Executive Summary
Hillsboro County Home Health Agency Inc. HCHHA has progressively increased its quality of service, market share, and overall bottom line since its establishment in 1946 in Hillsboro County. The institution was established with the sole mandate of providing healthcare to Hillsboro County residents. Despite many years of successful growth, the institution has witnessed a shrinking market share and consequently reducing profitability. This deteriorating financial position of the organization is now a concern for the Board of Management of HCHHA. The hospital intended to provide hospice services to the people Hillsboro County. This was intended to target the elderly as well as patients suffering from terminal illness. However, the hospital has not been able to provide this service effectively. Consequently, this has greatly inconvenienced patients as well as their families who desire consistent healthcare for their family members suffering chronic or terminal diseases. This strategic plan investigates all the issues facing HCHHA and puts into perspective all the causes of the issues. The Plan investigates the financial performance of the hospital in the healthcare market using the SWOT analysis method. This method identifies the weaknesses of the hospital from a business perspective that has led to its power financial performance as well as the threats that the business is facing in the industry that could further lead to further financial deterioration. It further identifies the strengths that the business can capitalize on to gain competitive advantage and increase market share. Based on this evaluation this strategy makes suggestions for improving the financial performance of the company. It further suggests a strategic approach in restructuring the business in order to enhance operational efficiency and excellence. The implementation of this strategy will help HCHHA to improve its financial as well as the operational management.
Strategic Plan for Hillsboro County Home Health Agency Inc.
The healthcare industry is increasingly becoming competitive. While the main mandate for healthcare facilities is to provide healthcare services to people, most privately owned facilities operate as businesses and require running profitably. The non-profit healthcare organizations equally require funds to manage the daily operations of the business (Porter, 2018). In this regard, revenue generation is important for any healthcare facility regardless of whether it is profit based or nonprofit based. It is important for the facility to maintain a stable source of income in order to remain operational both in the short run as well as in the long run.
Delegate your assignment to our experts and they will do the rest.
HCHHA was established as a nonprofit organization. However, it is currently experiencing some challenges that hinder its ability to achieve its mission and vision. The first challenge that the healthcare agency is currently facing is a shrinking market share. The second challenge is that the healthcare facility has not been able to provide an effective Medicare-certified hospice. This has largely inconvenienced the patients as well as their family members. Operational inefficiency at the facility has equally turned the facility to be less attractive to the residents of Hillsboro county as well as other counties within which it operates. This paper investigates the causes of this inefficiency both from a business perspective as well as operational perspective. It makes recommendations of the appropriate approaches and strategies that can help the facility improve from as business as well as an operational perspective. The strategy aims at helping the facility to realize its weaknesses and hence improve on them their operations to gain a competitive advantage in the market in which they operate.
Mission Statement
Hillsboro County Home Health Agency Inc. mission statement states, “ The mission of HCHHA is to serve individuals in their usual environments, and is concerned with well people as well as people with illness or disabilities. We strive to prevent disease or retard its progress and to reduce the ill effects of the unavoidable disease. We provide quality nursing and therapeutic care to the non-institutionalized sick and disabled. We also provide information and encouragement to individuals and families, special groups, and the community as a whole for the promotion of health .” Vision Statement
Hillsboro County Home Health Agency Inc. vision statement states “ Hillsboro County Home Health Agency Inc. strives to serve the community by promoting a healthy lifestyle which includes preventive measures in order to have a healthy community as a whole.” Core Values
Hillsboro County Home Health Agency Inc. core values include Accountability, Mutual respect, teamwork, integrity, and service excellence.
SWOT Analysis
Strengths
HCHHA has several strengths that it can leverage on as a way of improving its service delivery and overall competitive advantage. First, the healthcare facility is located in two convenient locations. The two locations are in Jasper and Hillsboro (Polancich, 2017). This convenient location is of great importance to the business in different ways. First, this location helps to access the right community and the community of interest. The organization was established to serve the people of Hillsboro country. Therefore, its location within Hillsboro enables the organization to be accessible and consequently reach the community of interest. Expansion to Jasper equally enables the organization to reach the target population within that region. Secondly, this location creates convenience for the customers because of the easy access. Therefore, the convenient location for the organization is a major strength that the organization can leverage on to gain a competitive advantage.
