2014 THE ADVISORY BOARD COMPANY ADVISORY.COM Womens Health Strategic Plan Template Marketing and Planning Leadership Council 2014 THE ADVISORY BOARD COMPANY ADVISORY.COM 2 Marketing and Planning Leadership Council Instructions How to use this template The Women's Health Strategic Plan Template assists you in developing a ready-to-present strategic plan that is goal-oriented, actionable, measurable and aligned with institution priorities. The template provides direction on key steps of the planning process: performance analysis, market assessment, strategic plan design, and plan evaluation. Review the available tools and exercises included in this document and add and remove slides to match the level of detail you need. The template is designed to be used as an active document across the life of the strategic plan. Progress on the plan can be continuously tracked using the scorecard provided and modifications can be made as needed. Templates for financial planning, implementation planning, and communication planning are also included. This template can be used for an individual hospital, service line or multihospital system service line. Throughout the template, institution is used to refer to either the hospital or the health system. The notes section of each slide describes the purpose of each component and provides instructions for the specific task to complete. Where appropriate, taking points and links to additional resources are provided to assist in the analysis. Further instructions appear on the slides as place holders and examples are provided throughout the template slides in italics. After completing the template, remove the Advisory Board slides (in red), and delete/replace all placeholder and sample text that appears on the slides to share the presentation with stakeholders. Marketing and Planning Leadership Council Women's Health Strategic Plan DATE VERSION (E.g., Draft, Final, Draft 3.0) Program/Department Name Add your institutions logo here 4 Road Map Strategic Plan Overview Volumes Patients Payers Payment Reform Employers Physicians Competitors Technology Regulatory Changes Goals & Objectives Initiative Design Initiative Prioritization Financial Summary Implementation Timeline Mission and Vision Program Benchmark Previous Strategic Plan Review Total Investment Summary Interdepartmental Support Performance Scorecard Communication Plan Additional Information CURRENT PERFORMANCE ANALYSIS FUTURE MARKET ASSESSMENT PLAN DESIGN PLAN SUMMARY 1234 5 Current Performance CURRENT PERFORMANCE FUTURE MARKET ASSESSMENT PLAN DESIGN PLAN SUMMARY 6 Current Performance Mission and Vision Institution Mission and Vision Describe your institution mission here. Women's Health Service Line Mission and Vision Describe your service line mission here. Current Performance Womens Health Program Benchmarks Contextualize Current Services Coordinating Existing Services Key to Creating a Comprehensive Womens Health Program Source: Service Line Strategy Advisor research and analysis. Progressive Intermediate Clinical OfferingsProgrammatic Infrastructure Womens Health Program Comparison Progressive Comprehensive Traditional Care Coordination/ Operations OB/GYN, MFM, urogynecology, gynecologic oncology, NICU, pediatrics, breast health, bone health, womens heart, womens GI, genetic counseling, fertility clinic, spa treatments, wellness and education OB/GYN, NICU, urogynecology, breast health, bone health, wellness and education Only obstetrics and gynecology included in service Administrative service line director for womens services Administrative service line director for womens services, and clinical leadership for OB/GYN, urogynecology, gynecologic oncology Clinical and administrative leadership for OB/GYN only Womens health navigator; womens health website helps direct patients to appropriate services; multiple services offered at once allowing women to complete yearly screens in one visit; system to track patient utilization of services and suggest annual visits Independently scheduled consultations and diagnostics; nurses assigned to labor and delivery, postpartum; little cross-training Cross-trained nurses for labor and nursery care; nurse navigator for breast center or oncology; centralized scheduling for breast health services but unlikely to include womens health Implications of womens health program benchmark: Describe impacts here 8 Current Performance Key Accomplishments 20XX-20XX GoalsInitiatives Accomplished or In Progress Increase Market Share Identify and promote services in secondary markets Expand referral networks in tertiary market Increase Clinical Quality Scores Streamline patient flow process to reduce wait time to consult Complete HCAHPS Maintain Margins Increase referrals Reduce cost of supplies Create programs to funnel patients into high-margin services Improve Care Coordination Streamline patient flow to eliminate fragmented care delivery Establish multidisciplinary case review meetings 20XX-20XX Strategic Plan Review 9 Current Performance Key Metrics 20XX-20XX 20XX-20XX Strategic Plan Review INCREASE SHAREIMPROVE QUALITYMAINTAIN MARGINS Describe factors/challenges that contributed to why you were not able to meet your target. Describe factors key to surpassing your target. Describe factors/challenges that contributed to why you were not able to meet your target. 