Title
ABC/123 Version X
1
Case Study: East Chestnut Regional Health System
MHA/506 Version 2
11CASE STUDY:
EAST CHESTNUT REGIONAL HEALTH SYSTEM
History
Within the last 10 years, East Chestnut Regional Health System (ECRH) was formed from the merger of three organizations: the East River Medical Center, the Northern Mountain Hospital Consortium, and the Archway Hospital.
East River Medical Center (ERMC)
ERMC is the anchor hospital for the system. The medical center resides along the east side of the Chestnut River. Historically, ERMC was recognized as the location of choice for medical care. However, this reputation has deteriorated over the last 3 to 5 years. As the city of Chestnut has grown, ERMC has found itself on the edge of an urban blight. Safety has been a concern for patients, visitors, and physicians who use and serve the medical center. The technology offered at the medical center has been maintained at an excellent level of proficiency. At the same time, the medical staff is aging with the average age of the physicians being 57. There are younger primary care physicians who serve the specialists, but the specialists are aging as well. ERMC boasts a Level 1 Trauma Center with an air service. The total number of licensed beds for ERMC is 550. On any given day, the occupancy rate is 300 heads on the beds.
Northern Mountain Hospital Consortium (NMHC)
NMHC was originally formed in response to the migration of patients to Chestnut. Due to the rather aggressive strategies carried out by the hospitals in Chestnut, these rural hospitals decided to create a consortium of rural hospitals so that they could gain economies of scale in a number of areas, which include group purchasing, benefit administration, and physician and staff recruitment. Additionally, they worked together to stem any further deterioration of their market share. Patients were selecting to go to the larger community for services and leaving the smaller communities that collared the Chestnut metropolitan area. NMHC represented individual hospitals in four counties that circled Chestnut County: Walnut, Butternut, Oak, and Maple. Walnut and Butternut Counties had good employment with Oak and Maple Counties being mostly rural. In each county, the inpatient facilities averaged about 20 years of age. The upkeep of these facilities has been sketchy. No facility needs any major upgrades, but modernization is needed. The state does not have a Certificate of Need (CON) process. The medical staff makeup varies each location. The hospitals in Oak and Maple Counties are critical access hospitals. Further details will be provided regarding these organizations later in the case study.
Archway Hospital (AH)
AH is located directly in the community of Chestnut. It fully resides in the urban area of the community. The hospital has 200 registered beds, but on any given day there are only 50 to 75 patients in this facility. This hospital was a Doctor of Osteopathy (DO) hospital; the ...
Case Study - The Merger of Two Competing Hospitals This case hig.docxwendolynhalbert
Case Study - The Merger of Two Competing Hospitals
This case highlights the process of merging two fully accredited hospitals, both of which have a full complement of state-of-the-art diagnostic technology, including MRI and CAT scanners, 24-hour physician-staffed emergency care centers, and specialized women’s centers. Both of these facilities are located in a community of 60,000 in the southeastern part of Idaho.
The success of the merger hinges on the timely resolution of several issues that the executive staff implemented, mutually enhancing solutions in the areas of: (1) leadership, (2) culture adaptation, (3) human resource management, (4) staffing, and (5) benefit issues.
Overview
Hospital A: Porter Regional Medical Center (PRMC)
Located on the east side of town, Porter Regional Medical Center (PRMC) was a for-profit hospital, consisting of 110 hospital beds, 8 of which were reserved for transitional care. PRMC was a privately owned facility. Mountain Health Care (MHC), a large healthcare organization in the Rocky Mountain region, owned the facility. Built in 1990, the facility was designed to efficiently handle patient flow from the emergency room to the pharmacy and to be a point of referral for more complicated patient conditions. PRMC services consisted of general and same-day surgery and full-service rehabilitation and radiology departments. Other services included a kidney dialysis center, on-site retail pharmacy, a regional Red Cross blood bank, 24-hour laboratory, home health, Infusion/Home IV, and a women’s center, including obstetrics and numerous other amenities.
Other assets owned by PRMC were the adjacent medical office buildings, a day care center, the land on which an assisted living center was located adjacent to the hospital, and the sports medicine complex adjacent to the state university’s arena. These assets represented 188,000 square feet of facility space housed on 63 acres. The hospital employed 450 personnel.
Last year, the hospital’s operating budget was $34 million. However, in the same year, the hospital experienced a $1 million loss, and a projected $500,000 loss was anticipated for the following year. After three years of red ink, PRMC decided to liquidate.
Hospital B: Banner Regional Medical Center (BRMC) and Turner Geriatric Center
Built in 1951, Banner Regional Medical Center (BRMC), a county-owned hospital, was located on the west side of town. The hospital structure included 154 inpatient beds and a geriatric healthcare center that consisted of 100-106 beds, 15 transitional care beds, and 7 rehabilitation beds. A medical office building with a parking structure was located adjacent to the hospital. The campus consisted of 561,366 square feet of building space, housed on 6 acres. The hospital’s operating budget for last year was $79 million. BRMC had a reserve fund of $20 million earmarked for major renovations to the existing facility’s emergency room and intensive care unit. BRMC’s servi ...
P H Y S I C I A N L E A D E R S H I PHow to Find the Idea.docxkarlhennesey
P H Y S I C I A N L E A D E R S H I P
How to Find the Ideal
Chief Medical Officer
John Byrnes, MD, president and CEO, Byrnes Group LLC, Ada, Michigan
H ave you ever hired the wrong physician executive—a physician who was well respected and a superb clinician, but for some reason failed as a leader? We have
probably all been there. Unfortunately, this problem is all too common.
The fallout from bad hiring decisions can be costly. A failed hire costs hospitals
and healthcare systems not only the fee paid to the executive recruiter but also
severance pay (in many cases) and the expense of hiring a replacement. The total cost
can be well over $500,000 for a typical chief medical officer (CMO). Healthcare
leaders need to do everything possible to avoid these mistakes.
So how do we select highly effective physician executives who will be successful
leaders in our organizations?
M Y F O R M U L A F O R S U C C E S S
I have been a system CMO twice. In one of these positions, I was responsible for
hiring CMOs for three hospitals across the healthcare system. Each hospital was
unique, not only in culture but also in size and geographic location. A CMO who
would be perfect for one hospital might not be successful in another. Hiring three
CMOs with distinctive skill sets that matched the organizations' needs was no
small feat.
If you are in a similar position, I recommend three steps: (1) partner with
leadership to appoint a selection committee, (2) have the selection committee read
relevant literature, and (3) retain an experienced executive recruiter.
P a r t n e r W i t h L e a d e r s h i p t o A p p o i n t a S e l e c t i o n C o m m i t t e e
As a system CMO seeking to hire three hospital CMOs, I first partnered with the CEO
and other members of the C-suite at each hospital to appoint a selection committee
at the local site. Each committee was made up of C-suite executives and physician
leaders from throughout the hospital. Everyone on the committee had input during
the selection process, but the hospital CEO had the final word.
H a v e t h e S e l e c t i o n C o m m i t t e e R e a d R e l e v a n t L i t e r a t u r e
Selection committee members should read books and articles about physician
leadership. Everyone on my health system's selection committees read two books.
Developing Physician Leaders for Successful Clinical Integration (Dye & Sokolov, 2013)
contains valuable advice on selecting, developing, and mentoring physician leaders.
311
Journal of H ealthcare M anagement 6 1 :5 S eptember/ O ctober 2 0 1 6
It was perfect for our situation. The second book, Exceptional Leadership: 16 Critical
Competencies for Healthcare Executives (Dye & Garman, 2015), is a review of the
essential leadership competencies for healthcare executives. Dye and Garman (2015,
xiii) define competencies as "a set of professional and personal skills, knowledge,
values, and traits that guide a leaders performanc ...
Surname 1
Hospital Budgeting Ethics
Atia Hanson
ORG 6660 Fiscal Administration in Mental Health Care Systems
Instructor: Matthew Geyer
June 16, 2020
Hospital Budgeting Ethics
Ethics, EBM, and hospital management discuss how hospital management should use evidence base medicine (EBM) to solve ethical issues that they face daily. In 2003 when the article was written the authors say that EBM was relatively a new concept and that it would be a powerful tool to use to find solutions for the ethical issues for hospital management in the hospital setting. They also discussed the down side to using EMB. It is not always easy to deal with stake holders being hospital management, and EBM could allow stake holders to have the upper hand. Hospital management will always have ethical issues that will pertain to funding, quality of patient care, staff and issues dealing with the community. In the article it was discussed how Germany was switching over their hospital payment system to disease related group (DRG) and how EBM would be a benefit, and how hospital management would deal with the ethical issues that would arise and try to solve them.
The article clearly states that evidence base medicine would help hospital management with ethical issues in a hospital setting. The hypothesis of this article was the use of EBM was a tool that should be used to develop a more ethical foundation for hospital management. Biller-Andorno, Lenk and Leititis have defined and explained all key terms within the article so that it was easy to understand except for one important term.
Review of Literature
Biller-Andorno, Lenk and Leititis have cited sources for their article that were pertinent to the topic. The articles used were articles on evidence base medicine, ethics and hospital policy with many of these articles being published between 2000 – 2002. There were some that were published in the 1990’s. I did not find this article to broad or too narrow, the authors stayed on the topic presented. I must admit at first, I was lost when the authors presented the fact that Germany was changing their payment system I did not know how this was related to the topic. But as I read over the article again I realized that Germany was going to calculate the hospital budget on only DRGs. This could pose as an ethical issue for the hospital management because Biller-Andorno, Lenk and Leititis stated that this would lead to some hospitals that had high overhead from their emergency an intensive care units’ their resources would need to be cut. This will lead hospital managers to try to take money from other units and staff which has ethical implications cutting funds from one place and using them somewhere else.
The conclusion discussed how hospital management must address ethical issues. Biller-Andorno, Lenk and Leititis implied during the conclusion that the increase of using EBM in hospital management could become a tool used as a power .
Case Study - The Merger of Two Competing Hospitals This case hig.docxwendolynhalbert
Case Study - The Merger of Two Competing Hospitals
This case highlights the process of merging two fully accredited hospitals, both of which have a full complement of state-of-the-art diagnostic technology, including MRI and CAT scanners, 24-hour physician-staffed emergency care centers, and specialized women’s centers. Both of these facilities are located in a community of 60,000 in the southeastern part of Idaho.
