I attended Sweeny Community Hospital board meeting held on 13th November 2018 at their boardroom, which started at 07:00hrs to 12:00hrs. In attendance was Mrs. Sherry Wall, who is a senior doctor at Sweeny Community Hospital among many other nurses and members of the public. Precisely, the meeting was set to discuss the challenges faced by the community in search of health services and the way forward to improve on service delivery. Also, the meeting came when there have been numerous complaints from the community about poor service in the hospital. Due to my curiosity, I arrived at the meeting 20 minutes earlier, and I had the privilege to sit where I could easily see those who come in. At the entrance of the boardroom, there were several copies of the meeting agenda, and each one of us was required to take a copy. As usual, the meeting started with a roll call where members mentioned their names one after the other.
Most importantly, it is crucial to point out that the meeting was so exciting and informative. I felt delighted and lucky to have been part of such a high-level management meeting. The board members discussed some issues which, if implemented, would change the healthcare and mode of service delivery to the community. First, the issue of the cost of medical commodities was discussed in details. Notably, the cost of providing healthcare services has gone up in recent years(Dinc & Gastmans, 2012). Therefore, it is evident that members of the community have been complaining about the same. The doctors looked into the issue of the cost in different ways. However, it was noted that it is difficult to come up with the cost of healthcare. Often, one has to understand the slight difference between service delivery and managing continuity. In other words, as much as a hospital aims at providing excellent healthcare services, it should also take into consideration the costs of running the facility.
Additionally, the high costs of supplies determine the value of medical health care. Most of the community hospitals such as Sweeny do not enjoy the lower prices of supplies that are attributed to discount. In other words, the price that the community hospital gets its supplies is slightly higher compared to other facilities that purchase medical commodities in more substantial amounts. As a result, the cost of medical services was too high. Nonetheless, to lower the cost of medical services, the hospital should start by reducing the cost of buying medical supplies (Bates et al., 2014). At the same note, shreds of advice were provided to the board members to ensure that policies are put in place to safeguard community from the high cost of services through shielding small community hospitals from high prices of supplies. By doing so, community hospitals would be able to acquire supplies at reasonable prices. Also, it was the agreed that this was the way forward towards attaining cost-effective healthcare.
Another issue discussed intensely in the meeting was the lack of the economies of scale, which is a proportionate saving in costs gained by an increased level of production. Small community hospitals operate with a minimal budget. Thus, most of these hospitals operate with fewer physicians' groups, and in particular, case two or three physicians. Equally, this is attributed to the lack of enough resources to pay and manage these physician groups (Bates et al., 2014). However, if the same community hospitals dealt with a small number of people, it would be easier for them to manage them. However, the hospital deals with a significant proportion of the populace, and as a result, it lacks adequate personnel to deal with the high number of patients each day. Therefore, many patients have to wait for over a long period to get the required services. In this case, the board was reminded to ensure that the hospital has more groups of physicians who will improve the service delivery of healthcare to the community.
Also, issues of state and the federal governments not supporting community hospitals come up. Much compliance has been put in place by the regulatory bodies of healthcare, which all of them come with a fee. Over time, the hospitals have been regulated primarily by audit contractors such as the HIPAA, and RAC (Fan, 2015). Concisely, all these regulations are put in place to ensure excellent service delivery. However, it was noted that the same bodies make administration cost to go high. As such, many hospitals such as the small community hospitals spend much money in administration compared to buying equipment and drugs. Also, this has been happening and in most cases approved by the two levels of government in goodwill. Nonetheless, the two levels of the government should reconsider their actions. In fact, hospitals do not need numerous stringent regulations for medical professionals such as nurses to provide better services.
As the meeting went on, there were complaints about trust issues between the nurses and patients. It was discussed that some patients regularly complained about how some nurses handled their confidential information. Confidentiality is ways of keeping something secret (Fan, 2015). I felt delighted that a doctor would stand up and tackle this issue of patient-nurse trust boldly. Also, we agreed that it was against the code of conduct of the medical profession for any person to disclose the health information of his or her patients. In other words, anyone who does this risks being deregistration from the professional body. Nonetheless, such cases should be reported to ensure that they do not reoccur or should ever happen again in the hospital. In addition, the board members reacted to this issue with anger and promised to come up with a disciplinary committee whose mandate will be to listen to such allegations and take disciplinary actions if nurses found guilty.
Members also suggested the introduction of a policy where nurses will be attending medical camps around the community in a way to bring health services closer to the patients. Also, these medical camps will provide free medical checkups for willing members of society and in turn provide medication at a lower price (Pocock & Phua, 2011). Furthermore, the policy suggestion comes amidst some complaints that some members of the community find it difficult to access the medical facility. Often, many were in agreement with the proposal. Thus, it was a duty and calling of the nurses and other medical practitioners to provide health services. As such, it would be better for them to take the services to the community with great honesty, integrity, and adhere to the highest standards of professionalism. In line with this, the board agreed to meet and deliberate on the same issue and finalize the policy in a few days.
Although this will help revolutionize the health care system and better service delivery, most nurses will not be happy. One person said that there should be motivation and incentives such as additional pay for those who will be conducting the duties over time. She further said that this would help a lot if implemented. Before members attended a short tea break and to respond to calls of nature, the issue of nurse's remuneration was discussed in depth. The board members promised the nurses that they would review their compensation very soon and increase their pay. Moreover, this surprised many nurses who were present as most of their efforts to demands were discussed more in-depth. However, it was evident in the minds of the board members that nurses as any other works should be paid well for them to work even harder.
Notably, money acts as the best motivator (Dinc & Gastmans, 2012). Nurses were pleased, and at the same time, they wanted the board to at least explain to them how much was going to be added into their account. Alternatively, instead of how soon will those changes are affected. However, at this juncture, the chairman adjourned the meeting for ten minutes to allow those who wish to take a bottle of water to do so and come back. It took me less than the ten minutes, and I was back in the room glued to my seat. As soon as the ten minutes elapsed, the room was packed, and everyone was ready to listen. As the meeting progressed, the board took center stage. Some members responded to most of the questions raised earlier, while the other waited for the new issues to arise and give their views. However, one thing which stood out is that the board was going to have a meeting with different levels of the local administration in a bid to come up with policies that will help improve service delivery in the community hospital.
The chairperson gave the vote of thanks and the closing remarks. However, in his comments, one member added that they were in a process to secure a grant, which will be used to purchase a new dialysis machine to increase the facility's ability to handle patients who require such services. However, he added that it was not the only project the board had in mind, some were at the initial stage. Therefore, it was clear that the board was much concerned with better service delivery contrary to what many thought. As the meeting adjourned, one could tell that indeed all that has been discussed in the meeting was for the good of the community regarding better medical services. I walked out of the room very delighted and pleased to be given a chance of attending it. In a nutshell, the meeting was eye-opening and educative.
Bates, D. W., Saria, S., Ohno-Machado, L., Shah, A., & Escobar, G. (2014). Big data in health care: using analytics to identify and manage high-risk and high-cost patients. Health Affairs, 33(7), 1123-1131.
Dinc, L., Gastmans, C. (2012). Trust and Trustworthiness in Nursing: An Argument-Based Literature Review. Nursing Inquiry, 19, 223-237.
Fan, M. D. (2015). Private data, public safety: A bounded access model of disclosure. NCL Rev., 94, 161.
Pocock, N. S., & Phua, K. H. (2011). Medical tourism and policy implications for health systems: a conceptual framework from a comparative study of Thailand, Singapore, and Malaysia. Globalization and health, 7(1), 12.
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