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Running Head: Corporate Social Responsibility Reaves 1 Final Project MBA 635 Professor Kapur Southern New Hampshire University Briana Reaves 1 Running Head: Corporate Social Responsibility Reaves 2 Corporate Social Responsibility I. Background Information The Community Health Center (CHC) is a non-profit organization that has 14 comprehensive primary care centers across Connecticut. Each of these primary care centers offers medical, dentistry, and behavioral health services. CHC has a special commitment to the uninsured, underinsured, and key populations such as individuals who have HIV/AIDS. The first CHC site opened on May 1, 1972, offering free dental care in a converted second floor apartment located in Middletown, CT (Center, 2016). Mark Masselli along with community activists and a group of Wesleyan University students whose missions were to address the lack of healthcare offered to people in need, started the first CHC site. Today, Mark Masseli is the CEO of the Community Health Center. Although the community health center has been very successful, there are still many organizational issues within the company. In this analysis, I will be introducing a new case management opportunity for the Community Health Center to help address some of the organizational issues The Community Health Center’s corporate mission is to provide primary care and social services to all, particularly to those who cannot gain access to such services elsewhere (Center, 2016). Introducing case workers as a new service offered within CHC aligns with the mission because many people that are underinsured and uninsured are not able to have case workers. Case workers provide assistance and counseling to at risk populations. They provide people with advocacy, information, and services that benefit patients’ needs. CHC currently does not have case workers, so this would be an entire new service the company would offer. Within the company, case management would be marketed by the providers that work within CHC. Providers would be able to determine which of their patients would greatly benefit 2 Running Head: Corporate Social Responsibility Reaves 3 from having a case manager assigned to them. The providers who would participate in this marketing process would primarily the primary care physicians and behavioral health clinicians. The case management service would be marketed externally by CHC’s news releases, external articles, and at events CHC holds. The Community Health Center’s biggest competitor are hospitals. Although, most hospitals offer case workers, CHC does not. In order for CHC to gain more patients than its competition, the company needs to ensure that it offers the same services as its competitor. Case workers that work for the hospitals and at CHC will differentiate because the case workers at CHC will pay the case workers employees more than the case worker employees that work at hospitals. The Community Health center provides care to the uninsured, underinsured, and key populations. Many patients within these populations face multiple hardships because it can be difficult for them to receive the necessary services they need. So offering case workers to patients will help patients overcome many of the hardships they face. For example, if a patient is newly diagnosed with diabetes, a case worker would be able to provide them with information about where they can further learn about diabetes, so they can get a better understanding. Such as informing them about a diabetes patient education group that is taking place and then following up with the patient to make sure that they went. Yes, the provider should be able to do this, but because they have so many tasks to complete, many of them fail to find the time to give this type of information to patients. Another example is, if the patient that was newly diagnosed with diabetes cannot afford their medication, a case worker would be able to offer the patient different programs that could assist them when paying for the medication and help them apply for it. The provider could offer the information about the program as well, but they don’t necessarily have 3 Running Head: Corporate Social Responsibility Reaves 4 the time to help the patient apply for them. So that would be one of the tasks the case worker would complete. II. Trends a. Internal Factors The CEO of CHC, Mark Masselli founded CHC off of the motto that ‘healthcare is a right, not a privilege.’ Based off of this motto, CHC has developed many strengths. CHC’s strengths lie in the talent, expertise, commitment and diversity of leadership (Center, 2016). CHC started off as one site that offered free dental care on a second floor apartment building. However, today CHC operates 14 comprehensive primary care centers and has over 200 service locations across the state of Connecticut (Center, 2016). These service locations include 51 licensed school-based health centers, six homeless shelter clinics, and preventive dentistry that is delivered in nearly 200 schools through their mobile dental clinic. (Center, 2016) CHC delivers care to over 145,000 patients in Connecticut which still continues to increase each day. CHC offers healthcare to all individuals that need healthcare. There are many healthcare facilities that do not accept individuals without insurance, but CHC sees patient’s whether they have insurance or not. Patients of CHC are able to come in and bring in their proof of income or tax return forms for the current year to be placed on a “sliding fee scale.” The sliding fee scale helps determine how much a patient has to pay for each visit based off of their income, if they do not have insurance. Having a sliding fee scale, ensures that all people have access to healthcare. CHC also has an “Access to Care” department who helps individuals obtain insurance. Before a patient is put on a sliding fee scale, they have to speak with an Access to Care coordinator. The Access to Care coordinator looks to see if the individual is eligible for insurance