Write a brief explanation that explains why the case represents its particular ACHE competency domain. (Be sure that the explanation justifies the assigned competency domain based upon the facts and circumstances of the case.)
Case 1: Communication and Relationship Management Memorial Hospital was moving rapidly to finalize its plans for new multiple-specialty outpatient center located 15 miles from the hospital campus. Strategically this was exactly what the health system needed to do. First, it would provide a presence in a community that traditionally was served by one of Memorial’s major competitors. And second, increased the ambulatory care services of the health system that lagged behind other health systems in this regard. The plan called for seven specializations to provide services to the patient and community population of this new area and to help channel patients that needed more intense treatment and care to the hospital itself. Six departments had agreed to this arrangement and were actively developing their budgets and management resources to cover this new location. But the Department of Psychiatry, although an initial service slated for the ambulatory facility, was now backing out of the agreement suggesting that they could not adequately resource the operation and felt it would significantly increase their overall patient volume. The CEO of the hospital understood that Psychiatry needed to be part of the service mix in order for this new facility to succeed. The market research conducted a year earlier to provide information on community needs, clearly suggested this service would be well received and perceived by people as a value addition to the other medical specialties being offered. With this sense of urgency in mind, the CEO arranged to meet with the Chair of Psychiatry and discuss the issue. The meeting took place within the next week and it was not a comfortable exchange according to the Chair. He felt pressured by the CEO to come on-board and develop the necessary budgetary and operational plans to be part of the new ambulatory center. From the perspective of the CEO, the meeting was equally non-productive. He reported that the Chair seemed to miss the critical points of why Psychiatry was needed as part of the service mix. Two subsequent meetings took place by both individuals with significant ‘back and forth’ between the two men until an agreement was met. The Chair of Psychiatry agreed that his department would join the other services, but that it needed to be phased-in process. The CEO, although disappointed that Psychiatry would require six to eight months for full implementation into the facility, understood that this was the most reasonable approach he could expect. The final agreement allowed Memorial Hospital to eventually offer all six services to its targeted community. It did require modifying some public relations materials and gaining the support of the other five services that this special arrangement was necessary to achieve the ultimate complement of services. The Department of Psychiatry gained the time it felt it needed to align its resources to add this service to its roster. The result was that Psychiatry actually achieved its adjusted operational program for the new facility in four and a half months, a good two months ahead of its original target date to begin operations. It is difficult to know exactly why the CEO and the Chair of Psychiatry arrived at their agreement. Both individuals did not appear too pleased with their initial exchange. Each seemed to have his own agenda without much interest in understanding the expectations of needs of the other party. It took two more projected meetings for a final agreement to be outlined. It is not clear either, what if any, long term affect this had for either the hospital administration or the leadership of the Department of Psychiatry. The general opinion throughout the administration and medical officers of the health system was the CEO paid a heavy political price for getting Psychiatry on board.