The second strength relates to the positive reputation within the community in which it operates. The organization is reputable in Hillsboro and beyond as a leading healthcare provider. A good reputation in the market can give an organization a competitive advantage over competitors. Therefore, HCHHA can leverage on this good reputation to build a competitive advantage over its competitors.
Lastly, the organization has an active and effective leadership. HCHHA’s executive director Martha Washington has been very instrumental in offering leadership that has largely shaped the organization’s growth (Polancich, 2017). Under her leadership, Martha has overseen the great expansion of the healthcare facility and its services. For instance, she has overseen the expansion of the healthcare facility and its functions into three main divisions. These divisions include community health, personal health services, and home care service. The organization must leverage on the innovative and transformational leadership in creating a competitive advantage.
Weaknesses
Despite the numerous strengths, the organization equally has several weaknesses. The success of this organization will depend on how it resolves and improves on this weakness in order to gain a competitive advantage and hence increase its market share. The first weakness is the consistent decline in the financial performance of the organization over the years. While HCHHA was set to be a non-profit making organization, it largely depends on the revenue it generates to offer services to the target population (Packard, 2014). However, the declining revenue makes it hard for the organization to sustain its service delivery, offer quality services or become innovative. Therefore, this weakness limits the operational performance of the organization.
The differences in perspective and differing opinions among board members on issues of governance and operations of the healthcare organization is another weakness for the organization. For HCHHA to prosper, its leadership must agree on the general direction that the organization takes and hence put in collective efforts. However, divisions in perspective delay the collective decision-making and equally impair collective responsibility in the running of the organization. Moreover, the board of management consists of 21 members. This large number makes decision making very slow or hard to arrive at collective agreements in board meetings and subsequent resolutions.
Thirdly, HCHHA has productivity problems since some of the employees are old. It is important to note that the older employees are less productive and innovative compared to a younger and vibrant workforce. Therefore, the older employees within this organization make it hard for it to deliver quality services to the customers consistently. Lastly, the operation of Jasper office has not yielded sufficient advantages for the organization both from a financial perspective as well as from an operational perspective. The board of management should realize this weakness if it is to improve the operation and financial performance of the organization. Improving on these weaknesses will help the organization to gain a competitive advantage over its competitors and hence increase its market share over the market of interest.
Opportunities
There are several opportunities within the healthcare industry in Hillsboro County and beyond that HCHHA can take advantage and improve its operational and financial performance. First, managed care organizations, as well as insurance companies, are increasingly expressing interest in home care services. Consequently, this is an indicator of the increasing demand in this segment of healthcare. Since HCHHA has largely specialized in home-care services, this increasing demand provides an opportunity for the business to grow its customer base as well as revenue generation consistently. As demand increases, the company should position itself to take advantage of the increased demand to increase revenue and overall market share.
Secondly, the availability of advertisement opportunities is another opportunity that HCHHA can exploit as it seeks to improve its market shares. The extensive use of social media as well as the availability of mainstream media all provides a platform for advertisement of the HCHHA operations and services. The role of social media in improving customer base, revenue generation, and overall market share cannot be ignored. Advertisement serves to increase awareness among the customers about the services offered by the organization. Moreover, advertisement convinces customers about the services and products offered by an organization, which increases its customer base. The management of the organization has not extensively advertised the services it offers to community and the target market segment. Therefore, advertisement remains a great opportunity for HCHHA that it can exploit to increase its market share.
Thirdly, technology in the healthcare system is greatly evolving. In the area of community health, several software platforms have been developed to facilitate the connection between caregivers and the people who need such cares. Moreover, technology continues to evolve in the field of occupational therapy as well as other forms of therapy. Such technological advancements present great opportunities for the healthcare industry and Hillsboro County Home Health Agency in particular. The organization should leverage the opportunities presented by the existing technology to improve its efficiency in operation and service delivery.
