Contents

About the Editors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv

Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xix
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxvii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxix

PART I POLICY ENVIRONMENT OF HEALTH SERVICES

DELIVERY

1 Carilion Clinic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Alexandra Piriz Mookerjee and Kurt Darr
Led by a new CEO, the efforts of a mid-Atlantic acute care
hospital to develop a vertically integrated, clinic-driven health
services system result in allegations of antitrust, excessive
healthcare costs, disruption of physician referral patterns, and
use of harsh collection practices, all of which cause a negative
reaction in its service area.

2 Flu Vaccine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Mary K. Feeney and Abigail Peterman
Flu vaccine shortages in 2004–2005 caused by a major
manufacturer’s problems with quality control result in federal
and state efforts to secure supplies of the vaccine and raise
public policy and resource-allocation issues that users can
role-play in three scenarios.

3 Merck’s Crixivan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Kimberly A. Rucker, Nora G. Albert, and Kurt Darr
A pharmaceutical manufacturer encounters significant negative
stakeholder reaction to its introduction of a new medication
for the human immunodeficiency virus despite having

vii
viii Contents
met expectations for clinical rigor and carefully assessing
stakeholders and the external environment.

4 Pineridge Quality Alliance: A Case Study in

Clinical Integration and Population Health . . . . . . . . . . . . 53
Tracy J. Farnsworth
A new CEO urges his board to move toward becoming an
accountable care organization and promoting regional popula-
tion health, which demands choosing among three common
approaches to navigating the challenges and opportunities of
developing a clinically integrated network.

5 Hawaii Health Systems Corporation:

The Politics of Public Health Systems
Governance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Earl G. Greenia
A healthcare executive facing continual public policy
restructuring of Hawaii’s Health Systems Corporation must
develop strategic options for his board to consider in response
to this environmental uncertainty.

PART II STRATEGIC MANAGEMENT

6 Riviera Medical Center . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

Michael J. King and Robert C. Myrtle
The CEO of a 350-bed hospital explores strategic alternatives
to enhance its financial situation and reputation by asking the
hospital board to approve a worksite wellness program to be
marketed to area companies to improve workers’ health and
decrease employers’ healthcare costs.

7 Edgewood Lake Hospital: Leadership in a

Rural Healthcare Facility During
Challenging Economic Times . . . . . . . . . . . . . . . . . . . . . 109
Brent C. Pottenger, Douglas Archer,
Stephen Cheung, and Robert C. Myrtle
The new CEO of a 30-bed, not-for-profit rural hospital faces a
turnaround situation to make the hospital profitable after 3 years
 Contents ix
of losses. Problems include challenging payer mix, employee
overstaffing, and difficulty recruiting physicians.

8 Klamath Care: Targeting and Managing

Growth and Company-Wide Development . . . . . . . . . . 121
Tracy J. Farnsworth, Leigh W. Cellucci,
and Carla Wiggins
The CEO of a growing system of urgent care centers recounts
the organization’s development over a decade while consider-
ing strategies and options for future growth in an increas-
ingly crowded marketplace with an analysis that uses financial,
market share, and demographic data.

9 Hospital Consolidation . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

Tracy J. Farnsworth
This case focuses on the relationship healthcare providers have
with their local and regional markets and the need to balance
organization and community interests when making decisions
that affect the healthcare marketplace.

10 Service Area Management . . . . . . . . . . . . . . . . . . . . . . . . 141

Tracy J. Farnsworth
Users are challenged to analyze, prioritize, and use disparate
information common to a dynamic and competitive healthcare
marketplace as part of an organization’s strategic planning and
marketing processes.

11 Western Healthcare Systems:

A Healthcare Delivery Continuum . . . . . . . . . . . . . . . . . . 157
Robert C. Myrtle
Western Healthcare Systems was creating an integrated
delivery system when an opportunity to acquire a large
multispecialty group arose, but it may be imprudent to
proceed because of hospital and multispecialty group
physician resistance.
x Contents
PART III ORGANIZATIONAL MANAGEMENT

12 Hartland Memorial Hospital:

Part 1, In-Box and Prioritization Exercise . . . . . . . . . . . . 175
Kent V. Rondeau, John E. Paul, and Jonathon S. Rakich
The VP for nursing services of a 285-bed for-profit hospital
must decide what actions to take regarding her in-box, which
includes e-mail, correspondence, and phone messages that
communicate various challenges, such as two angry nurses, a
wandering patient, staff shortages, and increasing numbers of
OR infections. Emphasizes priority setting, decision making,
and delegation.

