Problem
After we won the Certificate of Need against the for-profit hospital corporation, we proceeded with our planned $30 million (this would be equal to $50 million or more today) expansion, including a new obstetrical center. Construction wasprojected to take 2 years. However, we experienced 11 labor strikes during the project. Plus we had a very bad winter withhistoric levels of snow. It literally snowed for 3 days at one time and kept us in a lock-down situation for the hospital. And so, the project was delayed for a year, and it took us 3 years to expand the facility.
After all that, we discovered that we had a problem in our newly constructed newborn nursery. We had an unusually high rate of jaundice among our newborn babies. Back at this time, the jaundice rate was between 2 and 3% and we wererunning between 24 and 26%. Rumors had started to circulate in the community that babies were actually dying in ournewborn nurs- ery. That certainly was not true, but the jaundice rate was quite troubling. It was a serious problem. We reviewed everything trying to determine what was causing this raised jaundice rate. We reviewed all the levels of lead in the paint, we reviewed the tiles, and we reviewed all of the woodwork. We broke down everything and still could notfigure out what was causing the elevated jaundice rate. At that point, we were faced with a decision of whether we should close our obstetrical center until the jaundice rate could be reduced. For a hospital to close down its newborn obstetricalcenter and nursery would present a major problem. The high jaundice rate was threatening our hospital's reputation, our market share, and the millions of dollars we had just invested in expansion.
The problem had persisted for several months, and we were near closing of the obstetrical center. I called the Centers for Disease Control and Prevention (CDC) in Atlanta and asked them for help. Jaundice is not a communicabledisease, and the CDC generally doesn't get involved unless it is a communicable disease, but they had such an interest in this puzzling situation that they sent two experts to investigate. Amazingly, they discovered the problem within just 2weeks. The source of the problem actually was the type of detergent we had been using to launder the bedding. Our Director of Laundry had been under pressure to reduce his costs and had switched to a cheaper detergent. When we changed back to our original detergent, the jaundice rate immediately dropped back to a 2 to 3% rate. This solution allowed us to keep the obstetrical center and nursery open and eliminated any rumors that babies were dying in our newborn nursery. We had succeeded in protecting our patients, our reputation, as well as our obstetrical service, andinvestment in the facility.
Task
a) Would you have closed the newborn nursery unit until you had found the cause of the high jaundice rate? Explain why or why not.
b) What would you do with the Director of Laundry as far as his continued employment?
c) Would you have involved your OB-GYN in the decision to keep the newborn nursery open? Explain your answer.