Marketing and Planning Leadership Council Orthopedics Strategic Plan

Marketing and Planning Leadership Council Orthopedics Strategic Plan

Marketing and Planning Leadership Council Orthopedics Strategic Plan Template 2012 THE ADVISORY BOARD COMPANY ADVISORY.COM Marketing and Planning Leadership Council Instructions How to use this template The orthopedics Strategic Plan Template assists you in developing a ready-to-present strategic plan that is goaloriented, 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, 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 2012 THE ADVISORY BOARD COMPANY ADVISORY.COM 2 LOGO Program/Department Name Add your institutions logo here

Orthopedics Strategic Plan DATE VERSION (E.g., Draft, Final, Draft 3.0) Road Map Strategic Plan Overview 1 CURRENT PERFORMANCE ANALYSIS 2 3 FUTURE MARKET ASSESSMENT PLAN DESIGN 4 PLAN SUMMARY Mission and Vision Volumes Goals & Objectives Total Investment Summary Previous Strategic Plan Review Patients Initiative Design Interdepartmental Support Payers

Initiative Prioritization Performance Scorecard Payment Reform Financial Summary Communication Plan Employers Implementation Timeline Physicians Competitors Technology Regulatory Changes 4 Current Performance CURRENT PERFORMANCE FUTURE MARKET ASSESSMENT PLAN DESIGN 5 PLAN SUMMARY Current Performance Mission and Vision Institution Mission and Vision Describe your institution mission here. Orthopedics Service Line Mission and Vision

Describe your service line mission here. 6 Current Performance Key Accomplishments 20XX-20XX 20XX-20XX Strategic Plan Review Goals Initiatives 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 for top 3 high-margin services Reduce cost of supplies 7 Current Performance Key Metrics 20XX-20XX 20XX-20XX Strategic Plan Review INCREASE SHARE

IMPROVE QUALITY Market Share: Primary Market MAINTAIN MARGINS Wait Time to Consult (In Days) 40% Service Line Margin 1.4% 8 28% 4 1.2% 20XX Plan Target Current Describe factors/challenges that contributed to why you were not able to meet your target. 20XX Plan Target Current Describe factors key to surpassing your target. 8 20XX Plan Target

Current Describe factors/challenges that contributed to why you were not able to meet your target. Future Market Assessment CURRENT PERFORMANCE FUTURE MARKET ASSESSMENT PLAN DESIGN 9 PLAN SUMMARY Marketing and Planning Leadership Council Service Line Forecast Compendium OrthopedicsInpatient Inpatient Volume 2012 Service Line Snap Shot 2012 Volume 2.5M 2.4M Volume Estimated Growth Rate, 2012-2017 18% Multiple Major Joint Procedures Inpatient Total: 2.4M

10% General Medical Orthopedics Profitability (Per Case Contribution Profit) Orthopedics : $4K Efficiency (ALOS) 2012 Orthopedics: 4.3 days +5% Quality 8% 1.1M Revision of Joint Replacement 8% 91K 5% Other Surgical Orthopedics Orthopedics: Readmission Rate 11% Preventable Admission 0% Volume Mix Joint Replacement 51% Other Surgical Ortho 2%

5% 6% Hand and Foot 7% Surgical Trauma 1% 169K Surgical Trauma (Orthopedics) -1% 542K Foot Procedures -1% 24K Sports Medicine -1% 146K Hand Procedures -5% 21K Medical Ortho Medical Trauma 22% Drivers/Barriers Demographic Increasingly elderly, obese population to drive

joint replacement, fracture volumes Expanding joint Clinical replacement therapy to younger, older, sicker patients Surgeon preference continuing to shift sports medicine cases to ambulatory settings Increasing number of previous joint replacement patients and survivorship of patients increases revisions Technical advancements allow for earlier intervention with partial joint replacement Poor economic conditions reducing ability to pay, willingness to undergo elective therapy Increasing activity rates lead to increased joint replacement and sports med volumes Technology advances allowing procedures to migrate to outpatient setting Scrutiny of appropriateness to restrain some volume growth Use of regional anesthesia and aggressive rehab programs enabling joint replacement to shift outpatient Osteoporosis screening and prevention reducing acute episodes Fill in here 2011 THE ADVISORY BOARD COMPANY ADVISORY.COM 123K Medical Trauma (Orthopedics) Sports Med

