MHA FPX 5012 Assessment 1 Organizational Analysis of Erie County Medical Center

MHA FPX 5012 Assessment 1 Organizational Analysis of Erie County Medical Center

Organizational Analysis of Erie County Medical Center

Erie County Medical Center (ECMC) is a big hospital in Buffalo, NY. It cares about giving great medical treatment and making patients happy (ECMC, 2016). With over 3,000 workers, ECMC helps more than 400,000 patients each year in Western New York (Erie County Medical Center, 2021). Even though the hospital has grown a lot, its leaders need to watch many things that can affect the hospital. These include politics, rules, money, society, and technology.

This analysis (MHA FPX 5012 Assessment 1 Organizational Analysis of Erie County Medical Center) will look at these factors, and the hospital’s plans, find areas where it can do better, and suggest ways to improve. It will also highlight key leadership skills needed to reach the hospital’s goals.

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Part I: Environmental Analysis

The healthcare industry is dynamic and ever-changing due to the impact of various environmental forces. When these forces create change, it triggers a domino effect that impacts every industry and organization (Ginter, 2018). For this reason, leaders at ECMC should conduct an environmental analysis as part of the strategic planning process. This analysis is crucial because it allows ECMC to re-evaluate its strategies regularly. New threats can emerge, creative opportunities can arise, and weaknesses and vulnerabilities can shift over time (Ginter, 2018).

There are several tools that leaders can use to conduct this analysis, which will help them anticipate political and regulatory changes, economic fluctuations, the rise of new competitors, and technological advancements. These factors can significantly impact the hospital’s business operations, future growth, quality performance, and financial viability. By using these tools, ECMC can stay ahead of potential challenges and capitalize on new opportunities, ensuring they continue to provide high-quality care and maintain their financial health.

A SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis is a useful tool that can highlight ECMC’s strong points, areas needing improvement, potential opportunities for growth, and future threats such as regulatory changes or new competitors that could hinder progress and profitability (Baghouri, 2019). By using a SWOT analysis, leaders at ECMC can be proactive instead of reactive, creating strategies to tackle predicted challenges. Therefore, a SWOT analysis has been conducted for Erie County Medical Center and is detailed in the table below.

ECMC SWOT Analysis

Strengths

Only Level 1 Trauma Center in the Western New York (WNY) region
Reputation and brand loyalty
Ability to offer an array of services with over 30 outpatient specialty care services
Maintained financial stability
Weaknesses

ECMC is located in an impoverished Western New York (WNY) neighborhood, which may deter some patients from seeking services
Long patient wait times for emergency care regularly
Recent cybersecurity incident increases patient concerns about privacy and security of personal health information
Opportunities
Potential to improve or strengthen ECMC’s position through community outreach and engagement
Expansion of telemedicine and other technological advancements to enhance patient care
Threats
Emerging urgent care centers create competition
Regulation changes that could impact hospital operations and profitability
Ongoing concerns about cybersecurity and patient privacy

Legal and Regulatory Factors Impacting the Success of ECMC

As previously said, when a firm or industry achieves its objectives or enacts new rules and regulations, a domino effect arises, affecting other neighboring sectors and organizations, such as healthcare (Ginter, 2018). Since the implementation of the Affordable Care Act (ACA), government programs such as Medicare and Medicaid have encouraged and incentivized the transition to the Patient-Centered Medical Homes (PCMH) model (Clarke, 2020). The PCMH model promotes the use of primary care physicians as the first line of service for patient care (Clarke, 2020).

This shift can pose a threat to ECMC by potentially reducing patient volume and, consequently, revenue, as patients might begin using their primary care physicians (PCPs) instead of the emergency department (ED) at ECMC. Since the ACA’s implementation and the increase in the PCMH model, studies have shown a 15% decrease in emergency department visits and an 18% decrease in inpatient admissions, significantly impacting ECMC’s financial stability (LaPointe, 2016).

Furthermore, since the ACA’s introduction, hospital reimbursement for Medicare and Medicaid payments has changed, which has had a direct influence on ECMC’s financial situation (Rudowitz, 2016). Medicaid payments account for more than one-quarter of ECMC’s net patient income, while Medicare reimbursements account for more than 30%. The Affordable Care Act (ACA) has pushed Medicare and Medicaid toward value-based bundled payments to encourage efficient and effective delivery of high-quality healthcare services.

This new payment approach poses significant risk if hospitals and providers are unable to reduce health-care costs (LaPointe, 2016). A bundled payment, for example, is a single payment that covers all services delivered during a care episode. If physicians and hospitals must utilize greater resources or implement additional treatments, the hospital would suffer a financial loss (LaPointe, 2016). Furthermore, Medicare and Medicaid payments are often lower than those of other third-party payers, resulting in payment gaps (Rudowitz, 2016).