13 Bad Image Radiology Department . . . . . . . . . . . . . . . . . . 199

Kurt Darr
Management of a community hospital is unwilling to
recognize and address major problems in its radiology
department, which is directed by a radiologist whose disruptive
behavior and preoccupation with income and stock market
speculation have diminished the quality of radiograph readings
with tragic results.

14 Westmount Nursing Homes: Implementing a

Continuous Quality Improvement Initiative . . . . . . . . . . 213
Kent V. Rondeau
The future of a total quality management initiative is threatened
when the CEO has to overcome more than the expected barriers
and pitfalls in a chain of seven nursing homes and the initiative
becomes entangled in negotiations with the union representing
nurses.

15 District Hospital: A Lesson in Governance . . . . . . . . . . . 225

Cynthia Mahood Levin and Kurt Darr
A tax district community hospital has major problems with
its governance structure because of historical animosities
among internal stakeholders, medical staff politics, weak and
ambivalent senior management, and a disruptive member of
the medical staff who has ambitions to attain major power in
the hospital.
 Contents xi
16 Restructuring Decision Making at Holy
Family Hospital: Overcoming Resistance
to a Shared Governance Program . . . . . . . . . . . . . . . . . . 241
Kent V. Rondeau
A change initiative introduced to democratize decision making
and improve clinical care in a healthcare organization is met
with staff suspicion, derision, and resistance.

PART IV ORGANIZATIONAL EFFECTIVENESS

17 Attica Memorial Hospital:

The Ingelson Burn Center . . . . . . . . . . . . . . . . . . . . . . . . 253
Bonnie Eng-Suess and Robert C. Myrtle
After the merger of two hospitals, planning must include how
to consolidate duplicated services and realign units, including a
burn center, while considering the center’s financing and com-
munity and organizational impact.

18 Pediatric Dental Care Center . . . . . . . . . . . . . . . . . . . . . . 269

Eleanor Lin
A not-for-profit pediatric dental care center that has struggled
financially for years as it serves a Medicaid population is offered
the opportunity to become part of a federally qualified health
center, but to do so requires expanding services and significantly
changing its governance structure.

19 Radical Innovation on the Idaho Frontier:

Bengal Telepharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
Julie Frischmann, Neil Tocher, and Alexander R. Bolinger
Efforts to provide pharmacy services in a rural community are
successful because of creative thinking, perseverance, political deal
making, and using telepharmacy in a unique and effective way.

20 Structure and Funding of Hospitalist Programs . . . . . . . 293

John E. Paul and Gillian Gilson Watson
An academic medical center must decide how to structure
and fund hospitalist services in the context of its relationship
xii Contents
with an affiliated school of medicine; the history and content
of hospitalist functions; and other revenue that might be
derived from hospitalist services, even while considering several
alternate strategies.

21 Appian Health Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . 305

Robert C. Myrtle
A negotiation simulation allows participants to assume union
and hospital roles to work toward an acceptable collective
bargaining agreement.

22 Evolution of the Healthy Communities

Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317
Barry Ross
Several years after initiating healthcare services for diverse,
underserved communities, hospital leadership is planning
how to take its activities to a level with greater impact and
sustainability.

PART V LEADERSHIP CHALLENGES

23 Hospital Software Solutions (A) . . . . . . . . . . . . . . . . . . . . 327

Elizabeth M. A. Grasby and Jason Stornelli
A software company supplying information technology
services to Ontario (CN) hospitals has an ill-defined structure
and controls that frustrate a new employee with conflicting
demands from the firm’s managers, including expectations
inconsistent with her job description.

24 The Case of Tim’s Last Years . . . . . . . . . . . . . . . . . . . . . 341

Kurt Darr and Carla Jackie Sampson
Declining physical health forces an accomplished retired
professor to enter a life care community in which his
diminished independence leads to conflicts with manage-
ment and staff even as further health problems result in an
apparently willed death.
 Contents xiii
25 Autumn Park . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
Cara Thomason Embry and Robert C. Myrtle
The executive director and the director of assisted living in a
community for independent and assisted living must resolve a
disagreement as to the appropriate level of care for a difficult resident.

