6008 Assessment 3

Darktanion

cf_Exemplar_NHS-FP6008_Assessment_3.pdf

Home >Nursing homework help >6008 Assessment 3

Running head: IMPLEMENTATION PLAN 1

Implementation Plan for a New Initiative

Learner’s Name

Capella University

Economics and Decision Making in Health Care

Developing an Implementation Plan

December, 2018

IMPLEMENTATION PLAN FOR A NEW ECONOMIC OPPORTUNITY 2

Implementation Plan for a New Economic Opportunity

The economic initiative proposed to the senior management of Whilborne Medical

Center (WMC) is setting up an urgent care center (UCC) on WMC’s premises. A UCC is a

health care facility that offers immediate care for injuries and illnesses that are not life-

threatening (Yee, Lechner, & Boukus, 2013). The UCC at WMC will aim to deliver safe, timely,

patient-centered, efficient, and effective health care to the community as well as attempt to

address health inequalities in the community.

An economic and environmental analysis was conducted to determine the feasibility of

setting up the UCC, and a business plan was presented to the senior management of WMC. The

management believes that this initiative has the potential to benefit the organization in the short

and long term. With this in view, an implementation plan for setting up the UCC has been

prepared. The implementation plan includes a 5-year budget for the UCC, a timeline for rolling

out the UCC, an analysis of how the UCC might impact WMC, and an explanation of how WMC

should deal with dynamic environmental forces.

Budget for the Proposed Urgent Care Center

A budget has been prepared to show the projected revenue and the expenses that the UCC

expects to incur over a 5-year period following the completion of its construction. The budget

has been created based on the assumption that construction of the UCC will be completed by the

end of 2018. Therefore, the budget plan contains revenue and expenditure details for the first 5

years of operation, from 2019 to 2023.

Revenue per annum over a 5-year period has been calculated by multiplying the expected

patient volume by average consultation charges. It is estimated that around 357 patients will visit

IMPLEMENTATION PLAN FOR A NEW ECONOMIC OPPORTUNITY 3

the UCC per week and around $156 will be charged per patient per visit (AMN Healthcare,

2015; Yakobi, 2017). Thus, the revenue generated during the first year of operation is expected

to be around $2,730,000. The UCC’s revenue is expected to increase by 5.3% annually (“Urgent

Care Center Market,” 2018). Operating expenses for the UCC will comprise staff salaries, basic

utilities, insurance, and other operating expenses (such as administrative and marketing costs).

Staff salaries for the first three years include the salaries of a full-time physician

($232,000), a nurse practitioner ($112,000), a medical assistant ($35,000), and a medical

receptionist ($32,000) (U.S. Bureau of Labor Statistics, 2017). However, in years four and five,

new staff will be recruited to manage the increased number of patients. The new staff will

comprise a full-time nurse practitioner and a full-time physician, whose salaries will be

calculated taking into consideration the 2.7% per annum estimated actual growth rate of

employees’ salaries (Economic Policy Institute, 2018). Expenditure on basic utilities is assumed

to increase by 5% each year. Insurance expenses are assumed to increase in the fourth and fifth

years of operation owing to recruitment of two staff members. Other operating expenses are

assumed to be 12% of annual revenue based on trends observed in WMC’s financial statements.

The total expected capital cost for the project is $350,000. One half of this cost will be

funded through WMC’s reserves, and a bank loan will be arranged to fund the other half.

Therefore, WMC will need to take a loan of $175,000 to fund this economic initiative. Assuming

that the loan tenure is 5 years and the interest rate is 7% per annum, the loan repayment is

expected to be $41,580 per annum.

As per the budget, the UCC will earn a cash surplus during the first 5 years. The cash

surplus generated in the fourth and fifth years of operation may be lower than the third year

owing to recruitment of staff members in these years. The total cash surplus in the first 5 years is

Comment [A1]: Great job thinking ahead!

