The Case of the Unhealthy Hospital

Blake Memorial Hospital and its affiliate clinics are faced with a myriad of challenges among them being high cost of operation in both the clinics and the hospital, negative revenue returns and a dilapidating quality of health care. The newly hired CEO, Bruce Reid’s is tasked with the mandate of improving the quality standing of health care services along with deciding on a strategic framework that will restore the financial health of the hospital this may include cutting costs, internally or externally. Furthermore, Reid has to finalize a $ 70 million proposal that outlines his strategy on a financially sustainable path for the hospital’s facilities (Kovner,В 1991). Perhaps the most pertinent issue facing Reid is how deal with the off-site clinics that are underutilized and operate at a loss thus majorly contribute to the financial deficit of the Blake Memorial Hospital.

For Blake Memorial Hospital to remain sustainable and offer quality services for the long-term, the current hospital operations and budgetary distribution need reviewing. Since its inception, Blake Memorial Hospital’s Vision and mission has being geared towards providing societal needs that are not served by government and for-profit health facilities. The current changes are geared to sound and innovative investments that would improve positive revenue returns and bolster service the hospital provides to the community(Kovner, 1991). However, the current financial deficit of the hospital impedes this mission in the future as the hospital may fail to meet its mandate of care provision while poor service quality raising dissatisfaction among staff and developing a negative image of the hospital.

A positive hospital image may work to attract more insured patients within the Marksville area and healthy finances allow for improved hospital facilities. Among the main factors of consideration in restoring the financial health and quality of service would include. Internal cost cutting that includes staff reductions, closing of in-house clinics whose services needs are low and dwindling. Such a move is expected to save the Hospital over $ 5.9 million (Kovner, 1991). Secondly, Ried should consider what to do with the off-site clinics whose and financing are currently unsustainable. Furthermore with the city expected to stop the additional funding for the clinic programs, the financial liability is set to exacerbate the in-house budgetary needs.

However the ramifications of closing the clinics may cause the hospital to lose political allies in City Hall, which is a vital element in gaining access to grants as well as tax reliefs. Another key factor of consideration is how to attract more insured patients that would serve a good source of revenue for the Hospital. This can be achieved by offering competitive services and strategically relocating the hospital closer to well up neighbor hoods that would result in higher insurance reimbursements.

According to Ried, Notably, there are several other alternatives that Reid should consider among them being empowering the off-site clinics interms of their out patient service offering and upgrading. Additionally, partnering with other interested stakeholders such as the community, other health care service providers and health care donors in running the off-site clinics would help in alleviating the cost incurred by Blake Hospital. In the Health care service sector, it is increasingly important for Top management to become creative in solution development.

Transformational and participative leadership styles are necessary where inclusivity of the wide stakeholder pool is cannot be overemphasized (Parmelli et al., 2011). In this case study it is clear that the short-term goals of the hospital are improving service delivery and reducing costs. Notably Reid needs to take a holistic view of service delivery structure and identify the drivers of better quality of care outcomes(Schmitt, 2012).

For instance identifying the Marksville community’s health needs would help in developing and aligning the service offering for off-site clinics that would elicit higher patient turnout and require less funding. However additional off-site clinics in middle-class neighborhoods would also encourage more referrals to Blake Memorial hospital for acute cases. While staff downsizing is necessary at the main hospital this does not mean they should be cut. Relocation of staff to off-site clinics would serve as mini-hospitals that can serve to build community trust on service delivery of Blake Hospital. Involving a variety of stakeholders in decision making helps in better implementation of change in the service structure.

Political support can help mobilize neighborhoods as well as develop publicity around off-site initiatives in sourcing for donors. Offsite clinics can become an asset to Blake hospital by increasing the patient base and create a society-conscious brand image for the hospital. While in the short-term, Blake Hospital would be unable to increase high-tech based services, the hospital may benefit from striking a deal with St Barnabas Hospital, in terms of commission for referrals of patients requiring specialized treatment.

With a wider patient reach, Blake Hospital stands to gain high traffic within its hospital while working with clinics. At full capacity and a streamlined information system, the clinics can work efficiently while future service changes can be reviewed to fit the needs of the community. In the long-term Blake Memorial should work to adopt competitive technology that can continue to improve its service offering when the financial base is strong.


Schmitt, M. (2012). Leadership and Healthcare Performance (Doctoral dissertation).

Parmelli, E., Flodgren, G., Beyer, F., Baillie, N., Schaafsma, M. E., & Eccles, M. P. (2011). The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review.

Implementation Science, 6(1), 33. Kovner, A.В R. (1991). The Case of the Unhealthy Hospital. Retrieved from`