Download to read offline
Expansion Proposal-Amante
- 1. Rehabilitation Center Expansion Proposalby Fatima Amante HCS 325 University of Phoenix
- 2. Our Beneficiaries Qualityand Cost ADLS and IADL’s Disabled Substance Abuse
- 3. Long Term CareCommunication Patient Centric Care Model Technology Implementation Performance Evaluation Quality Assessment
- 4. Patient Centric Model Streamline and Cost Reduction Quality Improvement Service at Point of Delivery High-Volume and Low Risk Services Cross-training 360° Feedback
- 5. Internal Stakeholders Patient-StaffRelationships Health Care Staff Physicians Nurses Human Resources Health Care Professionals Managers and Administrators
- 6. External Stakeholders PharmaceuticalVendors State and Federal Government (Medicaid and Medicare) Insurers Consumer Advocacy Groups Partners
- 7.
- 8. Facility Expansion Strategy Expansion Costs and Funding Human Resources and Staffing Salary and Placement Capital Budget Market Shares and Competition Competitive Advantage
- 9. Conflict Management EmotionalDimension Communication Avoidance Compromise Accommodation Collaboration Organizational Behavior Acute Sub-Acute Chronic Interminable
- 10. Manager’s Role inConflict Management Assess Conflict Identify Parties Involved Analyze Issue Evaluate Compromise or Resolve Facilitate resolution meets organizational policy
- 11. Ethics Tort Law Contract Law Medical Malpractice Patient Self-determination Power of Attorney and Guardianship Beginning and End of Life Care
- 12. Financial and HumanResource Sector Budget Equipment Expansion / Renovation Costs Hiring New Staff Interview time and duration Funding for new hire pay Schedule and Deadline of Expansion Training Internal Applicants
- 13. Environmental Factors IncreasingHealth Care Expenditures Physician Supply Patient Trust and Consent Economic Influence
- 14. Tracking Quality andProgress Performance Statistical Evaluation Statistical Process control Rollout and Implementation Continuous Quality Improvement Six Sigma
Editor's Notes
- #2 Image from https://www.uhpa.org/campus-specific/educational-seminars-on-long-term-care/
- #3 Long Term Care is a dynamically expanding service with a dramatic increase in our aging baby boomers. Long Term Care * continues to grow due to an increasing rate of aging baby boomers * 2030 67 million people over 65 number of people over the age of 85 also doubles due to higher life expectancy We must engage in the high demand of services as an opportunity to expand our services in the community and improve care delivery and quality. Patient value-based service is becoming more and more of a popular concept Rehabilitation is a much needed service in a growing demographic of mental / physical disability, substance abuse and aging patient. Health care expenditures in the US are very high due to higher demand in services and lack of funding or insurance especially for the elderly Image from http://southbridgecarehomes.com/long-term-care/safe-caring-secure-long-term-care/
- #4 The Patient Centric Care Model demonstrates streamlining of care by efficient communication of teams and performance management. Continuous Quality Improvement is mobilized by monitoring staff performance and patient evaluation of services Technological Implementation is also a competitive advantage for an efficient communication method of patient data/information, services provided, payee information, health history and many more. Quick easy diagnosis, prognosis times and physician and staff convenience New medical technology that enhance care services, although expensive, they are a good investment for care quality and gain patient trust, secure long-term reimbursement. Evaluating Staff performance and communicating accordingly between different levels of management and supervision, data can be delivered based on each department or units specialty and contribute to overall CQI (Buchbinder 2012) Image from http://www.aachonline.org/portals/36/Images/DocsAroundComputerRGB.jpg
- #5 Streamlining services will expand efficiency of services with team work fluidity and management of performance Teams will be evaluated in performance by statistical goals being met or not Teams will meet at least every two weeks to provide input with each others concerns, goals and coaching with emphasis in opportunities of improvement and progress. Employees are rewarded for top performance and employees with opportunities to improve are placed in focus for more intrinsic reward/ motivation Service at point of delivery enhances patient satisfaction and categorizing services when high volumes are ate hand by evaluating each priority patient Differing departments/ units with unique specialties collaborate to provide broader perspective of improvement for overall organizational CQI (Buchbinder 2012)
