Question

The Executive Director of The Community Health Network, Ms. Diane Peterson, has asked you to come...

The Executive Director of The Community Health Network, Ms. Diane Peterson, has asked you to come up with recommendations in a business memo format for how the practice can improve access and quality while containing costs and positioning the network for future growth. She has asked you to complete this important task, since she knows that you are earning your credential in the discipline of health services management and possess the requisite experience.

Using the case study below:

You are the Assistant Director of The Community Health Network, a large multi-specialty practice located in Southwest Texas. This practice has been an integral part of the community for more than 30 years and employs 43 physicians and another 140 clinical and administrative personnel. When the practice was smaller, it experienced a healthy growth rate which averaged 13% annually. As the practice grew in size, it began to experience stagnant growth and now a bit of contraction in its' patient volume.

The Network wants to put the business back on a growth trajectory and appears willing to embrace changes in its existing business model. There are 150K residents in the metropolitan statistical area (M.S.A.), which can swell to 200K when factoring in work commuters. The largest portion of the population is between the ages of 38 and 50; however, the fastest growing segment of the population is between 51 and 65. The median family income is greater than that of many comparable communities across Southwest Texas. The practice includes general practitioners, endocrinologists, cardiologists, pathologists, obstetrics and gynecology, psychiatrists, oncologists, geriatricians, pediatricians, EENT, and surgeons. The clinic has the capability of performing a full range of diagnostic testing and outpatient services, including a limited number of surgical procedures.



Additional Information:


1. Scheduling for annual physicals is done weeks in advance in order to better coordinate the required lab work. The providers have decided to schedule physicals in the conjunction with other visits, which is believed to cause disruptions in laboratory services.

2. Patients call for routine issues and expect to be seen within 48 hours. This is a contributing factor in the overbooking of providers and can unintentionally pull necessary resources from more urgent cases.

3. Scheduling is centrally performed. It appears that the schedulers aren't 100% comfortable with the time needed for each type of appointment, which is contributing to backlogs and patient and personnel dissatisfaction. If there is a doubt as to the time necessary to see a particular type of appointment, then the schedulers have been instructed to simply place the patient in an available time slot. The providers do not want any downtime, since much of their reimbursement is based on a fee-for-service model.

4. Patients are often called and asked to come in early if there is an open slot.

5. The staff have been known to express concerns over the lack of resources necessary to perform their job.

6. The schedulers are concerned about the lack of functionality within the current phone system and believe this leads to inefficiency and poor customer service.

7. Patient’s have expressed concern that the hours of operation don’t accommodate working professionals, since they are currently closed on the weekends. At present, the practice accepts clients from 9 a.m. (CT) to 6 p.m. (CT), Monday through Friday.

8. The practice lacks technology, like a patient portal, that permits patients to book future appoints, receive the results from diagnostic testing, provide patient education materials, receive appoint reminders, and the like.

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Answer #1

To:   Ms. Diane Peterson

From: Ryan Scott

Date: March, 06, 2020

Re:   Recommendations

Purpose:

I am writing this business memo because i was asked to give recommendations on how the practice can improve in health services in terms of access and quality.

Summary:

To improve health services in quality and access, we need to consider several resources associated with the health services. Scheduling of physicals, patient timings, center work timings etc.should be improved in order to provide better health services.

Discussion:

According to the present conditions in health services we can follow these steps to improve:

1) Laboratory services are important so instead of booking physicals weeks ago, we can book them when laboratory work is most required and for regular lab work certain number of physicals may be hired. This will also help the providers to schedule physicals in a better manner for lab works and other visits.

2) Urgent cases should be treated on the priority basis and providers should be booked according to the number of urgent cases. For routine issues in house staff may be scheduled accordingly by asking the patients most suitable timing of availability. This will improve the services quality and resources may be used in a better way for urgent cases.

3) Every department should have a specific data about the patient appointments and this data is shared with the schedulers on the basis of case urgency. This will help the schedulers to ask providers for better services in time and this will also reduce the backlogs and patient dissatisfaction. Providers work on fee for service model so they can help in a better way if scheduling of appointments are done on the basis of need.

4) Retired patients or the patients who can come early, should be called by discussing the schedulers so that they can ask providers for resources on time. This will reduce the problem of less resources and increase the satisfaction level of the staff and patients.

5) Phone services should be improved to reduce the concerns of schedulers, mail services, chat and messaging services may also be used to improve customer service.

6) For working professionals, special time slot may be given on weekends or services to home may be started for better customer service.

7) A software service provider should be approached to design a software system so that patients can book or see the appointments and all the necessary information can be provided to patients by the software.

These are the recommendations for the betterment of the health services.

From

Ryan Scott

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