Middleville Regional Healthcare

Health Service Organization Management (HSA300)

Governing Board’s Role

The governing board is the highest level of authority in a nonprofit organization and maintains the ultimate decision-making authority (Hader, 2006). Although the governing board generally does not manage operations or work directly with employees, Middleville Regional Healthcare’s governing board primary purpose is to establish strategic goals aimed towards quality improvement and patient safety. To set the direction of the healthcare organization, governing board members must first review the organization’s mission, vision, and values statement. Without a clear understanding of what an organization wants to accomplish, the mission, and where it wants to be in the future, the vision, the board will be clueless as to what values should be woven into the company’s culture. Upon successful completion of the MVV, a strategic plan is developed, and the board can start making decisions.

Also, ensuring effective hospital management is another key priority of the board (Hader, 2006). The board does not concentrate on any other employees besides the chief executive officer (CEO). The CEO reports directly to the board. The committee evaluates, hire, set goals and objectives for, and does not replace anyone but the CEO. The board assures the CEO especially focuses on management depth in the organization, as well as, succession planning and management development activities. The CEO must ensure the medical personnel is cultivating their skills for future challenges and being held responsible and accountable for clinical service and performance to promote organizational achievement.

Ultimately, the governing board evaluates the strategy proposed by management and approves the strategy if they feel the plan will be a success. The board then monitors the implementation of the plan and challenges assumptions and analysis as necessary. Lastly, they encourage change when needed or required. The board needs to take long-term views of the organization, its objectives, and the means to achieve them.

Performance Measure for Success

As a healthcare organization, it is the sole duty of Middleville Regional Healthcare to provide high-quality care and services to their patients.

First, they should analyze their structure measures. Structure measures evaluate the infrastructure of a healthcare organization and determine whether those healthcare settings can deliver care. For example, what is Middleville Regional Healthcare average length of employment for their medical personnel? As a consultant, I would have to team with Human Resources and collect data regarding how long each of the 2,000 staff members been currently employed at the healthcare organization. Once all the data is collected, the information can be put into a computerized system that will sum up all the lengths of employment to provide us with an average length of time. The higher the average, the more like Middleville did a great job retaining employees. Employees who enjoy their place of work and are satisfied with their jobs tend to remain employees of the organization and are more likely to provide high-quality services to patients.

Next, Middleville should analyze their process measures. Process measures ensure providers are consistently providing patients with specific services that are consistent with recommended guidelines for care. For example, Middleville Regional Healthcare managed to deliver 2,300 babies. How many babies were born before the 37th week and received neonatal care? As a consultant, I would have to access patients records and assess how many babies were born prematurely. We would also have to look at the percentage of premature infants that were provided life support machines and medications to sustain life. We would have to assess whether each infant in neonatal care received round the clock monitoring, as well as, heated beds. We would also look at whether the premature babies had a feeding tube inserted inside their stomachs to receive the proper amount of nutrients. Premature babies require an adequate amount of care, and through process measures, Middleville can assess whether they are providing the recommended care for these babies. If babies are receiving appropriate care and does not have to spend as much time in neonatal care, then the quality of service is successful.

Finally, Middleville should analyze their outcome measures. Outcome measures assess a patient’s health because of the care they have received. For example, of the 221,000 outpatients’ visits at Middleville, how many patients made a recurring visit regarding the care they previously received? As a consultant, I would also analyze whether the recurring visit was made due to a medical error made on a staff members behalf. For example, a woman scheduled an appointment to have the birth control Nexplanon implanted into her arm. The birth control procedure was completed, but the patient returned two days later complaining the incision area was severely infected. Middleville would then have to evaluate whether the infection was the patient’s fault or did the staff members complete the procedure without adequately cleaning the incision area and sterilizing the equipment. If the condition improves, then the quality of service is a success. If the patient’s situation worsens, then Middleville needs to go back and reassess the process used by medical personnel.

Measuring the quality of care in a healthcare organization is vital because it tells us how the health system is performing and leads to improved care.