- #6 Patient-Staff relationships are the core of health care continuum and CQI Physician-patient relationships Availability Relationships with Staff especially with Nurses Pay and Efficiency of Services Nurse Shortages Nurses retire faster than the volume hired Balancing nurse work hours Job Burnouts Overworked Nurses Nurse-Patient Relationships Human Resources Determine time needed to acquire sufficient amount of staff and if budget friendly Training of new staff adds to cost Approval and Eligibility Evaluation Hiring support care staff such as Respiratory Technicians, Surgical Technicians etc. Managers and Administrators Execute, Control and Monitoring Performance standards and quality improvement, reassures stakeholders of expectations, capital, market share, and revenue management, strategic planning for continuous organizational survivability
- #7 Evaluation of efficient pharmaceutical drugs and cost of surplus purchases Return of Investment statistics Adhere to government regulation and policies to standard expectations and performance of organization for Medicaid and Medicare Coverage Manage documentation and electronic communication of patient insurers especially those provided by employers. Consumer Advocacy Groups payees assure safe, convenient, low-cost and high quality care provided by organizations that are funded. insurers have also implemented pay-for-performance programs based on various quality and customer service measures. Ensure organizational performance meets partner funding expectations such as partner hospitals and organizations.
- #8 Figure above from Buchbinder’s Intro to Health Care Management shows the essential components of strategic health care planning that constitutes the fluidity and efficiency of a plan. SWOT Analysis Market assessment complex and time consuming opportunities and threats Five Forces Model Power of the Healthcare Workforce supply and demand of healthcare providers Power of Consumers and Payers focus on patient-centric model, community needs, payer expectations and desired results. Technological Innovations Picture archive Communication System film imaging system reduce need for staff and increase in cost. Regulatory Environment liability reforms and care quality measures as influenced by medicaid and medicaid as well as care acts and other payers. Competitive Rivalry addressing competitive intelligence in monopolies and oligopolies and determine strategy to efficiently respond to organizational threats
- #9 Determining costs of new staff pay, training, equipment, renovation costs. Approval of funding and capital budget Determining quality equipment, staff and construction resources with a reasonable budget that won’t sacrifice quality. Expected Revenue and current reimbursement rates Determining areas with opportunity of improvement Current statistical performances Competitive advantages Opportunities of advantage in the Market and Market Share / Value Determine method of marketing and promotion of services Overall cost internal and external improvements
- #10 Conflict in the health care setting may not only impact the productivity and morale of the disagreeing individuals (e.g., physicians, nurses, technicians, administrative staff members),4 but also negatively affect patients and their family members if they interact with a demoralized or dis- enfranchised team member. Conflicts arise from Differences whether large or small Disagreement in values, motivations, perceptions, ideas or desires Trivial differences, Strong emotional influence from a deep personal need These needs could be to feel safe and secure, to feel respected and valued and for greater closeness and intimacy - ameliorate potential impact on patient care and safety low-intensity minor disagreements and high-intensity sabotage, litigation and all out war Trades of agreement and facilitation of managers (Simpao 2013) Image from http://conflictconsultantsnetwork.com/wp-content/uploads/2013/10/healthcare.jpg?width=127
- #11 Managers must influence a positive example on how employees can resolve conflicts especially when there’s a conflict of interest or involving organizational quality or improvement. Assessing the conflict is essential so as to avoid presumptions and allow each involved party to have an equal opportunity to assess their concerns when not emotionally compromised. Analyzing the issue and determining compromise or trade while facilitating that such exchanges meets organizational policy are essential Simpao suggests there are 5 ways to resolve conflict Competition Avoidance Compromise Accommodation Collaboration To successfully resolve a conflict, you will need to learn and practice two core skills: the ability to quickly reduce stress in the moment and the ability to remain comfortable enough with your emotions to react in constructive ways even in the midst of an argument or a perceived attack. • Understand what is really troubling other people • Understand yourself, including what is really troubling you • Stay motivated until the conflict is resolved • Communicate clearly and effectively • Attract and influence others
