Case #13 “The Day After”
Charlie Jones: former Chief Executive of Riley Memorial Hospital
Russell Adams: board chairman at Riley Memorial Hospital
Bill Handy: COO of Riley Memorial Hospital
Dr. Ralph Kemper: Chief of Radiology at Riley Memorial Hospital
Background and Facts
Over the last 18 months the average occupancy at Riley Memorial Hospital had fallen. This was certainly a cause for concern for Charlie and the hospital board. As a result, 134 employees were laid off to keep the hospital out of the red. This led to the closing of two specialized nursing units, which had a few trustees and several physicians extremely upset with the board’s decision. Charlie’s relationship with the board and medical staff had changed over time because of his inability to control the number of matters of importance due to a changing external environment. Consequently, Charlie lost his ability to make necessary decisions in a timely manner. With four physicians on the board, Charlie met with resistance when he tried to prepare the board for the economic downturn and the publics decline in the use of physicians and hospitals. Furthermore, Charlie met with resistance once again when he tried to review a proposed contract submitted by a health maintenance organization with the board. Instead of listening to what Charlie had to say, the four physicians persuaded the board to support private practitioners and engage in fee-for-service medicine. The board assured Charlie that the physicians would keep the hospitals needs and interests above those of the medical staff. Charlie appointed Bill Handy as the COO of Riley Memorial Hospital and turned over all internal operations to him. Although this new appointment was fully endorsed by the board, it was never understood or accepted by many of the physicians. The physicians at Riley Memorial Hospital considered Charlie’s role to primarily serve the interests of the medical staff. Many physicians believed Charlie did