Interview 1

Interview with a former financial VP for a local hospital

What is the title for housekeepers/ cleaners in a hospital? Would they be assigned wings/ wards or be everywhere as needed?

Title: Environmental Services

Assigned a floor/ wing/ section; some quick cleaners are hired to speed up the turnover between patients in at-capacity hospitals such as this one

The General Medical floor would be where patients go after the ICU; patients often have severe infections, pneumonia, are recovering from cardiac ICU, etc. A homeless patient could be in the General Medical floor to recover from sunburn, dehydration, malnourishment, etc.

How was the hospital affected by the 2008 market crash? Did the patient’s needs change?

Volumes fell: patients with elective services (like knee surgery, etc.) put off the procedures.

More patients were unemployed, so more patients did self-pay or charity care. Charity Care: patients under certain poverty guidelines written by the government and the hospital corporation provide for the care of people who cannot pay. This hospital has a very generous charity care program.

A homeless patient brought in by someone willing to pay for his care would initially be set up as self-pay, then would have to give the other person access to his account to cover the bill. If the homeless patient had insurance but did not have the card with him and refused to sign for the other person to cover the bill, this could cause a problem.

For workers, jobs could easily be obtained in July 2008 before the crash. After the crash, retirees were trying to return because their spouses lost their retirement.

Were there any improvement plans for workers in 2008?

There was not a formalized plan from corporate at this time. However, every department was always looking for ways to be more efficient. They focused largely on clinical outcomes and services.

Did the election of Obama as president affect anything at HCA? Did the outrageous oil prices?

Obama’s later Healthcare Act had a small impact on decreasing bad debt and charity care, thus increasing volume. However, the Act increased deductibles/ co-insurance for everyone. By 2016, several insurance plans went bankrupt across the country. No real changes beyond his influence on the economy occurred until the Healthcare Act.

Gas prices had a much greater effect on the workplace. Employees were struggling to get to work. Because the hospital was open 24/7,  there were not many opportunities to rearrange shifts or to work from home. Further, there was no way to add the correct amount of money to a person’s paycheck to cover the extra cost of gas. Thus, the hospital tried to connect people for ride sharing and carpooling.

What is the general feel of hospital culture? Do patients and housekeeping see each other? Would security be roaming the halls?

Environmental Services and patients interact when Environmental Services come in to clean the rooms. Environmental Services also check with nurses for special needs among the patients.

Security would be stationed in Emergency Department, walk the main floors and hallways, and walk/ drive/ bike around the building. However, they would not walk patient hallways unless an incident occurred.

Other jobs where patients and workers interact include imaging technicians, transporters, dietary workers, phlebotomists, pharmacy workers, IT people, and materials management. Transporters, dietary, and materials management would not require a college degree. Transporters would take patients downstairs when they leave the hospital or move them between floors and units. Dietary workers would bring up meals and talk to patients to ensure that they have everything they need. Materials managements would be responsible for purchasing supplies and bringing them up to the correct floors.

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