Running head: STRATEGIC PLAN 1

Surgery Service Line: Orthopedic- Hip and Knee Program

Team B

Paula Grundy

Amy Toman

Simonette Elgert

Brook Grzadinski

Jenna Godfryd

A project submitted in partial fulfillment of the

Requirements for the degree

Masters of Leadership

Siena Heights University

May 18, 2013

STRATEGIC PLAN 2

Background and Overview

Today, health care organizations are strategic in their planning, marketing and product

development. They collaborate with others to bring the newest technology together in specialized

areas in an attempt to capture the competition in their geographical areas. Companies also

examine how they can increase satisfaction scores while enhancing quality improvement. St.

John Hospital is one of those establishments. It was a small organization that was initiated by the

Sisters of St. Joseph and was once a 250 bed facility that employed 70 associates. It has grown to

5,036 employees and has a 1300 member medical staff. The organization is also one of the

nation’s top 100 hospitals including one of the top 15 teaching hospitals. St. John Hospital has

many specialties including cardiovascular services, physical therapy programs and a newly

developed orthopedic program. They have incorporated strategic thinking, strategic planning and

strategic momentum the major components of strategic management in many of their specialty

areas. The development of a strategic plan for the surgery service line for the orthopedic hip and

knee program is critical for success and necessary if the organization is to capture the

competitive market.

According to the Centers for Disease Control and Prevention there are 51.4

million inpatient surgeries done each year. Included in those surgeries are 719,000 knee surgeries

and 332,000 hip surgeries (Center for Disease Control, 2013, p. 1). This is a significant amount

of surgeries and one could project that this number will increase in future years; it has been

projected that by the year 2040 there will be over 80 million elderly in the United States alone.

This data supports the assumption that the increase in the elderly population will increase hip and

STRATEGIC PLAN 3

knee surgeries. The data also suggest that people are choosing to have this type of surgery

because it improves quality of life and risks although still present are small in comparison to

other type of surgeries. The use of current technology and equipment that lower length of stay is

also an important factor. This type of environmental analysis is difficult but it is the framework

in which St. John Hospital has chosen to develop its Hip and Knee program.

Directional Strategies

Directional Strategies are important in any organization as they help to guide an

organization as it grows and develops by providing guidelines to navigate the way business is

conducted. According to Swayne, Duncan, and Ginter (2008) directional strategies are found in

the organization’s mission, vision, and values statements. The mission statement should provide

the reason an organization exists. A vision statement provides a look into the future of where the

organization would like to be in the long run. According to Spallina (2004) the vision should also

be marketable and the basis for the strategic plan. While the values “are the principals that are

held dear by members of the organization” (Swayne, Duncan, and Ginter, 2008, pg 161).

Together these directional strategies, if used correctly, can build a foundation which can set an

organization ahead of the competition.

The mission statement of St. John Hospital and Medical Center states: “St. John

Providence Health System, as a Catholic health ministry, is committed to providing spiritually

centered, holistic care which sustains and improves the health of individuals in the communities

we serve, with special attention to the poor and vulnerable” (www.stjohnprovidence.org).

According to Swayne, Duncan, and Ginter (2008, pg 169) a mission statement should contain six

components. These are their target customers, principal services delivered, the geographical area

STRATEGIC PLAN 4

that services are to be delivered, specific values, explicit philosophy, and what makes a company

different from its competitors. The only item that is missing is the geographical area. Therefore,

the mission statement should be: St. John Providence Health System, as a Catholic health

ministry, is committed to providing spiritually centered, holistic care which sustains and

improves the health of individuals in southeastern Michigan, with special attention to the poor

and vulnerable.

The vision statement of St. John Providence states: Together, we deliver the highest

quality patient care experience, every day, everywhere, for everyone

(www.stjohnprovidence.org). Swayne, Duncan, and Ginter (2008) state that the vision statement

should be unique, idealistic, futuristic, and imagery; the vision of St. John Providence is simple,

direct, and has all the components of a vision statement.

Value statements should be unique and show the principles that an organization holds

valuable to accomplish its mission and vision. The value statement of St. John Providence is:

We are called to:

Service of the Poor –  Generosity of spirit, especially for persons most in need

Reverence –  Respect and compassion for the dignity and diversity of life

Integrity –  Inspiring trust through personal leadership

Wisdom – Integrating excellence and stewardship

Creativity – Courageous innovation

Dedication – Affirming the hope and joy of our ministry (www.stjohnprovidence.org)

The values of St. John Providence are powerful and show what the company stands for and

believes in.

