Preparing a Strategic Plan for an Agency Report

Strategic Plan Assignment: Module 2 Strategic Plan Assignment: Module 2 Criteria This criterion is linked to a Learning OutcomeExternal environmental assessment (20 points) This criterion is linked to a Learning OutcomeMission/vision of the organization (10 points) This criterion is linked to a Learning OutcomeGoals – 3 year plan (25 points) This criterion is linked to a Learning OutcomeOrganization: Strengths (5 points) Ratings 20.0 to >16.0 pts Exemplary Assessment of the external environment is complete, with specifics about the neighborhood and location 10.0 pts Exemplary The mission/vision of the organization is identified and there is a clear connection of this project to those factors 16.0 to >11.0 pts Meets Minimum Requirements Limited description of external environment 10.0 to >8.0 pts Meets Minimum Requirements Mission/vision is identified; however, no discussion regarding connection to the project 25.0 to >21.0 pts Exemplary Goals for Year 1, 2, 3 are clearly identified, with specific reference to two cost centers and items in each year that demonstrate progress for the project 5.0 to >4.0 pts Exemplary Identifies the strengths within the organization to support this project. Includes reference to System support where applicable. 11.0 Nee Mis min 8.0 to Needs Missio define to the 21.0 to >16.0 pts Meets Minimum Requirements Goals are delineated for fewer than 3 years. Discussion is limited. 4.0 to >2.0 pts Meets Minimum Requirements Only one strength is identified with limited discussion 1 N N o y Strategic Plan Assignment: Module 2 Criteria This criterion is linked to a Learning OutcomeOrganization: Weaknesses (5 points) This criterion is linked to a Learning OutcomeOrganization: Opportunities (5 points) This criterion is linked to a Learning OutcomeOrganization: Threats (5 points) This criterion is linked to a Learning Outcome3-year revenue projections (15 points) This criterion is linked to a Learning OutcomeAPA Format (10 points) Ratings 5.0 pts Exemplary Identifies weaknesses within the organization that could present challenges to the success of the project. 5.0 pts Exemplary Identifies opportunities the organization can take advantage of to support the project. 5.0 to >4.0 pts Meets Minimum Requirements Only one weakness is identified with limited discussion 5.0 to >4.0 pts Meets Minimum Requirements Only one opportunity is identified with limited discussion 5.0 pts Exemplary Identifies threats to the organization that could affect the success of the project. 5.0 to >4.0 pts Meets Minimum Requirements Only one threat is identified with limited discussion 15.0 to >12.0 pts Exemplary Graphs for each year and regression for three years’ revenues. Discussion relates well to the graphs. 12.0 to >10.0 pts Meets Minimum Requirements Some graphs missing. Discussion is limited 10.0 pts Preparing a Strategic Plan for an Agency Report

Exemplary UTA CON Title Page; Grammar, spelling, format, references are APA 6th edition 10.0 to >9.0 pts Meets Minimum Requirements Headings not 6th edition, few errors in citations, lacking introductory or conclusion paragraphs, incorrect Reference format 10.0 Nee No c reve 9 N M f Strategic Plan Assignment: Module 2 Criteria Total Points: 100.0 PreviousNext Ratings Running Head: STRATEGIC PLAN 1 Strategic Plan for Seton Medical Center Harker Heights Wound and Vascular Care Expansion Gena Beliveau The University of Texas at Arlington College of Nursing In partial fulfillments of the requirements of N5342 Management of Nursing Operations Candida Constantine-Castillo MSN, FACHE, CEN, CPHQ, CPHRM, CENP, NEA-BC, CSHA, HACP January 27, 2017 STRATEGIC PLAN 2 External Environmental Assessment Seton Medical Center Harker Heights was opened in 2012 as a joint venture between LHP, as private venture group and Seton Healthcare, part of the Ascension group. It is an 83 bed acute care facility with services that include cardiac catheterization laboratory, surgical services and women’s services, including labor and delivery with Level I nursery. We are positioned in the geographic center of Bell County (Bell County Road Map, 2014). With a population of over 350,000 people, Bell County is the 16th largest county in Texas. It has a younger population than state or national averages, and a higher percentage of persons that lack health insurance (United States Census Bureau, 2016). Until the opening of our facility, residents of Bell County had to travel to the far west or northern areas to receive medical care from two established acute care hospitals that are operated by what is now doing business as Baylor Scott and White. These two organizations offer similar services to ours and are the main competition we face in the area, as the surrounding counties are medical underserved and sparsely populated. Mission Statement The mission of our organization is the folllowing: We are called to serve each patient with dignity and respect while always providing exceptional