Question Number: 452

Please review documents thoroughly before bidding. Background reading: Campos, C. (2007). Addressing cultural barriers to the successful use of insulin in Hispanics with Type 2 diabetes. Retrieved from https://www.semanticscholar.org/paper/Addressing-cultural-barriers-to-the-successful-use-Campos/7069bbaf0e0abf5f3ed979b3fe9eb83850aeaaa8 Centers for Disease Control and Prevention (CDC). (n.d.). CDC’s Division of Diabetes Translation: Community health workers/promotores de salud: Critical connections in communities. Retrieved from http://www.cdc.gov/diabetes/projects/pdfs/comm.pdfou have accepted a job offer to work for the strategy group of a healthcare consulting firm. Your first project is developing the strategy for a community health center. Your firm has been hired by Dr. Novak, a well-known endocrinologist working with Western Hospital. He is passionate about prevention and early intervention of diabetes. He has led the effort to establish a community-based program to ensure ongoing treatment for this deadly disease for Hispanic seniors in the Lowertown community. His vision is that patients receive diabetes education and ongoing treatment in the language of their choice and in a culturally appropriate manner. Proper treatment and preventive care will improve patients’ quality of life while reducing hospitalizations from diabetes complications.Dr. Novak and his advisors plan to apply for funding from the Patient Protection and Affordable Care Act’s Community Health Center Fund to establish the Center for Diabetes Care. The fund supports the operation, expansion, and construction of community health centers. Before he can apply for the grant, Dr. Novak needs approval from the board of directors of Western Hospital. The board requires a detailed business case and strategic plan for the initiative.You will create a detailed report that includes a business plan and strategic plan based on the documentation provided and any additional research you conduct. You will also summarize the business case in a slide presentation to Western Hospital’s board of directors. Finally, you will present a report to Dr. Novak outlining the business risks of opening the center and providing strategies for managing those risks.It is January and the plan is to open the center the following April (15 months from today), which coincides with the start of Western Hospital’s fiscal year.

Question Number: 553

Final Project Healthcare Administration and Human Resource Management homework helpPlease review documents thoroughly before bidding. Background reading: Campos, C. (2007). Addressing cultural barriers to the successful use of insulin in Hispanics with Type 2 diabetes. Retrieved from https://www.semanticscholar.org/paper/Addressing-cultural-barriers-to-the-successful-use-Campos/7069bbaf0e0abf5f3ed979b3fe9eb83850aeaaa8 Centers for Disease Control and Prevention (CDC). (n.d.). CDC’s Division of Diabetes Translation: Community health workers/promotores de salud: Critical connections in communities. Retrieved from http://www.cdc.gov/diabetes/projects/pdfs/comm.pdfou have accepted a job offer to work for the strategy group of a healthcare consulting firm. Your first project is developing the strategy for a community health center. Your firm has been hired by Dr. Novak, a well-known endocrinologist working with Western Hospital. He is passionate about prevention and early intervention of diabetes. He has led the effort to establish a community-based program to ensure ongoing treatment for this deadly disease for Hispanic seniors in the Lowertown community. His vision is that patients receive diabetes education and ongoing treatment in the language of their choice and in a culturally appropriate manner. Proper treatment and preventive care will improve patients’ quality of life while reducing hospitalizations from diabetes complications.Dr. Novak and his advisors plan to apply for funding from the Patient Protection and Affordable Care Act’s Community Health Center Fund to establish the Center for Diabetes Care. The fund supports the operation, expansion, and construction of community health centers. Before he can apply for the grant, Dr. Novak needs approval from the board of directors of Western Hospital. The board requires a detailed business case and strategic plan for the initiative.You will create a detailed report that includes a business plan and strategic plan based on the documentation provided and any additional research you conduct. You will also summarize the business case in a slide presentation to Western Hospital’s board of directors. Finally, you will present a report to Dr. Novak outlining the business risks of opening the center and providing strategies for managing those risks.It is January and the plan is to open the center the following April (15 months from today), which coincides with the start of Western Hospital’s fiscal year.This Assessment requires submission of three (3) files.attachmentAssessment_Writing_Checklist.docxattachmentFM010_Assessment_FinancialProjectionsfortheCenterforDiabetesCare-5.xlsxattachmentFM010_Assessment_InterviewwithDrNovak.docxattachmentFM010Academic Writing Expectations ChecklistThe faculty Assessor will use this checklist to evaluate whether your written responses adhere to the conventions of scholarly writing. Review this checklist prior to submitting your Assessment to ensure your writing follows academic writing expectations. Click the links to access Writing Center resources:Sentence-Level Skills0Constructing complete and correct sentencesNote:See an explanation of sentence components and how to avoid sentence fragments and run-ons.0Using and spelling words correctlyNote:See a list of commonly misused words and information on MS Word’s spell check.0Using punctuation appropriatelyNote:See the different types of punctuation and their uses.0Using grammar appropriatelyNote: See a Grammarly tutorial to catch further errors.Paragraph-Level Skills0Using paragraph breaksNote:See a description of paragraph basics.0Focusing each paragraph on one central idea (rather than multiple ideas) Note:See an explanation of how topic sentences work.Use of Evidence0Using resources appropriatelyNote:See examples of integrating evidence in a paper. 