STRATEGIC PLAN 5

Swayne, Duncan, and Ginter (2008) state that after an organization has established its

mission, vision, and values, the next step is to establish the goals that will fulfill the mission and

vision. The goals for the hip and knee program at St. John Hospital are to decrease length of stay,

increase patient and physician satisfaction, decreasing readmission rates, improve the discharge

planning process with proper placement and equipment, quality improvement in the orthopedic

service line, and improvement in market strategies/plans to gain a competitive edge. These goals

will help to lead this program into the future.

External Environmental Analysis

The external environment surrounding a health care organization plays a significant role

not only in the care delivery but in the success of the organization as well. Each health care

organization is trying to position itself to become the leader in the industry. In order to attain

such position, health care organizations are constantly trying to develop their strategic

management such as strategic thinking and planning.

“To be successful, health care organization leaders must have an understanding of the

external environment in which they operate” (Swayne, Duncan & Ginter, 2008, p. 37). It is

important for leaders to be proactive rather than reactive. “One has to make the organization

capable of anticipating a storm, weathering it, and in fact, being ahead of it” (p. 37). There are

different external issues health care organizations are facing:

a. Legislative/Political

b. Economic Changes

c. Social/Demographic Changes

STRATEGIC PLAN 6

d. Technological Changes

e. Competitive Changes

f. Regulatory Changes

The utmost issue in the industry is the increasing cost of healthcare and the decreasing

cost of reimbursement from different payers. There is also rising number of the uninsured. The

national and the global economic downturn affected much of the different industries including

health care. According to the U.S. Census Bureau, as of October 2012, 16.3% of the U.S.

populations are without health insurance, 1.8% of which are over 65 (www.statisticbrain.com).

Because of these, hospitals face the greatest financial challenge, as they have to shoulder the

expenses incurred by patients with no insurance coverage. Although the mission of St. John

Hospital and Medical Center (SJHMC) is to improve the health of patients with attention given

to the poor and vulnerable, to care for the uninsured remains to be a financial burden for the

organization. The hospital must be creative in their strategic move to recoup its losses from

different areas of the operation.

Hip and knee replacements are surgical procedures mostly availed by patients over 60 to

increase their quality of life by relieving arthritis pain and improving mobility. In general, both

procedures are done on an elective basis after other alternatives have failed. Patients over the age

of 60, usually has healthcare coverage through the Medicare/Medicaid programs. SJHMC

recently renovated the orthopedic floor in order to increase marketability of the service line.

What the hospital need is to improve their marketing techniques in order to remain competitive.

As stated earlier, the service line has an underdeveloped marketing and advertising strategy.

Successful marketing of the service line also has the potential to increase the number of cases

STRATEGIC PLAN 7

that are being performed in the hospital. Increased surgical volume will help the hospital stay in

the competition. It will also assist the hospital with revenue increase.

Another challenge as outlined above is Technological Changes. There is a rapid increase

in advancement with technology. In order to maintain not just the competitive edge, but also the

improved delivery of health care in general, it is imperative for the industry to keep abreast on all

the latest innovation. A technological advancement identified for the hip and knee service line is

the acquisition of Makoplasty, a robotic device that assists physicians with the surgical delivery

(Grundy, Interview Reflection, 2013, p. 3). Though probably not the very latest, acquiring the

piece of equipment could bring increased surgeon satisfaction, better surgical outcomes and

marketing. Another identified need for the service line is the upgrade from Quadruple Aims

Model to C-Aims, a software tool that assist in identifying the effectiveness of strategy by

measuring outcomes such as patient and physician satisfaction, quality outcomes, and cost. But

there is no capital budget to purchase the upgrades and acquisition, putting us behind from the

rest of the competitors (Grundy Interview Reflection, 2013, p. 4).

Based on some of the information gathered from the service line consultant, Mike

Badali, the hip and knee service line at SJHMC is far from being competitive and is behind in

innovation. The drivers of the service line has good grasp of the hospital’s position in the market.

