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RunningHead:REPORT FORTHE REDEMPTION PROJECTTO OPEN A COMPREHENSIVESATELLITE CLINIC
Option 2: Providing Health Services in a Rural Community: A Report on Project Feasibility
Report for the Redemption project to open a comprehensive Satellite Clinic
Capstone Project (Final Submission)
Michael Ashu
Organizational Management: Strategy and Execution: HCM 580
Colorado State University-Global Campus
Dr. Arletta Wallace
March 27, 2016
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
Report for the Redemption project to open a comprehensive Satellite Clinic
Introduction
It is not uncommon that the rural dwellers are usually sidelined in very essential
developments or amenities that those in the metropolitan areas are enjoying, one of which is
healthcare. Pocahontas Memorial Hospital located at Duncan Road in Buckeye of West Virginia
is the only hospital available to the people of Pocahontas County with a population of more than
nine thousand, one hundred and thirty one people from ten towns, located in the south east region
of Western Virginia (www.pmhwv.org). The hospital accommodates twenty five beds and it is
typical for level- four trauma cases (www.pmh.org). The cost of care is skyrocketing and its
accessibility becoming difficult especially with the poor economy that characterizes the county.
Moreover, health professionals usually do not like working in rural areas which is the case with
this county.
Owing to these lapses, PMH desires to tender a complete satellite clinic inside the county
and a report for the viability of a project is crucial to give the Board of Directors guidance on
how to launch the clinic which would serve as part of a tactical idea for their yearly tactical
executive planning procedure. This health project that has been named as Redemption Health
Project would require a committee to be set up to oversee, act as well as coordinate its affairs.
The committee would consist of people of specific competencies, some who would be required
from the start of the project and others incorporated as the project proceeds. As a nonprofit
business focused on providing quality healthcare and furthering healthful life forms to the people
of the county and whose vision is equally directed towards leadership training (www.pmh.org),
PMH is in good standing to carry on with this project. Even its numerous goals, two of which to:
utilize dimension to identify troubles as well as enhance procedures; and to match conducts with
objectives plus principles are in support of this project(www.pmh.org).
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
Assessment
Internal and external stakeholders and their buy-in for this project
Both categories of stakeholders including investors are fully in agreement with this
project because PMH has long been the lone hospital existing in Pocahontas County; has been
plagued by many calamities such as financial crisis, fires and floods etc. It had its origin from the
very first hospital: Marlinton Hospital which was finally swept by flood still in West Virginia as
far back as 1906, over one hundred years ago. Though there is a nursing home in the county and
a health clinic built within PMH, these facilities put together cannot still deliver the services that
would meet the needs of the people of this county considering its present populace earlier stated.
Also, with a ratio of 1 primary doctor to 8,508 people and 1 dentist to 8,851 people, it is clear
that this county needs more health professionals and facilities as well.
Given the fact that cost of care is going up and accessibility is also limited, there are many in this
county who have been without care for long some without health insurance and still others with
health insurance who may have been seeking healthcare out of the county because the present
one is so expensive for them.
Choudhary (2012) explains that the case study presented examines the confused
societal, lawful, technical matters that are confronting nowadays suburban community hospitals
in United States. The towering health care charges, escalating population of the sick without
health insurance or else insufficient health insurance, decreased remunerations by government
bureaus, with rising quantity of medical doctor possessed outpatient care set-ups are crushing the
sustenance of community hospitals whose conventional assignment has been primary care.
Additionally, by means of the passing of the Patient Protection and Affordable Care Act in
March 2010, community hospitals are confronting fresh contests whose complete effect is
unidentified(Choudhary,2012,p.39).
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
Duarte, Goodson and Dougherty’s (2014) article on the Malcolm Baldrige National
Quality Award Winners (MBNQA) is focused on healthcare organizations embarking on
modernizations as a way of improving performance. PMH only accommodates 25 beds meaning,
it has limited space for inpatients. So many of the MBNQA winners run healthcare facilities that
have capacities ranging from 150 beds and above, besides the sophisticated equipments they use
that promote efficiency. Therefore, this project for a satellite clinic would be much appreciated to
decongest the PMH and give opportunities for innovations and more health care professionals to
work in this county.
Internal and external environmental challenges (e.g., consumer access, medical equipment,
community involvement required).
Of course, the challenges that health care organizations experience from both internal
and external environment in this day and age are enormous. The passing of the Affordable Care
Act of 2010 has injected into the health care system some changes which place more demand on
healthcare professionals in the way of practicing health care. For example, there is emphasis on
performance as opposed to quantity of the number of patients examined by a physician. Increase
in the number of patients because of expansion of Medicaid by the Center for Medicare and
Medicaid Services (Shi & Singh, 2012) has highlighted the theory of doing a little with less. This
involves both internal and external environments and is one challenge that PMH, the pioneer for
this new project would have to deal with. It can also be seen that the induction of accountable
care organizations (ACOs) is another test to healthcare organizations because it involves them
losing financially when they perform poorly in their practice and gaining when they provide
efficient healthcare services(Balgrosky,2015).
The concept of consumerism that gives the consumer an upper hand in the decision
making of his or her health care needs has also caused healthcare organizations to be alert and
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
be up and doing towards the supply of healthcare services because a consumer would conduct
a search online, follow advertisements over the television, the radio and even in magazines and
newspapers just to locate a precise health care facility, physician or medication that would
provide cure for his or her health issues. In this perspective, competition sets in as every
healthcare organization wants to be reckoned as the best. This would be another challenge to
confront the new project.
Medical equipment has become a source of winning many patients because the latter
believe that such equipment facilitates services and enhances efficiency. For the new satellite
health clinic to strive and compete favorably in the healthcare market, it would have to procure
the necessary medical equipment. Duarte et al (2014) relate cases of certain healthcare
organizations that make use of special technology to become winners of the MBNQA. The
authors mention that Bronson Methodist Hospital in Michigan applies a number of changes
involving the inauguration as well as web-facilitation of computer schemes; inside advancement
of software in order to assist medical doctors provide treatment to new born babies, apparatus to
accelerate the release of sick people hospitalized and at the same time preventing patients’
security mistakes (Duarte et al, (2014).
Community involvement in this project is awesome as not only are the construction
workers of the satellite clinic people from Pocahontas County but young men and women from
high school and college and even folks out of school from this county have been engaged in
different services of the project. Putting of posters in different areas of the county, on buses, and
distribution of flyers carrying the name of the project and activities concerning it have all been
done by these folks. There are even some very influential members of this county involved in the
committee overseeing the entire project. It is also very likely that some healthcare professionals
who are residents or people born and bred in this county would be stakeholders of the
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
Comprehensive Satellite Clinic. Farmer and Nemegeer (2014) write that community involvement
has been defined as societal connections in order to persuade as well as confine results; a societal
procedure as well as an accomplishment. It has equally been conferred as a state on a range amid
community willingness and also community “empowerment” (Farmer and Nemegeer (2014).
Market Analysis
A market analysis is necessary to supply the BODs with data for the market trend
of health care products and services. In the analysis conducted, much about Pocahontas County
unfolds. The county’s age groups are specified as follows: Age 0-4: 4.58%, 5-7: 13.48%, 18-
24:6.57%, 25-34: 10.37, 35- 44: 12.43%, 45-54:16.84%, 55-64:16.02%, 65; 18.72% (PMH
Health Need Assessment, 2013). It is important to understand that the “age group that consumes
the largest health care services, age 65+ years stands for the highest percentage of inhabitants in
the county” (Health Needs Assessment, 2013). Further, these are various segmentation of
different diseases or health outcomes: breast cancer incidence/one hundred thousand population:
110.40, cancer mortality /100,000 inhabitants: 184.20 and colon/rectal cancer incidence/100,000
population: 39.90 (PMH Health Needs Assessment, 2013).
Other cases are proportion of adults with “diabetes: 10.80%, infant mortality
for 1000 births: 17.19, heart disease deaths per one hundred thousand populace: 140.28 and low
births weight: 9.32%” (PMH Health Needs Assessment, 2013). Lung Cancer incidence for every
one hundred thousand populace: 84.90, adult obesity: 30.90% and adult reporting poor general
health: 22 % (PMH Health Needs Assessment, 2013).There is also prostate cancer incidence/one
hundred thousand populace: 91.80, stroke deaths/one hundred thousand inhabitants: 60.37 and
suicide deaths/100,000 population: 20.54 (PMH Health Needs Assessment, 2013).
