Hospital Clinic Closures: Risk–Benefit Analysis and Change Management Strategies Essay

Introduction

The hospital experienced a 15 percent loss of licensed, trained healthcare provider staff due to dislocation in the state’s healthcare industry. The hospital has established and maintains five distinct clinics. This paper aims to conduct a risk-benefit analysis of this change, citing the risks and benefits associated with closing any two units and transferring or laying off excess staff members, and ultimately, suggesting reasons for the departments to be closed.

Risks of Continuing to Offer the Services

The hospital risks a reduction in specific outcomes due to the workforce shortage, resulting from a 15% loss of trained staff. This change and workload increase have potential risks to the general human resource productivity and the organization’s healthcare quality. According to a review study by Mohanty et al. (2019), workplace shortages have impacted the well-being and quality of patient care.

More importantly, the health of healthcare workers is also negatively impacted by such a shortage. Fewer employees mean more effort, longer workdays, higher customer demands, and sometimes poor patient health safety. According to Dharmshaktu & Pangtey (2019), a poor work-life balance arises in situations of staff shortage.

Most doctors fail to give due respect and attention to their health and safety, which becomes unproductive to the general organization’s workflow, workforce, and workload. Workplace stress, burnout, and the risks of medical and medication errors rise, thus compromising occupational and patient safety. Therefore, continuing to offer services with 15% fewer staff risks losing clientele, compromising the occupational safety of healthcare workers, jeopardizing patient safety, undermining financial viability, and damaging the hospital’s reputation.

Benefits of Keeping the Services Available

Keeping all the hospital’s services with the current workforce also benefits the consumers of these services and the organization. Maintaining a walk-in orthopedic clinic will alleviate the burden on the emergency department, as it will handle most orthopedic injuries and provide outpatient orthopedic services. The referral-based radiology department provides imaging and radiological services to the organization and other local hospitals that require these services. MRI, CT scan, and ultrasound services are essential auxiliary diagnostic services that reduce consumers’ waiting times when seeking care in this health organization. Although this department is auxiliary, the benefit is not limited to a specific department.

Keeping the labor and delivery suite with neonatology provides three kinds of services in one department. Antenatal, delivery, and postnatal care will be provided in a single suite. These care services are related and can complement some pediatric care services. The wound care center, equipped with hyperbaric equipment, offers competitive services in the current healthcare market. Continuing to offer these subjects will make the hospital competitive in the state by attracting this particular cohort of patients requiring state-of-the-art wound care.

The locked inpatient pediatric psychiatric unit will provide mental health services to the pediatric and adolescent population. These are vulnerable population groups with unique mental health needs. Therefore, each unit offers unique services that keep the hospital running normally and interdependently.

Risk of Transferring Non-Physician Personnel from the Clinics to Be Closed

Transferring non-physician staff from clinics that are closing to the remaining clinics is a wise cost-cutting and workload-reduction step. However, various risks may accrue from this move. However, through interdependent multidisciplinary care and resource sharing, different clinics and units have varying workflows, protocols, job aids, standards of practice, work timelines, and intradepartmental hierarchies.

Each non-physician personnel member in the units to be closed is accustomed to their systems, skills, knowledge, experience, and workflows. Therefore, relocating them to a new department will decrease their productivity because they are not yet familiar with the new department’s knowledge, skills, and workflow requirements. Therefore, the risk of medical and medication errors, as well as patient harm, will be high. Acclimating this personnel to the new environment may take time and reduce their morale due to fear of the unknown and unfamiliar expectations from their new departments. Reduced morale may lead to poor job satisfaction among workers. This can also lead to high staff turnover in the current health crisis setting.

Using inexperienced staff will result in the specific receiving units incurring training costs to achieve optimal staffing. To achieve optimum staffing, departments need the right staff with the appropriate skills in the correct department at the right time. The organization must strive for both higher quality and quantity outcomes with less resource input.

Therefore, training the available, inexperienced staff will enable them to fit into the new roles in the new departments. As a result, time, human, and monetary resources will be required to achieve this optimum staffing. According to Rees (2019), addressing these challenges will require proper workforce planning and policing. This would enable well-integrated team-based care in the receiving departments, as well as new training tools and service delivery systems in the individual departments, to facilitate the transition and training process.

Potential Personnel Problems and Possible Solutions

Transferring employees to new assignments or laying off the extra staff are two potential solutions to closing two clinics, given the current health situation in the state. These strategies are not devoid of challenges and issues. The training mentioned above addresses the sole key problem arising from these potential challenges.

Training new staff would take time and consume more resources, which would be a challenge given the state’s existing financial and resource limitations. Implementing ongoing training concurrently with clinical care activities is a potential solution to this challenge. A doctor’s apprenticeship is one potential solution that could assist with this training (Cirelli et al., 2021). Assigning new staff to mentors or leaders in the receiving departments would provide solutions to time and resource limitations. The assumption is that the transferred workers have a theoretical background of processes and work in the new department because these departments are in the same hospital.

Staff morale and job satisfaction are also potential challenges of the two proposed changes in the hospital (de Miquel et al., 2022). These issues require good leadership and management strategies to improve the process outcomes. Improving workers’ satisfaction can be achieved by influencing their motivation. Transferring staff to unfamiliar departments will lower their morale and create anxiety for these staff members.

Motivation strategies will aim to prevent turnover and increase the productivity of transferred members. Bonuses and promotions for the transferred staff and existing members will boost staff morale. The increased workload resulting from a 15% staff reduction in the hospital has already created a less motivational environment for the non-transferred members. The move will rely on the remaining members to provide directions and training to the transferred members. Therefore, their satisfaction with the new state will be critical in creating a positive environment for continuity.