Lastly, the demand for Medicare-certified hospice within the Hillsboro County is also increasing. There is an increasing population of the elderly in this community. Moreover, families who have patients will terminal illness are increasingly resorting to Medicare-certified hospice services. The increasing demand for hospice services is an opportunity for growth that the business can leverage on as its strategies to grow and increase its markets share as well as financial performance.
Threats
The major threat to the success and operation to HCHHA is the existence of competition within the home care field and the overall healthcare industry. There are few barriers to entry in this industry. Many competing firms in the field of homecare are increasingly flooding the industry and the market particularly in the context of Hillsboro County within which the hospital operates. The increased competition offers a threat of shrinking market share and reduced revenue generation.
Secondly, changing regulatory frameworks that provide stiffer and stricter rules in the operations of healthcare services equally offers a threat to the running and survival of Hillsboro County Home Health Agency in the long run. For example, a new regulation requires physicians to be recertified every two months. This requirement is not only tedious to meet but also very expensive in the long run and adds to the organization’s overall expenditure in the end. Therefore, it offers a threat of increasing the overall cost of operations that have the effect of increasing organizational pricing and overall organizational costs.
Lastly, changes in the reimbursement system are equally a significant threat to the operations of Hillsboro County Home Health Agency. Such changes in reimbursement may lead to delayed reimbursements. The delay greatly affects the hospital’s ability to finance its operations and is a threat to Hillsboro County Home Health Agency’s ability to offer quality services to its customers.
Grand Strategies
Hillsboro County Home Health Agency has various available strategies that it can implement as a way of tackling the challenges that it is currently facing. For instance, HCHHA will restructure and expand its community health division with the view of incorporating Medicare-certified hospice. Consequently, its scope of operations will greatly expand in order to meet the overall expectations of the community and rely on the increasing demand for Medicare-certified hospice services. The graph below shows the trends in revenue generation for Medicare-certified hospice between the year 2012 and 2014 from the community health division compared to the overall revenue generated in the respective years.
The graph shows that the community health division of the organization contributes an insignificant fraction of revenue compared to the total revenue generated by the organization annually. This can partially be attributed to lack of Medicare-certified hospice within the facility that is largely demanded by the customers. In improving the revenue generation for the business, there is a need to capitalize on the great potential presented by the community health division that has largely been ignored and underutilized over the years.
The demand for Medicare-certified hospice within in the Hillsboro County cannot be ignored. Many families prefer to seek such services for their elderly members as well as their patients with terminal illness. While this segment of the market is greatly increasing, it is largely underserved by existing healthcare facilities and presents a great opportunity for healthcare facilities that choose to venture in it. Therefore, Medicare-certified hospice can greatly improve its revenue generation from the community health division by incorporating a Medicare-certified hospice.
Under this strategy, the major goal of the Medicare-certified hospice will be to provide emotional, physical and spiritual care to patients suffering from terminal diseases in a way that preserves their dignity and is comfortable to them. Conventional healthcare facilities have largely ignored the needs of such patients. The strategy seeks to fill that gap by providing Medicare-certified hospice service to this segment of the market that is underserved. The main objectives of this strategy will be to expand the community health section in a way that covers the needs of more people including those who are terminally ill. Therefore, it will help in increasing the market share for the organization and equally serve to boost revenue generation from the community health department.
The second strategy will involve building a healthcare system within the organization that truly cares for the people. This strategy will involve a restructuring of the home health division in a way that improves educational initiatives with the view of enhancing disease prevention at the family level (Berry & Evans, 2014). This strategy will shift the focus from the middle class to the entire community. It will be devoted to educating the community at large about important health issues and needs that are relevant to their communities and families.
The following graph shows the number of home visits conducted by HCHHA between 2010 and 2014.