26 Appalachian Home Health Services . . . . . . . . . . . . . . . . . 365

Kathryn H. Dansky
A not-for-profit home health agency faces a controversial
choice after learning its best applicant for a nursing position
is a convicted felon, and a review by management shows more
widespread problems with recruitment and staffing.

27 Suburban Health Center . . . . . . . . . . . . . . . . . . . . . . . . . . 373

Bruce D. Evans and George S. Cooley
The supervisor of the suburban branch of a city health
department faces problems with an insubordinate and possibly
incompetent nurse, even as the lack of authority and inadequate
support from superiors are complicated by the absence of
employee performance evaluations.

28 Team Building: From Success to Failure in 24 Hours . . 377

Cherie A. Hudson Whittlesey
What starts as a highly successful team-building exercise
becomes problematic when one physician challenges the process
and forces the facilitator to consider underlying issues and then
devise responses that will preserve team cooperation.

PART VI ETHICS INCIDENTS

29 Ethics Incidents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381

Kurt Darr
Twelve mini-case studies cover the spectrum of administrative
and clinical ethical issues, from conflicts of interest to dishonest
contractors and from infection control to advance medical directives.
xiv Contents
Administrative Ethics
Incident 1: Borrowed Time
Incident 2: ED Repeat Admissions: A Question of
Resource Use
Incident 3: The Administrative Institutional Ethics
Committee
Incident 4: Bits and Pieces
Incident 5: A Potentially Shocking Revelation
Incident 6: Intensive Care Unit Dysfunction

Clinical Ethics
Incident 7: Protecting the Community
Incident 8: Decisions
Incident 9: The Missing Needle Protector
Incident 10: To Vaccinate, or Not
Incident 11: Demarketing to Avoid Bankruptcy
Incident 12: Something Must Be Done, But What?
 About the Editors
Kurt Darr, JD, ScD, LFACHE, is Professor Emeritus of Hospital
Administration, and of Health Services Management and Leadership,
Department of Health Services Policy and Management, School of
Public Health, The George Washington University . Dr. Darr holds
the Doctor of Science from The Johns Hopkins University and the Master
of Hospital Administration and Juris Doctor from the University of
Minnesota. His baccalaureate degree was awarded by Concordia College,
Moorhead, MN.
Dr. Darr completed an administrative residency at the Rochester (MN)
Methodist Hospital and subsequently worked as an administrative associate
at the Mayo Clinic. After being commissioned in the U.S. Navy during the
Vietnam War, he served in administrative and educational assignments at
St. Albans Naval Hospital (NY) and Bethesda Naval Hospital (MD). He
completed postdoctoral fellowships with the U.S. Department of Health
and Human Services, the World Health Organization, and the Accrediting
Commission on Education for Health Services Administration.
Dr. Darr is admitted to practice before the Supreme Court of the state
of Minnesota and the Court of Appeals of the District of Columbia. He was
a mediator for the Civil Division of the Superior Court of the District of
Columbia and has served as a hearing officer for the American Arbitration
Association. Dr. Darr is a member of hospital committees on quality
improvement and on ethics in the District of Columbia metropolitan area.
He is a Life Fellow of the American College of Healthcare Executives.
Dr. Darr’s teaching and research interests include health services
management, administrative and clinical ethics, hospital organization
and management, quality improvement, and applying the Deming
method in health services. Dr. Darr is the editor and author of numerous
books, articles, and cases used for graduate education and professional
development in health services.