The success of the merger hinges on the timely resolution of several issues that the executive staff implemented, mutually enhancing solutions in the areas of: (1) leadership, (2) culture adaptation, (3) human resource management, (4) staffing, and (5) benefit issues.
Overview
Hospital A: Porter Regional Medical Center (PRMC)
Located on the east side of town, Porter Regional Medical Center (PRMC) was a for-profit hospital, consisting of 110 hospital beds, 8 of which were reserved for transitional care. PRMC was a privately owned facility. Mountain Health Care (MHC), a large healthcare organization in the Rocky Mountain region, owned the facility. Built in 1990, the facility was designed to efficiently handle patient flow from the emergency room to the pharmacy and to be a point of referral for more complicated patient conditions. PRMC services consisted of general and same-day surgery and full-service rehabilitation and radiology departments. Other services included a kidney dialysis center, on-site retail pharmacy, a regional Red Cross blood bank, 24-hour laboratory, home health, Infusion/Home IV, and a women’s center, including obstetrics and numerous other amenities.
Other assets owned by PRMC were the adjacent medical office buildings, a day care center, the land on which an assisted living center was located adjacent to the hospital, and the sports medicine complex adjacent to the state university’s arena. These assets represented 188,000 square feet of facility space housed on 63 acres. The hospital employed 450 personnel.
Last year, the hospital’s operating budget was $34 million. However, in the same year, the hospital experienced a $1 million loss, and a projected $500,000 loss was anticipated for the following year. After three years of red ink, PRMC decided to liquidate.
Hospital B: Banner Regional Medical Center (BRMC) and Turner Geriatric Center
Built in 1951, Banner Regional Medical Center (BRMC), a county-owned hospital, was located on the west side of town. The hospital structure included 154 inpatient beds and a geriatric healthcare center that consisted of 100-106 beds, 15 transitional care beds, and 7 rehabilitation beds. A medical office building with a parking structure was located adjacent to the hospital. The campus consisted of 561,366 square feet of building space, housed on 6 acres. The hospital’s operating budget for last year was $79 million. BRMC had a reserve fund of $20 million earmarked for major renovations to the existing facility’s emergency room and intensive care unit. BRMC’s servi ...
P H Y S I C I A N L E A D E R S H I PHow to Find the Idea.docxkarlhennesey
P H Y S I C I A N L E A D E R S H I P
How to Find the Ideal
Chief Medical Officer
John Byrnes, MD, president and CEO, Byrnes Group LLC, Ada, Michigan
H ave you ever hired the wrong physician executive—a physician who was well respected and a superb clinician, but for some reason failed as a leader? We have
probably all been there. Unfortunately, this problem is all too common.
The fallout from bad hiring decisions can be costly. A failed hire costs hospitals
and healthcare systems not only the fee paid to the executive recruiter but also
severance pay (in many cases) and the expense of hiring a replacement. The total cost
can be well over $500,000 for a typical chief medical officer (CMO). Healthcare
leaders need to do everything possible to avoid these mistakes.
So how do we select highly effective physician executives who will be successful
leaders in our organizations?
M Y F O R M U L A F O R S U C C E S S
I have been a system CMO twice. In one of these positions, I was responsible for
hiring CMOs for three hospitals across the healthcare system. Each hospital was
unique, not only in culture but also in size and geographic location. A CMO who
would be perfect for one hospital might not be successful in another. Hiring three
CMOs with distinctive skill sets that matched the organizations' needs was no
small feat.
If you are in a similar position, I recommend three steps: (1) partner with
leadership to appoint a selection committee, (2) have the selection committee read
relevant literature, and (3) retain an experienced executive recruiter.
P a r t n e r W i t h L e a d e r s h i p t o A p p o i n t a S e l e c t i o n C o m m i t t e e
As a system CMO seeking to hire three hospital CMOs, I first partnered with the CEO
and other members of the C-suite at each hospital to appoint a selection committee
at the local site. Each committee was made up of C-suite executives and physician
leaders from throughout the hospital. Everyone on the committee had input during
the selection process, but the hospital CEO had the final word.
H a v e t h e S e l e c t i o n C o m m i t t e e R e a d R e l e v a n t L i t e r a t u r e
Selection committee members should read books and articles about physician
leadership. Everyone on my health system's selection committees read two books.
Developing Physician Leaders for Successful Clinical Integration (Dye & Sokolov, 2013)
contains valuable advice on selecting, developing, and mentoring physician leaders.
311
Journal of H ealthcare M anagement 6 1 :5 S eptember/ O ctober 2 0 1 6
It was perfect for our situation. The second book, Exceptional Leadership: 16 Critical
Competencies for Healthcare Executives (Dye & Garman, 2015), is a review of the
essential leadership competencies for healthcare executives. Dye and Garman (2015,
xiii) define competencies as "a set of professional and personal skills, knowledge,
values, and traits that guide a leaders performanc ...
Surname 1
Hospital Budgeting Ethics
Atia Hanson
ORG 6660 Fiscal Administration in Mental Health Care Systems
Instructor: Matthew Geyer
June 16, 2020
Hospital Budgeting Ethics
Ethics, EBM, and hospital management discuss how hospital management should use evidence base medicine (EBM) to solve ethical issues that they face daily. In 2003 when the article was written the authors say that EBM was relatively a new concept and that it would be a powerful tool to use to find solutions for the ethical issues for hospital management in the hospital setting. They also discussed the down side to using EMB. It is not always easy to deal with stake holders being hospital management, and EBM could allow stake holders to have the upper hand. Hospital management will always have ethical issues that will pertain to funding, quality of patient care, staff and issues dealing with the community. In the article it was discussed how Germany was switching over their hospital payment system to disease related group (DRG) and how EBM would be a benefit, and how hospital management would deal with the ethical issues that would arise and try to solve them.
The article clearly states that evidence base medicine would help hospital management with ethical issues in a hospital setting. The hypothesis of this article was the use of EBM was a tool that should be used to develop a more ethical foundation for hospital management. Biller-Andorno, Lenk and Leititis have defined and explained all key terms within the article so that it was easy to understand except for one important term.
Review of Literature
Biller-Andorno, Lenk and Leititis have cited sources for their article that were pertinent to the topic. The articles used were articles on evidence base medicine, ethics and hospital policy with many of these articles being published between 2000 – 2002. There were some that were published in the 1990’s. I did not find this article to broad or too narrow, the authors stayed on the topic presented. I must admit at first, I was lost when the authors presented the fact that Germany was changing their payment system I did not know how this was related to the topic. But as I read over the article again I realized that Germany was going to calculate the hospital budget on only DRGs. This could pose as an ethical issue for the hospital management because Biller-Andorno, Lenk and Leititis stated that this would lead to some hospitals that had high overhead from their emergency an intensive care units’ their resources would need to be cut. This will lead hospital managers to try to take money from other units and staff which has ethical implications cutting funds from one place and using them somewhere else.
The conclusion discussed how hospital management must address ethical issues. Biller-Andorno, Lenk and Leititis implied during the conclusion that the increase of using EBM in hospital management could become a tool used as a power .
Exploring Hospital-Physician Business Relationships: What Trustees Need to Knowjhdgroup
This monograph discusses the key role of the health care organization governing board in working with physicians to frame the value exchange between both parties in the context of the organization’s mission, goals and market position. Our findings and recommendations address:• Guiding organizations in moving beyond transactional relationships• Specific opportunities for hospital/physician collaboration• Building an infrastructure to enable collaboration
Career in Hospital Management and Administration.By.Dr.Mahboob ali khan Phd Healthcare consultant
There has been seen a remarkable growth in the hospital industry in India, which has lead to a great demand and popularity of the hospital management related courses. The requirement of professional administrators in the hospitals is growing briskly mostly because the nature of work in hospitals is quite different from other organizations. Hospitals are expected to deliver quality service 24 x 7 x 365.
Review the Southeast Medical Center case study found on page 92 of.docxjoellemurphey
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources. Write a three- to five-page paper (excluding title and reference pages) with your selected recommendations and justifications. The paper must be in APA format.
Southeast Medical Center Case Study Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources
In-Depth Case Study: Southeast Medical Center
The following case study involving a large organized delivery system exemplifies many of the issues described earlier in this chapter.
History and Evolution
Southeast Medical Center (SMC; a pseudonym) was established as a public hospital in the 1920s, just before the Depression. Located in the Southeast, a $1 million bond financed the 250-bed facility. Major expansion projects in the 1950s increased the hospital’s size to 600 beds. Formal affiliation with the local university’s College of Medicine residency program in the 1970s further expanded capacity. Thus, SMC became a public academic health center and subsequently assumed multiple missions of patient care, teaching, and research. Capital improvement programs were conducted during the 1970s, and in 1982, a massive renovation and construction project ($160 million) added 550 beds to the facility. In the 1980s, a 59-bed freestanding rehabilitation center was opened adjacent to the hospital, and a physicians’ office building was constructed next to the hospital. Medical helicopters were also acquired in 1989, expanding SMC’s trauma services. In addition to serving as a regional provider for trauma, SMC also furnishes burn, neonatal, and transplant care for the region.
Responsibility for governance of SMC has shifted over the years. In the early years of operation, a hospital board ran SMC. In the 1940s, the city was given direct control over the hospital. In the 1980s, the state legislature created a public hospital authority (to be appointed by the county commission) to govern the hospital. In the 1990s, the hospital’s board of trustees voted to turn operations of the hospital over to a private, not-for-profit corporation (501c-3), the SMC Corporation. However, oversight for charity care remained with the county’s hospital authority. The SMC Corporation is directed by a 15-member board of directors and essentially manages the organized delivery system through a lease arrangement with the county hospital authority.
Today, SMC is a private, not-for-profit academic health center that is accredited by JCAHO. It also serves as the ...
Review the Southeast Medical Center case study found on page 92 of.docxronak56
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources. Write a three- to five-page paper (excluding title and reference pages) with your selected recommendations and justifications. The paper must be in APA format.
Southeast Medical Center Case Study
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources
In-Depth Case Study: Southeast Medical Center
The following case study involving a large organized delivery system exemplifies many of the issues described earlier in this chapter.
