Baptist Health South Florida is a modern-day clinical care network. The term refers to organizations involved in the proviso of healthcare services on a wider scale as limited to a single unit-based institution. As its name suggests, Baptist Health is a Christian-based organization with roots in a section of Protestant Christian Faith. From a historical perspective, the organization began as a single hospital in Miami (BHSF, 2019). It gradually grew into a massive organization with a chain of over ten hospitals and over fifty smaller clinical care units. The primary focus of the organization is the proviso of clinical care from a not-for-profit perspective. For clarification, Baptist health charges for its services, but unlike for-profit hospitals, money is not at the focal point of its decision-making. Further, the hospital utilizes all its net-income into healthcare-based community programs and into expanding its healthcare services.
Currently, Baptist Health runs ten major hospitals, spread across the Miami-Dade County, Monroe County, and Palm Beach Counties in Florida. A majority of these hospitals are general hospitals that handle a variety of community health needs such as primary care, emergency care, specialized care such as surgeries, and ambulatory care (BHSF, 2019). In recent years, Baptist Health has also invested in specialized hospitals such the Miami Cancer Institute that specializes in oncology. The hospital also runs smaller units, such as outpatient centers and urgent care centers. By definition, outpatient care centers are a kind of hospital that provides clinical care to patients whose illnesses do not require admission or extensive procedures (Brandenburg et al., 2015). On the other hand, urgent care centers provide emergency care of a mild nature, which may not require the extensive amenities available in a hospital setting. The idea behind outpatient centers and urgent care centers is to bring services closer to the populace and limit the pressure on hospital emergency rooms.
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Purpose and Mission
The mission and purpose of Baptist Health are elaborate and to some extent, convoluted. Based on the letter of the organization’s mission statement, three things stand out. The first is that the organization aims to provide the best healthcare services to all people regardless of their faith, belief or religious affiliation. The second, which to some extent may contradict the first component, is that the organization operates as “ guided by the spirit of Jesus Christ and the Judeo-Christian ethic ” (BHSF, 2019). Another aspect of the second component is that the organization aims to “ promote the sanctity and preservation of life ” (BHSF, 2019). Based on a close reading of these two quotes, which appear in subsequent sentences within the hospital’s mission, one cannot escape the indirect reference to ethical dilemmas such as reproductive health issues, including abortion and contraception. The combination of the two components above creates the meaning that whereas the hospital chain welcomes patients of all works of life, such patients ought to understand that the hospital operates under ethical limitations. Therefore, when a patient request contradicts Judeo-Christian ethics, clinicians will opt to adhere to Judeo-Christian ethic.
The third important component, more so from the perspective of healthcare in America, is that the hospital provides charity care but subject to availability of resources. Once again, the statement engenders some convolution. On the one hand, the hospital undertakes to provide clinical care to those who may not be able to afford it (BHSF, 2019). Such services are a departure from the normal operating procedure in the USA where the level of services availed depends largely on the medical cover program available to the patient (Dickman, Dickman & Woolhandler, 2017). However, Baptist Health does provide a caveat that such charitable services have limitations based on availability of resources.
Part B: Organizational Leadership Chart
Overview of the Organizational Chart
Baptist Health has an innovative, multi-tiered, and multifaceted organizational chart. The two main facets are the executives and the boards of directors. The executives are employees of the organization who run the organization itself and its various components (BHSF, 2019). The Boards comprise of volunteers who work without pay, perhaps as a service to humanity. The multifaceted chart component indicated above refers to the fact that for every level that as a set of executives, there is also a board to superintend over it. The Board hires the executives, determines the remuneration payable to the executives and evaluates the performance of the said executives. On the other hand, the executives undertake the day-to-day management and administration of the organization and its various components. The multi-tiered chart component means that leadership at the hospital is on several levels. The top level is the Baptist Hospital South Florida Leadership that runs the entire organization (BHSF, 2019). Under that, each of the main hospitals has its own leadership complete with executives and a Board. Other components of the hospital also have their leadership structure under the top leaders such as the Medical Group. The Foundation, the Enterprise, and the Outpatient services department.
The Leaders
At the top of the leadership chart is the board of directors for Baptist Health of South Florida, made up of 33 members who include academicians, business executives, and Baptist ministers. Parallel to the board is the team of executives who include President and CEO Brian E. Keely and five executive vice presidents. Falling under the top group is a set of twelve CEOs who are in charge of each of the hospital's departments. For example, Nelson Lazo is in charge of Doctors Hospital while Nancy Batista-Rodriguez is in charge of Baptist Outpatient Services (BHSF, 2019). The departments represented by the 12 executives also have their own board of directors with fifteen members each.
