Task 2/Service Line Development - General Case Scenario/CEO Position Overview.pdf Position Overview—CEO Trinity Community Hospital The CEO reports directly to the hospital’s board of trustees and has ultimate responsibility and accountability for the organization’s successful operation, growth, and development. Basic responsibilities include: 1) Organizing and overseeing an ongoing strategic planning process to ensure development and implementation of strategies that will ensure the hospital’s viability long into the future. The planning process should reflect a broad awareness of the community’s healthcare needs. 2) Ensuring that patient care is of consistently high quality and that the environment is safe for patients, visitors, and staff. 3) Ensuring that hospital operations are conducted in an efficient manner with emphasis on stewardship of hospital resources. 4) Ensuring that service excellence for patients and staff is a high priority. 5) Creating a positive learning environment for hospital and medical staff with emphasis on innovation and achievement. 6) Ensuring that the hospital is in compliance with all state and federal guidelines and that full accreditation by the Joint Commission and any other relevant accrediting agencies is constantly maintained. Task 2/Service Line Development - General Case Scenario/Trinity Community Hospital Board Profile.pdf T R I N I T Y C O M M U N I T Y H O S P I T A L — B O A R D P R O F I L E The hospital’s board is composed of six members from diverse backgrounds. The group agrees that there is a pressing need for new strategies to ensure the organization’s future success, but there is not always agreement on specific program priorities. T R IN IT Y C O M M U N IT Y H O S P IT A L— B O A R D P R O F ILE Mr. John Printer, Chairman Mr. Printer is a native of the community. He holds a degree in business administration from a local college and is the owner of a very successful communications business. His family has a long association with Community Hospital and he is committed to its success. Mr. Printer has excellent interpersonal skills and is adept at managing disagreement. T R IN IT Y C O M M U N IT Y H O S P IT A L— B O A R D P R O F ILE Mrs. Cathy Promo Mrs. Promo is a Chicago native. She holds an undergraduate degree in marketing. Mrs. Promo has lived in the community for seven years and is director of marketing for a local utility company. While she has limited knowledge of healthcare delivery, she is quite involved with the local chamber of commerce and recognizes the importance of good healthcare services in attracting new business and industry to the area. Mrs. Promo believes that extensive marketing and advertising would likely reverse the hospital’s downward utilization trend. T R IN IT Y C O M M U N IT Y H O S P IT A L— B O A R D P R O F ILE ...

1. Task 2/Service Line Development - General Case Scenario/CEO
Position Overview.pdf
Position Overview—CEO Trinity Community Hospital
The CEO reports directly to the hospital’s board of trustees and
has ultimate
responsibility and accountability for the organization’s
successful operation,
growth, and development. Basic responsibilities include:
1) Organizing and overseeing an ongoing strategic planning
process to ensure
development and implementation of strategies that will ensure
the hospital’s
viability long into the future. The planning process should
reflect a broad
awareness of the community’s healthcare needs.
2) Ensuring that patient care is of consistently high quality and
that the
environment is safe for patients, visitors, and staff.
3) Ensuring that hospital operations are conducted in an
efficient manner with

2. emphasis on stewardship of hospital resources.
4) Ensuring that service excellence for patients and staff is a
high priority.
5) Creating a positive learning environment for hospital and
medical staff with
emphasis on innovation and achievement.
6) Ensuring that the hospital is in compliance with all state and
federal guidelines
and that full accreditation by the Joint Commission and any
other relevant
accrediting agencies is constantly maintained.
Task 2/Service Line Development - General Case
Scenario/Trinity Community Hospital Board Profile.pdf
T R I N I T Y C O M M U N I T Y H O S P I T A L — B O A
R D P R O F I L E
The hospital’s board is composed of six members from diverse
backgrounds.
The group agrees that there is a pressing need for new strategies
to ensure the
organization’s future success, but there is not always agreement
on specific
program priorities.

3. T
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4. A
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Mr. John Printer, Chairman
Mr. Printer is a native of the
community. He holds a degree in
business administration from a
local college and is the owner of a
very successful communications
business. His family has a long
association with Community
Hospital and he is committed to its
success. Mr. Printer has excellent
interpersonal skills and is adept at
managing disagreement.
T
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C

5. O
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6. Mrs. Cathy Promo
Mrs. Promo is a Chicago native. She
holds an undergraduate degree in
marketing. Mrs. Promo has lived in
the community for seven years and
is director of marketing for a local
utility company. While she has
limited knowledge of healthcare
delivery, she is quite involved with
the local chamber of commerce
and recognizes the importance of
good healthcare services in
attracting new business and
industry to the area. Mrs. Promo
believes that extensive marketing
and advertising would likely
reverse the hospital’s downward
utilization trend.
T
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C
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M

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Mrs. Maria Lopez
Mrs. Lopez is a native of Mexico
but has lived in the community for

8. nine years. She holds an
undergraduate degree in
journalism and owns a small
newspaper that is quite popular
throughout the Latino community.
One of Mrs. Lopez’s priorities is
ensuring that adequate healthcare
services are available to all minority
groups.
T
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Mr. Robert Holland
Mr. Holland holds a CPA and works
for a local accounting firm. He is a
native of New York and has lived in
the community for five years. Mr.
Holland is quite interested in
national healthcare policy and
legislation, particularly as related
to healthcare finance, and
communicates frequently with the
hospital CFO.

10. T
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Dr. David Joint
Dr. Joint is an orthopedic surgeon
and a native of the community. He
has privileges at Community
Hospital but does little work there.
His group is planning to open a
branch office near the hospital
campus. Dr. Joint believes that
government has become far too
involved with healthcare delivery
and frequently comments that
physicians and hospitals are no
longer free to act in the best
interest of patients.
T
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12. O
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13. Dr. Randy Sharp
Dr. Sharp is a general surgeon. He
is a native of Georgia but has lived
in the community for fifteen years.
Dr. Sharp holds privileges at the
hospital and does much work
there. He has a keen interest in
cancer services and his group is
planning to recruit a subspecialty-
trained oncologic surgeon.
Task 2/Service Line Development - General Case
Scenario/Trinity Community Hospital Brochure.pdf
Trinity Community
Hospital
A Patient Centered Facility
Our MISSION at Trinity Community Hospital is to
provide quality healthcare for all those in need of
assistance
Trinity’s Commitment— We are committed to
serving the community in a capacity that permits
every patient to receive the care and support that

14. they require.
Quality and Safety— At Trinity Community
Hospital we endeavor to provide high quality
services while ensuring the safety of patients,
visitors, and staff.
Service Excellence— We will continue to strive to exceed the
service
expectations of our patients, visitors, employees, and
physicians.
Staff Achievement— We will provide opportunities for the
enhancement of
the skills and expertise of all staff members.
Growth and Profitability— We are striving to grow service
volume, to operate
efficiently, and to generate sufficient capital for investment.
“One of the things I keep learning is that the secret of
being happy is doing things for other people.”
- Dick Gregory
WHAT SETS US APART
Trinity Community Hospital is a 150-bed, not-for-profit
hospital offering a broad range of
medical, surgical, and support services to the community.

15. Our patient-friendly, pleasant environment truly sets us apart.
Each room is furnished with
recliners and sofa sleepers, Wi-Fi internet access, cable TV and
video distribution, a private
bathroom, and custom built cabinets that conceal medical hook-
ups and equipment.
Large windows, ample sunlight, natural woods, warm colors,
and tranquil views of our
expansive landscape facilitate a soothing environment to assist
and ease patient recovery.
Trinity’s Gift shop offers unique, one-of-a kind gifts and
stunning flower arrangements as well
as an array of cards and personal miscellany.
Trinity offers the patients and guests alike nourishing and
delectable cuisine prepared and
directed by the world renowned Russian Dietitian and Chef
Katarina Novikov. Guests may eat
in the Bistro/Café or may order meals to be delivered by room
service to a family member’s
hospital room.
Our emphasis on providing exceptional care and services to our
patients through our
outstanding employees and medical staff members distinguishes
us from other healthcare
facilities.

16. Features of Trinity Community Hospital
Full Joint Commission accreditation
Broad range of medical/surgical services including: internal
medicine, geriatrics, general
and thoracic surgery, pulmonology, gastroenterology, urology,
otolaryngology,
neurology, gynecology, orthopedics, and consulting cardiology
Modern, high-tech laboratory, radiology, pharmacy, and
physical and respiratory
therapy departments
Surgery and endoscopy suites providing the newest digital
equipment; robotic surgery
Newly renovated patient rooms with homelike ambience
Award-winning dietary department
Nursing staff known for clinical expertise and patient care
Highest patient satisfaction scores in the region; over 93% of
inpatients and outpatients
would recommend us to family and friends
Medical staff 100% board certified in their respective fields
Physician locater service to help you find the right physician
for your needs
“Success is the sum of small efforts, repeated

17. day in and day out.”
-Robert Collier
Task 2/Service Line Development - General Case
Scenario/Trinity Community Hospital Fact Sheet.pdf
Trinity Community Hospital Fact Sheet
Community Hospital is a 150-bed facility located in the
southeast United States.
Services available include internal medicine, pulmonary
medicine, gastroenterology,
urology, otolaryngology, general surgery, thoracic surgery,
gynecology, and neurology.
The obstetrics service was phased out earlier this year when the
anchor physician group
relocated to a competing hospital, but several gynecologists still
admit patients. The
hospital’s reputation is reasonably good, but it is not known for
excellence in any
specific service. Perhaps its greatest strength is a competent,
dedicated nursing staff
committed to outstanding patient care. Information from
community focus groups
reveals that the public discerns no clear direction for the
organization’s future growth
and development. A strategic plan targeting oncology,
orthopedic, and cardiovascular
care has been developed. A brief overview of the plan appears

