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Hospital Services of the Americas (fictitious) Developed by Dr….
Hospital Services of the Americas (fictitious) Developed by Dr. Donald V. McCain Hospital Services of the Americas (HSA), a for-profit organization, owns or manages 67 hospitals across North America. Their strategy has been growth through acquisition or a joint venture type of arrangement. Acquiring or managing as many as five and six new hospitals a year has left the organization with some significant internal issues. Their growth strategy has been used almost exclusively to any other form of corporate strategy. This has resulted in more of a short-term operational perspective and at the expense of any longterm corporate strategic plan for managed growth. As expenses have increased and revenues decline, the profit margins are being squeezed. The primary sources of revenue include: government Medicare/Medicaid programs (or similar for Canadian operations), insurance companies, the patients themselves, and management fees. There is some minor income from operations such as cafeterias, flower shops, etc. While the sources of revenue are known, due to changing costs, the actual contribution of each to the bottom line needs to be determined. The cumulative total returns for the last five years are declining at an increasing rate. At this time, senior management does not know if the hospitals owned or managed are providing the best performance. While layoffs appear to be the strategy to reduce costs, little attention has been given to growing the business, improving operations, or integrating systems across the chain of hospitals. Each hospital has its own internal financial reporting, standard operating procedures, and information systems. As a result, there is difficulty in gaining any economies of scale. The current ratio, operating profit margin, return on assets, debt ratio, and other major ratios when compared to the industry averages are mostly below industry averages. Recently, HSA has been significantly impacted by two external events. Covid-19 had a dramatic effect on the organization. The situation brought to light how inadequately prepared HSA was for this type of situation. There was a significant shortage of personal protection for the medical staff and ventilators for patients. Medical and support staff were called on to work very long hours under very stressful conditions. Essential services pay became an issue. This was across all of the operations. The relationships with suppliers were not strong enough for HSA to secure the needed supplies. As Covid-19 spread, there was a significant shortage of beds for the patients with no options to send patients to another one of their facilities. Just as HSA was recovering from the demands of Covid-19, they were hit with a ransomware cyber-attack on their computer network, forcing them to use their manual systems. Like many hospitals, HSA has lax cybersecurity controls, and the business of life and death is highly vulnerable to extortion. All of the major operating systems were impacted across the entire operation, including medical records and laboratory results, scheduling patient care, admissions, Copyright @ 2021, 2018 by Performance Advantage Group 2 and HSA patient portal. Doctors had to revert to documenting patient care on paper charts. Lab reports, X-ray images, and other information are still not flowing quickly, resulting in long waits for patients and for ambulance crews delivering patients with serious injuries. Some appointments and operations were postponed. Patients wanting medical records were told to mail inquires directly to HSA. Since all 67 hospitals are linked through a common network, all services were put on hold. The decision was made to not pay the $5.7 million dollar demand. Over two weeks later, most online systems were restored. With the headquarters in Dallas, Texas, the CEO is pretty autocratic and has a tendency to micromanage the hospitals as well as the headquarters’ operation. A culture of “management by fear and intimidation” may not be too much of a stretch to characterize his style. Due to this style, significant decisions at the hospital level must go up line for approval by headquarters. Hospitals’ senior management teams are reluctant to make decisions, fearing a backlash from the CEO. The philosophy of not managing local has resulted in increased expenses, lost opportunities, and lower morale. Since the president is modeling the autocratic style, the senior management in the hospitals is doing the same. There are significant issues among the chief nursing officer (CNO), the chief financial officer (CFO), and the chief executive officer (CEO). Most hospitals are in the process of combining the CFO’s responsibilities with that of a chief operating officer (COO). Not only is there a lack of teaming, but the relationships in some cases have become dysfunctional. This management style becomes apparent when trying to “lead” hospitals in other regions with unique situations and cultures. Headquarters and the hospitals are experiencing low morale and job satisfaction, reduced productivity, and high turnover. As the reputation is becoming tarnished, it is becoming increasingly difficult to hire and retain staff, especially nurses. Given the geographical dispersion of the hospitals, there is a vastly different clientele. In some rural areas of the US and Canada, there are significant differences between the needed care in the more remote areas than in the towns and cities. In addition, not all those needing medical services trust hospitals. In other cases, care is being provided to many who cannot afford to pay for services received. In larger cities, competition is significant. While competitor hospitals have highly recognized doctors, staff, and capabilities, HSA struggles to execute a marketing plan to position them against the competition and gain market share within these major cities. There is not a coherent and consistent message to the communities of how they want to be perceived -i.e., there is a lack of differentiation. Copyright @ 2021, 2018 by Performance Advantage Group 3 HSA is experiencing political and/or governmental pressure to provide services in these remote areas, even though they may be currently operating at a loss. For these areas, doctors are hard to find and retain
1) Develop a proposal for the Hospitals Services of the Americas based on your analysis. Please review the various models and processes and select one to provide the structure for your proposal. Discuss how you plan to price this project (method and amount) and support this with your rationale. You have completed your analysis for the Hospital Services of the Americas and are now ready to approach the client with a rundown of your services and provide, in writing, what you can do to assist your client. The proposal stage is a critical stage for a consultant as this will make or break whether or not you will get the contract/business. Moreover, having the right pricing structure will also play a major role in contract attainment.
Pricing Structure options (choose one):
Hourly Rate
Flat Rate or Project
Per Deim
Retainer
Scheduled Payment
2) Pick three management tools or methods for data gathering. Explain how you would apply them to this case. Based on your application, explain how this would have value to the client organization?
3) The Director of HSA wants to know how to address the many problems they are having and what process you would recommend. Apply ADKAR organizational change model to the HSA case study. Provide a step-by-step guide to how you will utilize ADKAR models and the expected results at each stage. Identify what actions you will take to embed the changes within HSA.
4) Develop and submit a written report of your findings and recommendations, including actions to ensure implementation. Then, present your findings and recommendations via a PowerPoint Presentation.
5) Develop an initial yet complete promotion plan for your company and your product/service offering for HSA. Include within the plan the objectives, channels of communication and frequency of use, promotional strategies, target audience, message and expected results for each target audience, budget, and measure of results/effectiveness. How will you modify your message for each target audience?
