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CAH HOSPITAL STRATEGIC PLANNING MODEL. PHIL CAMPBELL, FACHE. CAH Strategic Planning Model. Develops strategic plans for rural and CAH-eligible hospitals Integrates comparisons of clinical and operational performance measurements with state and national benchmarks

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cah strategic planning model
CAH Strategic Planning Model
  • Develops strategic plans for rural and CAH-eligible hospitals
  • Integrates comparisons of clinical and operational performance measurements with state and national benchmarks
  • Creates an effective decision-making tool for everyday operations

“Because what you measure gets done.”

...Tom Peters, In Search of Excellence

cah strategic planning model1
CAH Strategic Planning Model
  • Effective
  • Comprehensive
  • Low cost
  • Meets ORYX requirements
  • Builds on past successes
  • Builds confidence in management
effective
Effective
  • The planning model provides more than a notebook on a shelf and a checkmark on a JCAHO surveyor’s form.
  • The planning model integrates planning into all facets of the organization through coordinated reporting by core businessdrivers.
  • The plan creates a decision matrix which directs focus on values, mission and the vision for the future.
comprehensive

Core Business Drivers

Comprehensive
  • Utilizes 6 core business drivers which represent major divisions of healthcare operations addressing “real life” rural hospital operations
low cost
Low Cost
  • Specifically created by a rural hospital administrator for rural hospitals with limited resources
  • Utilizes existing data available through state health planning agencies
  • Utilizes CHIPS, a high-quality, low-cost source of DRG-specific data with cohort benchmarking
meets oryx requirements
Meets ORYX Requirements
  • Utilizes a format consistent with
    • ORYX requirements
    • JCAHO accreditation standards
    • Malcolm Baldrige Quality Criteria
builds on past successes
Builds on Past Successes
  • The strategic planning process utilizes past organizational successes to serve as key data elements that emphasize the positive contributions of management.
  • The planning process provides a dynamic motivational framework for management to highlight past successes and implement bold plans for the future.
builds confidence in management
Builds Confidence in Management
  • The process builds confidence in management by recognizing past contributions and involving management in every step of the process.
  • Presentations will utilize key managers during the data presentation phase of the process.
  • The final draft presentation will position the administrator and the Sr. management team in leadership roles for the plan implementation phase.

“Leadership and communication are the same thing.” Kip Tindell, CEO The Container Store, voted for two years the Best Company to work for in America.

decision making matrix applying hoshin planning principles
Decision Making MatrixApplying Hoshin Planning Principles
  • Mission/Vision Consistency Test - This the starting point for allstrategy development, clinical and operational performance measures, goals and objectives. Is what you are doing consistent with Mission and Vision?
  • Performance OutcomesData – Identifies performance gaps and opportunities that drive creation of goals and selection of quality improvement priorities.
  • Performance Improvement Process - Emphasizes participation in planning process review at all organization levels through existing standing committees.
mission statement revisits why the hospital exists
Mission StatementRevisits Why The Hospital Exists
  • Quality healthcare provider
  • Valuable asset to the community
  • Essential economic employment base

Core Business Drivers

vision statement defines future direction
Vision StatementDefines Future Direction

Where does the hospital need

to be in five years

to fulfill its mission?

Core Business Drivers

values states guiding principles
Values States Guiding Principles
  • Quality •Customer Focus
  • Diversity •Fairness
  • Value of employees, volunteers
access
Access
  • Physicians
  • Emergency services
  • Specialty services, i.e.
    • Surgery
    • OB
    • Multi-specialty clinics

Performance Measure

Physician Demand & Deficit Analysis

financial performance
Financial Performance
  • Profitability Assumptions
  • Capital Availability
  • Revenue Management
    • CAH, DSH, MDH
    • Appropriate Utilization
    • Registration Process
    • Billing

Cost Per Adjusted Discharge

  • Performance Measures
  • Budget Achievement
  • Cost per Adjusted Discharge
customer satisfaction
Customer Satisfaction
  • Measure Key Customers
  • External
    • Patients & Families
    • Community Leaders
    • Consumers
  • Internal
    • Employees
    • Medical Staff
    • Volunteers

Customer Satisfaction Rating

2nd Qtr ‘01

  • Performance Measures
  • Survey & Focus Group Results
compliance
The captain of the Titanic didn’t have a backup plan for unseen problemsCompliance

Compliance Plan

Compliance Officer

Trained Employees

Codes of Ethics

Periodic External Coding Review

  • Performance Measure
  • Effective Compliance Plan with External Review
process quality
Process Quality

CQI Operational in Major Clinical Areas

JCAHO Survey Readiness

Clinical/Operational Measures Driving Decisions

JCAHO SCORE

  • Performance Measures
  • JCAHO Grid Score
  • Survey Readiness Program Participation (Orion)
outcomes quality
Outcomes Quality

Door to Needle

Thrombolitic Therapy

ORYX Clinical Measurement System Driving TQM Priorities

Consistent Reporting in All Reports and Agendas Using Key Business Drivers Format

40

20

  • Performance Measures
  • Integrated Clinical (ORYX) and Operational Outcomes

.