Some information about rural areas reveals the following:
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
 Rural residents are likely to be less financially viable. Averagely, earnings for every head
in the rural area are “$7,417” less than in a metropolitan place (NRHA, 2007-16).Besides
this, Americans residing in the rural environment are more likely to live lower the
poverty level. Meanwhile, almost twenty four percent of rural kids live in financial lack.
 Rural inhabitants have fewer chances of having employer- offered health care protection
or else “prescription drug coverage” plus they have less chance of being protected by
Medicaid than their colleagues in metropolitan areas (NRHA, 2007-16).
 People who live in rural America depend a great deal on the federal Food Stamp, as
revealed by “The Carsey Institute of the University of New Hampshire” (NRHA, 2014).
However, the ACA promises to expand Medicaid coverage to people with very little
income to a certain level who meet the Medicaid requirement; meaning that, rural dwellers can
now benefit from this provision. Also children from age 19-26 can share health insurance with
their parents’ employment or personal health insurance policies. Because of smaller earnings in
the rural areas, a bigger section of the rural populace is going to be qualified for subsidies by
way of the Insurance Market places (Remember, getting America’s rural communities covered
begins with You! 2013).This might make the demand for healthcare more favorable unlike when
this was not the case.
The people in Pocahontas County are living in an area with eight rivers (www.pmhwv.
Org). The high incidence of cancer cases would be a target market for the satellite clinic.
Another target market would be Medicare and Medicaid patients and the baby boomers that are
aging and their many health needs should be a course of concern. Then you also have kids who
mostly exhibit some types of illnesses peculiar to them. Given the fact that PMH is the lone
hospital in the county, it shows, the satellite clinic is going to have support from many clients.
In particular, as the market analysis reveals, there are sixteen providers in Pocahontas
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
County in the areas: General Surgery: 1, Emergency Medicine:4, Family Practice:6, Nurse
Practitioner and Family Practitioner:1, Physician Assistance and Family Practitioner:2 and
Osteopathic Manipulative Medicine:2 (PMH Health Needs Assessment, 2013). Some folks are
troubled because the medical experts in the county are inadequate, the reason why these essential
health care services are absent: “OB/GYN, mammography, PAP tests, MRI, Non-emergency
transportation, Dialysis, Pediatrics (Health Needs Assessment, 2013) and so on. The clinic might
not be able to employ healthcare professionals who have so many years of experiences because
of high cost. It might be preferable to recruit fresh doctors who have just finished training and
mix with few that have been in medical practice for a good number of years. This new doctors
can begin to gather experience as they work and also do some additional training.
Competition is not something to be ignored even though there are few health facilities in
this county. The satellite clinic has to make sure that pricing is moderate because in the first
place, this people do not have a lot of money. There is a tendency of comparing prices of
healthcare services and products of the clinic with those in nearby counties and where those
others are cheaper, there is the likelihood to go for the cheaper ones. Also, doing a SWOT
analysis for one’s competitors would be helpful because it enables the organization to know the
strengths and weaknesses as well as opportunities and threats of its counterpart. If the strategy is
known, the better. This would equip the clinic on how they should plan and strategize also.
A SWOT Analysis
Doing a SWOT analysis for this new project might be necessary to reveal the external
opportunities and threats that would confront internal strengths and weaknesses of the new
comprehensive satellite clinic. Wijngaarden V, Scholton and Wijk (2010) write that the SWOT-
analysis is an instrument created for strategic analysis which embraces an argument amid
exterior advancement and interior abilities. These authors say that depending on the varience
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
between both strategic choices or else still a current strategic route is likely to be recognized for
the company. Watching the video where Erica Olsen explained how SWOT analysis is
performed, sheds more light to it (CSU-Global, 2016).
Erica specified the type of data to be collected for internal strengths and weaknesses to
include consumer reaction like the one from surveys and focus groups, worker information,
abilities, resources which include money, building and assets and the other is procedure such as
interaction (CSU-Global, 2016). For external opportunities and threats, she categorizes the sort
of data to include as secondary data that informs us about our environment for example,
mortgage rate, interest rate; competitive data and customer’s data as well. She mentions that this
would be gathered and a list of ideas created and dropped in a goal statement or prioritized or
flushed to be developed as goals (CSU-Global, 2016).
Now, to talk of the strength of this project, one could begin to think of the many
Pocahontas County patients going to receive treatment or put another way, the many lives that
would be safe. The project would be an instrument of fighting the diseases in this county.
There is a saying that two are better than one. With more health professionals employed to
work in the new clinic, a more serious and violent attack would be launched against health
problems affecting the people of this county. The ability for the project to cater for the needs of
patients, generate revenue, train and retain staff, operate the business under government rules
would also be strength. The project can also be a training ground to develop skills and expertise
for some health practitioners. This would also bring development in the county. Healthcare is
one of those amenities that people wanting to undertake businesses consider before launching
them in the place.
There are a number of weaknesses in a project such as this one. Undertaking a project to
open a comprehensive satellite health clinic requires enormous financial resources to procure
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
and install the necessary machines, computers, software, medical equipment or technology. For
example, adopting an EHR is very expensive and also requires a long period of waiting when
from experiences it might not generate the sort of profit that would justify the whole struggle,
except that with subsidies from HITECH it is a bit compensating. Employing, training and
paying staff also place a heavy financial demand and responsibility on the management of the
project. Treating and accommodating so many people infested with different diseases can also
post a danger to others and even to the people around, if proper care and expertise in risk
management techniques are not taken. What about medical malpractice that is likely to come
from the inefficiency of the healthcare expert which could attract litigation leading to paying
huge damages? This is also a big weakness.
Though opening such a project usually involves various people with different capabilities
and talents, there is a need to place these folks in their rightful positions to do that which they
can do very well. Otherwise, it could be a total failure when wrong individuals are positioned in
areas they are not very competent in. For example, a wrong person with inadequate foresight
selected to coordinate a project such as this, might end up crashing only after a huge amount of
money including time has been expended.
More health care professionals are to have the opportunity to work in this county who
previously would not have come into the county. The project would generally provide jobs for
other species of workers who are not necessarily healthcare savvy. With the new project, PMH
might have the opportunity to seek for grant from the Health Resources and Services
Administration (HRSA), the federal agency for improving access to health care services. Recall
that PMH is a non-profit healthcare organization. Opening a new project for a satellite clinic is a
demonstration that the hospital has concerns for the health care needs of the people of this county
which does not only run in line with its mission, vision and values but also conforms with the
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
demands of this government agency. The government is very stern with healthcare organizations
that present themselves as nonprofit to get loans and not abide to their promises. There are also
chances to receive patronage from specific groups such as clubs, schools, football teams,
companies and associations etcetera which would bring in regular income to the clinic.
External threats for this organization are inevitable. An outbreak of a new disease can
swallow-up funds and endanger the lives of healthcare professionals and residents or patients.
For example, imagine the threat that Ebola posted to most healthcare facilities that treated
victims and even the fear that it instilled in other health facilities and their healthcare
professionals such as clinicians (nurses, doctors, and specialists etc.). Having heard and watched
on the television the surprises and threats posted by terrorists to schools, churches, offices and
even healthcare facilities, it would be improper to ignore terrorism as being a threat to a project
such as this one even though at the bottom of one’s heart, one would not wish such to be the
case. Cyber attack has been sweeping across the globe in the recent past and even presently their
tactical and destructive nature cannot be ignored. These hackers are out to steal and damage
valuable information; they attack without any notice and should not be taken lightly.
Recommendation and Implementation
Despite the much publicity of having many people of meager earnings get health
insurance through exchange where they can be subsidized, there are still many people in the rural
areas who probably need assistance to follow up with this provision of ACA. My commendation
is that as part of commitment to meet the healthcare needs of the people of Pocahontas County,
PMH should assist to have such individuals have health insurance. This is going to be useful not
only to those individuals but even to PMH as well.