The table above shows a great decline in the number of annual visits between 2010 and 2014. It indicates that HCHHA has not capitalized on the growing need of home care by increasing the number of home visits. This strategy will respond to this gap by providing an avenue to increase revenue generation from the homecare division. The strategy aims to increase the number of home visits with the view of educating families on health issues. Secondly, the strategy aims at enhancing preventive approaches in disease control and healthcare provision (Smith & Reid, 2014). This approach will not only popularize the organization but also improve its reputation as an organization interested in the wellbeing of communities.
The last strategy will involve collaborations and partnerships with other healthcare organizations as well as government healthcare agencies. In the end, it will ensure that the HCHHA gets the prerequisite resources required to run extensive healthcare services within the county. Moreover, the partnerships will create networks as well as expertise required to run extensive healthcare programs. Lastly, it will give Hillsboro County Home Health Agency a competitive advantage over competitors and hence increase the market share for the organization.
Operational and Tactical Plan
The grand strategy will be designed and implemented tactfully as a way of guaranteeing an efficient and flawless modification of how HCHHA does things. The approach in operational implementation will involve four phases such as planning, budgeting, implementation, and monitoring phases.
The planning phase will involve outlining a proper plan of how the strategies discussed will be implemented in the organization. At this stage, the management of the organization will come up with an organizational structure that incorporates the above strategies. First, the structure will expand the community health division to include all the Medicare-certified hospice service section. The head of the community health division will manage this section. The management will determine the relevant roles required under this service section. Such roles may include professional counselors, occupational therapy, and program coordinators among others. The strategic planning will include a plan for the expansion of the home health division to incorporate a family educational department. It will further necessitate the creation of roles of health educators, counselors, and educational program coordinators. Therefore, the planning phase of the strategy will lay a structural foundation over which the plan will be implemented.
The budgeting phase involves allocating of sufficient resources at each stage of the implementation of the strategy. In this strategy, the budgeting phase will include a determination of resources required at each stage of the implementation. For instance, the implementation of the Medicare-certified hospice will include the construction of the hospice center, procurement of equipment and staffing. The family educational strategies will involve staffing of enough healthcare educators who will be able to reach a large percentage of the total number of households in the target market (Berry & Evans, 2014). Therefore, the budgeting phase will allocate sufficient resources required at each stage of the implementation process.
The third phase will be the actual implementation of the plan. At this stage, the organizational structure developed at the planning phase will be implemented, and a Medicare Hospice center will be established. The relevant staff for the different positions determined in the new structure will also be employed. Moreover, a new chain of command and the flow of responsibility within the new factions will equally be adopted. The region of interest will be subdivided into sections to be covered by different family educators. Furthermore, the strategy will involve putting up strategies for collaborations and equally identifying relevant healthcare agencies that the organization can collaborate with. A framework of seeking and coordinating collaborated activities will also be instituted.
The last phase of this strategic approach will be the evaluation of the impact of the strategy adopted in improving the efficiency of operations, market share and overall financial performance of the organization. The phase will include identification of appropriate key performance indicators. Such indicators are the point of monitoring the success or impact of a program and initiatives. The trends in the key performance indicators will indicate whether the organization is achieving its objectives or not (Fiscel, 2015). Depending on the results of the monitoring and evaluation process, the organization can make adjustments in its strategy where necessary with the view of maximizing impact.
Key Performance and Evaluation Indicators
The key performance and evaluation indicators (KPIs) demonstrate to the extent to which an organization is meeting its set objectives and consequently achieving its mission (Bergeron, 2015). Some of the KPIs include patient and their family satisfaction, readmission rate, employee satisfaction and some customers annually, revenue generation per division and market share.
The first key performance and evaluation indicator will be patient and family satisfaction. This key performance indicator measures the extent to which patients, as well as families, are satisfied with the service delivered to them (Hejdukova & Kureková, 2017). The essence of this strategic approach is to enhance customer experience and hence attract more customers. As such, monitoring customer satisfaction is important for the organization. Under this performance indicator, patients and families will be required to rate their level of satisfaction on a scale of 1-9. Any performance above the average rating of eight will be an indication of positive achievement for the organization.