and if they are, they help 4 Running Head: Corporate Social Responsibility Reaves 5 them apply. They also do outreach events to help people in the community that are insured to obtain insurance as well. Along with medical, dentistry, and behavioral services, CHC offers specialty services as well. Patients are able to see nutritionists/diabetes educator, chiropractors, podiatrists, and receive retinopathy exam all within CHC. So instead of having to be referred to these kind of specialists, patients are able to see them right in their local office. If CHC does not have a specialists a patient needs, they are then referred out to a specialist that accepts their insurance. Although the Community Health Center has many strengths, it also has its weaknesses. Most of CHC’s patients have Medicaid and Medicare insurance. There are many healthcare practices that do not accept those insurances, so CHC is one of the few in the state of Connecticut that does. According to You’ve got Medicaid-Why Can’t You See the Doctor, when comparing reimbursements rate among health insurance plans, Medicaid is the lowest payer, meaning it’s not a money maker for doctors’ offices (Renter, 2015). So many providers that work for CHC aren’t getting paid as much as they would if they worked for a practice that didn’t accept Medicaid. Because of this reason, this increases the provider turnover rate at CHC which in turn affects patients’ quality of care. This affects patients’ quality of care because their primary care physicians change, when the one they have been seeing has left the practice. CHC offers tuition reimbursement plans for providers. Licensed providers can earn up to $50,000 toward student loans in exchange for a 2-year commitment to a NHSC-approved site (Center, 2016). So the providers that participate in this program only end up staying with CHC for a little over 2 years. Many patients at CHC have chronic pain cases. The patients that have chronic pain cases, agree and partake in treatment plans their primary care physician comes up 5 Running Head: Corporate Social Responsibility Reaves 6 with. When their primary care physician ends up leaving, they have to see a completely different provider. So the provider they see has to learn and study their case which can take time. b. External Factors The Community Health center provides care to the uninsured, underinsured, and key populations. Obamacare also known as the Patient Protection and Affordable Care Act (ACA) allows most of the patients of CHC to have health insurance. On March 23, 2010, President Barrack Obama signed this law, so Americans could have access to affordable, quality health insurance, and to reduce the growth in U.S. healthcare spending (Obamacare, 2016). According to the Obamacare website, Obamacare offers many benefits to patients such as: • Letting young adults stay on their parents insurance until they turn 26 • Stopping insurance companies from denying coverage and charging more based off of a person’s health status • Stopping the insurance company from letting a person go because they’re sick or make a mistake on the application • Preventing gender discrimination • Stopping insurance companies from imposing unjustified rate hikes • Getting rid of life-time and annual dollar limits • Expanding Medicaid insurance to millions in states that decided to expand the program • Requiring all insurers to cover people with pre-existing conditions These benefits of Obamacare help to ensure that patients receive quality healthcare. Although, one of the things that affects a patient’s care under the ACA is whether or not doctors and hospitals will agree to accept patients who buy the healthcare plans (Leonard, 2015). In 6 Running Head: Corporate Social Responsibility Reaves 7 most states, doctors can choose not to participate in networks offered in the marketplaces, also known as exchanges (Leonard, 2015). Therefore, many patients end up seeing doctors outside of their healthcare network and have to pay an exorbitant amount of out-of-pocket expenses. However, the Community Health Center accepts most health insurances, so this helps many individual avoid out-of-pocket expenses. Since the Community Health Center is a non-profit organization, the company receives different grants from the government. For example, CHC has a suboxone program which is a treatment program for patients that are dependent on pain prescriptions, methadone, heroin, and opiates. The program director has to write a grant and submit it to a federal agency. Usually, the grants are submitted to federal agencies such as HRSA or SAMHSA. Both of these federal agencies provide grants to CHC for healthcare all of its key populations. Overall, CHC has about seven key populations which includes individuals with HIV/AIDS, HEP C, sexually transmitted disease prevention, LGB care, transgender health, substance abuse disorders, and primary care for the homeless (CHC, 2016). All of these key population programs are federally funded by the government. Grants through HRSA and SAMHSA provides support for each program. For example, with the suboxone program, the grants allow for the program to have care coordination, provider training, and the distribution of suboxone vouchers. Care coordinators help to monitor how the program is going and the patients. Providers of the program have to attend monthly trainings in order to get updated about different ways suboxone is affecting patients and how they can make it better. During the trainings, providers are not able to see patients for their appointments, so the grants that are received help to pay for the provider trainings along with making sure CHC can afford for providers to miss appointments. The program distributes suboxone vouchers to patient, so they do 7 Running Head: Corporate Social Responsibility Reaves 8 not have to pay for their medication to be treated. The suboxone program is just one example of CHC’s key population program. Overall, the programs are run similar, but this could not be possible without the grants CHC receives. All