Introduction
The health sector is one of the most significant institutions in the U.S. The sector promotes quality health through effective disease treatment and control, and medical research. The Johns Hopkins Hospital is one of the largest medical institutions in the U.S. with global recognition. Like many other healthcare institutions, the Johns Hopkins Hospital serves as a medical, teaching, and research center. The institution is a facility of the Johns Hopkins school of medicine located in Baltimore, Maryland. The hospital is significant to the American educational and health sectors. The center is headed by a chief executive officer (CEO), who is assisted by vice presidents from the various institutional departments. The Johns Hopkins Hospital is significant to the U.S. and global economies owing to its diverse management, services it offers, research conducted, and educational facilities.
This report will evaluate and explore the Johns Hopkins Hospital in the U.S. The report is divided into six various sections that will succinctly discuss various aspects of the hospital. The first part will give a brief description of the Johns Hopkins Hospital. The sections explore the historical background, services offered, and the hospital’s organizational structure. The second section will explore the ethical and legal environment that impacts the institution. The third section will discuss the economic issues that the hospital is facing. Meanwhile, the fourth part takes account of the technological integration within the institution’s departments. The fifth and the sixth part discuss institutional problem solving and decision-making, and financial management respectively. Therefore, this report is significant in identifying opportunities and gaps within the Johns Hopkins Hospital organizational structure.
The Johns Hopkins Hospital Description
History and Achievements
The Johns Hopkins Hospital is historically described as the founding institution of modern American medicine. The hospital was founded in 1889 by the famous Johns Hopkins who was a philanthropist, banker, and civic leader (Behr, n.d). Johns Hopkins founded the hospital using money from a bequest of over $7 million (Nguyen & Mogaji, 2022). The hospital established various medical specialists including neurosurgery, cardiac surgery, and child psychiatry. Although Johns Hopkins is the founder of the institution, various medics, including Harvey Cushing and Walter Dandy, contributed to the institutional growth and development (Nguyen & Mogaji, 2022). The introduction of specialty departments significantly contributed to the hospitals’ success and medical research hallmarks. For instance, in 1966 the Hopkins Gender Identity clinic did the first male-to-female sex reassignment surgery (Zurada et al., 2018). The Johns Hopkins Hospital has historically played a crucial role in medicine.
Moreover, the hospital is famous for its achievements in biomedicine. The discovery of restriction enzymes by the hospital revolutionized genetic engineering (Tröder & Zevnik, 2022). The restriction enzymes discovery granted the hospital its first Nobel Peace Prize. The Johns Hopkins Hospital is famous for the brain’s natural opiates (El, 2020). The discovery paved way for interest in the neurotransmitter pathways and functions. Furthermore, the institution is known for the three types of poliovirus identification and “blue baby” operation. Additionally, the Johns Hopkins Hospital contributed to heart surgery through the discovery of heparin and the Blalock-Thomas-Taussig Shunt (Bauer et al., 2021). The founding of the Johns Hopkins Hospital has significantly influenced humanity through medical discoveries. Therefore, the hospital’s achievements have helped human beings live a successful life through quality healthcare.
Services
The Johns Hopkins Hospital offers a wide range of medical services to the American and the global community. The institution is a referral center for different kinds of treatment not offered by major medical centers. The medical services and care at the Johns Hopkins Hospital are categorized into emergency care, specialty care, primary care, Johns Hopkins children’s center, and pharmacy. The emergency department offer services such as urgent medical attention and health disaster management (Guidera, n.d). The department has developed an emergency residency program that fosters clinical and humanistic professional development for urgent medical attention and response (Guidera, n.d). The hospital plays a crucial role in mitigating natural pandemics and emergent medical issues.
