Management of Children’s Hospital of Philadelphia


Children’s Hospital of Philadelphia is one of the most extensive medical facilities for pediatric care in the USA. Situated primarily in Pennsylvania, the hospital has a vast net of departments to admit patients from different parts of the country and abroad. In its structure, the hospital combines medical and surgical facilities and serves as a base for educating young doctors. The hospital embraces different specialties allowing it to admit all categories of young patients. Its breakthroughs in immunology and cancer treatment have been nationally acclaimed. The hospital has many rewards due to its exceptional medical performance and the management of the facilities that are the key elements of its achievements. This work looks upon the management of Children’s Hospital of Philadelphia and determines the main factors conducive to its success.

The mission of the Organization the Organization’s Strategy

The mission of the hospital centers around three main pillars of its work: fostering research into more effective cures for different diseases, teaching young doctors and preparing them for work within the best clinics in the country, and family-centered care. The hospital has large research facilities to allow its doctors to stay at the forefront of progress. Its Intellectual and developmental disabilities research center (IDDRC) will enable practitioners and scientists to share knowledge and engage all together in the development of new treatments. Moreover, IDDRC closely collaborates with other research centers around the country so that its researchers have access to the latest developments in their fields of interest. As a teaching facility for young doctors, Children’s Hospital of Philadelphia provides pediatric fellowship opportunities in most pediatric areas. The doctors have a unique opportunity to major in a chosen subspeciality working in a clinical environment under the supervision of the best clinical practitioners (Children’s Hospital of Philadelphia. Mission). Additionally, there is a Graduate Medical Education program aimed at the education of future medical leaders (Children’s Hospital of Philadelphia. Pediatric Fellowships). As a family-centered facility, the institution aims to improve children’s ties with relatives by working with parents and conducting educational work on how to communicate with children with deviant behavior and mental illnesses.

The Main Customer Base

The primary customer base consists of children who need medical consultations or treatment. The hospital offers pediatric and surgical treatment in all medical spheres, including intensive care unit, transplantation, and oncology programs. The hospital admits local children from Pennsylvania with all kinds of aches and children who require more complex treatment from all over the country and abroad. The customer base is vast as more children are asking for treatment at Children’s Hospital of Philadelphia than could be admitted at a given time.

The Key Competitors

Locally, Children’s Hospital of Philadelphia’s main competitors are UPMC Children’s Hospital of Pittsburgh and Penn State Health Children’s Hospital, the second and third largest and best-equipped hospitals in the state. Having the highest level neonatal intensive care unit and a Level I pediatric trauma center, the hospital competes nationwide with such hospitals as Dana-Farber Cancer Institute, Cincinnati Children’s Hospital Medical Center, Texas Children’s Hospital, Children’s National Hospital, and some others (Akard et al., 2021). Moreover, Children’s Hospital of Philadelphia has an international department where children with severe cases are admitted from all over the world. On a global scale, it competes with internationally acclaimed institutions as Birmingham Children’s Hospital NHS Trust in the UK, Women’s and Children’s Hospital in Singapore, and National Center for Child Health and Development in Japan.

Structure of Children’s Hospital of Philadelphia

The main hospital’s facilities are situated in University City on the campus of the University of Pennsylvania, which allows hospital practitioners to engage in the education of young doctors actively. This facility is one of the largest and is well equipped with all the necessary things for the treatment of children. Many divisions of Children’s Hospital of Philadelphia successfully operate off the hospital’s main grounds. These divisions include Children’s Seashore House, meant for rehabilitation, Buerger Center for Advanced Pediatric Care, Roberts Center for Pediatric Research, Saint Peter’s University Hospital, and some others (Children’s Miracle Network Pennsylvania). The hospital aims to expand further by building highly equipped medical facilities in different parts of the country.

The hospital CEO is Madeline Bell, who has started as a nurse at Children’s Hospital of Philadelphia and then moved into management. Her contribution to the hospital’s success can hardly be overestimated: she managed to set the largest pediatric ambulatory network in the country, developed many of the nationally acclaimed clinical programs, and attracted a number of grants for the hospital’s development (Madeline Bell, President, and CEO). When creating her executive team, she said: “With any big decision, I create a stakeholder map of the key people who need to be on board. […] I make it clear to people that they’re important to the process and they’ll be part of a win” (Botelho et al., 2017, p. 72). Her team has attracted the best doctors and researchers to the hospital and allowed the medical institution to receive many international awards.

Decision-making processes

The decision-making processes adopted by the executive team are rational decision-making and creative decision-making. Weighing all pros and cons, rational decision-making models are most effective when hospitals embrace new treatment standards or seek places for facilities expansion (Boland et al., 2019). Creative decision-making works in a field where there has been no similar experience and allows one to think of a completely new approach. Using this model, the executive team expanded the hospital’s pediatric ambulatory network across the country. In day-to-day operations, hospital staff relies on rational thinking since they deal with patients’ lives, and there is no place for an experiment (Boland et al., 2019). Carefully assessing the advantages and disadvantages of a chosen course of action, the executive team, together with doctors and researchers, find the best methods for patient treatment.

Implementation of Change

Several approaches are used for implementing change in Children’s Hospital of Philadelphia: the cognitive approach, the motivational approach, the reinforcement approach, and the social interaction approach. Within the cognitive approach, the executive team assesses new proposals to treatment from doctors and researchers, consults outside specialists and other healthcare institutions as to its effectiveness, and, based on collected information, makes a recommendation whether a new approach is feasible and should be used (Grol & Wensing, 2020). Within the motivational approach, the executive team sets a problem that should be solved and welcomes different proposals. After carefully assessing them and consulting with governmental bodies, the executive team may choose the best solution variant. The authors of the solution get monetary rewards. Within the social interaction approach, Children’s Hospital of Philadelphia learns about the most effective medical practices used for children’s treatment in other hospitals (Grol & Wensing, 2020). The management sees whether these practices have governmental approval and, after careful consideration, may recommend these practices for the hospital’s staff.

