Developing a Conceptual Framework for Health Care Operations: Challenges and Remedies

The United States health care system has reached a turning point where exorbitant costs and uneven care are no longer acceptable. Costs are rising, and neither hospitals nor insurance companies have any incentive to reduce them as they just try to push costs onto one another. Reforming the United States healthcare system will require a fundamentally different approach for all parties involved. The purpose of this thesis is to examine and discuss the major problems plaguing the healthcare industry, specifically involving hospitals and other health care organizations. Then, potential and actual solutions will be reviewed. Four major categories for health care challenges and issues are discussed: Payment, Information Systems, Business Strategy, and Operations Management. Authors and scholars who write about health care challenges often discuss remedies to them. These potential solutions from the literature are discussed in order to understand their feasibility. A practical approach to finding out if these potential solutions are viable is to ask someone who deals with these challenges every day. Over a span of four months, interviews were conducted with 18 health care administrators, physicians, nurses, and managers to see what issues they believed were facing the health care industry, and how they could be solved. The goal for these interviews was to see if health care professionals agreed or disagreed with the literature and to gather new information from their real-world experience. While many of them agreed with the literature solutions, they also recommended different solutions and offered new findings and insight. The interviews with health care professionals led to a new framework for change. Recommendations are then made based on the feedback from these interviews. No matter which department they worked in, these health care professionals unanimously emphasized the need for positive and productive company culture, standardization in all areas, additional communication, further staff education, and proper evaluation and performance measurement, as ways to reduce costs. The results show that while there is no simple, quick fix, these overarching themes will have a major impact on the industry as a whole, regardless of the future challenges it faces