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Hospital report cites fiscal, morale problems

Half the employees at Tampa General Hospital fear reprisals if they make suggestions or express their feelings honestly. Four-fifths believe it is difficult to make needed changes at the hospital. Operating margins and available cash at the 971-bed hospital are lower than at comparable facilities, but expenses per patient are consistently higher. Yet, the management team at Tampa General has been effective, by and large, "in addressing the institution's most significant needs in the 1980s."

Those findings are among the hundreds of conclusions drawn by a $204,780 management audit of Tampa General Hospital commissioned by the Hillsborough County Hospital Authority five months ago. The 250-page report, delivered to the nine authority members Wednesday, will be presented to the full authority today by the Washington, D.C., consultant who compiled it, The Lash Group.

The completion of the consultant's report, which highlights serious staff morale problems, dovetails with a second attempt to seek approval for $3.1-million in salary increases, touted as necessary to remain competitive in the health care job market.

With three authority members absent from the meeting last month, the salary proposal died in a deadlocked vote. But the across-the-board salary proposal got a positive recommendation Monday from the authority's Finance Committee, and hospital officials say they think the authority likely will approve today.

The authority decided Sept. 19 to seek the management audit during a debate on a scheduled vote on leasing Tampa General to a private, non-profit corporation as a means of reducing the hospital's losses and making it more competitive. Authority member Frank Fleischer recommended postponing the vote and ordering the audit to determine if Tampa General president Newell France's administration had done everything possible to achieve financial stability at the hospital.

The Lash Group's study identifies several factors defined as being critical to the long-term viability of Tampa General, which faces future cash crunches because of an expanding responsibility for indigent care.

The hospital must "forge strong bonds with a core group of physicians" who have an allegiance to Tampa General, the study says, as well as nurture its relationship with the University of South Florida, whose medical residents train at the hospital.

Tampa General must manage its organizational structure more effectively, especially with regard to interdepartmental communication, the study suggests. That need is underscored by a survey in which more than half of those responding said it was difficult to get help from another department in the hospital.

Hinting at a need for privatization, The Lash Group concluded that the hospital must evaluate barriers to methods of generating new capital, and if necessary, eliminate those barriers. Some methods mentioned specifically included setting up joint ventures with private physicians and closing meetings and contract negotiations from public view.

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