Medical Management Case Study

Step I - Executive Summary of the Case

Provide a brief (100 word maximum) summary of the case. What is the case about? (Here emphasize facts and leave lengthy judgments regarding cause and responsibility out of the summary. Include your recommendation(s). (I strongly suggest you write this part last)

At the Metro City Health Department's Care Center, a staff nurse; Dorothy Wilson, has been showing deterioration and failure to do her job. This includes lacking communication with members of the department, omitting tasks such as daily nurse home visits, failing to complete adequate written reports, and failing to sign out when leaving the office without telling any one and returning hours later. The supervisor, Helen Lawson, used to be very close with Dorothy Wilson when she first started at the department so she took matters into her own hands to find out why Wilson has not been doing well. She researched; looked at Wilson's file and records for job history, talked to other staff members about Wilson's poor work habits, Dr. Morgan, and supervisor Betsy Graham about recent findings to collect some information. I recommend she discuss the issues with Dorothy Wilson to see what the problem is, if there is any way she could help, and maybe get through to her in order to progress. If this doesn't work, I recommended there be consequences and include staff members to help encourage Wilson to become a enhanced worker and be the great staff nurse she used to be.

Step II - Essential Elements of the Information/ Background Facts

In this step you respond to three basic questions: Who? Where? When?

The answers to these three questions should provide the necessary context in which to view the problem, the alternatives, and your recommendation.

Helen Lawson is the supervisor of Metro City Health Department's suburban Health Center. Lawson relied greatly on another staff nurse Dorothy Wilson, when Lawson began working in the facility. But the staff doctor (Dr. Morgan) is planning on firing Wilson. Dr. Morgan's staff has been reporting that Wilson has not been working well, or communicating and has been acting strange. Morgan has realized that Wilson's lack of coordination is setting her up to lose her position to work in the state's agency and department. My recommendation is that the head of the department should have a serious talk with Dorothy Wilson to discuss the issues that have been occurring and notify Wilson of the consequences if she does not show progress.

Step III - Identify the Problem(s) or major issue(s) in the case

The problems and issues are essentially the gap between what you expect based on some ideal or better yet what someone else in a similar situation is experiencing, and what you find in the case. This should include primary and main secondary problem(s), if any.

The problems in this case are that Helen Lawson is having trouble trying to figure out the problem that has changed her employee's work efforts. Lawson used to rely on Dorothy Wilson but she cannot even communicate with her, neither can any other staff member. Lawson took a look at Wilson's file and realized that she has had eight different jobs in eight years for the same reasons, which raises some curiosity. Wilson's performance has diminished overtime. Another problem is that Wilson never let anyone know when she was leaving the office, she also took extended breaks and she failed to sign out periodically. The final problem is that she failed to take responsibility of writing legitimate reports of the periodic home visits that she is required to do.

Step IV - For each problem, identify its magnitude and significance

this is a critical step in the process. In real life situations, there are always more problems than time or resources permit to resolve. In fact, most problems are dumped and not addressed. Why should you pay attention to the problem? Moreover, why should you pay attention to it right now? If you don?t need to pay attention to the problem now, when do you need to pay attention to it? Magnitude is best expressed in terms of specific quantitative terms that clearly express how big/important the problem is.

Each of the problems in this case needs to be addressed as soon as possible. Helen Lawson is doing the right thing by stepping up and investigating why Dorothy Wilson has been deteriorating with her performance at work. The communication problem is very important because communication is key when working as a nurse in a medical facility. It is also important for Wilson to sign out when she leaves, and let the nurses know when she's going to be back because if something happens to her the department will have proof of what time she left and if she doesn't return then it could be an emergency where she might need help. The magnitude of these problems is coordination. If there is not communication then there is not coordination. The final issue that needs to be addressed is the required home visits that the nurse is supposed to complete. The families rely on the nurse and are not benefiting with missed visit from the nurse. The fact that Wilson doesn't take responsibility and clearly fails to write up organized reports shows that she is not doing her job.

Step V - Arrange Problems/Issues in Priority Order

The magnitude assessment should help you with this step, especially if quantification of the problem is easy.

All the current problems are important and have magnitude. But some need immediate and direct attention because they have the most consequences. The main priority that needs to be aided is finding out what Dorothy Wilson is going through, how she can be helped, and why she has changed. Lawson should start by taking care of the communication issue. As mentioned before, communication is key and not being able to interact with the staff in a medical facility can have great consequences. The next priority is enforcing staff to sign out every single time they leave the office due to liability issues. And the last problem to address is enforcing the home visits to be completed and organizing a written report about the visit.