Another recommendation is that even though, it is necessary to have all the sophisticated
technology to do all the good healthcare jobs plus retain many customers, at this initial stage,
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
PMH should avoid investing in very expensive equipment except they are just too necessary.
Rather, they should endeavor to borrow some of them. Another way is to spend on a few very
expensive and necessary medical equipments and borrow many of the cheap ones.
PMH has a capacity for 25 beds only in a county with 9,131 people since 2010 as dictated
by that year’s census. These numbers of beds are too few especially as it is long past 2010 and
this is 2016 which means the population of this county should have increased by now. My
recommendation is that this comprehensive satellite clinic should not be limited to an outpatient
or ambulatory clinic alone but a section be created for inpatients carrying a wider space that can
accommodate four times the size of PMH: 100-beds.
Strategy for encouraging health professionals and staff
One way to inspire healthcare professionals to work in the county is to advertise in the
television where the new project as well as the county can seldom be featured, besides the major
newspapers and I am suggesting that this media be used for advertisement frequently. It is vital
to recognize that to be able to attract healthcare professionals in a rural area, something extra has
to be done that would entice them; being that, most of them might not want to work in a rural
environment that do not have the types of amenities available in the urban settings. These lapses
sometime make working hard in rural places. McCann, Ryan and McKenna (2005) explain an
encounter by some healthcare experts who were sent to work in some rural areas in Northern
Ireland. They complained that proper budgeting for their services were not done and even those
rural dwellers they were meant to serve there were not so receptive to the services.
For this reason, the strategy appropriate for use should be an incentive strategy. This
would include providing free housing for the healthcare professionals and staff for the first six
months to enable them settle and become familiar with the area after which they can then foot
the bills for their housing. Physicians can be equipped with management skills so that besides
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
examining patients, they can also involve in managing certain aspects of the healthcare business.
This is the practice of Kaiser Permanente. But before then, advertisements for vacancies would
be made in the internet, Washington Post, LinkedIn, Indeed and some universities through career
and job fairs. This process could take about a year. When enough applications have come in, an
interview would be conducted and those selected would be the ones to benefit from the housing
incentive.
Feasibility for development of satellite clinic
As earlier stated in the second paragraph about the committee that would be in charge of the
project, the first task for members is to carry out a survey of where to site the clinic. The clinic is
said to be located some distance away from PMH and it should be in an unlike town entirely.
The committee members have to study all the other towns before agreeing on the actual one they
deem fit. It would be proper that team members include the local heads of all the towns in
Pocahontas County and the Mayor of the county should be consulted. Some other team members
could be officials from the Ministry of public health in addition to members from PMH etc.
There is quite a lot of work to be done here. This same team has to constitute itself, map out a
plan and formulate various strategies on how to follow-up with it.
Value-adding support and resources (e.g. equipment and technology)
Value-adding support and resources may denote improving the value of services by way of
procuring durable and efficient medical equipment; providing decent logistics such as a free
parking space for consumers to park their cars, rather than going somewhere else to park;
ensuring that the entire surrounding of the facility of the healthcare organization is non
hazardous, so as not to endanger visitors, employees and patients etc.; properly and clearly
inscribing the name and address of the organization on a board and putting this at the front of the
organizational building so that any visitor or stranger would clearly identify where this
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
organization is located in the event he or she is searching for the organization and many more.
The fact is that all of these activities serve as support to the main activities of the organization
and they enhance the value of the services as well.
Regarding the enhancement of the value of equipment and technology, it is already well
known that healthcare organizations are big consumers of technology because generally, it eases
services besides providing efficiency as well. They are all types of appliances used medically. A
few of them used for screening are magnetic resonance imaging (MRI) and CT scanners. Others
are Machines for X-rays, mobile apps, bar-code scanner, pharmacy information systems, medical
imaging and radiology information systems, clinical decision-support systems (CDS) etc.
Develop Strategic Initiative
Workman (2012) defines strategic initiative as “a product development or service
activity that is used to gain competitive advantage and requires “long-term”commitment in time
and resources to produce or provide. Workman says strategic initiative therefore differs from
“tactics and operations” in that the former is a blend of various analysis, behavioral techniques,
and the use of power and organizational politics to bring about broadly conceived outcomes,
whereas tactics are managerial actions that enact a strategy, and operations are the daily routines
that result from managerial actions” (p.23).
Based on the above definitions the strategic initiatives should be thus:
 To create a phone line where people can get information concerning the project and put
someone to be in charge
 An account should be opened with a good bank(Bank of America) and donations
requested from the public to raise funds for the project so as to facilitate its construction
 Have bill boards and flyers with the inscription Redemption Health Project for the
construction of a comprehensive satellite clinic on them including the location of the
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
clinic and the owners: PMH. The bill boards will be posted at street junctions, public
buildings and on buses and the flyers distributed to people in all the ten towns.
Short and long term plans for the implementations of strategic initiatives
 Both plans would be to connect with a reputable phone company, register and let the
company create the phone line and have someone be in charge.
 It would be proper to go ahead and open an account with the Bank of America and then
call for donations by first of all setting up an occasion where people comprising of
stakeholders of PMH, government bureaucrats and some members of the general public
will be invited in which case some soft drinks and snacks will be served. It is in this
meeting that this donation issue can be launched.
 Call for assistance from some higher school pupils and college students as well as out of
school volunteer folks and have them post bill boards at public buildings and major street
junctions and on buses. They would have to distribute flyers to the public: friends, school
mates, co-workers, commuters, football fans, job seekers and family members etc.
Printing of these materials would be done by a special printing company in the county.
There are buses provided by PMH that would drive the school pupils, students and
volunteers around to do the tasks. This would be done under the supervision of an
employee of PMH.
Brief discussion of how you will evaluate and benchmark this project
I see that the success of this project would first depend on the committee that would be set
up to oversee, act and coordinate its affairs. If the right persons are positioned appropriately,
and even when replacement is obvious and that is equally done accordingly. The committee
would need to follow-up with the plan and strategies that are made and formulated respectively.
This same team would be in charge of the builders to construct the clinic, be it a fresh building or
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
refurbishing an old one provided an old building could be located that would meet the
requirements. Renovating an old building might be less expensive but where it does not meet the
requirements, it would be a waste.
Another key success area of the project would be based on the resources needed, be it
financial resources or the materials that would be required for the construction plus all the
equipments and items that the clinic would also require starting the operation. It means, PMH
has to mobilize its team, not the committee overseeing the project anywhere, to be prepared in
advance as the work progresses to get whatever is necessary. Recruitment also needs intelligent
and proactive personnel. Perhaps, the initial Human Resources Officers who would be able to
employ the right professionals to take off with the work of this clinic. Normally, some few
members of staff from PMH will work in this new clinic but as of now, PMH even has shortage
of staff, so not many employees can come from the hospital.
Conclusion
The truth is that health care is the most important service that every individual needs
whether poor or rich and every American agrees to this claim as there is no politics in this. Yet,
the expensiveness of care makes one feels as though some people are not entitled to enjoy it
because they cannot afford to foot the bills. The passing of the ACA is one of the greatest
achievements in the history of Healthcare the U.S. can boast of, owing to all of the relieving
provisions associated with it. Perhaps, at this juncture, one would say, it is high time the rural
dwellers join the metropolitan inhabitants to enjoy all the amenities that the government and God
has for this nation and no longer should they be sidelined or forgotten in the distribution of
valuable services.
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
References
Balgrosky, J.A. (2015). Essentials of health information systems and technology. Burlington,
MA: Jones & Bartlett Learning, LLC.
Choudhary, A. (2012). Community hospital healthcare system: A strategic management case.
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CSC-GC. (2016). Organizational Management: Strategy and Execution: HCM580: Document
posted in Colorado State University Global Campus HCM580 Model 5 online classroom
achieved at portal.csuglobal.edu
Duarte, N.T., Goodson, J.R., & Dougherty, T-M.P. (2014). Managing innovation in hospitals and
health systems: Lessons from the malcolm baldrige national quality award
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Farmer, J., & Nimegeer, A. (2014).Community participation to design rural primary healthcare
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Ginter, P. M., Duncan, W.J., & Swayne, L.E. (2013). Strategic management of health care
organizations. San Francisco, CA: Jossy-Bass: A Willey Imprint
McCann, S. Ryan, A.A. & McKenna, H. (2005). The challenges associated with providing
community care for people with complex needs in rural areas: a
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National Rural HealthAssociation (2014). What’s difference about rural health care?