The readmission rate will be the second performance indicator. The organization will keep a record of all patients and monitor the number of patients readmitted with the same conditions. A decrease in patient readmission rates is an indicator of the success of the healthcare system implemented (Bergeron, 2015). On the contrary, a decrease in the number of customers is an indication of the poor performance of the system implemented.
Thirdly, the organization will monitor the number of clients, patients, and families they can serve periodically such as monthly, bi-annually, or annually. An increase in the number of patients that the organization serves with the implementation of this strategy demonstrates a positive impact of the strategy (Kushel, Eric, & Jennifer, 2014). In contrast, a decrease in the number of clients indicates a negative impact of the strategy. Therefore, the organization will evaluate the number of clients and monitor trends in that number monthly, bi-annually and annually (Pegler, 2016). Moreover, this number of patients compared to the total population of the market is equally indicative of the market share that the organization holds. As such, this key performance indicator will equally help in ensuring that the organization monitors trends in its market share.
Financial performance will be used to monitor the impact of this strategy. The actual financial performance aspects of the organization to monitor will include net revenue and total expenses of the organization. The table below shows the net revue revenue generated and the net expenses generated by the organization between 2012 and 2014.
| Year | Total Revenue | Total Expenses |
| 2012 | 6,659,511 | 6,614,692 |
| 2013 | 7 ,543,394 | 7,451,743 |
| 2014 | 7,913,949 | 8,006,059 |
The financial performance is indicated by the difference between the total revenue and the total expenses. Where expenses are more than the revenue as was the case of 2014, then the organization is incurring losses, and its financial performance is not good. A similar table will be used to track the financial performance for the organization after the implementation of the strategy. An increase in the net revenue will be indicative of a positive financial impact of the strategy is employed.
Lastly, the trends in the market share of the organization will be critical monitoring and evaluation of key performance indicators. The market share is a measure of the fraction of the market served by the organization in question. In monitoring the market share, the organization will contract an independent market survey company to conduct a periodic survey of the market to determine the market shared served by the HCHHA. A periodic evaluation of this market share will indicate whether the strategies employed are effective in increasing the market share for HCHHA. Change Management Plan
The internal and external impacts of change in an organization are diverse because of the stakeholders involved. Therefore, it is important for the organization to establish an effective strategy for managing change both with and outside the organization. This section outlines the change management strategy that will be employed for the organizational change anticipated by the implementation of this strategy. The change management framework will include three components (Pegler, 2016). The first component will be identifying resistance. The second component will be removing obstacles. The last component will be demonstrating short-term wins to the organization and all stakeholders.
Change Management Resistance Plan
The change management resistance plan will include three components. The first component will be identifying resistance. The second component will be removing obstacles. The last component will be demonstrating short-term wins to the organization and all stakeholders (Pegler, 2016).
Identifying Resistance to Change
Any change initiative within the organization is likely to meet substantial resistance from stakeholders of the organization who are comfortable with the status quo. The success of the organizational change implementation depends on the way the drivers of change maneuver such resistance in a way that maintains the agenda of change and wins the support of all stakeholders throughout the change process (Fiscel, 2015). In this change implementation, the organization will encounter several resistances at different points of implementation.
The first resistance may come from the board of management. It is important to note the board of management has the development of Medicare-certified hospice on account of its cost implications previously (Pegler, 2016). The resistance is likely to be replicated in the current case. Secondly, the staff is likely to offer resistance to the additional responsibilities that come with the running of a hospice. The third source may come from neighboring healthcare organizations whose collaborative partnerships will be sought under this strategy. Their concern will be the impact of the collaborations on the competition space within the industry. Moreover, staff members from different organizations may be opposed to the idea of working together and hence form a formidable approach to the implementation of this strategy. Resistance could equally come from government agencies such as competition regulating agencies who are opposed to the killing of the competition space within the healthcare industry.
The process of identifying sources or resistance to change is critical to the overall change management process. For instance, it helps in putting up appropriate stop-gap measures that can proactively address such resistance and hence facilitate a smooth implementation plan. As such, the sources of resistance identified above will shape the strategic approach used in overcoming such resistance.