of these factors have an impact on the corporate social responsibility, sustainability, and business ethics. According to A New Vision for Corporate Community Engagement in the Digital Age, companies are no longer asking whether they should align their strengths with the needs of the community, but how to do it effectively, affordably and at scale (Baldwin, 2017). CHC is actively aligning their strengths with the needs of the community. If CHC continues to adhere to this type of corporate social responsibility, this in turns affects the sustainability and business ethics. It affects the sustainability and business ethics because CHC will have to continue to innovate and evolve to align its giving practices with the business goals (Baldwin, 2017). The business goals of CHC are providing healthcare to all persons in the community and to maintain the quality of their services, so they can continue to receive grants. Maintaining the quality of services ties into business ethics because by maintaining the quality of services it helps to keep a positive ethical climate within the company. III. Ethics There are many ethical issues that can occur when implementing the case management service business plan for CHC. Since the Community Health Center is a non-profit organization, the company receives different grants from the government. If the case management service were to be implemented, CHC would need to receive a grant to hire case workers for the sites. So the case management service would be grant funded and CHC would have to ensure that the service is successful to continue receiving funds for the service. 8 Running Head: Corporate Social Responsibility Reaves 9 Due to the population handled on a daily basis, this service program would require individuals who are able to multitask and work in a challenging environment. The case workers would most likely have to take on tedious work loads because CHC caters to many patients that have very complex issues. So CHC would need to ensure that the retention rate for case workers stays low. It will not be fair to the patients to have to establish relationships with new case workers every few months. Many patients at CHC already have a difficult time having a consistent primary care physician. Most of CHC’s patients have Medicaid and Medicare insurance. There are many healthcare practices that do not accept those insurances, so CHC is one of the few in the state of Connecticut that does. According to You’ve got Medicaid-Why Can’t You See the Doctor, when comparing reimbursements rate among health insurance plans, Medicaid is the lowest payer, meaning it’s not a money maker for doctors’ offices (Renter, 2015). So many providers that work for CHC aren’t getting paid as much as they would if they worked for a practice that didn’t accept Medicaid. Because of this reason, this increases the provider turnover rate at CHC which in turn affects patients’ quality of care. This affects patients’ quality of care because their primary care physicians change, when the one they have been seeing has left the practice. These ethical issues impact the brand development and the decision making process because CHC would need to strategize on how they can convince the government to grant funds for the case management service. CHC would also have to try to ensure that the case managers have a low turnover rate. It becomes an ethical situation when patients have to be concerned about having a different case manager every few months. IV. Decision Making a. Decisions 9 Running Head: Corporate Social Responsibility 10 Reaves As previously described, there are many ethical issues that can occur when implementing the case management service business plan for CHC. Since the Community Health Center is a non-profit organization, the company receives different grants from the government. If the case management service were to be implemented, CHC would need to receive a grant to hire case workers for the sites. So the case management service would be grant funded and CHC would have to ensure that the service is successful to continue receiving funds for the service. Within these issues, decisions will need to be made regarding the case management service. CHC will need to decide how many case manager should be hired, what exactly their job descriptions will entail, and what rescources the case managers will be able to have access to, so the patients can utilize them. In order to make these decisions and ensure that the case management service is successful, it should be thoroughly evaluated to determine how CHC can enhance and improve it. Evaluating the service would also involve all of the stakeholders which would help the service become even more successful. Communication with stakeholders is a key step in the process of decision making. The input and feedback the stakeholders give regarding the case management service can help CHC continue to receive grants pertaining to the service. Based off the evaluation processes, CHC will be able to decide how to move forward with making decisions. The case management service can be evaluated by patient satisfaction surveys, employee satisfaction surveys and benchmarking. These three evaluation processes are very important for CHC to utilize. CHC has many organizational issues and having a case management service would primarily be the solution to the issues. For example, CHC has a high provider turnover rate. Many providers tend to leave the company due to heavy workloads. However, if each 10 Running Head: Corporate Social Responsibility 11 Reaves provider were to have a case manager, it would most likely reduce work related stress and in turn, providers would stay with the company. -Patient Satisfaction Surveys CHC can incorporate questions into their patient satisfaction surveys. The aim of patient satisfaction surveys is to identify whether and how service users evaluate services (Elsevier,1998). Within the patient satisfaction surveys, CHC will be able to ide ntify whether or not case management services are benefiting the patients. The