Johns Hopkins Hospital is famous for its excellence in various specialty care. The common specialty care offered by the hospital is neurology and neurosurgery, otolaryngology, psychiatry, rheumatology, and pediatric care, among others (Ercolano, n.d). Primary care involves the treatment of minor and chronic conditions by care physicians. Meanwhile, pediatric services are offered to children at the Johns Hopkins Children’s Center (Ercolano, n.d). The hospital has specialized pediatricians who have excellent professional records. The institution has also established various outlets within the hospital and surrounding areas that offer pharmaceutical services. The pharmacies provide outpatient services to patients with minor medical conditions. Although the Johns Hookins Hospital primarily serves as a healthcare center, it promotes biomedical research and educational services.
Organizational Structure
Johns Hopkins Hospital is organized into various departments and centers. The major departments are adult critical care, Arthritis center, and Asthma and Allergy Center, among others (Johns Hopkins Medicine, n.d). Given its large capacity and a broad range of services offered the institution is headed by two vice corporate chairpersons and one president (Meadowcroft, n.d). Eight vice presidents deputize to lead different departments including human resources, finance, medical affairs, facilities, clinical resource management, and corporate compliance, among others. Moreover, the institution is guided by a board of trustees with a chair and vice-chairperson (Meadowcroft, n.d). The board is composed of emeritus, honorary, and president emeritus trustees. While the human resource department is concerned with recruitment and employment relations, the finance department controls the fiscal transactions of the hospital. The effective Johns Hopkins Hospital leadership structure is crucial for its sustainability.
Ethical and Legal Environment
Ethical Environment
Ethical values are crucial among institutions since they guide interactions and stakeholders’ behaviors. The Johns Hopkins Hospital is a medical institution offering a wide range of services that require ethical values. On the daily basis the nurses, doctors, and other medical practitioners interact with patients who need medical care and moral support. Johns Hopkin’s ethical environment involves the values of integrity, respect, dignity, inclusion, excellence, and diversity. The core values have led to the development of an ethical code that guides medical practitioners and patients. For instance, the staff members are required to treat each other with respect and dignity. The medical officers treat their patients regardless of their ethnic background and socioeconomic status.
As a global organization, the Johns Hopkins Hospital adheres to five universal ethical principles: autonomy, justice, beneficence, nonmaleficence, and fidelity. Autonomy involves the ability of the patients to make their decisions (Molina-Mula & Gallo-Estrada, 2020). As a surgery center, Johns Hopkins is involved in organ transplants and other medical activities requiring patients’ consent. Consequently, any such action must be of the patients’ free will. Justice involves actions that are fair and unbiased (Molina-Mula & Gallo-Estrada, 2020). Meanwhile, beneficence involves acts of charity, mercy, and kindness with a strong connotation of moral obligation (Molina-Mula & Gallo-Estrada, 2020). Nonmaleficence requires medical actions to be weighed against benefits and risks (Avant & Swetz, 2020). Therefore, any medical action should be done for the patients’ benefit. Furthermore, the fidelity moral principle requires the medical officers to act in trust in their relationship with patients. Therefore, Johns Hopkins Hospital’s routine activities are consistent with the universal ethical principles.
Legal Environment
State Laws
The Johns Hopkins Hospital is in the state of Maryland, Baltimore. The hospital is regulated by the Maryland State laws for healthcare centers. The state of Maryland has passed specific healthcare laws that protect patients’ privacy (Theodos & Sittig, 2021). Consequently, sharing of patients’ information by healthcare officers is restricted, and can only be done with their consent (Molnar, 2017). The patients’ information is protected by the state’s medical record laws (Maryland Medical Records Laws, n.d). Moreover, the state has also passed laws regarding euthanasia. The Maryland statutes prohibit deliberate mercy killings but allow withholding or withdrawal of “life-sustaining” measures (Health-Gen. §§5-611 and 5-614). As a medical facility in the state of Maryland, Johns Hopkins Hospital must abide by the regulations.