Terms of Office and How Their Accountability/Productivity is Measured
Based on the organization’s website, there is a two-year term of service for the boards of directors but no definitive term of service for the executives. For example, Brian Keeley has been president and CEO of the entire organization for almost a quarter-century. There is no indication of any envisaged end to Keeley’s term. Normally, the respective boards employ and appoint the executives. These executives continue to serve indefinitely at the pleasure of the board. With regard to measuring accountability and productivity, the boards are responsible for assessing the executives. Baptist Health has a productivity-based remuneration program for its executives (BHSF, 2019) . To arrive at this remuneration package, each board evaluates the productivity of the executives under its authority every year. The obligation to evaluate on accountability also falls with the board of directors. However, they are no indication as to nature of the evaluation processes.
Part C: Major Components of the Organization
Baptist Health has thirteen main components, each of which has a designated set of duties, a set of executives, and a board of directors. The first component assumes the name Baptist Health South Florida and includes the top management and administration organ of the organization. This component is the primary policy-developer and decision-maker for the entire organization. The second component is the Baptist Health Medical Group, which brings together all the clinicians working under the Baptist Health umbrella in Florida, Kentucky and Southern Indiana (BHSF, 2019). The third component is Baptist Health South Florida Foundation, the philanthropic arm of the organization, which deals with assisting the less fortunate access healthcare services. Next is the Baptist Health Enterprises, an investment company with concerns in real estate and property development. The fifth and final general component is the Baptist Outpatient Services, which manages the outpatient centers and urgent care centers under the organization. The remaining eight components are individual hospitals, which fall directly under the superintendence of the first component but enjoy an element of autonomy. They include the West Kendall Baptist Hospital, the South Miami Hospital, the Miami Cancer Institute, the Mariners Hospital, the Homestead Hospital, the Fishermen's Community Hospital, the Doctors Hospital, Bethesda Hospital East & Bethesda Hospital West, and the Baptist Hospital of Miami (BHSF, 2019).
Part D: Performance Measurement
Baptist Health has a two-fold approach to performance measurements. The first is an internal program that assesses the performance of its variance components using a comprehensive assessment system. To its credit, the organization regularly publishes the findings of the assessment processes. On the other hand, the organization is a member of the National Quality Forum, a not-for-profit organization that independently focusing quality of care in hospitals (BHSF, 2019). National Quality Forum sets the priorities and goals in both quality of care and patient safety. The organization then uses those goals to assess the compliance of member healthcare institutions such as Baptist Health.
The internal assessment process combines process and outcomes based on a variety of parameters. As a point of comparison and perhaps for marketing purposes, Baptist health also compares the outcomes of its internal assessment with the other players in its area of operation. Among the key parameters used is the timely emergency care measurement, which assesses the duration between emergency patients getting to the hospital, and receiving substantive clinical care. This parameter is critical since bureaucratic-based delays in ER centers is a substantive problem for patients in America (Shah et al., 2017). Another important area of assessment relates to adherence to recommended care, which relates to following the rules of practice. Another area of assessment is the ability to undertake timely and effective diagnosis and clinical care for common conditions. This latter parameter is more relevant to outpatient and urgent care centers (Brandenburg et al., 2015). Finally, there is a timely and effective surgical care parameter that mainly focuses on the major hospitals. However, notably missing is any parameter relating to patient satisfaction and adherence to patient instructions and preferences. In modern healthcare, doing what the clinician considers as right should be subject to what the patient considers is right too. Patient satisfaction is an important factor over and above clinical outcomes (Chang et al., 2016).
Part E: Impact within the Last Ten Years
Over and above its major impact on creating jobs, over the last ten years, Baptist Health has had a major impact on healthcare. The first impact involves bringing healthcare services closer to the people. Within the last ten years, Baptist Health has opened several hospitals in different locations and expanded its older hospitals (BHSF, 2019). However, in terms of bringing healthcare services to the people, the greatest feat by the organization is the expansion of its outpatient and urgent health facilities in more than a hundred locations. Many Americans fail to see a clinician until late into the condition. The delays increase the cost of treatment and in some cases, compromise positive outcomes. Among the reasons for the delays is the distance to the nearest healthcare facilities or the duration it takes to receive treatment in a standard hospital. The outpatient and urgent care centers are not only nearer to the patient but also less bureaucratic, hence reducing the duration it takes for treatment (Brandenburg et al., 2015).
The second major impact of the hospital stems from its charity work, both through its hospitals and its foundation. Despite its high patient load, Baptist Health regularly makes annual losses, such as in 2016 (BHSF, 2019). Among the reasons for the losses stem from the fact that the institution places patient-care above pecuniary concerns. Although the USA is the most affluent nation in the world, a high GINI Coefficient has resulted in the presence of tens of millions of poor Americans who cannot afford healthcare services or are uninsured (Dickman, Dickman & Woolhandler, 2017). Other Americans have cost-sharing medial covers that exponentially limit the kind of clinical services they can access. Having a hospital that places patient welfare over money can make the difference between life and death for a patient.