7% General 172K Major Joint Replacement 2017 5-Year Growth: 41K Market Marketing and Planning Leadership Council Service Line Forecast Compendium OrthopedicsOutpatient HOPD Volume 2012 Service Line Snap Shot Volume Estimated Growth Rate, 2012-2017 6.0M 5.8M 2012 Volume Market Volume: 31.2 M Total Hip Arthroplasty (THA) Unicompartmental Knee Arthroplasty (UKA) HOPD Volume: 5.8M Outmigration (5-year growth) Market: 15% 2012

HOPD: 4% 5-Year Growth: 5% HOPD Volume Mix Fracture/Dislocation 11.90% 22.92% Sports Medicine 12.52% 13.53% Foot General Surgical Ortho Hand Drivers/Barriers 10K 344K Shoulder Arthroscopy 3% 200K Splint Application 3% 726K Fracture Treatment

-3% 882K Knee Meniscus Repair 3% 572K Increasingly elderly, obese population to drive joint replacement, fracture volumes Clinical Minimally invasive, unicompartmental knee enabling outpatient shift Baby Boomer awareness, preference for treatment of pain increasing Increasing activity rates lead to increased joint replacement and sports med volumes Expanding joint replacement therapy to younger, older, sicker patients Market Lower (or negative) outpatient contribution profit limits willingness to perform outpatient joint replacement Older, sicker patients require inpatient admissions Expanding use of arthroscopy to treat joint pain Scrutiny of appropriateness to restrain some volume growth Fill in here

Growing preference for conservative care slows growth of surgical therapies Growing number of ASCs competing for HOPD cases 1 14K 5% Demographic 2011 THE ADVISORY BOARD COMPANY ADVISORY.COM 19K Carpal Tunnel Release Joint Replacement 0.88% 38.26% 7K 89% Shoulder Arthroplasty Orthopedics: $ 486 237% 127% Hip Arthroscopy Profitability (Per Case Contribution Profit) 4K 142%

Total Knee Arthroplasty (TKA) 2017 239% Contribution profit for joint replacement procedures performed in HOPD settings is negative. Future Market Assessment Orthopedics Patient Mix and Financial Contribution by Care Setting Inpatient Care Contribution Profit Volume Other Surgical Ortho 1.85% Hand and Foot 50.75% Joint Replacement Joint Replacement 5.06% 6.02% Sports Med 7.08% General Medical Ortho 6.96% 22.28% Medical Trauma 47.23% Other Surgical Ortho 7.78%

17.86% 5.74% 2.64% 17.86% 0.89% Hand and Foot Sports Med General Medical Ortho Medical Trauma Surgical Trauma Surgical Trauma Hospital Outpatient Department Volume Contribution Profit Joint Replacement 0.88% Fracture/Dislocation Foot 38.26% 11.90% 22.92% Sports Medicine 12.52% 13.53% Hand Foot $614 M $222 M

$503 M $1.7 B General Surgical Ortho General Surgical Ortho Sports Medicine Fracture/Dislocation $484 M Joint$701 M Replacement Hand 12 Source Advisory Board Data and Analytics Group. Future Market Assessment Market Forces Impacting Orthopedics Services, 2011-2016 Patients 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 E.g. ., Structure pre- and post-operative patient education to reinforce expectations for surgery and involve family members in pre-discharge rehabilitation XXX Regulatory Changes Payment Reform

E.g., Orthopedics quality performance scrutinized under Value Based Purchasing XXX XXX E.g., Will need to extend care across the care continuum by standardizing the approach to consultation, pre-operative education and pain management XXX Technology Employers E.g., Consolidation of vendors and devices to manage down costs of implants E.g., Explore relationships with employers on bundled payments for joint replacement surgeries for employees XXX XXX Competitors Physicians 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. XXX E.g., Explore co-management arrangements with specialists to align with system initiatives and cost control efforts XXX 13