Eliminating Obstacles to Change
The sources of resistance identified above are great obstacles to the change process. The effectiveness of a change process largely depends on the ability to remove obstacles and maneuver resistance. Several initiatives will be adopted as a way of eliminating obstacles to change in the process of implementing this change strategy. Concerning the resistance from the board of management, the strategy must demonstrate the capacity to increase revenue generations (Storey, 2015). The project managers will explain to the board the inefficiency of focusing only on the homecare division that the organization has experienced in the past. It will include a demonstration of declining net revenue generations from the home care division. Secondly, they will demonstrate the increasing demand for the hospice services and how the organization is likely to increase its revenue tremendously by adopting such a hospice. The understanding will convince the board of management to buy into the idea and hence remove the obstacle that they had previously set.
The district managers and nurses will buy into the idea when they understand how the strategy in question will reduce their travel distances. They are currently involved in traveling over long distances to meet patients and families of terminally ill patients. Therefore, an understanding of how this strategy will bring the patients closer will gain great traction among the nurses as well as district managers (Gabel, 2015). Moreover, other workers will equally be educated on how the development of a hospice center will create opportunities for promotions and good working conditions. Such strategies will greatly help in removing the obstacle of resistance from the employees of the organization.
Thirdly, it will be important to keep all stakeholders updated on the strategies that the organization is implementing and the importance of such strategic organizational change to each stakeholder (Lavor, 2015). To this effect, the management team of this change management will hold frequent meetings and discussions with different stakeholders with the view of updating them on the importance of the change program to them as well as their roles in facilitating the change program. Therefore, this will overcome any potential resistance that any of the stakeholders may have to the change process and equally enlist their support towards that change.
Demonstrating Short-Term Wins
The third change management strategy will be the demonstration of short-term wins to the organization. When a new system is introduced within an organization, people are eager to see the impact of such new systems and organizational changes. A demonstration of such positive impacts of the change in the short run encourages all stakeholders to support the change initiative. Therefore, it is important to demonstrate short-term wins to all stakeholders affected by the change.
In the present case, short-term wins will be demonstrated in different ways. For instance, the short-term wins will be demonstrated by the reduced number of new entries into the market and particularly in the market segment offering Medicare-certified hospice services. This short win will demonstrate to the board that the strategy is indeed effective in eliminating competition and increasing the market share for the organization (Sonnega, Robinson & Levy, 2016). Secondly, the monitoring of travel time, as well as times, spend per patient at the Medicare-certified hospice will also demonstrate a short-term win. Ideally, the travel time will be greatly reduced and the times spend per patient will increase. Consequently, operational efficiency will be enhanced as a short-term win. The thirdly improved efficiency of employees will translate into a financial gain for the organization in the short run.
Patient surveys can equally be used to demonstrate short-term wins for the organization in the short run. The organization can commission a survey to determine the level of customer satisfaction. An improvement in customer satisfaction after the implementation of this strategy points to the fact that the strategy has been effective in enhancing customer experience. As such, patient survey and feedback in be largely utilized in this change management strategy to demonstrate short-term wins and consequently gain the support of all stakeholders to the process (Lavor, 2015).
Team Structure and Responsibilities
The above structure represents the team that will be mandated to execute the plan. The process owner will be the overall Physician in charge of all therapeutic services. The practice manager will coordinate and manage the Hospice’s daily operations. The medical assistants will include nurses, Physiotherapists and clinical officers. Their main role will be to monitor patients and offer primary healthcare to the patients. The Front desk receptionists will be in charge of receiving and directing visitors as well as patients. The care coordinator will be in charge of keeping patient information and scheduling different therapeutic activities for each patient.
Sponsor Roles and Responsibilities
The sponsors of this change will play a critical role in the overall change process. To begin with, the sponsors will finance the project. They will be responsible for providing the different resources required for the realization of this project. Secondly, sponsors will provide technical advice to the entire planning and the implementation process. They will offer insight in specific areas of the implementation where they have expertise. Lastly, sponsors will be responsible for popularizing the project. They will be ambassadors of the change both within the organization as well as within the community that is likely to be affected by the change.
