NO PLAGARISM!!!!!! Please follow all instructions. Please use the topic given below.

By the end of this course, you will need to prepare and submit a  management    action plan (MAP) addressing a specific healthcare problem or  scenario. This     can be either a “real world” management problem within your own  healthcare       organization or a scenario from the list in the Unit II Project Topic             assignment.

The topic is Implementing telehealth services in your facility.

Please include  documentation of all six steps shown below in your submission   of the MAP  assignment.

1. Clarify the Problem or Opportunity for Improvement                                                (OFI)
   Clearly  describe the problem or OFI    that     you     have               selected                       for   your    MAP. Why      is it        important   to           resolve this   problem          right          now?         What       are     the           consequences of     not        resolving   this         problem   right                        now?
2. Clarify your Measurable Goal
   Clearly  describe the desired                                        outcome from        your MAP implementation.      What     are     you           trying      to             accomplish? How will                     successful  MAP           implementation   be     measured        and                 assessed?  What   realistic                constraints do        you      have   as       you   begin           creation of your          plan?      Consider limits                 on     time, money,     and  other                    resources     that are     specific   to   your           MAP.
3. Prepare  a List of Possible  Actions
   Consider possible                                      root   causes of    the     OFI. Why do  you believe      the                problem         exists?           Brainstorm   and    present   a     list   of                all possible          actions that      you    may           need   to take     in   order       to   achieve   your            MAP      goal.   At     this    stage,         focus     on         generating   as   many               different options   and         ideas      as            possible. It      is       likely that          not all   of        your ideas     will make           it           into   your final    MAP.          Write      down   your     ideas  just             as they come   to   your            mind,         trying     not     to judge    or         analyze    them    at this                stage.
   In         your                    brainstorming,   be sure to             consider  ideas*            involving        the                following:
    

   leadership,
   governance,
   clinical  performance,
   physicians,
   nurses,
   clinical       support   services,
   knowledge      management,
   human resources,
   financial     management,
   internal     consulting,  and
   marketing.

    *It is    understood   that   some of these                                      areas   may not apply to  your  particular    MAP,         but            all       areas           should at         least    be     considered   in   this              process.

4. Organize     your Key      Action       Steps into a Management Action                              Plan
   Decide on the       sequencing   of    your                     key            action   steps. For   each key action    step,        what       other            steps     must be                  completed        before that     specific action         can be       taken?             Rearrange        your     key           action   steps   into    a    sequence       of   ordered           activity.       Then,   look      at          your    plan       once       again. Are   there      any     ways   to          simplify   the plan               further     before           presenting        it?
5. Accountability
   For each key       action       step, assign                a              responsible       party or group within       your                   organization     (by         position,         department,    or    team                 name,  not by     individual name),              and    assign a         suspense                   date by which the  key   action      step        must       be         completed.          Then,   based     upon      all   of your     key       action        steps       and   their               suspense dates,     provide    a               realistic         completion      date   for the        entire             MAP.
6. Measurement   and       Monitoring
   Now,     explain in                detail how     you          will   measure   the    success   of              your           MAP following          implementation and       how   you            will        monitor         ongoing          performance to   prevent         regression and                         loss   of the     positive    change      that has       taken        place.

Your   plan            should           consist   of no less than four        pages, and       any outside          sources   should       be        cited     and  referenced     using APA                    formatting.                  

Community Memorial Hospital Recruiting and Retention

Management Action Plan

You are the CEO of Community Memorial Hospital in Marion, Ohio: a town of 50,000

people. When you accepted your position five years ago, your community had a serious shortage

of primary care physicians. This was due largely to retirement or death of several senior

members of the medical staff who had helped to found the hospital 40 years earlier. Over recent

years, the young doctors who returned to the community after training were all in specialty role:

cardiology, orthopedics, pulmonology (no new primary care doctors for some years).

The hospital board of directors made it your top priority to recruit more family practice doctors

for the community, and you were successful! You were able to bring in four new family practice

doctors, just coming out of residency, to join the medical staff. You achieved this by sponsoring

the visas of foreign-trained physicians for two of the positions, and you also agreed to pay off

student loans for two U.S.-trained physicians for the other two positions. All four doctors agreed

to a five-year term of service in the community. The hope of the board and the medical staff of

course was that the doctors would settle into the community, start families in town, and stay for

the remainder of their careers.