As a result, hospitals like ECMC rely largely on Disproportionate Share Hospital (DSH) payments to augment their reduced reimbursement. However, with the ACA and federal policy changes, there has been a shift toward cutting DSH payments and limiting other supplemental payments (Rudowitz, 2016). Failure to react to changes in healthcare legislation and regulations might have a substantial influence on the performance of ECMC and other hospitals.

Part II: Organizational Assessment

A balanced scorecard, also known as an organizational scorecard, is a tool used by executives to evaluate their organizations from four different perspectives: financial, customer, internal business processes, and learning and innovation (AHRQ, n.d.). This tool is especially useful when executives need to evaluate current policies and procedures to see if they are in line with the goals of the business and its strategic direction. Using a balanced scorecard, ECMC leaders may identify areas for development, define strategic goals and objectives, and establish metrics to track success (AHRQ, n.d).

Implementing a balanced scorecard at ECMC can assist the hospital in accomplishing numerous objectives that are aligned with its strategic strategy. This instrument will improve not just the quality of care, but also patient happiness, income, and profitability. By concentrating on these four viewpoints, ECMC can ensure a complete approach to meeting its strategic objectives while maintaining excellent patient-centered care standards.

Certainly! Below is the balanced scorecard for ECMC based on the areas needing attention and quality improvement identified in the SWOT analysis:

PerspectivesObjectivesMeasuresTargets
FinancialImprove the revenue cycle processDays in accounts receivable (DAR)Reduce DAR by 20%
Net revenue per patient visitIncrease net revenue per visit by 10%
CustomerDecrease patient wait time in the EDAverage wait time from arrival to treatmentDecrease average wait time by 25%
Patient satisfaction scoreIncrease satisfaction score to 90%
Internal Business ProcessEnhance efficiency in ED operationsPatient throughput timeDecrease patient throughput time by 15%
Staff satisfaction scoreIncrease staff satisfaction score to 85%
Learning and InnovationEnhance privacy and security of patient infoCompliance with HIPAA regulationsAchieve 100% compliance with HIPAA
Implementation of cybersecurity measuresImplement cybersecurity measures by Q4 2024

This balanced scorecard provides a framework for ECMC to focus on key areas for improvement, aligning with the organization’s strategic goals and ensuring a comprehensive approach to addressing its challenges and opportunities.

Mission, Vision, and Values

It is clear that most sectors integrate quality improvement and strategic objectives with the organization’s overall strategy. A directed strategy incorporates the organization’s mission, vision, and values, articulating what they stand for and what they want to achieve (Speziale, 2015). Erie County Medical Center’s objective is “to provide every patient with the highest quality of care delivered with compassion” (Erie County Medical Center, 2016). The vision statement establishes a clear roadmap for mission planning and execution by articulating the expected long-term outcomes (CFI, 2015). ECMC’s goal is broad, including leadership in clinical results, high-quality family-centered care, becoming the hospital of choice, promoting community collaborations, and delivering excellent clinical staff education (Erie County Medical Center, 2016).

This directed approach clearly describes the goals that ECMC strives for as it seeks to realize its objective. Organizational values establish an ethical foundation for planning and decision-making (AHIIMA, 2018). ECMC’s fundamental values, which include access, quality, diversity, dignity, and compassion, among others, support its purpose and vision by demonstrating the organization’s key beliefs (Erie County Medical Center, 2016).

The ECMC balanced scorecard’s strategies and objectives are tightly aligned with its SWOT analysis, directed strategy, and current external environment. By concentrating on areas such as lowering patient wait times, optimizing revenue cycle procedures, raising patient happiness, and protecting the privacy and security of patient information, ECMC is trying to realize its goal and vision while remaining loyal to its fundamental principles.

Part III: Gap Identification

Patient Wait Times in EDAverage wait time: 60 minutesTarget wait time: 45 minutesGap of 15 minutesImprove triage process, increase staff, streamline workflows
Revenue Cycle ProcessAverage days in accounts receivable: 45 daysTarget: 35 daysGap of 10 daysImplement revenue cycle management software, optimize billing processes
Patient SatisfactionSatisfaction score: 80%Target: 90%Gap of 10%Enhance communication with patients, implement patient feedback system
Privacy and Security of Patient InformationCompliance with HIPAA: 90%Target: 100%Gap of 10%Strengthen cybersecurity measures, enhance staff training

This table outlines the current performance of ECMC in various areas compared to the desired performance. It identifies gaps between the two and suggests required actions or strategic initiatives to bridge these gaps and improve overall performance.

