Appraisal of an Organization’s Strategic Plan: A Case Study of NYC Health+ Hospi

Appraisal of an Organization’s Strategic Plan: A Case Study of NYC Health+ Hospitals Introduction Spread across 70 locations, the New York City Health+ Hospitals offer the largest public healthcare system in the country and offer essential outpatient, inpatient, and home-based care services to over a million people annually. With five post-acute and long-term care facilities and 11 acute care hospitals, the group is ranked high among institutions offering quality trauma care, mental health services, and Medicaid and Medicare for rehabilitation, nursing, and palliative care (NYC Heath+ Hospitals, 2021). The hospitals’ run based on a strategic plan developed by the board of directors and which was last updated on April 12, 2018, where the members were informed of the intent to establish a system scorecard and a seven-point financial plan that emphasizes ensuring the hospitals’ systems viability, the reduction of expenses, and achievement of efficient contracting. While these features do not entirely reflect the hospitals’ strategic plan, they nonetheless reflect the mission and vision and other metrics stated in the plan, aiming to enable the attainment of the hospitals’ long-term financial sustainability. Strategic Plan Analysis The NYC Health+ Hospitals vision is “to be a fully integrated health system that enables New Yorkers to live their healthiest lives” (NYC Heath Hospitals, 2021 b). The hospital’s mission is “to deliver high-quality health services with compassion, dignity, and respect to all without exception.” The hospital’s board developed values under the (prefix) ICARE that stands for Integrity, Compassion, Accountability, Respect, and Excellence. These values, mission, and vision are founded on the following strategic pillars: quality and outcomes, care excellence, financial sustainability, access to care, and culture and safety. A review of the organization’s strategic plan reveals the company focuses on achieving metrics set on 3 to 5 pillars at the providers’ level. The strategic plan also focuses on enhancing communication, documentation, and the harmonization of the various level’s dashboards and metrics. An updated dashboard (see appendix 1) offers insight into the hospital’s KPIs and how they implement multiple strategies to achieve the organization’s mission and vision. In the updated plan, the institution has introduced a new metric to increase primary care among unique primary care patients seen – a factor that will be assessed by measuring the primary care growth and access of patients benchmarked with 2017 figures. Regarding the pillar on access to care, the organization seeks to increase the number of e-consults completed per quarter, a top priority being the initiative to measure specialty areas. The pillar on financial stability enables the hospitals to achieve patient revenue growth and reduce expenses while abiding by the city’s, state, and federal policies beyond the hospital’s management control. The hospitals have also established new metrics on insurance applications and medical spending to increase the number of self-pay patients to insurance and increase revenues. The hospitals have also set sight on information technology, which they intend to leverage to achieve improved healthcare, including developing rapid testing abilities and enhancing the supply chain. The metrics are also based on improving overall quality and outcomes such as the sepsis 3-hour bundle, the HgbA1c control that should be below 8, and the percentage of people who leave without being attended by the emergency department. Validity of Data and Analytical Strategies As stated in the NYC Health+ Hospitals strategic plan, the organization seeks to increase primary care quality and improve its financial position. These objectives are attainable via the current strategic plan and affirm the company’s resolve to achieve its mission and vision, including improving the quality of care afforded at the hospitals and achieving ICARE. These goals are also founded on the five strategic pillars. These KPIs are likely influenced by the inpatient and discharge rates across the hospital’s 11 branches. As shown in appendix 2, the service score is set at an average of 61.5 against a target of 65.4 and a stretch of 70.1. The organization has also sought improved post-acute care and the probability of attaining a recommendation from former patients (see appendix 3). The KPI is established based on the patient’s likelihood to recommend, which over the years has risen to a high of 84.1 in 2018. With a target of 84.3, the hospitals average a score of 84.1 and a stretch of 85.9. Other KPIs that define the hospital’s need to achieve quality include the medical practice score set at 83.6 but to which the organization averages 82.2. The hospitals’ failure to achieve the set targets follows the diverse cultures across the 11 institutions that have proven challenging to harmonize despite applying a similar strategy not adapted to the individual hospitals. The hospitals have also established other KPIs classified into finance, internal processes, learning and growth, and customer satisfaction. The table below summarizes the KPIs based on their category. Table 1 KPIs Adopted by the NYC Health+ Hospitals Category in the Strategic Plan Indicator Customer Rate of patient complaints Availability of facilities for incoming patients Patient satisfaction percentage Learning and growth Employee absenteeism Training expenditures per capita Staff turnover Staff satisfaction rate Internal processes Emergency room waiting time Mean length of stay at the emergency department Number of clinical errors Hospital infection rates Bed occupancy Bed turnover Mortality rates Cancellation operations The average length of stay Finance Percentage of personnel costs and total costs The costs of materials and drugs (cost of doing business) The ratio of total revenue vs. total costs Percentage of hospital deductions Stakeholder’s Input Stakeholders could have been enlisted in the strategic plan during the planning process. During such procedures, stakeholders need to understand available options and how implementing the strategic plan will affect their bottom line. Notably, stakeholders are essential in determining how the organization will achieve its vision; hence, their views must be considered when analyzing external issues likely to affect the business. The first step, in this case, involves gathering information needed to understand and identify the issues, trends, and challenges in the environment – that is, conducting a PESTEL analysis. The analysis results are then used to identify and understand how various groups can influence the organization and characterize multiple demographics. Key stakeholders in this process would thus be internal and external partnerships that include patients, physicians, employers, insurance companies, pharmaceutical firms, and the government. Typically, patients have an ethical responsibility to their health and financial commitment to the hospital. Understanding their needs is critical to developing the strategic plan as it would serve to identify the appropriate technology and the type of treatments to avail. In this sense, it is evident that the most