18. later in this document.
There is no formal oncology, orthopedic, or cardiology
programs even though a few
orthopedic surgeons and cardiologists maintain privileges at the
hospital. While no
cancer specialists practice at the hospital, a group composed of
eight medical
oncologists and two radiation oncologists has expressed interest
in an affiliation to
develop a new cancer program. The community’s premier
orthopedic groups are
located quite close to competing facilities making it
inconvenient for them to perform
more than occasional surgeries at Community Hospital, but
several practices are
planning to open branch offices near the hospital campus.
Cardiologists on staff restrict
their activity to performing consults for physicians whose
patients have been admitted
to the facility. Since there is no diagnostic cath lab, they order
only noninvasive studies
such as echocardiograms, stress tests, and holter monitoring.
Many surgeons on staff
often comment that patients prefer competing facilities because
they offer more
sophisticated cardiac back-up capability.
The hospital is licensed for 150 beds—136 medical/surgical—
plus a 14-bed intensive
care unit. There are 20 operating rooms and an emergency
department. All basic
support services are available including laboratory, radiology,
pharmacy, physical
therapy, and respiratory therapy. In addition to basic X-ray, the
radiology department

19. has two CT scanners and one MRI scanner. It also offers nuclear
medicine and
ultrasound services. A mobile PET scanner is available two days
per week, but is poorly
utilized.
Medical Staff—The hospital’s medical staff is composed of
numerous specialties and all
physicians are board certified. Most staff members hold
privileges at one or both
competing hospitals in the county.
Family Medicine 13
Internal Medicine 14
Geriatrics 2
General Surgery 9
Thoracic Surgery 2
Gynecology 3

20. ENT 5
Urology 6
GI 12
Pulmonary 5
Cardiology 4
Radiology 6
Pathology 2
Emergency 6
Total 89
Facilities—Community Hospital is located on an attractive 25-
acre campus easily
accessible from all major roadways. In addition to the main
hospital, there are four
medical office buildings (MOBs) each containing 60,000 square
feet of space. Most of
the office space is leased to private physician groups. One of
the MOBs houses the
hospital’s outpatient imaging and laboratory services.
Hospital constructed 25 years ago
Inpatient units recently renovated
Ancillary services except physical therapy have room to expand

21. MOB 1 has 15,000 square feet of vacant space
Campus can accommodate an additional MOB of up to 60,000
square feet
Should the hospital decide to develop cancer and cardiovascular
services, vacant space
in MOB 1 is suitable for medical and radiation oncology; and
there is adequate space in
the main hospital for two cardiac catheterization labs. A new
15,000-square-foot
physical therapy/rehab center to support orthopedic program
development would have
to be constructed on campus, purchased adjacent to campus, or
leased adjacent to
campus. Though the campus will accommodate another MOB,
space for future
development could be strained.
Utilization Trends—Utilization of Community Hospital has
declined steadily over the
past three years. The loss of the OB program and erosion of
general surgery volumes
accounts for most of the downward trajectory.
2 Years Prior 1 Year Prior Current Year
Discharges 7,100 6,700 6,100
ALOS 4.0 4.1 4.3

22. Patient Days 28,400 27,470 26,230
ADC 77.8 75.3 71.9
Surgeries 12,500 11,800 10,950
OP Visits 95,000 90,800 89,400
ED Visits 32,000 31,200 28,900
Financial Performance—Declining patient volume has resulted
in deterioration of key
financial indicators at Community Hospital with an operating
loss occurring this year.
Thanks to a long history of profitable operation, however, there
is a capital reserve of
some $25,000,000. Much of this reserve would be required to
fund capital expenditures
anticipated for oncology, orthopedic, and cardiovascular
initiatives. Since much
additional expenditure for replacement of equipment and
refurbishment of the hospital
can be anticipated over the next five years, it will be important
to maintain a reasonable
level of capital for projects other than new program
development.
2 Years Prior 1 Year Prior Current Year
Revenue $461,500,000 $435,500,000 $427,000,000

23. Margin $ 23,075,000 $ 4,355,000 ($ 1,495,000)
AR Days 55 56 60
Payer mix remains reasonably strong, though the percentage of
Medicare, Medicaid,
and self-pay patients is increasing.
2 Years Prior 1 Year Prior Current Year
Medicare 32% 34% 35%
Medicaid 12% 15% 16%
Insured 50% 44% 41%
Self-pay 5 % 7% 8%
Service Region—Community Hospital is located in a thriving
county which represents its
primary service region. High tech business and industry find
the area attractive as do
retirees from across the nation. The area is noted for its mild
climate, cultural resources,
and strong educational system, including several colleges and a
university.

24. Prime location in a city of 400,000 and county of 900,000
Population growth of 4% per year
24% of population under 18
63% of population between 18–64
13% of population over 65
49% male
51% female
Competitive Environment—Community Hospital has two
primary competitors. Tertiary
Medical Center, a 700-bed facility, is ten miles away. It is a
private, not-for-profit
institution, but was once owned by the county. During the past
decade it has become a
premier medical center, complete with its own air ambulance
service.
Noted for excellent, comprehensive heart center
Strong orthopedic and neurosurgery programs
Trauma center
Cancer services available; poorly organized; no ACOS
accreditation
Excellent pediatric services

25. Strong financial performance; growing market share
No teaching programs or academic center affiliations
Regional Hospital, a 350-bed facility, is located seven miles
away. It is also private, not-
for-profit, and was the county’s first hospital. Regional’s
reputation is excellent
throughout the service area. It offers a wide range of services,
but is not designated as a
trauma center.
Cancer services available; poorly organized; no ACOS
accreditation
Strong orthopedic services
Cardiac services including open heart surgery
Adequate financial performance; growing market share
No teaching programs or academic center affiliations
Quaternary Medical Center, one of the nation’s foremost
academic research and
teaching institutions, is located 60 miles away, but is not
considered a significant
competitive threat. It boasts a comprehensive cancer center of
international repute that
attracts patients from across the nation and around the world.

26. Strategic Plan Highlights—Just over a year ago, Trinity
Community Hospital initiated a
strategic planning process. The Board of Trustees recognized
that a clear five-year plan
was essential in order to reverse declining performance trends.
The hospital CEO and
senior management staff were asked to assess community needs,
seek input from
medical staff members and community leaders, and to develop a
vision for the hospital
that would make it a vital component of the county’s healthcare
delivery system. The
Board requested that the five-year plan provide answers to four
basic questions:
1) Which services should we develop?
2) What are our five-year target outcomes for these services?
3) What level of capital investment will be required?
4) Will new programs provide sufficient margin to generate
adequate resources for
future growth?
Early in the planning process the management team determined
that the hospital’s
value to the community would be greatly enhanced by
development of a few premier
programs clearly differentiated from those offered by
competitors rather than
continuing to offer only baseline medical/surgical services.
Following* are brief
highlights of the five-year strategic plan.
* Refer to TCH Strategic Plan Power Point Presentation

27. Task 2/Service Line Development - General Case
Scenario/Trinity Community Hospital Strategic Plan.pdf
FIVE-YEAR PROGRAM PLAN
Prepared by Molly Briscoe, Planning Director
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28. Mission: To provide outstanding care for all our
patient
Vision: To position Trinity Community Hospital as a
premier provider of cancer, orthopedic, and
cardiovascular services
Values: To emphasize four basic principles of success
as we work to achieve our mission and vision
• Quality and Safety
• Service Excellence
• Staff Achievement
• Growth and Profitability
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Goal 1: Develop Regional Cancer Center Noted
for Clinical and Service Excellence
Strategy A: Offer Distinctive Clinical Programs and Services
• Multidisciplinary, disease-focused clinics: breast, GI, lung,
prostate
• Comprehensive medical, surgical, radiation, support services
• Evidence-based treatment and access to leading clinical trials
Strategy B: Emphasize Cancer Prevention and Control
• Community education
• Screening and risk assessment
• Outreach to underserved communities
Strategy C: Enhance Service Access
• Fast-track scheduling
• Patient navigation
1) Quality and Safety
• ACOS accreditation as
comprehensive community cancer
center
• >8% of patients accrued to clinical

30. trials
• Ongoing community screening for
top 4 disease sites
2) Service Excellence
• Patient likelihood of recommending
>90th percentile
• Physician satisfaction >90th
percentile
3) Staff Achievement
• Oncology nurse certification >90%
• Oncology staff retention >90%
4) Growth and Profitability
• Discharges—382
• Radiation Oncology Treatments—
9,100
• Chemo treatments—7,000
• Margin—$1,337,000
Five-Year Target Outcomes for
Regional Cancer Center
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1) Oncology center with simulator, linear accelerator,
infusion suite—$8,000,000 (includes renovation of
vacant space in MOB 1 )
Capital Investment for Regional Cancer Center
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Goal 2: Develop Regional Orthopedic Center Noted for
Clinical and Service Excellence
Strategy A: Offer Distinctive Clinical Programs and Services
• Spine, total joint, hand
• Comprehensive rehab and support programs
• Best practices and treatment protocols
Strategy B: Emphasize Prevention of Injury and Disease
• Community education
• Screening and risk assessment
• Outreach services to underserved communities
Strategy C: Enhance Service Access
• Fast-track scheduling
• Coordination of services
1) Quality and Safety
• CMS orthopedic indicator set >90th
percentile
• Pre/post procedure class attendance
>75%
2) Service Excellence
• Likelihood of recommending >90th

34. percentile
• Physician satisfaction >90th
percentile
3) Staff Achievement
• Orthopedic nursing staff
certification >75%
• Orthopedic staff retention rate >90%
4) Growth and Profitability
• Surgical cases—2100
• Physical therapy visits—6,500
• Margin—$2,171,500
Five-Year Target Outcomes for Regional Orthopedic Center
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1) New 5,000-square-foot physical therapy/rehab
center—$600,000 if constructed on campus;
$700,000 if purchased adjacent to campus
2) Radiology expansion/second MRI—$3,000,000
Capital Investment for Regional Orthopedic Center
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36. M
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Goal 3: Develop Cardiovascular Center Noted
for Clinical and Service Excellence

