Strategies and Recommendations Paper

Running head: STRATEGIES AND RECOMMENDATIONS PAPER

The Problems in the U.S. Healthcare System

Keller Graduate School/ Health Service Systems

Professor Judy Dennis-12/06/2010

Executive Summary

In this paper I will describe the problems in the U.S. healthcare system. I will also examine how we might use another nation's health care system for reform; specifically Canada's healthcare system. I will further evaluate how a new system would improve access to care, quality of care, and allow the United States to utilize resources more efficiently.

Introduction

Through the review of the Scenario Summary "You Decide" Activity I am the new Chief Executive Officer (CEO) of Middlefield Hospital. As such I am faced with the following challenges: the hospital's employee turnover rate exceeds 20%, over 100 nursing vacancies, a new hospital opening as competition in my market area, deteriorating employee morale, and a local college considering eliminating its nursing degree program due to continual difficulty in recruiting well qualified instructors.

Employee Morale & Turnover

As the VHA report suggests, there is a strong business case for creating a culture of retention. As nurses leave, this drives up hospital costs while driving down profitability, productivity, efficiency and quality. Monies spent on recruitment and replacement activities could obviously be better spent on creating workplace environments that value and reward employees, encourage employee loyalty, and ultimately support safe, high quality care. My recommendations are to:

* Create a culture of retention for all: nursing staff, Hospital CEOs, Trustees, Physician ,Leaders, Nurse Executives,

* Adopt fair and competitive compensation and benefit packages for nursing staff

* Minimize the paperwork and administrative burden that takes nursing time away from patient care (VHA Report, 2009).

Nursing Vacancies

Nursing schools need an infusion of resources, both from the public and private sectors, to create new faculty positions and develop new faculty. Through academic/ clinical partnerships, a standardized nursing residency program can appropriately prepare nurses to provide safe, high quality care in the complex and challenging environments of today's hospitals. Middlesex could partner with the local college, eliminating its nursing degree program. Through a collaborative partnership Middlesex can:

1. Strengthen the colleges' nursing program through innovation

2. Augment the colleges' value in the community with hospital internships and/or residency programs

It is vitally important recognize the realities of today's convoluted healthcare environment. As an organization, Middlesex Hospital must