Village Hospital's Palliative Care Unit: A Healthcare Case Study

This case study examines the feasibility of establishing a palliative care unit at Village Hospital, which is experiencing declining inpatient utilization. The assignment begins with defining palliative care and then explores how to assess the community's need for such a unit using the Epidemiological planning model. It then delves into estimating the demand for the new service, crafting a mission statement, and addressing the CEO's interest in transformational leadership by outlining the values, practices, and actions needed to create this culture. Furthermore, the assignment recommends an organizational structure for the palliative care unit and concludes with suggestions for achieving clinical excellence, considering techniques and approaches from Chapter 5. The analysis provides a comprehensive framework for healthcare management to make informed decisions regarding the implementation and success of a palliative care unit.

CASE HEALTH CARE ORGANIZATIONS
Village Hospital is experiencing a decline in inpatient utilization. Currently, it is
functioning at 86% inpatient utilization and consequently the Governing Board is
concerned about revenue and the hospital’s ability to remain open if inpatient utilization
continues to decline. The CEO is considering alternative uses for inpatient beds including
converting one med/surgical unit to a palliative care unit.
You have been hired as a consultant to help the senior management team and the Board
decide if this is a feasible option.
Answer the following in paragraph form – NO BULLETS! I EXPECT THAT YOU WILL
USE YOUR TEXT , PPS AND CLASS NOTES TO WRITE WELL THOUGHT OUT
COMPREHENSIVE ANSWERS
1. Provide the management team with a good definition of Palliative Care.
Firstly we need to understand what palliative care is before we set up a palliative care unit.
Palliative care is for the patients who are seriously or terminally ill. In these diseases, the cure is
not possible. In this, there is a requirement of providing relief from the painful symptoms and
stress due to the severe disease.
Palliative care is an extra layer of support which is provided to the patient from a specialised
team of doctors and nurses. Palliative care is provided along with the treatment of the disease.
Palliative care improves the quality of life of the patient.
2. How would help the management team evaluate whether there is a need in the
community for palliative care? Consider here the Epidemiological planning model
presented in Chapter 3. Specify the data you would suggest collecting to measure
community need.
There are many factors from which the management can decide the requirement for palliative
care unit. Palliative care offers a wide range of flexible approaches which help in reducing the
physical , psychological and existential burdens faced by the people suffering from life
threatening disease.

The Epidemiological Model focus on community-based and patient based standards. These
standards help in developing programs for the community. The evaluation model is based on
obtaining patient data and vital statistics from community data.
It can be applied in any community where the illness trajectory increases. It is important to
access main diseases from the people of the community is facing. It is also important to identify
the diseases and provide specific palliative care for the disease.
The Epidemiological measure is decided on many factors such as Need, demand and uses. Here
we have to access the need , demand and uses of palliative care unit. How many patient
percentage of the community requires palliative Care Unit. How is pollution suffering due to the
absence of palliative approach by the hospital? How much demand for palliative care in the
community can be noticed? Also, what are the diseases in the community which requires
palliative approach? All these questions need to be accessed before setting up a palliative care
unit.
3. Using the epidemiological planning model- how would you go about estimating the
demand for this new service? ( use formulas presented
Ch 3)
Demand is a broad term. For health care services it is the need felt, people ask for it. Patients in
hospital are in a constant interaction with the staff. If they need something they will ask the
hospital staff regarding that service. It can be felt by patient feedback.
The demand is influenced by many factors. It is influenced by illness behaviour. The illness
behaviour depends on the age, gender, education and the socio-economic status. Also patient
must have the knowledge about the palliative care service. The service should be cost effective
for the patient. The need, supply and demands overlap each other. Still, we need to assess the
need of a specific service to avoid unwanted expenses.
4. Write a mission statement for a palliative care unit/service.
To give compassionate, care and quality to enhance and comfort in the lives of people with life-
limiting illness.

5. The CEO now tells you that she wants to create a culture that embraces the concepts of
transformational leadership. First, what values would this culture be built upon? Second,
suggest to the CEO the specific practices, actions she should take to create this culture.
( consider here what palliative care is all about!)
Palliative care is all about providing comfort to the terminally ill patients. Here a
transformational leadership is required. It is mainly based on two values, inspiring the workforce
and challenging people to deliver high performance.
The change in culture is not an overnight process. A leader is required who can implement these
components and can drive the organisation in the correct direction. For the culture change, the
leader needs to provide an inspirational vision, which should be communicated by the leader.
The inspirational vision can drive the workforce to go beyond their routine work and take proper
and holistic care of patients.
Next, it is important to challenge people to deliver high performance. A transformational leader
will ask the team to deliver more , achieve higher standards of work. The leader will also
encourage to let go fears and find new ways of working together. This will help the institute to
provide high levels of palliative care.
6. What organizational structure would you recommend for a palliative care unit and
why?
Organization structure for palliative care Unit
CEO
MEDICAL OFFICER

Short course palliative care training IN CHARGE
Palliative care unit nurses PALLIATIVE CARE TEAM
REFER TO SPECIALIST TEAM IF REQUIRED
Initially, the palliative care organisation structure should be short. There should not be many
levels. The CEO herself should head the department. There should be constant guidance and
suggestions by the leaders for improvement. It is important to monitor the department closely by
the leaders hence the levels of organisational structure should be less.
7. Finally, the CEO tells you that she is most about concerned about clinical performance.
What would you suggest she put in place to achieve clinical excellence? ( consider
techniques, tools, approaches learned in Ch. 5. Again, be specific in your
recommendations.
There are various ways by which clinical excellence can be achieved. The people approaching
end life should be identified in time. The patient with a terminal illness and their family should
be communicated with all the necessary information. It is important to respond to their changing
needs quickly. They should be given in time personal care. Their psychological needs should
also be addressed. There must be access to medicine and required equipment. People with end
term illness require special care day and night. In their case, an emergency condition can appear
anytime. It is important to be coordinated with the emergency department. So that is a case of
emergency required measures can be taken.