10 Future Market Assessment CURRENT PERFORMANCE FUTURE MARKET ASSESSMENT PLAN DESIGN PLAN SUMMARY 11 Service Line Forecast Compendium Women's HealthInpatient 11 Source: Advisory Board Company Inpatient Market Estimators; Marketing and Planning Leadership Council research and analysis; Length of Stay Days Growth ProspectsQuality Metrics Market and Finances Delivery Antepartum/High Risk Pregnancies Hysterectomy Aging population is shifting demand towards midlife and geriatric life services, primarily in the OP setting Improved high risk pregnancy management reduces hospitalizations Laparoscopic and robotic technique shifting surgeries to OP setting Wide range of providers and system stakeholders seeking to lock patients into networks for ongoing management, intensifying competition for patient loyalty With tight hospital budgets, pulling form existing resources to launch a womens health program is an economical strategy for offering a new service Decline in birth rate reduces overall demand for IP labor and delivery services Lack of effective interventions to prevent prematurity continue to support NICU volumes Increasing number of women choose C-sections over vaginal delivery Payment reforms transfer focus from fee-for-service care to managing patient health across longer care episodes Profitability $2,950$3,335 Contribution profit per case GynecologyNeonatologyObstetrics $1,826 DemographicClinicalMarket Drivers/Barriers Estimated Growth Rate, Volume Mix Obstetrics Medical Gynecology Neonatology Surgical Gynecology Medicare Readmission Rate Medicare Preventable Admissions Medical Gynecology 24%0% Surgical Gynecology 7%0% 498K Gynecologic Surgery MFM General Gynecology Neonatology Gynecologic Oncology Obstetrics Urogynecology Breast Health 324K 61K 1.2M 67K 3.9M 596K 71K 2013 Volume 12 Service Line Forecast Compendium Women's HealthOutpatient Source: Advisory Board Company Outpatient Market Estimators; Marketing and Planning Leadership Council research and analysis; Growth Prospects Gyn Surg Outpatient Shift 2% Wide range of providers and system stakeholders seeking to lock patients into networks for ongoing management, intensifying competition for patient loyalty Application of robotics to gynecologic surgeries allow procedures to take place in OP setting Advances in clinical technology allow many OP procedures to be accomplished in physician offices Overall increasing trend towards minimally invasive procedures supports OP volumes Aging population and emphasis on preventative care shifts demand for womens services from labor and delivery to midlife and geriatric life services, such as womens heart and GI services Potential urogyn patients not seeking treatment due to embarrassment, lack of awareness Care Setting Changes With tight hospital budgets, pulling form existing resources to launch a womens health program is an economical strategy for offering a new service High consumer interest in genetic testing and IVF Many of the common GYN procedures can be done in the physician office, increasing competition for volumes Profitability $1,800$430 Contribution profit per case GynecologyObstetrics Market and Finances DemographicClinicalMarket Drivers/Barriers HOPD + Freestanding Estimated Growth Rate, Volume Mix Obstetrics General Gynecology Urogynecology Gynecologic Surgery Gyn Surg Outpatient Shift Gauge: As MIS Improves, Business Likely to Continue to Move Outpatient Inpatient Outpatient 2013 Volume REI Gynecologic Surgery General Gynecology Obstetrics 2.6M MFM Womens Imaging Urogynecology Breast Health Womens GI Womens Heart 10.2M 1.3M 36.5M 7.6M 40M 2.9M 1.5M 7.7M 1.3M 2K Gynecologic Oncology 13 Future Market Assessment Women's Health Patient Mix and Financial Contribution by Care Setting 2013 Outpatient Care Urogynecology Contribution Profit Per Case 2013 Inpatient Care Source Advisory Board Data and Analytics Group. Obstetrics Neonatology Urogynecology Gynecologic Surgery MFM Breast HealthGyn Onc General Gyn Neonatology Gynecologic Oncology Urogynecology Gynecologic Surgery General Gyn Breast Health Obstetrics MFM Volume Gynecologic Surgery Breast Health Urogynecology REI Obstetrics General Gyn Womens GI Womens Heart Womens Imaging MFM Volume Womens Heart Womens GI Womens Imaging Gyn OncObstetrics General Gyn MFM Breast Health Gyn Surg REI 14 Future Market Assessment Womens Health Projected Growth Rates By Care Setting Sources: Advisory Board Inpatient and Outpatient Market Estimators:. 