Retrieved from http://www.ruralhealthweb.org/go/top/about-the-nrha
Pocahontas Memorial Hospital.(2013). Community Health Needs Assessment. The Center for
Rural Health Development,1-14. Retrieved from http://pmhwv.org/pmh/content/uploads/
Pocahontas-County-Community-Health-Needs-Assessment_2013_Public-Document.pdf
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
Pocahontas Memorial Hospital. (1981). History of our hospital. Retrieved from
http://www.pmhwv.org
Van Wijngaarden, Scholten, G.R.M., & Van Wijk, K.P.(2012). Strategic analysis for health care
organizations: the suitability of the swot-analysis. International Journal of Health Planning
and Management, 27, 34-49. doi: 10.1002/hpm.1032
Workman, M. (2012). Bias in strategic initiative continuance decisions: framing interactions and
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U.S Department of Health & Human Services.(2013). The Affordable care act:
What it means to Rural Americans. Retrieved from http:// www.hhs.gov/
Healthcare/facts/factsheets/2013/09/rural09202013.html
Shi, L., & Singh, D.A.(2012). Delivering health care in America: A system approach
(5th Ed.). Burlington, MA: Jones & Bartlett Learning
Appendix Section A.
Strategy Thinking Map
Mission: The mission of the Comprehensive Satellite Clinic is to enhance and expand the
provision of quality healthcare delivery to the people of Pocahontas County.
Vision: Its vision is to be a strong instrument of healthy living to the people of Pocahontas
County.
Values: Values are teamwork, service and quality
Goals: To promote or encourage the practice of exercise or physical education
To assist in ensuring that folks in the county visit the clinic for consultation when they
become sick.
To grant incentives to healthcare professionals living out of the county and are
interested in working in the county.
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
To retain hardworking healthcare professionals who are ready to learn, take refresher
courses to be more skillful.
To strive for excellence in the provision of healthcare.
Adaptive Strategy: Vertical Integration----Type— Forward vertical integration: growing towards
the consumers or patients (downstream). Services offered: pre-acute, acute and post-acute
“Adding new members along the distribution channel (towards an earlier stage) for present
products and services or controlling the flow of patients from one institution to another”
(Ginter, Duncan, Swayne,2013)
Market Entry Strategy Development: The type of strategy where products and services are
created inside the mother organization using the latter’s financial and material resources. But in
this particular case the clinic will be opened some distance away from the mother organization.
Competitive Strategy: The Defender Strategic Posture will be suitable for this clinic even though
it maintains the market entry strategy. What is good about this strategy is that it spends time
enhancing the effectiveness of present activities which helps in reducing cost as well. It also
involves in vertical integration in order to safeguard the surge of market control for sick persons
as well as improve stability.
Implementation Strategy: Pre-Service, Point-of-Service, After-Service
Pre-Service: Market research – Embark on market research, did the analysis and obtains data
Target market: Different markets actually exist in Pocahontas County. Some of them are market
for different Cancer diseases, heart disease, Medicare/Medicaid, and stroke etc.
Services offered/Branding: pre-acute, acute and post-acute; surgeries, screening, test, X-Rays,
consultation, prescription, dialysis, and others
Pricing : Moderate within affordable means
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
Distribution of logistics: Sign board to guide patients and visitors, plus free parking
Promotion: Advertisements on TV, radio and internet, Social media, Washington Post, places
posters at public buildings and major street junctions etc.
Point-of-Service: Clinical operations: give injections, conduct test, do eye surgery and carry out
other laboratory operations, take BP and measure heart beat etc
Quality: Health care services are yielding tremendous results as patients receive cure
for their diseases, medical errors are minimized, no physician sued yet for
medical malpractice. Register with MBNQA also, HIPAA and HITECH Privacy
Rules and Health Information System instructions respectively are highlighted
Process Innovation: Mobile applications introduced, patient information even in the mobile app
Is (encrypted) converted to a form that cannot be read by an unauthorized
user, Some sophisticated X-ray machines are installed, customer service is
transformed. PMH introduces a program to offer free medical service to
Pocahontas inhabitants who do not have incomes, for a particular disease
at special period of the year.
Marketing: Marketing manager embarks on extensive advertisement using the media,
carries out research and consults various healthcare quality associations,
introduces a new website where health information searchers can gather
certain health information about the clinic.
Patients Satisfaction: More patients are coming into the clinic being referred by older patients
because of their satisfaction, CMS expresses satisfaction with the new clinic
because of the quality service offered to Medicare and Medicaid
beneficiaries etc., Some Pocahontas County folks without health insurance
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
are still being offered free medical care.
After-Service: Follow-up: Physicians introduce a procedure where they contact patients under
medication in their homes to find out how they are doing by phone.
Meanwhile, patients have the clinic’s website where they can
communicate with their doctors at after hours.
Clinical: Some emergency cases requiring clinical procedures receive attention.
Marketing: There are stakeholders who receive calls from outsiders who want to
know about the clinic.
Billing: Payments are made through credit cards, cash or having an account in the
Clinic’s website and payment made on a monthly interval.
Follow-on: Patients are reached out to introduce certain new programs of the clinic
they do not know about already
Clinical: Certain operations are carried out during this time.
Marketing Is an ongoing thing
Map of Selected Strategies for long-term organization (Ginter, Duncan and Swayne, 2013)App B
Adaptive Strategy Market Entry Strategies Competitive Str.
Expansionof Scope CooperationStrategies StrategicPosture
Vertical Integration:Originallyoperating Mergersin orderto: AnalyzerStrategicPos.
an acute care hospital 1. Improve efficiency&effectiveness in orderto:
DownwardStreamto control 2. Increase entry 1.Become stable
flowof patients 3. Improve earningsorrevenue 2. Lookfor more
ForwardVertical Integration 4. Rise above worriesof enduring openings
Acquisitionof the following: 3. Modify
A skillednursingunit 4. Make good use
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
Assistedliving,homehealth,hospicesetc of others strategies
Appendix C Total Population, Age Groups Diagram for Market Analysis
Area Reported Age Age Age Age Age Age Age Age PMH
Pocahontas C 0-4 5-17 18-24 25-34 35-44 45-54 55-64 65+ HNA,
4.58% 13.98% 6.57% 10.87% 12.43% 16.84% 16.02% 18.72% 2013
West Virginia 5.64% 15.52% 9.17% 11.94% 13.20% 15.15% 13.57% 15.82 %
Disease Segmentation Incidence per 100,000 populace in Pocahontas County
Lung Cancer: 84.90 Breast Cancer: 110.40
Colon/Rectal Cancer: 39.90
Prostrate C. 90.40
Death rate for every disease per 100,000 in Pocahontas County
Suicide Death: 20.54 Stroke Death: 60.37
Cancer Mortality:
184.20 Heart Disease Death: 140.28
Data from Appendix C is from PMH Health Needs Assessment, 2013 and not diagrams
REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC
Other Health Issues in percentage
Low Birth Weights: 9.80% Adult with Diabetes: 10.80%
Adult reporting poor
general health: 22% Adult Obesity: 30%
SWOT Analysis Diagram for the Redemption Project to build a Satellite Clinic
Strengths march these two Opportunities
We capitalize strengths. We invest opportunities
-Many healthcare professionals from other
Instrument to treat many diseases, put up states and this county will be able to work in
violent attack against diseases, meet health care the clinic. There will be opportunity to get
needs, ability to train, retain and pay staff and grants from HRSA. There could also be
abide by government regulations. This project patronage from clubs, schools, companies,
will also be a training ground for health experts and associations etc.
to develop skills and expertise
Internal Strengths and Weaknesses External Opportunities and Threats
Weaknesses Threats
We show up weaknesses We identify threats
The project requires much spending on New disease just like Ebola will endanger
equipment and other appliances e.g. spending in healthcare professionals and facilities.
EHR is usually not so profitable but for incentive Terrorism and cyber attack are very dread
from HITECH. Employing, training and paying dreadful and should be taken seriously.
staff puts another financial weight on the mgmt.
