Sayler_Affiliation Recommendation
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Long Term Care
Twin Pines Medical Center Affiliation Recommendation
Presented to the Twin Pines Medical Center (TPMC) Board of Directors
Prepared by Abigail Sayler
12/3/2023
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A. Goals and Rationale
1.
Explain key goals for the affiliation and specific criteria a candidate affiliate must meet.
The main goals of the affiliation are focused on improving the overall healthcare system and patient care. One goal is to reduce the stress and demand on the emergency department of TPMC (presumably a healthcare facility). This means finding ways to decrease emergency room visits for non-emergency issues, such as diabetic care.
Another goal is to decrease healthcare costs by improving and increasing options. This could involve finding more cost-effective ways to provide care, such as implementing telemedicine or utilizing community resources. By doing so, the overall cost of healthcare can be reduced.
Improving access to diabetic care is another important goal. This means ensuring that there are enough medical specialists who can effectively treat diabetics. This could involve recruiting more specialists or providing additional training to existing healthcare providers.
Lastly, the affiliation aims to improve patients' ability to obtain medical insurance or gain
financial assistance. This is important because many individuals may need access to adequate healthcare coverage or help with the financial burden of medical expenses. The affiliation can ensure that more individuals can access the care they need by providing aid or assisting patients to navigate the insurance system.
For a candidate affiliate to be successful, they must meet specific criteria. One important
measure is having medical specialists who can effectively treat diabetics. This is crucial for improving access to diabetic care. Additionally, the affiliation must meet the needs of
the overworked emergency department and decrease the demand from diabetic patients. This could involve implementing strategies to divert non-emergency diabetic cases to other healthcare settings or providing education and resources to help patients manage their condition outside the emergency department.
2.
Identify three
specific advantages a well-aligned affiliation would provide for TPMC.
A well-aligned affiliation focusing on education on evidence-based practices and prioritizing quality results for diabetes treatment would provide several advantages for TPMC. Firstly, TPMC would have access to the most current research and methodology of treatment for diabetes. This means they could stay up-to-date with the latest advancements in diabetes care, ensuring that their patients receive the most effective and evidence-based treatments available. This can lead to improved patient
outcomes and better overall care for individuals with diabetes.
Secondly, a well-aligned affiliation can improve patient satisfaction cost efficiency, and reduce emergency department (ED) utilization by diabetic patients. By aligning with an institution that focuses on quality and evidence-based care, TPMC can implement strategies and practices that enhance patient satisfaction, streamline 2
processes to improve cost efficiency, and reduce the need for diabetic patients to visit the ED for their care. This can result in better patient experiences, facilitated healthcare costs, and more appropriate utilization of healthcare resources.
Lastly, an affiliation can bring upgrades in technologies and education utilized by TPMC to increase life quality for the community. By partnering with an institution that
prioritizes quality and evidence-based care, TPMC can access advanced technologies and training programs to enhance its ability to provide high-quality care for individuals with diabetes. This can lead to improved outcomes, increased patient satisfaction, and a better overall quality of life for the community served by TPMC.
3.
Analyze the current state of TPMC and the projected market segmentation for TPMC anticipated from the proposed affiliation. Your analysis must be supported by demographic data and include the following elements:
• the current state of TPMC, including anticipated market segmentation
• location-specific demographics
• how the population’s health needs align with the proposed affiliation Twin Pines is in northern Louisiana and provides care to about 48,000, of whom thirty percent are uninsured. Most of the community uses Medicare. Because Medicare reimburses
care at a fixed amount, the overuse of higher care may not compensate for the profit the medical center requires. Even though the mission of Twin Pines is to provide care to the uninsured and underserved, they have been unsuccessful in providing higher levels of care that diabetic patients need desperately. The documented high overuse of the emergency room shows this. Due to fewer Medicare and more Medicaid patients, the necessity for affordable care can be lowered, giving the hospital more reimbursement. The hospital can sign patients up by utilizing their case managers. Implementing a diabetes care project will assist in lowering the number of emergency room patients. Managing diabetes from an outpatient office rather than an emergency room will improve the financial burden the hospital currently deals with. Affiliating with an organization that can provide an effective program will be an instant win for the patients and the medical facility. (Western Governors University, n.d.).
B. Affiliate Recommendation
1.
Recommend an affiliate based on your goals and rationale from part A and include key attributes of the proposed organization that support the affiliation.
To give high-quality care to diabetes patients in Pine Parish, TPMC and DCC are proposing a clinically integrated network affiliation agreement. Patients who join DC may
be sent to a local institution for complete treatment and diabetes education for self-
management by their primary care doctors.
DCC will offer diabetic-specific services such as education for patients and caregivers, remote and onsite monitoring, and nutrition and diet planning. An endocrinologist and advanced practice nurses at DCC will manage these specialist services.
