HMP 723 - Health Planning Midterm

Community Health Needs Assessment (CHNA)

- A state, tribal, local, or territorial health assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis. - Done once every 3 years.

situational Assessment

- Assessing the environment and the internal organization, after which the vision, mission, strategies, goals, objectives, and action steps are developed. Without this structure and sign posts as first steps, the organization cannot move forward. - One tool commonly used for the external and internal assessment is the SWOT analysis.

Government hospitals

- Operated by state, local, and federal governments to meet specific missions. The US Department of Defense, US Department of Veteran Affairs, US Public Health Service, and the US Department of Justice all operate hospitals. - Government hospitals are funded through a process that does not depend on the healthcare market

Balanced Scorecard

- The scorecard is usually divided into several areas that the organization considers important to achieving its mission. - Specific metrics should meet the following criteria: (1) importance to organization and staff, (2) measurability, (3) data validity, and (4) action ability.

For-profit hospitals

- Their mission is to generate profits for their shareholders. - Must pay federal and state corporate income taxes and local property taxes, and they should generate appropriate returns for stockholders

Direct-to-Consumer Marketing (DTCA)

Aimed at the consumer (a.k.a. patient) as opposed to the healthcare professional.

Attributes and characteristics contributing to the success of Transformational Leaders

Attributes : - Visionary, futuristic. - Catalyze followers. - Motivation - Goal oriented - Expertise - Flexibility - Communication Skills Personality Characteristics: - Self-knowledge, and confidence. - Authenticity - Charisma - Intelligence

Step 2 of SWOT analysis

Data on the organization are collected and sorted into four categories: strengths, weaknesses, opportunities, and threats. Organizational surveys are an effective means of gathering some of this information.

Step 3 of SWOT Analysis

Development of a SWOT matrix for each business alternative under consideration. •The hospital's expert panel would complete a separate SWOT matrix for each alternative.

SWOT analysis

Strengths, Weaknesses, Opportunities, Threats: - An examination of an organization's internal strengths and weaknesses, its opportunities for growth and improvement, and the threats that the external environment presents to its survival. Originally designed for use in other industries, it is gaining increased use in healthcare.

Threats in SWOT

factors that could negatively affect organizational performance. - Political or economic instability - increased demand for new expensive medical equipment - growing uninsured population

Step 1 of SWOT:

the collection and evaluation of key data. Depending on the organization, these data might include population demographics, community health status, sources of healthcare funding, and/or the current status of medical technology.

Down Stream Revenue

the revenue captured by the services a patient uses after his initial visit.

Great managers look inward

to their company as well as each individual employee. They notice differences in styles, goals, needs, and motivations of each person.

What is Culture?

Collection of values and norms shared by a group of individuals.

What If Analysis

refers to answering the question "what-if we did this?" or "what-if we did that?" which can be answered by running scenarios and sensitivities analyses for each strategic planning.

Characteristics of a Mission Statement:

- Broad in scope; do not include monetary amounts, numbers, percentages, ratios, or objectives - Less than 250 words in length - Inspiring - Identify the utility of a firm's products - Reveal that the firm is socially responsible - Reveal that the firm is environmentally responsible - Include nine components customers, products or services, markets, technology, concern for survival/growth/ profits, philosophy, self-concept, concern for public image, concern for employees - Reconciliatory - Enduring

Analyzing the External Environment

- By gathering information from external sources, healthcare organizations increase their likelihood of achieving success. - External information: •Market position •Local demographics •Competitors •Payers •Local business environment

Analysis of the Internal Environment

- Development of a mission and vision statement. - Need a clear link between values/mission and the strategic plan. - Early involvement with the board of directors and leadership team. - Internal data: -Finances -Personnel -Key assets -Quality of Care

Environmental Forces that Affect Strategy

- Economics and legislation (local and national) - Global and local politics - Demographic shifts and consumer behavior - Medical, information and communication technology - Payer strategies - Local employers - Competitors, new entrants and substitutes for healthcare services - Environment (e.g., hurricanes, tornados, earthquakes, droughts, increase in tropical diseases, etc.)

The Chief Financial Officer (CFO)

- Is critical to the development of the strategic plan because the CFO has responsibility for projecting workload and providing financial data. -The ability to provide accurate and timely information is often the most difficult part of the strategic planning process. Key data include growth projections, market share, departmental budgets, and monitoring of performance.

Ethics

- Is defined as moral duty, values, and obligation. - Ethical leaders have a moral responsibility to treat followers with dignity and respect and to act in ways that promote the welfare of others—most immediately, their followers (ACHE 2011).