Future Market Assessment Patients: Estimated Prevalence of Chronic Disease Utilization of Orthopedic Services by Patients with Rheumatoid Arthritis/Osteoarthritis Subservice Line General Medical Orthopedics Hand Joint Replacement Medical Trauma Other Surgical Orthopedics Sport Medicine Surgical Trauma Total Volume 177,845 21,620 1,031,257 192,366 133,586 152,549 551,082 Condition Volume 21,788 1,476 673,066 25,603 12,853 18,789 57,967 Percent of Total 12% 7% 65% 13% 10% 12% 11% Implications of prevalence of chronic condition on utilization of services Describe impacts here

E.g., The continued growth in prevalence of osteoarthritis/rheumatoid arthritis will increase the demand for orthopedic services, especially for joint replacement. 14 Future Market Assessment Patients: Geographic Distribution of Market by Region Potential Target Market Areas Patient Origin by Region Zip Code or County Region 4 40.00% Region 1 15.00% 20.00% Region 3 25.00% Implications of geographic distribution of patients across service area: Describe impacts here 15 Region 2 Future Market Assessment Patients: Age Distribution Comparison of Hook Patient Distribution to Current Region and Future Region Distribution Percentage of Population by Age, 2012 Hook Hospital Patients, 2012 Percentage of Population by Age, 20XX Neverland County, 2012 Hook Hospital Patients, 20XX 14.70% 5.80% 14.70%

5.80% 23.80% 26.02% Neverland County, 20XX 28.62% 23.80% 26.02% 28.62% 26.20% 26.20% 35.30% 35.30% 39.57% 39.57% Under 18 18 to 44 45 to 64 Implications of shifts in age distribution on services: Describe impacts here 16 65 and Over Future Market Assessment Patients: Payer Mix Comparison of Hook Patient Distribution to Current Region and Future Region Distribution Percentage of Population by Insurance, 2012 Hook Hospital Patients, 2012

Percentage of Population by Insurance, 20XX Neverland County, 2012 Hook Hospital Patients, 20XX Neverland County, 20XX 2.00% 14.00% 10.00% 4.00% 9.00% 5.80% 24.00% 11.00% 28.62% 35.00% 4.00%5.00% 26.02% 34.00% 30.00% 42.00% 39.57% 30.00% Medicare Medicaid Commercial Uninsured

46.00% Other Implications of shifting payer mix: 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. 17 Future Market Assessment Payers: Anticipated Changes in Reimbursement Models, Levels Key Hook Hospital Payers: X, Y, Z Payer Strategy Description Narrow NetworkPayers X and Y E.g., Increase in narrow networks in market as two major institutions move towards ACO model. Bundled payments Implications of the shifts in payer strategy: Describe impacts here E.g., Necessary to show how our program reduces overall cost of care for Orthopedics patients to remain provider of choice for payers. 18 Future Market Assessment Payment Reform Hook Hospitals Payment Reform Strategy Impact on Orthopedics Service Line 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. Implementation Actions : Patients and Services Affected: List steps the institution has taken towards implementing the new

payment model. List patient groups and specific services that will be affected by this shift. Implications of the shift in payment model: Describe impacts here E.g., Restricting surgeries to only the most appropriate cases to avoid overutilization of surgical procedures. 19 Future Market Assessment Employers: Anticipated Growth, Shifts in Payment Strategies Employer Number of Employees Anticipated Growth Comments Lily Manufacturing Co. ~1000 ~1100 Self-insured; looking into bundled payments for high-cost procedures 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 Orthopedics patients. 20 Future Market Assessment Employed Physicians: Anticipated Changes in Staffing and Leadership Orthopedic Surgeon Supply Forecast 2010-20201

Estimating Physician Need 21870 21740 21710 2010 2015 Physicians Needed 2020 US Population in Millions 308 M 322 M 335 M Orthopod/ 100,000 People 7.1 6.8 6.5 Expected Retirees New Recruits Needed US Department of Health and Human Services, The Physician Workforce: Projections and Research into Current Issues Affecting Supply and Demand , December 2008. 1 Implications of physician employment trends:

Describe impacts here E.g. Number of expected retirees will exacerbate current capacity issues; necessary to bolster recruitment efforts. 21 Future Market Assessment Independent Physicians: Referral Planning Hook Hospital Orthopedics Referring Physicians and Practice Watch List Current Market Referral Patterns Loyal Referrers Split Referrers Practice Watch List Disloyal Practice Tiger Medical Associates 30.00% 40.00% Comments Although physicians at Tiger have had a long standing relationship with Hook, Crimson Market Advantage data shows significant referrals to Hospital B. 30.00% 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. 22 Future Market Assessment Building Referral Relationships in Orthopedics Top Referring Specialties to Orthopedic Surgery1

