Strategic plan for Hillsboro County Home Health Agency

Overview

HCHHA or Middleboro healthcare organization is aimed to provide needful healthcare services to area’s population. In the Hillsboro country it is the only medicare certified healthcare agency. The responsibilities of individuals are decided and distributed among the staffs by the board members. The officer for the agency is elected by the board members. The management team has failed to build up appropriate strategic plan for competitive and commercial success of the agency. A detail strategic plan has been developed for the agency to improve the current financial, operational, patient care, and telehealth program.

Mission statement 

The mission of “Hillsboro County Home Health Agency, Inc” is to offer individual services to people, their illness and disabilities in the general environment. The health care agency is aimed to prevent spread of the disease and avoid the effect of all different unavoidable diseases. The disables are offered quality nurses in terms of high level nursing facilities as well as therapeutic care. For promotion of health “Hillsboro County Home Health Agency”, provides encouragement and data to families, individual ill people and community groups.

Vision statement

The vision statement for “Hillsboro County Home Health Agency” is: “to provide high quality medical care services to people who are retarded and suffering from serious disease”.

Core values

The core values of “Hillsboro County Home Health Agency” are as follows:

• To implement effective staffing program that can facilitate improved patient care process including high quality, specialized care to satisfy the staffs, nurses and physicians
• To become the leading employment choice for the healthcare workers in the country of Hillsboro by implementing Revenue Cycle Management (RCM) technologies
• To improve the decision making approach and healthcare information management system

SWOT analysis

Strength“Hillsboro County Home Health Agency” offers wider range health care services to patients  The agency is committed to technology based advancements The Hillsboro or Middleboro agency has large market share in medicare industryIt maintains professional telehealth program for monitoring chronic illness of individual patientsThe working staffs of this agency have good leadership, motivational and supporting capabilities.Geographical isolation is the other major strength for HCHHAThe agency holds enough of community support	WeaknessesThe financial structure of HCHHA medicare agency is very weak. Due to high political influence, the management team of the agency is facing political challenges Due to non-supportive of reward and incentive structure the rate of turnover among the doctors and nurses in HCCHA are increasing The organizational management structure of HCHHA is very weak Communications among the staffs are very weak thus, conflict is occurring among the associates.The among of liquid capital is negligible
OpportunitiesThe healthcare activities and operational process of HCHHA identified that it has opportunity to earn new service line development program Within Jasper community the agency has opportunities to increase its current penetration trends.In order to organize and manage data and information the HCHHA uses advanced Information Technology (IT) based operations successfully. With the help of quality advanced IT support the business operations runs all efficiently.  The agency is offering prolonged insurance coverage to their patients as a result it has opportunities to get market growth.	ThreatsSome of the older employees are not aware of advanced IT based activities and operations. Therefore, threats related to productivity might rise as a major threat. Similar group of physicians can establish in Jasper as well It is required for the healthcare agency to make periodic improvements in regular operations and activities. Expansion of OHA in jasper is a major threat.

Grand strategies or long-term strategic priorities

It is essential for HCHHA, to develop long-term sustainable business strategies. With the help of these strategies the agency will make long-term economic profit and market level advantages as well.

Child health initiatives will be increased: The patient care strategies of HCHHA are patient and employee focused but it lacks child health initiative programs. The agency must ensure that, prenatal program is included in the health care activities. Maternity nurses should take the responsibility seriously    

The overall financial performance of the company should be improved successfully: After analyzing the health care agency operations and functional activities, it is determined that it requires to improve their financial programs. The existing medicare service do not covers specific service given by divisions. Therefore, each of the division is required to manage individually allocated financial entity.

The strategies of HCHHA are required to be improved: It is determined that, the agency’s capability to be eligible for medicare refurbishment is not strong enough thus, requires further improvement.  In order to improve the clinical operation the connection between the clinical personnel and business office are needed to be improved.

The company requires using the electronic health record keeping system continuously: Theses days’ data management has become a major challenge for clinical industry operations which requires effective improvement. For managing large set of data the agency requires using E-health record keeping system. The authorized users such as doctors, patients, nurses and clinical physicians etc will be able to access patient’s health status related information from the record while required regardless of time and location.

