Middleville Regional Healthcare is a not-for-profit healthcare organization (HCO) that seeks to evaluate its strategic performance. The healthcare organization serves a community of 350,000 people. It seeks to evaluate its strategic performance in marketing, human resources, financing, and information technology. It is for this reason that the organization’s governing board sought the help of a consulting company.
The Governing Board and Its Role in Strategic Initiatives
A governing board is an important unit in any organization. While the governing board may go by different names in different organizations, it is often liable for any effects the organization’s policies have on the organizational performance (“Board Role in Strategic Planning”, n.d.). Before determining the role of the governing board in strategic initiatives, it is important to also look at the overall role they play in organizations.
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The overall role of any governing board is corporate governance. Corporate governance refers to the practices that ensure a governing board is held accountable, is fair and transparent in its organization’s relationship with its stakeholders (“Board Role in Strategic Planning”, n.d.). It is through corporate governance that the board is able to give its organization an overall direction. This overall direction includes taking part in strategic planning.
Strategic planning is important in ensuring the overall strategic success of an organization. In healthcare organizations, the board plays an integral role in ensuring the organizations’ strategic plan is successful (“The Board’s Role in Strategic Planning”, n.d.). However, in order for this to happen, there is a set of governance assets and abilities that the board must have to ensure strategic initiatives bring about the change they intend.
Governance Assets and Abilities
The following are governance assets and abilities that ensure effective performance of the governing board in strategic planning (“The Board’s Role in Strategic Planning”, n.d.):
Ability to pioneer new thinking: The board must be innovative in coming up with strategies to meet its community’s needs.
Ability to create and nurture a culture of change: The board should be able to develop a culture of change that is welcoming, and embraces change as an asset.
Ability to deal with unplanned change: The board must be ready to deal with unplanned change effectively. This requires them to keep a check on emerging trends.
Ability to define community benefit and value: The board must be able to define the community benefit and value when a strategic plan is successful.
Ability to anticipate market needs and opportunities: The board must be able to identify market needs and opportunities ahead of their organization’s competitors.
Middleville’s Regional Healthcare governing board’s role in strategic initiatives is pretty clear based on the preceding discussion. The board is responsible for initiating the process of developing strategic initiatives, creating a culture of change that embraces these initiatives, tracking any changes that might affect the initiatives, and defining the benefit and value to the community should the initiatives be implemented successfully.
Healthcare Performance Measurement
The performance of any healthcare organization is important in achieving its strategic goals and objectives. This performance must be effectively measured in order to track the progress made by the organization. The most vital goal of all healthcare organizations is the provision of quality healthcare. According to Shaw (2003), the measurement of performance is integral in identifying opportunities for improvement for all healthcare organizations.
The measurement of Middleville’s healthcare performance is integral in determining its overall performance. By measuring their performance, Middleville would be able to make improvements in its health priority setting, professional recognition and quality management (Shaw, 2003). There are three methods of performance measurement that Middleville can adopt. These include consumer surveys, third-party assessments, and regulatory inspection.
Consumer Surveys
This method of measurement involves the collection of data from the healthcare organization’s consumers – patients and their relatives. These surveys require standardization to some level while comparing the healthcare performance against national standards (Shaw, 2003). The performance indicators for such surveys include healthcare experience and the outcomes as perceived by patients and their relatives (Shaw, 2003).
This method of performance measurement has its advantage. When conducting consumer surveys, healthcare organizations are able to identify what services the patients and general public value (Shaw, 2003). Middleville should, therefore, conduct its consumer survey to determine the quality of their healthcare services. However, they should also be careful not to shift the focus of their surveys from patients to their healthcare personnel.
Third-party Assessments
Third-party assessments often involve the inclusion of stakeholders that are not directly involved in the hospital’s activities. One such method of third-party assessment is accreditation. Accreditation involves the measurement of healthcare performance based on the hospital’s compliance with a published set of healthcare standards (Shaw, 2003). The benefits of this accreditation programmes are what makes them suitable for Middleville.