Communication Plan
The success of the implementation of any organizational change highly depends on the support and goodwill of all stakeholders. Therefore, it is important to carry all the stakeholders along the process of change management to obtain their support at every stage of the change (Chikudate, 2015). For the effectiveness of this approach also depends on how well the stakeholders understand the change, its impact, and their role in the overall change strategy. The understanding can only come through proper communication from all the stakeholders. The following section outlines a strategic communication plan used in the implementation of this change management strategy.
The first level of communication will be regarding physical meetings. The first meeting will be held with the board of management because the change suggested cannot be implemented without the approval of the board of management (Lavor, 2015). Therefore, it is important for the board of management to understand not only the importance of the suggested change but also its financial implications as well as their role in realizing the change. Therefore, the meeting with the board of directors will aim at several things. First, it will aim at convincing the board about the benefits of the strategy.
Consequently, it will seek to approve the strategic approach being suggested. Secondly, this meeting will seek to enlist their support and goodwill towards the realization of the change strategy being implemented. Meetings as a form of communication will also be held with the employees. At this stage, all the employees will be familiarized with the intended change. Moreover, the employees will get an explanation of how the change will be beneficial to them in their roles and capacities within the organization. Moreover, the communication will also seek to enlist their support in the overall change process.
The second level of communication will be through emails and the noticeboard. All the internal stakeholders will be constantly updated about the progress of the implementation and where they might be required to participate through internal emails. However, employees who are not on emails will receive such updates through notice boards. As such, the two platforms will be used as a mode of communication throughout the implementation strategy and in this change management process. The third level of communication that will be used in this process will include newsletters and magazines. The change progress of change will equally be communicated to internal stakeholders through newsletters. Moreover, short-term wins will also be communicated through monthly newsletters that keep stakeholders abreast of the progress made.
External stakeholders such as customers, communities and relevant government agencies will equally need communication. Such communication will be executed through mainstream media as well as social media advertisements. The community will be communicated through such platforms of advertisements while government agencies will receive official communication through emails and letters.
Planning and Implementation
The planning phase will include identifying the different tasks that require to be completed sequentially in the process of implementing this project and change strategy. Planning will also include developing a change structure that is suitable for the desired change. At the planning stage, different roles and responsibilities of different capacities within the structure will be established. Moreover, planning will include determination of appropriate trainings required as well as a schedule of activities.
The implementation process will involve executing the schedule of activities identified at the planning stage. The time schedule discussed below will be implemented sequentially at the implementation stage. Moreover, the implementation stage will involve monitoring of resources to ensure that they comply with the budgetary allocation determined at the planning stage.
Training Plan
As already mentioned, all stakeholders are important in the implementation of change. They need to understand how they can play a role in the change process. That understanding necessitates training of all stakeholders involved in the change. Firstly, formal training will be held for management employees who are expected to spearhead the change process. They will be trained in their respective roles in change management in order to facilitate the entire process of change. The management staff will then be required to train their junior staff and will include hands-on training as well as training the relevant aspects of the change that affects their respective staff. For instance, the employees to work in the Medicare-certified hospice will be taken through training on relevant work instructions and standard operating procedures.
Timeline and Schedule For activities
| Activity | Time Duration | Starting Date | Expected Completion Date |
| Planning | Three months | 1 st November 2018 | 31 st of January 2019 |
| Getting board Approval | One month | 1 st February 2019 | 31 st February 2019 |
| Developing organizational structure | One month | 1 st March 2019 | 31 st March 2019 |
| Construction and equipping of a Medicare-certified hospice center | Six months | 1 st of April 2019 | 1 st of October 2019 |
| Recruitment for new positions | One month | 1 st of April 2019 | 31 st of April 2019 |
| Training | Two months | 1 st May 2019 | 31 st June 2019 |
| Advertisements | Two month | 1 st July 2019 | 1 st October 2019 |
| Roll out | 1 st October 2019 | ||
| Evaluation and monitoring | Monthly |
Incentives and celebrations of success
As already demonstrated, short term wins will greatly serve as an incentive to continue with the implementation process. The leadership will share every short term win and organize short celebrations for the short term wins. A demonstration of such short term wins will help in demonstrating the importance of the overall process and hence motivate people to further embrace the change.
