Controversial Decision Making In Health Care

Controversial Decision Making

MHA 601 Principles of Health Care Administration

Controversial Decision Making All of the toughest decision making responsibilities will fall to the CEO of an organization. When a highly controversial issue is thrown into the mix, then the CEO has an increased responsibility to make the best decision for all people involved without creating negative whiplash. The issue of an employee who possibly had HIV/AIDS and was working in the operating room, would fall into a highly controversial issue. If this situation is not handled with the utmost care, the negative whiplash resulting from the wrong decision could have a devastating impact on the entire community and the world.
As the CEO of this medical center, this situation would be the highest priority, especially since the story has already been leaked to the media and the media has issued a deadline for a press release. To begin with, the CEO must revisit the organization’s mission and vision statements to insure that all decisions will be aligned. The mission statement for the Community Medical Center reads like this: “We are committed to excellence in providing compassionate, personalized health care through mutual trust and respect, education and leadership, efficiency and service, and access and quality. We believe that by working together, we will improve the health of the community we serve” (SHRM, 2011, ex 3). This mission stands on trust and respect, and if the CEO doesn’t have concrete proof that this nurse is HIV/AIDS positive, then the CEO should attempt to get as many facts as possible before making a decision. A vision statement is a future standard, goal or objective that the organization is striving to attain (Tingum, n.d.).
Vision statements can state one single objective, or they can have multiple goals. These statements can also be updated and modified depending on the direction that the organization is taking. The vision statement of Community Medical Center is providing exceptional first-rate healthcare to the entire community. With this vision statement in mind, the CEO must consider the possibility of the health of the community being compromised if this nurse is truly afflicted with HIV/AIDS. If this nurse is compromised then all of the cases previously could be subject to scrutiny and this could bring up a large civil/criminal case against the
facility. The CEO needs to make a decision and now that the story has been leaked to the media, the window of decision has narrowed considerably.
The best decision making model for the CEO to use is the ‘garbage can model.’ This model is a reality based model and “involves sets of problems, solutions, energy, and participants” (Johnson, 2009, p. 217). There are multiple problems: surgeons threatening to leave, possible ethics violation in exposing a nurses’ personal medical information, pressure of national media attention, the potential of future loss of income resulting from damaged reputation. There are also multiple solutions, fight the nurse in court, allow the nurse to stay and hopefully call the surgeons bluff, request HIV/AIDS testing on the nurse to confirm or deny the allegations, or offer a settlement to the nurse. In this case, there are a number of participants that will be effected by any decision made: operating room nurse, surgeons, emergency room staff, surgical inpatient floor staff, surgical ICU, as well as all other clinical staff that could possibly lose their jobs if the decision is made in favor of the
nurse. When considering all of the problems, solutions, and participants involved in this case, the CEO would need to take into consideration the advice of the board, stakeholders, ethics committee, and the legal team. The least damaging decision financially would be to offer a settlement to the nurse with a possible reassignment of his choice. Although it was stated in the case study that the nurse was not open to being transferred to another department/floor, if the added bonus of money was involved, he may change his mind. The simplest and quickest resolution to the entire case would be to seek medical testing to prove if the nurse was in fact infected, and whether they could have been a danger to any patients. This solution is obviously not favorable to the nurse, as they apparently are infected or they would not be creating this scenario to begin with. If the CEO was to allow the nurse to stay on the operating room staff and the Chief of Surgery and their surgeons went through with their threat, then the hospital would be in a significant bind. Not only would this affect the revenue of the hospital, it would mean the layoff of hundreds of other employees that all have their jobs because of the surgeries performed in the hospital. As a last ditch effort, the CEO and board members could decide to allow the legal battle to play out and fight the nurse in court. This could prove costly as well as draw negative attention to the facility, however it would also show the community that their safety is a priority and that the rights of one single individual is not going to stand in the way of the Medical Center upholding their mission and vision statements of providing a service that can be trusted and safe. Once the CEO has reached the decision that they are going to stand behind, that decision must be communicated first to the staff involved (i.e. the surgeons and nurse) and then a press release will need to be drafted since the story has already been leaked. The wording and the message conveyed in the news release needs to be as positive and simple as possible and demonstrate the great concern and care that went into making the decision that would benefit the hospital and the community it serves. Ultimately, the CEO and the staff members need to make their decision and realize that it is the best for the communities’ safety and the well-being of the hospital to release the nurse unless negative HIV/AIDS results are provided.

References
Johnson, J. A. (2009). Health Organizations: Theory, Behavior, & Development. Sudbury, MA: Jones & Bartlett Publishers.
Society for Human Resource Management. (2011, December 22). Mission Statements: Company Mission Statement Examples. Retrieved from: http://www.shrm.org/templatestools/samples/policies/pages/missionstatementgeneral.asp x.
Tingum, J. (n.d.). Examples of Vision Statements in the Health Care Industry. Houston Chronicle. Retrieved from: http://smallbusiness.chron.com/examples-vision-statements- health-care-industry-17637.html.