5-Year Market Projections Inpatient 1% -6%-3% Outpatient 2%5%9% % 1%7%9% Highest Inpatient Growth SSL Strengths/ Weaknesses Breast HealthStrengths: Weaknesses: UrogynecologyStrengths: Weaknesses: Highest Outpatient Growth SSL Strengths/ Weaknesses Gynecologic Oncology Strengths: Weaknesses: Womens GIStrengths: Weaknesses: 9% 10%11%12%13%28% 5-Year Market Growth Rate 15 Future Market Assessment Market Forces Impacting Women's Health Services, Regulatory Changes E.g., Coverage expansion will shift the payer- mix to lean heavily on Medicaid patients. XXX Competitors E.g., Hospital Bs dedicated womens center facility and new DBT unit will make it difficult to compete for top talent, need to send clear messages to potential recruits of high-quality facilities at Hook XXX Physicians E.g. Maintain transparency throughout the womens outpatient service planning by presenting all groups with the option to participate and negotiating with physicians on which procedures they are willing to give up in their private offices XXX Employers E.g., Explore relationships with employers on providing fixed costs for womens health and wellness care for their employees XXX Payment Reform E.g., New payment models place risk on hospital for all care received, regardless of institution, as a result multiple points of contact are necessary to increase engagement overtime, such as community education and health screenings XXX Patients E.g.., The continued growth in midlife populations will provide an opportunity to partner with non-traditional service lines such as cardiology and gastroenterology by tailoring existing services to mid-aged women XXX Technology E.g., Evaluate technology investments on incremental volume and value-add potential XXX Payers E.g., Necessary to show how our program reduces overall cost of care for patients to remain provider of choice for payers under shift to value based care XXX 16 Future Market Assessment Patients: Geographic Distribution of Market by Region Patient Origin by Region Zip Code or County Region 1 Region 2 Region 3 Region 4 Potential Target Market Areas Implications of geographic distribution of patients across service area: Describe impacts here 17 Future Market Assessment Patients: Age Distribution Hook Hospital Patients, 2012 Percentage of Population by Age, 2012 Implications of shifts in age distribution on services: Comparison of Hook Patient Distribution to Current Region and Future Region Distribution Under 1818 to 4445 to 6465 and Over Describe impacts here Neverland County, 2012Hook Hospital Patients, 20XX Percentage of Population by Age, 20XX Neverland County, 20XX 18 Future Market Assessment Hook Hospital Patients, 2012 Describe impacts here E.g., Current payer mix at Hook does not reflect distribution at market level, need to attract patients with commercial payer insurance. Neverland County, 2012Hook Hospital Patients, 20XXNeverland County, 20XX MedicareMedicaidCommercialUninsuredOther Percentage of Population by Insurance, 2012 Percentage of Population by Insurance, 20XX Patients: Payer Mix Comparison of Hook Patient Distribution to Current Region and Future Region Distribution Implications of shifting payer mix: 19 Future Market Assessment Payers: Anticipated Changes in Reimbursement Models, Levels Payer StrategyDescription Narrow NetworkPayers X and Y E.g., Increase in narrow networks in market as two major institutions move towards ACO model. Readmission Penalties Implications of the shifts in payer strategy: Describe impacts here E.g., Necessary to show how our program reduces overall cost of care for women's health to remain provider of choice for payers. Key Hook Hospital Payers: X, Y, Z 20 Future Market Assessment Payment Reform Payment model under consideration by institution: Discuss the payment model(s) your hospital is moving towards here. E.g., Participating in Medicare Shared Savings Program. Implications of the shift in payment model: Implementation Actions : List steps the institution has taken towards implementing the new payment model. Patients and Services Affected: List patient groups and specific services that will be affected by this shift. Describe impacts here E.g., Keeping ACO patients out of ED and hospital essential to cutting costs; explore possibility of using nurse navigators to maintain relationships with patients post-care to promote care compliance. Hook Hospitals Payment Reform Strategy Impact on Women's Health Service Line 21 Future Market Assessment Employers: Anticipated Growth, Shifts in Payment Strategies Implications of the shifts in employer size, strategy: Describe impacts here E.g., E.g., Lily Manufacturing Co. represents viable, insured population; potential to build relationship with Lily to contract care for women's health patients. EmployerNumber of EmployeesAnticipated GrowthComments Lily Manufacturing Co.