Indirect Marketing

-It is not targeted directly to consumers but rather consists of leveraging brand recognition and awareness of a provider in the community. -Hospital signage is the cheapest and most effective marketing tool. -Word of Mouth advertising by patients.

A number of reasons that planning is crucial to the successful operation:

-it focuses attention on objectives -it helps offset the pervasive uncertainty -it enhances efficiency and effectiveness -it facilitates fulfillment of the management function of control

Role of the Board of Directors in Strategic Planning

1. A collaborative, community-oriented board stays in touch with the needs of the local population and develops new services to meet those needs. 2. Excellent working relationships between boards and senior leadership are necessary to enhance corporate governance. CEO succession is one of the board's most important responsibilities (Bowen 2014). 3. Additionally, the board should evaluate leadership's recommendations for new service lines (see Highlight 1.6) and monitor the quality of care.

Strategy Addresses

1. How management intends to grow the business; 2. How the organization relates to other companies in terms of competition and collaboration; 3. How the functional components of the business relate and coordinate with each other;

Two Keys to Success

1. Know your customers and target them. The best marketing message in the world delivered to the wrong consumer is a waste of money. You would likely not, for instance, advertise cataract surgery on ESPN. 2. Develop a compelling, unique selling proposition that makes you stand out. Are you better, faster, or less expensive than your competitors?

Four Types of Digital Media

1. Organizational Websites 2. Social Media 3. Patient Portals 4. Digital Bulletin Boards in patient waiting areas

The Crux of a Transformational Leader is:

1. Personal integrity 2. Public's trust (Without integrity, there is no trust) 3. A reminder of 3—"ty" ethical basis: -Honesty -Integrity -Credibility

Time frame of planning and who plans?

1. Strategic planning is long range and encompasses multiple years & at the senior management level 2. Operational planning is short term & performed at lower levels of the organization.

Mission, Vision, Values, and Goals

1. What is mission? Written Statement of an organization's fundamental purpose. 2. What is vision? Short, inspiring statement of what an organization intends to achieve in the future. 3. What are values? Social principles, goals and standards of an organization. 4. What are goals? Written objectives that can be measured to assess performance.

Steps in Scenario Analysis

1.Examination of key factors in the external environment 2.Identification of key uncertainties and driving forces 3.Creation of scenarios 4.Integration of scenarios into strategic planning

Transformational Leadership

A model of leadership that emphasizes being a change agent, putting the self aside to work for the good of all involved, and motivating one another to maximize individual and group potential. *Communicates the mission and vision of the organization, creatively solves problems, and mentors employees.*

Transactional Leadership

A model of leadership that emphasizes giving rewards for good performance or taking corrective action for poor performance; it suggests that followers are motivated only by this expectation of reward or threat of punishment. *Sometimes called managerial leadership because it focuses mainly on enforcing policy*

What is Planning?

A technical managerial function that enables HSOs to deal with the present and anticipate the future. It involves deciding what to do as well as how to do it.

Marketing Plan

A written document guiding marketing activities. It considers the competitive marketplace, the healthcare organization's capabilities, and areas with the greatest economic potential.

Not-for-profit hospitals

Considered 501(c)(3) organizations by the Internal Revenue Service. The 501(c)(3) designation identifies an organization as "any corporation that is organized or operated exclusively for religious, charitable, scientific, public safety, literary, or educational purposes."

Management Roles

Focus on the present, assuring operations support the vision and mission. Incremental continuous quality improvement is the province of the management role.

Weaknesses in SWOT

In SWOT analysis, these are internal factors about a business that can be seen as negative factors. Weaknesses might include a poorly trained workforce, limited production capacity, ageing equipment or poor cash flow. This information would also have been obtained from an internal audit.

Leadership

Is the ability to guide, influence, and inspire individuals to meet organizational goals. The healthcare industry has identified competency models that focus on those behaviors and technical skills that characterize outstanding leadership.

Allocation of Resources

Is the way an organization spends its money on facilities, staff, technology, and new programs. Because resources are limited, the leadership team must decide which areas or projects are most important and require additional investment.

Mission Statement Components

Mission statements can and do vary in length, content, format, and specificity. Most practitioners and academicians of strategic management feel that an effective statement should include nine components. 1. —Who are the firm's customers? 2. Products or services—What are the firm's major products or services? 3. Markets—Geographically, where does the firm compete? 4. Technology—Is the firm technologically current? 5. Concern for survival, growth, and profitability—Is the firm committed to growth and financial soundness? 6. Philosophy—What are the basic beliefs, values, aspirations, and ethical priorities of the firm? 7. Self-concept—What is the firm's distinctive competence or major competitive advantage? 8. Concern for public image—Is the firm responsive to social, community, and environmental concerns? 9. Concern for employees—Are employees a valuable asset of the firm?