Tracy J . Farnsworth, EdD, MHSA, MBA, FACHE, is President

and Chief Executive Officer of the Proposed Idaho College of
Osteopathic Medicine . Dr. Farnsworth has served as Director and
Associate Dean of the School of Health Professions, Division of Health

xv
xvi About the Editors
Sciences, Idaho State University (ISU [Pocatello]) since 2010. He is
Associate Professor in the Health Care Administration Program at ISU
and has served as Program Director.
Dr. Farnsworth is a graduate of Brigham Young University. He
received master’s degrees in Business and Health Services Administration
from Arizona State University and the Doctor of Education in Educational
Leadership from ISU. In 2014, Dr. Farnsworth was awarded the
Kole-McGuffey Prize for excellence in education research, and in 2016
he received the J. Warren Perry Distinguished Author Award from the
Association of Schools of Allied Health Professions.
Prior to becoming an educator, Dr. Farnsworth had executive-level
appointments with Intermountain Healthcare, Catholic Healthcare West,
the City of Hope National Medical Center, and other public and private
healthcare systems.
A Fellow of the American College of Healthcare Executives,
Dr. Farnsworth has written and spoken widely on subjects related to
hospital and health systems performance improvement, healthcare reform,
medical education, healthcare leadership and governance, and inter-
professional education/collaboration.

Robert C . Myrtle, DPA, is Professor Emeritus of Health Services

Administration, Sol Price School of Public Policy, University of
Southern California . Dr. Myrtle received a bachelor’s degree in business
administration from the California State University, Long Beach, and a
master’s and doctoral degree in public administration from the University
of Southern California. During 41 years at the University of Southern
California (USC), Dr. Myrtle co-authored two books on management;
18 book chapters; 51 articles in journals, including Health Care Management
Review, Health Policy and Planning, Public Administration Review, Social
Science and Medicine, and The Gerontologist; and 70 conference papers
and professional reports. He has academic appointments in the Leonard
Davis School of Gerontology and the Marshall School of Business and is
a Visiting Professor in the Institute of Health Policy and Management at
the National Taiwan University.
Dr. Myrtle’s key research interests are leadership, executive
development, and organizational and management effectiveness. Current
research includes the influence of managers’ behavior on perceptions
of overall leadership effectiveness; examining factors influencing
the performance of surgical teams; and assessing factors influencing
organizational legitimacy during and following major natural disasters.
Dr. Myrtle is the recipient of the Academy of Management’s Health
Care Division’s Teaching Excellence Award and the American Society for
Public Administration’s Los Angeles Chapter Harry Scoville Award for
 About the Editors xvii
Academic Excellence. He was named Professor of the Year at USC and
has three times been named Most Inspirational Business Professor. He is
the recipient of the American College of Healthcare Executives Regents
Award, and the Hubert H. Humphrey Award for best article of the year
appearing in the Journal of Health and Human Services Administration .
Dr. Myrtle was chair of the Los Angeles County Hospitals and
Health Services Commission. He was board chair for SCAN Health Plan
and was a member of the board of directors for the Huntington Medical
Foundation. He has served as board chair of Health and Human Services
for the City of Long Beach (CA).