It appears that there has been work done around environmental and SWOT analysis. They have

good handle of the external market updates. They are knowledgeable of operating inhibitors and

the opportunities to improve the service line. The availability of the capital dollars appears to be

inhibiting then from moving up. Instead of increasing external marketing and advertising, the

department took a different approach to market their services. The hip and knee service line

chose the “focused factory approach”, optimizing the patient and family experience through a

STRATEGIC PLAN 8

seamless process from the time they hit pre-surgical screening to their discharge from the

hospital and beyond (post-hospitalization follow-up). The department improved the joint camp

program, made improvements to the physical look of the unit (spa, gym) and added extra

services such as nail and hair services and massage with the goal to improve patient experience

and increase patient satisfaction. While they are focused on improving the internal environment,

the external approach is in a reactionary mode. The department acknowledged the fact that one

of our weakness points is the integration of operational strategies and implementation.

The orthopedic service line is the fastest growing product for inpatient and outpatient

services. A 17% increase is predicted by the year 2021. (Grundy, Interview Reflection, 2013, p.

3). In order for this service line to do well, it is imperative for SJHMC to sustain its program and

stay in the competition.

Service Area Competitor Analysis

The system service area in which St. John Hospital is drawing most of its population is

St. Clair, Macomb, Oakland, Wayne, Lapeer, Genesee, Livingston, and Washtenaw. The east

region planning zone includes St. Clair, South Central Macomb, Northern Macomb, Lakefront

and Detroit East. The Providence Region which includes the Providence Hospital Medical

Center Zones includes Southfield Zone, East Oakland Zone, Detroit Zone, North Wayne Zone,

Western Edge Zone, and North Oakland Zone. The Providence Park zones include the Western

Zone, Central Zone and the Southwestern Zone. The population in this area are as follows;

Macomb County (849,649), Oakland County (1,225,333), Wayne County (1,820,650), St. Clair

Shores (160, 182), Lapeer County ( 1,225,333), Livingston (183,113), Genesee (436,144), and

Washtenaw County (352,102) these numbers were estimated for the year 2012 (Semcog, 2014).

STRATEGIC PLAN 9

This service area was identified because of its location to the St. John Providence Health

Systems and the competitors were determined based on the location, population and service

brand of the orthopedic field.

The competitors that have been identified are Beaumont Hospital in Troy and St. Joseph

Mercy Oakland Hospital. The statistics gathered from these health systems support them being

prime competitors. In 2011 Beaumont completed 375 hip replacements and 790 knee

replacements in comparison St. Joseph Mercy Oakland completed 937 knee replacements and

326 hip replacements which place both systems above St. John Hospital who only completed

500. Unfortunately, when it comes to the marketing strategies most of our promotions are done

in the same locations and are minimal in comparison (Healthgrade, 2014). St. John Health

System advertises through local news letters and offer teaching sessions that are taught by our

physicians. The competitors advertise by newspaper, television media and bill boards. So,

Marketing is a strength that is identified with both competitors. Another strength is associated

with the service line is that they advertise themselves as being pioneers in patient safety, patient

satisfaction and service excellence. They also have joint replacement excellence awards and

orthopedic surgery excellence awards. The St. John system has processes that are also focused on

patient satisfaction this includes offering private rooms, conducting hourly rounds, bedside

reporting and specialty services which are not offered at the other facilities, but one of our

weaknesses is that we have not perfected those services as of yet. St. John Hospital has been

identified as a center for excellence.

As mentioned the marketing of the competitors does put them ahead when it comes to

healthcare services and they also have perfected their service when it comes to patient

satisfaction. Offering services that even by word of mouth is beyond other health care facilities

STRATEGIC PLAN 10

makes them unique and desirable. Another strategy that is used is the aggressiveness of

promotions on specialized care. St. Joseph Mercy Hospital logo is remarkable medicine,

remarkable care they recognize their doctors as being recognized leaders in health care. They

also have to their credit 85 years of servicing the community and they pride themselves on being

a teaching hospital. Beaumont Hospital is also aggressive in the area of promotion they promote

themselves as having the best doctors and they pride themselves on housing physicians and

private practices which lead to great hospital services and are recognized as the nation’s leading

institutions.

Upon completion of this analysis it was noted that St. John Hospital is behind on its

strategic planning objectives. As a system the marketing strategies need to be implemented and

the services need to be perfected across the continuum. St. John Hospital does have services that

are unique to specific services lines thus has the potential to lead the competitive market. Based

on the above findings the system needs to analyze its current strategic plan and enhance it

according to the strengths and weaknesses of our competitor. St. John Hospital has the potential

of leading the market for the orthopedic service line and with diligence and hard work this could

be our future.