~1000~1100Self-insured; looking for partner for disease management program 22 Future Market Assessment Employed Physicians: Anticipated Changes in Staffing and Leadership Implications of physician employment trends: Describe impacts here E.g. Number of expected retirees will exacerbate current capacity issues; necessary to bolster recruitment efforts. Expected Retirees Estimating Physician Need New Recruits Needed 308 M322 M335 M US Population in Millions OB/GYNs per 100,000 People Source: US Department of Health and Human Services, The Physician Workforce: Projections and Research into Current Issues Affecting Supply and Demand, December Physicians Needed 23 Future Market Assessment Independent Physicians: Referral Planning Implications of physician referral trends: Describe impacts here E.g., Significant referral leakage to Hospital B will impact volumes, need to assess why physicians are choosing B over us. Hook Hospital Women's Health Referring Physicians and Practice Watch List Practice Watch List PracticeComments Tiger Medical Associates Although physicians at Tiger have had a long standing relationship with Hook, Crimson Market Advantage data shows significant referrals to Hospital B. 24 Future Market Assessment Competitors: Market Competition Assessment Name and DescriptionKey Areas of CompetitionNew Programs and FacilitiesRisk to Market Share Primary Competitors 1.Hospital A 2.Hospital B 1.Comprehensive pelvic floor and midlife program 2.One-stop-shop womens health center Secondary Competitors 1.Employer A Emerging Competitors 1. Implications of shifts in competitors growth efforts: Describe impacts here E.g., Hospital Bs updated facility and new equipment will make it difficult to compete for top talent, need to send clear messages to potential recruits of high-quality facilities at Hook. 25 Future Market Assessment Technology: Overview of Women's Health Technology Implications of technological changes: Describe how current technology capacity compares to the market and how this impacts the service line. Womens Services Technology Adoption Outlook Many Capital Technologies Restricted to Progressive Programs ModalityConservativeLate MajorityEarly MajorityEarly AdopterProgressive Obstetrics/ Maternal Fetal Medicine Gynecology and Womens Health Urogynecology Breast Imaging 2D US Amniocentesis Chorionic villus sampling Cordocentesis IVF 1 3D/4D US Hysterectomy Myomectomy UAE/UFE 5 GEA 4 MRgFUS 6 Robotic Surgery for Hysterectomy Permanent Birth Control Urodynamic Testing System Biofeedback TOT Sling Sacral Nerve Modulation POP Repair Kit Robotic Surgery for Sacrocolpopexy Pelvic Floor US Full-Field Digital Mammography Breast US Film Mammography Breast MRI (coil) MBI 7 Automated Breast US Breast Tomosynthesis PEM 8 Fetal MRI Fetal Surgery Fertility Preservation for ART 2 ECMO 3 Robotic Surgery for Myomectomy Womens Heart Program Womens GI Program Breast MRI (dedicated) Percutaneous Tibial Nerve Stimulation 26 Future Market Assessment Technology: New Technology Needs Novel Technology Upgrades Implications of technology needs on service line: Describe the impact here Additional Capacity for Existing Technology 27 Future Market Assessment Care Coordination: Performance and Needs Care Coordination Performance Assessment Strongly Disagree - Strongly Agree (0-10) Primary care providers receive patient discharge instructions from specialists8 Womens service line physicians and nurses are aware when their patients receive consultation or treatment from other providers practicing at our institution 4 Additional womens health appointments are scheduled for patients by administrators or nurse navigator 10 Medical staff can transfer and access up-to-date, accurate patient records from any department or facility9 Duplicative diagnostics do not occur across the womens program and in-network specialists or across service lines 6 Top 3 targets for improvement and implications: E.g. Our womens health navigator streamlines referrals and provides patients with a direct line of contact to other related departments (breast, cardiology, colorectal, radiology, health & wellness, etc.). This navigator has helped mitigate patient leakage by guiding patients through the entire care continuum at our health system. 