The executive team is responsible for deciding what changes will be made. However, these are doctors, nurses, technical specialists, and researchers who are responsible for carrying out the changes, depending on the field where these changes will be implemented. Communication plays a very important role in changes’ implementation since people adopt changes readily only if they understand the benefits of these innovations. That is why at Children’s Hospital of Philadelphia, weekly conferences are set to communicate the necessity of the proposed changes to the staff and outline the benefits of the proposed course of action. To see that the proposed changes are put into practice, the executive team uses the reinforcement approach, sanctioning employees who shy away from changes and rewarding those who are at the forefront of them.

Motivational Environment

Motivation is a key factor in enhancing employees’ performance in the healthcare system. The management of Children’s Hospital of Philadelphia uses a complex motivational system to keep the workforce content and happy. First of all, there is considerable support from supervisors who are open to discussion and are willing to advise on any situation (Afolabi, 2018). Secondly, performance-related issues, such as an increase in pay due to exceptional performance, boost employees’ performance. Among other factors, rewards to those medical workers who made a significant contribution to the treatment of patients, comfortable working environment, and career development can be named.

The effectiveness of the communication

The communication within Children’s Hospital of Philadelphia is rather effective. Managers organize weekly conferences with the staff to explain their ideas on the hospital’s development and welcome all sorts of questions. There is a supervision board within each department; supervisors are there to consult the staff (Howick et al., 2018). Moreover, there are regular cross-department meetings where heads of the departments can exchange ideas and find areas of mutual interest.

Communication with outside stakeholders aims to provide information to parents as to the possibilities of children’s treatment at the hospital; apart from a site, there is a phone number where parents may ask all questions concerning options of treatment at the hospital’s facilities. For international patients, information is available in Spanish and Arabic. Communication with outside organizations aims to exchange experience and promote new clinical standards through regular conferences and meetings.

Ethical Dilemmas

The ethical dilemmas Children’s Hospital of Philadelphia faces are somewhat challenging. First of all, it is the dilemma of health equality, since not every child can be admitted to a hospital, but only with medical insurance or on a payment. Apart from life-saving medical services, qualified help is often unavailable to children from low-income families. This situation runs counter to the doctor’s desire to provide medical assistance to everyone.

Since patients in critical conditions are often admitted to the hospital’s intensive care unit, another dilemma is how to inform parents about patients’ actual condition and prospects if they are not good. It is easier to keep silent about one’s prognosis and hope that it will not work out than see children’s parents collapse in agony at the doctors’ words. Moreover, the hospital admits many children with oncology whose chances to live are not very good, notwithstanding the best equipment and medicine. The issue of how to inform a child that he is about to die on their condition remains of the most challenging ethical dilemmas the doctor’s face (Bringedal, 2018). Moreover, the patient’s right to refuse treatment presents a complex issue for a doctor. When a patient refuses a necessary treatment for his wellbeing, the doctor faces a choice whether to insist or let the patient considerably worsens.

Today, in the COVID pandemic, the ethical dilemma the medical workers are likely to face is the shortages of medication and staff. Doctors will have to give preference to patients they are able to help. How this choice will be done and on what grounds is an issue that will have to be resolved, if the worst comes to the worst.

Sources of Employee Empowerment

Employee empowerment in the medical setting serves as a key factor of employee content since doctors want to make clinical decisions concerning their patients’ wellbeing. In Children’s Hospital of Philadelphia, the main source of empowerment is the delegation of responsibilities from upper management level to doctors who treat patients. Giving doctors a reasonable level of freedom in choosing appropriate treatment, managers make medical workers feel confident. The empowerment is conducted through regular communication with the staff, modeling real-life situations, and carefully explaining tasks to the workforce (Baird et al., 2018). Moreover, the level of accountability of empowered teams is high enough for managers to control the whole treatment process.

The Role of Technology

To perform complex operations and save lives, Children’s Hospital of Philadelphia is equipped with necessary medical equipment. With the help of medical equipment, prevention, diagnosis, and treatment of diseases are carried out. Thanks to new technologies, there is a constant improvement of medical equipment, an increase in its efficiency, and an increase in inaccuracy. This is especially noticeable in ophthalmology, endoscopy, laboratory diagnostics, surgery, and rehabilitation medicine.

X-ray technology is widely used in Children’s Hospital of Philadelphia, allowing doctors to take photographs of internal organs. A special technique of X-ray examination – tomography – makes it possible to take pictures of the layer lying at a certain depth of the examined organs: lungs, kidneys, etc. The doctors of Children’s Hospital of Philadelphia use one of the latest achievements of science and technology called biosensors – miniature devices that combine detectors and a computer. Such a biosensor can analyze dozens of blood components within a few seconds. This technique helps doctors to analyze the patient’s condition and diagnose the disease. All the equipment is regularly renovated thanks to donations and governmental support.


The management of Children’s Hospital of Philadelphia has played a major role in its becoming one of the country’s leading medical institutions for children. Due to the management’s strategy as well as including everyone into decision-making processes by delegating powers, the executive team managed to attract the best doctors and staff. Moreover, the hospital has become one of the leading research institutions within the country, where clinical and research bases are closely interconnected. Due to the effective communication with outside stakeholders, the management enhanced the hospital’s reputation, which allowed to attract foreign patients to the facilities and considerably increase money inflows. Being the center for innovation and research, the hospital remains one of the best facilities for children’s treatment across the globe.


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