Internal Environment Analysis

Service Delivery

Point-of-service is the activities that take place once the patient arrives for services

(Swayne, Duncan, & Ginter, 2008).The point-of-service at SJH&MC for the elective hip and

knee surgeries starts on a scheduled day where the patient comes in as expected and gets

registered in same day surgery. The patient is then transported to the pre-operative area and is

STRATEGIC PLAN 11

prepped for surgery. Once out of the operating room the patient is placed in recovery. Recovery

room time is only a few hours post operatively then the patient is moved to the orthopedic unit to

where they continue recovering. Once on the unit the patient is cared for by a support team

consisting of nurses, nurse assistants, physical therapy, occupational therapy, social worker, case

manager, orthopedic technician and the orthopedic physician assistant. The patient’s focus on the

orthopedic unit is mobility, functionality, and pain control. The support team works with

patient’s in the room and in the gym located on the unit. The patients are equipped with the

necessary tools and equipment to be successful upon discharge.

Point-of-service Strengths Point-of- service Weaknesses The location of registration on day of

surgery is conveniently located right off entrance.

There is no delay from registration to pre-operative location.

The orthopedic unit is located in a modern area of the hospital and the area is clean in appearance.

The patient rooms are all private. The rooms are equipped with a flat screen television. There is room for a family member to spend the night.

The support team are highly trained individuals specialized in orthopedic surgeries.

There is a brand new gym with state of the art equipment located on the unit for patients to rehabilitate.

Patients receive workout clothes to wear at the gym.

Spa services free of charge are offered to the patients. Services include hair salon, nail salon and massage therapy.

Coming through same day surgery first before going to pre-operative area.

Parking is not close to entry where patients go to same day surgery.

Same day surgery is outdated in appearance compared to the orthopedic unit.

The orthopedic unit struggles to maintain satisfactory patient experience scores.

The orthopedic unit had challenges with nurse turnover and retention.

Patients are asked to give a personal history including review of their medications before and after surgery.

Orthopedic services are not recognized as a center of excellence.

STRATEGIC PLAN 12

Competitive relevance of the strengths of SJH&MC elective hip and knee surgeries

Point of service strengths Is the value of the strength high or low?

Is the strength rare?

Is the strength easy or difficult to imitate?

Can the strength be sustained?

The location of registration on day of surgery is conveniently located right off entrance.

There is no delay from registration to pre-operative location.

The orthopedic unit is located in a modern area of the hospital and the area is clean in appearance.

The patient rooms are all private. The rooms are equipped with a flat screen television. There is room for a family member to spend the night.

The support team are highly trained individuals specialized in orthopedic surgeries.

There is a brand new gym with state of the art equipment located on the unit for patients to rehabilitate.

Patients receive workout clothes to wear at the gym.

Spa services free of charge are offered to the patients. Services include hair salon, nail salon and massage therapy.

H

H

H

H

H

H

L

H

N

N

N

N

N

Y

N

Y

E

E

E

E

E

E

E

D

N

N

Y

Y

N

Y

N

Y

STRATEGIC PLAN 13

Competitive relevance of the weaknesses of SJH&MC elective hip and knee surgeries

Point of service weaknesses Is the value of the weakness high or low?

Is the weakness common among competitors?

Is the weakness easy or difficult to correct?

Can competitors sustain their advantage?

Coming through same day surgery first before going to pre-operative area.

Parking is not close to entry where patients go to same day surgery.

Same day surgery is outdated in appearance compared to the orthopedic unit.

The orthopedic unit struggles to maintain satisfactory patient experience scores.

The orthopedic unit had challenges with nurse turnover and retention.

Patients are asked to give a personal history including review of their medications before and after surgery.

Orthopedic services are not recognized as a center of excellence.

L

H

L

H

H

L

H

Y

Y

Y

N

N

N

N

E

D

E

E

E

D

E

Y

Y

Y

Y

Y

Y

Y

STRATEGIC PLAN 14

Based on the evaluation of the strengths and weaknesses above one could say that the

elective hip and knee surgeries at SJH&MC has no competitive advantages. SJH&MC is valued

in its image and free spa services but they do not sustain a rare or imitability of services among

its competitors.