When patients are successfully monitored, the overarching aim of this affiliation will be fulfilled. DCC's efforts resulted in the treatment and teaching of effective self-monitoring.
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Managing diabetic care through DCC will result in fewer individuals with complicated diabetes-related illnesses being treated in the emergency department.
The clinically integrated network affiliation will allow medical experts to work together to manage Pine Parish's diabetic population while retaining their independence as independent hospitals.
2.
Identify the major benefits of affiliation with this organization and describe how these benefits strategically align with TPMC’s goals.
Major Benefits of Affiliation
Associated TPMC Goal
Ability to utilize a nearby health facility for complete diabetic management and avoid using the emergency department.
To give multiplex diabetes treatment to the community. This includes an office with nutritionists, podiatrists, endocrinologists, health teachers, and more.
Diabetic cases are educated to manage their condition independently and watch out
for chronic illnesses.
Based on the TPMC documentation, there are increased visits to the emergency room by patients with diabetic complications. However, this would be avoidable if TPMC had an office clinic for these patients and educated them (Western Governors University, n.d.). When increased management independence and watching of diabetes taught by IHC, the rate of ED visits related to diabetes-related illness will decline.
Both organizations will maintain independence when the partnership is agreed upon; however, an upcoming merger can potentially occur.
TPMC runs a tight margin and constantly seeks methods to limit expenses while keeping top-tier patient care (Western Governors University, n.d.). The partnership
with IHC would provide improved services, increase care quality, and limit expenses or struggles regarding a merger.
3.
Discuss specific reasons to avoid affiliation with each
of the other potential candidates. Support your reasons with sources.
Candidate Partner
Reasons to Avoid Affiliation
The Mayo Clinic
The perception associated with the Mayo Clinic limits how TPMC was founded. The Mayo Clinic, being so technologically advanced compared to TPMC, will require a significant buy-in. However, TPMC needs more revenue to improve its systems to access the digital platforms necessary for affiliation with the Mayo Clinic. Current research of the Mayo Clinic does not emphasize the uninsured or underinsured patients; TPMC sees a significant amount. The preventative care and teachings done by the Mayo Clinic could not change the 4
current demand for emergency department cases of diabetic patients in Pine Parish. This is due to associated costs arising from necessary lifesaving treatment. (Mayo Clinic, n.d.).
John Hopkins Medicine
Like the Mayo Clinic, Johns Hopkins is a worldwide medical facility with partnerships
known internationally. An affiliation with TPMC and Johns Hopkins Medicine would depend mainly on social media, and both patients and providers need to have access to high-speed internet/wifi and modern computers and cell phones. The community,
as would TPMC, whose funds are already limited, would struggle. So, this venture would be expensive, and there would be limited profit for some time, resulting in areas of TPMC failing. (John Hopskins Medicine, n.d.).
C. Affiliation Plan
1.
Describe your proposed affiliation structure and include justification for the selection.
The presented partnership structure is a clinically integrated network. This means that both TPMC and IHC will maintain their autonomy as separate entities, but they will come together in a partnership to manage the health needs of the community better. This affiliation aims to bring more medical resources from IHC to TPMC to meet the increasing demand for healthcare services for diabetic residents. By pooling their resources and expertise, TPMC and IHC can work together to provide better care for these patients.
For this partnership to succeed, an organizational structure will be made. The CEOs of both TPMC and IHC will remain in their positions as they have the experience and knowledge to lead their respective organizations. However, a new integrated executive board will be formed to manage the alliance.
This board will include both CEOs, as they will provide overall guidance and strategic direction. Additionally, two members of higher-level leadership from each organization will be included, as they can bring their expertise and perspectives to the table. Finally, one physician from each organization will also be part of the board, as they can provide valuable insights and represent the interests of the medical staff.
By creating this leadership structure, the affiliation can ensure that both TPMC and IHC have a voice in decision-making and that the partnership is effectively managed for the benefit of the community.
2.
Create new organizational, vision, mission, and value statements for the new proposed affiliation structure. 5
Organizational Statement
The base of this partnership is to provide to the underserved and increase community health. As a clinically incorporated network, TPMC and IHC remain independent healthcare providers working together to increase the overall health and life quality for all diabetic patients.
Vision Statement
The vision includes increasing the care quality of diabetic patients with the community's residents at the forefront of our minds. This partnership is committed to revolutionizing and giving progressive care to the most needy populations.
Mission Statement
The mission of this partnership is to provide hope and health in the neighborhoods of Louisiana. The mission statement will be “To advance, preserve, and increase the long-term health of the people we serve.”
Value Statement
In quest of the vision, the joint executive team and employees of TPMC/IHC will be led using these values: honesty, greatness, modernization, collective teamwork, consideration, empathy, capacity, and diversification.
3.