patient satisfaction surveys would also be able to determine any improvements the case management service needs. For example, if a patient is newly diagnosed with diabetes, a case worker would be able to provide them with information about where they can further learn about diabetes, so they can get a better understanding. Such as informing them about a diabetes patient education group that is taking place and then following up with the patient to make sure that they went. Yes, the provider should be able to do this, but because they have so many tasks to complete, many of them fail to find the time to give this type of information to patients. Another example is, if the patient that was newly diagnosed with diabetes cannot afford their medication, a case worker would be able to offer the patient different programs that could assist them when paying for the medication and help them apply for it. The provider could offer the information about the program as well, but they don’t necessarily have the time to help the patient apply for them. So that would be one of the tasks the case worker would complete. To ensure that having a case manager complete this type of task benefits the patient, a direct question can be asked on the survey asking the patient if a case manager has helped them with getting access to resources that will enhance the success of the outcome of their treatment plans. 11 Running Head: Corporate Social Responsibility 12 Reaves Considering the population CHC has, it can be very difficult for to obtain the patient satisfaction surveys. Many times, patients move, the patient does not understand the questions they are being asked to answer, they cannot read or write, they can’t remember who the case manager they met was, etc . So the best way to conduct the process for patients to complete the surveys is to have them complete it in the office with a secretary. If patients are able to complete the surveys in the office they will be able to ask questions if they don’t understand the questions and the visits with the provider and case manager will be fresh in their minds. -Employee Satisfaction Surveys In the employee satisfaction survey, questions about the case management service can be included. By providing questions about the case management service, CHC will be able to determine if the service is benefiting providers. Providers will also be able to give the company feedback about the service and what can be improved. As stated previously, since there is a high provider turnover rate, the case management service would be able to decrease the provider turnover rate. So it is very important for to get the provider’s input to help evaluate the case management service. -Benchmarking Benchmarking is a measurement of quality of an organization’s policies, products, strategies etc. When using the benchmarking process, CHC will be able to compare the case management service to other organizations. By comparing the case management service to other companies’ case management service, CHC will be able to generate ideas in order to improve the service. For example, one of the competitors of CHC is StayWell Health Center. StayWell Health Center offers a case management service and many patients choose to 12 Running Head: Corporate Social Responsibility 13 Reaves become patients there because of this. However, is CHC were to have a case management service and the benchmarking process was completed, CHC would find that StayWell Health Center case managers have to refer patients to get their bloodwork done at hospitals. Because of the population the health centers serve, many patients do not have transportation. So if a patient has to travel to get their bloodwork done at a hospital, they either don’t get it done or it takes them a long period time. CHC works with Quest Diagnostics. Quest Diagnostics provides clinical laboratory services for patients. Quest Diagnostics agreed to have a “Quest lab” located at CHC site. This was a great opportunity for both CHC and Quest Diagnostics because right after a patient gets out of an appointment, they are able to go get there bloodwork done right then and there at a Quest lab. Many patients have difficulty with transportation, so it makes it very convenient for them to not have to travel somewhere else to get their bloodwork done. So using the benchmarking process to evaluate the case management process would also help CHC determine its advantages. CHC will use these three types of evaluations to make decision on the case management service. The results from the evaluations will be able to determine the amount of case managers that are needed, what their jobs should entail, and what other resources are needed regarding the patients. b. Culture and Stakeholders These decisions and processes will affect business sustainability and elements of corporate culture because when CHC implements the case management service, the company will have to ensure that it meets the legal, ethical, and economic 13 Running Head: Corporate Social Responsibility 14 Reaves responsibilities. If CHC does not adhere to meeting these responsibilities, this could cause them not to or lose the grant for the service. The community will strongly be involved in the decisions being made because they are who CHC caters to. The processes of the decision making will help establish a great corporate culture within CHC because it allows all of the stakeholders to be involved. The case management service will affect everyone in the and outside of the company. It will affect stakeholders internally because the patients and employees will be the people that primarily benefit from the service. Externally, when case managers have to refer patients to outside resources, this decision making will affect those other companies as well. No stakeholders should be alienated during this process. It is very crucial to have them involved because they will make the case management service a success. V. Impact The issues that CHC faces regarding the case management service will have a major impact on the community. Since CHC is a non-profit organization, the company would have to continue to recieve a grant to be able to hire case workers. If CHC can prove that case workers ate very beneficial to the company’s success, the federal government would be able to provide funding to provide the salaries and resources to have the case management service. CHC would need to use the evaluation processes to determine how to make the case management service a success as stated previously. Depending how much funding the company can get for the case management service, if the service turns out to be successful, the government would most likely be willing to offer more funds. 