IMPLEMENTATION PLAN FOR A NEW ECONOMIC OPPORTUNITY 4

estimated at $7,783,369.30 (see Appendix for more information on the 5-year budget for the

proposed economic initiative).

Rolling out the Economic Initiative

The first step in the implementation plan is to set a timeline to roll out the UCC to the

public. It is assumed that it will take around 2 months for WMC senior management to approve

the project and for a bank to approve the loan. Considering that construction of the UCC will

take around 7 months, the process is scheduled to begin in June 2018 and is expected to be

completed by December 2018. After discussing with WMC’s senior management, the plan is to

have the UCC fully operational from the first month of 2019.

Active engagement and participation by stakeholders can ensure better clinical outcomes

and patient experience in an urgent care setting. The board of directors of WMC and the senior

management, the physicians, the nurses, and other staff members of WMC are some of the

relevant internal stakeholders of this economic initiative. For successful implementation of the

plan, it is crucial to collaborate with all internal stakeholders to obtain their inputs during the

initial stages of implementation and decision-making. Meetings will be held with the

stakeholders on a regular basis to discuss the progress of the UCC and devise ways to improve

its health care services.

WMC has always strived to focus on the six areas of health care quality stated by the

Institute of Medicine (IOM), namely timeliness, safety, patient-centeredness, efficiency, equity,

and effectiveness (Agency for Healthcare Research and Quality, 2015). It will be communicated

to all internal stakeholders that the UCC will also focus on these six areas and that setting up the

UCC will take WMC a step forward toward accomplishing its vision of serving the community.

IMPLEMENTATION PLAN FOR A NEW ECONOMIC OPPORTUNITY 5

In order to make this initiative sustainable, the staff working at the UCC will be encouraged to

keep WMC’s vision in mind while trying to meet their short- and long-term goals.

Patients are the key external stakeholders in the health care business. If patients receive

quick and timely care from excellent service providers, they will be encouraged to visit again and

refer new patients to the UCC. Being compassionate with patients, dealing with them in an

ethical and culturally sensitive manner, and communicating medical information effectively will

encourage patient loyalty while also ensuring that they adhere to their treatment plan (“Helping

patients make informed decisions,” 2014). The resultant increase in patient flow and goodwill

will help the UCC become a successful and sustainable venture.

To ensure that the rollout of the center is done in an ethical and culturally sensitive

manner, the UCC will follow the principles of the American Academy of Urgent Care Medicine,

which includes not discriminating against patients on the basis of gender, age, color, religion,

culture, disability, or other characteristics (Agency for Healthcare Research and Quality, 2015).

The UCC will have a diverse workforce that can identify and relate to cultural differences;

familiarize themselves with health care delivery relevant to patients’ unique socioeconomic,

linguistic, and cultural requirements; and provide unbiased care. Hence, by delivering ethically

and culturally sensitive health care services, physicians will enhance patient experience and

medical outcomes (Cigna, n.d.).

With all the stakeholders engaged in the process and focused on achieving the center’s

vision, the rollout of the UCC will be a success and it will help WMC to sustain itself within the

health care business. However, the implementation plan has some areas of uncertainty. The

successful rollout of the UCC is highly dependent on the timely disbursement of the loan

required for the construction of the UCC. If the loan does not get disbursed on time, then the

IMPLEMENTATION PLAN FOR A NEW ECONOMIC OPPORTUNITY 6

rollout will have to be set for a different timeline when the loan amount becomes available, and

this will delay the implementation plan. Also, it is uncertain whether the actual number of patient

visits at the UCC will match the estimated patient volume. This is because people in the

community may not be aware of the benefits of availing care at the UCC due to lack of sufficient

information, misinformation, or misunderstanding. The center will then have to bear the

operating losses arising from low patient turnout. Further, an aging population suggests that the

number of people who will need health care is set to increase in the coming years (Yakobi,

2017). This will overburden all health care practitioners at WMC.

