In every organization, there are factors that determine its success. One of the most crucial components in the management of the organization that takes care of the decision making and running of the organization. Management, in summary, is the practice where individuals or group oversee how processes are carried out by subordinates in an organization. The administration delegates the implementation of the processes to the subordinates and gives them instructions on the implementation. In the healthcare setting management also plays a critical role in ensuring that quality and affordable medical services are provided to the patients.
Management takes care of: first, planning; the managers create outlines on how procedures in the health organization are going to be done for example issuing of bed space in the wards. Second, organizing, the management body will give descriptions on how roles in the organization will be done, who will have which role and therefore provide leadership to the staff in the organization. Management also involves motivating the workers in the organization; the managers have to be authoritative in their work to make sure their decisions are followed in addition to providing motivation to the employees to make them feel part of the organization and remove any frustrations (Stefl, 364). Effective management is therefore required in the healthcare sector to ensure continuity of the organization, quality of service, observation of legal regulations and efficient consumption of resources. This paper studies how efficient management can be achieved in healthcare organizations by contrasting between poor management and efficient management. The paper studies that New York City Health and Hospitals Corporation (HHC).
The New York City Health and Hospitals Corporation is the largest existing municipal hospital in the United States that provides healthcare services to the low-income earners both insured and the uninsured. The organization has in the past experienced glitches in operation that has been caused by poor management practices. In the recent past, the organization has managed to overcome some of the challenges that it had been facing, while still catering to the people who cannot afford medical services. The organization is divided into seven affiliations distributed regionally. The number of employees to total up to 39,000 professional workers, having four nursing facilities, diagnostic centers, healthcare agencies (Otis, 1).
An organization that is facing challenges in making profits and has deficits in their budgets show that they have ineffective management practices. An example of such is the New York Health and Hospitals Corporation, which has a projected deficit of $1.6 billion in 2019. The organization therefore required management restructuring. The practices are discussed in this section.
First, having conducive legal environment plays a huge role in ensuring effective management. The legislature or the state through its various bodies sets regulations that govern the healthcare organizations in the country. Some of the regulations are favorable to some healthcare organizations but a limitation to others. The New York HHC facilities provide quality services to the patients and are able to do this in a cost-effective way. The corporation was able to do this while still serving the uninsured and low-income earners in New York who bring little or no revenue to the corporation. The city of New York provides the New York HHC with direct financial funding since the health-care sector is majorly funded by the public that enables the New York HHC to fund most of its operations (Caress & Parrott, 1). The state plans to cut such funding to the corporation through the implementation of the Affordable Care Act, this is going to have an adverse effect on the corporation. Therefore, public health-care organizations such as the New York HHC would not be able to tolerate the cost of serving the Medicaid patients, such as immigrants and the under-insured. Governor Cuomo states that any cuts that would be made to the Disproportionate Share Hospital (DSH) payments would be a risk to the health sector and would result in the closing down of many of the existing facilities. The federal government plans to cut the DSH by $2 billion, thus projecting a loss of $340 million in New York in 2018 (Otis). The funding will greatly affect the public healthcare organizations such as the New York HHC. The implementation of this cut will mean that New York HHC will be unable to provide care services to the under-insured and other Medicaid patients since it would not have the available funding to bear such costs. The corporation will have to send away the patients who are unable to cover their costs or will have to cover the costs with the risk of losses (Caress & Parrott, 2). Therefore, improper legal formulations lead to ineffective management in the healthcare environment.
