Question

In an effort to control costs and maximize revenues, the Rehabilitation Unit at Cross Hospital reduced the number of its managers and increased the number of units for which each manager was responsible. Within a year, the number of adverse events on the units had doubled. This may be attributable to:

1) The overload of staff nurses.
2) Resistance to change by staff.
3) A change in reporting systems.
4) Fewer clinical leaders to remove barriers to care.

Answer 1

The increase in adverse events at Cross Hospital's Rehabilitation Unit after reducing the number of managers is most likely due to option 4) Fewer clinical leaders to remove barriers to care, which is consistent with the issues health systems face such as consolidation, work overload, and administrative changes.

Step-by-step explanation:

The question asks what may have contributed to the doubling of adverse events in a Rehabilitation Unit at Cross Hospital after reducing the number of managers and increasing the number of units each manager is responsible for. Given the context, the most appropriate option would be 4) Fewer clinical leaders to remove barriers to care. This aligns with the broader issues in healthcare, such as challenges related to hospital mergers, work overload, and the need to control healthcare costs while improving efficiency, as seen with the introduction of electronic medical records (EMRs) by the Affordable Care Act (ACA).

Options 1) The overload of staff nurses and 3) A change in reporting systems might also play a role but are not directly linked to management structure changes mentioned in the scenario. Option 2) Resistance to change by staff is a possible factor, but there is no direct evidence provided that it is the main issue.

Thus, fewer clinical leaders to oversee care and manage unit operations are likely a key factor, possibly leading to poorer supervision and a decrease in care quality.