37. Strategy A: Offer Distinctive Clinical Programs and Services
• Peripheral artery disease, heart failure, electrophysiology
• Cardiology for women
• Evidence-based treatment
Strategy B: Emphasize Prevention and Control of
Cardiovascular Disease
• Community Education
• Screening and risk assessment
• Outreach services to underserved communities
Strategy C: Enhance Service Access
• Fast-track scheduling
• Coordination of services
1) Quality and Safety
• CMS AMI indicator set >90th
percentile
• CMS heart failure indicator set >90th
percentile
2) Service Excellence
• Patient satisfaction >90th percentile
• Physician satisfaction >90th
percentile
3) Staff Achievement
• Cardiac certified nursing staff >90%
• Cardiac staff retention rate >90%

38. 4) Growth and Profitability
• Diagnostic catheterizations—2,000
• Peripheral vascular procedures—500
• Margin—$3,625,000
Five-Year Target Outcomes for
Cardiovascular Center
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39. 1) Cath labs (2)—$4,500,000
2) Cardiac rehab expansion—$500,000
Capital Investment for Cardiovascular Center
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Successful implementation of the plan outlined
above will drive dramatic increases in volume and

40. improved financial performance for Community
Hospital. Most important, however, it will make
available the most advanced approaches for
preventing, diagnosing, and treating disease
processes impacting thousands throughout the
hospital’s service area.
Plan Summary
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41. 1) Quality and Safety
• All relevant CMS indicator sets >90th
percentile
• Implementation of computerized MD
order entry
2) Service Excellence
• Inpatient likelihood of recommending
>90th percentile
• Outpatient likelihood of recommending
>90th percentile
• Physician satisfaction >95th percentile
3) Staff Achievement
• Employee retention rate >88%
• Annual employee satisfaction >90%
4) Growth and Profitability
• Growth and Profitability
• Discharges—7,800
• ALOS—4 days
• ADC—85.5
• Surgeries—14,800
• Outpatient visits—116,220
• ED visits—36,100
• Revenue—$624,000.000
• Margin—$31,200,000
Trinity Community Hospital
Five-Year Hospital-Wide Target Outcomes
F

42. IV
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Task 2/Service Line Development - Task 2 Artifacts/Community
Health Needs Assessment.pdf
1
Community Health Needs Assessment
During the past year, a focused community health needs

43. assessment was conducted by
Trinity Community Hospital. The assessment targeted cancer,
orthopedic, and
cardiovascular services within the hospital’s primary service
region. It utilized
information from multiple sources, including epidemiological
surveys, state healthcare
facilities’ planning guidelines, interviews with physicians and
other healthcare
professionals, and community focus groups. Following are
highlights of the assessment
results.
Oncology Services
1) Demand—an aging population will create a sharp increase in
the demand for
oncology services in the primary service area.
15% of the population will be over 65 within the next five
years.
50% of men and 33% of women are expected to develop cancer
during their
lifetimes.
New cancer cases are expected to grow from 3,200 this year to
4,282 in five
years (+34%).
2) Existing Resources—facilities and resources to prevent,
diagnose, and treat cancer

44. are already stressed.
Interviews with medical and radiation oncologists confirm that
physician
practices are at capacity and that recruitment of additional
physicians is
underway. State planning data confirms the need.
Facilities and equipment to diagnose and treat cancer patients
are not keeping
pace with growth in patient volume. The community already
needs additional
linear accelerators, chemo units, operating suites, and advanced
imaging
equipment.
Physicians, nurses, social workers, and patients indicate that
services available
are fragmented and poorly coordinated. Delays in scheduling
services are
common. Of the two hospitals currently providing cancer care,
neither of them
offers patient navigator programs to facilitate timely scheduling
of tests,
treatments, and other services.
There is little emphasis on cancer prevention and control.
Widespread screening
for the top cancer sites (breast, lung, prostate, GI) should be
available
throughout the community in order to diagnose and treat the
disease as early as
possible, thus improving outcomes and lowering costs.
Educational programs focusing on lifestyle modification
including diet, exercise,

45. nutrition shopping for healthier food products, and smoking
cessation are
infrequent and sporadic.
2
Orthopedic Services
1) Demand—the need for orthopedic services in the primary
service area is expected to
grow rapidly in the next five years.
Orthopedic cases are expected to climb from 11,800 to 17,338
(+46%).
Inpatient joint and spine procedures are expected to increase by
30%.
Outpatient joint and spine procedures are expected to increase
by 350%.
2) Existing Resources—with current resources, physicians and
hospitals will be unable
to meet the growing demand for orthopedic services.
Interviews with orthopedic and neurosurgeons confirm that
recruitment of
additional physicians is a priority. State planning data confirms

46. the need.
All hospitals in the county will need to add imaging equipment,
surgical suites,
and physical therapy/rehab capacity.
Patient care coordinators are needed to ensure that services are
scheduled in a
timely fashion.
Educational programs targeting accident prevention and healthy
lifestyles are
needed, especially for the elderly and those participating in
athletics and fitness
activities.
Cardiovascular Services
1) Demand—as with cancer and orthopedics, there will be a
large increase in demand
for cardiovascular services in the primary service area in the
next five years.
Cases of coronary artery disease are expected to grow from
54,000 to 65,700
(+21.6%).
Diagnostic cath procedures are expected to increase from
10,800 to 13,140
(+22%).
Angioplasties are expected to grow from 4,000 to 5032
(+25.8%).

47. 2) Existing Resources—additional facilities, equipment,
physicians and other resources
will be needed to provide quality care for those impacted by
cardiovascular disease.
Cardiology and cardiovascular surgery groups are recruiting
additional
physicians. State planning data confirms the need.
All hospitals in the county will need additional cath labs,
surgical suites, and
cardiac rehab capacity.
Patient care coordinators will be needed to facilitate timely
scheduling of
services.
Little emphasis is being placed on education concerning
cardiac risk factors,
healthy living, and lifestyle modification.
Task 2/Task 2.docx
Introduction:
A community health assessment is a developmental process that
is added to and amended over time. It is not an end in itself, but
a way of using information to plan healthcare and public health
programs. In the “Service Line Development Case Study,” there
is a community health needs assessment that describes the state
of local individuals’ health. This assessment allows the major
risk factors, the causes of ill health, and the actions required to
address these health risks to be identified.
Task:

48. A. Analyze the community health needs assessment in the case
study by doing the following:
1. Discuss major risk factors identified in the assessment.
2. Discuss whether the healthcare facility in the case study is
addressing the needs identified in the assessment.
B. Develop a health planning summary outlining
recommendations of how to resolve any outstanding community
health needs.
C. When you use sources, include all in-text citations and
references in APA format.
Note: When bulleted points are present in the task prompt, the
level of detail or support called for in the rubric refers to those
bulleted points.Note: For definitions of terms commonly used in
the rubric, see the Rubric Terms web link included in the
Evaluation Procedures section.Note: When using sources to
support ideas and elements in a paper or project, the submission
MUST include APA formatted in-text citations with a
corresponding reference list for any direct quotes or
paraphrasing. It is not necessary to list sources that were
consulted if they have not been quoted or paraphrased in the
text of the paper or project.
Note: No more than a combined total of 30% of a submission
can be directly quoted or closely paraphrased from sources,
even if cited correctly. For tips on using APA style, please refer
to the APA Handout web link included in the General
Instructions section.
Web Links:
1.
Service Line Development - General Case Scenario
2.
Service Line Development - Task 2 Artifacts

49. Evaluation Method
Task 3/Service Line Development - General Case Scenario/CEO
Position Overview.pdf
Position Overview—CEO Trinity Community Hospital
The CEO reports directly to the hospital’s board of trustees and
has ultimate
responsibility and accountability for the organization’s
successful operation,
growth, and development. Basic responsibilities include:
1) Organizing and overseeing an ongoing strategic planning
process to ensure
development and implementation of strategies that will ensure
the hospital’s
viability long into the future. The planning process should
reflect a broad
awareness of the community’s healthcare needs.
2) Ensuring that patient care is of consistently high quality and
that the
environment is safe for patients, visitors, and staff.
3) Ensuring that hospital operations are conducted in an
efficient manner with

50. emphasis on stewardship of hospital resources.
4) Ensuring that service excellence for patients and staff is a
high priority.
5) Creating a positive learning environment for hospital and
medical staff with
emphasis on innovation and achievement.
6) Ensuring that the hospital is in compliance with all state and
federal guidelines
and that full accreditation by the Joint Commission and any
other relevant
accrediting agencies is constantly maintained.
Task 3/Service Line Development - General Case
Scenario/Trinity Community Hospital Board Profile.pdf
T R I N I T Y C O M M U N I T Y H O S P I T A L — B O A
R D P R O F I L E
The hospital’s board is composed of six members from diverse
backgrounds.
The group agrees that there is a pressing need for new strategies
to ensure the
organization’s future success, but there is not always agreement
on specific

51. program priorities.
T
R
IN
IT
Y
C
O
M
M
U
N
IT
Y
H
O
S
P
IT
A
L—
B
O

52. A
R
D
P
R
O
F
ILE
Mr. John Printer, Chairman
Mr. Printer is a native of the
community. He holds a degree in
business administration from a
local college and is the owner of a
very successful communications
business. His family has a long
association with Community
Hospital and he is committed to its
success. Mr. Printer has excellent
interpersonal skills and is adept at
managing disagreement.
T
R
IN
IT
Y

53. C
O
M
M
U
N
IT
Y
H
O
S
P
IT
A
L—
B
O
A
R
D
P
R
O
F

54. ILE
Mrs. Cathy Promo
Mrs. Promo is a Chicago native. She
holds an undergraduate degree in
marketing. Mrs. Promo has lived in
the community for seven years and
is director of marketing for a local
utility company. While she has
limited knowledge of healthcare
delivery, she is quite involved with
the local chamber of commerce
and recognizes the importance of
good healthcare services in
attracting new business and
industry to the area. Mrs. Promo
believes that extensive marketing
and advertising would likely
reverse the hospital’s downward
utilization trend.
T
R
IN
IT
Y
C
O
M

55. M
U
N
IT
Y
H
O
S
P
IT
A
L—
B
O
A
R
D
P
R
O
F
ILE
Mrs. Maria Lopez
Mrs. Lopez is a native of Mexico

56. but has lived in the community for
nine years. She holds an
undergraduate degree in
journalism and owns a small
newspaper that is quite popular
throughout the Latino community.
One of Mrs. Lopez’s priorities is
ensuring that adequate healthcare
services are available to all minority
groups.
T
R
IN
IT
Y
C
O
M
M
U
N
IT
Y
H
O
S

57. P
IT
A
L—
B
O
A
R
D
P
R
O
F
ILE
Mr. Robert Holland
Mr. Holland holds a CPA and works
for a local accounting firm. He is a
native of New York and has lived in
the community for five years. Mr.
Holland is quite interested in
national healthcare policy and
legislation, particularly as related
to healthcare finance, and
communicates frequently with the
hospital CFO.

