Kilroy’s Acute Care Hospital Strategic Plan

Group 4:Mitchell Cooper

Alyssa RandazzoAndrea Ratz

Catherine RussoErin Weisenbach

Table of Contents

Executive Summary……………………………………………………………………………………...2

Historical Background…………………………………………………………………………………....4

Organizational Direction………………………………………………………………………...……….5

Environmental Assessment…………………………………………………………………..….……...5

External Assessment…………………………………………………………………………….5

Internal Assessment……………………………………………………………………………..6

Competitive Position…………………………………………………………………………..…6

Critical Strategic Issues and Response Strategies …………………………………………………..6

Critical Issues………………………………………………………………………....………….7

Short-term Objectives ………………………………………………………………………..…7

Long-term Objectives…………………………………………………………………………....7

Measurement Objectives………………………………………………………………………..8

Financial Impact……………………………………………………………………………..…..9

Barriers/Constraint………………………………………………………………………………9

Description of Process and Next Steps……………………………………………………………..….9

Executive Summary

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Kilroy’s Acute Care Hospital is a not for profit, 101-bed facility that opened in 1994. A small group of Bloomington physicians decided to open the hospital in order to improve the health and healing of the diverse communities in the area. Not only would this be beneficial to the health of those around the area, but acute care hospitals are also profitable for the economy. People from all over Indiana started coming to Kilroy’s for surgeries related to acute surgical needs like life threatening injuries or illnesses. After 7 year years of endless successful operations and treatments in the acute care department, Kilroy’s decided to open a department specifically focusing on respiratory problems.

Kilroy’s Acute Care Hospital focuses on four main values: compassion, innovation, respect, and excellence. These values guide us in caring for our patients and ensuring that the community receives the best treatment available. Kilroy’s strives to provide the best care by using innovative technology, which will be exhibited by the use of a mobile phone app to improve patient flow and tracking. Kilroy’s plans to achieve excellence by implementing quality improvement programs in order to keep up with our changing environment. Our organization strives to set the standard for care, regionally and nationally, for health and healing so our community can recover quickly. Our organization’s mission is to improve the health and healing of the diverse communities we serve in Bloomington, Indiana.

After examining our environmental assessment, it conveyed that 55% acute care patients are over the age of 60. The population of Bloomington is 80,405 people. There are 6,287 homes in Bloomington that have one or more people age 60 or older. While this number is relatively low, we anticipate the numbers of patients to increase as the 30-50 year olds become older. Since Bloomington is a competitive area, Kilroy’s Acute Care Hospital will focus on innovation and technology. Kilroy’s has created the Pocket Clinician, or PC, which will allow clinicians to connect quicker and provide each other with real-time patient data in an effort to improve efficiency and increase patient satisfaction.

Kilroy’s Acute Care Hospital is a 101-bed, not for profit facility with over 200 employees.Kilroy’s offers over 10 medical services, including Emergency Care, Urgent Care, and Trauma Care & Acute Care Surgery to name a few. With the addition of the PC technology, Kilroy’s will need mandatory training programs in order for our employees to understand how to properly use the Pocket Clinician. Looking ahead, if the PC is successful for Kilroy’s, we can expand number of beds and increase our number of employees.

With the implementation of the Patient Protection and Affordable Care Act (ACA), Kilroy’s will face opportunities and challenges moving into the future. Since the law was passed in 2010, almost every year there has been additional regulations that are put into place. Since the main purpose of the ACA is to increase the amount of people who have insurance and access to healthcare, Kilroy’s will have to prepare for an influx of patients in the future. According to the Department of Health and Human Services (HHS), the ACA healthcare exchanges have allowed roughly 11 million people to gain access to insurance. Even though this influx in patients may not be substantial enough for us to devote our entire focus on, the ACA comes with a number of other regulations with regards to reimbursement that will affect Kilroy’s directly.

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Kilroy’s will have to devote its resources heavily to increase the quality of care due to the ACA requiring reimbursement institutions like Medicare to pay based on quality and not quantity (a patient’s length of stay). Kilroy’s will, across the organization, have to implement quality improvement programs in order to keep pace with the changing external environment. We will have to carefully select our hospital team that is committed to providing optimal patient care, while at the same time upholding Kilroy’s mission and values.

MACRA will affect our strategic plan by us needing to understand the new ways payments work as far as Medicare and Medicaid. Physicians’ salaries are a top priority for Kilroy’s acute care hospital and we fully need to understand payment methods and transactions. Population health will affect our strategic plan by changing to more of a team based care. Our communication and teamwork will need to be abundant to ensure our success. Access will increase if we can have patients see more PA or NP. Volume to Value will affect our strategic plan by focusing more on the quality of the care we give rather than the amount of patients we see. There is a transition in healthcare favoring quality care over sheer profit, and that is one of our core values.