Middleville Regional Healthcare is performing better in specific areas compared to its competitors, Brierfield and Greystone. After analyzing the data from the chart, Middleville has a low admissions rate of 13,000 compared to its competitor Brierfield whose admission rate is 17,000. However, a lower admissions rate is not necessarily bad because the more patients being admitted into a hospital, the longer the wait times patients experience before they are admitted. Middleville should reduce or keep a stable admissions rate to avoid medical personnel completing rushed work and taking shortcuts when providing care. Since Middleville is equipped with more staff than their competitors, they should be able to provide high-quality care and place staff members in parts of the organization that is understaffed. Middleville is also doing a great job ensuring their census rate does not outmatch the number of beds they have available. Patient satisfaction drops drastically when the number of patients outmatches the number of available beds. Since Middleville fills 350 beds on certain days and has 575 beds available, they should be able to provide quality care. Middleville has the most significant number of outpatient visits. OP visits are beneficial for the organization because many health insurances are starting to support outpatient services, thus bringing more revenue into Middleville.

Also, Middleville has the largest numbers of births compared to its competitors. To stand out from its competitors, Middleville should offer learning and development course that teach new mothers why breastfeeding is important and demonstrate the proper way to breastfeed their babies. Not only will these classes be informative for the mothers, but these classes will also help the organization save money on formula, thus lowering the amount of funds Middleville would spend on new shipments of baby formula for mothers that decide not to breastfeed.

Furthermore, Middleville had the second highest expenses in the data chart. To lower the amount of expenditures Middleville inquires, they should have each department schedule a regular view of its budget and spending to determine where the organization is spending the most money. After analyzing the budget and spending reports, the organization can work to find supplies at a lower cost or negotiate with vendors to get medical supplies and equipment at a lower rate. For example, changing the brand of garbage bags can save the organization thousands of dollars each year.

Implementing Technology Systems

For many years, numerous presidents have tried to encourage healthcare organizations to implement electronic medical records (EMR) into their practice. However, in the recent years, President Obama has reinforced the federal government’s commitment of this target and is offering nearly $20 million in stimulus money during the next five years to help healthcare providers implement digital record systems (Hoffmann, 2009). Electronic medical records can be beneficial to both patients and providers. Patients can enjoy the luxury of improved diagnosis and treatment, reduction in the number of errors found within their health records, and they can receive faster care and decision-making responses from medical professionals.

On the other hand, healthcare providers can quickly transfer patient data from one location to the next, save money on storage space, and increase the number of patients they serve and increase productivity. Also, healthcare organizations can improve results management and patient care due to a reduction of errors within the organization, and they can save money on operational costs such as transcription services and overtime labor cost. Middleville has the option to customize their EMR system, and the system can drastically improve the bottom line of the HCO through accurately and efficiently processing patient billing.

Employee Satisfaction and Retention Methods

Organizations that depend on a highly skilled, stable workforce must be attuned to the needs of their employees and provide adequate compensation and benefits that enhance job satisfaction and lessen job mobility (Kinard, 2000). Human Resources and management must work together to ensure employees are motivated and satisfied to achieve the organizational goal. Since Middleville has suffered a drastic reduction in the amount of money available for a salary increase, HR could offer a one-time bonus for each employee based on their job performance. However, not all employees are motivated by a monetary gain to perform their job duties well. To demonstrate to employees they are valued by Middleville, HR can start with something as simple as buying their employees lunch on occasions. It is a sweet and tangible gesture used to reward employees for their hard work. Also, it is an opportunity for management to be more involved with their employees through face to face interaction. Management can congratulate employees on a job well done and elaborate on factors that contributed to their accomplishments.

Also, Middleville HR department can offer employees a flexible work schedule. Allowing certain employees to cut back on hours can save the organization money, as well as, enable employees to see the company understands they have a life outside of work. If employees feel they can coordinate their work schedule with their personal agenda, they are more likely to be satisfied with coming in and working their chosen shift. Middleville HR department should also consider offering a comprehensive medical, dental, and vision package to their employees. Since this is a tax-deductible expense, it is going to cost the organization less in the long-run. Sometimes, employees are not satisfied with their job because they feel they lack the proper training to keep up with work demands. Middleville HR department can find a way to incorporate training programs that allow medical staff to enhance and develop their skills. The training can also help the team stay updated on the constantly changing rules and regulations in healthcare.

Money cannot buy employee satisfaction. The more appreciated the medical staff feels, the more committed they are to perform above company standards. High-quality performance and productivity is the key to great quality services.

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