Today you have some devastating news. At the request of your chief of staff, you have

polled the young family practice doctors, and none of them are planning to stay beyond the end

of their five-year contracts. Their departure dates are scattered over the next 18 months, but all of

them tell you that they are leaving. Your town, like many American towns, will now be without

primary care again.

Some of the problems that you are aware of that are affecting the hospital’s ability to

keep family practice doctors are:

 limited recreational activities for young doctors and families once they are in the

community,

 heavier on-call burden for doctors due to a smaller total number on staff,

 slightly higher salaries for primary care doctors in neighboring larger communities, and

 not as large of a bonus on their contracts because the smaller community does not create

as busy a daily practice as a major city.

You need to look into all areas that affect the hospital’s ability to recruit and retain

primary care doctors. There is no quick fix to this situation and no absolute right or wrong

answer, but the success of the hospital and the entire community depends on you. Can you

change the minds of any of the current doctors? What can you do to bring in more doctors—ones

who will stay this time?

Community Memorial Hospital

Recruiting and Retention Management Action Plan

I. Clarify the Problem or Opportunity for Improvement (OFI)

A. The problem at Community Memorial Hospital (CMH) is recruitment and retention

of family practice providers. I believe retention is a larger factor because four new

family practice doctors were recruited; however, for whatever reason, they have

chosen not to stay on at CMH. Once family practice providers are hired on, keeping

them happy is just as important, if not more important, than recruiting new providers.

B. The consequence of not resolving the problem right now is leaving a community of

50,000 people with no family practice provider to meet their healthcare needs.

II. Clarify Your Measurable Goal

A. The benchmark set is to convince all four family practice providers to remain on staff

with CMH.

B. Determine the reasons for the shortage of family practice providers within the

community by performing an employee assessment of current leadership

performance. Determine why CMH struggles with the recruitment and retention of

needed providers and then work to make CMH a desirable place to work.

C. The realistic constraints I face are funding and time. I have 18 months to convince the

providers to stay on with CMH or to recruit more family practice providers.

III. Prepare a List of Possible Actions

A. Leadership Governance

1. A possible root cause is, as a leader, I should have been more engaged sooner.

When taking over as CEO it should not have taken five years to realize there was

a retention problem with the current primary care providers. Workforce planning

involves planning manning requirements over the next one to five years. This

should be reviewed annually; therefore, I should have knowledge of a

provider’s plans sooner than the 18 months’ notice currently given.

2. Evaluate, restate, and re-commit to the current mission. I would determine

whether the current mission statement of the hospital supports the community.

Organizational excellence begins with and is measured by stakeholder

satisfaction; employees are stakeholders who have a vested interest in the success

of the company they work for (White & Griffith, 2010).

a. According to a survey of Massachusetts physicians regarding recruitment and

retention of primary care physicians at community health centers (CHCs),

89% said believing in the mission of the organization was their first

consideration in choosing a CHC. Regarding retention, 82% reported high

satisfaction with the mission and goals of their current CHC (MassAHEC

Network, 2010).

3. Perform an assessment of superiors, peers, and subordinates to determine

leadership effectiveness in providing a good cultural leadership foundation where

associates are empowered and motivated to meet customer needs (White &

Griffith, 2010, p. 41).

a. According to the Massachusetts survey, those providers who choose to stay at

their current CHC gave a 50% satisfaction rating when given opportunities to

participate in policy development and 36% satisfaction rating for

opportunities to participate in community-based research (MassAHEC

Network, 2010).

i. The final element of physician privilege is continuous quality

improvement and peer review. This element establishes that physicians

will play an active part in their healthcare organization’s (HCO)

continuous improvement process while also taking an active role in

conducting and receiving peer review assessments.

B. Clinical Performance

1. Determine if the hospital providing excellent patient care with the current staff,

equipment and facilities? Distribute patient surveys to evaluate whether the

hospital is providing safe, effective, patient centered, timely, efficient and

equitable care to its patients and associates.

2. In order to remain competitive and consistent with the HCO’s needs, it is

imperative to remain informed on market share improvements. Is CMH keeping

up with the provider’s current and future technological needs? I must ensure

physicians maintain education levels equal to the current technology.