care. Our mission as a Catholic Health Care Ministry inspires us to provide care for and to improve the health of those we serve with a special concern for the poor and the vulnerable. We are called to be a sign of God’s unconditional love for all and believe that all persons by their creation are endowed with dignity. We provide STRATEGIC PLAN 3 exceptional care through collaboration with our Associates, Physicians, Volunteers and Community Partners. (Seton Medical Center Harker Heights, 2012). Pursuant to this goal, we seek to improve the health of our poor and vulnerable citizens and provide them with exceptional care. We have been successful in this regard, expanding our services to the community by aiding the opening of a fitness center for community use in a joint effort with the Armed Services YMCA and also by supporting the Killeen Free Clinic with midlevel providers and transition nurses. We can further aid this by expanding our outreach for persons in our community with wounds and vascular disease. Goals for Three Year Plan One of the most profitable and highly regarded services lines within our organization is the Heart and Vascular Center. This department offers care for patients with cardiovascular, peripheral vascular and cardiac electrophysiological disorders. It has shown consistent, sustained growth since our opening in 2012, both in volume and diversity of service. Preparing a Strategic Plan for an Agency Report

The volumes are expected to continue increase, supported by the expansion of the outpatient area for cardiac catheterization laboratory, addition of a wound care clinic and brining an additional cardiologist on staff with peripheral vascular training. A timeline for these three goals will follow. Year One The initial step in this three year plan would be opening an outpatient wound care clinic. This can be completed in existing space in the Medical Office Building, owned by the facility. The internal redesign would take 3-4 months to complete during which time staff will be hired STRATEGIC PLAN 4 for the clinic. Within a six month timeframe the outpatient clinic will begin seeing patients and generating revenue. The additional benefit to the wound care practice is the resulting increased referrals to the Heart and Vascular Center for angiographic assessment of patients with nonhealing wounds. Up to 95% of non-healing wounds and amputations can be prevented by implementing minimally invasive modalities such as those offered by our Heart and Vascular Center (Muhs, Gagne, Maldonado, & Sheehan, 2006). This will create a vitally important and mutually beneficial relationship between the Wound Care Center and the Heart and Vascular Center. Estimates of increased referral for procedures would result in 10% increase in procedural volumes each year the would clinic is open (Pandya, J, personal communication, January 24, 2017). Year Two With the wound care center operating, the need for a second peripheral interventionalist will follow closely. This will require collaboration with the major cardiology practice, as their group is not employed by the facility. Their peripheral interventional specialist is the busiest practitioner in the group, so by logical extension, an increase in referrals would create this need within their practice. Our facility can facilitate this by offering flexible scheduling for procedures, specialized equipment that is state of the art, while ensuring excellence in clinical outcomes supported by our staff. With our present facilities, we could support an additional 5% in procedure volume for vascular cases (Simons, M., personal communication, January 26, 2017). STRATEGIC PLAN 5 Year Three As the wound care clinic and added vascular specialist increase volumes, it will become necessary to expand out outpatient holding area. This will require expansion of the area that is presently used for storage in the Heart and Vascular Center. Procedures will continue as per usual routine during this phase; only minimal barricading of construction area will be necessary. This storage room has an exterior wall that will be taken out and the room enlarged to create a radial lounge. This area will allow the present staff to be more productive by increasing the number of low acuity recovery and pre-procedure patients to 8 for the two licensed personnel. Presently, due to physical space constraints, these two staff members have only 3 low acuity patients at maximum. In addition to increasing our throughput and allowing a 20% increase in procedural volumes, this will also allow for same day discharge of patients with radial access. This will decrease the burden of keeping these patients overnight, without additional reimbursement, which is our present practice. This will represent a cost savings, although it will be difficult to forecast until we have physician and patient buy-in for same day discharge. It would be an appropriate item to benchmark in Year Four of this project. Organizational SWOT Analysis