Strategy Formulation/Evaluation

Overview

Strategic management of health care organizations a difficult task, but it is an essential

process. The initial component is to generate strategic goals from the mission, vision and values

of the organization. This allows for direction and ensures a link between the organization and the

goals which makes it easier for the managers to create momentum and the associates to

formulate buy in. Once the strategic goals are established the governing board will be able to

meet and frame directional strategies (Swayne, et, al. 2008) According to Swayne, Duncan and

Ginter the work of boards of directors is extremely important. Boards are created to ensure that

strategic leaders have additional expertise available to them for making policy decisions that

provide direction to the organization. The effectiveness of the board is key factor in the

effectiveness of the organization ( p. 187). Directional strategies are the guidelines used by the

organization to state what the organization should be doing and how they should be achieving

their goals. Once the directional strategies have been develop a comprehensive strategic thinking

map of hierarchy decisions and alternatives should also be developed this assist managers to

work through other strategic decisions as they emerge (p. 200). These alternatives include

adaptive strategies, market entry strategies, competitive strategies and implementation strategies

(p.201). This allows the organization to modify the strategies as scenarios emerge. Once the

STRATEGIC PLAN 15

strategies have been initiated the organization needs a process in which they can evaluate

whether the strategies are working. The health care team in charge of decision making must

understand the internal and external environments and methods for evaluating strategies this is a

fundamental for strategic management. There are several frameworks that can be used but the

organization must be able to replace or modify a coherent and integrated alternative. Next,

strategies and their impact on the organization will be discussed in detail.

Adaptive Strategies

The hip and knee program is a relatively new program at St. John Hospital and Medical

Center. The services have recently expanded with the opening of joint camp and the Valade gym,

educational center, and spa. The direction of this service has become well established and has

just finished its growth stages. At this point, the adaptive strategy that should be used is the

maintenance of scope strategies with a focus of enhancement. According to Swayne, Duncan,

and Ginter (2008) maintenance of scope strategy is used when a past strategy has been successful

and little change is needed. This is usually completed by process improvements, increasing the

quality of the service, decreasing cost, and increasing clinical results.

One of the evaluation methods that can be used to evaluate the adaptive strategy of

maintenance of scope is the TOWS approach. The TOWS approach analyses the organizations

strengths and weaknesses and compares them to the external opportunities and threats. The hip

and knee program at St. John Hospital has become successful due to increased physician support,

a new facility with a gym, educational center, and spa, a dedicated operating room, exceptional

nursing care, and excellent clinical results. The weakness of the hip and knee program includes a

lack of marketing/advertising as an orthopedic center of excellence. There is a market for this

STRATEGIC PLAN 16

service in the area. As the population lives longer, active lifestyles there will be an increase need

for joint replacement. The competitors in the area already have marketing strategies that draw in

the patients to their programs. This may be an area that St. John Hospital may want to explore as

a means of enhancing this program.

The second evaluation method that can be used to evaluate maintenance of scope is

through the strategic position and action evaluation (SPACE) analysis. Swayne, Duncan, and

Ginter (2008) state that this analysis “is used to determine the appropriate strategic posture of the

organization” (pg. 258). The hip and knee program at St. John Hospital falls into a conservative

posture. At this time with the opening of the Valade gym, educational center, and spa along with

significant physician support will give the hip and knee program a competitive edge over the

competition and help to gain patients that would choose this facility. This fits with the

enhancement strategy of maintenance because this program needs to make small improvements

to gain an even more competitive advantage. Most patients who elect to have knee or hip

replacement surgery are covered by insurance which can bring a profit to the hospital. Therefore,

working toward increasing patient outcomes, decreasing cost, increasing patient and physician

satisfaction, and keeping these patients within St. John Hospital can increase this competitive

advantage.

Market - Entry Strategy

To remain viable in the healthcare industry, different strategies must be used in order to gain

grasp of the competition. “There are many strategic alternatives available to a health care organization

and a particular organization may pursue several different types of strategies simultaneously or

sequentially (Swayne, Duncan & Ginter, 2008, p. 197). One type of strategy is called “adaptive strategy”.

STRATEGIC PLAN 17

This strategy provides the primary methods for achieving the vision and it determine and specify the

scope of the organization (p. 200). Another type is called the “market entry strategy”. It is the means for

accomplishing the adaptive strategy. Together, they shape the health care landscape. (p. 227).