expensive treatments do not necessarily indicate the best style. As public health institutions, the NYC Health+ Hospitals should prioritize regulating costs while determining other KPIs with patients as crucial stakeholders under consideration. Over the years, the NYC Health+ Hospitals have employed several strategies to achieve a balanced performance for the organization. Using the balanced scorecard method, it is possible to identify the history and success of the implementation of various strategies at the organization and how they affect its financial returns, the greater employee alignment to the overall organization’s goals, the improved collaboration within the hospitals, and the organization and stakeholder’s focus on the strategy. The balanced scorecard can be defined as “a tool that translates an organization’s mission and strategy into a comprehensive set of performance measures that provides the framework for a strategic measurement and management system” (Niven, 2002). The score cars are used to determine the effectiveness of an organization’s strategy along with the learning and growth perspective, internal processes efficiency, customer perspective, and financial perspective. The researcher interviewed five personnel from the NYC Health+ Hospitals from Kaplan and Norton’s (1992) theory on the four processes that connect the long-term strategies and short-term activities in the balanced scorecard system, and the researcher interviewed five personnel from the NYC Health+ Hospitals. Later, each of the five was sent a questionnaire seeking information regarding how the organization enhances service delivery to its customers. Under the internal business perspective of the performance management tool, the researcher sought to find what the organization excels at. The researcher also questioned what the organization could continue to do to create value for its stakeholders by innovation and learning perspectives and what management thought the customers saw them. The researcher also questioned the organization’s financial attitudes by determining what they look at to shareholders. The conceptual framework considered in this case is the economic perspective that includes the net shareholder’s value, the revenue opportunities creation, asset utilization, and the system cost structure. Next is the customer focus perspective, which considers product functionality, customer relationships, customer loyalty, and customer retention. The third is the innovation and learning perspective that includes the quality of information systems, operating efficiencies, employee training, and innovation processes. Fourth is the internal business process perspective that considers the demand flexibility, flow time, productivity rates, and operations strategy. These factors as independent variables influence the service delivery as the dependent variable as they influence the hospital’s ability to develop interpersonal relationships with its customers, identify customer-initiated products, and increase the number of repeat customers. Performing an ANOVA analysis using Excel to determine the correlation present between the above variables reveals the following: Table 2 Correlation Analysis Model Unstandardized coefficients Standardized coefficients t Sig. B Std. Error Beta Constant 1.842 0.804 2.294 .005 Financial perspective .446 .132 .064 3.598 .000 Customer focused perspective .344 .150 .182 2.408 .004 Internal business perspective .267 .063 .108 4.198 .000 Learning and innovation .336 .085 .286 4.133 .001 The results show that the hospitals’ service delivery and financial perspective have a statistical significance, as is the internal business. The results imply that the hospital emphasizes improving its financial bottom line over other aspects, which is explained by the strategic plan that focuses on meeting financial obligations. References NYC Health+ Hospitals. (2021). About NYC Health + Hospitals. Niven, P. (2002). Balanced Scorecard: Step-by-Step: Maximizing Performance and Maintaining Results. John Wiley & Sons, Inc. NYC Health+ Hospitals. (2021 a). Mission and Values. Instructions Develop a strategic plan that establishes top priorities for a department or division, aligned with the organization’s strategic plan, which you appraised in Assessment 2. Include the following elements in your plan: • A balanced scorecard for the department or division. The following interactive media may help you in constructing your balanced scorecard: o A Balanced Scorecard for Change. • A minimum of four departmental strategic priorities, one from each balanced scorecard domain (financial, customer, internal processes, learning and growth). • Graphical representations showing alignments between the departmental strategic priorities and the organization’s strategic plan. Evaluation The following tasks correspond to the grading criteria in the assessment scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed. • Determine departmental strategic priorities. o Include at least one strategic priority for each balanced scorecard domain (financial, customer, internal processes, learning and growth). o Why are these priorities important? o Are these priorities feasible? o For example, do they reflect departmental objectives, available resources, and a specific time frame? o Explain. • Evaluate the effects of organizational policies on departmental strategic priorities. o How do existing policies hinder or facilitate what you hope to accomplish? • Align departmental strategic priorities with elements of an organization’s strategic plan. o Represent the alignments graphically in a crosswalk table, Venn diagram, or any other format that clearly illustrates the alignments. • Create a balanced scorecard for a department or division. o Each scorecard domain must include an objective, performance metric, benchmark target, and prospective initiative. o Submit your balanced scorecard as an appendix in your assessment. • Communicate clearly and concisely in a form and style appropriate for the audience and for the substance, purpose, and context of the message being conveyed. o Consider the needs of your audience. o Be succinct and mindful of communication best practices. o Carefully review your materials to avoid errors that could distract the audience and make it more difficult for them to focus on the substance of your strategic plan. Competencies Measured By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria: • Competency 3: Propose a strategic plan that integrates feedback from other disciplines and aligns with organizational priorities. o Determine departmental strategic priorities. o Align departmental strategic priorities with elements of an organization’s strategic plan. o Create a balanced scorecard for a department or division. • Competency 4: Recommend policy changes that support a strategic plan. o Evaluate the effects of organizational policies on departmental strategic priorities. • Competency 5: Address assessment purpose in effective written or multimedia presentations, incorporating appropriate evidence and communicating in a form and style consistent with applicable professional and academic standards. o Communicate clearly and concisely in a form and style appropriate for the audience and

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