of the high turnover rate of leadership. The average military member that is charged with administrative command only stays in the leadership position for 3 years then rotates to another assignment either. The member are given bright individuals with not so sharp tools to work with and they make the mission work every day.

the most optimal approach a manger might want to pursue when faced with a problem in need of timely solution would be to see out the subject matter expert for that particular situation and utilize the analytical obsession to identify some root causes then utilize the fire fighter method and act quickly to ensure a positive change.