Second, controlling the gap between the public and private healthcare organizations. In the healthcare environment, there are two broad networks; the public hospital networks and the private hospital networks. The objective of most of the private hospitals is reducing operating costs while providing quality service with the aim of getting higher profits. On the other hand, public hospitals work to provide quality services to the general public especially the low-income earners and the under-insured, who are perceived as less profitable. The New York HHC takes up the cost of providing services and serving people that the private hospitals avoid. This means that the corporation takes up excess burden than it is supposed to handle. The private hospital network in the New York City avoids the load of serving the uninsured and people that had substance abuse diseases, thus automatically shifting this load to the public network (New York State Nurses Association, 1). Such situation creates an unequal environment that hinders effective management in public healthcare institutions (New York HHC). It is reported that in the year 2016, five key private networks recorded profits that amounted to $877 while the New York HHC continued to crumble in huge losses (Caress & Parrott, 21). The private healthcare organizations record large operating surplus, hence enjoying huge benefits in addition to having tax exemptions. Therefore, public healthcare organizations may not be in the position to have effective management because of the overwhelming load that has been put upon them by the private sector health care organizations, which leave them with high costs (Caress & Parrot, 22). Therefore, private sector players have to be compelled to take in patients whom they presume to be less profitable so that the New York HHC may have an opportunity to effectively manage its organizations.
Third, recruitment, and maintenance of a proper number of staff and positions. Recruiting and having employees in the organization means that the organization incurs expenses in terms of salaries and allowances. Having a large staff brings about excess expenses while the benefit is still the same when these excess employees are cut out. Healthcare organizations have to maintain employees that are required only, any excess has to be cut off. The New York HHC has made some cuts offs to the management positions, it reduced the management positions by 476. The corporation cut off 396 managers and 80 positions that were unoccupied in order to cut down operational costs. The corporation later laid off thirty-five administrative workers, with projected savings from this cut off estimated to be more than 4.5 million dollars. The president of the corporation stated that they had to reduce the administrative costs so that resources may be allocated to the primary focus of providing care to the patients (Campanile, 1). The administrators who were laid off had no direct impact on the patient care costs and therefore their lay off was somewhat justified. Therefore, healthcare organizations should have the proper number of staff, so that costs may be reduced thus promoting effective management.
Management is the act in which subordinates in an organization carry out tasks that have been delegated to them under the supervision of the managers. The success of an organization depends highly on the management since it is composed of the planning, organizing, and motivation and leading of the employees which are the major aspects of an organization. The New York HHC is the largest healthcare organization the United States, serving many of the low-income earners in New York. The organization is, however, facing management and financial glitches that threaten its continuity. The threats that affect New York HHC mainly affect the management of the organization. First, new regulations that limit the services their services. New York HHC is a public healthcare network and therefore it highly depends on the funding from the public through the federal government. With the changed in the Affordable Care Act, the financial support provided to this organization will be reduced and therefore the organization will be limited to providing healthcare services to all people. Effective management is also a challenge at New York HHC since the private sector networks bias some of the patients (less profitable patients) and the effect is the cost burden on the organization's side. Finally, the organization had excess staff that had no direct effect on the patient's care cost and therefore were not crucial to the organization. In conclusion, proper legislation should be put in place to support healthcare organizations financially and put a balance between the private sector players and the public sector players.
Campanile, C., NYC's Hospital System axes 35 Workers in Savings Push. Retrieved from: www.nypost.co/2018/03/10/nycs-axes-35-workers-in-savings-push/, 2017.
Caress, B., & Parrott, J. On Restructuring the NYC Health + Hospitals Corporation: Preserving and Expanding Access to Care for all New Yorkers. United States: New York State Nurses Association. 2017
New York State Nurses Association. New Report: NYC Public Hospital System Faces Heavy Burden with Public Funding at Risk and Private Hospitals Avoiding Unprofitable Patients. Retrieved from: www.prnewswire.com/news-releases/new-report-nyc-public-hospital-system-faces-heavy-burden-with-public-funding-at-risk-and-private-hospitals-avoiding-unprofitable-patients-300529176.html, 2017.
Stefl, M., Common Competencies for all Healthcare Managers: The Healthcare Leadership Alliance Model. United States: Trinity University.2008.
Otis, A., Hospitals Face Financial Blow that could Weaken NYC Health Care. Retrieved from: www.nydailynews.com/amp/new-yrok/hospitals-face-finacial-blow-weaken-nyc-health-care-article-1.3530742, 2017.
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