History and Evolution
Southeast Medical Center (SMC; a pseudonym) was established as a public hospital in the 1920s, just before the Depression. Located in the Southeast, a $1 million bond financed the 250-bed facility. Major expansion projects in the 1950s increased the hospital’s size to 600 beds. Formal affiliation with the local university’s College of Medicine residency program in the 1970s further expanded capacity. Thus, SMC became a public academic health center and subsequently assumed multiple missions of patient care, teaching, and research. Capital improvement programs were conducted during the 1970s, and in 1982, a massive renovation and construction project ($160 million) added 550 beds to the facility. In the 1980s, a 59-bed freestanding rehabilitation center was opened adjacent to the hospital, and a physicians’ office building was constructed next to the hospital. Medical helicopters were also acquired in 1989, expanding SMC’s trauma services. In addition to serving as a regional provider for trauma, SMC also furnishes burn, neonatal, and transplant care for the region.
Responsibility for governance of SMC has shifted over the years. In the early years of operation, a hospital board ran SMC. In the 1940s, the city was given direct control over the hospital. In the 1980s, the state legislature created a public hospital authority (to be appointed by the county commission) to govern the hospital. In the 1990s, the hospital’s board of trustees voted to turn operations of the hospital over to a private, not-for-profit corporation (501c-3), the SMC Corporation. However, oversight for charity care remained with the county’s hospital authority. The SMC Corporation is directed by a 15-member board of directors and essentially manages the organized delivery system through a lease arrangement with the county hospital authority.
Today, SMC is a private, not-for-profit academic health center that is accredited by JCAHO. It also serves as the ...
Top Most Impactful Healthcare Leaders to Watch in 2023.pdfCIO Look Magazine
This edition features The Top Most Impactful Healthcare Leaders that are at the forefront of leading us into a digital future
Read More: https://ciolook.com/top-most-impactful-healthcare-leaders-to-watch-in-2023-may2023/
Running Head Organization and Management of a Health Care Facilit.docxtoltonkendal
Running Head: Organization and Management of a Health Care Facility
Running Head: Organization and Management of a Health Care Facility
Organization and Management of a Health Care Facility
Introduction
The organization that a health care facility can distinguish will determine its potential success and the longevity of that success because preparation, patience and organization are vital. Health care facilities are constantly changing, advancing and revamping. With this being a known unknown there is a major need for organization throughout the entire infrastructure of the organization. Organization is highly important because it allows for facilities to function and run smoothly with little to no confusion within each department acting as a well-oiled machine (Cruz, 2013 p.472). It is very difficult for a facility or organization to protect and flourish if there is no structure present. After witnessing first-hand the lack of proper structure and management take place, this caused a great deal of confusion from the upper management as they could not decipher the numerous departments’ primary responsibilities and this took a huge toll on their success. This particular lack of structure can and will decide an organizations fate if not fixed immediately. Healthcare facilities management must be in a sense bulletproof because of the many adversities which can and will arise as the healthcare realm changes. The healthcare realm changes and overlaps its previous methods for rules and regulations. This comes about due to the constant need for revitalization within the healthcare realm. If a facility lacks organization there is no structure and no sense of direction it will most likely fail. Of course there are spurts of success and lagging success for every healthcare facility today. But the elite healthcare facilities always find a way to revamp and restructure in order to flourish. The most important entity any facility or organization can acquire is the loyalty of its consumers. Loyalty has been proven to provide not only success but longevity of success for healthcare facilities and if health providers implement this type of atmosphere success is prominent.
Hospital Organizational Structure
In today’s’ world there is a major need for organizational structure, rules and regulations that not only govern the conduct within an organization but also protects customers’ rights and interests. The structuring of a hospital needs to be configured in a strategic way that will benefit all of its occupants regardless of what their economic and ethnic background might be. Without proper structure and legislation it’s highly difficult for a hospital to thrive within the healthcare realm. One will be able to recognize by the end of this reading a well-organized structured system for any hospital organization to thrive for many years to come and that is due to the proper planning, methods and steps that are outlined to const ...
Step 2 Grading Rubric EconomyTask descriptionComponents of .docxrjoseph5
Step 2 Grading Rubric: Economy
Task description
Components of the task
Total points
Major economic features
Current demographic and economic features:
What is the population of your country, its age and gender composition? (2 points)
What are the major natural resources and the major features of the economy? Is the economy driven by the export of minerals and raw materials, agriculture, significant industries, or a mixture of these? What are the main exports and imports? (5 points)
Which countries are its largest trading partners? Is the country a member of regional or continental African trading blocs? (3 points)
What are major livelihood strategies, formal and informal, in both rural and urban settings? In other words, how do people in your country make a living? (5 points)
15
Economic policies
How did colonial policies impact your country’s current economic conditions? (5 points)
How has domestic economic policy since independence shaped the country? (5 points)
How have international economic forces shaped your country’s economy? For example, has your country been impacted by World Bank or International Monetary Fund programs? Do international trade agreements impact your country? (5 points)
15
Basic economic conditions
What is the current Gross Domestic Product (GDP) and Gross National Product (GNP)? What is the significance of these numbers for the economy of this country? (3 points)
What is the unemployment rate? (I point)
What is the poverty rate? (I point)
What is the foreign debt? (I point)
What do all these different economic indicators show about the state of the economy in your country? (3 points)
9
Technology
To what extent are the Internet and mobile phones, including the mobile banking system, used in your country? Do these affect economic potential and how so? (4 points)
4
Conclusion
Using all the data and analysis you have done pertaining to the above questions, write a conclusion addressing the economic health of your country and analyze the main factors contributing to its current strengths and challenges. (3 points)
3
Other requirements
Referencing:Evidential Proof of sources used: Papershould be supported by evidence and quotations from sources. At least three sources with APA citation at the bottom of the report, Variation in selection of sources necessary (2 points). Full points for accurate use of APA in-text and reference list)
Organization of text: Well organized, detailed and logical/cohesive arguments addressing relevant issues.(2 points)
4
CASE 6
From Nothing to Something: Defining Governance and Infrastructure in a Small Medical Practice
Dea Robinson
Midtown Neurology was started by a single physician who had been practicing in the community for nearly 20 years. As the practice grew, it evolved from a “mom-n-pop” operation to a more complex model. The founding physician recruited four new neurologists to join and continue to help build the practice. Subseq.
This is a short presentation to accompany a collection of case studies and evaluations I did while pursuing my MBA.It covers a VERY brief description and comparison of the management aspect of healthcare and healthcare sciences.
INTEGRATED thought leaders Dr. William Jessee and Don Seymour share their insight and advice on the emerging pay/risk trend in today's evolving healthcare environment. This webinar coincides with their 3-part video series titled "Raising the Bar."
Module 1Module 2Module 3Module 4MHA506 - Health Care S.docxroushhsiu
Module 1
Module 2
Module 3
Module 4
MHA506 - Health Care System Organization
X
X
X
MHA507 - Health Care Delivery Systems
X
X
X
MHM525 - Marketing in Healthcare
X
MHM502 - Health Care Finance
X
MHM514 - Health Information Systems
X
MHM522 - Legal Aspects of Health Administration
X
Title: Organizational Structure and Functions
Common services or functions they can share
Blood banks; same blood banks can be used, in GAH, and in community clinic.
The pharmacy can also be one area that will be shared because they will need to bring the medicines that will be required (DeCoske, Tryon & White, 2011).
Operating rooms can also be shared between both sectors, and these will save money and resources.
Explain the organizational relationships between the structure blocks
Horizontal linkages; in these linkages, every person in the organization has an equal relationship (Talbot & Verrinder, 2010).
They are most needed when there is a need for coordination that is close in all the organization segments.
Vertical linkages; these linkages tie subordinates and supervisors together.
The supervisor is in charge of evaluating and providing guidance towards any improvement necessary.
How (if appropriate) will you integrate the services of physicians whose specialty is in geriatric treatment within the GAH /CC?
Geriatrics is a specialty that has its focus on older adults' health care with aim of promoting their health (Talbot & Verrinder, 2010).
There is no specific age for a patient to be under the care of a geriatric physician.
The first thing will be published on the hospital website about geriatrics. The second thing will be researching the best geriatrics in California.
Define the mission statement for the GAH and Community Clinic
The mission statement for Golden Age Hospital and the Community Clinic is a specialized facility for geriatric and education offers (Andrews, Jelley & Jelley, 2013).
It will also be focused on compassionate delivery of care that is client-cantered to the elderly population and the caregivers.
It is also aimed at expanding services according to the seniors at their residential places.
Prepare a simple organizational diagram, depicting the organizational structure (blocks) of the existing Mission Hospital (MVH), Children’s Hospital (CHOC), and the proposed Golden Age Hospital (GAH), and the community clinic (CC) (Harris, 2015).
C.E.O
Public Health Officer
Doctors
Workers
Nurses
Pharmaceuticals
Surgeons
Geriatrics
What is the recommended hospital size (number of beds)?
Taking into consideration the Orange County and its branches, the elderly population takes about 40 percent of the overall population (Epting, 2011).
This means that out of the people of 122, they represent 48.8.
This data depicts that, on average, Golden Age Hospital is recommended to have fifty beds.
What significant services/treatments will be offered based on your survey results at the ...
How to Start, Run and Manage a Hospital Successfully by Dr.Mahboob ali khan Phd Healthcare consultant
The purpose of this paper is to give a brief outline of the pre-planning and strategic thinking in which an entrepreneur might consider before investing in or starting up a new hospital in the developing world.
There are numerous examples of hospital startups that were ill-conceived or poorly planned and have resulted in either a hospital that was partially constructed and abandoned or were completed and within two years failed in profitability and now sit idle. Other examples exist of underperforming assets. What went wrong? What could the investors have done to decrease their investment risk and increase the chances of the hospital being successful?Globalization of Healthcare.
Running Head BENCHMARK ASSIGNMENT - SWOT ANALYSIS1 .docxtoddr4
Running Head: BENCHMARK ASSIGNMENT - SWOT ANALYSIS
1
BENCHMARK ASSIGNMENT - SWOT ANALYSIS
2
Benchmark Assignment - Swot Analysis
Institution affiliation:
Students name:
Date:
Purpose of conducting the analysis in the context of the scenario.