N = 253,000 Patient Records Other 1.45% General Surgery 1.62% Pain Management 1.63% Physical Therapy Emergency Medicine 3.05% Internal Medicine & 72.97% General Practice 4.11% 15.16% Podiatry 1 Excludes those patients referred by orthopedic surgery pr with no referral specialty named. Implications of referral sources: Discuss implication of referral distribution amongst physicians and specialists Primary care physicians (PCPs) drive the largest share of referrals to the orthopedic specialty. Podiatrists, however, may be an underserved referral source. 23 Future Market Assessment Competitors: Market Competition Assessment Name and Description Key Areas of Competition New Programs and Facilities Risk to Market Share Primary Competitors 1. Hospital A

2. Hospital B 1. Recently developed a total joint center of excellence 2. New outpatient Orthopedics surgery 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. 24 Future Market Assessment Technology: Overview of Orthopedics &Spine Technology Implications of technological changes: Describe how current technology capacity compares to the market and how this impacts the service line. 25 Future Market Assessment Technology: New Technology Needs Novel Technology Upgrades Additional Capacity for Existing Technology Implications of technology needs on service line: Describe the impact here 26 Future Market Assessment

Regulatory Impact Regulation Potential readmission penalties Impact Heightened scrutiny on long term outcome tracking capabilities 27 Future Market Assessment Themes Emerging Across Future Market Assessment Top 5 Market & Industry Changes Affecting Service Line 1 2 3 4 5 28 Strategic Plan Design CURRENT PERFORMANCE ANALYSIS FUTURE MARKET ASSESSMENT PLAN DESIGN 29 PLAN SUMMARY

Strategic Plan Design Defining Terms Initiative Institution level goals that address broad strategic issues defined by the leadership such as growth, quality, patient satisfaction, physician alignment, financial health, etc. Program-specific, high level action items that address system level goals such as increase brand awareness, promote secondary market, increase technology utilization, etc. Focused action items that meet a defined objective such as implement 24/7 patient information hotline, launch media campaign to promote service, develop internal processes, etc. Grow Volumes Improve Patient Satisfaction Increase Market Share Improve Care Process Specialist Consult Hotline Patient Flow Assessment % 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 Total Appointment Duration Sample Metrics Definition Objective Examples Goal 30 Strategic Plan Design Institution Goals Institution Level Goals & Orthopedics Objectives Grow Volumes Service Line Objectives Increase market share Capture latent demand Improve Patient Satisfaction Improve Care Initiative Goal #4 Goal #5 Objective #1

Objective #1 Objective #1 Objective #2 Objective #2 Objective #2 Objective #3 Objective #3 Objective #3 Processes Improve Outpatient Strengthen referring Objective Goal #3 Experience relationship with Goal Improve Patient Engagement physicians 31 Strategic Plan Design Objective and Initiative Design Instructions Marketing and Planning Leadership Council

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 & Orthopedics 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 Goal #1: Grow Volume Objective #1: Increase Share Initiative #1: 24/7 Specialist Consult Line Initiative #2: Host Educational Seminars for At-Risk Individuals (Golfers. Skiers, Tennis Players, 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 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 2012 THE ADVISORY BOARD COMPANY ADVISORY.COM 32 Strategic Plan Design Goal #X: Goal 33 Goal #X: Goal Objective #X: Title

Goal Metric Title Objective Metric Title 40% 40% 28% 28% Current Target Current Target DRIVERS Internal External Describe internal drivers here Describe external drivers here BARRIERS Internal External Describe internal barriers here 34

Describe external barriers here Initiative Goal #X: Goal Objective #X: Title Goal Objective Resources Required Initiative #X: Title Facilities: Description Equipment: Information Technology: Staff/Training: Initiative Progress Measures Targets Marketing/Communications: Outcomes Metrics Interdepartmental Coordination: Expected Cost: Process Metrics 35 Initiative Goal #X: Goal Initiatives to Goal