Develop a leadership plan for the proposed affiliation structure that includes the following elements:
strategies for overall organization management
strategies for the collaborative decision-making process
evidence-based principles, strategies, and tools of effective change management
The leadership plan for the given partnership structure includes several key points. Firstly, a two-year clinically integrated network affiliation agreement between TPMC and IHC will exist. This agreement will outline the terms and goals of the affiliation.
Secondly, a joint executive board will be created, consisting of representatives from both
organizations. This board will have equal representation and voting power, ensuring that decisions are made collaboratively.
The board will review the outcomes presented by a collaborative committee. This committee will assess the proposed initiatives and determine the metrics that must be tracked to measure their success.
Projects that need funds or office resources will be given to the joint executive group by the collective committee. The panel can grant access to these resources as needed to support the affiliation's goals.
The collaborative committee will consist of upper-level leadership representatives from TPMC and IHC and members of multidisciplinary medical teams. They will meet monthly to review emergency department (ED) metrics and incoming proposals.
The chosen liaisons from TPMC and IHC will be tasked with creating and leading these meetings. This ensures that there is clear communication and coordination between the two organizations.
The leadership plan establishes a structure for successful group management, evidence-
based change management, and collective decision-making. The monthly meetings will allow for ongoing assessment of the affiliation's efforts and provide an opportunity to 6
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discuss innovative methods based on current research. Explain how to keep and increase
staff satisfaction, engagement, and keeping employment in an environment of positive change. Keeping and increasing staff satisfaction, engagement, and employment in an environment of positive change is difficult, especially during affiliation or merger. These transitions can cause high levels of anxiety and stress among employees. To address these challenges, it is essential to identify the possible risks that may arise with employees during the transition period. This involves recognizing that change is a personal and emotional issue, particularly in the workplace. A study by Laframboise et al.
(2003) found that staff resistance can create barriers to creating and developing a relocation or merger.
To combat these fears and anxieties, creating an environment where employees feel comfortable expressing their concerns and worries to the executive team is crucial. This requires building trust between the staff and the leadership. The executive team should serve as positive role models for all staff, demonstrating resilience and adaptability even in the face of failures or disruptions to the plans.
Additionally, it is essential to involve the staff throughout the process and remind them of the importance of the affiliation or merger to the organization. This helps to maintain their engagement and motivation by providing a sense of purpose and understanding.
Overall, keeping and increasing staff satisfaction engagement and keeping employment with a positive change culture requires addressing employees' anxieties and concerns, building trust, and involving them in the process. (Laframboise et al., 2002).
4.
Describe two
opportunities and two
challenges for the affiliation for TPMC.
Opportunities
Challenges
Since IHC is known worldwide, healthcare facilities can access the new and most currently used electronic health record (EHR) programs. An affiliation with IHC would allow TPMC to update its systems and train its staff to use the new software. We could monitor the benefits in patients' health due to the new system.
The top technology resource tier is implementing TPMC into IHC’s electronic health record system (EHR), called iCentra (Intermountain Health, 2001). Both companies must have central programs to share patient health information. However, TPMC cannot afford to support new EHR programs. This would cause either the partnership to be unsuccessful or IHC to pay
for more modern software.
Due to limited education in long-term care of diabetic cases at TPMC. This is a chance for training and teaching for all employees at TPMC by the new providers and employees at IHC.
Patient volumes increase due to referrals for the TPMC ED to the clinic, resulting in challenges from insufficient staff to treat the patients properly. This could decrease patient satisfaction and cause readmission to the emergency department for further care for their health needs.
5.
Discuss the impact the organizational cultures of TPMC and the affiliate organization could have on the future of the proposed affiliation.
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The impact of the organizational cultures of TPMC and the partnering company on the potentially discussed partnership is that both organizations prioritize patient care and have a collaborative approach to giving quality care to diabetic clients. The multidisciplinary team of the affiliate organization, IHC, focuses on comprehensive diabetes and endocrinology care. They work together to find solutions tailored to each patient's specific needs. This team approach allows them to utilize their experience and education to effectively manage symptoms and reduce complications. This is especially important in a community with critical needs, as it ensures that patients receive the necessary aid and support.
On the other hand, the organizational culture of TPMC is centered around "putting people first." This means their primary focus is on caring for patients above all else. This aligns with the collaborative approach of IHC, as both organizations aim to give top-tier care to all diabetic cases.
Overall, the shared commitment to patient care and the collaborative approach to disease management between TPMC and the affiliate organization will likely contribute to the success of the proposed affiliation. It ensures that the needs of diabetic patients are prioritized and that they receive comprehensive, tailored treatment plans. (Western Governors University, n.d.).
6.
Discuss reasons for termination of the affiliation agreement.