SWOT analysis is carried out to be able to identify and appraise the internal (strengths and weaknesses) and external (opportunities and threats) environments which affect the operations of the business. This enables the management to recognize factors that influence the functioning of the hospital and hence provide necessary information required to improve and identify the roadblocks to management and planning. SWOT analysis enables the organization to prepare for the opportunities available and exploit them fully, attempt to prevent risks and problems faced. Thereafter, the organization will be able to design reliable and trustworthy strategies during decision making process (Abdel-Basset et al 2018).
Analyze the limitations and advantages of conducting a SWOT analysis.
Advantages
SWOT analysis provides critical and essential information regarding the operations of the business enabling the management to understand the business dealing better. The organization will be able to maximize on areas they are good at(strengths),capitalize on the market niches available by exploring all avenues for continuity of its operations.conversely,the business will be able to deal with the weaknesses posed internally and view threats in different perspective understanding they are there to improve the company but not to bring it into its knees(Abdel-Basset et al 2018).Thereafter, the business will confidently establish its goals and strategies which are aligned with its vision and mission and work tirelessly to achieve the objectives.
Limitations of SWOT analysis
According to Abdel-Basset et al 2018, the analysis only mull over issues that encompasses Strengths, Weaknesses, Opportunities and Threats making it a challenge to deal with the unforeseen issues.Swot analysis categorically identify issues but do not offer solution to the concerns requiring the management to design work breakdown schedule to execute the implementation of the details of swot analysis. When using the SWOT, one is able to obtain several ideas and a lot of information which very few are helpful in the execution of the strategies.Similarly,the SWOT analysis does not provide choices to all the ideas collected making it difficult for the organization to identify which one will work best. SWOT analysis only presents what need to be done, or what posses’ challenges and the prospects of the business. This limitation will require the management to organize strategies and schedule to be followed to execute the contents of the analysis.
Table 1: SWOT Analysis
Stevens’s district hospital has employed for the past two years experienced special expe.
One way to improve your verbal communication is to own your thoughts.docxjuliennehar
One way to improve your verbal communication is to own your thoughts and feelings.
You-language
is a way of speaking that projects responsibility onto another person and tends to be judgmental.
I-language
, on the other hand, is a way of speaking that owns responsibility and is descriptive rather than judgmental. Study the following example:
You-language statement
I-language statement
"You make me so mad!"
"I feel very angry when you interrupt me when I'm telling a story."
Complete the following two parts of your written assignment in one Word document. First, show your skill at translating You-language messages into I-language messages. Secondly, apply this skill to your own communication.
Part 1
Translate the following
You-language
statements into
I-language
messages.
Sentences to be translated:
You are so selfish.
You don't understand a word I'm saying.
You are too nosy; mind your own business.
You totally humiliated me in front of our friends.
You never help me around the house.
Part 2
Think of a You-language statement that you find yourself using when you communicate with a friend, family member, spouse, or romantic partner. Compose a paragraph that explains the situation in which you have used this You-language message. Consider how you would translate this You-language statement into an I-language message.
.
One paragraphHas your family experienced significant upward or .docxjuliennehar
One paragraph:
Has your family experienced significant upward or downward mobility over the past three or four generations? How do you think your values and behavior might differ had you experienced the opposite pattern of mobility? How might it have been different had your family been of a different ethnic or racial origin?
One para:
One of the more interesting topics of study is the area of deviance and social control. Choose a form of deviance with which you are familiar (not necessarily something you’ve done, but something someone you know did) and discuss why society views that behavior as deviant and whether perceptions of that behavior have changed over time. Explain which theory of deviance you think works best for understanding the deviant behavior you’ve chosen to discuss
.
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Career in Hospital Management and Administration.By.Dr.Mahboob ali khan Phd Healthcare consultant
There has been seen a remarkable growth in the hospital industry in India, which has lead to a great demand and popularity of the hospital management related courses. The requirement of professional administrators in the hospitals is growing briskly mostly because the nature of work in hospitals is quite different from other organizations. Hospitals are expected to deliver quality service 24 x 7 x 365.
Review the Southeast Medical Center case study found on page 92 of.docxjoellemurphey
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources. Write a three- to five-page paper (excluding title and reference pages) with your selected recommendations and justifications. The paper must be in APA format.
Southeast Medical Center Case Study Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources
In-Depth Case Study: Southeast Medical Center
The following case study involving a large organized delivery system exemplifies many of the issues described earlier in this chapter.
History and Evolution
Southeast Medical Center (SMC; a pseudonym) was established as a public hospital in the 1920s, just before the Depression. Located in the Southeast, a $1 million bond financed the 250-bed facility. Major expansion projects in the 1950s increased the hospital’s size to 600 beds. Formal affiliation with the local university’s College of Medicine residency program in the 1970s further expanded capacity. Thus, SMC became a public academic health center and subsequently assumed multiple missions of patient care, teaching, and research. Capital improvement programs were conducted during the 1970s, and in 1982, a massive renovation and construction project ($160 million) added 550 beds to the facility. In the 1980s, a 59-bed freestanding rehabilitation center was opened adjacent to the hospital, and a physicians’ office building was constructed next to the hospital. Medical helicopters were also acquired in 1989, expanding SMC’s trauma services. In addition to serving as a regional provider for trauma, SMC also furnishes burn, neonatal, and transplant care for the region.
Responsibility for governance of SMC has shifted over the years. In the early years of operation, a hospital board ran SMC. In the 1940s, the city was given direct control over the hospital. In the 1980s, the state legislature created a public hospital authority (to be appointed by the county commission) to govern the hospital. In the 1990s, the hospital’s board of trustees voted to turn operations of the hospital over to a private, not-for-profit corporation (501c-3), the SMC Corporation. However, oversight for charity care remained with the county’s hospital authority. The SMC Corporation is directed by a 15-member board of directors and essentially manages the organized delivery system through a lease arrangement with the county hospital authority.
Today, SMC is a private, not-for-profit academic health center that is accredited by JCAHO. It also serves as the ...
Review the Southeast Medical Center case study found on page 92 of.docxronak56
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources. Write a three- to five-page paper (excluding title and reference pages) with your selected recommendations and justifications. The paper must be in APA format.
Southeast Medical Center Case Study
Review the Southeast Medical Center case study found on page 92 of the course text. Of the recommendations found on pages 100-101, select the three which you consider to be the highest priority/most important to the case. Justify your reasoning. Support your opinion with a minimum of two outside scholarly resources
In-Depth Case Study: Southeast Medical Center
The following case study involving a large organized delivery system exemplifies many of the issues described earlier in this chapter.
History and Evolution
Southeast Medical Center (SMC; a pseudonym) was established as a public hospital in the 1920s, just before the Depression. Located in the Southeast, a $1 million bond financed the 250-bed facility. Major expansion projects in the 1950s increased the hospital’s size to 600 beds. Formal affiliation with the local university’s College of Medicine residency program in the 1970s further expanded capacity. Thus, SMC became a public academic health center and subsequently assumed multiple missions of patient care, teaching, and research. Capital improvement programs were conducted during the 1970s, and in 1982, a massive renovation and construction project ($160 million) added 550 beds to the facility. In the 1980s, a 59-bed freestanding rehabilitation center was opened adjacent to the hospital, and a physicians’ office building was constructed next to the hospital. Medical helicopters were also acquired in 1989, expanding SMC’s trauma services. In addition to serving as a regional provider for trauma, SMC also furnishes burn, neonatal, and transplant care for the region.
Responsibility for governance of SMC has shifted over the years. In the early years of operation, a hospital board ran SMC. In the 1940s, the city was given direct control over the hospital. In the 1980s, the state legislature created a public hospital authority (to be appointed by the county commission) to govern the hospital. In the 1990s, the hospital’s board of trustees voted to turn operations of the hospital over to a private, not-for-profit corporation (501c-3), the SMC Corporation. However, oversight for charity care remained with the county’s hospital authority. The SMC Corporation is directed by a 15-member board of directors and essentially manages the organized delivery system through a lease arrangement with the county hospital authority.
Today, SMC is a private, not-for-profit academic health center that is accredited by JCAHO. It also serves as the ...
Top Most Impactful Healthcare Leaders to Watch in 2023.pdfCIO Look Magazine
This edition features The Top Most Impactful Healthcare Leaders that are at the forefront of leading us into a digital future
Read More: https://ciolook.com/top-most-impactful-healthcare-leaders-to-watch-in-2023-may2023/
Running Head Organization and Management of a Health Care Facilit.docxtoltonkendal
Running Head: Organization and Management of a Health Care Facility
Running Head: Organization and Management of a Health Care Facility
Organization and Management of a Health Care Facility
Introduction
The organization that a health care facility can distinguish will determine its potential success and the longevity of that success because preparation, patience and organization are vital. Health care facilities are constantly changing, advancing and revamping. With this being a known unknown there is a major need for organization throughout the entire infrastructure of the organization. Organization is highly important because it allows for facilities to function and run smoothly with little to no confusion within each department acting as a well-oiled machine (Cruz, 2013 p.472). It is very difficult for a facility or organization to protect and flourish if there is no structure present. After witnessing first-hand the lack of proper structure and management take place, this caused a great deal of confusion from the upper management as they could not decipher the numerous departments’ primary responsibilities and this took a huge toll on their success. This particular lack of structure can and will decide an organizations fate if not fixed immediately. Healthcare facilities management must be in a sense bulletproof because of the many adversities which can and will arise as the healthcare realm changes. The healthcare realm changes and overlaps its previous methods for rules and regulations. This comes about due to the constant need for revitalization within the healthcare realm. If a facility lacks organization there is no structure and no sense of direction it will most likely fail. Of course there are spurts of success and lagging success for every healthcare facility today. But the elite healthcare facilities always find a way to revamp and restructure in order to flourish. The most important entity any facility or organization can acquire is the loyalty of its consumers. Loyalty has been proven to provide not only success but longevity of success for healthcare facilities and if health providers implement this type of atmosphere success is prominent.
