You have a job as the middle-level executive in a 250 bed hospital.  The hospital is technically a ¯n-profit(ospital, but it is run as close to a ¯r profit’oal as possible.  As a result of dislocations to the health care industry in your state, your hospital has suffered a 15% loss of trained health care provider staff across the entire hospital, including physicians, nurses, and licensed personnel of all kinds.  The hospital has operated five (5) clinics:  a walk-in orthopedic clinic; a referral based radiology department with MRI, CT, and ultrasound facilities; a labor-and-delivery suite with neonatology; a wound care center with hyperbaric equipment; and, a locked, in-patient pediatric psychiatric facility.

Your CEO has assigned you the task of making a report to her, for presentation to the hospital Board, assessing the risks associated with closing two of these five clinics.  She has asked you to describe the risks of closing each clinic, as well as the risks of continuing to run the clinics.  

You should evaluate the following:  

1.         the risks of continuing to offer the services with 15% less staff;

2.         the benefits of continuing to offer the services of each clinic;

3.         the risks of transferring non-physician personnel from the clinics to be closed to those that will remain open, and an assessment of the training challenges/risks of using inexperienced staff in the new clinics;

4.         the potential personnel problems and possible solutions resulting from either (or both) transferring employees to new assignments or laying off any extra staff; and,

5.         any other problems or risks that may be encountered.

Make a recommendation which two clinics should be closed, with a brief explanation why they should close and the others should remain open. Then, identify and describe in detail the consequences you anticipate (such as any process or implementation issues) and how you should prepare to manage them. 

Suggest a basic timeline for the implementation of your suggestions, taking into account the risks that you have identified and the steps you propose to take.

Finally, provide a brief statement of your assessment of the Cynefin system in which this process with be conducted.  The Cynefin discussion is included in the Announcements for each Section.

You should prepare a memorandum that can be understood quickly and clearly.  Do NOT worry about the revenue issues (this is confidential information that you do not have, but which the Board will know.)   Consider any additional costs which you may identify.