The adaptive strategy identified as appropriate to be used in the orthopedic service line at St. John

Hospital and Medical Center (SJHMC) specifically the hip and knee program is Maintenance of Scope

with focus on enhancements. As stated earlier, the realization of this strategy is by process improvements,

increase quality and clinical results and decrease cost. The means to evaluate maintenance of scope is by

analysis of threats, opportunities, weaknesses, and strengths (TOWS) and strategic position and action

evaluation (SPACE) approach.

In order to accomplish the above adaptive strategy, it must be linked to a market-entry strategy

type. In the case of SJHMC’s hip and knee program, after learning of their processes and position in the

market, the use of reconfiguring the value chain strategy seems appropriate and fitting. This strategy is

best accomplished by changing the sequence of activities they perform, thus changing the value that is

delivered to the customer. The hip and knee program started its reconfiguration work recently with the

renovation of the unit with the addition of the spa and gym, provision of all private rooms and value

added services such as hair and nail services and massage. In order to optimize the patient experience, the

whole process from admission to discharge was revisited, non-value added encounters were eliminated

and the process was made leaner. This strategy seems to take the program to the right direction. Increased

improvement with marketing and advertising will definitely have an added impact to the success of the

program.

To determine whether St. John Hospital and Medical Center puts patients and families first in the

delivery of their care, the evaluation exercise on page 313 was completed. The mode of delivery of

services and programs that we currently offer at SJHMC is aligned with the hospital’s mission, vision,

STRATEGIC PLAN 18

and values. It is patient and family centered. All internal and external resources and strategies are being

utilized and maintained to a higher level to achieve the goal for the department.

Given that the program is unable to obtain capital dollars for acquisition of new surgical

equipment and computer software, it is best for the department to stay on course with the maintenance

and reconfiguration strategy. The team needs to continue their work on partnering with the physicians to

increase referrals and improving the overall patient experience.

(-6 worst, -1 best)

-3 Market share-2 Product quality-3 Product life cycle-3 Product replacement cycle-3 Customer/patient loyalty-3 Competition’s capacity utilization-2 Technological know-how

(+1 worst, +6 best)

2 Growth potential2 Profit potential3 Financial stability4 Technological know-how5 Resource Utilization3 Capital intensity4 Ease of entry into market3 Productivity, capacity utilization

STRATEGIC PLAN 19

Average 2.7 -6= -3.3 Average = 3.25

Financial Strength Environmental Stability(+1 worst, +6 best)

2 Return on investment2 Leverage3 Liquidity2 Capital required/available2 Cash flow3 Ease of exit from market3 Risk involved in business

Average= 2.43

(-6 worst, -1 best)

-3 Technological changes-3 Rate of inflation-3 Demand variability-2 Price range of competing services-5 Barriers to entry into market-5 Competitive pressure-3 Price elasticity of demand

Average 3.43 -6= -2.6Strategic Posture

Strategic position and action evaluation factors

Space Matrix

STRATEGIC PLAN 20

The factors indicated above identify elective hip and knee surgeries at SJH&MC as a

conservative posture. The conservative posture suggests that the organization is in a stable

market but with low growth. It also indicates that the focus of the organization is on financial

stability. The critical factor is the lack of competitiveness in the market.

Strategic Position.

STRATEGIC PLAN 21

Orthopedic surgery has escaped the focus as an identified center for excellence, which

currently focuses on heart and vascular care, oncology, weight management and neuroscience

despite the opportunities in this market. The number of Medicare patients treated for major joint

replacement (DRG469 and DRG 470) at St. John Hospital and Medical was 222 patients during

October 2010 through September 2011. Henry Ford Hospital treated 156 patients and Beaumont

Royal Oak treated 1,173 patients (www.medicare.gov). There is significant opportunity for

improvement in the acquisition and retention of patient at the organization. Since the addition of

the spa and gym, the physical environment and added amenities are comparable, if not superior,

to the competitors. The organization needs to take a more competitive position. The marketing

and advertising aspect for the program is severely underdeveloped due to financial constraints.

The orthopedic physicians have affiliations with multiple hospitals in the area, so loyalties are

fragmented. The focus, at the present time, needs to be improving the customer and physician

satisfaction and loyalty. Although orthopedic surgery may be necessary as a result of trauma,

most joint replacements are considered an elective surgery. The consumer may have the time

and resources to research their options and discuss the options with their physician of choice.

The organization need to help the consumer realize that despite the uncertain economic times in

healthcare, the commitment to safe, reliable health care remains constant.