Strengths We are a de novo facility conceived and designed by local physicians who wanted to create a choice for Central Texas that offered personalized care and clinical excellence. (Ball, 2012). This physician group is not part of our ownership, but they are strongly influential within STRATEGIC PLAN 6 the facility, serving as directors in many of our services. The medical director of our Heart and Vascular Center is a native Texan who trained in Bell County and has practiced here with the widely respected Austin Heart group for over 20 years. He has a strong commitment to clinical excellence; he and his colleagues at Austin Heart have been integral in the development of our cardiac service line. We physician leadership that lives our mission, with every patient, every day. In addition our strong physician leadership, we also have a reputation for clinical excellence that is supported by the our designation as a Chest Pain Center with PCI. We are able to obtain this designation after only 2 years of operation. Our entire facility participated in an interdisciplinary effort to implement the streamlined, evidence based processes that the Society for Chest Pain Centers and American College of Cardiology look for when awarding this designation. Preparing a Strategic Plan for an Agency Report

A final strength that we possess within our area that will aid with attaining our goals and mission is low staff turnover within the Heart and Vascular Center. Despite being centered in a military community, less than 10 miles from the largest military instillation in the world, we have experience no nursing turnover in this mobile community. We have a core staff of registered nurses who each have greater than 10 years of experience in cardiac care and have worked in our unit since its opening. We have never had a nurse resign or transfer. Our staff lives our mission every day, with every patient. STRATEGIC PLAN 7 Weaknesses We are a de novo facility, so we are growing our base of referring primary care doctors. We have had some difficulty with attracting primary care doctors to our area, due in part to a national shortage. We spent significant resources on trying to attract pediatric providers as well, and when this effort was unsuccessful we abandoned the initiative for a dedicated pediatric service. This coincided with the opening of a Children’s hospital in a neighboring community, so there was little impetus to pursue this, but resources were misdirected for some time in this regard. As previously mentioned, we are military community. This does lead to a higher than anticipated turnover in staff at all levels throughout the facility. Our voluntary nursing turnover is annualized with a goal of less than 25%. This is higher than is usually accepted within the industry (Roussel, Thomas, & Harris, 2016). It has been accepted by our administration as part of doing business in the Fort Hood community, but we suffer the same ill effects of increase cost, difficulty maintaining staffing levels and ongoing educational needs. Finally, we are small. We do not offer some highly specialized care modalities that consumer seek such as neurosurgery or cardiothoracic surgery. It is unlikely, even with the aforementioned expansion projects that we could start viable programs in these costly, albeit prestigious, service lines. This is a feature that is worrisome to a minority of our patients; most are willing to accept referral to outlying facility should they require these types of services. STRATEGIC PLAN 8 Opportunities We have an opportunity to pursue accreditation for our cardiac catheterization laboratory through the American College of Cardiology. This would further designate our facility as a cardiac center of excellence in our small community. We would benefit from the marketability of this accolade and it is a reasonably attainable goal. We can expand our primary care base by adding mid-level providers at the outpatient clinics that are our referring centers. This would represent a potential cost savings and increase our profile within the community. It would also increase the number of referring providers. Finally, our facility has an opportunity to increase its share of potential employees, contribute to local economic and academic development by serving as a clinical site for local radiologic technologist programs. We have in place programs for ADN and BSN students; this is a logical extension and would help us with some hard to fill vacancies in our service area. There are two local community colleges that interested in pursuing this joint venture. Threats One of the biggest threats to our organization is not necessarily unique, but at a small facility it is felt more sharply. That is burden of uninsured care. We have found that the original payer mix analysis for our area did not take into account the fact that our uninsured persons were likely older and sicker than the general population, which is younger than average due to the high number