As we move into the future, Kilroy’s will look to make technological leaps forward in order to become one of the best in its industry. In order to compete in the ever-changing and demanding healthcare environment, Kilroy’s hospital has decided to focus on using technology to improve patient flow and tracking. Clinicians need the ability to be connected wherever and whenever. Thus, Kilroy’s has created the Pocket Clinician which will allow clinicians to connect quicker and provide each other with real-time patient data in an effort to improve efficiency and increase patient satisfaction.

Kilroy’s Acute Care Hospital will address the critical issues mentioned above by setting a list of short and long term goals in order for our organization to continuously strive for improvement. One important short term goal is conducting a needs assessment in order to determine which hospital departments are in need of additional space. Once completed, we will begin building expansion plans and launch a campaign project. Another short term goal is to increase focus on population health through conducting community assessments to see the types of services that can improve community health. We must shift patient care to team based approach where we involved more Nurse Practitioners and Physician Assistants. Other short term goals include ensuring that entire organization is committed to the shift from volume to value care, and making sure reimbursements are dependent on quality of care; which therefore requires Kilroy’s to exhibit an environment committed to our core mission and values. Some long term goals (3-5 years) include improvement of quality of healthcare services, reduction of healthcare costs through Accountable Care Organizations (ACOs), increased coordination among all stakeholders of Kilroy’s Acute Care Hospital, improvement in patient safety within Kilroy’s, and implementation of continuous performance improvements (lean six sigma).

Kilroy’s will measure the success of the organization by using the The Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS), which is a CMS performance initiative. These patient satisfaction surveys will give feedback on patient’s overall experience by focusing on doctor and nurse communication, food service, and hospital environment. These

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surveys are an important way for Kilroy’s to focus on creating an environment that supports the core mission and values.

Historical Background

Kilroy’s Acute Care Hospital is a not for profit, 101-bed facility that opened in 1994 in Bloomington, Indiana. A small group of Hoosier based physicians decided to open the hospital in order to improve the health and healing of the diverse communities in the surrounding areas. Not only would this be beneficial to the health of those around the area, but acute care hospitals are also found to be extremely profitable for the economy. Overall, acute care hospitals provide great benefit to the United States economy, as they bring in hundreds of millions of dollars. According to the Centers for Medicare and Medicaid Services, from 1994 to 2001 outpatient visits alone increased by 40.6%. However at this time there was also a decrease in community hospitals of about 100 across the country. As these numbers are now rising, Kilroy’s Acute Care Hospital is doing everything possible to stand out among the acute care hospitals.

When Kilroy’s first opened, people from all over Indiana started coming to Kilroy’s for surgeries related to acute surgical needs like life threatening injuries or illnesses. After 7 year years of endless successful operations and treatments in the acute care department, Kilroy’s decided to open a department specifically focusing on respiratory problems. This department worked specifically on patients with allergies, asthma, and expanded as far as pneumonia. As this is a broad spectrum of focus, Kilroy’s hand picked doctors from across the country that focus on these respiratory problems.

While all of this was taking place early in 2001, Kilroy’s was also given a donation from an anonymous Hoosier for a stabilization unit in the hospital. This unit is for patients to regain themselves post surgery whether that may be because they are not able to go home and be on their own yet or because they need further therapy in Kilroy’s physical therapy program. This unit has helped train many of the PT students with the IU School of Health and Rehabilitation Sciences. Kilroy’s is proudly expanding their services to patients and to the community around them.

Organizational Direction

MissionKilroy’s Acute Care Hospital is dedicated to providing patient care and committed to improving

the health and healing of the diverse communities we serve.

VisionThe vision for Kilroy’s Acute Care is to set the regional standard for health and healing.

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Values Compassion - Showing empathy towards our patients

Innovation - Providing cutting-edge technologies and proceduresRespect - Doing the right thing and valuing all people

Excellence - Setting the highest standards in acute care in the area

Kilroy’s Acute Care Hospital takes great pride in its mission, vision, and values. Its main objective is to fulfill organizational goals and to provide cost-effective, accessible, and quality

care to our patients. As Kilroy’s continues to grow and expand, these values will continue to set the hospital’s standards.

Environmental Assessment

External AssessmentOur external assessment shows us that the majority of acute care patients (55%) are over the age of 60. The current population in Bloomington, IN is 80,405. There are currently 6,287 homes in Bloomington that have one or more people age 60 or older. This number is relatively low, but we anticipate increasing numbers of patients as the 30-50 year olds become older. Since Bloomington is a competitive area, Kilroy’s Acute Care Hospital has decided to focus on innovation and technology. Kilroy’s has created the Pocket Clinician, or PC, which will allow clinicians to connect quicker and provide each other with real-time patient data in an effort to improve efficiency and increase patient satisfaction.