58. T
R
IN
IT
Y
C
O
M
M
U
N
IT
Y
H
O
S
P
IT
A
L—
B
O
A
R

59. D
P
R
O
F
ILE
Dr. David Joint
Dr. Joint is an orthopedic surgeon
and a native of the community. He
has privileges at Community
Hospital but does little work there.
His group is planning to open a
branch office near the hospital
campus. Dr. Joint believes that
government has become far too
involved with healthcare delivery
and frequently comments that
physicians and hospitals are no
longer free to act in the best
interest of patients.
T
R
IN
IT
Y
C

60. O
M
M
U
N
IT
Y
H
O
S
P
IT
A
L—
B
O
A
R
D
P
R
O
F
ILE

61. Dr. Randy Sharp
Dr. Sharp is a general surgeon. He
is a native of Georgia but has lived
in the community for fifteen years.
Dr. Sharp holds privileges at the
hospital and does much work
there. He has a keen interest in
cancer services and his group is
planning to recruit a subspecialty-
trained oncologic surgeon.
Task 3/Service Line Development - General Case
Scenario/Trinity Community Hospital Brochure.pdf
Trinity Community
Hospital
A Patient Centered Facility
Our MISSION at Trinity Community Hospital is to
provide quality healthcare for all those in need of
assistance
Trinity’s Commitment— We are committed to
serving the community in a capacity that permits

62. every patient to receive the care and support that
they require.
Quality and Safety— At Trinity Community
Hospital we endeavor to provide high quality
services while ensuring the safety of patients,
visitors, and staff.
Service Excellence— We will continue to strive to exceed the
service
expectations of our patients, visitors, employees, and
physicians.
Staff Achievement— We will provide opportunities for the
enhancement of
the skills and expertise of all staff members.
Growth and Profitability— We are striving to grow service
volume, to operate
efficiently, and to generate sufficient capital for investment.
“One of the things I keep learning is that the secret of
being happy is doing things for other people.”
- Dick Gregory
WHAT SETS US APART
Trinity Community Hospital is a 150-bed, not-for-profit
hospital offering a broad range of

63. medical, surgical, and support services to the community.
Our patient-friendly, pleasant environment truly sets us apart.
Each room is furnished with
recliners and sofa sleepers, Wi-Fi internet access, cable TV and
video distribution, a private
bathroom, and custom built cabinets that conceal medical hook-
ups and equipment.
Large windows, ample sunlight, natural woods, warm colors,
and tranquil views of our
expansive landscape facilitate a soothing environment to assist
and ease patient recovery.
Trinity’s Gift shop offers unique, one-of-a kind gifts and
stunning flower arrangements as well
as an array of cards and personal miscellany.
Trinity offers the patients and guests alike nourishing and
delectable cuisine prepared and
directed by the world renowned Russian Dietitian and Chef
Katarina Novikov. Guests may eat
in the Bistro/Café or may order meals to be delivered by room
service to a family member’s
hospital room.
Our emphasis on providing exceptional care and services to our
patients through our
outstanding employees and medical staff members distinguishes
us from other healthcare
facilities.

64. Features of Trinity Community Hospital
Full Joint Commission accreditation
Broad range of medical/surgical services including: internal
medicine, geriatrics, general
and thoracic surgery, pulmonology, gastroenterology, urology,
otolaryngology,
neurology, gynecology, orthopedics, and consulting cardiology
Modern, high-tech laboratory, radiology, pharmacy, and
physical and respiratory
therapy departments
Surgery and endoscopy suites providing the newest digital
equipment; robotic surgery
Newly renovated patient rooms with homelike ambience
Award-winning dietary department
Nursing staff known for clinical expertise and patient care
Highest patient satisfaction scores in the region; over 93% of
inpatients and outpatients
would recommend us to family and friends
Medical staff 100% board certified in their respective fields
Physician locater service to help you find the right physician
for your needs

65. “Success is the sum of small efforts, repeated
day in and day out.”
-Robert Collier
Task 3/Service Line Development - General Case
Scenario/Trinity Community Hospital Fact Sheet.pdf
Trinity Community Hospital Fact Sheet
Community Hospital is a 150-bed facility located in the
southeast United States.
Services available include internal medicine, pulmonary
medicine, gastroenterology,
urology, otolaryngology, general surgery, thoracic surgery,
gynecology, and neurology.
The obstetrics service was phased out earlier this year when the
anchor physician group
relocated to a competing hospital, but several gynecologists still
admit patients. The
hospital’s reputation is reasonably good, but it is not known for
excellence in any
specific service. Perhaps its greatest strength is a competent,
dedicated nursing staff
committed to outstanding patient care. Information from
community focus groups
reveals that the public discerns no clear direction for the
organization’s future growth
and development. A strategic plan targeting oncology,
orthopedic, and cardiovascular

66. care has been developed. A brief overview of the plan appears
later in this document.
There is no formal oncology, orthopedic, or cardiology
programs even though a few
orthopedic surgeons and cardiologists maintain privileges at the
hospital. While no
cancer specialists practice at the hospital, a group composed of
eight medical
oncologists and two radiation oncologists has expressed interest
in an affiliation to
develop a new cancer program. The community’s premier
orthopedic groups are
located quite close to competing facilities making it
inconvenient for them to perform
more than occasional surgeries at Community Hospital, but
several practices are
planning to open branch offices near the hospital campus.
Cardiologists on staff restrict
their activity to performing consults for physicians whose
patients have been admitted
to the facility. Since there is no diagnostic cath lab, they order
only noninvasive studies
such as echocardiograms, stress tests, and holter monitoring.
Many surgeons on staff
often comment that patients prefer competing facilities because
they offer more
sophisticated cardiac back-up capability.
The hospital is licensed for 150 beds—136 medical/surgical—
plus a 14-bed intensive
care unit. There are 20 operating rooms and an emergency
department. All basic
support services are available including laboratory, radiology,
pharmacy, physical
therapy, and respiratory therapy. In addition to basic X-ray, the

67. radiology department
has two CT scanners and one MRI scanner. It also offers nuclear
medicine and
ultrasound services. A mobile PET scanner is available two days
per week, but is poorly
utilized.
Medical Staff—The hospital’s medical staff is composed of
numerous specialties and all
physicians are board certified. Most staff members hold
privileges at one or both
competing hospitals in the county.
Family Medicine 13
Internal Medicine 14
Geriatrics 2
General Surgery 9
Thoracic Surgery 2

68. Gynecology 3
ENT 5
Urology 6
GI 12
Pulmonary 5
Cardiology 4
Radiology 6
Pathology 2
Emergency 6
Total 89
Facilities—Community Hospital is located on an attractive 25-
acre campus easily
accessible from all major roadways. In addition to the main
hospital, there are four
medical office buildings (MOBs) each containing 60,000 square
feet of space. Most of
the office space is leased to private physician groups. One of
the MOBs houses the
hospital’s outpatient imaging and laboratory services.
Hospital constructed 25 years ago
Inpatient units recently renovated

69. Ancillary services except physical therapy have room to expand
MOB 1 has 15,000 square feet of vacant space
Campus can accommodate an additional MOB of up to 60,000
square feet
Should the hospital decide to develop cancer and cardiovascular
services, vacant space
in MOB 1 is suitable for medical and radiation oncology; and
there is adequate space in
the main hospital for two cardiac catheterization labs. A new
15,000-square-foot
physical therapy/rehab center to support orthopedic program
development would have
to be constructed on campus, purchased adjacent to campus, or
leased adjacent to
campus. Though the campus will accommodate another MOB,
space for future
development could be strained.
Utilization Trends—Utilization of Community Hospital has
declined steadily over the
past three years. The loss of the OB program and erosion of
general surgery volumes
accounts for most of the downward trajectory.
2 Years Prior 1 Year Prior Current Year
Discharges 7,100 6,700 6,100

70. ALOS 4.0 4.1 4.3
Patient Days 28,400 27,470 26,230
ADC 77.8 75.3 71.9
Surgeries 12,500 11,800 10,950
OP Visits 95,000 90,800 89,400
ED Visits 32,000 31,200 28,900
Financial Performance—Declining patient volume has resulted
in deterioration of key
financial indicators at Community Hospital with an operating
loss occurring this year.
Thanks to a long history of profitable operation, however, there
is a capital reserve of
some $25,000,000. Much of this reserve would be required to
fund capital expenditures
anticipated for oncology, orthopedic, and cardiovascular
initiatives. Since much
additional expenditure for replacement of equipment and
refurbishment of the hospital
can be anticipated over the next five years, it will be important
to maintain a reasonable
level of capital for projects other than new program
development.
2 Years Prior 1 Year Prior Current Year
Revenue $461,500,000 $435,500,000 $427,000,000

71. Margin $ 23,075,000 $ 4,355,000 ($ 1,495,000)
AR Days 55 56 60
Payer mix remains reasonably strong, though the percentage of
Medicare, Medicaid,
and self-pay patients is increasing.
2 Years Prior 1 Year Prior Current Year
Medicare 32% 34% 35%
Medicaid 12% 15% 16%
Insured 50% 44% 41%
Self-pay 5 % 7% 8%
Service Region—Community Hospital is located in a thriving
county which represents its
primary service region. High tech business and industry find
the area attractive as do
retirees from across the nation. The area is noted for its mild
climate, cultural resources,
and strong educational system, including several colleges and a

72. university.
Prime location in a city of 400,000 and county of 900,000
Population growth of 4% per year
24% of population under 18
63% of population between 18–64
13% of population over 65
49% male
51% female
Competitive Environment—Community Hospital has two
primary competitors. Tertiary
Medical Center, a 700-bed facility, is ten miles away. It is a
private, not-for-profit
institution, but was once owned by the county. During the past
decade it has become a
premier medical center, complete with its own air ambulance
service.
Noted for excellent, comprehensive heart center
Strong orthopedic and neurosurgery programs
Trauma center
Cancer services available; poorly organized; no ACOS
accreditation

73. Excellent pediatric services
Strong financial performance; growing market share
No teaching programs or academic center affiliations
Regional Hospital, a 350-bed facility, is located seven miles
away. It is also private, not-
for-profit, and was the county’s first hospital. Regional’s
reputation is excellent
throughout the service area. It offers a wide range of services,
but is not designated as a
trauma center.
Cancer services available; poorly organized; no ACOS
accreditation
Strong orthopedic services
Cardiac services including open heart surgery
Adequate financial performance; growing market share
No teaching programs or academic center affiliations
Quaternary Medical Center, one of the nation’s foremost
academic research and
teaching institutions, is located 60 miles away, but is not
considered a significant
competitive threat. It boasts a comprehensive cancer center of
international repute that
attracts patients from across the nation and around the world.