Employee engagement strategies: HCHHA needs to apply effective employee engagement strategies to keep them interested to assigned responsibilities. It will help to reduce the employee turnover rate.

The company should qualify for further medical care refurbishment options:   HCHHA requires implementing quality medicare renovation action to ensure that the predictable medical actions are organization successfully.   

Operational and tactical plan

For improving the operational and practical structure of the company different tactical planning are required to be implemented by company associates. The details of theses planning are as follows:

Child health program initiatives: The director of community health division has identified that, child health care initiatives are needed to be incorporated by the healthcare agency.  Children less than 1 year old need special care. Apart from this, bilirubin therapy (“a photo light therapy”) is required to be incorporated by the associates. HCHHA must develop proper child health information strategy that is comprises of hierarchy of children registers. At each level data those have been collected should be analyzed for implementing effective strategies. The registers are available in practice patient management system, primary health organization register and district level register. Additionally, the agency needs to develop effective IT infrastructure to ensure proper information flow between the registers and local providers. HCHHA must focus on local as well as regional child service initiatives. In addition to that, child health workforce plan is also needed by be developed to implement the health initiative program. The agency head must lead or govern the child health initiative program to ensure that it is running towards expected direction. The existing child health status analyzing techniques requires further research, evaluation and improvement.

Development of financial performance: The financial performance of HCHHA requires to be improved.  The agency must ensure that the outstanding debt are recovered, sell assets and rearrange expenses are reduced. The agency must offer extra payment options using new market development techniques. Other techniques that may improve financial structure of the agency include other venture diversification band automated change management actions. Apart from this, the integrity department of HCHHA agency should create revenue framework. Besides this, automated charge management system implementation is another mechanism needed successful financial performance. The finance department should recruit more numbers of staffs so that they can address and identify potential risks. The challenges associated to revenue cycle will become easier to identify.  

Medical care improvement: The current medical care approach and mechanism is needed to be improved to earn commercial revenue and effective competitive edges. People who are seeking for health care services must be searched by the agency. Apart from this, comprehensive home health initiative is needed to expand the home health care facilities.

Use of E-health record keeping system: HCHHA should use E-health record keeping scheme for storing patient’s health related information that can be fetched by authorized users while required. Only precise authorized users such as doctor, nurse and physicians are able to retrieve data from server while required. The agency associates are needed to perform workflow analysis. Using standard clinical guidelines developers need to implement evidence based activities. Before executing the final program developers should select most suitable vendors and contractors. In order to provide a better work infrastructure to HCHHA agency, the associates are needed to invest needful amount of capitals.

Reducing staff turnover rate: The frequently reducing rate of staff turnover has to be controlled. The agency policy and procedures are required to be employee based for some of the home care divisions. A good working environment is needed to be created to motivate the employee and keep them engaged with hr primarily assigned roles and responsibilities. By the end of every 4 years the remuneration of nurses must be increased by 30%.  Apart from that, new employee sustain program is desired to be implemented.

Key performance and evaluation indicators

The HCHHA or Middleboro home health agency is these days facing major operational and practical challenge which requires major focus and attention of the associates. The aim of the agency is to deliver needful patient care services to ill and disable people. However, people care unit of the agency needs to consider the below Key Performance Indicators (KPI):

• Treatment cost
• Patient wait time
• Safety of the patients
• Patient’s waiting time
• Patient’s satisfaction rate
• Average hospital stay

The evaluation indicators that are to be considered by HCHHA to improve the overall infrastructure include the below:

Proper resource allocation: In order to create an effective clinical infrastructure for HCHHA proper resource utilization is essential. In other words, for individual activity allocation of proper resources is required. The board committee is comprises of executives, professional advisory board, building and grounds, publicity and public returns, operation manager, equipments, hardware, software, e-health record keeping system developers, tester, marketing team associates etc. It is responsibility of the agency head to check performance, skills and knowledge of the applicants before recruiting them. Using performance analysis matrix, their skills need to be analyzed. Based on expertise individuals are needed to be assigned to individual activity. The agency should make sure that no issues of resource over allocation will occur that may interrupt the expected revenue.