Hospital Organizational Structure
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Step 2 Grading Rubric EconomyTask descriptionComponents of .docxrjoseph5
Step 2 Grading Rubric: Economy
Task description
Components of the task
Total points
Major economic features
Current demographic and economic features:
What is the population of your country, its age and gender composition? (2 points)
What are the major natural resources and the major features of the economy? Is the economy driven by the export of minerals and raw materials, agriculture, significant industries, or a mixture of these? What are the main exports and imports? (5 points)
Which countries are its largest trading partners? Is the country a member of regional or continental African trading blocs? (3 points)
What are major livelihood strategies, formal and informal, in both rural and urban settings? In other words, how do people in your country make a living? (5 points)
15
Economic policies
How did colonial policies impact your country’s current economic conditions? (5 points)
How has domestic economic policy since independence shaped the country? (5 points)
How have international economic forces shaped your country’s economy? For example, has your country been impacted by World Bank or International Monetary Fund programs? Do international trade agreements impact your country? (5 points)
15
Basic economic conditions
What is the current Gross Domestic Product (GDP) and Gross National Product (GNP)? What is the significance of these numbers for the economy of this country? (3 points)
What is the unemployment rate? (I point)
What is the poverty rate? (I point)
What is the foreign debt? (I point)
What do all these different economic indicators show about the state of the economy in your country? (3 points)
9
Technology
To what extent are the Internet and mobile phones, including the mobile banking system, used in your country? Do these affect economic potential and how so? (4 points)
4
Conclusion
Using all the data and analysis you have done pertaining to the above questions, write a conclusion addressing the economic health of your country and analyze the main factors contributing to its current strengths and challenges. (3 points)
3
Other requirements
Referencing:Evidential Proof of sources used: Papershould be supported by evidence and quotations from sources. At least three sources with APA citation at the bottom of the report, Variation in selection of sources necessary (2 points). Full points for accurate use of APA in-text and reference list)
Organization of text: Well organized, detailed and logical/cohesive arguments addressing relevant issues.(2 points)
4
CASE 6
From Nothing to Something: Defining Governance and Infrastructure in a Small Medical Practice
Dea Robinson
Midtown Neurology was started by a single physician who had been practicing in the community for nearly 20 years. As the practice grew, it evolved from a “mom-n-pop” operation to a more complex model. The founding physician recruited four new neurologists to join and continue to help build the practice. Subseq.
This is a short presentation to accompany a collection of case studies and evaluations I did while pursuing my MBA.It covers a VERY brief description and comparison of the management aspect of healthcare and healthcare sciences.
INTEGRATED thought leaders Dr. William Jessee and Don Seymour share their insight and advice on the emerging pay/risk trend in today's evolving healthcare environment. This webinar coincides with their 3-part video series titled "Raising the Bar."
Module 1Module 2Module 3Module 4MHA506 - Health Care S.docxroushhsiu
Module 1
Module 2
Module 3
Module 4
MHA506 - Health Care System Organization
X
X
X
MHA507 - Health Care Delivery Systems
X
X
X
MHM525 - Marketing in Healthcare
X
MHM502 - Health Care Finance
X
MHM514 - Health Information Systems
X
MHM522 - Legal Aspects of Health Administration
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Title: Organizational Structure and Functions
Common services or functions they can share
Blood banks; same blood banks can be used, in GAH, and in community clinic.
The pharmacy can also be one area that will be shared because they will need to bring the medicines that will be required (DeCoske, Tryon & White, 2011).
Operating rooms can also be shared between both sectors, and these will save money and resources.
Explain the organizational relationships between the structure blocks
Horizontal linkages; in these linkages, every person in the organization has an equal relationship (Talbot & Verrinder, 2010).
They are most needed when there is a need for coordination that is close in all the organization segments.
Vertical linkages; these linkages tie subordinates and supervisors together.
The supervisor is in charge of evaluating and providing guidance towards any improvement necessary.
How (if appropriate) will you integrate the services of physicians whose specialty is in geriatric treatment within the GAH /CC?
Geriatrics is a specialty that has its focus on older adults' health care with aim of promoting their health (Talbot & Verrinder, 2010).
There is no specific age for a patient to be under the care of a geriatric physician.
The first thing will be published on the hospital website about geriatrics. The second thing will be researching the best geriatrics in California.
Define the mission statement for the GAH and Community Clinic
The mission statement for Golden Age Hospital and the Community Clinic is a specialized facility for geriatric and education offers (Andrews, Jelley & Jelley, 2013).
It will also be focused on compassionate delivery of care that is client-cantered to the elderly population and the caregivers.
It is also aimed at expanding services according to the seniors at their residential places.
Prepare a simple organizational diagram, depicting the organizational structure (blocks) of the existing Mission Hospital (MVH), Children’s Hospital (CHOC), and the proposed Golden Age Hospital (GAH), and the community clinic (CC) (Harris, 2015).
C.E.O
Public Health Officer
Doctors
Workers
Nurses
Pharmaceuticals
Surgeons
Geriatrics
What is the recommended hospital size (number of beds)?
Taking into consideration the Orange County and its branches, the elderly population takes about 40 percent of the overall population (Epting, 2011).
This means that out of the people of 122, they represent 48.8.
This data depicts that, on average, Golden Age Hospital is recommended to have fifty beds.
What significant services/treatments will be offered based on your survey results at the ...
How to Start, Run and Manage a Hospital Successfully by Dr.Mahboob ali khan Phd Healthcare consultant
The purpose of this paper is to give a brief outline of the pre-planning and strategic thinking in which an entrepreneur might consider before investing in or starting up a new hospital in the developing world.
There are numerous examples of hospital startups that were ill-conceived or poorly planned and have resulted in either a hospital that was partially constructed and abandoned or were completed and within two years failed in profitability and now sit idle. Other examples exist of underperforming assets. What went wrong? What could the investors have done to decrease their investment risk and increase the chances of the hospital being successful?Globalization of Healthcare.
Running Head BENCHMARK ASSIGNMENT - SWOT ANALYSIS1 .docxtoddr4
Running Head: BENCHMARK ASSIGNMENT - SWOT ANALYSIS
1
BENCHMARK ASSIGNMENT - SWOT ANALYSIS
2
Benchmark Assignment - Swot Analysis
Institution affiliation:
Students name:
Date:
Purpose of conducting the analysis in the context of the scenario.
SWOT analysis is carried out to be able to identify and appraise the internal (strengths and weaknesses) and external (opportunities and threats) environments which affect the operations of the business. This enables the management to recognize factors that influence the functioning of the hospital and hence provide necessary information required to improve and identify the roadblocks to management and planning. SWOT analysis enables the organization to prepare for the opportunities available and exploit them fully, attempt to prevent risks and problems faced. Thereafter, the organization will be able to design reliable and trustworthy strategies during decision making process (Abdel-Basset et al 2018).
Analyze the limitations and advantages of conducting a SWOT analysis.
Advantages
SWOT analysis provides critical and essential information regarding the operations of the business enabling the management to understand the business dealing better. The organization will be able to maximize on areas they are good at(strengths),capitalize on the market niches available by exploring all avenues for continuity of its operations.conversely,the business will be able to deal with the weaknesses posed internally and view threats in different perspective understanding they are there to improve the company but not to bring it into its knees(Abdel-Basset et al 2018).Thereafter, the business will confidently establish its goals and strategies which are aligned with its vision and mission and work tirelessly to achieve the objectives.
Limitations of SWOT analysis
According to Abdel-Basset et al 2018, the analysis only mull over issues that encompasses Strengths, Weaknesses, Opportunities and Threats making it a challenge to deal with the unforeseen issues.Swot analysis categorically identify issues but do not offer solution to the concerns requiring the management to design work breakdown schedule to execute the implementation of the details of swot analysis. When using the SWOT, one is able to obtain several ideas and a lot of information which very few are helpful in the execution of the strategies.Similarly,the SWOT analysis does not provide choices to all the ideas collected making it difficult for the organization to identify which one will work best. SWOT analysis only presents what need to be done, or what posses’ challenges and the prospects of the business. This limitation will require the management to organize strategies and schedule to be followed to execute the contents of the analysis.
Table 1: SWOT Analysis
Stevens’s district hospital has employed for the past two years experienced special expe.
Similar to TitleABC123 Version X1Case Study East Chestnut Regio.docx (20)
One way to improve your verbal communication is to own your thoughts.docxjuliennehar
One way to improve your verbal communication is to own your thoughts and feelings.
You-language
is a way of speaking that projects responsibility onto another person and tends to be judgmental.
I-language
, on the other hand, is a way of speaking that owns responsibility and is descriptive rather than judgmental. Study the following example:
You-language statement
I-language statement
"You make me so mad!"
"I feel very angry when you interrupt me when I'm telling a story."
Complete the following two parts of your written assignment in one Word document. First, show your skill at translating You-language messages into I-language messages. Secondly, apply this skill to your own communication.
Part 1
Translate the following
You-language
statements into
I-language
messages.
Sentences to be translated:
You are so selfish.
You don't understand a word I'm saying.
You are too nosy; mind your own business.
You totally humiliated me in front of our friends.
You never help me around the house.
Part 2
Think of a You-language statement that you find yourself using when you communicate with a friend, family member, spouse, or romantic partner. Compose a paragraph that explains the situation in which you have used this You-language message. Consider how you would translate this You-language statement into an I-language message.
.
One paragraphHas your family experienced significant upward or .docxjuliennehar
One paragraph:
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One para:
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one paragraph for each conceptoriginal workSocial Stratifica.docxjuliennehar
one paragraph for
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Note
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one page
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One page on one-page essay explaining Reid's critique of Hume's skepticism.
Plato
https://iep.utm.edu/plato/ (Links to an external site.)
Plato: The Republic: Allegory of the Cave (see Book VII)
https://iep.utm.edu/republic/
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Support your viewpoints from your readings and other appropriate outside sources, in APA format.
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One of the main political separations that divide people today is Li.docxjuliennehar
One of the main political separations that divide people today is Liberal versus Conservative. These two sides have very distinct views on many educational issues. Based on your assigned group, listed below by last name, describe the liberal and conservative perspectives on your specific educational issue
Multiculturalism (Last name begins with A-L)
What roles have these views played in either creating or shaping current educational policy?
.
One of the very first cases that caught Freud’s attention when he wa.docxjuliennehar
One of the very first cases that caught Freud’s attention when he was starting to develop his psychoanalytic theory was that of Anna O, a patient of fellow psychiatrist Josef Breuer. Although Freud did not directly treat her, he did thoroughly analyze her case as he was fascinated by the fact that her hysteria was “cured” by Breuer. It is her case that he believes was the beginning of the psychoanalytic approach.