Professor Emeritus Darr coauthored the textbook, Managing Health

Services Organizations and Systems, Sixth Edition (2014), with Beaufort B.
Longest, Jr., published by Health Professions Press. This health services
management textbook should be used as a complement to Cases in Health
Services Management .
 Contributors
Nora G . Albert, MHA
Project Manager
Children’s National Health System
111 Michigan Ave, NW
Washington, DC 20010
Douglas Archer, MHA
Hospital Administrator
Sutter Health-Memorial
Hospital–Los Banos
520 West I St.
Los Banos, CA 93635
Alexander R . Bolinger, PhD,
MBA
Associate Professor of
Management
Idaho State University
921 S. 8th Ave.
Pocatello, ID 83209-8020
Leigh W . Cellucci, PhD, MBA
Professor and Program Director
Department of Health Services
and Information Management
East Carolina University
Greenville, NC 27858-668
Stephen Cheung, MHA, DDS
School of Dentistry
State Capital Center
School of Policy, Planning,
and Development
University of Southern California
Sacramento, CA 95811
George S . Cooley
Long Green Associates, Inc.
Long Green, MD 21092
Kathryn H . Dansky, PhD
Associate Professor Emerita
Department of Health Policy and
Administration
College of Health and Human
Development
Pennsylvania State University
201 Main
University Park, PA 16802
Kurt Darr, JD, ScD, LFACHE
Professor Emeritus, Hospital
Administration
Dept. of Health Services
Management & Leadership
The George Washington
University
2175 K Street, NW
Suite 320
Washington, DC 20037
Cara Thomason Embry, MSG,
MHA, RN
Sol Price School of Public
Health
University of Southern California
Los Angeles, CA 90089-0626
xix
xx Contributors
Bonnie Eng-Suess, MHA
Director of Hospital Risk
Contracting and Operations
Dignity Health
251 S. Lake Ave., Ste 700
Pasadena, CA 91101
Bruce D . Evans, MBA
Professor of Management
University of Dallas
Satish & Yasmin Gupta College
of Business
1845 E. Northgate Dr.
Irving, TX 75062
Tracy J . Farnsworth, EdD,
MHSA, MBA, FACHE
Associate Dean and Director
Kasiska School of Health
Professions
Division of Health Sciences
Idaho State University
921 South 8th Ave.
Pocatello, ID 83209-8090
Mary K . Feeney, PhD
Associate Professor and Lincoln
Professor of Ethics in Public
Affairs
School of Public Affairs
Arizona State University
411 N. Central Ave., Suite 450
Phoenix, AZ 85004
Julie Frischmann
Instructor/Academic Coach
Student Success Center
Idaho State University
921 S. 8th Ave.
Pocatello, ID 83209-8010
Elizabeth M . A . Grasby, PhD
c/o Richard Ivey School of
Business
The University of Western
Ontario
1151 Richmond Street North
London, Ontario N6A 3K7
CANADA
Earl G . Greenia, PhD, FACHE
Professor, Healthcare
Administration & Management
Colorado State University–Global
Campus
7800 E. Orchard Road
Greenwood Village, CO 80111
Michael J . King, MHA
Chief Financial Officer, Shared
Services Division
Tenet Healthcare Corporation
1445 Ross Ave., Suite 1400
Dallas, TX 75202
Eleanor Lin, MHA, DDS
Children’s Dental Health Clinic
455 E. Columbia St.
Long Beach, CA 90806
Cynthia Mahood Levin, MHSA
Healthcare Consultant
Palo Alto, CA
Nova Ashanti Monteiro, MD
Children’s National Medical Center
111 Michigan Avenue NW
Washington, DC 20010
Robert C . Myrtle, DPA
Professor Emeritus, Health
Services Administration
Sol Price School of Public Policy
University of Southern California
105 Siena Drive
Long Beach, CA 90803