0Citing and referencing resources accuratelyNote: See examples of citing and referencing resources in a paper.0Paraphrasing (explaining in one’s own words) to avoid plagiarizing the sourceNote:See paraphrasing strategies.Formatting Written Assignments0 Using appropriate APA formatting, including title page, margins, and fontNote:See APA overview and APA template from the Writing Center.Comments: Projected Capital CostsYear 1Year 2Year 3Server $15,000 Remodel of Office Space $98,550 Security System $2,654 Furniture $12,281 $1,000 $1,000 Practice Management System $5,000 $2,500 $2,500 Computers & Cabling $41,696 Total $175,181 $3,500 $3,500 Interview WithDr. Novak to Discuss the Center for Diabetes CareAfter you are assigned to the project, you meet with Dr. Novak to discuss the Center for Diabetes Care. You: Dr. Novak, it’s great to meet you. I’ve been looking forward to our discussion.Dr. Novak: The pleasure is mine. Before we start, here’s some information that you’ll need. I’ve included an excerpt of Western’s Community Health Needs Assessment, which will give you background information on our patient population. There are excerpts from a presentation I gave to our steering committee. The excerpts cover the program structure, marketing plans, timeline, and Western Hospital’s vision and mission. I’ve also included the financial projections for the Center for Diabetes Care. Finally, there are two excellent articles for your reference.You: Great. Thanks for putting this together. I know we’ve got a lot to discuss. I’d like to start by learning about why you decided to start the Center for Diabetes Care.Dr. Novak: As you know, I’m an endocrinologist, and I’ve treated many Hispanic patients. This is partly because of my language skills and partly based on my clinical interests. When patients receive a diagnosis of Type 2 diabetes, they have to navigate a complex and often intimidating healthcare system. They may require treatment by multiple specialists. Managing Type 2 diabetes can be confusing and overwhelming for any patient. I’ve seen countless patients suffer needless medical complications because they did not receive appropriate treatment or preventative care for Type 2 diabetes.In many cases, Hispanics with a diagnosis of Type 2 diabetes face even more challenges than other patients.Why? For many of my patients, there is a language barrier. But the barriers to my Hispanic patients getting proper care for diabetes go beyond a language issue. The issue is a complex combination of culture, accessibility, healthcare literacy, and finances. My colleague Dr. Campos wrote an excellent article titled “Addressing Cultural Barriers to the Successful Use of Insulin in Hispanics WithType 2 Diabetes”that explores this in detail. I’ve included it in the file I gave you.You: Why are you launching the program now?Dr. Novak: As you can see, this is an issue I am passionate about. I’ve been tinkering with this concept for some time. New sources of grant funding are available since the passage of the Patient Protection and Affordable Care Act in 2010.When I learned about the Patient Protection and Affordable Care Act’s Prevention and Public Health Funding, I was thrilled. This grant funding will enable Western to create a program to support a vulnerable population. You: Tell me why you chose a model based on community health workers. Dr. Novak: Community health workers are a bridge to healthcare providers and a credible source of education for patients. I’ve given you an article from the Centers for Disease Control and Preventionabout community health workers. It's a great overview of why community health workerscan effectively reach an underserved population of diabetes sufferers. Many of my Hispanic patients don’t speak English well. I speak Spanish but most doctors in this community do not. This communication barrier impacts patients’ ability to follow through with treatment. Treatments for diabetes may also be at odds with patients’ cultural beliefs. I believe that a group of trained community healthcare workers can support these vulnerable patients and even act as their advocates. Think about the economics of the Center for Diabetes Care from the perspective of unnecessary healthcare costs that can be eliminated. We’ll pay the community health workers roughly $80,000 a year, including the cost of benefits. On average at Western the cost per inpatient day is $2,000, and the average length of stay at Western for a patient with diabetes as the first-listed diagnosis is 5days. Patients with diabetes hospitalized for other conditions stay an average of 1 day longer than patients without diabetes. If you do the math, the economics of the program look pretty good. You: Tell me more about the population that the Center for Diabetes Care will serve.Dr. Novak: The patient population we are targeting is the Hispanic population,aged65 and older, that suffer from type 2 diabetes. For our educational endeavors, we expand the target to their families. For our educational outreach, our target is the entire community, with an emphasis on the Hispanic population. Our geographic target is Lowertown, which is more than 70% Hispanic. Western has an urgent care center there, and the program will be housed in the former pharmacy and storage area. The pharmacy at the urgent care center closed a few years ago when a few of the big chain pharmacies came to