Identification of method of evaluation: Different evaluation methods such as risk analysis, human error detection and usability analysis are there. Based on company objectives the most suitable evaluation method is needed to be considered by the executives. An accurate evaluation method will help to combine the benchmarking that will help to provide a basis of setting usability criteria. It will help to make combination with standards to evaluate competitive comparison.

Data arrangement and measurement instrument: In order to deliver expected services to ill and retarded patients, information gathering is much essential. Data are needed to be gathered from different resources and those data should be rearranged accurately. The gathered data are then categorized into structured data, semi structured data and unstructured data. The categorization will make the process of information access faster and easier. Not only this but also, proper measurement instruments are also should be utilized accurately.

Evaluation question design and development: HCHHA requires developing different evaluation question. Proper evaluation questions are needed to be developed to ensure the operational and functional success. The design detail will help to produce unbiased appraisal of program related benefits. These evaluations are dependent on resources, precision and standard business effectiveness.  

Change management plan

The size of the change and its impact on the community and the organization

The finance committee head of HCHHA is concerned on significant changes in refurbishment by implementing mandatory modifications in medicare activities for child and adults. The impacts of the changes in HCHHA are elaborated:

Improvement in patient care: For health care providers process of patient care has become one of the major concerns. The agency needs to focus on both non-medical and medical perspectives. In order to improve the patient care process trained personnel in terms of doctors, nurses are needed to be hired. The agency needs to purchase proper instruments, equipments, accurate medications etc. Not only this but also, new additional technologies should be adopted by HCHHA.

If patient care approach is successfully implemented then, the medicare process will be dynamically improved. In fact quality of patient care process will also be developed.

Cost reduction: Estimated cost for equipments, travel, and health are activities and other programs are needed to be structure to ensure that the improvement has been accomplished in the preliminarily allocated budget structure. Net administrative cost and expense has to be prepared accurately to highlight that actual cost is lesser than planned cost.

If cost structure is successfully completed by the finance manager then, the revenue and commercial success of the agency will grow exponentially.  

Efficiency improvement: The efficiency of HCHHA healthcare agency will be improved if performance of operation team and individuals get improved. The output of operational procedure and other process will be improved if performance of individual is improved. The agency requires arranging performance improvement and training development program for the staffs and other working associates.

Overall efficiency of the agency and individual staffs will be improved if they all successfully attend the training and development program

The organization’s readiness for change

The agency healthcare operational and functional program identified that, they are known for their prudent funding administration and high quality patient care activities. These processes is a multi-level, multi faceted design outline focused on implementing changes and share those among the working staffs. These change effectiveness will direct the process of organizational work flow, decision making, communication and reward generating approach as well. However, there is no single path that can be followed to reach the expected change.

The best suited ways need to be followed to meet the agency objectives include proper analysis, assessment and selection of most suitable tools and techniques. t the project initiation stage, expected organizational activities and ongoing activities are needed to be analyzed. After that, each of departmental activities in terms of managerial, financial, marketing and operational activities should be analyzed. For individual activity, assessment has to be done and approved by the project associates and others.

The operational activities are needed to be governed and completed followed by different analysis and assessment. Different project development knowledge areas such as strategy development, risk analysis, stakeholder development plan, and schedule and budget management are there which require company attention. In order to manage and complete any project successfully different project management tools and techniques are available such as Gantt chart, CPM, and WBS etc. If these tools are suitably used and applied by agency associates then expected outcomes will be generated and the agency would be able to meet expected outcomes and preliminary project objectives.

Among these tools, Gantt chart is the best suited tool which will give a visual representation of the plan and make all staffs aware of project objectives and expected ultimate outcomes.

Change management strategy

For this healthcare organization, the change management strategy can be developed followed by Kotter’s 8 steps of change model.

Creation of Urgency: Change management idea implementation is essential for project and organizational success. The Agency needs to create supporting business environment. It will help to make staffs aware of current issues and respective changes that can bring commercial profit and revenue as well in the operational ambiance. In this stage the agency is requires to build a discussion forum where all the associates can make discussion among each other. The management needs of the agency should be first identified and based on that change process should by needs to be emphasized. This stage will help to identify the needs which means why changes are needed. It will help to determine the relationship between eventual success and likely support.

