Duke University Children's Hopsital Case Study
Business and Management
Submitted By ChiRiChi
Duke University's Children's Hospital (DCH) is a pediatric hospital that is located on Duke University Hospital’s fifth floor. DCH is a 134-bed facility with 800 employees who care for patients in neonatal ICU, pediatric ICU, pediatric emergency room, intermediate care unit, bone-marrow transplant unit, subspecialty clinic, and outreach clinic (Meliones, 2000). The annual operating loss of DCH grew from a high $4 million in 1992 to a staggering $11 million in 1996, forcing hospital administrators to cut-down resources. This move made some caregivers feel that the clinical care quality at DCH had deteriorated. Complaints from parents were on the rise, dissatisfied doctors considered sending their patients to other hospitals, and some frustrated staff members eventually quit. As important as DCH’s institutional mission was to promote the community’s health, so important it was to not lose focus from the big picture during a difficult time. The specific goal of clinicians is to restore the health of their patients; however, cost is not something that they want on their minds. Hospital administrators on the other hand have their specific goal to control the rapidly growing healthcare costs. Cost-cutting in such testing conditions traumatized patients, frustrated clinicians, and crippled the mission of DCH. The decision to remove a respirator therapist who worked in the night shift, for instance, affected not only the patient and her parents, but also the insurance company, which ended up paying additional charges for the ventilator and ICU (Meliones, 2000). These situations also give clinicians a powerlessness feeling because decisions related to clinical practice were being taken without taking their inputs into consideration. Tradeoffs between patient care quality and cost control measures thus turned into a source of intense conflict for DCH healthcare...