Feng Shui and the Restructuring of the Hospital Corporation: A Call for Change in the Face of the Medical Error Epidemic

Abstract

Feng Shui is the eastern art and science of being in harmony with your environment. Feng shui is a structural system designed to align an internal environment with the outside world. The concept of feng shui can be applied to institutions, as there is a need for an organization to be properly structured to meet internal and external objectives. In particular, the American hospital has undergone significant structural changes to both facilitate internal operations and to meet the demands of external constituencies. While the average hospital is now far more complex than in the past, the fundamental corporate model, the so-called "three legged stool," board, administration and medical staff, has remained much the same for many years. This essay considers the continuing viability of the basic legal structure of hospitals - the three legged stool - and to determine whether or not this legal framework retains its effectiveness in the current environment in which acute care institutions must function. The article considers whether hospitals can respond to pressures in the areas of patient safety and quality if they are locked into the traditional triad corporate legal model. The question can be framed as an analysis of whether the three legged stool allows hospitals to achieve the necessary internal efficiencies to face the external pressures being placed on the hospital. The discussion will examine major trends in hospital law that relate to quality of care concerns, and the ways hospitals have responded to quality pressures. The article will explore the implications of medical errors on hospital operations, and will consider the inadequacies of the three legged stool. The article will end with a consideration of how the hospital corporate legal model might be altered to improve current and future quality of care challenges.

Keywords: hospital efficiency, quality health care, hospital quality, legal structure of hospitals, hospital structure

JEL Classification: I18, K32, L00