Case Study Mercy Hospital
Mercy Hospital, started in 1895, is a 143-bed hospital in a small community of 37,000 people. Mercy Hospital is located on a small hill in the center of the town surrounded by upper and upper-middle class homes on the hill and low-income neighborhoods at the base of the hill and surrounding a main street of shops, restaurants, and services. The main buildings consist of dark red brick with two floors in the center and wings out to each side. Several additions had been added to the rear of the building in the 1960’s.
The dingy green halls are lined with long windows overlooking the lawns. Few changes have occurred to renovate the hospital in the last twenty years. Most of the patient rooms hold four patients each, except the section of private rooms set aside for those who can afford them. The operating suite occupies on wing of the top floor. There is a small pediatric unit and small maternity unit, both appear to be stuck in the 1950’s. There are no security devices on the doors to these units.
As one walks through the halls, it is not unusual to see patients lying alone on stretchers, patient care technicians and nurses gather in nursing stations while patient call lights go unanswered, and soiled linens dropped on the floor. Physicians give directions to nurses who refuse to follow their orders. Families can be seen caring for family members because there is no one else who seems to care. While a simple electronic medical record system was installed, it is not used by physicians or nurses who state it is too difficult to use and they do not have time to learn.
A stop at the Pharmacy indicates that many medications are misplaced on the shelves, there is a backlog of prescriptions to fill, and there is no system for managing unit dosing for patient safety. The electronic system for managing patient prescriptions has been installed but is not used reportedly because “there is just not enough time and it is too difficult.” Several pharmacy technicians work in the pharmacy to help in filling prescriptions and transporting them to the units. However, there is no evidence that these technicians have been trained in a formal program or have passed the national pharmacy technician exam.