Executive Summary
The hospital, with 250 beds, is a non-profit institution with five functioning clinics.After a 15% loss in qualified healthcare providers, the hospital’s chief executive officer has ordered a mid-level administrator to assess the dangers of closing two of the facility’s five clinics. The paper evaluates the potential downsides, benefits, and risks associated with transferring non-medical staff from clinics that will be closed, as well as continuing to provide the same level of service with 15% fewer employees.
After reviewing the information, it was decided that the wound care clinic, the radiology department, the labor and delivery room, and the locked inpatient pediatric psychiatric facility should all remain open. On the other hand, the walk-in orthopedic clinic and radiology department should be closed. The projected consequences of this choice include difficulties in procedure and implementation, difficulties in training staff, and issues with employees that will need careful management.
Introduction
The five clinics are located in impoverished rural areas. Numerous customers are low-income, elderly, and minority Americans. Having the clinics closed involves a great deal of risk. The affiliated hospital with which the clinics are connected is located in a significant urban location, whereas the clinics are located in various rural areas. Nevertheless, these clinics were open to reducing the possibility of patients not obtaining adequate care. This paper will assess the risks of continuing to deliver services with reduced staff, the advantages of retaining each clinic, the risks of transferring non-physician staff members, potential personnel problems, and possible solutions.
Assessing the Risks Associated with Closing Two Clinics
Staffing Risk
Staffing is a significant issue for clinics since they usually serve a large population, especially minority groups. If there are insufficient personnel at a clinic, it cannot function at an optimal level. Because many clinics are understaffed, reducing staff by 15% is impractical. The nursing staff has experienced a consistent decrease in nurses, which hurts patient satisfaction (De Simone et al., 2018).
As nurses’ workloads increase, the quality of care provided to patients may begin to deteriorate. Due to a rise in the number of patients, staff members may become exhausted and anxious. Furthermore, medical errors may occur as a result of overworked nurses.
Additionally, providing services with 15% fewer staff may complicate worker relationships. The employees may find themselves overworked, resulting in workplace issues. Something as fundamental as a break could lead to conflict between employees if they feel neglected. As a result of the nursing shortage, 12-hour schedules have been implemented in many hospitals.
Nonetheless, 12-hour schedules have been linked to healthcare workers’ absenteeism and job satisfaction (Suter et al., 2020). Consequently, they may direct their anger at the patients. Employees may experience burnout due to insufficient personnel, as organizations frequently reduce their workforce if they feel they can save money.
Another potential problem is the high rate of employee turnover. Short-staffed shifts may be tolerated for a limited period, but ultimately, workers will get weary of them. As a result, employees will have little choice but to venture elsewhere for work. In addition, staff adaptability would be affected since workers may be unable to take a break when needed.
Furthermore, the price tag for finding and training new staff members is expected to be staggering. Mentally, emotionally, and physically exhausted people are likelier to report being sick when the staff is reduced (Dall’Ora et al., 2020). Consequently, it can only increase workplace stress and anxiety. Thus, the patients will be negatively affected by staffing shortages.
Benefits of Clinics
Walk-In Orthopedic Clinic
Every clinic plays a vital role in society, as it offers various services to patients, each with advantages. Clients can walk into a walk-in orthopedic clinic whenever they desire to receive medication, as the name suggests. The walk-in clinics aid in treating medical emergencies, such as accidents; they manage injuries and prevalent infections.
In the walk-in clinic, there is no waiting list for treatment. Most walk-in clinics have lengthy waiting lists, and orthopedic clinics receive various patients daily (Azfar et al., 2019). It is easier for patients to access care when they need it because they can frequently walk in without an appointment
Referral-Based Radiology Unit
A referral-based radiology department equipped with MRI, CT, and imaging radiology allows for X-ray imaging and imaging of cross-sections. These clinics are staffed with trained professionals who perform their tasks with precision. Imaging and radiology make special surgeries possible. Before beginning treatment, the disease’s presence is confirmed by radiology. In addition, scanning is performed to verify that the treatment provided is warranted.
Labor-and-Delivery Suite with Neonatology
A labor and delivery room equipped with neonatology enables the safe and effective delivery of newborns. The nurses and midwives have the skills necessary to care for newborns. In regions where mothers do not give birth at home, the incidence of children born with defects is low, and when they do occur, they are handled appropriately by professionals (Zhou et al., 2019). The government encourages all expectant women to give birth in hospitals.
Wound Care Clinic
A wound care clinic is staffed with experts who clean wounds and provide multidisciplinary client care to guarantee that patients undergo continuous wound care. These clinics treat chronic lesions resulting from excessive blood pressure, infection, or malignancy.
