Shands Healthcare Case Study

According to the Tampa Tribune, Shands Healthcare paid the federal government and Florida a total of $26 million to settle allegations of false claims to Medicare, Medicaid and TRICARE, according to a statement from the Department of Justice. The facilities at Shands were billing state and federal health care programs from 2003 to 2008 for inpatient services and procedures that should have been recorded as outpatient care (The Tampa Tribune, 2013).
The VA had its share of problems as well. The Senate panel indicated that managers at several health facilities lied to investigators about problems including scheduling appointments. The investigators also found chronic problem by personnel covering up the delays at approximately 1,000 veteran’s
hospitals and clinics. The results revealed that managers at 13 locations lied to investigators about scheduling issues and other related problems. It was noted that 42 of the 93 locations engaged in modifications of schedules. In addition, 19 locations had cancelled and then rebooked appointments for the same day to meet on-time performance goals (CBS, 2014).
The alleged referenced mismanagement by Shands Hospital Systems and the Veteran Administration is consistent with the perceived attitudes and behaviors of their employee’s perception of the overall efficiency of their organizations.
For example, Out of 20 (Shands healthcare workers) surveyed, 8 identified as By-Chance Managers and 4 of 8 indicated that their managers functions at low reliability, which results in an outcome of 50%. Out of 17 (VA healthcare workers), 15 identified as By-Chance Managers and 14 out of 15 indicated that their managers functions at low reliability, which results in an outcome of 94%. The 94% is overwhelmingly an indication of perceived inefficiency of some employees. In contrast, By-Design/Evidence Based Managers at both Shands and the VA revealed that Out of 20 Shands healthcare workers surveyed, 12 identified as “by-design” managers and 11 out of 12 indicated that their managers functions at high reliability, which results in an outcome of 92%, which suggests that “by design/evidence-based” management is working for those employees. Only one Shands “by-design” managers out of 12 or 8% indicated a “by-design” manager function at low reliability.
It appears that “By-Design/Evidence-Based” management is working for the VA employees that used the “evidence-based” methodology. For example, Out of 17 VA healthcare workers surveyed, 2 identified as “by-design” manager, and both functions at high reliability or (0% low reliability). There was a VA (by-chance)
manager that functions at (high reliability), 1 of 15, which represents only 7%.
This suggests that not only both organizations have their share of alleged inefficiencies; it also suggests that the companies do not have the right talent for the job nor the right management systems or both. Pfeffer and Sutton, emphasized companies that acquire the best talent were the best companies. Financial rewards also played a role in organization’s performance, and companies “must adapt or die. They continued to argue that excessively basic ordinary knowledge is not smart. Also, in reference to “best practices” that are often poor, inaccurate, or total outdated. Even more disturbing, multitudes of leaders use this questionable information in their decision making that is dangerous to the wellbeing of their organizations. In relation to management standards, personal experience is not good enough to keep hospital out of financial turmoil (Pfeffer & Sutton, 2009).
The researcher’s recommendations include that organizations need to understand that customers’ perceptions and needs dictates whether a product or service is “excellent.” If “quality” involves understanding customer expectations, then organizations need to create a product or service that consistently meets that expectation.
Finally, implementing an Evidence-Based management models and other tools like Six Sigma, Continuous Quality Improvement, etc., are excellent tools to help manage those expectations. Evidence-Based diagnostic tools also helps to detect the causes of undesirable performance and to design solutions. It is mindful to note, an effective and sustainable “evidence-based” management model is not easy. It often requires dedication and commitment, but long-term, it is worth it. Trust your “Evidence” not your “Instincts.” As Nike would say, “Just do
it.”