74. Strategic Plan Highlights—Just over a year ago, Trinity
Community Hospital initiated a
strategic planning process. The Board of Trustees recognized
that a clear five-year plan
was essential in order to reverse declining performance trends.
The hospital CEO and
senior management staff were asked to assess community needs,
seek input from
medical staff members and community leaders, and to develop a
vision for the hospital
that would make it a vital component of the county’s healthcare
delivery system. The
Board requested that the five-year plan provide answers to four
basic questions:
1) Which services should we develop?
2) What are our five-year target outcomes for these services?
3) What level of capital investment will be required?
4) Will new programs provide sufficient margin to generate
adequate resources for
future growth?
Early in the planning process the management team determined
that the hospital’s
value to the community would be greatly enhanced by
development of a few premier
programs clearly differentiated from those offered by
competitors rather than
continuing to offer only baseline medical/surgical services.
Following* are brief
highlights of the five-year strategic plan.
* Refer to TCH Strategic Plan Power Point Presentation

75. Task 3/Service Line Development - General Case
Scenario/Trinity Community Hospital Strategic Plan.pdf
FIVE-YEAR PROGRAM PLAN
Prepared by Molly Briscoe, Planning Director
F
IV
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A
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N

76. Mission: To provide outstanding care for all our
patient
Vision: To position Trinity Community Hospital as a
premier provider of cancer, orthopedic, and
cardiovascular services
Values: To emphasize four basic principles of success
as we work to achieve our mission and vision
• Quality and Safety
• Service Excellence
• Staff Achievement
• Growth and Profitability
F
IV
E
-Y
E
A
R
P
R
O

77. G
R
A
M
P
LA
N
Goal 1: Develop Regional Cancer Center Noted
for Clinical and Service Excellence
Strategy A: Offer Distinctive Clinical Programs and Services
• Multidisciplinary, disease-focused clinics: breast, GI, lung,
prostate
• Comprehensive medical, surgical, radiation, support services
• Evidence-based treatment and access to leading clinical trials
Strategy B: Emphasize Cancer Prevention and Control
• Community education
• Screening and risk assessment
• Outreach to underserved communities
Strategy C: Enhance Service Access
• Fast-track scheduling
• Patient navigation
1) Quality and Safety
• ACOS accreditation as
comprehensive community cancer
center

78. • >8% of patients accrued to clinical
trials
• Ongoing community screening for
top 4 disease sites
2) Service Excellence
• Patient likelihood of recommending
>90th percentile
• Physician satisfaction >90th
percentile
3) Staff Achievement
• Oncology nurse certification >90%
• Oncology staff retention >90%
4) Growth and Profitability
• Discharges—382
• Radiation Oncology Treatments—
9,100
• Chemo treatments—7,000
• Margin—$1,337,000
Five-Year Target Outcomes for
Regional Cancer Center
F
IV
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E

79. A
R
P
R
O
G
R
A
M
P
LA
N
1) Oncology center with simulator, linear accelerator,
infusion suite—$8,000,000 (includes renovation of
vacant space in MOB 1 )
Capital Investment for Regional Cancer Center
F
IV
E
-Y
E
A
R

80. P
R
O
G
R
A
M
P
LA
N
F
IV
E
-Y
E
A
R
P
R
O
G
R

81. A
M
P
LA
N
Goal 2: Develop Regional Orthopedic Center Noted for
Clinical and Service Excellence
Strategy A: Offer Distinctive Clinical Programs and Services
• Spine, total joint, hand
• Comprehensive rehab and support programs
• Best practices and treatment protocols
Strategy B: Emphasize Prevention of Injury and Disease
• Community education
• Screening and risk assessment
• Outreach services to underserved communities
Strategy C: Enhance Service Access
• Fast-track scheduling
• Coordination of services
1) Quality and Safety
• CMS orthopedic indicator set >90th
percentile
• Pre/post procedure class attendance
>75%
2) Service Excellence

82. • Likelihood of recommending >90th
percentile
• Physician satisfaction >90th
percentile
3) Staff Achievement
• Orthopedic nursing staff
certification >75%
• Orthopedic staff retention rate >90%
4) Growth and Profitability
• Surgical cases—2100
• Physical therapy visits—6,500
• Margin—$2,171,500
Five-Year Target Outcomes for Regional Orthopedic Center
F
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E
A
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P
R
O
G
R

83. A
M
P
LA
N
1) New 5,000-square-foot physical therapy/rehab
center—$600,000 if constructed on campus;
$700,000 if purchased adjacent to campus
2) Radiology expansion/second MRI—$3,000,000
Capital Investment for Regional Orthopedic Center
F
IV
E
-Y
E
A
R
P
R
O
G
R
A

84. M
P
LA
N
F
IV
E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
Goal 3: Develop Cardiovascular Center Noted

85. for Clinical and Service Excellence
Strategy A: Offer Distinctive Clinical Programs and Services
• Peripheral artery disease, heart failure, electrophysiology
• Cardiology for women
• Evidence-based treatment
Strategy B: Emphasize Prevention and Control of
Cardiovascular Disease
• Community Education
• Screening and risk assessment
• Outreach services to underserved communities
Strategy C: Enhance Service Access
• Fast-track scheduling
• Coordination of services
1) Quality and Safety
• CMS AMI indicator set >90th
percentile
• CMS heart failure indicator set >90th
percentile
2) Service Excellence
• Patient satisfaction >90th percentile
• Physician satisfaction >90th
percentile
3) Staff Achievement
• Cardiac certified nursing staff >90%
• Cardiac staff retention rate >90%

86. 4) Growth and Profitability
• Diagnostic catheterizations—2,000
• Peripheral vascular procedures—500
• Margin—$3,625,000
Five-Year Target Outcomes for
Cardiovascular Center
F
IV
E
-Y
E
A
R
P
R
O
G
R
A
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P
LA
N

87. 1) Cath labs (2)—$4,500,000
2) Cardiac rehab expansion—$500,000
Capital Investment for Cardiovascular Center
F
IV
E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
Successful implementation of the plan outlined

88. above will drive dramatic increases in volume and
improved financial performance for Community
Hospital. Most important, however, it will make
available the most advanced approaches for
preventing, diagnosing, and treating disease
processes impacting thousands throughout the
hospital’s service area.
Plan Summary
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E
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N

89. 1) Quality and Safety
• All relevant CMS indicator sets >90th
percentile
• Implementation of computerized MD
order entry
2) Service Excellence
• Inpatient likelihood of recommending
>90th percentile
• Outpatient likelihood of recommending
>90th percentile
• Physician satisfaction >95th percentile
3) Staff Achievement
• Employee retention rate >88%
• Annual employee satisfaction >90%
4) Growth and Profitability
• Growth and Profitability
• Discharges—7,800
• ALOS—4 days
• ADC—85.5
• Surgeries—14,800
• Outpatient visits—116,220
• ED visits—36,100
• Revenue—$624,000.000
• Margin—$31,200,000
Trinity Community Hospital
Five-Year Hospital-Wide Target Outcomes

90. F
IV
E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
Task 3/Service Line Development - Task 3 Artifacts/Email from
Holland to CEO.pdf
Morgan Reece, CEO
Legislative Trends
Morgan—

91. Let’s make sure that we pay adequate attention to the health
policy/legislative environment as we go forward with our
planning
process for new services. I am afraid that the legislative mind
set on both the state and national levels is to reduce payments to
hospitals. I know that Dr. Joint has a similar concern regarding
physician reimbursement.
How can we make sure that our legislator’s understand the real
world of healthcare delivery? Hospital margins are already thin
and
are declining. What about working more closely with the
Hospital Political Action Committee to frame feedback to
legislators?
Robert
Robert Holland, BOD
Task 3/Service Line Development - Task 3 Artifacts/Email from
Joint to CEO.pdf
Morgan Reece, CEO
Legislative Trends
Morgan—
What are we going to do to make sure that Congress does not
reduce payments to physicians (hospitals too)? Everyone is
talking
about opening the doors to millions of people (good thing), but

92. to do it they will keep reimbursement flat or cut it.
If payment to physicians does not keep pace with increases in
cost, many groups won’t be able to recruit new docs and will
turn
patients away. In the end, many will be discouraged from going
to medical school in the first place, and the physician shortage
will
worsen. Help!
David
Dr. David Joint, BOD
Task 3/Service Line Development - Task 3 Artifacts/Voice Mail
from Joint to CEO.mp3Voicemail Script
Jenna Owens
Jenna Owens's Album
2010
Other
29570.82
eng -
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00007DD0 00007DBF 00002BFA 00002BFA
eng -
00000000 00000210 00000A1A 000000000013D9D6 00000000
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Task 3/Task 3.docx
Directions
SUBDOMAIN 705.4 - HEALTHCARE VALUES, POLICY, &
LAWCompetency 705.4.1: Health Policy - The graduate
effectively interprets health policy initiatives.