Any malpractice may attract litigation and huge
damages. Treating and accommodating folks
infested with so many diseases may affect
neighbors except there is assistance from risk
management merged with clinical services

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CAPSTONE PROJECT(FINAL SUBMISSION)

  • 1. RunningHead:REPORT FORTHE REDEMPTION PROJECTTO OPEN A COMPREHENSIVESATELLITE CLINIC Option 2: Providing Health Services in a Rural Community: A Report on Project Feasibility Report for the Redemption project to open a comprehensive Satellite Clinic Capstone Project (Final Submission) Michael Ashu Organizational Management: Strategy and Execution: HCM 580 Colorado State University-Global Campus Dr. Arletta Wallace March 27, 2016
  • 2. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC Report for the Redemption project to open a comprehensive Satellite Clinic Introduction It is not uncommon that the rural dwellers are usually sidelined in very essential developments or amenities that those in the metropolitan areas are enjoying, one of which is healthcare. Pocahontas Memorial Hospital located at Duncan Road in Buckeye of West Virginia is the only hospital available to the people of Pocahontas County with a population of more than nine thousand, one hundred and thirty one people from ten towns, located in the south east region of Western Virginia (www.pmhwv.org). The hospital accommodates twenty five beds and it is typical for level- four trauma cases (www.pmh.org). The cost of care is skyrocketing and its accessibility becoming difficult especially with the poor economy that characterizes the county. Moreover, health professionals usually do not like working in rural areas which is the case with this county. Owing to these lapses, PMH desires to tender a complete satellite clinic inside the county and a report for the viability of a project is crucial to give the Board of Directors guidance on how to launch the clinic which would serve as part of a tactical idea for their yearly tactical executive planning procedure. This health project that has been named as Redemption Health Project would require a committee to be set up to oversee, act as well as coordinate its affairs. The committee would consist of people of specific competencies, some who would be required from the start of the project and others incorporated as the project proceeds. As a nonprofit business focused on providing quality healthcare and furthering healthful life forms to the people of the county and whose vision is equally directed towards leadership training (www.pmh.org), PMH is in good standing to carry on with this project. Even its numerous goals, two of which to: utilize dimension to identify troubles as well as enhance procedures; and to match conducts with objectives plus principles are in support of this project(www.pmh.org).
  • 3. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC Assessment Internal and external stakeholders and their buy-in for this project Both categories of stakeholders including investors are fully in agreement with this project because PMH has long been the lone hospital existing in Pocahontas County; has been plagued by many calamities such as financial crisis, fires and floods etc. It had its origin from the very first hospital: Marlinton Hospital which was finally swept by flood still in West Virginia as far back as 1906, over one hundred years ago. Though there is a nursing home in the county and a health clinic built within PMH, these facilities put together cannot still deliver the services that would meet the needs of the people of this county considering its present populace earlier stated. Also, with a ratio of 1 primary doctor to 8,508 people and 1 dentist to 8,851 people, it is clear that this county needs more health professionals and facilities as well. Given the fact that cost of care is going up and accessibility is also limited, there are many in this county who have been without care for long some without health insurance and still others with health insurance who may have been seeking healthcare out of the county because the present one is so expensive for them. Choudhary (2012) explains that the case study presented examines the confused societal, lawful, technical matters that are confronting nowadays suburban community hospitals in United States. The towering health care charges, escalating population of the sick without health insurance or else insufficient health insurance, decreased remunerations by government bureaus, with rising quantity of medical doctor possessed outpatient care set-ups are crushing the sustenance of community hospitals whose conventional assignment has been primary care. Additionally, by means of the passing of the Patient Protection and Affordable Care Act in March 2010, community hospitals are confronting fresh contests whose complete effect is unidentified(Choudhary,2012,p.39).
  • 4. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC Duarte, Goodson and Dougherty’s (2014) article on the Malcolm Baldrige National Quality Award Winners (MBNQA) is focused on healthcare organizations embarking on modernizations as a way of improving performance. PMH only accommodates 25 beds meaning, it has limited space for inpatients. So many of the MBNQA winners run healthcare facilities that have capacities ranging from 150 beds and above, besides the sophisticated equipments they use that promote efficiency. Therefore, this project for a satellite clinic would be much appreciated to decongest the PMH and give opportunities for innovations and more health care professionals to work in this county. Internal and external environmental challenges (e.g., consumer access, medical equipment, community involvement required). Of course, the challenges that health care organizations experience from both internal and external environment in this day and age are enormous. The passing of the Affordable Care Act of 2010 has injected into the health care system some changes which place more demand on healthcare professionals in the way of practicing health care. For example, there is emphasis on performance as opposed to quantity of the number of patients examined by a physician. Increase in the number of patients because of expansion of Medicaid by the Center for Medicare and Medicaid Services (Shi & Singh, 2012) has highlighted the theory of doing a little with less. This involves both internal and external environments and is one challenge that PMH, the pioneer for this new project would have to deal with. It can also be seen that the induction of accountable care organizations (ACOs) is another test to healthcare organizations because it involves them losing financially when they perform poorly in their practice and gaining when they provide efficient healthcare services(Balgrosky,2015). The concept of consumerism that gives the consumer an upper hand in the decision making of his or her health care needs has also caused healthcare organizations to be alert and
  • 5. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC be up and doing towards the supply of healthcare services because a consumer would conduct a search online, follow advertisements over the television, the radio and even in magazines and newspapers just to locate a precise health care facility, physician or medication that would provide cure for his or her health issues. In this perspective, competition sets in as every healthcare organization wants to be reckoned as the best. This would be another challenge to confront the new project. Medical equipment has become a source of winning many patients because the latter believe that such equipment facilitates services and enhances efficiency. For the new satellite health clinic to strive and compete favorably in the healthcare market, it would have to procure the necessary medical equipment. Duarte et al (2014) relate cases of certain healthcare organizations that make use of special technology to become winners of the MBNQA. The authors mention that Bronson Methodist Hospital in Michigan applies a number of changes involving the inauguration as well as web-facilitation of computer schemes; inside advancement of software in order to assist medical doctors provide treatment to new born babies, apparatus to accelerate the release of sick people hospitalized and at the same time preventing patients’ security mistakes (Duarte et al, (2014). Community involvement in this project is awesome as not only are the construction workers of the satellite clinic people from Pocahontas County but young men and women from high school and college and even folks out of school from this county have been engaged in different services of the project. Putting of posters in different areas of the county, on buses, and distribution of flyers carrying the name of the project and activities concerning it have all been done by these folks. There are even some very influential members of this county involved in the committee overseeing the entire project. It is also very likely that some healthcare professionals who are residents or people born and bred in this county would be stakeholders of the
  • 6. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC Comprehensive Satellite Clinic. Farmer and Nemegeer (2014) write that community involvement has been defined as societal connections in order to persuade as well as confine results; a societal procedure as well as an accomplishment. It has equally been conferred as a state on a range amid community willingness and also community “empowerment” (Farmer and Nemegeer (2014). Market Analysis A market analysis is necessary to supply the BODs with data for the market trend of health care products and services. In the analysis conducted, much about Pocahontas County unfolds. The county’s age groups are specified as follows: Age 0-4: 4.58%, 5-7: 13.48%, 18- 24:6.57%, 25-34: 10.37, 35- 44: 12.43%, 45-54:16.84%, 55-64:16.02%, 65; 18.72% (PMH Health Need Assessment, 2013). It is important to understand that the “age group that consumes the largest health care services, age 65+ years stands for the highest percentage of inhabitants in the county” (Health Needs Assessment, 2013). Further, these are various segmentation of different diseases or health outcomes: breast cancer incidence/one hundred thousand population: 110.40, cancer mortality /100,000 inhabitants: 184.20 and colon/rectal cancer incidence/100,000 population: 39.90 (PMH Health Needs Assessment, 2013). Other cases are proportion of adults with “diabetes: 10.80%, infant mortality for 1000 births: 17.19, heart disease deaths per one hundred thousand populace: 140.28 and low births weight: 9.32%” (PMH Health Needs Assessment, 2013). Lung Cancer incidence for every one hundred thousand populace: 84.90, adult obesity: 30.90% and adult reporting poor general health: 22 % (PMH Health Needs Assessment, 2013).There is also prostate cancer incidence/one hundred thousand populace: 91.80, stroke deaths/one hundred thousand inhabitants: 60.37 and suicide deaths/100,000 population: 20.54 (PMH Health Needs Assessment, 2013). Some information about rural areas reveals the following:
  • 7. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC  Rural residents are likely to be less financially viable. Averagely, earnings for every head in the rural area are “$7,417” less than in a metropolitan place (NRHA, 2007-16).Besides this, Americans residing in the rural environment are more likely to live lower the poverty level. Meanwhile, almost twenty four percent of rural kids live in financial lack.  Rural inhabitants have fewer chances of having employer- offered health care protection or else “prescription drug coverage” plus they have less chance of being protected by Medicaid than their colleagues in metropolitan areas (NRHA, 2007-16).  People who live in rural America depend a great deal on the federal Food Stamp, as revealed by “The Carsey Institute of the University of New Hampshire” (NRHA, 2014). However, the ACA promises to expand Medicaid coverage to people with very little income to a certain level who meet the Medicaid requirement; meaning that, rural dwellers can now benefit from this provision. Also children from age 19-26 can share health insurance with their parents’ employment or personal health insurance policies. Because of smaller earnings in the rural areas, a bigger section of the rural populace is going to be qualified for subsidies by way of the Insurance Market places (Remember, getting America’s rural communities covered begins with You! 2013).This might make the demand for healthcare more favorable unlike when this was not the case. The people in Pocahontas County are living in an area with eight rivers (www.pmhwv. Org). The high incidence of cancer cases would be a target market for the satellite clinic. Another target market would be Medicare and Medicaid patients and the baby boomers that are aging and their many health needs should be a course of concern. Then you also have kids who mostly exhibit some types of illnesses peculiar to them. Given the fact that PMH is the lone hospital in the county, it shows, the satellite clinic is going to have support from many clients. In particular, as the market analysis reveals, there are sixteen providers in Pocahontas
  • 8. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC County in the areas: General Surgery: 1, Emergency Medicine:4, Family Practice:6, Nurse Practitioner and Family Practitioner:1, Physician Assistance and Family Practitioner:2 and Osteopathic Manipulative Medicine:2 (PMH Health Needs Assessment, 2013). Some folks are troubled because the medical experts in the county are inadequate, the reason why these essential health care services are absent: “OB/GYN, mammography, PAP tests, MRI, Non-emergency transportation, Dialysis, Pediatrics (Health Needs Assessment, 2013) and so on. The clinic might not be able to employ healthcare professionals who have so many years of experiences because of high cost. It might be preferable to recruit fresh doctors who have just finished training and mix with few that have been in medical practice for a good number of years. This new doctors can begin to gather experience as they work and also do some additional training. Competition is not something to be ignored even though there are few health facilities in this county. The satellite clinic has to make sure that pricing is moderate because in the first place, this people do not have a lot of money. There is a tendency of comparing prices of healthcare services and products of the clinic with those in nearby counties and where those others are cheaper, there is the likelihood to go for the cheaper ones. Also, doing a SWOT analysis for one’s competitors would be helpful because it enables the organization to know the strengths and weaknesses as well as opportunities and threats of its counterpart. If the strategy is known, the better. This would equip the clinic on how they should plan and strategize also. A SWOT Analysis Doing a SWOT analysis for this new project might be necessary to reveal the external opportunities and threats that would confront internal strengths and weaknesses of the new comprehensive satellite clinic. Wijngaarden V, Scholton and Wijk (2010) write that the SWOT- analysis is an instrument created for strategic analysis which embraces an argument amid exterior advancement and interior abilities. These authors say that depending on the varience
  • 9. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC between both strategic choices or else still a current strategic route is likely to be recognized for the company. Watching the video where Erica Olsen explained how SWOT analysis is performed, sheds more light to it (CSU-Global, 2016). Erica specified the type of data to be collected for internal strengths and weaknesses to include consumer reaction like the one from surveys and focus groups, worker information, abilities, resources which include money, building and assets and the other is procedure such as interaction (CSU-Global, 2016). For external opportunities and threats, she categorizes the sort of data to include as secondary data that informs us about our environment for example, mortgage rate, interest rate; competitive data and customer’s data as well. She mentions that this would be gathered and a list of ideas created and dropped in a goal statement or prioritized or flushed to be developed as goals (CSU-Global, 2016). Now, to talk of the strength of this project, one could begin to think of the many Pocahontas County patients going to receive treatment or put another way, the many lives that would be safe. The project would be an instrument of fighting the diseases in this county. There is a saying that two are better than one. With more health professionals employed to work in the new clinic, a more serious and violent attack would be launched against health problems affecting the people of this county. The ability for the project to cater for the needs of patients, generate revenue, train and retain staff, operate the business under government rules would also be strength. The project can also be a training ground to develop skills and expertise for some health practitioners. This would also bring development in the county. Healthcare is one of those amenities that people wanting to undertake businesses consider before launching them in the place. There are a number of weaknesses in a project such as this one. Undertaking a project to open a comprehensive satellite health clinic requires enormous financial resources to procure
  • 10. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC and install the necessary machines, computers, software, medical equipment or technology. For example, adopting an EHR is very expensive and also requires a long period of waiting when from experiences it might not generate the sort of profit that would justify the whole struggle, except that with subsidies from HITECH it is a bit compensating. Employing, training and paying staff also place a heavy financial demand and responsibility on the management of the project. Treating and accommodating so many people infested with different diseases can also post a danger to others and even to the people around, if proper care and expertise in risk management techniques are not taken. What about medical malpractice that is likely to come from the inefficiency of the healthcare expert which could attract litigation leading to paying huge damages? This is also a big weakness. Though opening such a project usually involves various people with different capabilities and talents, there is a need to place these folks in their rightful positions to do that which they can do very well. Otherwise, it could be a total failure when wrong individuals are positioned in areas they are not very competent in. For example, a wrong person with inadequate foresight selected to coordinate a project such as this, might end up crashing only after a huge amount of money including time has been expended. More health care professionals are to have the opportunity to work in this county who previously would not have come into the county. The project would generally provide jobs for other species of workers who are not necessarily healthcare savvy. With the new project, PMH might have the opportunity to seek for grant from the Health Resources and Services Administration (HRSA), the federal agency for improving access to health care services. Recall that PMH is a non-profit healthcare organization. Opening a new project for a satellite clinic is a demonstration that the hospital has concerns for the health care needs of the people of this county which does not only run in line with its mission, vision and values but also conforms with the
  • 11. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC demands of this government agency. The government is very stern with healthcare organizations that present themselves as nonprofit to get loans and not abide to their promises. There are also chances to receive patronage from specific groups such as clubs, schools, football teams, companies and associations etcetera which would bring in regular income to the clinic. External threats for this organization are inevitable. An outbreak of a new disease can swallow-up funds and endanger the lives of healthcare professionals and residents or patients. For example, imagine the threat that Ebola posted to most healthcare facilities that treated victims and even the fear that it instilled in other health facilities and their healthcare professionals such as clinicians (nurses, doctors, and specialists etc.). Having heard and watched on the television the surprises and threats posted by terrorists to schools, churches, offices and even healthcare facilities, it would be improper to ignore terrorism as being a threat to a project such as this one even though at the bottom of one’s heart, one would not wish such to be the case. Cyber attack has been sweeping across the globe in the recent past and even presently their tactical and destructive nature cannot be ignored. These hackers are out to steal and damage valuable information; they attack without any notice and should not be taken lightly. Recommendation and Implementation Despite the much publicity of having many people of meager earnings get health insurance through exchange where they can be subsidized, there are still many people in the rural areas who probably need assistance to follow up with this provision of ACA. My commendation is that as part of commitment to meet the healthcare needs of the people of Pocahontas County, PMH should assist to have such individuals have health insurance. This is going to be useful not only to those individuals but even to PMH as well. Another recommendation is that even though, it is necessary to have all the sophisticated technology to do all the good healthcare jobs plus retain many customers, at this initial stage,