28 Future Market Assessment Regulatory Impact RegulationImpact CMS physician supervision requirements for OP services Clinical trials coverage 29 Future Market Assessment Themes Emerging Across Future Market Assessment Top 5 Market & Industry Changes Affecting Service Line 30 Strategic Plan Design CURRENT PERFORMANCE ANALYSIS FUTURE MARKET ASSESSMENT PLAN DESIGN PLAN SUMMARY Strategic Plan Design Defining Terms Institution level goals that address broad strategic issues defined by the leadership such as growth, quality, patient satisfaction, physician alignment, financial health, etc. Goal Focused action items that meet a defined objective such as build a one-stop-shop womens health center, launch media campaign to promote urogynecology services, develop internal processes, etc. Program-specific, high level action items that address system level goals such as increase brand awareness, promote secondary market, increase technology utilization, etc. Grow Volumes Improve Patient Satisfaction Increase Market Share Improve Care Process Womens Health Center Pelvic Floor Program % Increase in Volumes % Increase in Patient Satisfaction % Increase in Primary and Secondary Market Share Decrease in Wait-time to Consult Number of Referrals Generated per Month Decrease in Patient Leakage 31 ObjectiveInitiative Definition Examples Sample Metrics 32 Strategic Plan Design Institution Level Goals & Women's Health Objectives ObjectiveInitiative Goal Grow Volumes Improve Patient Satisfaction Goal #3 Increase market share Capture latent demand Strengthen relationship with referring physicians Improve Care Processes Improve Outpatient Experience Improve Patient Engagement Goal #4Goal #5 Objective #1 Objective #2 Objective #3 Objective #1 Objective #2 Objective #3 Objective #1 Objective #2 Objective #3 Institution Goals Service Line Objectives 2014 THE ADVISORY BOARD COMPANY ADVISORY.COM 33 Marketing and Planning Leadership Council Strategic Plan Design Objective and Initiative Design Instructions The following section of the strategic plan template will assist you in designing, prioritizing, and planning initiatives that address measurable service line objectives. This section is organized by institution level goal. For each goal-based sub-section, add one slide for each objective outlined on the Institution Level Goals & Women's Health Objectives page. Then add one slide for each initiative that corresponds to the objective. For each institution level goal, you may have 1-3 objectives and for each objective, you may have several initiatives. Finally, for each sub-section, prioritize initiatives, summarize financial resources required, and provide a high-level implementation timeline. For example, a subsection might include the following slides There are three sets of strategic plan design slides in this template: (1)Blank Template Slidescopy and paste these slides as needed to complete your plan [Goal #X 6 Slides] (2)Sample Set 1examples of how the template might be completed [Grow Volumes 6 Slides] (3)Sample Set 2examples of how the template might be completed [Improve Patient Satisfaction 6 Slides] After completing the strategic plan design slides, delete the sample slides and blank slides. Marketing and Planning Leadership Council Goal #1: Grow Volume Objective #1: Increase Share Initiative #1: Build One-Stop-Shop Womens Center Initiative #2: Brand Existing Services as Womens (e.g. womens heart, womens GI etc.) Objective #2: Strengthen Referrals Initiative #1: Physician Survey Initiative #2: Revamp Physician Liaison Program Prioritization of Initiatives Related to Goal Financial Summary of Initiatives Related to Goal Implementation Timeline for Initiatives Related to Goal 34 Goal #X: Goal Strategic Plan Design 35 ObjectiveInitiativeGoal BARRIERS DRIVERS Internal External Describe internal drivers here Describe internal barriers hereDescribe external barriers here Describe external drivers here Goal #X: Goal Objective #X: Title 36 Goal #X: Goal Objective #X: Title Initiative #X: Title Description Initiative Progress MeasuresTargets Outcomes Metrics Process Metrics Resources Required Facilities: Equipment: Information Technology: Staff/Training: Marketing/Communications: Interdepartmental Coordination: Expected Cost: ObjectiveInitiativeGoal 37 Goal #X: Goal Initiatives to Goal Lowest PriorityHighest PrioritySecondary Priority Feasibility of Implementation Initiative 1 Initiative 2 Initiative 3 Initiative 4 Secondary Priority Low High Potential Impact on Goal Prioritization of Initiatives by Potential Impact and Feasibility ObjectiveInitiativeGoal 38 Goal #X: Goal Financial Summary Initiative Goal Investment Capital Investment Facilities Equipment Information Technology Subtotal Operating Investment Clinical Staff Training / Development Marketing and Communication Administrative Costs Subtotal Initiative Investment Investment Required for Initiatives to Goal ObjectiveInitiativeGoal 39 Goal #X: Goal Implementation Timeline InitiativeYR 1YR 