Accreditation programmes have a number of advantages that healthcare organizations can appreciate. According to Shaw (2003), the programmes are independent, voluntary and are developed from a multi-disciplinary assessment of healthcare functions and organizations. Therefore, they are tailored to the assessment of healthcare. Middleville will, therefore, benefit from their reliability.
Regulatory Inspection
Regulatory inspections are common in most countries. These inspections are often conducted to ensure hospitals comply with a country’s licensing regulations (Shaw, 2003). In the provision of healthcare regulatory inspections that are often addressed include the quality of medicines, medical devices, hygiene, fire and radiation prevention, and infection control. In some cases, even blood transfusions are included in regulatory inspections.
The benefit of regulatory inspection is the legal authority they have. This legal authority ensures transparency. Regulatory inspections also help hospitals to conform with the measurements of performance for hospital safety (Shaw, 2003). Therefore, the quality of healthcare provided is greatly improved. However, Middleville should not solely rely on regulatory inspections but should use them in conjunction with the other two methods.
Dealing with Competition
Middleville Regional Healthcare is not the only not-for-profit healthcare organization in the community it serves. Middleville faces competition from two other HCOs – Brierfield and Greystone. In order to determine the performance of these HCOs, an analysis was conducted. The analysis looked at the resources (financial, human resource and bed capacity) and the number of patients each HCO serves in the community. The table below details this information.
| Name | Beds | Admissions | Census | OP Visits | Births | Expenses (000) | Personnel |
| Middleville | 575 | 13,000 | 350 | 221,000 | 2,300 | $125,000 | 2,000 |
| Brierfield | 380 | 17,000 | 260 | 175,000 | 1,200 | $130,000 | 1,875 |
| Greystone | 350 | 10,000 | 180 | 40,000 | 900 | $80,000 | 1,200 |
From the table above, it is clear Middleville maintains a competitive lead over the other healthcare organizations. However, in order to maintain this lead while continuing to offer quality healthcare to the community, Middleville needs to focus on specific areas in the healthcare industry. Middleville should, therefore, focus on increasing the number of healthcare personnel, the hospital’s capacity to serve patients and investing in information technology.
Increase Number of Healthcare Personnel
Healthcare personnel are important in any healthcare organization. The personnel are important in ensuring that quality healthcare is indeed offered to every patient that walks into a hospital. From the statistics, Middleville has the highest number of healthcare personnel. However, it also has the highest number of outpatient visits. It is, therefore, necessary that Middleville invests in the recruitment of more personnel.
Increasing the number of healthcare personnel improves the quality of healthcare offered. According to the Institute of Medicine (US) (2002), having a higher staffing level of registered nurses (RN) reduces the rate of urinary tract infections and length of stay at the hospital. This reflects improved healthcare provision. Middleville would, therefore, be able to improve its healthcare delivery and maintain a competitive lead in the market share.
Increase Hospital’s Capacity to Serve Patients
Having the right infrastructure is key for any hospital. This infrastructure should also be enough if the hospital intends to effectively serve the community. When a hospital has enough infrastructure, it can effectively offer both primary and specialized care to its patients (Institute of Medicine, 2003). Middleville has a bed capacity of 575, which despite being the highest, still needs some improvement.
By increasing is bed capacity, Middleville stands to benefit a lot. More beds reduce crowding in the hospital. When there is no crowding, the hospital does not have to periodically close some of its departments or divert ambulances to other facilities (Institute of Medicine, 2003). Middleville stands to benefit from this by eliminating the possibility of losing patients to its competitors.
Invest in Information Technology
Information technology has become an integral solution to the improvement of healthcare. According to the Institute of Medicine (US) (2003), having the necessary infrastructure of clinical information has a lot of benefits. The infrastructure can be used to coordinate patient care and support the operation of multidisciplinary teams. Information technology is also integral to the measurement of healthcare performance.