WMC must thus be ready to facilitate a larger number of patients than it may have

anticipated. This negative impact can be mitigated by expanding WMC over the next few years

by using the revenue generated by the UCC. WMC’s capacity and workforce could be expanded

through the construction of additional departments or centers, addition of facilities and

equipment, and hiring of new staff.

Strategies to Deal With Dynamic Environmental Forces

Various environmental forces, such as the presence of a retail health clinic in the center’s

vicinity and the possibility of new UCCs being set up in the vicinity, could affect the urgent care

services offered at WMC. The retail health clinic and the UCC have some common key

characteristics such as easy accessibility, extended hours, convenience, and health care at

affordable costs (Chang et al., 2015). This makes both clinics viable options for patients.

However, UCCs are particularly beneficial to patients who wish to avail immediate health care

services from physicians for conditions that are not life-threatening. UCCs, often staffed with

emergency medicine physicians and equipped with more testing facilities than a retail clinic, are

capable of providing care with high acuity (Chang et al., 2015). Therefore, by virtue of the

IMPLEMENTATION PLAN FOR A NEW ECONOMIC OPPORTUNITY 7

convenient and quality health care it provides, the UCC is an economically viable asset for

WMC.

Another factor that could affect the UCC at WMC is possible competition from

upcoming UCCs and primary health clinics in the vicinity. Patients will choose the UCC over

other clinics in the neighborhood once they have complete trust in it. Staff at the UCC will send

out frequent health reminders to regular patients to ensure that the patients do not miss their

regular checkups. This will help the patients to not miss their regular checkups. Also, the staff

will analyze patients’ views on health care and customize care to improve patient outcomes and

experience. This will not only help increase patient visits but also improve patients’ level of trust

in the UCC (“Helping patients make informed decisions,” 2014). With all these measures in

place, the UCC will be able to beat the competition from upcoming UCCs, making it a viable

asset to WMC in the face of unpredictable environmental situations.

Conclusion

The budget for the UCC shows that it will be economically viable for WMC. With the

active commitment and cooperation of all the key stakeholders at WMC and the strategies

planned to face dynamic environmental forces, the team endeavors to implement the initiative

successfully. It is believed that the UCC will serve not only as an additional revenue stream but

also as a viable asset that provides quality community health care services.

IMPLEMENTATION PLAN FOR A NEW ECONOMIC OPPORTUNITY 8

References

Agency for Healthcare Research and Quality. (2015). The six domains of health care quality.

Retrieved from https://ahrq.gov/professionals/quality-patient-

safety/talkingquality/create/sixdomains.html

AMN Healthcare. (2015). Convenient care: Growth and staffing trends in urgent care and retail

medicine. Retrieved from https://

amnhealthcare.com/uploadedFiles/MainSite/Content/Healthcare_Industry_Insights/Indust

ry_Research/AMN%2015%20W001_Convenient%20Care%20Whitepaper(1).pdf

Chang, J. E., Brundage, S. C., & Chokshi, D. A. (2015). Convenient ambulatory care—promise,

pitfalls, and policy. The New England Journal of Medicine, 373(4), 382–388. Retrieved

from

http://library.capella.edu/login?qurl=https%3A%2F%2Fsearch.proquest.com%2Fdocvie

w%2F1698429950%3Fac

Cigna. (n.d.). Cultural competency in health care: Delivering quality care to an increasingly

diverse population. Retrieved from https://cigna.com/assets/docs/about-cigna/thn-white-

papers/cultural-competency-in-health-care-final.pdf

Economic Policy Institute. (2018, April 6). Nominal wage tracker. Retrieved from

https://epi.org/nominal-wage-tracker/

Helping patients make informed decisions. (2014, April). Retrieved from https://cmpa-

acpm.ca/en/advice-publications/browse-articles/2014/helping-patients-make-informed-

decisions

IMPLEMENTATION PLAN FOR A NEW ECONOMIC OPPORTUNITY 9

Qin, H., Prybutok, G. L., Prybutok, V. R., & Wang, B. (2015). Quantitative comparisons of

urgent care service providers. International Journal of Health Care Quality

Assurance, 28(6), 574–594. Retrieved from

http://library.capella.edu/login?qurl=https%3A%2F%2Fsearch.proquest.com%2Fdocvie

w%2F1694933787%3Facco

Urgent Care Center Market by Service (Acute Illness Treatment, Trauma/Injury Treatment,