C. Physicians

1. Develop a physician supply plan that is carried to small geographic areas because

easy access to primary care physicians is important to patient satisfaction (White

& Griffith, 2010, p. 196). Ensure MCH is competitive with surrounding HCOs.

2. Recruiting

a. According to the Massachusetts survey, The interview process scored high in

importance in all levels. 89% felt visiting the CHC was important, 87%

wanted a site that met most of their professional needs, 85% wanted to meet

other members of the clinical team, and 84% wanted an understanding of the

community of patients to be served (MassAHEC Network, 2010). Change the

interview process.

D. Retention

a. According to the Massachusetts survey, rated most important are the

following categories: work/life balance 94%, support staff 85%, professional

development 82%, compensation 80%, and protected time for administrative

responsibilities 75%. Less important is productivity incentives (43%) and

increase in mid-level providers (41%; MassAHEC Network, 2010).

b. Providers also rated 52% satisfaction with administrations support for clinical

practice goals, 46% educational/professional opportunities for family, 42%

fringe benefits, 42% total compensation (MassAHEC Network, 2010).

c. Only 16% reported they were unlikely to remain at their site for five years and

19% were unsure. 50% reported that within 10 years they would be working

somewhere else (MassAHEC Network, 2010).

d. By organizing physicians by service lines, HCOs are more able to document

clinical excellence, forming a foundation for privilege and compensation

negotiations that allows both the HCO and physicians to earn incentives under

more recent compensation plans (White & Griffith, 2010).

e. Promote and reward a leadership environment by involving physicians in

the decision-making process; HCOs show physicians they are valued

members of a productive team. HCOs with a high level of physician

engagement receive higher revenue, increase referrals from engaged

physicians, reduce recruiting costs, and sustain significant growth and

profitability (White & Griffith, 2010).

E. Nurses

1. Employ nurse practitioners who are able to perform physical examinations,

diagnose and treat certain acute and chronic medical conditions, provide health

maintenance care and collaborate with physicians (White & Griffith, 2010, p.

238). This will allow more time for current providers to spend on administration

work and, hopefully, offer a less stressful working environment.

F. Clinical Support Services

1. According to the Massachusetts survey, administration support rated as most

important by 79% of the respondents.

2. Costs will not be cut in clinical support services to go toward provider incentive

programs.

G. Knowledge Management

1. Ensure proper training on all processes.

H. Human Resources

1. Review and update the annual workforce plan, and ensure it is consistent with the

long-range financial plan to ensure funding is available to support projected

manning

requirements.

2. Workforce development retention is an important focus because keeping valued

employees costs less than recruitment and retraining new employees. One way to

keep retention high is to promote a healthy workplace by promoting diversity and

cultural competence.

3. Do not recruit just from within the United States. Cultural competence and

workforce diversity cultural competence is a set of complementary behaviors,

practices, and policies that enables a system, an agency, or individuals to work

and affectively serve pluralistic, multiethnic, and linguistically diverse

communities (White & Griffith, 2010).

4. The third function is workforce maintenance. Workforce maintenance goes hand

in hand with retention efforts. Remain competitive in regards to compensation,

retirement benefits, adequate training in order to complete the mission, employee

safety, handling of grievances, and monitoring employee satisfaction.

a. According to the Massachusetts survey, 50% of respondents participated in

Visa and/or loan repayment programs; however, only 10% deemed the

incentive as important. 51% rated fringe benefits as important. This is

followed by wanting a specific geographic region (63%) and wanting to live

near family (52%; MassAHEC Network, 2010).

b. The intent of the Merritt Hawkins 2011 Review of Physician Recruiting

Incentives is to quantify financial and other incentives offered by our clients to

physician candidates during the course of recruitment. The range of incentives

detailed in the review may be used as a benchmark for evaluating which

recruitment incentives are customary and competitive in today’s physician job

market. In addition, the review is based on a national sample of search

assignments and provides an indication of which medical specialties are

currently in the greatest demand and the types of medical settings into which

physicians are being recruited (Merritt

Hawkins, 2011).

i. 76% were offered a signing bonus of, on average, $23,790.

ii. The average income offered for family practice providers is $178,000.

iii. Most search assignments (44%) were for communities of 100,000 or more.