  • 12. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC PMH should avoid investing in very expensive equipment except they are just too necessary. Rather, they should endeavor to borrow some of them. Another way is to spend on a few very expensive and necessary medical equipments and borrow many of the cheap ones. PMH has a capacity for 25 beds only in a county with 9,131 people since 2010 as dictated by that year’s census. These numbers of beds are too few especially as it is long past 2010 and this is 2016 which means the population of this county should have increased by now. My recommendation is that this comprehensive satellite clinic should not be limited to an outpatient or ambulatory clinic alone but a section be created for inpatients carrying a wider space that can accommodate four times the size of PMH: 100-beds. Strategy for encouraging health professionals and staff One way to inspire healthcare professionals to work in the county is to advertise in the television where the new project as well as the county can seldom be featured, besides the major newspapers and I am suggesting that this media be used for advertisement frequently. It is vital to recognize that to be able to attract healthcare professionals in a rural area, something extra has to be done that would entice them; being that, most of them might not want to work in a rural environment that do not have the types of amenities available in the urban settings. These lapses sometime make working hard in rural places. McCann, Ryan and McKenna (2005) explain an encounter by some healthcare experts who were sent to work in some rural areas in Northern Ireland. They complained that proper budgeting for their services were not done and even those rural dwellers they were meant to serve there were not so receptive to the services. For this reason, the strategy appropriate for use should be an incentive strategy. This would include providing free housing for the healthcare professionals and staff for the first six months to enable them settle and become familiar with the area after which they can then foot the bills for their housing. Physicians can be equipped with management skills so that besides
  • 13. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC examining patients, they can also involve in managing certain aspects of the healthcare business. This is the practice of Kaiser Permanente. But before then, advertisements for vacancies would be made in the internet, Washington Post, LinkedIn, Indeed and some universities through career and job fairs. This process could take about a year. When enough applications have come in, an interview would be conducted and those selected would be the ones to benefit from the housing incentive. Feasibility for development of satellite clinic As earlier stated in the second paragraph about the committee that would be in charge of the project, the first task for members is to carry out a survey of where to site the clinic. The clinic is said to be located some distance away from PMH and it should be in an unlike town entirely. The committee members have to study all the other towns before agreeing on the actual one they deem fit. It would be proper that team members include the local heads of all the towns in Pocahontas County and the Mayor of the county should be consulted. Some other team members could be officials from the Ministry of public health in addition to members from PMH etc. There is quite a lot of work to be done here. This same team has to constitute itself, map out a plan and formulate various strategies on how to follow-up with it. Value-adding support and resources (e.g. equipment and technology) Value-adding support and resources may denote improving the value of services by way of procuring durable and efficient medical equipment; providing decent logistics such as a free parking space for consumers to park their cars, rather than going somewhere else to park; ensuring that the entire surrounding of the facility of the healthcare organization is non hazardous, so as not to endanger visitors, employees and patients etc.; properly and clearly inscribing the name and address of the organization on a board and putting this at the front of the organizational building so that any visitor or stranger would clearly identify where this
  • 14. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC organization is located in the event he or she is searching for the organization and many more. The fact is that all of these activities serve as support to the main activities of the organization and they enhance the value of the services as well. Regarding the enhancement of the value of equipment and technology, it is already well known that healthcare organizations are big consumers of technology because generally, it eases services besides providing efficiency as well. They are all types of appliances used medically. A few of them used for screening are magnetic resonance imaging (MRI) and CT scanners. Others are Machines for X-rays, mobile apps, bar-code scanner, pharmacy information systems, medical imaging and radiology information systems, clinical decision-support systems (CDS) etc. Develop Strategic Initiative Workman (2012) defines strategic initiative as “a product development or service activity that is used to gain competitive advantage and requires “long-term”commitment in time and resources to produce or provide. Workman says strategic initiative therefore differs from “tactics and operations” in that the former is a blend of various analysis, behavioral techniques, and the use of power and organizational politics to bring about broadly conceived outcomes, whereas tactics are managerial actions that enact a strategy, and operations are the daily routines that result from managerial actions” (p.23). Based on the above definitions the strategic initiatives should be thus:  To create a phone line where people can get information concerning the project and put someone to be in charge  An account should be opened with a good bank(Bank of America) and donations requested from the public to raise funds for the project so as to facilitate its construction  Have bill boards and flyers with the inscription Redemption Health Project for the construction of a comprehensive satellite clinic on them including the location of the
  • 15. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC clinic and the owners: PMH. The bill boards will be posted at street junctions, public buildings and on buses and the flyers distributed to people in all the ten towns. Short and long term plans for the implementations of strategic initiatives  Both plans would be to connect with a reputable phone company, register and let the company create the phone line and have someone be in charge.  It would be proper to go ahead and open an account with the Bank of America and then call for donations by first of all setting up an occasion where people comprising of stakeholders of PMH, government bureaucrats and some members of the general public will be invited in which case some soft drinks and snacks will be served. It is in this meeting that this donation issue can be launched.  Call for assistance from some higher school pupils and college students as well as out of school volunteer folks and have them post bill boards at public buildings and major street junctions and on buses. They would have to distribute flyers to the public: friends, school mates, co-workers, commuters, football fans, job seekers and family members etc. Printing of these materials would be done by a special printing company in the county. There are buses provided by PMH that would drive the school pupils, students and volunteers around to do the tasks. This would be done under the supervision of an employee of PMH. Brief discussion of how you will evaluate and benchmark this project I see that the success of this project would first depend on the committee that would be set up to oversee, act and coordinate its affairs. If the right persons are positioned appropriately, and even when replacement is obvious and that is equally done accordingly. The committee would need to follow-up with the plan and strategies that are made and formulated respectively. This same team would be in charge of the builders to construct the clinic, be it a fresh building or
  • 16. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC refurbishing an old one provided an old building could be located that would meet the requirements. Renovating an old building might be less expensive but where it does not meet the requirements, it would be a waste. Another key success area of the project would be based on the resources needed, be it financial resources or the materials that would be required for the construction plus all the equipments and items that the clinic would also require starting the operation. It means, PMH has to mobilize its team, not the committee overseeing the project anywhere, to be prepared in advance as the work progresses to get whatever is necessary. Recruitment also needs intelligent and proactive personnel. Perhaps, the initial Human Resources Officers who would be able to employ the right professionals to take off with the work of this clinic. Normally, some few members of staff from PMH will work in this new clinic but as of now, PMH even has shortage of staff, so not many employees can come from the hospital. Conclusion The truth is that health care is the most important service that every individual needs whether poor or rich and every American agrees to this claim as there is no politics in this. Yet, the expensiveness of care makes one feels as though some people are not entitled to enjoy it because they cannot afford to foot the bills. The passing of the ACA is one of the greatest achievements in the history of Healthcare the U.S. can boast of, owing to all of the relieving provisions associated with it. Perhaps, at this juncture, one would say, it is high time the rural dwellers join the metropolitan inhabitants to enjoy all the amenities that the government and God has for this nation and no longer should they be sidelined or forgotten in the distribution of valuable services.