John E . Paul, PhD, MSPH
Clinical Professor and Associate
Chair for Academics
Department of Health Policy and
Management
Gillings School of Global Public
Health
University of North Carolina at
Chapel Hill
135 Dauer Drive.
Chapel Hill, NC 27599
Abigail Peterman
Center for Science, Technology
and Environmental Policy
Studies
Arizona State University
University Center
411 N. Central Ave.
Phoenix, AZ 85004
Alexandra Piriz Mookerjee,
MHSA
Administrator
Westminster Communities of
Florida
Magnolia Towers
100 E. Anderson St.
Orlando, FL 32801
Brent C . Pottenger, MD, MHA
Dept. of Physical Medicine &
Rehabilitation
Johns Hopkins Medicine
707 North Broadway
Baltimore, MD 21205
Jonathon S . Rakich
Professor Emeritus
Indiana University Southeast
4201 Grant Line Road
New Albany, IN 47150
Contributors xxi
Kent Rondeau, PhD
Associate Professor
School of Public Health
University of Alberta
Faculty of Extension, Enterprise
Square
10230 Jasper Ave., Room 2-216
Edmonton, Alberta T5J 4P6
CANADA
Barry Ross, MPH, MBA
Vice President, Healthy
Communities
St. Jude Medical Center
101 E. Valencia Mesa Dr.
Fullerton, CA 92835
Kimberly A . Rucker
Healthcare Consultant
Washington, DC
Carla Jackie Sampson, MBA,
FACHE
Graduate Research Associate
Florida Center for Nursing
12424 Research Pkwy, #220
Orlando, FL 32826
Jessica Silcox, RN, MSN
Staff Development Educator &
Stroke Coordinator
Sentara Northern Virginia
Medical Center
2300 Opitz Blvd.
Woodbridge, VA 22191
Jason Stornelli
c/o Richard Ivey School of
Business
The University of Western
Ontario
1151 Richmond Street North
London, Ontario N6A 3K7
CANADA
xxii Contributors
Neil Tocher, PhD
Professor of Management
Idaho State University
921 S. 8th Ave.
Pocatello, ID 83209-8020
Gillian Gilson Watson, MHA
Department of Hospital Medicine
University of North Carolina
Hospitals
101 Manning Dr.
Chapel Hill, NC 27599-7085
Cherie A . Hudson Whittlesey,
ML
Director, Organizational
Learning and Effectiveness
St. Jude Medical Center
101 E. Valencia Mesa Dr.
Fullerton, CA 92835
Carla Wiggins, PhD
Professor and MHA Program
Director
Weber State University
3875 Stadium Way, Dept. 3911
Ogden, UT 84408
 Preface
Like its predecessors, the sixth edition of Cases in Health Services
Management describes management problems and issues in various
healthcare settings. The primary criterion to select a case was that it had
to be rich in applied lessons. Case selection was tempered by the editors’
90 years of combined experience in teaching and using the case method.
The result is a comprehensive set of health services management cases in
one volume.
Cases vary in length and complexity and are grouped into six parts.
Of the 28 cases in this edition, 14 are new. There are two new ethics
incidents. Cases and ethics incidents that have stood the test of time and
use were retained in this edition. All have been updated and edited to make
them as streamlined as possible. Consistent with the evolving healthcare
delivery system, half the cases are set outside of acute care hospitals. Those
include a long-term care facility, a health network, a continuing care
retirement community, an emergency department, a hospital burn unit, a
dental clinic, a pharmaceutical company, a city health department, a home
health agency, and a software company.
Acute care hospital cases include a range of sizes, types, ownerships,
and geographic locations, including rural and inner-city settings. One
hospital case is set in a multi-institutional system; another applies the
principles of continuous quality improvement. An in-box exercise set in
a hospital simulates the time pressures that confront managers and the
importance of prioritizing the issues, and a labor relations role-play case
creates a powerful learning experience that emphasizes the challenges and
dynamics of any negotiated relationship.
Depending on depth of analysis and time available for out-of-class
preparation, most cases can be analyzed in two hours, or less. A few cases
are short and have one issue. Most, however, are integrative and complex
and involve multiple problems and issues. As a result, analyses will often
require applying concepts from different disciplinary fields and knowledge
areas. This may require users to synthesize and apply knowledge, skills,
and experience from the social and health sciences in their analyses and
discussions.

xxiii
xxiv Preface
The primary use of this book of cases is the education of health ser-
vices managers. Case analysis bridges theory and practice. In this regard,
students studying health services management, as well as experienced
managers, will find the cases informative as they hone analytical and
problem-solving skills. These cases can also be used in continuing profes-
sional development for practicing managers.
By their nature, cases present events, situations, problems, and issues.
The dynamics of the analysis, including the group discussion, make
the case method a powerful and rich tool for learning. Users are urged
to review the Introduction, which describes the case method and case
analysis.
The cases included in this volume are intended to stimulate discus-
sion and analysis. In most instances, the names of organizations and indi-
viduals are disguised. In all instances, authors of the cases have prepared
well-written, factual situations that are based on field research in a specific
organization, or a composite case based on experience with several organi-
zations. No case is meant to reflect positively or negatively on actual per-
sons or organizations, or to depict either effective or ineffective handling
of administrative situations.
The 28 cases and 12 ethics incidents are organized into six parts:
Part I: Policy Environment of Health Services Delivery (five cases)
Part II: Strategic Management (six cases)
Part III: Organizational Management (five cases)
Part IV: Organizational Effectiveness (six cases)
Part V: Leadership Challenges (six cases)
Part VI: Ethics Incidents (12 statements of fact that show ethics issues)
The case synopses in the table of contents identify organizational setting,
dominant themes, and managerial problems. The core task of teaching
effective health services management is to hone the ability to identify
and define problems as well as sharpen the judgment and ability to apply
the skills and methods to solve them. As experiential learning in health
services management education has given way to more discipline-based
didactic preparation, and as younger, less-experienced students have
entered graduate programs, cases that apply didactic work have become
more important. Using these cases following a comprehensive academic
grounding in the health services and management disciplines will prepare
users for the types of problems they will encounter as health services
managers. With instructor or seminar-leader guidance, cases such as those
in this volume can make an important contribution to that goal.