The Marion Camp Memorial Hospital provides convalescent care for patients with long-term illnesses as well as for patients who require extended periods at physical therapy. The average length of stay at the hospital is for months. The hospital is supported through a combination of state and federal funding, medicare payments, and private donations. Less than 10 percent of the hospital’s revenue is derived from the patients.
The hospital director, H. John (Big Jack) Pace, has become increasingly concerned with the number of complaints the hospital is receiving on various aspects of its health care, and he recently made this the main topic at the monthly staff meeting.
In the attendance of the meeting were Alan Carter, chief physician: Nancy Ames, supervisor of nursing; Phil Rogers, manager of support services; and Charlotte James, assistant director. Mr. Pace began the meeting with a brief statement outlining some of the many complaints he’d received, which ranged from cold meals to beds not being changed often enough.
Some of the complaints were from hospital employees themselves. Mr. Pace indicated that he hoped that this wasn’t the start of a decline in the quality of health care. However, his main concern was an upcoming inspection for reaccreditation by the state. In his words, “You know how they can pick up on something like this and blow it all out of proportion. ” Charlotte James, who has been investigating the problem, reported that she was having difficulties because “doctors, nurses, dieticians, and support people have different definitions of quality.
She also noted that most of the complaints seemed to relate to support services rather than medical care, and Phil Rogers tended to agree with her, but he indicated that he had not been able to “turn things around. ” He pointed out that support people (nurses’ aids, kitchen workers, janitors, painters, etc. ) were unskilled or semiskilled personnel who generally received the minimum wage. He noted that the turnover was high, morale was low, there were no professional standards, and few workers viewed themselves as a part of the “health care team. ”