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Essay / Research Paper Abstract
This 18 page paper provides an overview of a change initiative, one that focus on the merger between Beth Israel and Deaconess hospitals in Boston and the subsequent problems for nursing staff. Bibliography lists 20 sources.
Page Count:
18 pages (~225 words per page)
File: MH11_MHCodeGre.rtf
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an age of cost-containment and combined services at a time when managed care was on the rise. The product of an effort to apply private business practices to the
merger led to measures to cut costs through the consolidation of both managerial structure and staffing. The approach, though, led to many more problems in terms of meeting the
needs of patients and in maintaining an adequate nursing staff. From a nursing perspective, the changes that occurred at the newly developed BIDMC were not positive and staff
turnover rates in the months following the merger were high. The issues that occurred at BIDMC were the result of applying cost-containment efforts to hospitals that already had nursing
structures and systems of care in place. Consolidation with a focus on creating a level of care for the most patients using the least amount of staffing was clearly
out of alignment with some of the protocols and nursing management theories already in place. In understanding the impacts and developing a change plan for BIDMC in the presence
of the shift resulting from the merger, it is necessary to identify the most significant problems and their impacts. Background The 1990s were marked by a
period of restructuring in many industries, including healthcare. Managed care organizations and changes in reimbursement rates for private insurance resulted in a fiscal loss for many teaching hospitals (Weinberg,
2003). The Balanced Budget Act of 1997 placed an even greater strain on the budgets of hospitals like Beth Israel Hospital and New England Deaconess, based on limits placed
on Medicare reimbursement systems. Suddenly, many smaller teaching hospitals were faced with competition and limited resources, requiring a change that would help them make ends meet (Weinberg, 2003).
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