c982 affiliation comparison and analysis worksheet assignment 1
2 and 3c982 affiliation comparison and analysis worksheet assignment 1
2 and 3c982 affiliation comparison and analysis worksheet
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Affiliation Comparison and Analysis Worksheet (Assignments 1, 2, and 3)
Instructions:
Use this worksheet to gather relevant information for the assessment, the Affiliation Recommendation. The worksheet is from
Grube and Finnerty’s list of topics for affiliation (see the sidebar on page 2 in “How to Make the Strategic Partnering Decision”)
and has been modified to fit the assignments.
Assignments 1 and 2:
For assignments 1 and 2, use the Twin Pines Medical Center Profile in the course to find the necessary information. Be aware
that to answer the questions in these sections, you will need to draw inferences or make reasonable assumptions about Twin
Pines Medical Center (TPMC). For assignment 1 complete topics 1–5 in Table 1 below. For assignment 2 complete topics 6–8 in
Table 1 below.
Table 1
Strategic Topics Twin Pines Medical Center (TPMC)
The community served by TPMC is composed of largely low-income people with a
disproportionate percentage of minorities, 47.6% (Twin Pines Medical Center [TPMC],
n.d.) when compared to the national averages of 23.7% (US Census Bureau, 2019). About a
third of the residents are uninsured with another 36% enrolled in Medicaid (TPMC, n.d.).
The TPMC Profile also tells us that about ¾ of the population lives in an urban setting
(n.d.).
The community suffers from extensive emergency department utilization, primarily related
1. Community goals to unmanaged diabetic-related conditions, representing near 1 in 4 ED visits in 2014
What are the community’s (TPMC, n.d.). As a fictional location, community economic data is not available, though,
demographic and market needs? one can extrapolate from the uninsured and Medicaid enrollee rates that most people are
Based on those needs, what near or below the poverty level.
should be TPMC’s goals for Given these circumstances, TPMC could benefit from a robust outpatient diabetes
affiliation?
management program. Such a program would be most effective if it targeted nutrition
management, weight management, exercise, and disease education (Wexler, 2020), perhaps
specializing in diabetes management among underprivileged populations.
Based on these needs, TPMC should seek affiliation with a healthcare partner that has
extensive experience in diabetes managements. It should be a system that not only has
experience with minority patients in predominantly urban populations but also has
experience with this same programming delivered via telehealth. It would be best if the
potential affiliate had experience with a population with similar cultural needs.
1
, TPMC has adopted operational strategies that revolve around patient centered care and
fiscal responsibility. TPMC promotes patient centered care by cultivating a “culture of
quality” (TPMC, n.d.) by empowering employees as quality ambassadors. This is
accomplished by leaders setting examples for all employees as well as implementation of
programs that promote identifying safety issues and sharing safety issues and action plans
with all staff. They have also adopted a policy of fiscal responsibility. They accomplish this
by setting quality standards that are driven by evidence-based practices and ensuring
physician engagement, regardless of the patient’s financial means (TPMC, n.d.).
TPMC’s patient fiscal responsibility strategy is critical to achieving the medical centers
goals of providing a robust diabetes management program to the community they serve.
2. Strategic plans This is largely a product of the community’s poverty and will become an even more critical
What are TPMC’s operational
strategies? factor in healthcare delivery as the shift is made toward a value-based healthcare model
What strategies are most critical (cite).
to achieving community goals? Any adjustments to operational strategies must be congruent with both the mission of
What strategies could be adjusted
to fit an affiliation? TPMC and their culture. More important than identifying which specific strategies can be
adjusted, TPMC must consider how flexible any strategy is and to what degree they could
be adjusted without compromising who they are as an organization. As Tom Donohoe
stated, “If the strategies, directions, and goals aren’t clear to the parties… they will really
struggle.” (State of Reform, 2018). That said, the most flexible operational strategy TPMC
has is their approach to encouraging quality. The TPMC Profile cites numerous programs
used to improve safety and quality. What was not mentioned was how they were addressing
the patient’s perception of quality, which is a substantial consideration in a value-based
market. As Pevec & Pisnik point out in their conceptual model, patient satisfaction in a
value-based healthcare system is a product of perceived service quality, perceived service
value, and organization reputation (2018, p. 178). Being able to adapt this strategy will
allow TPMC to better align with organizations following a value-based model.
2
, “Twin Pines Medical Center offers a range of services, including dental and vision
(optometry) services, family and internal medicine, pediatric medicine, women’s health
3. Clinical services, quality, clinics (including WIC services), behavioral health, a pharmacy, and transportation services
and outcomes
What clinical services does TPMC
for patients.” (TPMC, n.d.). What TPMC does not have is a diabetes management program
provide? and appears to be lacking a dedicated endocrinology department. TPMC would benefit
In what areas can TPMC improve from developing an endocrinology department as well as a diabetes management program,
the quality of the services as research has shown that thyroid dysfunctions are more common in people with diabetes
provided? (Hage, Zantout, & Azar, 2011). The goal and purpose of such a program would be to
What are the goals for improving
provide low cost diabetes management, prevention, and education to the population that
clinical services and quality?
What are the desired healthcare TPMC serves to reduce ED visits and improve the wellbeing of the community. An affiliate
outcomes of an affiliation? for this project would need to have experience in creating such a program with fiscal
responsibility and good outcomes while allowing TPMC to maintain its desired autonomy
(TPMC, n.d.).
Currently TPMC benefits from board-certified Family Practice and Internal Medicine
physicians, board certified optometrists, A full-time pharmacist, as well as dental and
women’s health staff. The emergency department also includes an MD at all times as well
as a mid-level provider during the week. Other staff include respiratory therapists,
4. Clinical and staff
commitments and support dieticians, nursing, and health education staff(cite).
What kind of clinical expertise To meet affiliation goals, TPMC would need access to an endocrinologist and appropriate
(e.g., medical specialties) is staff. According to research published in The Journal of Clinical Endocrinology &
currently available to TPMC? Metabolism, an endocrinologist averages about 2,959 patient visits per year (Vigersky et
What clinical expertise and other al., 2014). Given that of the 48,000 patients in the TPMC service area and that 17.9% of
staff will TPMC need to meet the
goals of the affiliation?
them are diabetic (TPMC, n.d.), there are 8,592 diabetics to be served. Given these facts,
mid-level providers that specialize in endocrinology and/or diabetes management will be
required to meet the needs of the population. It would also be prudent to staff
endocrinology nurses to provide education and assessment of patient needs. The board has
also identified the need for a nutritionist and/or health educator (TPMC, n.d.).
3
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