Service Line Development Task 2, 3 and 4 (Just for Puja)

Puja,

Please see the attached file Service Line Development Task 2, 3 and 4 in zip format..

Thanks,

Task 2/Service Line Development – General Case Scenario/CEO Position Overview

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

TRINITY COMMUNITY HOSPITAL—BOARD PROFILE

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.

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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.

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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.

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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.

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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.

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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.

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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

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 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
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 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 2/Service Line Development – General Case Scenario/Trinity Community Hospital Fact Sheet

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
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.

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

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
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

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.

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

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, 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 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 2/Service Line Development – General Case Scenario/Trinity Community Hospital Strategic Plan

FIVE-YEAR PROGRAM PLAN
Prepared by Molly Briscoe, Planning Director

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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
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
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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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
• 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

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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
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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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

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Task 2/Service Line Development – Task 2 Artifacts/Community Health Needs Assessment

Community Health Needs Assessment

During the past year, a focused community health needs 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

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,
nutrition shopping for healthier food products, and smoking cessation are
infrequent and sporadic.

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 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%).

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 x

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:
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:

Service Line Development – General Case Scenario

Service Line Development – Task 2 Artifacts

Evaluation Method

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Task 3/Service Line Development – General Case Scenario/CEO Position Overview

Position Overview—CEO Trinity Community Hospital

1) Organizing and overseeing an ongoing strategic planning process to ensure

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 3/Service Line Development – General Case Scenario/Trinity Community Hospital Board Profile

TRINITY COMMUNITY HOSPITAL—BOARD PROFILE

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Mr. John Printer, Chairman

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Mrs. Cathy Promo

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Mrs. Maria Lopez

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Mr. Robert Holland

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Dr. David Joint

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Dr. Randy Sharp

Task 3/Service Line Development – General Case Scenario/Trinity Community Hospital Brochure

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 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.

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.

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

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 3/Service Line Development – General Case Scenario/Trinity Community Hospital Fact Sheet

Trinity Community Hospital Fact Sheet

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

Radiology 6

Pathology 2

Emergency 6

Total 89

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

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

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.

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%

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

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

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

future growth?

* Refer to TCH Strategic Plan Power Point Presentation

Task 3/Service Line Development – General Case Scenario/Trinity Community Hospital Strategic Plan

FIVE-YEAR PROGRAM PLAN
Prepared by Molly Briscoe, Planning Director

FIV
E-YEA

R
P

R
O

G
R

A
M

P
LA

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

FIV
E-YEA

R
P

R
O

G
R

A
M

P
LA

N
Goal 1: Develop Regional Cancer Center Noted

for Clinical and Service Excellence

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

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

FIV
E-YEA

R
P

R
O

G
R

A
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LA

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
FIV

E-YEA
R

P
R

O
G

R
A

M
P

LA
N

FIV
E-YEA

R
P

R
O

G
R

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

• 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
FIV

E-YEA
R

P
R

O
G

R
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
FIV

E-YEA
R

P
R

O
G

R
A

M
P

LA
N

FIV
E-YEA

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
• 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

FIV
E-YEA

R
P

R
O

G
R

A
M

P
LA

1) Cath labs (2)—$4,500,000

2) Cardiac rehab expansion—$500,000

Capital Investment for Cardiovascular Center
FIV

E-YEA
R

P
R

O
G

R
A

M
P

LA
N

Plan Summary
FIV

E-YEA
R

P
R

O
G

R
A

M
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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
>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

Trinity Community Hospital
Five-Year Hospital-Wide Target Outcomes

FIV
E-YEA

R
P

R
O

G
R

A
M

P
LA

Task 3/Service Line Development – Task 3 Artifacts/Email from Holland to CEO

Morgan Reece, CEO

Legislative Trends

Morgan—

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

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 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.mp3
Voicemail Script

Jenna Owens

Jenna Owens’s Album

2010

Other

29.57082

eng –
00000553 00000001 00008B1A 0000000D 0000061F 0000156D 00007DD0 00007DBF 00002BFA 00002BFA

eng –
00000000 00000210 00000A1A 000000000013D9D6 00000000 00000000 00000000 00000000 00000000 00000000 00000000 00000000

Task 3/Task 3 x

Directions

SUBDOMAIN 705.4 – HEALTHCARE VALUES, POLICY, & LAW

Competency 705.4.1: Health Policy

– The graduate effectively interprets health policy initiatives.
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.

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:

Service Line Development – General Case Scenario

Service Line Development – Task 3 Artifacts

Task 4/Service Line Development – General Case Scenario/CEO Position Overview

Position Overview—CEO Trinity Community Hospital

1) Organizing and overseeing an ongoing strategic planning process to ensure

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 4/Service Line Development – General Case Scenario/Trinity Community Hospital Board Profile

TRINITY COMMUNITY HOSPITAL—BOARD PROFILE

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Mr. John Printer, Chairman

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Mrs. Cathy Promo

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Mrs. Maria Lopez

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Mr. Robert Holland

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Dr. David Joint

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Dr. Randy Sharp

Task 4/Service Line Development – General Case Scenario/Trinity Community Hospital Brochure

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 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.

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.

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

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

Trinity Community Hospital Fact Sheet

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

Radiology 6

Pathology 2

Emergency 6

Total 89

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

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

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.

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%

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

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

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

future growth?

* Refer to TCH Strategic Plan Power Point Presentation

Task 4/Service Line Development – General Case Scenario/Trinity Community Hospital Strategic Plan

FIVE-YEAR PROGRAM PLAN
Prepared by Molly Briscoe, Planning Director

FIV
E-YEA

R
P

R
O

G
R

A
M

P
LA

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

FIV
E-YEA

R
P

R
O

G
R

A
M

P
LA

N
Goal 1: Develop Regional Cancer Center Noted

for Clinical and Service Excellence

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

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

FIV
E-YEA

R
P

R
O

G
R

A
M

P
LA

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
FIV

E-YEA
R

P
R

O
G

R
A

M
P

LA
N

FIV
E-YEA

R
P

R
O

G
R

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

• 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
FIV

E-YEA
R

P
R

O
G

R
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
FIV

E-YEA
R

P
R

O
G

R
A

M
P

LA
N

FIV
E-YEA

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
• 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

FIV
E-YEA

R
P

R
O

G
R

A
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LA

1) Cath labs (2)—$4,500,000

2) Cardiac rehab expansion—$500,000

Capital Investment for Cardiovascular Center
FIV

E-YEA
R

P
R

O
G

R
A

M
P

LA
N

Plan Summary
FIV

E-YEA
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
>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

Trinity Community Hospital
Five-Year Hospital-Wide Target Outcomes

FIV
E-YEA

R
P

R
O

G
R

A
M

P
LA

Task 4/Service Line Development – Task 4 Artifacts/Email from CFO to CEO Five Year Financial Estimates

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

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

Morgan Reece, CEO

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

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
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

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 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.

aŀƭŎƻƳ

Malcolm Stile, MD

Task 4/Task 4 x

Directions

SUBDOMAIN 705.1 – HEALTHCARE ENVIRONMENT & COMMUNITY HEALTH
SUBDOMAIN 705.2 – HEALTHCARE ECONOMICS & FINANCE
SUBDOMAIN 705.3 – HEALTHCARE OPERATIONS MANAGEMENT

Competency 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.
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.

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.

Web Links:

Service Line Development – General Case Scenario

Service Line Development – Task 4 Artifacts

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