14 Running Head: Corporate Social Responsibility 15 Reaves The Community Health center provides care to the uninsured, underinsured, and key populations. Many patients within these populations face multiple hardships because it can be difficult for them to receive the necessary services they need. So offering case workers to patients would have a major impact on the community as well as globally. Case workers provide assistance and counseling to at risk populations. They provide people with advocacy, information, and services that benefit patients’ needs. CHC currently does not have case workers, so this would be an entire new service the company would offer. For example, if a patient is newly diagnosed with diabetes, a case worker would be able to provide them with information about where they can further learn about diabetes, so they can get a better understanding. Such as informing them about a diabetes patient education group that is taking place and then following up with the patient to make sure that they went. Yes, the provider should be able to do this, but because they have so many tasks to complete, many of them fail to find the time to give this type of information to patients. Another example is, if the patient that was newly diagnosed with diabetes cannot afford their medication, a case worker would be able to offer the patient different programs that could assist them when paying for the medication and help them apply for it. The provider could offer the information about the program as well, but they don’t necessarily have the time to help the patient apply for them. So that would be one of the tasks the case worker would complete. Recently, the Primary Care Development Corporation (PCDC) completed financing on a $47 million project that will drastically increase access to primary care services at CHC (PCDC, 2017). The financing is going to increase services at CHC by 60 percent which will expand it’s reach to 11,000 patients in economically distressed areas (PCDC, 2017). So this 15 Running Head: Corporate Social Responsibility 16 Reaves service increase will allow for CHC’s case management service to become needed since CHC will be gaining more patients. Overall, the case management service is a great asset to the Community Health Center because it will help improve organizational issues in a major way. Not only will it benefit the employees, but it will help patients receive the best healthcare possible. There are many decisions that will have to be made to make sure that the service will be successful, but it will have a major impact on the community. VI. Outcomes The Community Health Center’s corporate mission is to provide primary care and social services to all, particularly to those who cannot gain access to such services elsewhere (Center, 2016). Introducing case workers as a new service offered within CHC aligns with the mission because many people that are underinsured and uninsured are not able to have case workers. Case workers provide assistance and counseling to at risk populations. They provide people with advocacy, information, and services that benefit patients’ needs. The case management service would further develop cultural awareness and civic engagement. Culture awareness at CHC aligns with cultural competence. The Community Health Center employs and provides care to people of all different backgrounds and ethnicities. One of CHC’s main focuses to ensure that the needs of the patients are met is cultural competence. Cultural competence is a set of congruent behaviors, attitudes, and policies that come together in a system, agency, or those professions to work effectively in cross-cultural situations (Cultural Competence, 2004). CHC employees work together to accommodate each patient. For example, CHC provides care to many Muslim women. Most Muslim women that are patients of CHC request to see female 16 Running Head: Corporate Social Responsibility 17 Reaves providers. According to Respecting Muslim Patients’ Needs, for observant Muslim women, covering up the body is important when they are in the company of non-mahram males, those not related by blood or marriage (Rabin, 2010). CHC employees always honor these types of requests because they are aware and respect the cultural values of patients. According to the Curricula Enhancement Module website, cultural competence consists of five essential elements such as: • Valuing diversity • Having the capacity for cultural self-assessment • Being conscious of the dynamics inherent when cultures interact • Having institutionalized culture knowledge • Having developed adaptations to service delivery reflecting an understanding of cultural diversity CHC honors all of these elements within cultural competence and awareness. The example above proves that these elements reflect the attitudes, structures, policies, and services of the organization. Along with cultural awareness, CHC honors all socioeconomic backgrounds. CHC employees show respect and provide care to patients in different social and economic positions based on income, education, and occupation. CHC believes that no patient should be turned away no matter what their socioeconomic status may be. As stated previously in the economic factors, CHC has key populations within the agency. For example, CHC provides care to transgender patients. Many of the transgender patients prefer to be called