Running head: CASE STUDY SEVENTY-THREE 1

Case Study Seventy-Three: Conflict of Interest

Name of Student

Name of Institution

Date
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Case Study Seventy-Three: Conflict of Interest

Background Statement

The case study is predominantly based on the conflict of interest among five senior

orthopaedic surgeons at the Sleepy Hallow General Hospital. The five orthopaedic surgeons each

prefer to purchase their knee and hip implants from different vendors. As the administrative

officer in charge of finances for the hospital’s operating room, it has come to my attention that

the conflict of interest among the orthopaedic surgeons is costly to the hospital. After thorough

research and consultation with some of the implant companies, I came to the conclusion that if

all of the hospital’s knee and hip implants were to be procured from one company that had

standardized equipment, then we could reduce the cost by up to 40%, which is around $2.8

million annually. Therefore, it is up to me as the administrative officer in accountable of finances

to set up meetings with the respective orthopaedic surgeons and try to brief them on the matter.

The Causes and Effects

As per the World Bank official 2010 health report on hospitals, conflicts of interest may

start at any stage of a procurement process when the involved parties, in this case the orthopaedic

surgeons, are driven by selfish interests (World Bank, 2010). As the chief administrator in charge

of finance, it is my duty to hold meetings with the five surgeons and hopefully in the end come

with a long-lasting solution that will leave all the parties satisfied.

The main reason why I have to see over the role of regulating the knee and hip implants

purchase is because as the chief administrator in the finance department, it is my duty to preside

over all procurement processes. Furthermore, I have to ensure that the resources of the Sleepy

Hallow General Hospital are not miss-used in any way. I try as much as possible and engage
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only in resources that can help save a significant amount of money. As a challenge, I have to

oversee all hospital purchases and consult with various hospital stakeholders to ensure that they

only make credible purchases. This can sometimes be problematic as some of them fail to see the

sense in saving as they believe that the hospital has sufficient funds which is actually the

opposite. The price of everything from all medical and food supplies to electric and fuel bills

have escalated over the years. However, the work has it upsides as I am able to interact with

many people since the hospital has over five hundred working staff including the doctors and

technicians. As a result, I have made lots of valuable relationships that are both beneficial to my

private and professional life.

The Strengths and Weaknesses of the Hospital

The award and evaluation of the tender of knee and hip implants is especially significant

to the quality of care offered by the hospital. It is one of the most significant phases, because of

the great amount of expertise and caution required. Therefore, to avoid conflict of interest in the

implants procurement, the hospital has erected laws that properly denotes the meaning of conflict

of interest, and also set up guidelines for stakeholders involved in the procurement matters to

reveal evidence about their private assets and interests, as well as exempting themselves from

other policymaking endeavours, and banning them from engaging in some functions if the

possibilities of conflict of interest arise.

Another strength of the hospital is access to viable data, stakeholder involvement in the

essential phases of the procurement process, and defined review techniques are paramount to

accountability and transparency in the hospital procurement, and in this way important in

avoiding conflict of interest. Another aspect is the effective enforcement and implementation of
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regulations embedded in the hospital’s policy which will help in establishing a deterrent impact

and guarantee integrity amid the process.

One weakness with regards to this case is that there might be an existing conflict of

interest within the management. There some officials that want to take advantage of some of the

hospital’s financial gaps to benefit themselves. I suspect that the huge variance in the companies

that supply the orthopaedic department with knee and hip implants. Since the surgeons are from

the same department, they should be working as a team. However, due to selfish reasons and

interests, they have resulted to working alone, something that the hospital is paying dearly by

losing up to $2.8 million every year.

Alternative Solutions and Recommendations

Integrity in the Sleepy Hallow General Hospital is important to the productive and

effective operation of the institution as well as long-term trust and principles in departments

(orthopaedic) such as accountability, openness, and transparency. There should be a distinct line

between private and public affairs. It should be understood that conflicts of interest are

categorized into two: monetary and non-fiscal interests. Pecuniary interest revolves around

pecuniary gain and may upshot from a member of the hospital’s staff accepting hospitality or

gifts, or receiving special offers for procurement deals. As for non-pecuniary interests, they do

not revolve around the financial aspect (Dewey, 2016). They may stem from family or personal

relationships, or indulgence in cultural and social activities.

Another potential solution to ensure sustainable development of the hospital is by

ensuring transparency, accountability, and efficiency in all hospital processes. Hospital

procurement is a vital component to the general achievement of growth objectives such as

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expanding hospital wards, hiring new medical professionals, and purchasing up to date

sophisticated medical machinery (Dewey, 2016). Effective hospital procurement processes lead

towards the effective management of hospital expenditure which can lead to the soundness of the

hospital’s management. Besides, the goal of hospital procurement is to provide quality and cost-

minimal medical supplies through fair and open transactions (Zuabi et al. 2016). The quality of

care provided at the hospital greatly depends on the quality of medical supplies and

infrastructures.

As aforementioned, the three key guidelines, among others, that are required for well-

managed and effective procurements of knee and hip implants by the orthopaedic department

are; transparency, accountability, and efficiency. These principles are outlined in international

best practices for health care (Zuabi et al. 2016). However, the overseeing the adoption of best

practices is a sensitive subject from the lens of practicality, hence, to achieve this, the three key

guidelines should be scrutinized against the hospital’s policies (Dewey, 2016). Efficiency in

hospital procurement is paramount to ensuring the best quality of care is administered to the

patients that come to Sleepy Hallow General Hospital to get their treatments. Unaccountability

diminishes the level of quality care at the hospital.

In fact, good practices in procurement procedures helps in cutting costs and produces

timely care. Lack of efficient procurement guidelines only leads to negative effects on

development agendas such as expansion of services (Zuabi et al. 2016). To add to this, it also

negatively affects professionalism and service delivery. Hospital procurement is expected to

make savings by improving efficiency, and that is where my role comes in. Strict standards and

regulations can facilitate procuring entities, such as the five orthopaedic surgeons, and suppliers

to work in harmony so that they can share the privileges of collaboration and innovation.
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Another important recommendation is legal intervention by the government so as to

protect the hospital against unethical and inappropriate acts in the procurement processes like

fraudulent supply companies (Dewey, 2016). The hospital should be keen on performance

measurements and stipulating proper assessment processes for all contracts, establishing

suppliers selection strategies that evade political interference, and institution of accountability

management policies to see to it that supplier and hospital departments such as the orthopaedic

one, work towards the betterment and improvement of the quality of care offered at the hospital

(Zuabi et al. 2016).

Conclusion

Finally, as the chief executive in charge of finance at the Sleepy Hallow General

Hospital, I insist that transparency is an essential part of saving the hospital’s funds by reducing

instances of conflict of interest. Also, departments should work together so that they can share

information about their supplies which can greatly save the hospital from incurring insignificant

expenses. If the orthopaedic department surgeons had worked in collaboration, the hospital

would have saved around $2.8 million of the expenses of knee and hip implants last year, which

is approximately 40% of the total amount spent.

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References

Dewey, J., PhD. (2016). Stark law. Salem Press of Health. Retrieved from Academic Search

Complete, EBSCOhost.

World Bank (2010). “Use of country procurement systems: Second Progress Report.”

Washington.

Zuabi, N., Weiss, L. D., & Langdorf, M. I. (2016). Emergency Medical Treatment and Labor Act

(EMTALA) 2002-15: Review of office of inspector general patient dumping settlements.

Western Journal of Emergency Medicine, 17(3), 245–251.

Doi:10.5811/westjem.2016.3.29705