the neighborhood. We’ll renovate the space for the team’s use, and we’ll have four small consultation rooms. This will make our space convenient for Lowertown residents. For those who can’t or don’t want to visit the clinic, the community health workers can visit them in their homes.You: Will insurance reimburse the Center for Diabetes Care for community health workers’ visits to patients’ homes?Dr. Novak: Yes, in this state, insurance will reimburse for home visits by the community health workers because they will be my employees. The exception is that they won’t reimburse for diabetes education—at least in this state. We’ll have to keep a close eye on the regulations, and we’ll have to document everything. That’s one reason we’re providing the community health workers with iPads—to ensure proper documentation. You: How has the medical community at Western responded to the Center for Diabetes Care?Dr. Novak:Support from both the provider and the community is a critical factor for success for this program. My colleagues at Western that treat other chronic diseases are interested in this program, as well. The community health worker model can be a viable option for treating other populations that would benefit from an alternative to the traditional medical system. It’s exciting to lead the team that is driving the protocols, policies, and procedures our community health workers will use at Western.You: What’s the reaction from the Hispanic community in Lowertown? Dr. Novak: The support from the Hispanic community has been overwhelming. We have several Hispanic community leaders who have been strong advocates. Leaders in the Hispanic community recognize that access to healthcare is an issue for many in the Lowertown area. Rosa Sanchez, State Senator from this district, is on the steering committee for the Center for Diabetes Care. She’s married to a friend of mine from residency. She’s a passionate advocate for healthcare access. We also have Hugo Guzman on the steering committee. He’s a very successful entrepreneur whose mom and uncle are patients of mine. Rosa and Hugo give us credibility in the Hispanic community.You: Tell me more about the steering committee.Dr. Novak: I’ve created a steering committee that consists of another endocrinologist, a pharmacist, a nurse practitioner, and a nutritionist. As I mentioned, we also have community leaders on the steering committee. We’ve been meeting every other week for a working breakfast. Initially we spent our time refining the vision and mission statement for the program. You’ll see this in the documentation I’ve provided. We’ve also developed the organizational structure and roles and responsibilities for the staff. You: Let’s discuss the organizational structure of the Center for Diabetes Care.Dr. Novak: This is another critical aspect of the Center for Diabetes Care. I’ve worked with human resources at Western Hospital to create a program overview, which includes a description of roles and responsibilities.You’ll see this in the information I’ve prepared for you. We’ll have a team of four community health workers. I’ll work with a nurse practitioner to oversee the team.A big challenge is to get the right individuals in the community health worker roles. I need individuals with a combination of language skills, cultural competency, the ability to collaborate with the entire care team, and appropriate clinical knowledge. Human resources hasn’t created job descriptions yet but you can get a good sense of the role from the program overview.The nurse practitioner will have to have the same skill set as the community health workers. They will also have to be flexible and innovative. We will develop policies and procedures but the nurse practitioner will support the community health workers in dealing with ambiguity in their roles. They will also have to be an excellent presenter, as they will conduct community education seminars and represent the Center for Diabetes Care.You: What training, if any, will you provide to the community health workers?Dr. Novak: We expect our community health workers to have some education in healthcare or nursing. We’ll also look for language skills. I believe that the key to this program is finding community health workers that our patients will be able to relate to. We want a team that our patients will be happy to see. The success of this program rests on our community health workers’ ability to relate to patients.All of our staff, including the receptionist, will go through an intensive 3-week training program. The training will address cultural competency and diabetes care and prevention. They’ll also learn basic first aid. Every year, we’ll have an annual formal training for the staff. This will most likely be a weeklong intensive training at an off-site location.I want to create a learning culture for the staff at the Center for Diabetes Care. We’ll have 2-hour Monday morning meetings. These will include an expert speaker every other week. This could be me, a nutritionist, a pharmacist, or a community health worker from a different organization. The culture will be collaborative. We’ll learn from each other’s successes and failures. Each community health worker will present a success from the last week and share a case or an issue that is challenging them. The community health workers will improve their patient care skills and knowledge of diabetes with this format. You: Let’s go over the financials for the Center for Diabetes Care.Dr. Novak: We are so short on time, I’d prefer you review the financials on your own. I’ve worked with a senior financial analyst at Western. We’ve pulled together some numbers I feel really good about. You: How will you get the word out about the Center for Diabetes Care?Dr. Novak: We have to communicate with multiple groups for the Center for