iv. 92% of searches offered a relocation allowance averaging $10,454.

v. Signing bonuses, relocation, and continuing medical education allowances

remain standard in most physician recruitment incentive packages (Merritt

Hawkins, 2011).

c. Offer incentive packages for current and new providers. Include relative value

unit bonuses versus per-patient bonuses. Relative value unit bonuses are a

metric for determining physician productivity based on work units performed

by a physician rather than the number of patients seen (Merritt Hawkins,

2011). This incentive gives more points to patients who may require more

time and care versus a patient seen for something simple such as a cold. This

is a twofold incentive for providers and patients. Eliminate educational loan

forgiveness as only 29% of searches, and only 10% deemed it as important

(Merritt Hawkins, 2011; MassAHEC Network, 2010). Also, include

malpractice coverage, health insurance benefits, a relocation allowance, a

signing bonus, a competitive and set salary, bonuses for profit sharing, and

leadership and retention stipends.

I. Internal Consulting

1. Empower associates involvement with process improvement teams.

2. Create a process-improvement council whose sole objective is improving

recruiting and retention within the organization. Ensure that associates from

each area are represented.

J. Marketing

1. Improve the organization’s marketing strategy to attract customers and to aid in

recruitment of future providers.

IV. Analyze and Prioritize Key Action Steps

A. Use bold font for the most effective key action steps.

B. Use strikethrough font for actions that can be dropped from the list without

consequence.

V. Organize your Key Action Steps into a Management Action Plan (revise order)

C. Create a process improvement council whose sole objective is improving recruiting

and retention within the organization.

D. Perform an assessment of superiors, peers, and subordinates to determine leadership

effectiveness.

E. Review and update the annual workforce plan, and ensure it is consistent with the

long-range financial plan to ensure funding is available to support projected manning

requirements.

F. Revise incentive packages for current and new providers

1. Eliminate educational loan forgiveness as only 29% of searches, and only 10%

deemed it as important (Merritt Hawkins, 2011; MassAHEC Network, 2010).

Also, include malpractice coverage, health insurance benefits, a relocation

allowance, a signing bonus, a competitive and set salary, bonuses for profit

sharing, and leadership and retention stipends.

VI. Accountability

A. Create a process-improvement council whose sole objective is improving recruiting

and retention within the organization. Ensure that associates from each area are

represented. Immediately implement the team. Caregiving teams will head up the

council. The council will be ongoing with monthly feedback provided to the CEO.

B. Perform an assessment of superiors, peers, and subordinates to determine leadership

effectiveness. POC: Human resource management with the results of the assessment

submitted within 60 days.

C. Review and update the annual workforce plan, and ensure it is consistent with the

long-range financial plan to ensure funding is available to support projected manning

requirements. POC: CEO with a completion timeline of 60 days.

D. Revise incentive packages for current and new providers

1. Eliminate educational loan forgiveness as only 29% of searches, and only 10%
deemed it as important (Merritt Hawkins, 2011; MassAHEC Network, 2010).

Also, include malpractice coverage, health insurance benefits, a relocation

allowance, a signing bonus, a competitive and set salary, bonuses for profit

sharing, and leadership and retention stipends. POC: Human resource

management. Completion timeline of 90 days to be submitted for approval to the

board. Final approval of plan completed within six months.

VII. Measurement and Monitoring

A. I will create a Recruiting and Retention Measurement and Review Committee.

Surveys will be conducted quarterly to determine associate and patient satisfaction. It

is imperative that, during this process, the hospital maintain excellent patient care at

all times.

B. A review will be conducted within six months as to provider retention intentions and

recruiting efforts. If no progress is noted at that time, the review plan will be re-

evaluated.

References

MassAHEC Network. (2010, January). Recruitment and retention of primary care physicians at

community health centers: A survey of Massachusetts physicians. Retrieved from

http://www.umassmed.edu/uploadedFiles/CWM_CHPR/About_Us/RecruitmentRetention

PCPs_CHCs_January2010

Merritt Hawkins. (2011). 2011 review of physician recruiting incentives. Retrieved from

http://www.merritthawkins.com/pdf/mha2011incentivesurvPDF

White, K. R., & Griffith, J. R. (2010). The well-managed healthcare organization (7th ed.).

Chicago, IL: Health Administration Press.