Goal Objective Initiative Prioritization of Initiatives by Potential Impact and Feasibility Secondary Priority Highest Priority High Potential Impact on Goal Low Lowest Priority Low High Feasibility of Implementation Initiative 1 Initiative 2 Initiative 3 Initiative 4 36 Secondary Priority Goal #X: Goal Financial Summary Goal Objective Initiative

Investment Required for Initiatives to Goal Initiative 1 2 3 4 5 Capital Investment Facilities Equipment Information Technology Subtotal Operating Investment Clinical Staff Training / Development Marketing and Communication Administrative Costs Subtotal Initiative Investment 37 6 7 8 Goal Investment Goal #X: Goal Implementation Timeline Initiatives related to Goal

Initiative YR 1 YR 2 Initiative #1 Initiative #2 Initiative #3 Initiative #4 Initiative #5 Initiative #6 Initiative #7 Initiative #8 Initiative #9 Initiative #10 38 YR 3 YR 4 YR 5 Strategic Plan Design Goal #1: Grow Volumes 39 Goal #1: Grow Volume Objective #1: E.g., Increase Market Share by % Goal Market Share: Primary Market Objective Initiative Market Share: Secondary Market

40% 40% 28% 28% Current Target Current Target DRIVERS Internal External Strong referral protocols from employed physician practices Substantial marketing and advertising budget Competitor closing down facilities, scaling back on service offerings Currently unmet demand within the market BARRIERS Internal External Lack of capacity in region 3 EMR integration behind that of competitors

40 Competitor employing significant numbers of new physicians Goal #1: Grow Volume Objective #1: E.g., Increase Market Share by X% Goal Objective Initiative Resources Required Initiative #1: Specialist Consult Hotline A specialist consult hotline will operate during business hours to provide patients and potential new patients with phone consultations with trained specialists. Hotline operators will: Facilities: Small office or desk space in or near Orthopedics department (1) Answer general questions about Orthopedics-related services and health concerns. (2) Direct potential patients to specialists and assist in appointment scheduling. (3) Answer questions if a patients specialist is not reachable. (4) Direct callers to education resources for patients and family members. Equipment: Phones, computers, office supplies Initiative Progress Measures Outcomes Metrics Public awareness of specialty services 30% awareness

Caller satisfaction 80% caller satisfaction Referrals generated Call Volume/Calls Answered Process Metrics Targets Wait-time to answer 250 referrals/month 500 calls/month 4 minutes 41 Information Technology: Software for logging/tracking call information and collecting data, ability to schedule appointments, and communicate with specialists. Staff/Training: 1 FTE and 2 part-time. Training on call process and resources for education. Marketing/Communications: External media campaign, marketing collateral for referring physicians and potential patients. Interdepartmental Coordination: Marketing, outpatient primary care, IT/IS, operations Expected Cost: $200,000 Goal #1: Grow Volume Initiatives to Grow Volume Goal Objective

Initiative Prioritization of Initiatives by Potential Impact and Feasibility Secondary Priority Highest Priority High Initiative 6 Initiative 4 Initiative 2 Initiative 3 Potential Impact on Volume Initiative 5 Specialist Consult Line Initiative 7 Low Lowest Priority Low High Feasibility of Implementation 42 Secondary Priority Goal #1: Grow Volume Financial Summary Goal Objective

Initiative Investment Required for Initiatives to Grow Volume Specialist Consult Line 2 3 4 Capital Investment Facilities 3,000 Equipment 3,000 Information Technology 90,000 Subtotal 96,000 Operating Investment Clinical Staff 90,000 Training / Development 2,000 Marketing and Communication 10,000

Administrative Costs 2,000 Subtotal 104,000 Initiative Investment 200,000 43 5 6 7 8 Goal Investment Goal #1: Grow Volume Implementation Timeline Goal Objective Initiative Initiatives Related to Growing Volume Initiative YR 1 YR 2 Specialist Consult Hotline

Initiative #2 Initiative #3 Initiative #4 Initiative #5 Initiative #6 Initiative #7 Initiative #8 Initiative #9 Initiative #10 44 YR 3 YR 4 YR 5 Strategic Plan Design Goal #2: Improve Patient Satisfaction 45 Goal #2: Improve Patient Satisfaction Objective #1: Improve Care Process 15 Goal Wait-Time to Consult (in days) Objective Initiative Total Appointment Duration (in hours) 3 6