2YR 3YR 4YR 5 Initiative #1 Initiative #2 Initiative #3 Initiative #4 Initiative #5 Initiative #6 Initiative #7 Initiative #8 Initiative #9 Initiative #10 Initiatives related to Goal 40 Goal #1: Grow Volumes Strategic Plan Design 41 Goal #1: Grow Volume Objective #1: E.g., Increase Market Share by % ObjectiveInitiativeGoal BARRIERS DRIVERS Internal External Strong referral protocols from employed physician practices Substantial marketing and advertising budget Lack of capacity in region 3 EMR integration behind that of competitors Competitor employing significant numbers of new physicians Competitor closing down facilities, scaling back on service offerings Currently unmet demand within the market 42 Goal #1: Grow Volume Objective #1: E.g., Increase Market Share by X% Initiative #1: One-Stop-Shop Womens Health Center One-stop-shop womens center is a comprehensive center in which patients can see multiple providers under one roof in a series of back- to-back appointments. To differentiate such a womens health center as being more than just a series of coordinated doctors visits, progressive institutions offer spa-like amenities and sessions with nontraditional providers. Most womens health centers offer: (1)Womens health screening exams (e.g. mammography, DEXA, urodynamics, etc.) (2)A direct line to specialists and assistance in appointment scheduling (3)Educational resources for patients and family members Initiative Progress MeasuresTargets Outcomes Metrics Public awareness of womens services 30% awareness Patient satisfaction 80% patient satisfaction Referrals generated 250 referrals/month Process Metrics Consults scheduled following screening exams 100 consults/ month Care coordination plan developed Resources Required Facilities: Dedicated on or off-campus womens health center facility. Equipment: Mammography, breast ultrasound, DEXA, urodynamics, breast biopsy equipment, perinatal testing etc. Information Technology: Ability to schedule appointments, and communicate with specialists. Staff: 8 FTEs and 2 part-time health educators Marketing/Communications: External and internal media campaign, marketing collateral for referring physicians and potential patients. Interdepartmental Coordination: Marketing, breast care, radiology, OB/GYN, cardiology, general surgery, urogynecology, REI, primary care, oncology. IT/IS, operations Expected Cost: $4,650,000 ObjectiveInitiativeGoal 43 Goal #1: Grow Volume Initiatives to Grow Volume Lowest PriorityHighest PrioritySecondary Priority Feasibility of Implementation Womens Health Center Initiative 4 Initiative 3 Initiative 1 Initiative 5 Initiative 6 Initiative 7 Secondary Priority Low High Potential Impact on Volume Prioritization of Initiatives by Potential Impact and Feasibility ObjectiveInitiativeGoal 44 Goal #1: Grow Volume Financial Summary Womens Health Center Goal Investment Capital Investment Facilities 3M Equipment 600K Information Technology 200K Subtotal 3.8M Operating Investment Clinical Staff 800K Training / Development 4K Marketing and Communication 40K Administrative Costs 4K Subtotal 848K Initiative Investment 4.65M Investment Required for Initiatives to Grow Volume ObjectiveInitiativeGoal 45 Goal #1: Grow Volume Implementation Timeline InitiativeYR 1YR 2YR 3YR 4YR 5 Womens Health Center Initiative #2 Initiative #3 Initiative #4 Initiative #5 Initiative #6 Initiative #7 Initiative #8 Initiative #9 Initiative #10 ObjectiveInitiativeGoal Initiatives Related to Growing Volume 46 Goal #2: Improve Patient Satisfaction Strategic Plan Design 47 Goal #2: Improve Patient Satisfaction Objective #1: Improve Care Process ObjectiveInitiativeGoal 47 BARRIERS DRIVERS Internal External New womens health scheduling line Dedicated womens health nurse navigator Only 50% of physician practices on EMR Lack of effective means for communication between various womens health specialty departments (breast, OB/GYN, cardiology, general surgery, etc.) Physician shortage resulting in long wait times; physician recruitment highly competitive Local payers not yet reimbursing for alternative visits types such as e-visits, phone visits Patient population well-educated and health literate, comfortable with new care models Local payers beginning to reimburse for care coordination efforts 48 Goal #2: Improve Patient Satisfaction Objective #1: Improve Care Processes Initiative #1: Patient Flow Assessment A 4-person, multidisciplinary task force will design and conduct patient flow assessment to identify areas to streamline patient visits. The team will be responsible for: (1)Identify issues in care flow affecting patient satisfaction. (2)Prioritize top 3-5 opportunities (3)Develop plan for implementing redesigned care process. Initiative Progress MeasuresTarget Outcomes Metrics Number of