RFarmer-HSA-599-Assign3
Assignment #3 The Case for Open Heart Surgery at Cabarrus Memorial Hospital
HAS 599 Health Services Administration Capstone
Introduction:
Cabarrus Memorial Hospital (CMH) was established and opened for patients on July 26, 1937. The originally facility had 50 inpatient bed and a staff of 19 employees. The first addition of 100 beds was completed in 1940. A second addition opened in 1951 and brought the total bed capacity to 339. A construction and renovation program, started in 1969, expanded the total licensed capacity to 350 acute care beds and 30 bassinets. Cabarrus Memorial Hospital was a well-equipped facility in which Mr. Cannon, owner of Cannon Mills and had wanted all of his employees to have the best healthcare. Cabarrus Memorial Hospital had increased the availability of diagnostic and therapeutic cardiovascular services to the community.
Cabarrus Memorial Hospital was dedicated to mostly education. They were affiliated with Duke University Medical Center, and it allowed specialists to practice of Cabarrus Memorial Hospital. The goal was for everyone to have the best healthcare services. The issues now facing Cabarrus Memorial Hospital were to address the opening of a new cardiovascular service program, in order to continue to provide this excellence in care.
Discuss ways the program does or does not comply with the hospital’s mission.
The missions for Cabarrus Memorial Hospital is that within the community can come to the hospital and get the services receive excellence in care. The hospital in the past year had referred 117 patients to open heart surgery and 82 to angioplasty. Cabarrus Memorial Hospital would be complying with their mission, with the corporation of a cardiac surgical program. Their goal is o educate, provide excellent care to their patients. They have developed a plan to establish the program and pay for the renovations for the program.
The new program being considered would include one open heart surgical suite for adult procedures with the capacity for 400 procedures per year. The additional cardiac service being considered would provide patients of Cabarrus Memorial Hospital with a full-service cardiology programs available at other community hospitals and with service areas comparable in size to the Cabarrus Memorial Hospital service area. The programs and large expenditures would assure continually of care for patients who received initial cardiac for patients who received initial cardiac care at Cabarrus Memorial Hospital. A major part of the board of trustees’ consideration was whether or not there exists a large enough service area to sufficiently support open heart surgery and the expansion of the existing cardiac services. The trustees in making their expansion: the primary and secondary service areas based data; population growth; population epidemiology; availability of existing open heart surgery medical centers; accessibility to cardiac surgery programs continuity of cardiology care; ad rate of demand for open heart surgery.
Analyze whether or not Cabarrus Memorial Hospital has sufficient infrastructure and financial resources/leverage necessary to add the program.
In addition to the market demand and trend analysis, the board was faced with the financial aspect of the decision. An open heart program would incur a number of expenses. It was projected there would be a need for ten beds licensed as acute care beds, not then being utilized to become operational as coronary care beds. A total of 5,811 square feet of hospital space would require renovation. The projected capital costs, including construction and equipment without borrowing money. Direct costs for the open heart program were projected to be $2,364,392 in year1, $3,217,739 in year 2, and $5,438,392 in year 3. The average length of stay per open heart patient was projected to be nine days. Projected average open heart surgery per case was $13,000 without catheterization and $15,000 with catheterization. The average room and board charges were estimated at $826 per day. All ancillaries were projected at $3,725 per day. Total average projected charge for each open heart surgery procedure was $40,957.
With the regards to their infrastructure, they seem to have strong board directors. The governing boards needs to be involved in the strategic directions of the organization; they seem to be involved. There is a board chairman in place as well to moderate discussion especially if there are any issues of conflict. The size of the board, it could be helpful to bring on additional member or members to add additional members or members to add depth to the based as thy attempt to expand.
Describe the competitive situation among other area hospitals that could impact the decision.
The overall service category is acute care facilities with cardiac care units with open heart surgery problem. There are sixteen facilities in North Carolina. One out of the sixteen existing facilities only one deemed Cabarrus to be in their service area. Patients may be willing to make such a trip for a one-time appointment. The travel becomes tiresome for procedures requiring multiple doctor visits, treatments, and follow-up. Cabarrus Memorial Hospital currently services Cabarrus Memorial currently services Cabarrus and Rowan countries. The 292 patients had to commute facilities that were 50 or more miles away. This interrupted their continuity of care. Of Cabarrus Memorial Hospital has a distinct advantage over the other facilities for this particular area. From the demographics, the need is only going to increase over time. Cabarrus County had a higher incidence of open heart surgery that was found in the state of North Carolina which is need of treatment. The competition would not play a factor. Their patients have already inquired why such a program is not offered at the hospital. If Cabarrus Memorial Hospital offers the program, they will be allowing convenience for their patients and their families and would cut down of the delay of care for their cardiac patients.
Describe the change in the service area required for the cardiovascular surgery service.
The past ten years, North Carolina open heart surgery volume had increased an average of 26% per year. Statistical forecast had redirected continued increases in the use of rate r 1,000 populations for the next five years. The rate of .43 open heart surgery per 1,000 population ten years ago had increased to 1.39 per 1,000. Cardiac catheterization was the major diagnostic procedure that resulted in a recommendation for open heart surgery. North Carolina cardiac catheterization volume had grown at an average annual rate of16.2% over the prior nine years. The rate of growth t was slowing anecdotal projections and trended forecasts predicted continue growth for the next five years. Over there past year, the ratio had increased to 4.54 adult catheterizations for each open heart procedure.
Discuss alternative strategies the Board should consider before making a “go/no-go” decision on the possible addition of the open heart program.
The alternative strategy needs to be considered would be the cost of the growth in demand. They need to derive their alternative strategies by taking an external audit and internal audit on their past decisions. The development of validated risk stratification model will allow for focus on the patient selection and overall improvement in development of the cardiovascular surgery service.
The additional cardiac service being considered would provide patients of Cabarrus Memorial Hospital with a full service cardiology-program consistent with programs available at other community hospitals and with service areas comparable in size to the Cabarrus Memorial Hospital service areas. The problems and large expenditures would assume continuity of care for patients who received initial cardiac care at Cabarrus Memorial Hospital.
References
Swayne, L.E., Duncan, J., & Ginter, P.M. (2009), Strategic management of healthcare organizations (6th ed.). San Francisco: Jossey-Bass.