Federal Laws and Regulations
The Federal laws apply throughout the U.S., and all institutions are required to follow them. Various federal laws affect the routine operations of the Johns Hopkins Hospital. The Affordable Care Act introduced the Hospital Readmissions Reduction Program that requires centers for Medicare and Medicaid to reduce payouts to hospitals with excessive readmission (Maryland Medical Records Laws, n.d). The Healthcare Quality Improvement Act of 1986 provides immunity to health officers and institutions like the Johns Hopkins Hospital during conducting assessments. Meanwhile, Medicare and Medicaid provide insurance coverage for low-income individuals who receive healthcare services from Johns Hopkins Hospital. Furthermore, the Joint Commission is obligated by the Federal laws to accredit hospitals in the U.S. Therefore, as a U.S. medical institution, Johns Hopkins Hospital, acts according to the Federal laws and regulations.
Economic Issues Facing the Johns Hopkins Hospital
Although Johns Hopkins Hospital is a non-profitable organization, it faces various economic issues that affect service delivery. The major economic issue is the post-COVID-19 recovery. The U.S. was one of the most affected countries by the COVID-19, and many businesses shut down. Moreover, the essential service providers including hospitals had difficulties in surviving due to increased service demand with fewer customer payouts (Kaye et al., 2021). Consequently, the hospital is among the many institutions that are struggling to recover economically post COVID-19. Since the hospital was at the frontline of offering emergency services during the lockdown, it ran short of medical supplies that need sufficient capital to purchase.
The Johns Hopkins Hospital is funded by the wellwishers and the Federal government. The donors sometimes fail to release funds on time, leading to delayed services and medical activities. For instance, the research department depends on donations and may be delayed due to limited resources. Meanwhile, Federal funding is subject to change due to the dynamic global economy. An increase in living costs and a negative economic shift leads to reduced national funding to the institution. Therefore, the major economic issues facing the Johns Hopkins Hospital are post-pandemic fiscal hardships and delayed funding for educational and research activities.
Healthcare Technologies Adopted
Management
Human Resource Department
The human resource department is significant in developing, reinforcing, and changing organizational culture. The department utilizes various technologies to ease its processes and procedures of payments, performance management, training and development, recruitment and onboarding, and reinforcing the institution’s values and culture. The Johns Hopkins Hospital human resource department uses websites and social media platforms in hiring (Kieffer, 2019). Interested professionals can seek employment through the hospitals’ Smart enrollment portal (Kieffer, 2019). Moreover, the department has automated the salary payment, making it easier to pay its hundreds of employees. The human resource department utilizes the hospital’s custom-made software that tracks employee performance (Kieffer, 2019). The system allows the doctors, and other medical professionals to record hours worked and get approved by the management. Technological integration among the human resource activities has improved internal competitiveness.
Finance Department
The finance department is involved in controlling and giving reports of the hospital’s fiscal transactions. The Johns Hopkins Hospital’s finance department has adopted smart analytics that allows automated fiscal scrutiny. Smart analytics technology has helped the company track down its pecuniary performance (Lu & Chesbrough, 2021). Moreover, online payment methods like the use of credit cards and mobile payment technologies. The e-payment modes have made it easy for clients without cash to receive medical services (Fahlevi & Alharbi, 2021). Furthermore, the finance department has automated its main activities like balance sheet and annual financial performance report generation. Therefore, technological integration in the finance department has eased complicated activities.
Clinical Department
Electronic Health Record
The clinical department is involved in record-keeping which is crucial in tracking patients’ health performance. Moreover, record-keeping is significant in decision-making among medical officers. The use of a manual record-keeping system is cumbersome given the Johns Hopkins Hospital’s large capacity. Consequently, the organization has adopted an electronic health recording system. The system allows medical officers to enter their patients’ information that can be tracked by any other officer attending to a similar patient. Through the electronic health record system, the officers can forecast their patients’ health performance (Walsh et al.,2021). Moreover, the system has automated features that help the officers in decision making like effective drug administration and creation of treatment plans. Therefore, the adoption of an electronic health recording system is beneficial to Johns Hopkins Hospital’s practitioners and patients.
Health Information Exchange (HIE)
HIE involves the electronic mobilization of health care information across the organization within a region, community, and hospital system. The Johns Hopkins Hospital has various centers that share patients’ information for effective medical services administration. For instance, the cancer center shares information with the adult critical care center. The hospital has adopted a system that allows the HIE with the patients’ consent. The Chesapeake Regional Information System (CRISP) is the adopted HIE that allows information sharing for payment, treatment, health operations, or research purposes (Molnar, 2017). The CRISP allows the Johns Hopkins Hospital to effectively share information for institutional growth and development.