of active duty military personnel and dependents. This results in a large number of uninsured patients seeking care in our emergency department for clinic level medical needs. (Sowell, 2016). STRATEGIC PLAN 9 An additional threat is the established healthcare system giant that operates less than 25 miles from our doors. Baylor Scott and White is a very large organization with more dollars to spend on marketing, innovation and charitable work than we have. They offer an insurance program that is widely held by many private employers in the area; this plan limits access to our facility by these patients. On a positive note, several major employers voted to remove this health plan as their insurer over the past two years, most notably the Killeen Independent School District. A final threat, which is internal, is fear. Preparing a Strategic Plan for an Agency Report

We are slow to adapt innovation due the perceived costs associated with it. The cardiology service line has used a great deal of political capital and leverage to implement new technology, but it has been with great reluctance. There is a sense of trepidation that can be pervasive when discussing money in a small facility. We must not let this blind us to opportunity that exists. STRATEGIC PLAN 10 Revenue Analysis In the following Appendix A-C, the data from each phase will be analyzed separately. Appendix A VASCULAR INTERVENTION VOLUMES Values Forecast Upper Confidence Bound Poly. (Values) Lower Confidence Bound 60 50 40 30 20 10 1/1/15 2/1/15 3/1/15 4/1/15 5/1/15 6/1/15 7/1/15 8/1/15 9/1/15 10/1/15 11/1/15 12/1/15 1/1/16 2/1/16 3/1/16 4/1/16 5/1/16 6/1/16 7/1/16 8/1/16 9/1/16 10/1/16 11/1/16 12/1/16 1/1/17 2/1/17 3/1/17 4/1/17 5/1/17 6/1/17 7/1/17 8/1/17 9/1/17 10/1/17 11/1/17 12/1/17 (10) The above chart projects our procedural volumes for peripheral intervention for 2017, based on 2015-2016 volumes. These values are slight increases year over year. With an average reimbursement of $5,600 per procedure (Fayer, G. personal communication, January 23, 2017), the revenue increase for 2017 without implement this plan would most likely be $201,600 for 2017. STRATEGIC PLAN 11 Appendix B Forecast for 2017-2020 with wound care clinic 40 35 30 25 20 15 10 5 1-Feb 1-Jan 1-Dec 1-Nov 1-Oct 1-Sep 1-Aug 1-Jul 1-Jun 1-May 1-Apr 1-Mar 1-Feb 1-Jan 1-Dec 1-Oct 1-Nov 1-Sep 1-Aug 1-Jul 1-Jun 1-Apr 1-May 1-Mar 1-Feb 1-Jan 0 Appendix B represents the predicted increase in peripheral interventions based on the volumes from the wound clinic. This increase, calculated at present average reimbursement rates would result in an increase in revenue of $134,000 annually, above and beyond our forecast growth from market share increases. STRATEGIC PLAN 12 The below appendix represents the projected 20% increase in volumes with additional radial lounge renovations. This annualized volume would amount to an additional 40 procedures annually, or an increase to revenue of roughly $224, 000. This accounts also for the addition of the second peripheral interventionalist, who is not a cost of the facility, but independent practitioner. Appendix C STRATEGIC PLAN 13 References Ball, P. (2012). Hospital Joint Venture between LHP Hospital Group, Inc. and Seton Family of Hospitals Establishes First New Hospital in Bell County, TX in 35 Years. Retrieved from http://www.prweb.com/releases/Hospital/JointVenture/prweb9616763.htm Bell County Road Map, 2014, Retrieved from http://www.bellcountytx.com/about_us/county_maps/index.php Muhs, B., Gagne, P., Maldonado, T., & Sheehan, P. (2006). Minimally invasive revascularization strategies for chronic lower limb ischemia. International Journal Of Lower Extremity Wounds, 5(1), 35-39 Seton Medical Center Harker Heights, 2012, About Us. Retrieved from http://setonharkerheights.net/about-us/ Sowell, L. (2016). Seton announces new partnership with healthcare savings provider. Copperas Cove Leader Press. Retrieved from http://www.coveleaderpress.com/living/setonannounces-new-partnership-healthcare-savings-provider United States Census Bureau, 2016, Quick Facts. Retrieved from http://www.census.gov/quickfacts/table/PST045213/48027 1 N4232 Management of Nursing Operations Strategic Planning Scenario The following scenario provides the basis for the new service line and information for you to use as you develop the Strategic Plan, Marketing Plan, and Formal Strategic Business Plan assignments. If you have ready access to data within your facility, you do not need to use this scenario: it is here to expedite the work needed in this class. In order to meet the health care needs of the community services in your facility need to be expanded to include short-stay services for ____ patients (identify the type of patients you will see in your new department). The facility has a strong base of physicians and surgeons to support the expansion plus additional space to accommodate this expansion. Additional FTEs will be required to staff this new area. (Develop the staffing needs by identifyi …