Laying off some staff to accommodate the current hospital’s financial situation will worsen the new clinical and nonclinical workload. Therefore. The risk of increased waiting time, medical errors, and staff turnover will also rise. Thus, the remaining staff must stay motivated and vision-oriented to achieve the hospital’s goals and mission. Offering severance packages to the laid-off staff will motivate them in the quest for professional advancement and job seeking (Bhandari et al., 2021). The remaining staff will also require similar motivational interventions to keep them focused and retained in their various jobs.

Clinics to Be Closed

The decision to close two of the five clinics will be a necessary administrative step to sustain the current hospital’s financial situation. However, choosing which clinics to close and retain will require astute leadership, sound management, and expert knowledge. This decision will be determined by the organization’s mission, the clinics’ client capacities, risk of closure, benefits of retaining them, and productivity impacts.

Following the risk and benefits assessment previously described, the walk-in orthopedic clinic and the locked inpatient pediatric psychiatric facility should be closed. The orthopedic clinic is a low-volume clinic that serves a clientele who can receive initial care at the outpatient clinic. The costs of running this clinic will be higher than the expenditures incurred from paying staff and purchasing orthopedic equipment. Moreover, this walk-in clinic would not be well-equipped to handle emergency orthopedic care and primary orthopedic medical and nursing care.

The locked inpatient pediatric psychiatric unit also likely serves fewer clients, but would need specialist psychiatrists and psychiatric mental health nurse practitioners. Closing the orthopedic clinic and pediatric psychiatric facility will yield significant outcomes requiring proficient handling. The relocation of non-medical personnel from terminated facilities to other clinics requires meticulous planning and training to ensure their competency in new responsibilities.

Novice employees may require additional guidance and education to maintain the standard of care provided by existing clinics. The remaining units most likely serve a larger volume of clientele. Thus, their closure would impact many consumers and stakeholders, potentially leading to reduced consumer satisfaction.

Anticipated Consequences

The decision to lay off additional staff members in a hospital can have far-reaching implications, particularly regarding legal ramifications surrounding labor laws, unemployment benefits, and severance pay. To minimize the possibility of legal challenges arising from this process, the hospital administration may need to seek guidance from specialized experts within the field. This approach will ensure that any potential issues are handled appropriately and with utmost care and diligence.

Closing the two clinics can have far-reaching effects, potentially impacting patient satisfaction and the hospital’s reputation. Patients who rely on these facilities may feel left behind, leading to negative word-of-mouth that could harm the organization’s image. To prevent this outcome, hospitals must clearly communicate with patients and stakeholders about why closures are necessary and the measures being taken to minimize any adverse consequences. By doing so transparently and proactively, the health organization can help preserve its standing while reducing the harm caused by clinic closures. Clinic closure would also lead to deterioration in the health of the leadoff health workers and the remaining workers (Elser et al., 2019). Change communication and planned change management will help minimize or prevent these outcomes

Change is an inevitable process, but it faces various obstacles. In healthcare management, change is often met with stiff resistance. Staff resistance to change would be evident in increased turnover, reduced morale, and decreased productivity. Changing the communication and education of staff about the change is a potential solution that would improve staff engagement in the change process.

Change Timeline

This change management process will be systematic and ideally take at least two months. Over the next two months, the implementation strategy for closing the two clinics should be developed and implemented. Over the next two months, the strategy should be explained to all interested parties, including patients, employees, and the hospital board. The clinics should close gradually over the next six months, allowing the hospital sufficient time to relocate staff, educate the transferred staff, and address the anticipated consequences to its reputation and legal standing resulting from the closures.

Cynefin Framework

According to the Cynefin model, this choice is complex because it incorporates several interrelated aspects and requires a more nuanced strategy than a straightforward cause-and-effect relationship. The hospital must examine the effects of each choice alternative while considering the various viewpoints of stakeholders, including patients, employees, and the community. Laying off some workers is a viable strategy to handle the current hospital’s financial situation. However, some units will suffer a shortage from the loss of skilled workers. Therefore, transferring some unskilled workers to the existing departments. The hospital may incur additional costs for planning and training.

References

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Cirelli, C., Hayre, J., & Applebee, J. (2021). Doctor apprenticeships: a dilemma for the future of general practice in the NHS. Journal of the Royal Society of Medicine, 114(11), 505–506. Web.

de Miquel, C., Domènech-Abella, J., Felez-Nobrega, M., Cristóbal-Narváez, P., Mortier, P., Vilagut, G., Alonso, J., Olaya, B., & Haro, J. M. (2022). The mental health of employees with job loss and income loss during the COVID-19 pandemic: The mediating role of perceived financial stress. International Journal of Environmental Research and Public Health, 19(6), 3158. Web.

Dharmshaktu, G. S., & Pangtey, T. (2019). Doctor! Thou shall abide by the amended Hippocratic oath. Journal of Family Medicine and Primary Care, 8(10), 3450–3451. Web.

Elser, H., Ben-Michael, E., Rehkopf, D., Modrek, S., Eisen, E. A., & Cullen, M. R. (2019). Layoffs and the mental health and safety of remaining workers: a difference-in-differences analysis of the US aluminum industry. Journal of Epidemiology and Community Health, 73(12), 1094–1100. Web.

Mohanty, A., Kabi, A., & Mohanty, A. P. (2019). Health problems in healthcare workers: A review. Journal of Family Medicine and Primary Care, 8(8), 2568–2572. Web.

Rees, G. H. (2019). The evolution of New Zealand’s health workforce policy and planning system: a study of workforce governance and health reform. Human Resources for Health, 17(1), 51. Web.