coordinated appointments Increase by 30% Total appointment duration Reduce by 50% Patient satisfaction on care coordination Increase by 25% Process Metrics Key stakeholders identified and feedback collected Key areas of improvement identified Care redesign plan developed and approved by leadership Resources Required Facilities: N/A Equipment: N/A Information Technology: N/A Staff/Training: Training for staff on new care process. Details TBD pending completion of assessment and process review. Marketing/Communications: Internal education campaign to implement new care process. Details TBD pending completion of assessment and process review. Interdepartmental Coordination: Interview stakeholders from related service lines. Engage marketing to conduct focus groups and assist with collecting patient satisfaction survey data. Expected Cost: $75,000 ObjectiveInitiativeGoal 49 Goal #2: Improve Patient Satisfaction Initiatives to Improve Patient Satisfaction Lowest PriorityHighest PrioritySecondary Priority Feasibility of Implementation Patient Flow Assessment Initiative 2 Initiative 3 Initiative 4 Initiative 5 Initiative 6 Initiative 7 Secondary Priority Low High Potential Impact on Patient Satisfaction Prioritization of Initiatives by Potential Impact and Feasibility ObjectiveInitiativeGoal 50 Goal #2: Improve Patient Satisfaction Financial Summary Patient Flow Assessment Goal Investment Capital Investment Facilities 0 Equipment 0 Information Technology 0 Subtotal 0 Operating Investment Clinical Staff 0 Training / Development 30,000 Marketing and Communication 15,000 Administrative Costs 30,000 Subtotal 75,000 Initiative Investment $75,000 Investment Required for Initiatives to Improve Patient Satisfaction ObjectiveInitiativeGoal 51 Goal #2: Improve Patient Satisfaction Implementation Timeline InitiativeYR 1YR 2YR 3YR 4YR 5 Patient Flow Assessment Initiative #2 Initiative #3 Initiative #4 Initiative #5 Initiative #6 Initiative #7 Initiative #8 Initiative #9 Initiative #10 Initiatives related to Improve Patient Satisfaction 52 Strategic Plan Summary CURRENT PERFORMANCE ANALYSIS FUTURE MARKET ASSESSMENT PLAN DESIGN PLAN SUMMARY 53 Plan Summary Total Investment Required for Strategic Initiatives, 20XX-20XX Grow Volume Patient Satisfaction QualityGoal XGoal Z Capital Investment Facilities Equipment Information Technology Subtotal Operating Investment Clinical Staff Training / Development Marketing and Communications Administrative Costs Subtotal Total Goal Investment Total Plan Investment : 54 Plan Summary Interdepartmental Support Required for Strategic Initiatives, 20XX-20XX MarketingRadiology Goal #3 Department XXX E.g., Collaborate around breast screening and patient pathway to oncology services.. Department #4 Department #5 XXX 55 Performance Scorecard GoalObjectiveOwner Status of Related Initiatives Metric Value at Plan Launch (Insert Date) Current Value (insert Date) Target Value (Insert Date) Grow Volume Increase Market Share by X% Dr. Pan, Administrator, SL Primary Market Share Secondary Market Share Capture Latent Demand for X Service Mary Markets, Asst. Director, Marketing Volume, Service X Referrals, Service X Physician Awareness, Service X Patient Satisfaction Improve Patient Care Process Stephanie Egan, Care Manager Patient satisfaction scores Patient wait times On TrackMinor SetbacksMajor Setbacks Strategic Plan Summary 56 Communication Plan: Key Messages and Communication Tactics Plan Summary StakeholderLevel of DetailKey MessagesCommunication Tactics Board of DirectorsHigh Level SummaryService objectives and expected outcomes Memo System LeadershipOverview of Objectives, Targets and Summary of Initiatives Objectives and expected outcomes Necessary Resources Persons Accountable Initial kickoff presentation. Interim progress meetings to review status and discuss changes. Service Line StaffDetailed action plan on initiatives and progress metrics. Objectives and expected outcomes Initiatives & Implementation Timeline Roles/Responsibilities Weekly meetings during 3 month launch. Monthly post launch. Referring Independent Physicians High level summary of initiatives Expected improvements in care delivery, quality, and efficiency Impact on relationship, workflow Discussion with physicians during visits with liaisons. Marketing collateral highlighting improvements in service. 