performance measures 1 of 3
Performance Measures (1 of 3)
  • Access
    • Physician Recruitment Plan Success
    • New Services Implemented from Strategic Plan
  • Financial Performance
    • Budget Achievement
    • Cost Per Adjusted Discharge compared with

State and National Benchmarks

performance measures 2 of 3
Performance Measures(2 of 3)
  • Customer Satisfaction
    • Documented Improvement in Satisfaction Survey Data
    • Positive Results Reported from Medical Staff Focus Groups
  • Compliance
    • Compliance Plan Implemented
    • Compliance Officer in Place
    • Periodic External Review of Coding Implemented
performance measures 3 of 3
Performance Measures(3 of 3)
  • Process Quality
    • Acceptable JCAHO Grid Score
    • Continuous Survey Readiness Program Implemented in CQI
    • Core Business Drivers Format Used in All Agendas, Reports, and Minutes
  • Outcomes Quality
    • ORYX Clinical Performance Measurement System Implemented
    • Clinical and Operational Performance Goals Achievement Reported
go or no go cah application decision
“Go” or “No Go”CAH Application Decision
  • Completed Comprehensive Strategic Plan
  • Define CAH Long-Term Assumptions
  • Review Specific CAH Financial Projections
  • Review Barriers to Success
    • Clinical
    • Operational
    • Political (EX. state Medicaid adopting Medicare CAH rules)

CAH? Yes

No

cah strategic planning process 1 of 2
CAH Strategic Planning Process(1 of 2)

EXECUTIVEDECISION

  • Understand the Process
  • Establish Agreement and Timetable

PRELIMINARY MANAGEMENT TEAM MEETING

  • Define Roles & Responsibilities
  • Select Dates
  • Decision: Data Elements
  • First Rough Draft of Performance Measures

DATA PRESENTATION TO PLANNNG TEAM

DRAFT STRATEGIC PLAN PRESENTATION

  • Includes Board, Senior Management, and Invited Community Leaders
  • Brainstorm to Rough Draft Mission, Vision, Values, and Core Performance Measures
  • Core Performance Measurements Selection by Administrator

COMPLETED STRATEGIC PLAN WITH CAH DECISION

cah strategic planning process 2 of 2
CAH Strategic Planning Process(2 of 2)

EXECUTIVEDECISION

PRELIMINARY MANAGEMENT TEAM MEETING

DATA PRESENTATION TO PLANNNG TEAM

  • Final Draft Presentation of Strategy and Goals by Administrative Team

DRAFT STRATEGIC PLAN PRESENTATION

  • Agenda, Minutes, Reports Reflect Measures by Core Business Drivers

COMPLETED STRATEGIC PLAN WITH CAH DECISION

completed strategic plan outline
Completed Strategic Plan Outline
  • Mission Statement
  • Vision Statement
  • Values Statement
  • Core Business Drivers
    • Performance Measures
    • Strategies
      • Goals
        • Objectives to Achieve Goals
strategy outline example 1 of 3
Strategy Outline Example(1 of 3)

Core Business Driver:Access

Performance Measure:Physician Demand & Deficit Analysis

Strategy:

EX. Recruit Three Primary Care physicians during next 36 months. One (1) Primary Care Physician and One (1) General Surgeon in 2004

Initiate Orthopedic Surgery Program in 2005

strategy outline example 2 of 3
Strategy Outline Example(2 of 3)

Goal 1. EX. Add Primary Care Physician in 2004

Objective 1.1 – Finalize placement of Dr. Smith with Dr. Jones during 1st Quarter.

Objective 1.2 - Complete compliance review of physician guarantee and medical office building rental agreement by 2/1/04 for practice start date of 7/1/04.

Objective 1.3 - Remodel medical office building by 6/1/04.

strategy outline example 3 of 3
Strategy Outline Example(3 of 3)

Goal 2.Review Current Gen. Surgeon Search

Objective 2.1 - Involve active staff surgeons in search process.

Objective 2.2 - Consider changing physician recruiting contractor.

Goal 3.Initiate Search for Ortho by 2/01/05.

Goal 4.Evaluate and report progress quarterly

planning data elements 1 of 2
List of past successes.InformationSource: Internal

Physician demand/deficit analysis.Information source: State Health Planning

Active searches. Commitments. Internal

JCAHO survey report.Internal

Performance Improvement Plan.Internal.

Outcome measures/ORYX reports. Internal

Plan of Patient Care.Internal

Copy of Mission, Vision, Values Statements.Internal

Capital plans, funding sources.Internal

Planning Data Elements(1 of 2)
planning data elements 2 of 2
CAH financial analysis. External

Income Statement -12 months. Internal

Organizational Chart.Internal

Audits—3yrs.Internal

Cost reports.Internal

Customer Satisfaction studies.Internal

Employee Handbook.Internal

Compliance Plan summary.Internal

DRG Specific CHIPS Utilization Reports. External

Service line profitability.Internal

Planning Data Elements(2 of 2)
completed strategic plan
Completed Strategic Plan
  • Use your planDon’t allow your strategic plan to sit on a shelf.
  • Operationalizeyour planIncorporate performance measures into agenda templates and force them to be reviewed monthly and quarterly