Information technology systems could also improve healthcare by providing access to the necessary data. This data is often complete and accurate and may include patient data, clinical guidelines, and public health data (Institute of Medicine, 2003). Some members of Middleville’s governing board are aware of these benefits and are willing to invest in electronic medical record (EMR) systems. The following discussion highlights the cost-benefit analysis of EMR systems.
Cost-Benefit Analysis of Electronic Medical Record (EMR) Systems
According to Alpert (2016), an EMR is a legal, digital patient record that may be used for personal or clinical information. While the cost of installing and running such systems is expensive, the overall benefits far outweigh the cost. According to Choi et al. (2013), some of these benefits include the positive financial return on investment (ROI) and improvement in revenue through a reduction of billing errors and maintenance expenses of paper-charts.
Middleville should, therefore, invest in an EMR system as they stand to benefit from cost-saving. The implementation plan of such a system would require a practice readiness assessment, definition of implementation goals, selection of a system with proper requirements, installation and configuration of the system, and evaluation of the system’s performance to determine any needed improvements (“EMR Implementation Plan”, n.d.).
Employee Retention and Satisfaction
A challenge facing Middleville is the retention and satisfaction of its health personnel. These challenges are due to budgetary constraints that have limited the HCO’s capacity for salary increment. However, there are other benefits that Middleville’s human resource department can offer to its employees and still retain and satisfy them. These strategies include:
Recognition: This involves recognizing personnel for their good work and rewarding them with extra time off or employee of the month awards (Vincent, 2013).
Paying employees on time: Middleville should ensure all its employees are salaried as per their contract agreement.
Conclusion
It is clear what measures Middleville’s governing board should take and implement as part of their strategic initiatives. These measures will go a long way in improving the quality of healthcare the HCO offers and ensuring that it maintains a competitive lead over other HCOs in the market.
References
“ Board Role in Strategic Planning.” (n.d.). Simply Strategic Planning . Retrieved 21 November 2018, from http://www.simply-strategic-planning.com/board-role-in-strategic-planning.html
“ EMR Implementation Plan – Six Stages Road Map.” (n.d.). Binary Spectrum . Retrieved 21 November 2018, from http://binaryspectrum.com/electronicmedicalrecord/six-stages-in-the-EMR-implementation-road-map.html
“ The Board’s Role in Strategic Planning.” (n.d.). The Walker Company . Retrieved 21 November 2018, from https://www.mnhospitals.org/Portals/0/Documents/Trustees/Board-Role-in-Strategic-Planning.pdf
Alpert, J. S. (2016). “The electronic medical record in 2016: Advantages and disadvantages.” Digital Medicine , 2(2), 48-51. Retrieved 21 November 2018, from http://www.digitmedicine.com/article.asp?issn=2226-8561;year=2016;volume=2;issue=2;spage=48;epage=51;aulast=Alpert
Choi, J. S., Lee, W. B. & Rhee, P. (2013). “Cost-Benefit Analysis of Electronic Medical Record System at a Tertiary Care Hospital.” Health Informatic Research , 19(3), 205-214. Retrieved 21 November 2018, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3810528/
Institute of Medicine (US) Committee on Assuring the Health of the Public in the 21 st Century. (2002). “The Health Care Delivery System.” NCBI . Retrieved 21 November 2018, from https://www.ncbi.nlm.nih.gov/books/NBK221227/
Shaw, C. (2003). “How can hospital performance be measured and monitored?” World Health Organization Europe . Retrieved 21 November 2018, from http://www.euro.who.int/__data/assets/pdf_file/0009/74718/E82975.pdf
Vincent, J. G. (2018, April 3). “5 Effective Employee Retention Strategies in Healthcare.” Eagle’s Flight . Retrieved 21 November 2018, from https://www.eaglesflight.com/blog/5-effective-employee-retention-strategies-in-healthcare