Problem Solving and Decision Making
Unilateral Decision Making
As a large corporation, decision-making is key for Johns Hopkins Hospital. The institutional management is involved in decision-making when it is facing a crisis or for its daily operations. Unilateral decision-making involves one-sided decisions that exclude team members’ feedback. Although the institution promotes teamwork among its stakeholders, unilateral decision-making can be made at the management level. For instance, the department heads and supervisors decide on individual employees’ activities. However, the made decisions must be consistent with the hospital’s values and principles. The unilaterally made decisions allow the managers to take full control of activities, disallowing room for negotiations. Furthermore, medical officers at Johns Hopkins unilaterally make decisions when administering drugs and treatment plans based on their exercise of care and skill. Managers, supervisors, and medical officers make unilateral decisions to solve problems at individual levels.
Group Decision Making
Teamwork is significant for institutional development and consequent business growth. Although Johns Hopkins Hospital has highly qualified medical practitioners, consultation is crucial when solving complicated medical issues. Therefore, the medical officers make group decisions when dealing with chronic medical conditions. The group decisions are also made at the management level. The hospital’s board of trustees consult with other management levels when formulating strategic plans and deciding on key institutional issues. Moreover, the departmental heads work closely to develop crucial internal policies and employees’ codes of conduct. The patients’ and other stakeholders’ inputs are key to effective problem-solving. Consequently, they are consulted anytime the hospital faces crises and during policy formulation. Therefore, group decision-making is significant in improving stakeholders’ relationships for problem-solving.
Financial Management
Revenue Management Sytem
The Johns Hopkins Hospital has integrated technology into its revenue management system. The system utilizes automotive features to collect revenue information and analyze it for key decision-making. The hospital is a not-for-profit, and receives its funding from the federal, state, and wellwishers, among other external sources. Therefore, the revenue management system tracks all the income and generates reports for the stakeholders (Zietlow et al., 2018). Moreover, the system analyses the income from the medical services and the institution’s assets. The combined revenue reports are used for the organization’s processes and activities’ fund allocation. The Johns Hopkins Hospital revenue management system help in analyzing the institutional income that is crucial for decision making.
Financial Management Functions
The Johns Hopkins financial management performs various functions for institutional development. Financial management is significant for the organization to stay afloat and sustainable in the medical sector (Zietlow et al., 2018). Moreover, the management allows the organization to comply with state and federal laws. Planning, organizing, and directing fiscal activities are important for Johns Hopkins Hospital. Technological integration within financial management activities has bolstered their effectiveness. Therefore, Johns Hopkins Hospital’s financial management is significant for short and long-term decision-making.
The financial management at Johns Hopkins Hospital serves various purposes: financial planning, cash flow management, resource allocation, capital budgeting, and decision and control. Financial planning involves the hospital having a comprehensive picture of its finances, fiscal goals, and strategies to achieve those goals (Onder et al., 2022). Meanwhile, cash flow management is the tracking of revenue and expenditure of the organization. Comprehensive cash flow management and financial planning help in resource allocation and capital budgeting. The financial management at Johns Hopkins Hospital helps in key decision-making.
Conclusion
The Johns Hopkins Hospital is crucial for economic growth and health care services in the U.S. The hospital is located in the state of Maryland and is regulated by federal and state laws. As a medical institution, ethical codes help in regulating its stakeholders’ interactions. The hospital instills the values of integrity, dignity, and trust among its employees and clients. Like many organizations that are funded by the government and well-wishers, Johns Hopkins faces revenue delays. Moreover, the institution is one of the organizations still facing post-COVID-19 fiscal impacts. The institution has adopted technology in its various departments for effective service delivery. Consequently, the Johns Hopkins Hospital is ranked among the top hospitals in the U.S. with global recognition.
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