  • 17. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC References Balgrosky, J.A. (2015). Essentials of health information systems and technology. Burlington, MA: Jones & Bartlett Learning, LLC. Choudhary, A. (2012). Community hospital healthcare system: A strategic management case. Journal of International Academy for Case Studies, 18(2), 39-45 CSC-GC. (2016). Organizational Management: Strategy and Execution: HCM580: Document posted in Colorado State University Global Campus HCM580 Model 5 online classroom achieved at portal.csuglobal.edu Duarte, N.T., Goodson, J.R., & Dougherty, T-M.P. (2014). Managing innovation in hospitals and health systems: Lessons from the malcolm baldrige national quality award Study. International Journal of Healthcare Management, 7(1), 21-33. Farmer, J., & Nimegeer, A. (2014).Community participation to design rural primary healthcare services. Bio Med Central Health Services Research, 14(130), 1-10. Ginter, P. M., Duncan, W.J., & Swayne, L.E. (2013). Strategic management of health care organizations. San Francisco, CA: Jossy-Bass: A Willey Imprint McCann, S. Ryan, A.A. & McKenna, H. (2005). The challenges associated with providing community care for people with complex needs in rural areas: a qualitative investigation, Health and Social Care in the Community, 13(5), 462-469. winners.Internatinal Journal of Health Management,7(1), 21-34. National Rural HealthAssociation (2014). What’s difference about rural health care? Retrieved from http://www.ruralhealthweb.org/go/top/about-the-nrha Pocahontas Memorial Hospital.(2013). Community Health Needs Assessment. The Center for Rural Health Development,1-14. Retrieved from http://pmhwv.org/pmh/content/uploads/ Pocahontas-County-Community-Health-Needs-Assessment_2013_Public-Document.pdf
  • 18. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC Pocahontas Memorial Hospital. (1981). History of our hospital. Retrieved from http://www.pmhwv.org Van Wijngaarden, Scholten, G.R.M., & Van Wijk, K.P.(2012). Strategic analysis for health care organizations: the suitability of the swot-analysis. International Journal of Health Planning and Management, 27, 34-49. doi: 10.1002/hpm.1032 Workman, M. (2012). Bias in strategic initiative continuance decisions: framing interactions and Hrd. Emerald Management Decision, 50(1). 21-42. doi: 10.1108/00251741211194859 U.S Department of Health & Human Services.(2013). The Affordable care act: What it means to Rural Americans. Retrieved from http:// www.hhs.gov/ Healthcare/facts/factsheets/2013/09/rural09202013.html Shi, L., & Singh, D.A.(2012). Delivering health care in America: A system approach (5th Ed.). Burlington, MA: Jones & Bartlett Learning Appendix Section A. Strategy Thinking Map Mission: The mission of the Comprehensive Satellite Clinic is to enhance and expand the provision of quality healthcare delivery to the people of Pocahontas County. Vision: Its vision is to be a strong instrument of healthy living to the people of Pocahontas County. Values: Values are teamwork, service and quality Goals: To promote or encourage the practice of exercise or physical education To assist in ensuring that folks in the county visit the clinic for consultation when they become sick. To grant incentives to healthcare professionals living out of the county and are interested in working in the county.
  • 19. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC To retain hardworking healthcare professionals who are ready to learn, take refresher courses to be more skillful. To strive for excellence in the provision of healthcare. Adaptive Strategy: Vertical Integration----Type— Forward vertical integration: growing towards the consumers or patients (downstream). Services offered: pre-acute, acute and post-acute “Adding new members along the distribution channel (towards an earlier stage) for present products and services or controlling the flow of patients from one institution to another” (Ginter, Duncan, Swayne,2013) Market Entry Strategy Development: The type of strategy where products and services are created inside the mother organization using the latter’s financial and material resources. But in this particular case the clinic will be opened some distance away from the mother organization. Competitive Strategy: The Defender Strategic Posture will be suitable for this clinic even though it maintains the market entry strategy. What is good about this strategy is that it spends time enhancing the effectiveness of present activities which helps in reducing cost as well. It also involves in vertical integration in order to safeguard the surge of market control for sick persons as well as improve stability. Implementation Strategy: Pre-Service, Point-of-Service, After-Service Pre-Service: Market research – Embark on market research, did the analysis and obtains data Target market: Different markets actually exist in Pocahontas County. Some of them are market for different Cancer diseases, heart disease, Medicare/Medicaid, and stroke etc. Services offered/Branding: pre-acute, acute and post-acute; surgeries, screening, test, X-Rays, consultation, prescription, dialysis, and others Pricing : Moderate within affordable means
  • 20. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC Distribution of logistics: Sign board to guide patients and visitors, plus free parking Promotion: Advertisements on TV, radio and internet, Social media, Washington Post, places posters at public buildings and major street junctions etc. Point-of-Service: Clinical operations: give injections, conduct test, do eye surgery and carry out other laboratory operations, take BP and measure heart beat etc Quality: Health care services are yielding tremendous results as patients receive cure for their diseases, medical errors are minimized, no physician sued yet for medical malpractice. Register with MBNQA also, HIPAA and HITECH Privacy Rules and Health Information System instructions respectively are highlighted Process Innovation: Mobile applications introduced, patient information even in the mobile app Is (encrypted) converted to a form that cannot be read by an unauthorized user, Some sophisticated X-ray machines are installed, customer service is transformed. PMH introduces a program to offer free medical service to Pocahontas inhabitants who do not have incomes, for a particular disease at special period of the year. Marketing: Marketing manager embarks on extensive advertisement using the media, carries out research and consults various healthcare quality associations, introduces a new website where health information searchers can gather certain health information about the clinic. Patients Satisfaction: More patients are coming into the clinic being referred by older patients because of their satisfaction, CMS expresses satisfaction with the new clinic because of the quality service offered to Medicare and Medicaid beneficiaries etc., Some Pocahontas County folks without health insurance
  • 21. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC are still being offered free medical care. After-Service: Follow-up: Physicians introduce a procedure where they contact patients under medication in their homes to find out how they are doing by phone. Meanwhile, patients have the clinic’s website where they can communicate with their doctors at after hours. Clinical: Some emergency cases requiring clinical procedures receive attention. Marketing: There are stakeholders who receive calls from outsiders who want to know about the clinic. Billing: Payments are made through credit cards, cash or having an account in the Clinic’s website and payment made on a monthly interval. Follow-on: Patients are reached out to introduce certain new programs of the clinic they do not know about already Clinical: Certain operations are carried out during this time. Marketing Is an ongoing thing Map of Selected Strategies for long-term organization (Ginter, Duncan and Swayne, 2013)App B Adaptive Strategy Market Entry Strategies Competitive Str. Expansionof Scope CooperationStrategies StrategicPosture Vertical Integration:Originallyoperating Mergersin orderto: AnalyzerStrategicPos. an acute care hospital 1. Improve efficiency&effectiveness in orderto: DownwardStreamto control 2. Increase entry 1.Become stable flowof patients 3. Improve earningsorrevenue 2. Lookfor more ForwardVertical Integration 4. Rise above worriesof enduring openings Acquisitionof the following: 3. Modify A skillednursingunit 4. Make good use
  • 22. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC Assistedliving,homehealth,hospicesetc of others strategies Appendix C Total Population, Age Groups Diagram for Market Analysis Area Reported Age Age Age Age Age Age Age Age PMH Pocahontas C 0-4 5-17 18-24 25-34 35-44 45-54 55-64 65+ HNA, 4.58% 13.98% 6.57% 10.87% 12.43% 16.84% 16.02% 18.72% 2013 West Virginia 5.64% 15.52% 9.17% 11.94% 13.20% 15.15% 13.57% 15.82 % Disease Segmentation Incidence per 100,000 populace in Pocahontas County Lung Cancer: 84.90 Breast Cancer: 110.40 Colon/Rectal Cancer: 39.90 Prostrate C. 90.40 Death rate for every disease per 100,000 in Pocahontas County Suicide Death: 20.54 Stroke Death: 60.37 Cancer Mortality: 184.20 Heart Disease Death: 140.28 Data from Appendix C is from PMH Health Needs Assessment, 2013 and not diagrams
  • 23. REPORT FOR THE REDEMPTION PROJECT TO OPEN A COMPREHENSIVESATELLITE CLINIC Other Health Issues in percentage Low Birth Weights: 9.80% Adult with Diabetes: 10.80% Adult reporting poor general health: 22% Adult Obesity: 30% SWOT Analysis Diagram for the Redemption Project to build a Satellite Clinic Strengths march these two Opportunities We capitalize strengths. We invest opportunities -Many healthcare professionals from other Instrument to treat many diseases, put up states and this county will be able to work in violent attack against diseases, meet health care the clinic. There will be opportunity to get needs, ability to train, retain and pay staff and grants from HRSA. There could also be abide by government regulations. This project patronage from clubs, schools, companies, will also be a training ground for health experts and associations etc. to develop skills and expertise Internal Strengths and Weaknesses External Opportunities and Threats Weaknesses Threats We show up weaknesses We identify threats The project requires much spending on New disease just like Ebola will endanger equipment and other appliances e.g. spending in healthcare professionals and facilities. EHR is usually not so profitable but for incentive Terrorism and cyber attack are very dread from HITECH. Employing, training and paying dreadful and should be taken seriously. staff puts another financial weight on the mgmt. Any malpractice may attract litigation and huge damages. Treating and accommodating folks infested with so many diseases may affect neighbors except there is assistance from risk management merged with clinical services