The end of the partnership agreement may be considered for several reasons. One of the main factors to consider is the performance and outcomes of the affiliation. The partnership aims to provide TPMC's diabetic patients with more treatment options. If this goal needs to be effectively met, it will be best to end the partnership.
TPMC will start by exploring other potential candidates that could better serve the community's needs. If termination is chosen, acting promptly to prevent staff burnout and patient dissatisfaction is essential.
Another factor to consider is the impact on emergency department (ED) utilization. If there is no decrease in ED utilization after the first year of the affiliation, it suggests that the union
needs to achieve its goal and be reviewed.
Additionally, if IHC fails to uphold the terms of the affiliation agreement or if there is no revenue generated from the addition of the clinic, it indicates a failing affiliation that should be terminated.
Lastly, if the affiliation puts TPMC into significant debt that cannot be resolved, continuing the relationship may not be worth it. In such cases, TPMC should explore alternative options to assist the ED.
7.
Provide a potential exit strategy that is actionable and includes three
action steps.
The potential exit strategy outlined in the answer involves several action steps. First, the joint executive board will vote twice yearly to decide whether to continue or terminate the affiliation. This step ensures that there is a regular evaluation of the union and allows for a decision to be made based on the board's assessment.
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Second, the board will meet monthly to review the affiliation's outcomes. This regular review allows the board to stay informed about the progress and effectiveness of the partnership. It provides an opportunity to identify any issues or areas for improvement.
Third, the board may provide oversight and leadership on implementation initiatives due to these meetings. This step ensures that the board takes an active role in guiding and supporting the implementation of initiatives that arise from the affiliation. It allows for effective decision-making and provides the board's expertise is utilized.
Additionally, the collective committee will meet every two weeks to analyze the quality of the data. This step ensures a regular assessment of the quality of care provided through the affiliation. The committee will analyze data on the number of emergency department visits, outcomes of these visits, length of admissions, and patient compliance with treatment. This information will help the committee determine if any initiatives implemented are adequate or need improvement.
Furthermore, patient satisfaction will be analyzed monthly and discussed at the committee hearings. This step ensures that patient feedback is regularly collected and considered. Any trends in patient issues will be identified, allowing for targeted improvements.
Overall, this exit strategy includes regular evaluations, oversight and leadership from the
board, data analysis by the collaborative committee, and consideration of patient satisfaction. These action steps provide a comprehensive approach to assessing the affiliation and making informed decisions about its continuation or termination.
8.
Discuss future challenges and opportunities that could result from the affiliation in regard to the evolving community healthcare landscape.
The potential difficulties and opportunities from the partnership with the growing community
healthcare landscape are discussed in the provided answer. One future challenge mentioned is that uninsured and underinsured patients may not take advantage of clinics focused on diabetes care and management. This is a challenge because
these patients may not have access to the necessary resources and support to manage their
diabetes effectively. On the other hand, an opportunity mentioned is that with the teaching and resources provided to diabetic patients, they can learn to self-manage their chronic illnesses. This can lead to better diabetes control and decreased emergency department (ED) service demand. These changes can potentially transform the community healthcare landscape by improving access to diabetes care and management and reducing the burden on EDs. It may also lead to other affiliation agreements with TPMC, as the success of this affiliation demonstrates the potential benefits of collaboration in addressing community healthcare needs. (MiQ Partners,
2021).
D. APA Sources
Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.
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Intermountain Health. (n.d.). Intermountain Leadership team
. Retrieved December 3, 2023, from https://intermountainhealthcare.org/about/who-we-are/leadership/
Intermountain Health. (2001, March 19). Cerner, Intermountain Healthcare Implement iCentra EHR
. intermountainhealthcare.org. Retrieved December 3, 2023, from https://intermountainhealthcare.org/news/2015/03/cerner-intermountain-healthcare-
implement-icentra-ehr/
John Hopskins Medicine. (n.d.). About Johns Hopkins Medicine
. John Hopkins Medicine. Retrieved December 10, 2023, from https://www.hopkinsmedicine.org/about
Laframboise, D. E., Nelson, R., & Schmaltz, J. (2002). Managing resistance to change in workplace accommodation projects. Journal of Facilities Management
, 1
(4), 306–321. https://doi.org/10.1108/14725960310808024
Mayo Clinic. (n.d.). About us
. Retrieved December 10, 2023, from https://www.mayoclinic.org/about-mayo-clinic
MiQ Partners. (2021). The impact of regulation on healthcare automation
. Retrieved December 3, 2023, from https://miqpartners.com/impact-of-regulation-on-healthcare-
automation/
Western Govenor’s University. (n.d.). Profile: Twin Pines Medical Center
. Master of Health Leadership Program. Retrieved December 3, 2023, from https://wgu.yourlearningportal.com/wgu/resources/courses/wgu_courses/hcm/mhl/
C982_MHL5310_healthcare_models/resources/profile_tpmc.pdf
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