Locked Pediatric Psychiatric Inpatient Unit
A locked, inpatient pediatric psychiatric facility may offer skilled care to children and adolescents with severe mental health problems who need prolonged therapy in a secure setting. Young people with mental health issues like depression, anxiety, psychosis, and eating disorders can get help and encouragement at these facilities specifically created to treat and assist them (Eapen et al., 2023). This psychiatric clinic may offer a safe and secure setting to manage such risks for children with mental disorders who risk injuring themselves or others.
Transferring Risks
Transferring non-medical staff from one clinic to another is a significant problem. Relocating these employees is one of the most challenging undertakings since, despite their inexperience, they have received specific training for their present duties. All team members must receive rapid training if there is even the slightest shift in the workplace environment. There will likely be a delay in patient transfers while the clinic undergoes training, affecting the clinic’s daily operations.
Since the newly transferred personnel are unfamiliar with the clinic’s procedures, additional training resources and time may be required (Johansen & Sowa, 2019). It is not uncommon for difficulties to arise when a clinic’s non-medical staff has been transferred to a new facility. Errors made in the initial few days of adjusting to a new clinic, poor productivity due to inexperience, confusing duties, and the difficulties connected with transition are just a few examples.
Having inexperienced personnel working in the clinic might be a challenge. New employees sometimes lack confidence and direction in their roles because they lack experience (Ho et al., 2021). Therefore, it is necessary to provide sufficient training for newly hired employees to ensure they are ready to perform their duties. The inexperienced worker lacks the necessary expertise to perform well in the role. In addition, inexperienced workers have trouble dealing with pressure since they lack the necessary skills.
Potential Personnel Problems
When workers are dismissed, they may not receive advance notice. Frequently, organizations reduce their workforce to save money. The organization may experience a decline in morale, resulting in a decline in productivity. In addition, a company may downsize to hire less qualified workers at a lower salary. Hiring less qualified personnel can raise the risks of negligence and medical errors (Rodziewicz et al., 2022).
Different measures must be implemented to help minimize risk within the facility. The organization’s culture might change due to employee concerns about their security. To prevent job loss, workers may pursue employment elsewhere to provide stability. Layoffs have benefits because organizations can eliminate workers who do not share their vision.
Other Potential Problems and Risks
Other issues or hazards connected with shutting down two of the five clinics include a drop in income owing to reduced patient numbers. Closing these clinics would also lead to less access to specialist treatment for patients and an increased strain on the remaining clinics. Before making a final decision, the hospital may be required to assess the possible financial effect of closing the clinics (Germack et al., 2019). Furthermore, it must explore alternatives such as decreasing hours of operation or reorganizing staff assignments.
Clinics Closing Recommendations
It is recommended that the orthopedic walk-in clinic and radiology department with MRI, CT, and ultrasound clinics be shut down. This is because the two clinics require expertise and well-trained workers. Working with non-physicists in these crucial areas is difficult. These clinics require high-quality devices that need expertise, such as X-ray machines.
Furthermore, most individuals in society do not regularly suffer from ailments that necessitate the services of these two clinics. People who require wound care and delivery-related services are more prevalent than those who require a CT scan (Johansen & Sowa, 2019). As a result, it is best to leave inpatient children’s psychiatry clinics, wound care, and labor and delivery as they are widely desired in society.
Consequences of Clinic Closure and Preparation to Manage Them
If the orthopedic clinic and radiology department are closed, the hospital may lose funds and reputation, decreasing client satisfaction. The hospital must devise a strategy for patients to get orthopedic and radiology therapy at other clinics or hospitals in the event of an emergency. The hospital must also inform its employees of the clinic’s closure and assist anyone affected. In addition, the hospital must prioritize recruiting new employees and guarantee that patients receive prompt care. Ultimately, the hospital must invest in equipment, facility upkeep, and renovations.
Timeline
Within a year, the clinics will have to be closed. The hospital may take time to properly dissolve one clinic before moving on to the next. Patients will have time to locate suitable replacement physicians within the allowed window. The workers might then be sent to a different department within the hospital or a different clinic. The steps that need to be followed include conducting a complete review of the financial effect of closing each clinic and analyzing the availability of additional healthcare providers. This will be followed by developing a strategy to transfer personnel to other departments in the hospital.
The whole process of clinic closure will follow the Cynefin system framework, a model that may be used to classify complex problems and make better decisions. The Cynefin framework should be utilized to identify complex situations, which include several interrelated elements and call for a holistic solution method (Shao et al., 2022). Clinic closures and personnel shortages fall within the complicated domain since they are challenging to forecast, regulate, and include several linked causes. The suggested strategy for solving problems in the complex domain is to employ sense-making to gain insight into the issue at hand, investigate potential avenues of threat, and then react with repetitive trials.
Conclusion
Clinics are helpful because they point patients toward tools they might employ to improve their health. There is a significant danger associated with the clinics being closed. Since these establishments were designed around the principle that everyone who needs medical care should have access to it at an affordable price, clinics include almost everything you might want, and often more. Clinics will provide excellent care to all patients, regardless of whether or not they have health insurance.
References
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