Gap Analysis Narrative

When it comes to ECMC’s internal business operations, continuous congestion has resulted in decreased patient traffic and income for the emergency department (ED) (Erie County Medical Center, 2014). This condition, along with the rising popularity of the Patient-Centered Medical Home (PCMH) model, has the potential to greatly affect organizational performance, since patients may be less inclined to visit ECMC’s emergency department. As the only hospital in the region with a Level 1 trauma center, ECMC faces high patient loads in the emergency department, resulting in long wait times, walk-outs, and medication mistakes due to overcrowding, all of which result in financial loss (Salway, 2017).

Key performance indicators (KPIs) are critical for comparing an organization’s performance to internal goals or standards. ECMC can use performance dashboards to analyze average patient wait times, review staffing levels, and measure progress toward the organization’s target of 24-minute wait times (Everett, 2021; Hing, 2012). Furthermore, ECMC can track the revenue earned by the ED to assess financial success.

Since ECMC’s current staffing shortfall, its financial situation has been hampered by rising personnel expenditures owing to premium pay and overtime (Erie County Medical Center, 2020). The overall aim is to cut overtime and premium pay by 5% while also ensuring that the hospital has an acceptable staffing level to satisfy the demands of its patients. However, premium pay staffing expenditures climbed by 7.2% in the past year, resulting in a performance disparity (Erie County Medical Center, 2020).

To track progress toward closing the gap, ECMC officials utilize key performance indicators (KPIs) such as personnel numbers, academic affiliations, employee burnout rates, and overtime and premium pay payouts. These measurements are used to assess progress toward organizational goals.

Healthcare businesses nowadays face a number of issues connected to social variables that influence competition. The patient population has recently become more diverse across the country (Nair, 2019). This tendency has coupled with a reduction in patient satisfaction at ECMC, which has plummeted to 65% despite the organization’s increasing patient diversity (Erie County Medical Center, 2020). ECMC strives to deliver health services that meet the cultural, socioeconomic, and linguistic demands of its varied patient group while maintaining a 98% overall satisfaction rating.

Clearly, the gap analysis reveals a considerable disparity and space for improvement. To address this, ECMC will use patient satisfaction surveys as a major performance metric, with progress monitored regularly. The ultimate aim is to achieve and maintain a patient satisfaction rate of 98% by January 1, 2022.

Finally, ECMC’s basic principles prioritize privacy and secrecy. However, growing worries about health information security might have a detrimental influence on the organization’s profitability and future orientation. ECMC aims to achieve and maintain zero incidences of confidentiality breaches and cybersecurity assaults. Currently, there is a gap between the ideal condition and the current situation.

To assess progress toward this goal, ECMC will monitor critical indicators such as the number of confidentiality breaches, workers trained on Electronic Health Record (EHR) security procedures, and cybersecurity incidents. By monitoring these indicators, ECMC can guarantee that it is progressing toward its aim of protecting patient information and preserving confidence.

Part IV: Leadership Recommendation

After assessing environmental factors, ECMC discovered a way to improve their company operations by establishing a new service line: an urgent care center (UCC). This new service line would not only generate more money but would also considerably improve the workflow of ECMC’s emergency department (ED) (Ayers, n.d.). By building this urgent care facility, ECMC can divert non-critical patients away from the ED, lowering or eliminating overcrowding. This would ensure that patients in need of emergency treatment receive prompt attention, as wait times and congestion would be decreased (Ayers, 2021).

In addition to the UCC, implementing a team-based style of care is another endeavor to reduce wait times. This strategy would enable staffing levels to better match patient arrivals, resulting in more efficient treatment (Intermountain Healthcare, 2017). Implementing such projects will need both human and technological resources. Whether ECMC establishes an urgent care facility or adopts a team-based approach, increased personnel will be required, necessitating additional financial resources.

If ECMC decides to launch a new service line, leaders will require a variety of financial resources for building, increased staffing, and other related costs. These approaches can reduce financial loss by making better use of resources, improving workflow, shortening patient wait times, and improving patient outcomes (Salway, 2017). By tackling these crucial areas, ECMC may go closer to meeting its performance objectives and providing better service to its patients.

The hospital must add enough full-time employees to fulfill patient demand and prevent premium pay and overtime expenses if it hopes to strengthen its financial position. Additionally, hospitals that participate in Medicare must maintain proper staffing levels in order to be compliant (Eaton, 2020). ECMC may solve this issue by expanding its academic ties, reviewing and enhancing the hiring process, and hiring more full-time personnel to decrease overtime and premium pay costs.