93. Competency 705.4.2: Health Legislation - The graduate
analyzes strategies that impact health legislation.
Introduction:
Healthcare does not operate in a vacuum. Trends that emerge in
the national market are influenced by legislation, delivery of
care, changes in payment methods, and social and economic
conditions. Healthcare professionals monitor policy at the
national level by reviewing legislative initiatives and analyzing
rules and regulations. Understanding healthcare policy helps in
facilitating grant reviews and in developing new program
initiatives. Legislation may cause changes in the way hospitals
and healthcare providers deliver patient care. It is beneficial for
hospitals to incorporate the national trends, policy, and
legislation in determining the appropriate path for selecting
service lines. You will use the “Service Line Development Case
Study” to complete this task. Imagine that you have received a
memo asking you to identify national trends, policy, and
legislation and to summarize the impact it will have on the new
service line. The proposed service lines are the following:
• Orthopedic center
• Cardiovascular center
• Cancer center
Task:
A. Identify national healthcare trends and policy initiatives
evident in the attached “Service Line Development Case Study.”
1. Discuss how identified trends impact the delivery of
healthcare in the case study.
2. Discuss possible legislation that may result from these
trends.
B. When you use sources, include all in-text citations and
references in APA format.

94. Note: When bulleted points are present in the task prompt, the
level of detail or support called for in the rubric refers to those
bulleted points.
Note: For definitions of terms commonly used in the rubric, see
the Rubric Terms web link included in the Evaluation
Procedures section.
Note: When using sources to support ideas and elements in a
paper or project, the submission MUST include APA formatted
in-text citations with a corresponding reference list for any
direct quotes or paraphrasing. It is not necessary to list sources
that were consulted if they have not been quoted or paraphrased
in the text of the paper or project.
Note: No more than a combined total of 30% of a submission
can be directly quoted or closely paraphrased from sources,
even if cited correctly. For tips on using APA style, please refer
to the APA Handout web link included in the General
Instructions section.
Web Links:
1.
Service Line Development - General Case Scenario
2.
Service Line Development - Task 3 Artifacts
Task 4/Service Line Development - General Case Scenario/CEO
Position Overview.pdf
Position Overview—CEO Trinity Community Hospital

95. The CEO reports directly to the hospital’s board of trustees and
has ultimate
responsibility and accountability for the organization’s
successful operation,
growth, and development. Basic responsibilities include:
1) Organizing and overseeing an ongoing strategic planning
process to ensure
development and implementation of strategies that will ensure
the hospital’s
viability long into the future. The planning process should
reflect a broad
awareness of the community’s healthcare needs.
2) Ensuring that patient care is of consistently high quality and
that the
environment is safe for patients, visitors, and staff.
3) Ensuring that hospital operations are conducted in an
efficient manner with
emphasis on stewardship of hospital resources.
4) Ensuring that service excellence for patients and staff is a
high priority.
5) Creating a positive learning environment for hospital and
medical staff with
emphasis on innovation and achievement.

96. 6) Ensuring that the hospital is in compliance with all state and
federal guidelines
and that full accreditation by the Joint Commission and any
other relevant
accrediting agencies is constantly maintained.
Task 4/Service Line Development - General Case
Scenario/Trinity Community Hospital Board Profile.pdf
T R I N I T Y C O M M U N I T Y H O S P I T A L — B O A
R D P R O F I L E
The hospital’s board is composed of six members from diverse
backgrounds.
The group agrees that there is a pressing need for new strategies
to ensure the
organization’s future success, but there is not always agreement
on specific
program priorities.
T
R
IN
IT
Y

97. C
O
M
M
U
N
IT
Y
H
O
S
P
IT
A
L—
B
O
A
R
D
P
R
O
F

98. ILE
Mr. John Printer, Chairman
Mr. Printer is a native of the
community. He holds a degree in
business administration from a
local college and is the owner of a
very successful communications
business. His family has a long
association with Community
Hospital and he is committed to its
success. Mr. Printer has excellent
interpersonal skills and is adept at
managing disagreement.
T
R
IN
IT
Y
C
O
M
M
U
N
IT

99. Y
H
O
S
P
IT
A
L—
B
O
A
R
D
P
R
O
F
ILE
Mrs. Cathy Promo
Mrs. Promo is a Chicago native. She
holds an undergraduate degree in
marketing. Mrs. Promo has lived in
the community for seven years and
is director of marketing for a local
utility company. While she has
limited knowledge of healthcare

100. delivery, she is quite involved with
the local chamber of commerce
and recognizes the importance of
good healthcare services in
attracting new business and
industry to the area. Mrs. Promo
believes that extensive marketing
and advertising would likely
reverse the hospital’s downward
utilization trend.
T
R
IN
IT
Y
C
O
M
M
U
N
IT
Y
H
O
S

101. P
IT
A
L—
B
O
A
R
D
P
R
O
F
ILE
Mrs. Maria Lopez
Mrs. Lopez is a native of Mexico
but has lived in the community for
nine years. She holds an
undergraduate degree in
journalism and owns a small
newspaper that is quite popular
throughout the Latino community.
One of Mrs. Lopez’s priorities is
ensuring that adequate healthcare
services are available to all minority
groups.

102. T
R
IN
IT
Y
C
O
M
M
U
N
IT
Y
H
O
S
P
IT
A
L—
B
O
A

103. R
D
P
R
O
F
ILE
Mr. Robert Holland
Mr. Holland holds a CPA and works
for a local accounting firm. He is a
native of New York and has lived in
the community for five years. Mr.
Holland is quite interested in
national healthcare policy and
legislation, particularly as related
to healthcare finance, and
communicates frequently with the
hospital CFO.
T
R
IN
IT
Y
C
O

104. M
M
U
N
IT
Y
H
O
S
P
IT
A
L—
B
O
A
R
D
P
R
O
F
ILE
Dr. David Joint

105. Dr. Joint is an orthopedic surgeon
and a native of the community. He
has privileges at Community
Hospital but does little work there.
His group is planning to open a
branch office near the hospital
campus. Dr. Joint believes that
government has become far too
involved with healthcare delivery
and frequently comments that
physicians and hospitals are no
longer free to act in the best
interest of patients.
T
R
IN
IT
Y
C
O
M
M
U
N
IT
Y

106. H
O
S
P
IT
A
L—
B
O
A
R
D
P
R
O
F
ILE
Dr. Randy Sharp
Dr. Sharp is a general surgeon. He
is a native of Georgia but has lived
in the community for fifteen years.
Dr. Sharp holds privileges at the
hospital and does much work
there. He has a keen interest in
cancer services and his group is
planning to recruit a subspecialty-

107. trained oncologic surgeon.
Task 4/Service Line Development - General Case
Scenario/Trinity Community Hospital Brochure.pdf
Trinity Community
Hospital
A Patient Centered Facility
Our MISSION at Trinity Community Hospital is to
provide quality healthcare for all those in need of
assistance
Trinity’s Commitment— We are committed to
serving the community in a capacity that permits
every patient to receive the care and support that
they require.
Quality and Safety— At Trinity Community
Hospital we endeavor to provide high quality
services while ensuring the safety of patients,
visitors, and staff.
Service Excellence— We will continue to strive to exceed the
service
expectations of our patients, visitors, employees, and

108. physicians.
Staff Achievement— We will provide opportunities for the
enhancement of
the skills and expertise of all staff members.
Growth and Profitability— We are striving to grow service
volume, to operate
efficiently, and to generate sufficient capital for investment.
“One of the things I keep learning is that the secret of
being happy is doing things for other people.”
- Dick Gregory
WHAT SETS US APART
Trinity Community Hospital is a 150-bed, not-for-profit
hospital offering a broad range of
medical, surgical, and support services to the community.
Our patient-friendly, pleasant environment truly sets us apart.
Each room is furnished with
recliners and sofa sleepers, Wi-Fi internet access, cable TV and
video distribution, a private
bathroom, and custom built cabinets that conceal medical hook-
ups and equipment.
Large windows, ample sunlight, natural woods, warm colors,
and tranquil views of our

109. expansive landscape facilitate a soothing environment to assist
and ease patient recovery.
Trinity’s Gift shop offers unique, one-of-a kind gifts and
stunning flower arrangements as well
as an array of cards and personal miscellany.
Trinity offers the patients and guests alike nourishing and
delectable cuisine prepared and
directed by the world renowned Russian Dietitian and Chef
Katarina Novikov. Guests may eat
in the Bistro/Café or may order meals to be delivered by room
service to a family member’s
hospital room.
Our emphasis on providing exceptional care and services to our
patients through our
outstanding employees and medical staff members distinguishes
us from other healthcare
facilities.
Features of Trinity Community Hospital
Full Joint Commission accreditation
Broad range of medical/surgical services including: internal

110. medicine, geriatrics, general
and thoracic surgery, pulmonology, gastroenterology, urology,
otolaryngology,
neurology, gynecology, orthopedics, and consulting cardiology
Modern, high-tech laboratory, radiology, pharmacy, and
physical and respiratory
therapy departments
Surgery and endoscopy suites providing the newest digital
equipment; robotic surgery
Newly renovated patient rooms with homelike ambience
Award-winning dietary department
Nursing staff known for clinical expertise and patient care
Highest patient satisfaction scores in the region; over 93% of
inpatients and outpatients
would recommend us to family and friends
Medical staff 100% board certified in their respective fields
Physician locater service to help you find the right physician
for your needs
“Success is the sum of small efforts, repeated
day in and day out.”
-Robert Collier
Task 4/Service Line Development - General Case
Scenario/Trinity Community Hospital Fact Sheet.pdf