Through your analysis of this case, you will not only look deeper into Freud’s psychoanalytic theory but also see how Jung’s neo-psychoanalytic theory compares and contrasts with Freud’s theory.
Review the following:
The Case of Anna O.
One of the first cases that inspired Freud in the development of what would eventually become the Psychoanalytic Theory was the case of Anna O. Anna O. was actually a patient of one of Freud’s colleagues Josef Breuer. Using Breuer’s case notes, Freud was able to analyze the key facts of Anna O’s case.
Anna O. first developed her symptoms while she was taking care of her very ill father with whom she was extremely close. Some of her initial symptoms were loss of appetite to the extent of not eating, weakness, anemia, and development a severe nervous cough. Eventually she developed a severe optic headache and lost the ability to move her head, which then progressed into paralysis of both arms. Her symptoms were not solely physical as she would vacillate between a normal, mental state and a manic-type state in which she would become extremely agitated. There was even a notation of a time for which she hallucinated that the ribbons in her hair were snakes.
Toward the end of her father’s life she stopped speaking her native language of German and instead only spoke in English. A little over a year after she began taking care of her father he passed away. After his passing her symptoms grew to affect her vision, a loss of ability to focus her attention, more extreme hallucinations, and a number of suicidal attempts (Hurst, 1982).
Both Freud and Jung would acknowledge that unconscious processes are at work in this woman's problems. However, they would come to different conclusions about the origin of these problems and the method by which she should be treated.
Research Freud’s and Jung’s theories of personality using your textbook, the Internet, and the Argosy University online library resources. Based on your research, respond to the following:
Compare and contrast Freud's view of the unconscious with Jung's view and apply this case example in your explanations.
On what specific points would they agree and disagree regarding the purpose and manifestation of the unconscious in the case of Anna?
How might they each approach the treatment of Anna? What might be those specific interventions? How might Anna experience these interventions considering her history?
Write a 2–3-page paper in Word format. Apply APA standards to citation of sources. Use the following file naming convention: LastnameFirstInitial_M2_A.
One of the great benefits of the Apache web server is its wide range.docxjuliennehar
One of the great benefits of the Apache web server is its wide range of OS and platform support. Apache will run on any Unix-like OS (e.g. Linux, Unix, Mac, Solaris, and Berkeley Software Distribution (BSD) and most Windows OSs).
If you could pick any OS to run Apache on, which would you pick and why?
Once you select the OS, be sure to discuss the specifics in the steps you would take to install Apache on the operating system
.
Criteria for grading
* Quality of Initial Posting
* Writing mechanics ( Spelling, Grammar, APA) and Information Literacy
.
One of the most difficult components of effective .docxjuliennehar
One of the most difficult components of effective management and leadership is uncertainty. Uncertainty exists everywhere in an organization. Each of the four functions of
management (planning, organizing, leading, and controlling) is affected by uncertainties that lie within an organization and its operations. However, many uncertainties that affect an
organization are external to the organization itself. These cannot always be controlled, but they must be planned for when possible, and adapted to when planning is not possible.
This final week contains a culmination of the concepts introduced throughout the course and is designed to help you think about future challenges involved in management.
Review previous resources as needed to prepare for your Signature Assignment.
Activity Resources:
No Activity Resource available.
Activity Description:
In a paper, discuss the following points:
1. Present an overall description of what management entails and how it is properly implemented in today’s fast paced business environment.
2. Describe and give examples of how the challenges managers face in today’s world are characterized by uncertainty, ambiguity, and sudden changes or
threats from the environment.
3. Describe the skills that are important for managers to have to be successful under these existing conditions.
4. Illustrate the qualities that are important to managers today to function under these conditions.
5. Relate the issues above to a scenario and assessment of yourself as a manager in 5 years. Include a vision of the organization you will be in and the role
you would like to play. Also include a discussion of steps you need to take to strengthen your skills to be successful in your desired managerial role.
Support your paper with minimum of five scholarly resources. In addition to these specified resources, other appropriate scholarly resources, including older
.
One of the high points of the campaign will be a look to the future .docxjuliennehar
One of the high points of the campaign will be a look to the future of Healing Hands Hospital. Mr. Wood asks you to help the public relations committee come up with some ideas that can be used in the campaign of community education.
Create a PowerPoint presentation
(4–6 slides)
outlining some options that the future may hold for Healing Hands Hospital. Include the following information in your presentation:
Future health care trends
Technologies
Innovations
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One of the most basic aims of human computer interaction has been sp.docxjuliennehar
One of the most basic aims of human computer interaction has been speech-recognition. The ability to talk to machines in common language, rather than through mechanical devices or artificial languages, has been a major desirable in business, education, government, and about every other field of endeavor. In the last few years, there have been enormous strides made by researchers and software engineers alike, and there are now effective products on the market that do a solid basic job. In fact, this particular text that you are now reading was entered into this course by your instructor using a voice-recognition program called Dragon Naturally Speaking. This entire paragraph was entered with only two errors that required correction.
As speech-recognition technology becomes more mature, it has been increasingly applied in many areas.
Assignment Expectations (50 points total)
After reading the course materials, prepare a paper discussing the following topics.
Discuss why HCI is important and has evolved to ensure that the needs of different kinds of users are taken into account in computer systems. Discuss the application of speech recognition as a tool for Human Computer Interaction
In this paper, please consider both current major issues in the field, and major future developments that hold promise.
Length:
Minimum 3–5 pages excluding cover page and references (since a page is about 300 words, this is approximately 900 –1,500 words).
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One of the most common workplace communication tools is a telephon.docxjuliennehar
One of the most common workplace communication tools is a telephone. What key principles should you keep in mind when conveying a message via phone versus communicating by email? Include a clear description of phone and email etiquette in your response.
Your response should be at least 200 words in length. You are required to use at least your textbook as source material for your response. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.
Anderson, L., & Bolt, S. (2011).
Professionalism: Skills for workplace success
(2nd ed., Pg. 82-84). Upper Saddle River, NJ: Prentice Hall.
.
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Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
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TitleABC123 Version X1Case Study East Chestnut Regio.docx
1. Title
ABC/123 Version X
1
Case Study: East Chestnut Regional Health System
MHA/506 Version 2
11CASE STUDY:
EAST CHESTNUT REGIONAL HEALTH SYSTEM
History
Within the last 10 years, East Chestnut Regional Health System
(ECRH) was formed from the merger of three organizations: the
East River Medical Center, the Northern Mountain Hospital
Consortium, and the Archway Hospital.
East River Medical Center (ERMC)
ERMC is the anchor hospital for the system. The medical center
resides along the east side of the Chestnut River. Historically,
ERMC was recognized as the location of choice for medical
care. However, this reputation has deteriorated over the last 3 to
5 years. As the city of Chestnut has grown, ERMC has found
itself on the edge of an urban blight. Safety has been a concern
for patients, visitors, and physicians who use and serve the
medical center. The technology offered at the medical center
has been maintained at an excellent level of proficiency. At the
same time, the medical staff is aging with the average age of the
physicians being 57. There are younger primary care physicians
who serve the specialists, but the specialists are aging as well.
ERMC boasts a Level 1 Trauma Center with an air service. The
total number of licensed beds for ERMC is 550. On any given
day, the occupancy rate is 300 heads on the beds.
2. Northern Mountain Hospital Consortium (NMHC)
NMHC was originally formed in response to the migration of
patients to Chestnut. Due to the rather aggressive strategies
carried out by the hospitals in Chestnut, these rural hospitals
decided to create a consortium of rural hospitals so that they
could gain economies of scale in a number of areas, which
include group purchasing, benefit administration, and physician
and staff recruitment. Additionally, they worked together to
stem any further deterioration of their market share. Patients
were selecting to go to the larger community for services and
leaving the smaller communities that collared the Chestnut
metropolitan area. NMHC represented individual hospitals in
four counties that circled Chestnut County: Walnut, Butternut,
Oak, and Maple. Walnut and Butternut Counties had good
employment with Oak and Maple Counties being mostly rural.
In each county, the inpatient facilities averaged about 20 years
of age. The upkeep of these facilities has been sketchy. No
facility needs any major upgrades, but modernization is needed.
The state does not have a Certificate of Need (CON) process.
The medical staff makeup varies each location. The hospitals in
Oak and Maple Counties are critical access hospitals. Further
details will be provided regarding these organizations later in
the case study.
Archway Hospital (AH)
AH is located directly in the community of Chestnut. It fully
resides in the urban area of the community. The hospital has
200 registered beds, but on any given day there are only 50 to
75 patients in this facility. This hospital was a Doctor of
Osteopathy (DO) hospital; therefore, most of the physicians that
worked out of this facility were DOs. The payer mix for this
hospital was heavily burdened with Medicare and Medicaid.
This payer mix composed nearly 85% of the reimbursement. The
facility is aging and needs considerable repairs. It is
3. questionable if it will be worth the investment in this facility.
Leadership and Organizational Culture
The original merger that created the East Chestnut Regional
Health System (ECRH) occurred 10 years ago. This merger was
between ERMC and AH. AH had a rather dynamic leader who
was about 57 years old at the time of the merger. The AH CEO
became the new President and Chief Executive Officer of ECRH
after the merger. Since this CEO had only worked in a smaller
organization, he had not experienced the cultural changes and
demands that occur after the merging of a large organization.
Additionally, he began to change the culture of the organization
such that decisions were made on a decentralized basis. He
trusted the management team at AH to do the right things and
make the right decisions with low supervision. However, the
Chief Operating Officer (COO) who was put in charge was
originally from AH but left 2 years after the merger with a new
COO being put in place. This COO developed a rather poor
reputation and was known to want to build his own empire at
AH and to be dishonest at times. This reputation created a
culture within the traditional AH that lacked a cohesive team
effort to create a system. This positioning of the COO was left
unattended by the President and CEO of ECRH since he was
actively pursuing the acquisition of NMHC. The hospitals of
NMHC were doing okay, but those in the consortium realized
that their ability to stand alone was becoming difficult in
today’s market. When the leadership of the consortium assessed
the market as to a partnership, they decided that ECRH would
be the best choice. The other option was to develop a for-profit
hospital that also resided in Chestnut. The leadership was
attracted to what they saw happen with AH. They liked that the
central leadership of the system allowed AH to continue on as
their own entity without a lot of centralized control.