- #12 Tort Law regulates health care services an plays a very important role in conducting long-term care. Applying restrictions and policies are essential in running a fluid progress of expansion to avoid violation of government restrictions. Tort and Medical Systems Reform Negligence must be proven with root of causation Intentional Tort (assault, battery, false imprisonment, defamation of character, privacy invasion Infliction of Mental distress Health Care Power of Attorney HCPA/ Guardianship health care decision and full guardianship of patient ethical dilemma in how much families should spend or should they utilize patients assets to pay for care conflict between providers and guardian Patient Self-Determination Patients have ever right to decide whether to accept or deny care Otherwise can be decided by guardian if patient is unable to decipher comprehensively e.g. paralyzed, coma, dementia etc. (Buchbinder 2012) End-of-Life Decisions physician directives living wills HCPA allows patient to decide on wish concerning ventilators assistive cardiovascular device, feeding tubes, pacemaker etc. death with dignity how a chronically ill person is treated are based on the values of the country. (Austin and Wetle 2012)
- #13 Budget can affect the quality and availability of newly hired staff Determining new equipment costs and reliable vendors will have time and monetary investment needs as well Expansion and construction costs will depend on services acquired and vendors Realty agreements and reassuring government regulations of health care facilities and long-term care Hiring new staff will also add costs for training new staff with those who have experience since facility is originally short-term care Staff time investment of training will need strategic planning of how each team can efficiently communicate progress with trainees and executing organizational expectations of performance and productivity.
- #14 Since the passing of Medicaid and Medicare national health expenditures of GDP has increased by 6.3% 1960 to 16% in 2004 $6,289 per person. By 2009 GDP increased to 2.47 trillion or $8046 per person, 2013 3.02 trillion at $9505 per person. National Health Expenditures (Austin & Wetle 2012) More physicians are retiring than the count of physicians graduating Outsourcing IMG’s are partially sufficient especially at MUC’s but not enough to serve the growing rate of aging baby boomers Longer life expectancies from advancing medical technology and health improvements Patient privacy and trusting a new facility can be a challenge Demographic of the community must also be evaluated on the diversity of patients and cases to be served. Future Directions in Health Care Delivery rise of cost and demographics expansion of medicaid and access to purchase of premiums can increase patient count instead of having patients transferred from one facility to the other in order to balance staff shortage (Buchbinder 2012)
- #15 Stakeholder Determinant of Quality Assessment Technical Management clinical performance of HC providers Interpersonal Relationship Management coproduction care by patients and providers Amenities of Care patient in interest in individual well-being Ethical Principles providers autonomic interest in societal and organizational well-being health service quality is driven by both clinical and nonclinical processes Effectiveness providing services based on knowledge to those that benefit and can refrain from this not likely to benefit Efficiency avoid waste in equipment, supplies, ideas and energy Execute Six Sigma SIX SIGMA resource intensive tool best applied to important costly issues in key processes employee structured process called DMAIC Define mapping future organizational states, delimiting work scope Measure creation of metrics and application of determining progress Analyze breakdown of understanding process (flowchart) Improve specifies steps needed to achieve define step Control ensuring improvements are continuous or permanent (Buchbinder 2012) Image from http://www.execusist.com/wp-content/uploads/2013/05/quality-assurance.png References Buchbinder, S. B., & Shanks, N. H. (2012). INTRODUCTION TO HEALTH CARE MANAGEMENT. Jones and Bartlett Learning. Simpao, A. F., M.D. (2013). Conflict management in the health care workplace. Physician Executive, 39(6), 54-6, 58. Retrieved from http://search.proquest.com/docview/1492870510?accountid=35812 Anttila, K., & Moss, T. (1999). Eight steps to effective health care communications. Compensation & Benefits Management, 15(2), 31-37. Retrieved from http://search.proquest.com/docview/206606093?accountid=458 Jerry D. VanVactor, (2012) "Strategic health care logistics planning in emergency management", Disaster Prevention and Management: An International Journal, Vol. 21 Iss: 3, pp.299 - 309 Austin, A., & Wetle, V. (2012). The United States health care system, combining business, health, and delivery. (2nd ed.). Upper Saddle River, NJ: Pearson Education.