Diabetes Care to be successful. First, we need referrals from general practitioners and endocrinologists who treat patients in our target population. Second, we need to reach out to patients and their extended families. We need to explain our program togeneral practitioners and endocrinologists who treatthe Hispanic population with Type 2 diabetes. They will talk to their patients about this program and encourage them to participate. Of course, we need to educate nurses in these practices, as well. We’ll need to create marketing materials for doctors and nurses to give to patients who would benefit from our program.We’ll do a marketing blitz for our partners within the hospital. Members of the steering committee can lead the charge within their professional group. We need to ensure awareness and credibility among those whom the community health workers will interface with.We also need to develop a marketing program for the primary caregivers to potential patients for the program. Typically, the primary caregivers are adult children. The diabetes patient may or may not live with the adult child but the child is essentially responsible for the parent’s welfare. In my practice, I observe that the children are concerned about their parents’ diabetes, especially as complications manifest. Often they are desperate to help their parents but do not know what to do.We want to engage the primary caregivers on two levels. First, we need to encourage their parents to enroll inthe Center for Diabetes Care. Second, we want them to be as involved as possible in treatment. We’ll conduct ongoing education sessions for them in the evenings and on weekends to maximize participation. We’ll also use some targeted marketing to reach the Hispanic community. We’ll focus on cost-effective, highly targeted vehicles, such as outdoor, online, and radio. You’ll see more detail in the presentation for the steering committee that I gave you.You: What role will technology play in the Center for Diabetes Care?Dr. Novak: Technology has an important role in allowing us to communicate with patients and with the broader care team. We will give the community health workers iPads. They’ll use videos to explain treatment to patients. They will also use the iPads to update patients’ records and insurance billing. Electronic medical records will allow us to collaborate more easily with the broader care team. Western is finally moving away from paper charts. The hospital just started using an electronic medical records system. We need to figure out how we can adapt the system to fit our patients’ needs. Since the system is so new at Western, we haven’t determined if customization will be required.You: I know the launch date is April of next year. Tell me about the timeline and key milestones.Dr. Novak: The timeline is in the presentation to the steering committee. You: I know that we need to wrap up soon. I have one more question for you. How will you measure success for the Center for Diabetes Care?Dr. Novak: I see several ways to quantify success. First, from our patients’ point of view, are we slowing or stopping disease progression and optimizing the reduction of all risk factors associated with microvascular and macrovascular disease complications? Directionally we’ll measure this by the reduction in average HbA1c levels. Current levels for the target population are 10.5 and our goal isa reduction to 8.5 in 2years. This is significant because each 100 basis point reduction means a 15% to 18% reduction in mortality, heart attack, and stroke, and a 35% reduction in cardiovascular complications. We’ll also evaluate the reduction in hospital admission, readmission, and emergency room visits for diabetics in our target population. Specifically, we’ll measure the “all-cause” hospitalization for patients in our target population, or the rate of overall discharge for patients with diabetes as an “any-listed” diagnosis. In our third year of operation, our goal is to reduce this from 386 per 1,000, Western’s current rate for the Hispanic population (65 and older) with diabetes, to 310 per 1,000. The target is based on the hospitalization rate for the general population in the same age range with diabetes at benchmark hospitals. The frequency of our contact with patients is also important. Ideally we’d see patients every 2 months for check-ups. Realistically, we anticipate that we will see each patient on average 4.5 times a year. That’s the assumption we used to create projections for patient revenue.From a financial perspective, success to me means the ability to operate at breakeven without grant funding by Year 3. One key issue for me is ensuring that we bill insurance for all services. I want no lost revenue due to insufficient documentation. From a community perspective, we should be reducing healthcare costs through preventative care. Beyond that, we want to empower Hispanic patients through education and advocacy. We’ll be conducting annual surveys about their attitude toward healthcare, and we are looking to see statistically significant year-over-year improvement on key metrics about attitudes toward the healthcare system.Finally, we’ll assess the engagement of our staff. We’ll measure this through retention rates and annual employee satisfaction surveys. We’ll also measure internal success based on the size of our best practices and lessons learned databases. This program is a model for others, not just for diabetes care but also for other diseases and other patient populations. We need to ensure that everything we learn is documented.You: Sounds like great inputs for a balanced scorecard.Dr. Novak: I’d be interested in hearing more about that. (Dr. Novak glances at his watch.) I’ve got to run. You should have everything you need. I’m looking forward to seeing your report and presentation.