57 Communication Plan: Strategies to Address Potential Concerns Plan Summary StakeholderPotential ConcernsStrategies to Address ConcernsSpokesperson(s) Board of Directors N/ACEO System Leadership Cost of new equipmentIllustrate patient need and potential for competitive advantage Service Line Director & Strategic Planning Officer Service Line Staff Noncompliance with new care processes Provide kick-off and ongoing training Initiative Owners Incentivize increases in patient satisfaction scores Service Line Director Referring Independent Physicians Lack of awareness of increases in quality Provide routine updates to physician liaisons on quality improvements Physician Liaisons 58 Defining Womens Health 59 Gender Based Medicine Research Points to Key Differences in Women Source: Service Line Strategy Advisor research and analysis; Women and Men: 10 Differences that Make a Difference SWHR, available at:(accessed September 21, 2011); Service Line Strategy Advisor research and analysis. Identifying Differences in Womens Health Womens Health Programs Specialize in Gender-Specific Health Issues Disease/DisorderDifferences Present Between Men and Women Heart Disease Heart disease kills 50,000 more women than men annually Women are more likely than men to have a second heart attack within in the first year Heart disease strikes women 10 years later than men Depression Women are 2 to 3 times more likely to suffer depression Women are most vulnerable to depression during hormonal transitions (i.e. puberty, pregnancy, and menopause) Osteoporosis80 percent of osteoporosis sufferers are women Autoimmune Disease 3 out of 4 autoimmune disease patients are women Autoimmune disease is the fourth largest cause of disability among women Stroke40,000 more women than men suffer a stroke each year Smoking Smoking has a more negative effect heart health in women than men Women are less successful at quitting smoking and have more severe withdrawal symptoms Womens Health Services Catering to Different Stages of Life Allows Targeted Approach to Womens Competitive Programs Pushing the Full Care Continuum Source: Service Line Strategy Advisor research and analysis. Services Required by Women at Each Life Stage Finding the Right Niche for Womens Health Center Program 75 and older Infancy and Childhood Pediatric and Adolescent Care Gynecologic Health (including office visits, screening exams) Sexual Health Obstetrical Care Breast Health (including mammography) Urogynecology (incontinence, pelvic health) Osteoporosis Screening Digestive Health (colorectal screening) Heart Health (screening and wellness programs) Infertility Services VP, Business Development/Womens Service Line Leader Pediatrics Maternity Care Inpatient Obstetrics General Obstetrics and Gynecology Breast Health and Imaging Surgical Gynecology Pelvic Floor Services Womens Urology Gynecologic Oncology Midlife Screenings Womens Heart Womens GI Womens and Childrens Service Line Structure Building an Effective, Tangible Service Line Starts with Organizational Structure Definition of Womens Health Service Line Extends Beyond Ob and Gyn Visualizing the Womens and Childrens Service Line Traditional Service Line Comprehensive Service Line Progressive Service Line Whether or not pediatrics is included in the Womens Service Line depends on the strategic goals and level of care of the institution. Source: Service Line Strategy Advisor research and analysis. These services typically report to the women's service line leader through a matrix reporting structure. Models of Womens Health Programs Models of Womens Health Programs Differ in Comprehensiveness, Centralization Example Models of Womens Health Programs by Comprehensiveness, Ease of Implementation Source: Service Line Strategy Advisor research and analysis Co-located providers at either an on-campus or off-campus facility Appointments booked either independently or with assistance from a clinical coordinator Emphasis on branding womens health center important to make the services more than just a building Multiple, coordinated appointments with physicians in the same facility, on-campus or off One stop shop day clinic differentiates itself from simply co-locating providers by seamlessly integrating appointments Novel offerings include spa-like amenities and architecture, resource library, health coach Program Comprehensiveness Most services housed under non-womens outpatient clinics Procedures, consults coordinated by nurse navigators or dedicated schedulers, who may also be involved in patient education Allows hospitals a low- cost option to provide womens services and minimize duplication Requires increased marketing efforts to brand womens services Virtual Womens Health Program Co-Located Providers One-Stop Shop Day Health Center Ease of Implementation Gateway Provider Single provider conducts initial patient education assessments Refers patients to specialists as appropriate Often an OB/GYN, nurse, or nurse practitioner with interest in womens health care Using a midlevel provider eliminates turf wars, accusations of playing favorites Decentralized ModelsSingle-Site Models 2011 THE ADVISORY BOARD COMPANY ADVISORY.COM 2445 M Street NW I Washington DC P I F advisory.com