28 Jun HEALTH POLICY AND MANAGEMENT
Instructions:
Prepare a briefing note of no more than 1,000 words (excluding title page and bibliography) on
the hypothetical scenario describe d below. The briefing note should include references (APA
style). While the use of references may not be prototypical for briefing notes, the academic
nature of this exercise re nders it a required element.
Note that reference materials on preparing br iefing notes have been provided on our Moodle
course website to assist you in the assignment.
Hypothetical Scenario:
Unionville General Hospital (UGH) has been experiencing a growing number of service
pressures due to fiscal pressures, population growth, and aging. These growing pressures are
causing UGH to consider new approaches and strate gies. The status quo is just not an option.
The UGH Board of Directors had hoped that th e establishment of the multi-year Hospital
Accountability Agreement with th e LHIN would solve the year-after-year ambiguity of funding
levels and the uncertainty of looming deficits and consequent balancing between service needs
and operating costs.
UGH had met the service volumes measured in the accountability agreemen t, but it was done at
the expense of other “unmeasured” programs and services. As a result, the accountability
agreement and the potential penalties contained therein often meant skewed priorities for UGH
and less ability to meet the actual needs of the community. For example, the accountability
agreement measured the reduction in wait times for hip and knee replacements and the hospital
had no choice but to prioritize this service to avoid financial pena lties, even though the real need
in the community was for increased cardiac care.
The UGH Board was also facing frequent complaints from its physicians that they could not get
the operating room time and the clinic time they needed to serve their patients. Several doctors
were threatening to stop taking emergency call while a number of them went as far as
contemplating the prospect of changing hospitals . These trends were very worrisome to the
UGH Board and management.
There were 2 neighbouring hospitals within the LHIN offering many of the same programs to
their communities. The 3 hospitals were about 20 to 30 minutes from each other. There was
historical competition among the 3 hospitals to ope n specialty programs in such areas as cardiac
care, rehabilitation, geriatrics, and other areas. This caused more financial burden for the
“winning hospital” and actually reduced accessibility overall with in the LHIN. It was obvious
(and confirmed by the LHIN) that a ll 3 hospitals were suffering the same fate. Something had to
be done. The three Board Chairs had met and agreed to support talks by their management
teams.
Challenge:
As the Chief Executive Officer of UGH, you have been asked to present recommendations to the
Board for integration options with one or both of the two neighbouring hospitals. While the full
range of integration options are possible, there a ppears to be a general lack of will by all parties
for a formal (corporate) amalgamation. Other op tions for clinical, service, functional, and
physician integration seem to hold more promise.
You are to prepare a briefing note for the Board on preferred options and next steps. You will
identify 1 to 3 integration options/strategies, state the rationale for your choices (including
expected benefits), and recommend the next steps to be taken.
:
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