111. Trinity Community Hospital Fact Sheet
Community Hospital is a 150-bed facility located in the
southeast United States.
Services available include internal medicine, pulmonary
medicine, gastroenterology,
urology, otolaryngology, general surgery, thoracic surgery,
gynecology, and neurology.
The obstetrics service was phased out earlier this year when the
anchor physician group
relocated to a competing hospital, but several gynecologists still
admit patients. The
hospital’s reputation is reasonably good, but it is not known for
excellence in any
specific service. Perhaps its greatest strength is a competent,
dedicated nursing staff
committed to outstanding patient care. Information from
community focus groups
reveals that the public discerns no clear direction for the
organization’s future growth
and development. A strategic plan targeting oncology,
orthopedic, and cardiovascular
care has been developed. A brief overview of the plan appears
later in this document.
There is no formal oncology, orthopedic, or cardiology
programs even though a few
orthopedic surgeons and cardiologists maintain privileges at the
hospital. While no
cancer specialists practice at the hospital, a group composed of
eight medical
oncologists and two radiation oncologists has expressed interest
in an affiliation to

112. develop a new cancer program. The community’s premier
orthopedic groups are
located quite close to competing facilities making it
inconvenient for them to perform
more than occasional surgeries at Community Hospital, but
several practices are
planning to open branch offices near the hospital campus.
Cardiologists on staff restrict
their activity to performing consults for physicians whose
patients have been admitted
to the facility. Since there is no diagnostic cath lab, they order
only noninvasive studies
such as echocardiograms, stress tests, and holter monitoring.
Many surgeons on staff
often comment that patients prefer competing facilities because
they offer more
sophisticated cardiac back-up capability.
The hospital is licensed for 150 beds—136 medical/surgical—
plus a 14-bed intensive
care unit. There are 20 operating rooms and an emergency
department. All basic
support services are available including laboratory, radiology,
pharmacy, physical
therapy, and respiratory therapy. In addition to basic X-ray, the
radiology department
has two CT scanners and one MRI scanner. It also offers nuclear
medicine and
ultrasound services. A mobile PET scanner is available two days
per week, but is poorly
utilized.

113. Medical Staff—The hospital’s medical staff is composed of
numerous specialties and all
physicians are board certified. Most staff members hold
privileges at one or both
competing hospitals in the county.
Family Medicine 13
Internal Medicine 14
Geriatrics 2
General Surgery 9
Thoracic Surgery 2
Gynecology 3
ENT 5
Urology 6
GI 12
Pulmonary 5
Cardiology 4

114. Radiology 6
Pathology 2
Emergency 6
Total 89
Facilities—Community Hospital is located on an attractive 25-
acre campus easily
accessible from all major roadways. In addition to the main
hospital, there are four
medical office buildings (MOBs) each containing 60,000 square
feet of space. Most of
the office space is leased to private physician groups. One of
the MOBs houses the
hospital’s outpatient imaging and laboratory services.
Hospital constructed 25 years ago
Inpatient units recently renovated
Ancillary services except physical therapy have room to expand
MOB 1 has 15,000 square feet of vacant space
Campus can accommodate an additional MOB of up to 60,000
square feet
Should the hospital decide to develop cancer and cardiovascular
services, vacant space
in MOB 1 is suitable for medical and radiation oncology; and
there is adequate space in

115. the main hospital for two cardiac catheterization labs. A new
15,000-square-foot
physical therapy/rehab center to support orthopedic program
development would have
to be constructed on campus, purchased adjacent to campus, or
leased adjacent to
campus. Though the campus will accommodate another MOB,
space for future
development could be strained.
Utilization Trends—Utilization of Community Hospital has
declined steadily over the
past three years. The loss of the OB program and erosion of
general surgery volumes
accounts for most of the downward trajectory.
2 Years Prior 1 Year Prior Current Year
Discharges 7,100 6,700 6,100
ALOS 4.0 4.1 4.3
Patient Days 28,400 27,470 26,230
ADC 77.8 75.3 71.9
Surgeries 12,500 11,800 10,950
OP Visits 95,000 90,800 89,400
ED Visits 32,000 31,200 28,900

116. Financial Performance—Declining patient volume has resulted
in deterioration of key
financial indicators at Community Hospital with an operating
loss occurring this year.
Thanks to a long history of profitable operation, however, there
is a capital reserve of
some $25,000,000. Much of this reserve would be required to
fund capital expenditures
anticipated for oncology, orthopedic, and cardiovascular
initiatives. Since much
additional expenditure for replacement of equipment and
refurbishment of the hospital
can be anticipated over the next five years, it will be important
to maintain a reasonable
level of capital for projects other than new program
development.
2 Years Prior 1 Year Prior Current Year
Revenue $461,500,000 $435,500,000 $427,000,000
Margin $ 23,075,000 $ 4,355,000 ($ 1,495,000)
AR Days 55 56 60
Payer mix remains reasonably strong, though the percentage of
Medicare, Medicaid,
and self-pay patients is increasing.

117. 2 Years Prior 1 Year Prior Current Year
Medicare 32% 34% 35%
Medicaid 12% 15% 16%
Insured 50% 44% 41%
Self-pay 5 % 7% 8%
Service Region—Community Hospital is located in a thriving
county which represents its
primary service region. High tech business and industry find
the area attractive as do
retirees from across the nation. The area is noted for its mild
climate, cultural resources,
and strong educational system, including several colleges and a
university.
Prime location in a city of 400,000 and county of 900,000
Population growth of 4% per year
24% of population under 18
63% of population between 18–64

118. 13% of population over 65
49% male
51% female
Competitive Environment—Community Hospital has two
primary competitors. Tertiary
Medical Center, a 700-bed facility, is ten miles away. It is a
private, not-for-profit
institution, but was once owned by the county. During the past
decade it has become a
premier medical center, complete with its own air ambulance
service.
Noted for excellent, comprehensive heart center
Strong orthopedic and neurosurgery programs
Trauma center
Cancer services available; poorly organized; no ACOS
accreditation
Excellent pediatric services
Strong financial performance; growing market share
No teaching programs or academic center affiliations
Regional Hospital, a 350-bed facility, is located seven miles
away. It is also private, not-
for-profit, and was the county’s first hospital. Regional’s
reputation is excellent
throughout the service area. It offers a wide range of services,

119. but is not designated as a
trauma center.
Cancer services available; poorly organized; no ACOS
accreditation
Strong orthopedic services
Cardiac services including open heart surgery
Adequate financial performance; growing market share
No teaching programs or academic center affiliations
Quaternary Medical Center, one of the nation’s foremost
academic research and
teaching institutions, is located 60 miles away, but is not
considered a significant
competitive threat. It boasts a comprehensive cancer center of
international repute that
attracts patients from across the nation and around the world.
Strategic Plan Highlights—Just over a year ago, Trinity
Community Hospital initiated a
strategic planning process. The Board of Trustees recognized
that a clear five-year plan
was essential in order to reverse declining performance trends.
The hospital CEO and
senior management staff were asked to assess community needs,
seek input from
medical staff members and community leaders, and to develop a

120. vision for the hospital
that would make it a vital component of the county’s healthcare
delivery system. The
Board requested that the five-year plan provide answers to four
basic questions:
1) Which services should we develop?
2) What are our five-year target outcomes for these services?
3) What level of capital investment will be required?
4) Will new programs provide sufficient margin to generate
adequate resources for
future growth?
Early in the planning process the management team determined
that the hospital’s
value to the community would be greatly enhanced by
development of a few premier
programs clearly differentiated from those offered by
competitors rather than
continuing to offer only baseline medical/surgical services.
Following* are brief
highlights of the five-year strategic plan.
* Refer to TCH Strategic Plan Power Point Presentation
Task 4/Service Line Development - General Case
Scenario/Trinity Community Hospital Strategic Plan.pdf
FIVE-YEAR PROGRAM PLAN
Prepared by Molly Briscoe, Planning Director

121. F
IV
E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
Mission: To provide outstanding care for all our
patient
Vision: To position Trinity Community Hospital as a
premier provider of cancer, orthopedic, and
cardiovascular services
Values: To emphasize four basic principles of success
as we work to achieve our mission and vision

122. • Quality and Safety
• Service Excellence
• Staff Achievement
• Growth and Profitability
F
IV
E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
Goal 1: Develop Regional Cancer Center Noted

123. for Clinical and Service Excellence
Strategy A: Offer Distinctive Clinical Programs and Services
• Multidisciplinary, disease-focused clinics: breast, GI, lung,
prostate
• Comprehensive medical, surgical, radiation, support services
• Evidence-based treatment and access to leading clinical trials
Strategy B: Emphasize Cancer Prevention and Control
• Community education
• Screening and risk assessment
• Outreach to underserved communities
Strategy C: Enhance Service Access
• Fast-track scheduling
• Patient navigation
1) Quality and Safety
• ACOS accreditation as
comprehensive community cancer
center
• >8% of patients accrued to clinical
trials
• Ongoing community screening for
top 4 disease sites
2) Service Excellence
• Patient likelihood of recommending
>90th percentile
• Physician satisfaction >90th

124. percentile
3) Staff Achievement
• Oncology nurse certification >90%
• Oncology staff retention >90%
4) Growth and Profitability
• Discharges—382
• Radiation Oncology Treatments—
9,100
• Chemo treatments—7,000
• Margin—$1,337,000
Five-Year Target Outcomes for
Regional Cancer Center
F
IV
E
-Y
E
A
R
P
R
O
G
R

125. A
M
P
LA
N
1) Oncology center with simulator, linear accelerator,
infusion suite—$8,000,000 (includes renovation of
vacant space in MOB 1 )
Capital Investment for Regional Cancer Center
F
IV
E
-Y
E
A
R
P
R
O
G
R
A
M

126. P
LA
N
F
IV
E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
Goal 2: Develop Regional Orthopedic Center Noted for
Clinical and Service Excellence

127. Strategy A: Offer Distinctive Clinical Programs and Services
• Spine, total joint, hand
• Comprehensive rehab and support programs
• Best practices and treatment protocols
Strategy B: Emphasize Prevention of Injury and Disease
• Community education
• Screening and risk assessment
• Outreach services to underserved communities
Strategy C: Enhance Service Access
• Fast-track scheduling
• Coordination of services
1) Quality and Safety
• CMS orthopedic indicator set >90th
percentile
• Pre/post procedure class attendance
>75%
2) Service Excellence
• Likelihood of recommending >90th
percentile
• Physician satisfaction >90th
percentile
3) Staff Achievement
• Orthopedic nursing staff
certification >75%
• Orthopedic staff retention rate >90%