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Internal AssessmentKilroy’s Acute Care Hospital is a 101-bed, not for profit facility with over 200 employees.The current services offered at Kilroys include:

● Emergency Care● Urgent Care● Prehospital Care● Critical Care● Trauma Care & Acute Care Surgery● Respiratory Services● Short-Term Stabilization Unit● Physical Therapy

Kilroy’s is a financially stable organization. With the addition of new technology (PC), we will need mandatory training programs in order for our employees to understand how to properly use the Pocket Clinician. Looking ahead, if the PC is successful for Kilroy’s, we can expand number of beds and increase our number of employees.

Competitive Position

Supplier Power: There are not very many competitors in the area; therefore, supplier power is high. Since Kilroy’s focuses on innovation and technology, we strive to have the highest quality supplies to satisfy patient needs.

Buyer Power: Since we are not part of a larger health system, we have relatively sufficient buyer power.Competitive Rivalry: Competition is relatively high in the Bloomington area. This is due to our competitors, IU health and Bloomington Meadows.

Threat of Substitution: There is a very low threat for substitution because there are not many facilities in the Bloomington area that offer overnight stay. There are substitutes that exist, like minute clinics and urgent care; however, there are very limited options for overnight stay.

Threat of New Entry: The Bloomington area market is competitive and it would be difficult for a start-up, but if a larger, national company came to Bloomington, there would be a high threat of new entry.

Competitor Analysis

Name: Location: Distance (miles): Services:

Bloomington Meadows

Bloomington Less than 5 -Acute inpatient care-Dual Diagnosis programs-Free professional assessment and referral services

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-Outpatient medication management clinic

IU Health Bloomington Less than 5 -Behavioral HealthCritical Care-Emergency Medicine-Hospice-Physical Therapy-Pediatrics-Women’s Health

Kindred Hospital Indianapolis 46 -Critical Care-Pulmonary Services-Complex Wound Care Services-Rehabilitation

St. Vincent Seton Specialty Hospital

Indianapolis 53 -Long Term Acute Care-Rehabilitation-Physical Therapy-Occupational Therapy-Respiratory Therapy

Critical Strategic Issues and Response Strategies Following fiscal year 2015, the management of Kilroy’s Acute Care conducted extensive employee and patient satisfaction analyses. Once the data was aggregated from the analysis, management was presented with five critical strategic issues that must be at the center of focus moving into the future. These critical issues must be accompanied by effective response strategies and goals to address them. The five most important issues and responses are listed below. Moving into the future, Kilroy’s Acute Care has a need to: 1) Increase Quality and Delivery of Care2) Expand Current Operation Building Structures3) Increase Meaningful Use throughout the hospital4) Increase Outreach and Community Involvement5) Adapt to new legislation and implementations

In order to address these specific issues, Kilroy’s management has sorted realistic short term and long term goals for the organization. In addition, since new legislation implementation is introduced frequently in today’s healthcare, Kilroy’s management has also provided key implementation factors to address and respond to moving into the future.

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Short-term objectives (1-2 year established):

1) Conduct needs assessment in order to determine which hospital departments are in need of additional space. Once, completed, begin building expansion plans and launch campaign project.

2) Increase focus on Population Health through conducting community assessments to see the types of services that can improve community health. Must shift patient care to team based approach where we involved more Nurse Practitioners and Physician Assistants.

3) Ensure that entire organization is committed to the shift from volume to value care. Reimbursements are dependent on quality of care which therefore requires Kilroy’s to exhibit an environment committed to our core mission and values.

Long-term objectives (3-5 years established):

1) Improve quality of healthcare services2) Reduce healthcare costs through Accountable Care Organizations (ACOs) and

increased coordination among all stakeholders of Kilroy’s Acute Care3) Improve patient safety within Kilroy’s 4) Implement continuous performance improvements (Lean Six Sigma)

Measurement and Legislative objectives: 1) Over the next couple of years, The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will start to unfold across the healthcare industry. The most significant impact that MACRA will have is that it will drastically change the way reimbursements are made. Reimbursements from Medicare and Medicaid will be made based on quality of care rather than the volume of care. Increases emphasis of our core values is required by all stakeholders of our organization in order to maintain reimbursements from governmental organizations.

2) The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is another CMS performance initiative that will affect reimbursements. Patient satisfaction surveys will have the patient give feedback on overall experience throughout his/her stay. These surveys focus on doctor and nurse communication, food service, hospital environment, and more. It is extremely important that moving into the future, Kilroy’s acute care focuses on creating an environment that will uphold Kilroy’s core mission and values.