By the time all of this was put together, the President and CEO
of ECRH was near retirement. He retired about three years after
all of the merger activity was complete. During those three
4. years, he became lax in his leadership role. ECRH deteriorated
in market share and profitability during this time. Upon his
retirement, the Board of ECRH performed a national search for
a replacement. They employed Hunter Brown as the new
President and CEO. Mr. Brown was the CEO of a smaller health
system and had been in that position for nearly 10 years.
Therefore, he had limited experience from other markets in the
art of strategic implementation. However, he was also well
trained, bright, and articulate in expressing his knowledge. He
has now been the President/CEO of ECRH for nine months.
As for the remainder of the leadership team for ECRH, there is
a newly hired corporate counsel. She has 15 years of experience
and is extremely competent in the work that she does.
The CEO also hired a new Chief Financial Officer. He has taken
good strides in managing the accounts receivable throughout the
system as well as extracting exceptional dollars from high
quality supply chain management.
The Chief Operating Officer (COO) is new and has three years
of previous experience from the same organization where the
CEO departed.
The Chief Medical Officer (CMO) has been retained from the
old leadership team. His reputation is excellent, and he works
well with other physicians, including the medical staff and the
employed physicians.
The Chief Nursing Officer (CNO) is three years away from
retirement. She is known for not getting along with the medical
staff and will always defend nursing when at times this is not
appropriate.
The Senior Vice President for Human Resources is competent
and respected by management and staff throughout the
organization.
5. The remainder of the leadership team was retained from the old
regime. This included information technology, employed
physician group leadership, marketing, human resources, and
other vice presidents or directors responsible for varying
service lines. It should be noted that the IT leadership is just
completing the implementation of the EPIC system. The future
for this team depends on how well the overall implementation of
the system goes. Likewise those in the marketing department
will need to be stellar in senior leadership advisement regarding
the marketing of complex issues that will be encountered ahead.
They have been told if marketing misses the target, then
replacements will occur within this department.
The new CEO inherited the management team of AH and
NMHC. For NMHC the organizational structure was left intact
with the COOs for each of the individual hospitals being
retained. It was agreed that this traditional structure would be
left intact for at least five years. This agreement was near its
end and the new CEO had plans to change the existing structure
as well as management. This change was being considered for
this year’s strategic plan development. Even if the structure of
NMHC was going to be changed to a more direct relationship
with corporate leadership, all of the existing COO’s would be
retained as they have performed well since the merger. As for
the COO of AH, he had been recently terminated. An interim
COO is now in place pending the board approved closure of this
hospital.
Competitive Assessment
ECRH was not the only provider of care in the community.
There was a for-profit hospital, Banford Medical Center (BMC),
that had been purchased by a large publicly traded for-profit
health system about 10 years ago. The for-profit health system
was the largest in the country. The CEO of this hospital was
good at optimizing performance as a result of the weaknesses of
ECRH and its leadership. He was an effective opportunist.
BMC has 400 registered beds with a current occupancy rate of
6. 85%. They have been effective at taking market share away
from ECRH. For each loss of service line market share by
ECRH, BMC has shown proportional gains. After the
acquisition of BMC, the for-profit immediately moved to build a
new facility. This new facility is located on the growing
wealthy edge of the community. Additionally, at the time that
this new facility was developed, the for-profit syndicated
ownership to the physicians. The highest level of syndication
occurred with the obstetrics and gynecology physicians in the
community. Therefore, women’s services deteriorated at ECRH.
It should be noted that this physician syndication occurred
before the Affordable Care Act was passed, which precluded
hospital ownership by physicians.
It is important that additional information is provided regarding
ECRH. ECRH recently purchased 100 acres of land across the
interstate from BMC. This land is located northwest of Chester.
The intention is to eventually build a new medical center on this
location. The initial planning of this land has occurred and it
has been approved to build a regional oncology center on this
site. The construction of the project is already underway with an
anticipated completion in 6 months.
In addition, ECRH has an orthopedic hospital attached to the
current ERMC site and a behavioral health hospital at this same
location. ECRH also has two ambulatory surgical centers that
are conveniently located on the growing northwest and
southwest side in the community. The one surgical center is
located on the 100 acre development site. The orthopedic
hospital has done well and has been listed in the top 100
orthopedic hospitals. However, the behavioral health hospital is
losing significant dollars, so the Board of Directors for ECRH
has decided to close down this hospital. ECRH has also
developed a joint venture imaging center with the radiologists.
This center resides across from a major shopping area in the
community. It is conveniently located near heavily populated
neighborhoods and shopping. The only downside is the location
7. is not close to physician offices that would refer to this center.
However, if a new facility is built on the 100 acres, which
would include physician offices, the imaging center will be in
an ideal location. Leadership is developing a free standing
emergency center on the 100 acre site, which is on the
northwest side of Chestnut.
The last competitive issue is the location of a medical school
and hospital in the city of Chestnut. The facility resides in a
downtown location. This medical school had been established
by the state nearly 45 years ago and is associated with
Greenbranch University. It mostly serves the indigent
community in Chestnut and the surrounding area. This academic
center has a rather negative reputation in the surrounding area.
There are four other medical academic centers in the state as
well as a medical center with a world renowned reputation.
There have been ongoing rumors that this world renowned
organization was planning on assuming the responsibility of the
Chestnut academic center. This change would substantially alter
the complexion of the local medical community if it were to
occur. Speed in ECRH dealing with some of its market issues is
an imperative.
Additional Market Information: Population Demographics
Chestnut County
· With 433,689 people, Chestnut County is the 6th most
populated county in the state.
· The largest Chestnut County racial/ethnic groups are
Caucasian (70.1%), African American (18.5%), and Hispanic
(6.5%).
· In 2015, the median household income of Chestnut County
residents was $41,777. However, 21.1% of Chestnut County
residents live in poverty.
8. · The median age for Chestnut County residents is 37.7 years
old.
· Employment is strong in Chestnut County. Unemployment
resides at 4.5%. Employer diversity is strong since the
community is not dependent on singular large employers.
Employment includes some high-tech jobs, general
manufacturing to support the automobile industry, and there is a
large university, Greenbranch University, located in the
community. The university has 25,000 students and offers most
majors, which includes engineering and nursing.
Walnut County
· With 42,537 people, Walnut County is the 57th most populated
county in the state.
· The largest Walnut County racial/ethnic groups are Caucasian
(89.8%), followed by Hispanic (7.2%) and African American
(3%).
· In 2015, the median household income of Walnut County
residents was $55,120. However, 10.8% of Walnut County
residents live in poverty.
· The median age for Walnut County residents is 39.8 years old.
Butternut County
· With 38,352 people, Butternut County is the 65th most
populated county in the state.
· The largest Butternut County racial/ethnic groups are White
(87.0%), Hispanic (9.5%), and African American (1.7%).
9. · In 2015, the median household income of Butternut County
residents was $50,663. However, 13.4% of Butternut County
residents live in poverty.
· The median age for Butternut County residents is 39.7 years
old.
Oak County
· With 37,120 people, Oak County is the 66th most populated
county in the state.
· The largest Oak County racial/ethnic groups are Caucasian
(93.3%), Hispanic (4.0%), and African American (1.1%).
· In 2015, the median household income of Oak County
residents was $42,492. However, 14.9% of Oak County
residents live in poverty.
· The median age for Oak County residents is 46.6 years old.
Maple County
· With 27,816 people, Maple County is the 79th most populated
county in the state.
· The largest Maple County racial/ethnic groups are Caucasian
(90.8%), Hispanic (7.1%), and African American (1.0%).
· In 2015, the median household income of Maple County
residents was $39,353. However, 15.4% of Maple County
residents live in poverty.
· The median age for Maple County residents is 48.2 years old.
10. · Both Oak and Maple Counties are rural with an older
population. Many patients have Medicare and Medicaid that
come from these two counties. Likewise the hospitals located in
each of these counties have been designated as critical access.
Like many rural counties, Oak and Maple have been blighted
with younger people using drugs, including methamphetamine.
Employed Physicians
ECRH employs 400 physicians throughout its system. The
breakdown for each location is as follows:
Chestnut County
· 135 primary care
· 100 specialists
Walnut County
· 40 primary care
· 10 specialists
Butternut County
· 30 primary care
· 12 specialists
Oak County
· 27 primary care
11. · 10 specialists
Maple County
· 25 primary care
· 11 specialists
There have been ongoing complaints from the newly recruited
physicians that their practices have not been marketed well;
thus, their patient volumes have been slow to grow.
Service Line Performance Information
The following is a list of bullet points regarding service line
performance by ECRH and issues of operational concern.
1. Women’s health services deteriorated significantly since the
syndication by Banford Medical Center. Obstetrical deliveries
are down 20% across the system. BMC has done an excellent
job of creating attractive facility and services for women. This
includes nurse navigation, women’s breast center, and a series
of other amenities. BMC has also started a neonatal intensive
care unit, which rivals the services of ECRH.
2. The cardiologists at ECRH are aging. This has been a
traditionally strong service for ECRH, but 50% of the
cardiologists will be retiring within the next 3 to 5 years. All
cardiologists who serve ERCH are employed by the health
system. Cardiology is a service that is gaining strength within
the Greenbranch Medical Center, particularly since they brought
in a renowned cardiologist to rebuild their program.
3. The orthopedic volumes are down 7%. ECRH does jointly
operate an orthopedic hospital with an independent orthopedic
group located in the community. There have been some internal
12. problems within the orthopedic group where the old guard of
orthopedic surgeons has forced a low retention with younger,
and to some degree better trained, surgeons. Retention is
becoming a growing concern regarding the status of this group
with consideration of ECRH hiring their own surgeons. The
joint venture hospital does not exclude other surgeons from
working in this hospital.
4. Emergency department (ED) volumes are down 5%. The
hospital uses an emergency physician group to supply
physicians to cover all of the EDs within ERCH. These
physicians are known for poor customer service and making
rude comments to patients who are self-pay or Medicaid.
5. The ambulatory visits and services are up 3%. This volume
increase is from the younger primary care physicians who have
been employed by ECRH. This young group of physicians has
become great support for ECRH and refer patients loyally to the
organization.