The next important impact of Baptist Health concerning healthcare is its investment in oncology. Modern healthcare technology has made great headway in combating communicable diseases. However, non-communicable diseases such as cancer continue to create substantive healthcare challenges. In the last ten years, Baptist Health has invested hundreds of millions of dollars towards oncology (BHSF, 2019). The investment includes building a state of the art cancer hospital in Miami and undertaking research on cancers and their cures.
Finally, but on a negative note, Baptist Health has also contributed to the absence of patient autonomy in its areas of operation. As a not-for-profit organization with over a hundred centers in South Florida, Baptist Health is the only available and affordable option for a large number of patients. In modern healthcare, clinicians adhere to professional ethics, while patients come with personal preferences (Miles & Asbridge, 2017). However, as reflected in its mission statement, Baptist health has its own set of non-professional preferences based inter alia on Judeo-Christian ethics. In some cases, patients may have to choose between affordable care and personal preferences, which is an unfair choice, form the perspective of social justice.
Part F: Critique and Improvement
Personal Critique
From a personal perspective, Baptist Health South Florida has significantly impacted healthcare and made a monumental difference for the people of Florida. As a not-for-profit organization, Baptist Health puts back its earnings to aid in the health and betterment of the communities it serves. It has continued to build larger, more advanced and better-equipped hospitals to serve the public. Its greatest achievement, in my opinion, lies in the large collection of smaller units such as the outpatient and urgent care centers. Most people need hospitalization because they missed the chance for effective management of their conditions at their advent (Dickman, Dickman & Woolhandler, 2017). The fear of spending too much time in triage and other processes keep sick people away from the hospital until it is too late for early mitigation. The smaller, less bureaucratic centers make a major difference to patients as they can now seek medical attention in time, which improves chances of positive outcomes. Conversely, Baptist Health has a reputation as one of the best places to work in the healthcare industry. Available research shows that most errors in healthcare emanate from human error, occasioned by factors such as fatigue and poor working conditions (Wheatley, 2017). By creating a good working environment for its clinicians, Baptist health ensures better health outcomes for its patients.
Suggested Changes
I would suggest two relatively significant changes to Baptist Health, one related to clinical care and the other to administration. Beginning with the administrative change, as a not-for-profit organization, Baptist Health directly or indirectly handles public funds. Under the circumstances, the company should have a level of accountability that is relatively higher in private corporations. Without casting any aspersions on the organization’s leadership, it is telling that the President and CEO have retained the position for over twenty-four years. Further, the other executives serve at the pleasure of the board and may retain their positions for elongated periods. Just as with the presidency, offices of public importance require regular changes and an injection of new ideas. I would effect change in these areas by adjusting the work contracts of all executives by adjusting terms of service into a series of renewable terms. After about five years, the board would, after review, determine whether to renew an executive’s contract or seek fresh human talent.
The second recommendation may be controversial and revolves around the ethical issue of patient autonomy. Faith is a personal issue, not an institutional one. Bethesda Health is an institution in spite of its Christian leaning. Further, in its mission, the hospital clearly states that it handles patients indiscriminately in spite of their faith or creed. The hospital should consider adjusting its mission to eliminate language that suggests the limitation of patient autonomy.
References
BHSF (2019). Baptist Health South Florida. https://baptisthealth.net/
Brandenburg, L., Gabow, P., Steele, G., Toussaint, J., & Tyson, B. J. (2015). Innovation and best practices in health care scheduling. NAM Perspectives .
Chang, B. P., Carter, E., Suh, E. H., Kronish, I. M., & Edmondson, D. (2016). Patient treatment in emergency department hallways and patient perception of clinician-patient communication. The American journal of emergency medicine , 34 (6), 1163.
Dickman, S. L., Himmelstein, D. U., & Woolhandler, S. (2017). Inequality and the health-care system in the USA. The Lancet , 389 (10077), 1431-1441.
Miles, A., & Asbridge, J. (2017). Person-Centered Healthcare-moving from rhetoric to methods, through implementation to outcomes. European Journal for Person Centered Healthcare , 5 (1), 1-9.
Shah, N. R., Navarro, M. D. L. M. G.-W. R., & Kanter, M. D. M. (2017, May 24). Health Care Providers Must Stop Wasting Patients' Time. Retrieved from https://hbr.org/2017/05/health-care-providers-must-stop-wasting-patients-time .
Wheatley, C. (2017). Nursing overtime: should it be regulated?. Nursing Economics , 35 (4), 213.
