Edited by: Paul B. Hoffman and Frankie Perry
Publisher: Cambridge University Press – 255 pages
Book Review by: Sonu Chandiram
This book presents seven case studies of healthcare management mistakes as real life events that occurred at healthcare organizations. Healthcare expert comment on those mistakes and what should have been done to prevent them, as well as what steps should have been taken to produce better results.
The editors of this book – Paul B. Hoffmann and Frankie Perry – who have both served as directors of hospitals, state that healthcare managers should view mistakes as learning opportunities. The material in this book some of those mistakes for the benefit of those who lead hospitals, their doctors and others affiliated with them, as well as patients, their families and communities.
Paul B. Hoffman is affiliated with Provenance Health Partners which provides consulting services to hospitals and other healthcare systems. Among other positions he has held, he has served as Executive Director of Emory University Hospital in Atlanta and Director of Stanford University Hospital and Clinics.
Frankie Perry is on the faculty of the University of New Mexico and as Executive Director of the Chairman’s Society in Atlanta, which provides education and training to chairmen and members of boards at hospitals and other healthcare entities. She has served as Assistant Medical Director of Hurley Medical Center in Flint, Michigan. She is a registered nurse
The Foreword has been written by Richard J. Davidson, President of the American Hospital Association
A number of models are presented in this book to disclose, identify, interpret, acknowledge, correct and prevent mistakes in healthcare management. It looks at the relationship between management and mistakes.
The types of the mistakes examined in the case studies are of a wide range:
- Failed hospital merger
- Ineffectual governance
- Inept strategic planning
- Information technology setback
- Medical errors
- Nursing shortage
- Public relations fiasco
Medical errors at the Paradise Hills Medical Center in the South:
Twenty-two oncology patients received radiation in dosages in excess of what was prescribed for them because of a flaw in the calibration of the equipment. The medical physicist responsible for the errors had been asked to resign.
Members of the board were upset and fearful of the consequences of either informing or withholding information on the excess radiation dosage. The hospital’s ethics committee recommended that patients be notified of the errors, but the hospital administration decided not to because of the potential lawsuits and negative publicity from news media coverage.
About three months later one of the patients learned of the errors and filed a lawsuit a lawsuit for fraud because the hospital did not inform her of the excess radiation dosage.
The hospital’s malpractice insurance policy did not cover fraud. This case was settled out of court for $300,000 in favor of the patient. The media learned of this and several other patients filed suits and received compensation in out-of-court settlements.
Failed hospital merger in Illinois of Richland River Valley Healthcare System with J. Blair Sutton Memorial Hospital
Three years after the merger of RRVHS and JBSMH, there was still no consolidation of clinical services as planned, to save on expenses, and the hospitals, four miles apart, were still duplicating all operations except those relating to business operations. This obviously cannot maximize cost savings. With the staffs demoralized by the constant conflicts between the two hospitals on numerous issues, the “marriage” failed and the merger was dissolved.
Ineffectual governance at the Pleasant Valley Regional Health System in Pennsylvania:
Tim Wiserman, the CEO of this organization for over 18 years, was proud of his accomplishments and the hospital’s growth from a free-standing one into an integrated system. His board had given him their confidence to run the hospitals pretty much by himself because he was so capable and successful.
But when Pleasant Valley’s market share was dwindling as a result of competitors offering managed care plans, Tim presented plans to keep the hospital dominant in the area with its lion’s share of the market. But the board members of the hospital would not agree with his plans to keep the hospital dominant.
They stuck to their position that they should not and will not negotiate with insurance companies and will not lower the prices of its services even as its competitors were doing that to eat away at Pleasant Valley’s business. As a result of not winning his board’s cooperation, the CEO Tim Wiserman had become ineffectual.
This is a valuable book. The consequences of healthcare mismanagement are severe: lives can be taken, careers destroyed, many million of dollars lost and reputations tainted. This subject is of enormous importance to healthcare providers and recipients as well. Hoffman and Perry have presented the problems, solutions and preventive measures well.