128. 4) Growth and Profitability
• Surgical cases—2100
• Physical therapy visits—6,500
• Margin—$2,171,500
Five-Year Target Outcomes for Regional Orthopedic Center
F
IV
E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
1) New 5,000-square-foot physical therapy/rehab

129. center—$600,000 if constructed on campus;
$700,000 if purchased adjacent to campus
2) Radiology expansion/second MRI—$3,000,000
Capital Investment for Regional Orthopedic Center
F
IV
E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
F
IV

130. E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
Goal 3: Develop Cardiovascular Center Noted
for Clinical and Service Excellence
Strategy A: Offer Distinctive Clinical Programs and Services
• Peripheral artery disease, heart failure, electrophysiology
• Cardiology for women
• Evidence-based treatment
Strategy B: Emphasize Prevention and Control of
Cardiovascular Disease
• Community Education
• Screening and risk assessment

131. • Outreach services to underserved communities
Strategy C: Enhance Service Access
• Fast-track scheduling
• Coordination of services
1) Quality and Safety
• CMS AMI indicator set >90th
percentile
• CMS heart failure indicator set >90th
percentile
2) Service Excellence
• Patient satisfaction >90th percentile
• Physician satisfaction >90th
percentile
3) Staff Achievement
• Cardiac certified nursing staff >90%
• Cardiac staff retention rate >90%
4) Growth and Profitability
• Diagnostic catheterizations—2,000
• Peripheral vascular procedures—500
• Margin—$3,625,000
Five-Year Target Outcomes for
Cardiovascular Center
F

132. IV
E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
1) Cath labs (2)—$4,500,000
2) Cardiac rehab expansion—$500,000
Capital Investment for Cardiovascular Center
F
IV
E

133. -Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
Successful implementation of the plan outlined
above will drive dramatic increases in volume and
improved financial performance for Community
Hospital. Most important, however, it will make
available the most advanced approaches for
preventing, diagnosing, and treating disease
processes impacting thousands throughout the
hospital’s service area.
Plan Summary
F

134. IV
E
-Y
E
A
R
P
R
O
G
R
A
M
P
LA
N
1) Quality and Safety
• All relevant CMS indicator sets >90th
percentile
• Implementation of computerized MD
order entry
2) Service Excellence
• Inpatient likelihood of recommending

135. >90th percentile
• Outpatient likelihood of recommending
>90th percentile
• Physician satisfaction >95th percentile
3) Staff Achievement
• Employee retention rate >88%
• Annual employee satisfaction >90%
4) Growth and Profitability
• Growth and Profitability
• Discharges—7,800
• ALOS—4 days
• ADC—85.5
• Surgeries—14,800
• Outpatient visits—116,220
• ED visits—36,100
• Revenue—$624,000.000
• Margin—$31,200,000
Trinity Community Hospital
Five-Year Hospital-Wide Target Outcomes
F
IV
E
-Y
E
A
R
P

136. R
O
G
R
A
M
P
LA
N
Task 4/Service Line Development - Task 4 Artifacts/Email from
CFO to CEO Five Year Financial Estimates .pdf
Morgan—
Following are estimates of the financial information you
requested in order to complete your board presentations on
development of cancer, orthopedic, and cardiology programs.
Obviously, no one has a crystal ball, but I think these are
reasonable
given what we believe will happen with reimbursement trends,
improved operating efficiency, increased volume, payer mix,
etc.
Morgan Reece, CEO
Five-Year Financial Estimates Presentations
Mike Corrigan, CFO

137. Cancer—Five-Year Projection
1) gross charges per oncology discharge—$70,000
2) gross charges per radiation oncology treatment—$450
3) gross charges per chemo treatment—$600
4) collections—35%
5) ratio of cost to charges—30%
Orthopedics— Five-Year Projection
1) gross charges per orthopedic surgical case—$25,000
2) gross charges per physical therapy treatment—$275
3) collections—35%
4) ratio of cost to charges—31%
Mike
Cardiology— Five-Year Projection
1) gross charges per diagnostic cath—$30,000
2) gross charges per peripheral vascular procedure—$25,000
3) collections—35%
4) ratio of cost to charges—30%
Total Hospital— Five-Year Projection
1) gross charges per hospital discharge—$80,000
2) overall collections—35%
3) overall ratio of cost to charges—30%
Task 4/Service Line Development - Task 4 Artifacts/Email from
David Joint.pdf
Morgan Reece, CEO

138. Branch Orthopedic Office
Morgan—
My group will open its branch office near the hospital in
approximately three months. Five of our surgeons are applying
for privileges
at Trinity and would like to use the facility for some of their
patients. I assume that you will be working with the board to get
the go
ahead for development of orthopedics as an area of focus for the
hospital. The community really needs more capacity, and I think
we
could develop a truly exceptional program. Look forward to
hearing more about this at the next board meeting.
David
Dr. David Joint, MD
Task 4/Service Line Development - Task 4 Artifacts/Email from
Fred Brian.pdf
Morgan Reece, CEO
Branch Orthopedic Office
Morgan—
Just wanted you and the hospital team to know that our group
has secured office space to open a branch orthopedic practice
near

139. adjacent to the Trinity campus. We anticipate having everything
ready to go in 4-6 months. Six of our physicians have begun the
process of getting hospital privileges, so it won’t be long until
we will want to admit patients to your facility. I would
encourage you
to gain approval from the board to move forward with
development of a true orthopedic program. Much opportunity
exists for us to
work together to provide some additional services for patients
that are currently not available. For example, I hope to work
with your
director of patient care to develop pre- and post-procedural care
maps for total joint patients. Let me know if I can be of
assistance
as you work through issues with the start-up of a new service.
Fred
Fred Brian, MD
Task 4/Service Line Development - Task 4 Artifacts/Email from
Malcom Stile.pdf
Morgan Reece, CEO
Cath Lab/Peripheral Vascular Service
Morgan—
Wanted to confirm that my practice group is looking forward to
working with you to develop a cardiovascular program at
Trinity. As
you know, the community is in real need of additional capacity

140. to diagnose and treat cardiovascular illness. All six members of
my
group are planning to do work at the hospital once necessary
resources are in place. With availability of a state-of-the-art
cath lab,
many patients could be diagnosed and treated at Trinity who
now have to go to other hospitals in the community—
particularly those
with peripheral vascular disease. Most of these patients do not
require cardiac surgical back-up making Trinity an ideal choice
for
such a program. I also think that we have an opportunity to
develop outstanding screening and educational outreach
programs
targeting segments of the population at high risk for
cardiovascular disease. Also think it might be worth pursuing a
link with
Academic Medical Center for cardiac services. Some of their
clinical trials might be appropriate for patients at Trinity. Look
forward
to working with you and the hospital staff.
Malcolm Stile, MD
Task 4/Task 4.docx
Directions
SUBDOMAIN 705.1 - HEALTHCARE ENVIRONMENT &
COMMUNITY HEALTH
SUBDOMAIN 705.2 - HEALTHCARE ECONOMICS &
FINANCE
SUBDOMAIN 705.3 - HEALTHCARE OPERATIONS
MANAGEMENTCompetency 705.1.2: International Healthcare
Trends - The graduate analyzes international healthcare trends
and assesses their impact on local health issues to develop
strategies for improvement.

141. Competency 705.2.1: Service Line Management - The graduate
evaluates and analyzes a healthcare organization’s management
of service lines.
Competency 705.2.2: Costs and Productivity - The graduate
manages costs and productivity to improve a healthcare
organization’s sustainability.
Competency 705.2.3: Revenue Analysis - The graduate performs
net revenue analysis to maximize a healthcare organization’s
financial performance.
Competency 705.3.1: Communication - The graduate designs,
develops, creates and communicates a healthcare organization’s
marketing strategy to staff and the public.
Introduction:
Organizations periodically seek to establish a new line of
business or improve performance of an existing one. You should
understand the marketplace as well as the internal environment,
and how both may impact the ultimate success of the
organization’s service line. Using the “Service Line
Development Case Study,” you will assess the viability of
developing one of the following new service lines:
• Orthopedic center
• Cardiovascular center
• Cancer center
You will assume the role of a CEO in a healthcare facility. The
CEO is tasked with developing a new service line. You will
present the findings to the board of directors for buy-in and
approval.
Task:
A. Determine the feasibility of one of the proposed service
lines in the attached “Service Line Development Case Study” by
doing the following:
1. Evaluate the demand for the new service line in the market
area defined in the case study.

142. 2. Analyze how current international healthcare trends could be
incorporated into the development of the new service line.
3. Discuss the existing programs and service lines in the
healthcare organization that could serve as complementary
components of the new service line.
4. Analyze the financial and operating data to determine the
financial feasibility of instituting the new service line.
5. Discuss target and marketing referral services for physicians.
B. Create a multimedia presentation (e.g., PowerPoint,
Keynote) in which you recommend the next steps to develop and
implement the selected service line.
C. When you use sources, include all in-text citations and
references in APA format.
Note: When bulleted points are present in the task prompt, the
level of detail or support called for in the rubric refers to those
bulleted points.
Note: For definitions of terms commonly used in the rubric, see
the Rubric Terms web link included in the Evaluation
Procedures section.
Note: When using sources to support ideas and elements in a
paper or project, the submission MUST include APA formatted
in-text citations with a corresponding reference list for any
direct quotes or paraphrasing. It is not necessary to list sources
that were consulted if they have not been quoted or paraphrased
in the text of the paper or project.
Note: No more than a combined total of 30% of a submission
can be directly quoted or closely paraphrased from sources,
even if cited correctly. For tips on using APA style, please refer
to the APA Handout web link included in the General
Instructions section.

143. Web Links:
1.
Service Line Development - General Case Scenario
2.
Service Line Development - Task 4 Artifacts