This endeavor will need numerous resources:

  • Human Resources (HR) Department: The Human Resources (HR) Department will need to review and change hiring rules in order to recruit and retain additional full-time employees.
  • Financial Resources: Adequate cash will be required to meet the expenses connected with recruiting new employees.
  • Academic affiliations: Strengthening relationships with schools and health science programs will result in a pipeline of skilled healthcare workers.

By establishing university ties, ECMC can provide a consistent supply of trained healthcare professionals to satisfy staffing demands, decreasing dependency on overtime and premium pay. This technique not only assists ECMC in meeting regulatory standards, but also improves financial stability and patient care (Intermountain Healthcare, 2017).

As previously stated, ECMC has seen an increase in patient diversity while simultaneously decreasing patient satisfaction. To address these difficulties and assist ECMC reach its goal patient satisfaction ratings, management will mandate cultural competency training for all personnel. This program will entail forming an employee training team, finding financial means to support the training, and assuring complete participation by all employees.

According to research, a lack of cultural competency in healthcare institutions results in low patient satisfaction, insufficient patient care and communication, and an inability to deliver high-quality, culturally relevant healthcare services (Smallwood, 2018). As a result, patients may seek care from rivals, resulting in lower patient numbers and profitability for ECMC (Health Policy Institute, n.d.).

ECMC’s goal in establishing obligatory cultural competency training is to build trust and respect between patients and caregivers, boost the use of preventative care, eliminate healthcare inequities, improve efficiency, and raise patient satisfaction. This training will enable ECMC personnel to better understand and satisfy the cultural, social, and linguistic needs of their varied patient group, resulting in enhanced patient satisfaction and overall treatment quality.

For organizational growth and learning, ECMC will use new technologies and security measures to improve the safety of electronic health records (EHRs). To address the current gap in EHR security, ECMC will incorporate best practices that encompass physical, administrative, and technical measures. All staff will get training on the new security measures, regulations, and processes (Rodriguez, 2020).

Examples of these precautions are:

  • Access Control: Limiting access to health information depending on the user’s job.
  • Audit Trails: Audit trails track who accesses information and what changes are made.
  • Encryption: Encryption is the process of transforming data into a safe format that needs a decryption key.
  • Passwords and PIN numbers: Ensure that only authorized users have access to the system.

Implementing these safety measures will assist ECMC in meeting HIPAA regulations and achieving its fundamental principles of safeguarding the privacy, confidentiality, and security of personal health information (Rodriguez 2020). By doing so, ECMC will improve its capacity to secure patient information, increasing patient trust and overall organizational integrity.

Part V: Leadership Implications

Leaders at ECMC are responsible for creating the organization’s strategic direction, ensuring that ECMC’s culture and values are aligned, and, most critically, managing change. The American College of Healthcare Executives has outlined vital success qualities required to fulfill a variety of corporate objectives (ACHE, 2015). According to ECMC’s directional strategy, balanced scorecard, and gap analysis, the following leadership competencies are required to achieve the organization’s goals: leadership, communication and relationship management, professionalism, knowledge of the healthcare environment, and business skills and knowledge. Communication and relationship management are key competencies because leaders must be able to express goals clearly and concisely, create and sustain professional relationships at work, and guide constructive interactions while managing change (ACHE, 2020). 

Under the leadership competency category, leaders must be adept in conforming to legal and regulatory norms. Healthcare is a dynamic sector with often changing rules and regulations. Leaders must build this capability not just to remain compliant with existing standards, but also to anticipate changes and implement strategic initiatives to assure ECMC’s continued success and profitability.

Furthermore, when crises, problems, or complexities develop, leaders must be able to respond and adapt as needed to overcome hurdles while adhering to legal and regulatory requirements. This ability entails maintaining up to speed on regulatory changes, recognizing the implications for the organization, and executing necessary adjustments quickly. By doing so, executives can protect ECMC’s operations, reputation, and financial health.

Advanced skills and understanding of the healthcare sector are another key qualification that can help you achieve your organization’s goals. Leaders must have extensive medical knowledge and expertise to back it up. The capacity to detect and develop this skill in others is also critical (NHS, 2019). Effective leaders thrive at task delegation and can select personnel who are most suited for certain positions, which is an important step toward accomplishing corporate goals (NHS, 2019).

For example, in employee training sessions, identifying healthcare professionals who are well-suited to instruct others on cultural competency or the use of EHR systems indicates good leadership. Leaders should also be able to analyze the present situation, find areas for improvement, and explore chances for growth and development. They should devise ways to overcome hurdles and effectively convey these objectives to team members, encouraging teamwork and gaining stakeholder support (ACHE, 2015). This holistic strategy guarantees that ECMC can adapt to new situations, meet obstacles, and continue to deliver high-quality treatment.

References – MHA FPX 5012 Assessment 1 Organizational Analysis of Erie County Medical Center

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