Physical Examination, Immunization & Vaccination), Ownership (Corporate Owned,

Physician Owned, Hospital Owned), and Region - Global Forecast to 2023. (2018,

March). Retrieved from https://marketsandmarkets.com/Market-Reports/urgent-care-

center-market-197843477.html

U.S. Bureau of Labor Statistics. (2017). Occupational employment statistics. Retrieved from

https://www.bls.gov/oes/current/naics4_621400.htm

Yakobi, R. (2017). Impact of urgent care centers on emergency department visits. Health Care

Current Reviews, 5(3). http://dx.doi.org/10.4172/2375-4273.1000204

Yee, T., Lechner, A. E., & Boukus, E. R. (2013). The surge in urgent care centers: Emergency

department alternative or costly convenience? Research Briefs. Retrieved from

https://researchgate.net/profile/Tracy_Yee/publication/257202014_The_surge_in_urgent

_care_centers_emergency_department_alternative_or_costly_convenience/links/5750682

008aed9fa2bd2d531

Comment [A2]: ‘www.’ has to be included in the link for it to work.

IMPLEMENTATION PLAN FOR A NEW ECONOMIC OPPORTUNITY 10

Appendix

5-Year Budget for Proposed Economic Initiative

FY 2019 FY 2020 FY 2021 FY 2022 FY 2023 Year 1 Year 2 Year 3 Year 4 Year 5 Total

($) ($) ($) ($) ($) ($)

Opening Cash Balance 0.00 1,465,820.00 3,024,260.00 4,680,446.00 6,312,389.73 0.00

Fund Received 175,000.00 Loan 175,000.00

Operating Receipts Patient Service Receipts (UCC)

2,730,000.00 2,866,500.00 3,009,825.00 3,160,316.25 3,318,332.06 15,084,973.31

Total Receipts 2,730,000.00 2,866,500.00 3,009,825.00 3,160,316.25 3,318,332.06 15,084,973.31

Operating Payments Staff Salaries 825,000.00 849,750.00 875,242.50 1,023,885.20 1,315,719.80 4,889,597.50 Basic Utilities 55,000.00 57,750.00 60,637.50 63,669.38 66,852.84 303,909.72 Insurance 15,000.00 15,000.00 15,000.00 20,000.00 25,000.00 90,000.00 Other Operating Payments 327,600.00 343,980.00 361,179.00 379,237.95 398,199.85 1,810,196.80 Total Operating Payments 1,222,600.00 1,266,480.00 1,312,059.00 1,486,792.52 1,805,772.49 7,093,704.01

Operating Surplus/Deficit 1,507,400.00 1,600,020.00 1,697,766.00 1,673,523.73 1,512,559.57 7,991,269.30

Nonoperating Payments Annual Loan Repayment (41,580.00) (41,580.00) (41,580.00) (41,580.00) (41,580.00) (207,900.00) Total Nonoperating Expenses

(41,580.00) (41,580.00) (41,580.00) (41,580.00) (41,580.00) (207,900.00)

Investments Construction, Furniture, and Equipment

(350,000.00) - - - -

Cash Surplus/Deficit 1,465,820.00 1,558,440.00 1,656,186.00 1,631,943.73 1,470,979.57 7,783,369.30

Closing Cash Balance 1,465,820.00 3,024,260.00 4,680,446.00 6,312,389.73 7,783,369.30 7,783,369.30