6. General surgery cases are down 4%. The aging surgeons are
starting to retire and it is difficult to recruit new surgeons to
replace past demand. Some of this work is going to Greenbranch
since they have good general surgeons.
7. The oncology services for ECRH have increased in volume
and revenue by 4%. ECRH’s development of the new oncology
center has created a magnet for referrals to the oncologists. The
oncologists are very enthusiastic about the development of this
new center and have begun to shift work to ECRH.
8. ECRH has the regional burn center. ECRH works with
Greenbranch Medical Center for training residence in the burn
setting. This includes the plastic and general surgeons. The
downside of this service is that it is losing money. A decision
has been made to close down this service with Greenbranch
13. starting their burn center.
9. ECRH is a Level 1 Trauma Center, and this designation has
been a historical positive for the system. The helicopter service
is well recognized by the community as well as first responder
professionals found in the region. They historically have been
top of mind for major trauma cases. The usage of this service is
down 5% since the for-profit has established a similar service.
BMC however only has a Level 2 Trauma Center. They have
worked diligently to acquire ambulance services in some of the
outlying communities. This has helped feed patients to BMC.
10. The ECRH Board of Directors decided to close down the
behavioral health hospital. It is uncertain where patients will be
able to receive inpatient care. An active out-patient service will
still be provided by ECRH.
Payer Mix
The payer mix for ECRH has deteriorated. The current inpatient
payer mix for the entire system is as follows:
· 55% Medicare
· 15% Medicaid
· 30% Commercial
There has been a long standing joint venture relationship with a
national insurance company for commercial insurance.
Administratively this venture has not developed as anticipated;
however, in some of the regional markets, the Chestnut Care
insurance has a strong presence. Of the 30% commercial pay,
20% is Chestnut Care based. The national insurance company in
the venture is Aetna. The next strongest product is Anthem. It is
the expectation of the CEO that Chestnut Care be leveraged and
positioned for growth.
14. The 15% Medicaid has helped the hospital gain additional
disproportionate share dollars, which does help the bottom line
of the hospital.
Historical Strategic Initiatives
Accountable Care Organization
When the Affordable Care Act was passed in 2010, ECRH
decided to get into the one-sided model of an accountable care
organization (ACO). This venture has not gone well, and ECRH
has decided to leave the ACO business. However, they are
concerned about the public image of this decision. The details
of the termination are under discussion with a need to determine
how to minimize the public perception of termination,
particularly since there was so much marketing of their getting
in this venture. The regulatory requirements of the government
regarding the timing of terminating an ACO venture further
complicate this decision.
Primary Care Medical Home
The employed primary care group has been active in
establishing accredited primary care medical homes within all
of the primary care offices throughout the ECRH system. This
initiative is a positive emerging strategy for ECRH. It has also
been an attractive draw for the family practitioners from
Greenbranch Medical Center residency program since
Greenbranch has established an accredited medical home for
their family practice residency program.
American Nursing Credential Center Status (ANCC)
15. ECRH has been working on becoming a magnet status for
ERMC. This work has stalled out as an initiative. Some of this
is due to the nursing leadership within ERMC. The CEO intends
to move this priority up in the organization’s goals.
Information Technology
ECRH has invested heavily in their information technology
infrastructure. This investment became a requirement just to be
able to gather the data needed for the ACO development. This
cost has become significantly greater than anticipated. ECRH
fully implemented EPIC as their core information technology
system. There have been implementation problems since the
ECRH was operating off of multiple systems before the decision
to consolidate to one platform. The implementation of EPIC
required considerable retraining for the staff and physicians.
Data conversions have gone well. The difficulties have been
more human-related relative to the effective use of the system.
One of the major issues has been the lack of ECRH not meeting
meaningful use requirements which has cost ECRH significant
lost revenue from not meeting these goals.
Legal Actions Pending for ECRH
Federal Trade Commission Investigation
With the merger and acquisition of NMHC, questions of
antitrust have been raised. In the service lines of cardiology and
oncology it has been found that ECRH controls 60% of the
cardiology market and 52% of the oncology market. Chestnut
Care in some markets has been strong in steering patient
volumes to ERMC. Union leaders for the varying trades were
instrumental in precipitating this investigation. At the time that
this issue was raised, the President and Executive Branch of the
federal government were very pro-labor, thus, their interest in
pursuing this matter.
16. As to the projected disposition of this case, it is anticipated that
a negative determination will be made due to the market share
control in oncology and cardiology. This could force ECRH to
divest their ownership in the Chestnut Care insurance venture.
Another option might be that certain hospitals of NMHC be
divested. It is not anticipated that both determinations would
occur. This case has cost ECRH considerable money to stave off
investigation of this allegation.
Predatory Collections and the Loss of Not-for-profit Tax Status
for NMHC
NMHC negotiated that they would continue to act
independently. The consortium leadership set policies that
included predatory collections for the patients that would be
served in the NMHC hospitals. In a recent evening news report,
an investigative reporter interviewed an elderly patient that had
her home taken from her to pay for her medical bills. This home
had been in her family for over 100 years. This story prompted
the state’s Attorney General’s Office to investigate the
predatory collection policies of ECRH and NMHC.
The state has already taken an aggressive stance to investigate
the status of not-for-profits not fulfilling requirements (e.g.,
charity care, research, and education). The state is in economic
trouble and is seeking revenue from wherever they can find it.
The outlook is dim regarding the anticipated final decision of
the Attorney General’s Office. If NMHC is required to pay
taxes, this would wipe out the bottom line for these hospitals
and many of the needed services supplied to the indigent
population by ECRH would be reduced or eliminated.
Faith & Main Consultants Report
Within the last year, ECRH contracted with Faith & Main to
study the market perception of their women’s services. The
following is a summation of the findings of Faith & Main.
17. Interest in a Women’s Center Crosses County Lines
· 36% of women in the service area would travel across county
lines to receive excellent women’s health services
· 72% of women in Chestnut County would consider using the
women’s services of East Chestnut Regional Medical Center
· Women in all counties were most interested in these services:
· Breast care
· General gynecology services
· Female doctors
· Services in one area
· Physicals for women
Interest in a Heart Care and a Health Information Line
· A physician approved source of information
· A nurse help line that could be a resource for women’s care in
heart health as well be a source for health navigation.
Clear Expectations Regarding Getting Appointments with Their
Primary Care Physician
· Women expect same-day appointments
· In the collar counties to Chestnut County, women ranked this
18. in the top 28.7%
· Chestnut County women ranked this in the top 37.7%
· Expectation of same-day appointments ranked highest for
women of childbearing age
· Percent expecting same-day appointments
· 42.9 % of Chestnut County women of childbearing age
· 31.3% of collar county women of childbearing age
· Willingness to be Seen by a Nurse Practitioner
Overwhelmingly “Yes”
· 75.7% of Chestnut County women of childbearing age
· 76.1% of collar county women of childbearing age
Respondents Expressed How Health Care Could Be Improved
· 24% of all Chestnut County women, and 26% of all collar
county women named adding more primary care doctors and
more children’s care with urgent care outranking any other
single topic.
Respondents of Childbearing Age Widely Represented in Study:
· 86% of women respondents of childbearing age in Chestnut
County had children under the age of 18
· 76% of women respondents of childbearing age in the collar
counties had children under the age of 18
19. Willingness to be seen by nurse practitioner was viewed as
favorable by those in this study.
This data from Faith & Main will be used to ramp up
improvements in the women’s services for ECRH.
Strategic Plan Goals for the Upcoming Year
· Women’s service line improvement
· Increase obstetrical deliveries by 20% over 3 years
· Establish nurse navigation system for the entire system
· Facility improvement and development for women’s services
· Improve access standards for women’s care
· Assist in the marketing of the implementation of the
consultant’s report regarding women’s services
· Oncology Center grand opening
· Mature the retail strategy with the primary care employed
physician group
· Assess the market impact of the lawsuits and develop
marketing strategy to counteract the negative impact if
decisions are made against ECRH
· Aggressively recruit new physicians to reduce the average age
of the medical staff and strategically enhance service line
development
· Use lean management processes to correct service issues found
20. in the ED. Improve ED visits by 6%.
· Review physician contracts to enhance physician service
performance
· Investigate the fast track ED concept
· Implement the free standing ED strategy
· Abandon the Accountable Care Organization (ACO)
· Re-establish relationships with regional emergency medical
services to raise the utilization of the medical air service.
Growth goal is to get back to the previous level of utilization
within 18 months
· Decision to close the regional burn unit and let those cases go
to the academic medical center
· Implement the decision to close the behavioral health services
of ECRH
· Implement the decision to close AH
CEO Instruction to Marketing Team
The marketing department for East Chestnut Regional Health
System will be asked to step up their game to develop a
marketing plan for the regional health system. The CEO has had
some concerns regarding the ability of the marketing department
to keep up with the rapidly moving strategic environment that
he has created. So he established a time line for the department
to develop a system wide marketing plan over the next six
weeks. The VP of marketing has been in all of the senior
leadership cabinet meetings so she is aware of all of the details.
Therefore, the learning curve regarding the institutional
strategic goals is of no concern.
The following are elements that the CEO wants in the marketing
plan.
21. 1. A consultant, Faith & Main, was used to test the impression
of the women in the key service markets for East Chestnut
Health System. The summary of the consultant’s report can be
seen above. The survey covered all aspects of women’s care.
The marketing department will need to develop a marketing
campaign to match the recommendations of the consultant’s
report.
a. It is recognized that the age span for communicating with
women consumers will be quite variable. On one end of the
spectrum you have the younger child bearing age women, next
are the women that are middle aged followed by women that are
pre-elederly then those that are elderly. Therefore, a
communication plan using social media to conventional
marketing techniques will be required.
2. A communication plan will need to be developed for the
closure of the regional burn center as well the exiting the
accountable care organization and the closure of the behavioral
health hospital.
3. A communication plan will be needed to deal with the closure
of AH.
4. A branding strategy will need to be developed to overcome
the current weak brand identity that is in place for the combined
ECRH entities.
5. Develop marketing strategy for new physicians being
recruited to the system. The ideal situation would be to have a
common identity for all marketing material. In the past the
marketing material has been local hospital based.
6. Develop marketing plan for the Primary Care Medical Home
strategy as well the retail strategy for the primary care network.