Formation of powerful alliance: In order to implement strategies according to primary plan formation of strong alliance is essential. Skills, range of experiences will work while design such powerful alliance. It will help to distribute roles, responsibilities and ideas among all associates. Individual’s skill and experiences will help to drive the project towards expected success line.

Creating change vision: It has been identified that, sometimes change initiatives can be complicated and hard to realize. Particularly people from lower hierarchy fail to understand the change required. Change vision will help to encapsulate only the useful way. The company vision is required to be simple and effective as well to make sure that it is realized by all.  

Communicating vision: In this stage the project vision needs to be communicated among each agency associates. In order to generate support, design and development of mission and vision statement are not enough rather communicating theses details among associates are also essential. The vision message needs to be shared continuously.

Removal of obstacles: The above stages are essential to strengthen the outline of the change scheme. In this stage, potential obstacles will be removed and make sure that the process is flowing towards the expected direction. Social, environmental, political, legal and economical obstacles are removed in this stage. The child care initiative program, financial or cost distribution of HCHHA agency is weak and requires managerial attention. In this stage, the total project duration and resources will be broken down into small phase to make the project easier and error free.

Creating short term winning: It is determined that, company can earn advantages from new processes. Short term and long term winning activities should be identified. Total investment need to re motivate all the staffs. However, the investment has to be justified.

Building on the change: Employee habit and process improvement are not enough for organizational success. In this stage, continuous improvement plan has to be implemented to re built the agency goal and objectives.

Changes in corporate culture: The corporate culture of HCHHA healthcare agency is required to be changed to keep all staffs engaged to the assigned roles and responsibilities.    

Team structure and responsibilities

Strategic planning is a procedure that assists to lead a project to the expected aims and objectives. Strategic planning is always determined as long term plan developed by organizational committee associates and approved by the agency leaders. After evaluating the case scenario of Hillsboro County Home Health Agency, Inc. it is determined that, aim of the agency is to offer quality health care and nursing services to the disables and retarder people.

The team must be structured depending on experiences, skills and knowledge of associates. The agency structure in 2014 is comprises of executive director, finance expert, processional legal advisory etc. The leader needs to assign respective roles and responsibilities among the associates and ensure that goals and objectives of the agency have met successfully. The management team needs to arrange required training and development program, from where the team will be able to learn new ideas. The strategic roles and responsibility that HCHHA agency needs to distribute among members are detailed in the below section:

Roles	Responsibility
Project manager	Function of the project administrator is to check operational as well as functional activities of the healthcare agency and control its progress and govern it towards the expected outcomes and goals.
Finance head	Responsibility of finance head is to conduct a feasibility study at the strategic plan implementation initiation stage. It will help the agency to avoid economic risks and other commercial misinterpretations.
Operation manager	Operation manager of the agency will be responsible to check the running functional and operational activities. The operation head needs to ensure that all the healthcare oriented operations are running accurately.  In addition to this the manager also requires to prepare effective planning for quality service delivery.
Electronic system developer	Very first reasonability of the technical head is to lead other technical experts involved in the team.  In order to keep health related data HCHHA is willing to develop an electronic record keeping system. Proper protection mechanism are also required to incorporated to the system by the developer to make sure that no other unwanted users are fetching data from the server without permission.
Accurate budget estimation	The finance departmental head are required to estimate the budget initially. It will help to utilize money effectively. The decision making approach of organization will be improved and performance will also be monitored.

Sponsor roles and responsibilities

It is determined that, successful commence of a project is dependent on project sponsorship. If a project is perfectly funded or invested as required then, meeting the final objectives will become much easier to the agency. The responsibility of project sponsor is to approve needful resources and ensure that decisions connected to economics and project cash flow.  In case of strategic planning and long term sustainability the role of project sponsors are much critical.  Sponsors wrap most of the organizational responsibilities, decisive governance, and activities. The responsibilities that are to be played by the project associates include:

• The sponsors should recognize and qualify project level benefits and realize those benefits respectively
• Sponsors must participate in all project development activities
• They should provide the members an appropriate direction and make sure that the members are governed towards the expected project objectives
• They are responsible to develop the steering committee and guide members to give project empowerment
• The sponsors should give proper direction to the members
• They are responsible to implement key project initiatives and business strategies
• Sponsors should review needful changes based on respective project environment in terms of schedule, tasks, time, priorities and budget
• The sponsor’s role is to identify the Critical Success Factors (CSF)
• The sponsors are needed to negotiate with associates stakeholders to earn agreement while discriminated opinions are coming from different stakeholders
• They should keep on communicate with the project team members and stakeholders to maintain the initial commitment
• The most vital liability of sponsor is to evaluate success of the project as soon as it get completed

Planning and implementation

After reviewing the case scenario of HCHHA, it has been determined that major issues are associated to resource allocation and steering committee formation. During planning and implementation theses activities needs team member’s attention. The tasks on which the team sponsor and supervisor need to focus on include:

Scope design: Project scope statement is a running tool that is used to identify the actual aim and objective of project. The scope must be clearly designed and shared among the team members. Properly developed scope statement helps in managing scope creep and potential risks. The scope needs to be shared among the stakeholders as well.  The scope that has been developed at the initial phase can be changed or modified with changing desire of the associates.     

Feasibility study: The project sponsors and company executive are required to conduct a feasibility analysis at the project initiation stage to realize the project status. The project associates will be able to understand that whether the plan will be a victorious or not from the project report.

Proper allocation of resources:  In order to accomplish any project successfully, at the planning stage different physical and human resources are identified. Based on requirement, skill and experiences the best suited resources should be allocated to each project development activities. The project lead should assign all resources making sure that risks of resource over allocation are all being avoided.

Schedule design: The project lead ought to develop a project schedule followed by its complexity. Depending on complexity of each project development activities the schedule needs to be prepared. It will help to determine the root causes of risks, team motivation and critical path of the project. The major actions or strategies that associates staffs require to implement include implementation of staffing structure, selection of leading choice for healthcare employment, reconciling practices, IT for improving process, expansion of jasper facilities and improvement of financial processes through organizational management. 

Establishing steering committee: The agency needs to develop an accurate project steering committee and make sure that the child care initiatives and other health care activities are properly controlled and monitored.

Communications plan

Purpose of communication	Who	When	Frequency	Type of communication	Channel of communication
Discussion on staff improvement plan for reducing the rate of excessive staff turnover	Steering committee members and stakeholder	At the project initiation stage	weekly	Formal	presentation, face to face meeting
Discussion related to medicare financials	Doctors, nurses and other members of patient care units	Project planning  stage	weekly	Written and formal	presentation and face to face interaction
Demonstration regarding bargaining power insurance	Project sponsor and marketing head	At the project initiation stage	monthly	verbal and formal	Direct team face to face meeting
Discussion about detail protective state regulations and policies	HR manager and marketing monthly team	planning and ongoing stages	weekly	formal	video and audio conference
Discussion on project status	project team and project leader	At the end of each project development stage	monthly	formal	Presentation and meeting

Besides developing the project communication plan the other aspects on which the team needs to focus on include utilizing accurate project communication channel and creating a communication office along with customer service bench. People who will are part of the service desk must interact with the patients and their families and ensure that all the raised queries are solved.  Open communication is the best way that must be used while interacting with each other. The HCHHA workplace must follow open communication because it gives equal interacting and participating opportunities to each team associates. In order to fulfill work activities open communication is the most applicable communication process. For this healthcare agency both the verbal and nonverbal communication approach are applicable.

Change management resistance plan

After analyzing the working scenario of Hillsboro County Home Health Agency, it has been determined that, the present status needs some changes. With the help of certain driving forces the organization can be improved or changed.  Kurt Lewin’s Force Field Analysis approach is applied to identify the current risks that require changes or modifications.   

Figure 1: Force field analysis result for HCHHA

(Source: created by author)

The obstacles that are required to be changed include: lack of necessary project resources, lack of technical aspects consideration and incorrect budget estimation. The driving forces that will help to develop the current status of the agency include proper project budget, implementation of childcare initiative plan, quality nursing.

Training plan

Currently the organization does not have any specific training and development program. Therefore, the strategic training and development plan that are applicable for this organization are as follows:

Organization of training seminars and workshops: Based on healthcare activities needful training and development program are required to be arranged and implemented.

Developing manual training: Success and failure of any organization is dependent on performance of each individual. After analyzing the performance of each participant periodic and manual training program has to be implemented by the project team leader.   