Budget
This change process will make use of the following budget.
| Item | Amount |
| Construction | $ 200,000 |
| Recruitment process | $ 500 |
| trainings | $ 1200 |
| Advertisements | $ 8500 |
| Equipment | $ 10,000 |
| Miscellaneous | $ 500 |
| Total | $ 220,700 |
Conclusion
Overall, the major issues facing the Hillsboro County Home Health Agency include reducing revenue generation as well as a shrinking market share. Moreover, the inconvenience caused by the lack of a Medicare-certified hospice at the organization’s facility is increasingly becoming a concern for the customers as well as the employees. This strategic change plan seeks to address these challenges. The major strengths for Hillsboro County Home Health Agency include convenient location, competent leadership and a good reputation within the community it operates. The weaknesses include poor financial performance, low productivity from older employees and differences in perspectives and opinions among the board members. There is an opportunity for the business in emerging technologies and increasing demand for Medicare-certified services. The threats include increasing competition and stiffer regulatory requirements. The suggested strategies involve the adoption of Medicare-certified hospice services, adoption of educational services for the home health division and collaboration with other healthcare providers. The change management process will include identification of resistance, removing of obstacles and the demonstration of short-term wins. Finally, budgeting and scheduling provided will aid and guide the implementation process.
References
Bergeron, B. P. (2015). Key Performance Indicators. Performance Management in Healthcare, 14 (2), 39-52.
Berry, N. J., & Evans, J. (2014). Cost Effectiveness of Home Health Care as an Alternative to Inpatient Care. Home Health Care Services Quarterly, 6 (4), 11-25.
Chikudate, N. (2015). Questioning Organizational Change. Collective Myopia in Japanese Organizations, 155-164.
Fiscel, M. R. (2015). Home Care Organizational Leadership and Structure in a Changing Environment. Home Health Care Management & Practice, 11 (6), 49-60.
Gabel, S. (2015). Implementing Change in Healthcare Organizations. Leaders and Healthcare Organizational Change, 23 (6), 137-153.
Hejduková, P., & Kureková, L. (2017). Healthcare systems and performance evaluation: Comparison of performance indicators in v4 countries using models of composite indicators. E M Ekonomie a Management, 20 (3), 133-146.
Kushel, B., Eric V., and Jennifer S. (2014). Factors Associated With the Health Care Utilization of Homeless Persons. Journal of the American Medical Association, 285(2):200-206
Lavor, J. (2015). Long-Term Care and Home Health Care. Home Health Care Services, 25 (2), 19-73.
Packard, T. (2014). Organizational Change in Human Service Organizations. Social Work, 12 (3), 134-146.
Pegler, F. (2016). Organizational Change and Innovation. Managing Nonprofit Organizations, 12 (7), 384-417.
Polancich, D. (2017). Hillsboro County Home Health Agency SWOT Analysis. Journal of Leadership in Healthcare, 13 (4), 256-269.
Porter, E. J. (2018). Home Care as a Complex Experience: A Chronological Case Study of Hillsboro County Home Health Agency Inc. Home Health Care Services Quarterly, 27 (3), 167-186.
Smith, H. L., & Reid, R. A. (2014). Integrating Hospice and Home Health Services. Home Health Care Services Quarterly, 8 (1), 87-102.
Sonnega, A., Robinson, K., & Levy, H. (2016). Home and community-based service and other senior service use: Prevalence and characteristics in a national sample. Home Health Care Services Quarterly, 36 (1), 16-28.
Storey, J. (2015). Governance and organizational change. The Routledge Companion to Organizational Change, 24 (12), 223-238.