3) The fate of the Patient Protection and Affordable Care Act (ACA) is currently unknown due to the shift in the political climate in the United States. Until any changes are made, we must prepare for the increase in number of insured patients which will bring demographics that Kilroy’s Acute has not seen before. Staffing and expansion measures will need to be closely monitored moving into the future.

Financial Impact

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Year 0 Year 1 Year 2 Year 3 Year 4 Year 5

Marketing $50,000 $25,000 $25,000

Hospital Improvement Allocation

$75,000 $75,000 $75,000 $75,000 $75,000 $75,000

Pocket Clinician System

$1,350,000 $500,000 $500,000 $500,000 $500,000 $500,000

New Unit Construction

$2,000,000 $1,500,000 $100,000

Total: $1,425,000 $575,000 $575,000 $2,625,000 $2,100,000 $700,000

Total Cost:

$8,000,000

Barriers/ConstraintsKilroy’s Acute Care will have to face the possibility of the Pocket Clinician System malfunctioning or not being properly utilized for patient care. The PC System is meant to optimize the time that is spent with patients by allowing physicians and nurses access to a wide variety of patient information that can provide a higher-quality of care. There is the possibility that the PC System could malfunction or the information may not be completely up to date when physicians or nurses access it. This could impact the quality of the PC System and how it assists in the care of Kilroy’s patients.

With the addition of the stabilization unit, Kilroy’s Acute Care will also have to face many risks, but also many opportunities. The new unit is being built thanks to a large anonymous donation, but once the unit is established Kilroy’s will have to decide if the new unit can be sustained. In the future Kilroy’s will have to pay any additional expenses it incurs, or pay for any repairs or depreciation expenses. Kilroy’s needs to make sure the stabilization unit is providing the highest quality of care for patients while maintaining a profit margin. However, this new service can provide Kilroy’s Acute Care with additional revenue and an inflow of more patients.

Description of Process and Next Steps

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As we move into the future, Kilroy’s Acute Care Hospital will look to make technological leaps forward in order to become one of the best in its industry. In order to compete in the ever-changing and demanding healthcare environment, Kilroy’s hospital has decided to focus on using technology to improve patient flow and tracking. Clinicians need the ability to be connected wherever and whenever. Thus, Kilroy’s has created the Pocket Clinician, or PC, which will allow clinicians to connect quicker and provide each other with real-time patient data in an effort to improve efficiency and increase patient satisfaction.

Staying connected to patients is vital to providing successful care. With the current healthcare system shifting from volume to value, and with the significant emphasis of collaborative care, our Pocket Clinician aligns our physicians with these current trends and allows our hospital to continue to provide high-quality care.

The Pocket Clinician, PC, will allow clinicians the ability to monitor all the technologies that their patient is utilizing at the click of a button. By having the ability to quickly check vital signs like heart rate and blood pressure, and lab test results while walking the hallways, in elevators, or anywhere in the hospital, physicians and nurses will be able to optimize the time spent with their patients by having knowledge about the patient's medications and conditions before walking into the room. The Pocket Clinician will also alert the clinicians if a patient’s alarm has been triggered, which will then provide the clinician with to-the-minute information about the emergency so they can respond accordingly. The PC will have the ability to scan and keep track of medications each patient is currently being issued, which will help to alleviate mistakes in improper medicine dosages and administration.

The PC are built with busy clinicians in mind. With long-lasting batteries, drop-proof technology, and a barcode scanner, the Pocket Clinician is built to provide the same top level of care our physicians and nurses provide on a daily basis. SInce the Pocket Clinician is collecting the most up-to-date patient information and diagnosis codes, all information needed for proper documentation for insurance companies and medicare/medicaid payments will be personalized and easy communicated between the health care providers.

This is just the beginning of Kilroy’s making technological strides into the future of innovative, excellent care. With the Pocket Clinician we hope to move in the right direction in improving patient satisfaction and collaborative care. Kilroy’s Acute Care Hospital will continue to aim to be one of the best in health care in the Bloomington area. This new technology will begin a preliminary round of implementation starting in 2017, after both physicians and nurses are provided training on the new technology.

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As aforementioned above, Kilroy’s will be conducted a needs assessment of the hospital in the near future to determine which of our departments are being utilized the most, and what our community is in need of. This will then lead to an expansion of Kilroy’s, and possibly the addition of another specialty department.

In order to be successful in our proposed hospital expansion, Kilroy’s will take the results of the needs assessment along with our financials for the year and conduct a cost-value analysis of adding another specialty department.

We, the Kilroy’s Strategic Planning Committee, vow to adhere to the mission and values of Kilroy’s Acute Care Hospital and carry out this strategic plan.

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