Current 1 Target Current Target DRIVERS Internal External New phone triage and scheduling line Wait times now posted online Patient population well-educated and health literate, comfortable with new care models Local payers beginning to reimburse for care coordination efforts BARRIERS Internal External Only 50% of physician practices on EMR Lack of effective means for communication between hospital departments 46 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 Goal #2: Improve Patient Satisfaction Objective #1: Improve Care Processes Goal Objective Initiative Resources Required 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: Facilities: N/A (1) Identify issues in care flow affecting patient satisfaction. (2) Prioritize top 3-5 opportunities (3) Develop plan for implementing redesigned care process. Equipment: N/A Information Technology: N/A Initiative Progress Measures Outcomes Metrics Process Metrics Target Patient wait times Reduce by 30%

Total appointment duration Reduce by 50% Patient satisfaction on wait times Increase by 25% 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. Key stakeholders identified and feedback collected Interdepartmental Coordination: Interview stakeholders from related service lines. Engage marketing to conduct focus groups and assist with collecting patient satisfaction survey data. Key areas of improvement identified Expected Cost: $75,000 Care redesign plan developed and approved by leadership 47 Goal #2: Improve Patient Satisfaction Initiatives to Improve Patient Satisfaction Goal Objective Initiative

Prioritization of Initiatives by Potential Impact and Feasibility Secondary Priority Highest Priority High Initiative 6 Patient Flow Assessment Potential Impact on Patient Satisfaction Initiative 2 Initiative 3 Initiative 5 Initiative 4 Initiative 7 Low Lowest Priority Low High Feasibility of Implementation 48 Secondary Priority Goal #2: Improve Patient Satisfaction Financial Summary Goal Objective Initiative

Investment Required for Initiatives to Improve Patient Satisfaction Patient Flow Assessment 2 3 4 5 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 49 6 7 8 Goal Investment Goal #2: Improve Patient Satisfaction Implementation Timeline Initiatives related to Improve Patient Satisfaction Initiative YR 1 YR 2 Patient Flow Assessment Initiative #2 Initiative #3 Initiative #4 Initiative #5 Initiative #6 Initiative #7 Initiative #8 Initiative #9

Initiative #10 50 YR 3 YR 4 YR 5 Strategic Plan Summary CURRENT PERFORMANCE ANALYSIS FUTURE MARKET ASSESSMENT PLAN DESIGN 51 PLAN SUMMARY Plan Summary Total Investment Required for Strategic Initiatives, 20XX-20XX Grow Volume Patient Satisfaction Quality Goal X 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 : 52 Goal Z Plan Summary Interdepartmental Support Required for Strategic Initiatives, 20XX-20XX Marketing Pain Management Goal #3 Department Department #4 Department #5 XXX XXX XXX XXX XXX XXX E.g., Collaborate XXX XXX

XXX around surgical consults and patient algorithms. 53 Strategic Plan Summary Performance Scorecard Goal Objective Increase Market Share by X% Owner Status of Related Initiatives Dr. Pan, Administrator, SL Metric Primary Market Share Grow Volume Secondary Market Share Capture Latent Demand for X Service Mary Markets, Asst. Director, Marketing Volume, Service X

Referrals, Service X Physician Awareness, Service X faction Improve Patient Care Process On Track Minor Setbacks Stephanie Egan, Care Manager Major Setbacks Patient satisfaction scores 54 Value at Plan Launch (Insert Date) Current Value (insert Date) Target Value (Insert Date) Plan Summary Communication Plan: Key Messages and Communication Tactics Stakeholder Level of Detail Key Messages Communication Tactics

Board of Directors High Level Summary Service objectives and expected outcomes Memo System Leadership Overview 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 Staff Detailed 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. 55 Plan Summary Communication Plan: Strategies to Address Potential Concerns Stakeholder Potential Concerns Board of Directors N/A System Leadership Cost of new equipment Illustrate 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 Provide routine updates to physician liaisons on quality improvements Physician Liaisons Referring Independent Physicians Lack of awareness of increases in quality Strategies to Address Concerns Spokesperson(s) CEO 56 2445 M Street NW I Washington DC 20037 P 202.266.5600 I F 202.266.5700 2011 THE ADVISORY BOARD COMPANY ADVISORY.COM advisory.com

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