by a different name, but sometimes their name hasn’t been legally changed. So out of respect, CHC has implemented a 17 Running Head: Corporate Social Responsibility 18 Reaves section in their chart for a preferred name to be entered. Employees are advised to use the preferred name when speaking to them. Since CHC is very diverse, there are many patients that speak different languages. To help communicate efficiently with patients whose first language isn’t English, CHC hires employees that are able to speak more than one language. Some of the positions at CHC, require employees to be bilingual. At CHC, it is preferred that an individual knows how to speak Spanish because over 50% of the patients at CHC speak Spanish. CHC also has many polish speaking patients and have to hire employees that speak polish as well. If an employee is not able to communicate with an employee because they do not speak the same language, they can use CHC’s language line. CHC’s language line has over 12 different languages. The employees have to call the language line to speak to an interpreter that is able to translate. Utilizing the language ensures effective communication, so patients can receive the healthcare they deserve. The Community Health Center engages in civic engagement because the company works to help people in the community. Civic engagement means working to make a difference in the civic life of our communities and developing the combination of knowledge, skills, values, and motivation to make a difference (Ehrlrich, 2000). By ensuring that CHC displays cultural awareness this ties into civic engagement. CHC constantly has to develop knowledge about different cultures within the community, so they can provide proper care as stated in the examples above. Alignment As stated previously, The Community Health Center’s corporate mission is to provide primary care and social services to all, particularly to those who cannot gain access to such services 18 Running Head: Corporate Social Responsibility 19 Reaves elsewhere (Center, 2016).CHC’s vision is to define how a full spectrum of healthcare services – including both physical and mental health that can be delivered where they are needed most. The intent in everything they do is to improve health outcomes for the patients and build healthy communities (Center, 2016). CHC also values it’s motto that ‘Healthcare is a right, and not a privledge.’ The efforts of cultural awareness and civic engagement play major roles when they align with CHC’s misson, vision, and values. The healthcare industry has existed for many years and is forever developing. Most developed countries have a universal healthcare system that allows all citizens to have access. However, the healthcare system in the U.S. does not allow all of its citizen’s to partake in healthcare because not all citizens are able to afford or qualify for health insurance. Although, the Emergency Medical Treatment and Labor Act (EMTALA) ensures public access to emergency services regardless of ability to pay (CMS, 2012). So an uninsured individual is able to go to a public hospital to be treated. Medicare-participating hospitals that offer emergency services must provide a medical screening examination when a request is made for examination or treatment for any emergency medical condition (CMS, 2012). Nonetheless, if an uninsured individual does not have a medical emergency, it can be very difficult for them to be seen. Privately for-profit hospitals are allowed to turn uninsured individuals away. This is how the idea of having a community health center came about. The first CHC site opened on May 1, 1972, offering free dental care in a converted second floor apartment located in Middletown, CT (Center, 2016). Mark Masselli along with community activists and a group of Wesleyan University students whose missions were to address the lack of healthcare offered to people in need, started the first CHC site. Today, Mark Masseli is the CEO of the Community Health Center. Before Masselli founded CHC, he started a crisis center within the 19 Running Head: Corporate Social Responsibility 20 Reaves community. From the crisis center, Masselli discovered that problems people brought to the center all shared a common characteristic, they all originated from the lack of early and consistent access to good, affordable healthcare (Center, 2016). Masselli brought an entrepreneurial spirit to his non-profit organization and continues to build CHC sites within Connecticut. Impact The alignment of the cultural awareness and civic engagement efforts with corporate mission, vision, and values improve corporate exposure because there are many underserved communities that are in desperate need of need resources. So if CHC displays cultural awareness and civic engagement, this will expose the company to the community. CHC offers healthcare to all individuals that need healthcare. There are many healthcare facilities that do not accept individuals without insurance, but CHC sees patient’s whether they have insurance or not. Patients of CHC are able to come in and bring in their proof of income or tax return forms for the current year to be placed on a “sliding fee scale.” The sliding fee scale helps determine how much a patient has to pay for each visit based off of their income, if they do not have insurance. Having a sliding fee scale, ensures that all people have access to healthcare. CHC also has an “Access to Care” department who helps individuals obtain insurance. Before a patient is put on a sliding fee scale, they have to speak with an Access to Care coordinator. The Access to Care coordinator looks to see if the individual is eligible for insurance and if they are, they help them apply. They also do outreach events to help people in the community that are insured to obtain insurance as well. If the company is exposed to the company, this will increase profits as well. Through this whole process, CHC displays cultural awareness and civic engagement because they are catering to all 20 Running Head: Corporate Social