Operational Planning

More narrow and limited than strategic planning.

The term "Strategic Planning" is sometimes used synonymously with the term..

Strategic Management

What is Strategic Planning?

Strategic Planning is the set of organizational processes for identifying the desired future of the organization and developing decision guidelines.

Chief Information Officer (CIO)

Provides internal and external information. Sources of data include literature searches, internal databases, community surveys, focus groups and interviews with community leaders, and physicians. Internal data is of particular importance because it highlights an organization's strengths and weaknesses.

Fiduciary Responsibility

Refers to the obligation that one party has in relationship with another one to act entirely on the other party's behalf and best interest. It is considered to be the standard of the highest care.

Sensitivity Analysis

Refers to the process of tweaking just one key input or driver in a model and seeing how sensitive the model is to the change in that variable

Opportunities in SWOT

Significant new business initiatives available to a healthcare organization. - collaboration among healthcare organizations through the development of healthcare delivery networks - increased funding for healthcare informatics -integrated, patient-focused care.

T/F - As a percentage of the US economy, healthcare spending in 2019 was 17.8 percent of the gross domestic product (GDP).

TRUE

T/F - The largest component of national economy and largest healthcare expenditures was hospital care, which Medical cost is expected to increase in 2020

TRUE

Strengths in SWOT

The current factors that have prompted outstanding organizational performance. - state-of-the-art medical equipment. - competent personnel - growth through mergers and acquisitions

The Board of Directors

The governing body appointed to hold fiduciary responsibility for the organization. As part of this responsibility, they make policy decisions that guide the future of the organization. An essential component is the development of a strategic plan that is consistent with the mission and vision of the organization.

Chief Executive Officer (CEO)

The highest-ranking executive in an organization, has operational responsibility for strategic planning, hiring of senior leadership, and managing of operations. The CEO is frequently a member of the board of directors and serves as a key interface between the board and operations.

Hospital Board Responsiblities

The hospital board of directors' role is to serve as the governing body of the hospital. The board is responsible for oversight of the hospital: -The board is responsible for the establishment of the hospital's strategic plan including mission and vision development - hiring and monitoring an effective CEO - oversight of quality improvement, patient safety, performance, measurement & risk identification - overseeing the hospital's financial well-being including approving the hospital annual budget - staying educated in healthcare industry news and best practices - being a representative of the hospital in the community - the board is not involved in the day-to-day operations of the hospital. The daily operation of the hospital is management's responsibility. The board governs and management manages.

Competitive Advantage

The way that an organization succeeds in the competition with its rivals is by doing something that gives it an advantage in the eyes of the consumers of its products and services and the sources of its capital.

Groupthink

a concept introduced in 1972 by social psychologist Irving Janis that refers to a mentality that develops in groups as a result of deterioration of "mental efficiency, reality testing, and moral judgment" caused by pressures among group members. The more input there is into a decision, the more plausible and innovative the solutions.

Scenario Analysis

a more in-depth approach to forecasting. It draws on a range of disciplines and interests, among them economics, psychology, sociology, and demographics. It does not rely on extrapolation of historical trends. Rather, it seeks to explore possible developments that may only be connected to the past.

Great Leaders look Outward

at the competition, use alternative routes and focus on broad patterns to make connections. They are visionaries, strategic thinkers, and activators.

force field analysis

identifying the forces driving or hindering change—in other words, the forces driving its strengths, weaknesses, opportunities, and threats.

STEP 4: SWOT Analysis

incorporating the SWOT analysis into the decision-making process to determine which business alternative best meets the organization's overall strategic plan.

HIMSS Analytics EMR Adoption Model

• Measures the level of clinical information systems adoption in US hospitals. • It rates hospitals' level of adoption using a seven-stage scale, where Stage 0 indicates the lowest level of adoption and Stage 7 indicates the highest level of adoption.

Patient Portals

• Secure websites that give patients 24-hour access to personal health information. •Advanced patient portals allow patients to do the following: -Communicate via secure e-mail with their healthcare teams -Request prescription refills -Schedule appointments -Check insurance coverage

Strategic planning

•A process of defining and managing actions that will shape an organization; the development of organizational objectives and measurement of ongoing performance.

Benefits of Strategic Planning (I)

•Aggressive and proactive •Create a desired future •Clarity of strategic vision •Motivate greater organizational achievement •Direct attention to the long term

Benefits of Strategic Planning (II)

•Awareness of external environment •Efficient allocation of resources •Inspire and energize employees •Basis of metrics for success

Healthcare Data warehouse

•Database that integrates multiple types of data, such as patient demographic information, comprehensive clinical information, and resource utilization data.

