Case Study: Reading Rehabilitation Hospital

Q1) Who are RRH’s stakeholders? What do they want from RRH? How do they define quality?

A1) Main stakeholders of RRH are:

 The patients coming to the hospital.

 The therapist treating the patients.
 The hospitals sending their patients to RRH which includes RHMC, Saint Josephs Medical
Centre and Community General Hospitals. Also, a few traditional nursing home centres.
 Seventh Day Adventist Churches.
 Insurance companies.
 Government.

Main expectation of patients was to get the treatment as soon as possible. Which means
that they wanted to get discharged as soon as possible? Also the patients were overall
happy with the quality of service provided as the Patient’s perception of quality was 8.7
which was more than 8 which was national benchmark.

Hospitals which sent the patients to RRH wanted to minimize the patient days because the
patients were being sponsored by these hospitals and they wanted to minimize their
expenditure.

Whereas, the churches wanted to include spiritual healing along with medical healing in the
overall rehabilitation process.

The insurance companies also along with hospitals wanted to reduce the patient days to
minimize their own cost.

Government too wanted to minimize their expenditure by reducing the patient days as their
policies were being implemented by the state budget.

Q2) What are the benefits of the new system in which care delivery is organized around
diagnoses or a service line in comparison to the old system where patient care was
organized by function? What are the drawbacks?

A2) The benefits of the new system:

 Improvement in co ordination of care. Now the medical services were much more in
sync and had synergy.
  Increase in patients’ focus and satisfaction. Much more attention to patients were
given now and their satisfaction was also insured.

Hence, above given are a few benefits of the new system.

The disadvantages of the new system are:

 The staff members that were required in RRH had increased because of the new
system.
 Decrease in utilization.

Q3) At 116 therapists is RRH overstaffed? How many therapists would you hire?

A3)

Actual Billable hours for 1998 130026

Workdays per week 5

work hours per day 8
work hours per week 40
Total work hours per year 2000
At 75% usage 1500
Number of therapists 116
Expected billable hours for
1998 174000
Excess billable hours 43974
overstaffed therapists 29.316

Hence, clearly, at 166 therapists currently, RRH is overstaffed. I would hire 87 (116-29)
therapists for the job.

Q4) Should RRH keeps service lines or return to the earlier way of organizing care around
functions?

A4) it has been found that the service lines are better alternatives as compared to the earlier
way of functioning of the organization. Earlier it wasn’t patient focused whereas now the
service lines made the patients more cardinal. The coordination of care as well as patient focus
& satisfaction was improved. Utilization also decreased. In this competitive environment it
wouldn’t be possible to achieve quality by sacrificing efficiency, increased coordination as well
as scheduling has also benefitted the organization. Hence, we conclude that there was
overstaffing.