  Appointing training officer: The healthcare agency is needed to appoint skilled and experienced training officer who will give periodically training to the project team associates and team members. The training officer must have ability to lead the rest of the associates.

Incentives and celebration of successes

Reward is the best ways to keep all staffs engaged to assigned responsibilities.  The strategies that are implemented by the agency to celebrate the success are as follows:

Annual bonus: Once in a year, all the staffs are needed to be awarded with bonus amount. It will motivate each staff and make sure that the aim of the organization has been met.

1.5 additional payments on vacations and holidays: The staffs who will show interest working on holidays must be paid double than regular. Timely appraisal and reward will help to develop the working environment of the agency.   

Timeline/schedule of activities

The project will take 100 days for its successful accomplishment and the total expense that is estimated for the project is $150,000.

The project schedule is given below:

WBS	Task Name	Duration	Start	Finish	Resource Names	Cost
0	Schedule for strategic plan of HCHHA	100 days	Thu 9/26/19	Wed 2/12/20		$149,872.00
1	Developing project mission statement	5 days	Thu 9/26/19	Wed 10/2/19	Project lead	$3,280.00
2	Designing vision of the company	6 days	Thu 10/3/19	Thu 10/10/19	marketing head	$3,840.00
3	Analyzing current organizational status	2 days	Fri 10/11/19	Mon 10/14/19	operation head, finance lead	$2,560.00
4	developing improvement strategies	3 days	Tue 10/15/19	Thu 10/17/19	operation head, Project lead	$4,008.00
5	Roles and responsibility distribution	8 days	Tue 10/15/19	Thu 10/24/19	operation head	$5,440.00
6	Developing project steering committee	4 days	Fri 10/25/19	Wed 10/30/19	Project lead	$2,624.00
7	Developing legal plan	7 days	Thu 10/31/19	Fri 11/8/19	legal expert	$3,360.00
8	Developing management team	5 days	Mon 11/11/19	Fri 11/15/19	operation head	$3,400.00
9	Hiring technical experts	6 days	Mon 11/18/19	Mon 11/25/19	Project lead	$3,936.00
10	Homecare division development	19 days	Tue 11/26/19	Fri 12/20/19		$92,200.00
10.1	personal care service improvement plan	5 days	Tue 11/26/19	Mon 12/2/19	marketing head	$3,200.00
10.2	purchasing needful healthcare equipments	6 days	Tue 12/3/19	Tue 12/10/19	equipment cost[1]	$80,000.00
10.3	Arranging training for the staffs	8 days	Wed 12/11/19	Fri 12/20/19	Project lead	$5,248.00
10.4	Developing telehealth program	7 days	Wed 12/11/19	Thu 12/19/19	system designed	$3,752.00
11	Outlining E-healthcare system configuration	26 days	Fri 12/20/19	Fri 1/24/20		$16,824.00
11.1	database connectivity to the system	5 days	Mon 12/23/19	Fri 12/27/19	system developer	$2,800.00
11.2	Incorporating protection mechanism	9 days	Fri 12/20/19	Wed 1/1/20	system designed	$4,824.00
11.3	System simulation	9 days	Thu 1/2/20	Tue 1/14/20	system developer	$5,040.00
11.4	testing and debug	8 days	Wed 1/15/20	Fri 1/24/20	tester	$4,160.00
12	Interviewing nurses and physicians	8 days	Mon 1/27/20	Wed 2/5/20	marketing head	$5,120.00
13	handover the final project strategy	5 days	Thu 2/6/20	Wed 2/12/20	Project lead	$3,280.00

Figure 3: The project Work Breakdown Structure

(Source: created by author)

Budget for change management

In order to change existing budget structure of the organization the other aspects on which the company needs to focus on include:

Creation of control system:  The overall organizational healthcare process needs to be improved by implementation health data keeping system. The E-health record keeping system will control the access and ensure that no unwanted users are competent to fetch health related data from the server anytime.   

Collaboration with the finance officers: While allocating budget for individual activities, resources and purchasing healthcare equipments it is essential for the agency to collaborate with the finance officers. For successful implementation of the objectives partnership in sponsorship is very essential.

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