Responsibility 21 Reaves people in the community regardless of their social status and background. With this corporate exposure, it also can increase profits. The efforts of cultural awareness and civic engagement can improve profits because the more patients CHC receives, the more profits will increase. As stated previously, CHC is funded by grants. So if CHC receives more patients, the company will be able to present it to the government to be provided with more money. As a healthcare practice, CHC also receives money through patients insurances. Citizens pay monthly insurance fees to ensure they will be covered when they go see to the doctor, hospital, or clinic (Understanding the U.S. Healthcare System, 2016). Most U.S. citizens obtain health insurance through their employers. If a patient is not able to obtain health insurance through their employer, they can fall under the Patient Protection and Affordable Care Act also known as “Obamacare” that was voted into law. (Understanding the U.S. Healthcare System, 2016). The Patient Protection and Affordable Care Act allows citizens who cannot afford, or did not want insurance, or because they were rejected because of pre-existing conditions, to be insured. So CHC is able to get paid through this type of an insurance. There are many challenges that come along with this type of insurance, but CHC is still able to make profit because of the many patients that are being seen. The more patients that are, the more money that is made. The Community Health Center would not be able to be successful, if it did not display cultural awareness and civic engagement. There are many people in the community that need CHC, so they can receive the healthcare that they need. CHC has to continue to obtain knowledge about the community to ensure that patients’ needs are being met. VII. Conclusion 21 Running Head: Corporate Social Responsibility 22 Reaves The intrinsic rewards for the community health center will be the employee satisfaction and the profits they will receive from having the case management service. As stated previously, CHC has a high turnover rate, so having the case management service will increase employee satisfaction when it comes to providing more support to providers. CHC will also be able to bill insurance companies for each case management service visit. So this would increase the company’s profits. The extrinsic rewards would be developing relationships with outside companies and resources. Within the case management service, patients will have to be referred out to different facilities regarding what their treatment plans contain. For example, CHC will be able to develop relationships with pain management clinics in different areas, so patients can be referred to them for pain management. The case management service will be a great asset to the Community Health Center because it will help improve organizational issues in a major way. Not only will it benefit the employees, but it will help patients receive the best healthcare possible. The case management service is a great need for CHC and it is almost guaranteed that it will help ensure the continued success of the company. Although, implementing the case management service business plan will be a great challenge, it is the worth the effort. 22 Running Head: Corporate Social Responsibility 23 Reaves References Center, C. H. (2016, July). Our History. Retrieved from Community Health Center: http://www.chc1.com/About-Us/Our-History CMS. (2012, March). Emergency Medical and Treatment Act. Retrieved from Centers of Medicare and Medicaid Services: https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA/ Rabin, R. C. (2010). Repecting Muslim Patients’ Needs . The New York Times. Renter, E. (2015). You’ve got Medicaid-Why Can’t You See the Doctor? U.S. News. Understanding the U.S. Healthcare System. (2016, November). Retrieved from Interexchange: https://www.interexchange.org/articles/abroad/2015/08/10/understanding-us-healthcaresystem/ PCDC. (2017). PCDC Financing Supports $47 Million Expansion of Primary Care in Connecticut. CHC News. Retrieved from https://www.chc1.com/News-and-Events/NewsReleases/pcdc-financing-supports-47-million-expansion-of-primary-care-in-connecticut Baldwin, G. (2017). A New Vision for Corporate Community Engagement in the Digital Age. Retrieved from Volunteering is CSR website: http://blogs.volunteermatch.org/volunteeringiscsr/2017/04/19/anew-vision-for-corporate-community-engagement-in-the-digital-age/?gclid=CjwKCAiAz7UBRBAEiwAVrz-9cwBYtjlriOk2N3wKfivElemnerYTnTE2FtRHs8oJzvxnTwMRzFySRoCfaIQAvD_BwE 23 Running Head: Corporate Social Responsibility 24 Reaves 24 RUNNING HEAD: FINAL PROJECT Reaves 1 Briana Reaves Professor Rayford MBS 690 Southern New Hampshire University 1 RUNNING HEAD: FINAL PROJECT Reaves 2 Case Manage Service within the Community Health Center Operations Management Operations management as is known today started during the 20th century. During this century, many organizations experienced growth which necessitated operations management approaches for proper handling of business processes. The Second World War also proved to be very supportive of operations management. The War necessitated the development of means to help in the efficient allocation of resources, and the industrial revolution that followed the War further increased interest in operations management. Founded in 1972, Community Health Center Inc. is one of the organizations that have experienced operations management first hand. Community Health Center Inc. has been part of and a recipient of the significant forces behind shifts and changes in operational management in recent years, and how it has responded to these forces in terms of addressing the ensuing obstacles, business operations, organizational structures, and operations management philosophy interesting. Significant forces behind operations management and how they impacted business operations of the organization One of the greatest forces behind operations management is the growing interest in concepts like Total Quality Management (TQM). Throughout the 1980s, TQM emerged as a particular area of interest to operations managers. TQM was seen as the best way of overseeing all processes of an organization to improve the quality of output of every process (Bayraktar et al., 2007). Years that followed the 1980s witnessed an explosion of interest in increasing quality. For the service industry, especially, quality became very crucial as it was the selling point. Healthcare organizations included in their mandate to provide affordable care the idea of quality. 