Trends in the External Environment

•Hospital/Healthcare system merger and acquisition (M&A) •Accountable care organizations (ACOs) and population health •Expanded insurance coverage under the ACA •An estimated 10.3 million Americans •Increased participation in healthcare systems •The impact of specialty hospitals •The rise of ambulatory surgery centers and outpatient surgery, free standing labs and imaging centers •The wide-spreading UC •Professional/manpower shortage

Managing Healthcare Personnel

•Hospitals should routinely perform salary surveys to compare their salary rates to local and state peers. • Good communication skills •Patient satisfaction is also improved when healthcare professionals communicate clearly, express empathy, and demonstrate good listening skills.

An organization's strategic plan needs to address the following core areas:

•Improvement of healthcare quality •Increased patient access •Improved employee retention •Differentiation in the market •Improved alignment of resources

Regional Planning

•Includes an analysis of population demographics and the development of mathematical models designed to determine the need for health services in local communities. •Typically, academic medical centers generate the strongest presence on a regional level, followed by larger tertiary community hospitals.

Healthcare data analysts

•Individuals hired by healthcare organizations to compile, validate, and analyze crucial medical data.

Local Planning

•Local governmental entities and other organizations in the community can provide additional funding and thus significantly influence the allocation of healthcare resources.

The Concept of "Strategy" (II)

•Major resource commitments •Seeks advantage over competitors •Pursue few strategies at one time •Rarely changed

The Chief Nursing Officer (CNO)

•Nursing leadership is an important part of the organization's decision-making process and should be involved in strategic planning. The involvement of nursing leadership provides an important perspective on the allocation of resources, marketing of new services, and enhancement of quality. •Research found that 10% of chief nursing officers (CNO) had voting membership on the board of directors. More recently, the Magnet Hospital designation requires documentation on the nurse executive's role in the senior leadership decision-making process.

Evaluation of Performance

•One useful tool for linking strategic goals to annual operating performance is called a dashboard. •Dashboards could include the following: •Quality of care (e.g., hospital-acquired infection rates and 30-day readmission rates) •Patient satisfaction •Market penetration

The Concept of "Strategy" (I)

•Overall direction •Long time horizon •Organization-wide impact •Fully utilizes all assets •Matches organization to environment

The Five Ps of Healthcare Marketing

•People—patient demographics along with the physicians and healthcare workers required to deliver a quality service line within the local market •Product—the type of healthcare service to be offered and the quality outcomes to be measured •Price—the fee schedule or rate of reimbursement for the service, adjusted for payer mix •Place—the location of the service, including the facility, parking, signage, and easy access to major highways •Promotion—the method of advertising to be used to appeal to physicians, patients, health plans, and local businesses

The Concept of "Strategy" (III)

•Requires change throughout the organization •Requires collaboration throughout the organization •Future-oriented •Marked by uncertainty and risk

Purpose of Strategic Planning?

•Satisfy and reward stakeholders •Pursue and fulfill the mission •Survive

The Chief Medical Officer (CMO)

•Senior clinical leadership can improve treatment outcomes by supporting innovation in clinical practice as well as interdisciplinary collaboration among the healthcare delivery team. •Physician input is essential to the development of any new clinical services, and a collaborative relationship among the clinical team is a key to future success.

E-Health/Telemedicine/Telehealth

•Telemedicine was originally used to describe medical service provision across a distance. • The term telehealth was introduced to reflect a broader scope of health-related functions. -E-health, used to cover a broad range of data processing and computer networking applications (including the Internet) in healthcare, has emerged

National Planning

•The United States has experienced significant improvement in the health status of its population over the past decade. However, research demonstrates that minorities suffer disproportionately from many diseases.

Joint venture

•The combination of the resources of two organizations to accomplish a specific purpose. •These include the opportunity to invest in new administrative technologies such as electronic billing systems, online claims processing, electronic medical records, and web-based patient scheduling.

Strategic Plans Take:

•Three to five years to implement •Wide range of organizational activities •Covers broad geographic area •Large number of employees •High monetary cost

Gap Analysis

•a review of an organization's internal and external environments for purposes of revealing difference or gaps. •These gaps become the focal points that shape the strategic plan. •Two of the most important gaps organizations need to address today are found in the areas of information technology and diversity.

Joint Ventures

•enable organizations to preserve capital, expand services, and better meet community healthcare needs.

Strategic Financial Planning

•improve ability to manage resources and reduce costs. •with inadequate reimbursement, greater price competition, and a growing shortage of professional staff, healthcare organizations are forced to improve financial performance to gain greater access to capital and remain competitive. •Higher volumes are needed with limited financial constraints.