Upon comparing customer satisfaction scores via Hospital Compare

(www.medicare.gov), SJH&MC satisfaction score are comparable to Henry Ford Health System

and Beaumont Health System with the exception of cleanliness in which SJH&MC lags behind.

Despite the similarities in overall satisfaction scores, only 69% of the patient treated at SJH&MC

would recommend the hospital, whereas 72% of the patients at Beaumont hospital would

STRATEGIC PLAN 22

recommend the hospital. Although, this information is not at the unit level, it would be the

information that the consumer can freely access and potential use to make their hospital choice.

The customer needs to be the primary focus. Although, large advertising campaigns are

not financially supported, there are opportunities through community events and groups to

promote the services at the organization and bring people into the institution. Senior community

centers churches and senior living communities are a great place to hold lectures and educational

programs. Also, partnering with physicians on these ventures will encourage the choosing of the

hospital. One would be remiss not to assess the nursing care of the orthopedic population which

can tie into physician satisfaction. Increasing the nursing satisfaction would potentially decrease

the turnover of staff. Ensuring long term staff also helps to forge partnerships with physician.

Nursing certification in orthopedic nursing would validate that the nurses on that unit are experts

in the area of orthopedics. Certification is also a necessary component in the Magnet journey.

As previously stated, the patient satisfactions are comparable among the competitor

hospital. The organization needs to ensure that the patients are well cared for, even outside the

walls of the hospital. Currently, a program is in place to ensure new prescriptions are delivered

to the patient’s room prior to discharge. Potential initiatives could be follow up phone calls from

the units, ensuring follow up appointments are scheduled prior to discharge. The process from

admission needs to be seamless, with mapped processes, to ensure that every customer has the

best possible experience and outcomes.

Summary and Conclusion

Addendum A

STRATEGIC PLAN 23

Mission: St. John Providence Health System, as a Catholic health ministry, is committed to providing spiritually centered, holistic care which sustains and improves the health of individuals in the communities we serve, with special attention to the poor and vulnerable.

Vision: Together, we deliver the highest quality patient care experience, every day, everywhere, for everyone (www.stjohnprovidence.org)

 

Service line: Orthopedic Surgery

Parent (Hospital) Strategic Goal

Service line

Critical Success Factor

Service Line Strategy

Measure/Target Tactical/Action Plan

Maintain and enhance the hip and knee program

Product competitiveness

Adaptive Strategy Increase utilization of spa services by 5% over last fiscal year

Improve patient satisfaction scores by 5% over last fiscal year

Promote ancillary services at pre-surgical education session and book appointments

Initiate purposeful hourly rounding

Partner with housekeeping to keep environment clean

Utilize holistic modalities (aromatherapy, music therapy) to enhance pain

STRATEGIC PLAN 24

control

Promote spa services throughout hospital stay

Home care representative to meet patient in hospital and advise on home care process

Reconfiguring the value chain strategy

Ability to serve market at lowest cost structure

 Market Strategy Revisit the pre-admission to discharge process and eliminate non-value added encounters

Increase the market share in hip and knee population through advertising

Positive word of mouth advertising

 Market Strategy Participate in a minimum of 5 community each yearly

Nursing staff and/or physician to provide community education opportunities

Publish items related to ortho services in local community papers or church flyers

Increase staff participation at

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community events (Arthritis Walks, Senior expos) and have promotional material for distribution

Identify as a Center of Excellence

Financial strength

Competitive Strategy

Obtain orthopedic certification for hospital program

Greater than 50% of staff RN have bachelor’s degree or greater

Increase the number of certified RN by 10% each year

Continue to utilize technologically advanced equipment and evidence based practice

Ensure physician and staff are educated and utilizing best practices

Offer incentive to nurses for obtaining orthopedic certification

 

Conclusion

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St. John Hospital and Medical has the framework to become a leader in the market of hip

and knee surgery but currently lags behind its competitors. We must take a more competitive

position to ensure viability of the program. The plan should focus on improving the currently

process and positive word of mouth advertising given the lack of advertising funding. The

increase in patient and physician satisfaction along with quality improvements of the service line

will draw positive attention to the service line. As the organization gains more of the market

share, the revenue will naturally increase. The increase in revenue can be reinvested into the

program allowing the current services to be maintained and additional services to be offered.

STRATEGIC PLAN 27

STRATEGIC PLAN 28

Strategic Plan