2 RUNNING HEAD: FINAL PROJECT Reaves 3 As one of the organizations that were formed during this period, Community Health Center Inc. had created a selling point by focusing on quality. The 1970s is a period in which there was a lot of interest in the development of information systems. At the time, there were massive research and developments in computer integrated systems to help in the management of information. Although the computational power of most of the systems developed during this time was very low, computers remained a crucial aspect of operations management. Computers were used to store information relating to different processes, retrieve information, plan inventories, make projections, and establish the point of efficiency. Community Health Center Inc., as do other healthcare organizations of the time, were very lucky to have computers at their disposal. In 1972, for instance, Regenstrief Institute developed the first electronic medical record. Although the first EHR systems were very expensive to be afforded by the then smaller organizations such as Community Health Center Inc., their availability prompted many of these organizations to develop cheaper internal systems to streamline the storage and management of patient information (Evans, 2016). Besides TQM and information systems, technological advancements in the areas of production have also played a big role in pushing operations management towards what it is today. Advancements in medical technologies, for instance, have made it possible for healthcare organizations to streamline operations as they are efficient. Key obstacles to management as a result of the evolution of operations management Any process of evolution brings with it rapid shifts and changes that make the business environment very unstable. The evolution of operations management brought with it many shifts in the way business operations are carried out, and some of these changes necessitated the restructuring of organizational processes. There have been many operations management 3 RUNNING HEAD: FINAL PROJECT Reaves 4 philosophies that have been developed over time and many of them are still in the testing phases. One challenge faced by early adopters is higher risks especially when organizations are yet to effectively train staff on new techniques. Also, rapid technological advancements in the field of operations management force organizations to adapt quickly to new technologies or else risk going obsolete and old-fashioned. In many cases, adoption of any new technology, especially in the healthcare industry, comes at huge costs that many organizations are not always able to suffice. This sometimes forces organizations to sacrifice other important business aspects to adopt technology to keep pace with the rest of the players in the industry. Another obstacle that organizations have had to deal with concerning the evolution and development of operations management is environmental consciousness. Previously, companies did not have to be concerned so much about how their operations impacted the environment. Of late, however, governments have come up with regulations to govern the interactions between organizations, people, and the physical environment. Things like climate change and environmental pollution have become a big concern for modern operations managers, and this has resulted in the development of concepts such as the triple bottom line and lean manufacturing. Triple bottom line (TBL) encourages operations managers to not only focus on profits but also to pay attention to the environment and communities (Gimenez, Sierra & Rodon, 2012). Community Health Center Inc. has invested in research and innovation as a way of staying ahead in matters of technological advancements. For instance, the organization has over the years taken part in the national All of Us initiative which pioneers research and development in the area of health. The organization further works with the Weitzman Institute in research and innovation, and this helps it to keep tabs with the latest in the area of technology. Remaining 4 RUNNING HEAD: FINAL PROJECT Reaves 5 ahead of the rest in matters of technology is often the best way to make sure one is not left behind. Besides this, Community Health Center Inc. has also tried to incorporate the concept of sustainable business operations in its operations as a way of addressing the challenges associated with environmental conservation. Changes to operations management philosophies and organizational structures The recent few years have seen many business operations become very complex. This has been prompted by various factors including liberalization and opening up of borders, new consumer demands, globalization, technological advancements, and the emergence of new business challenges. In response, operations managers have had to come up with new operations management philosophies as well as re-engineer organizational structures. One of the key changes in operations management is the introduction of business process management (BPM). BPM involves a focus on key business processes individually to identify areas of improvement. In recent years, many organizations have shifted focus from systems theory to BPM. Systems theory looks at processes as a single system with integrated processes and aspects. In contrast, BPM tends to analyze every process individually to establish issues, and this gives operations managers a better understanding of each process and how they integrate with the rest of the organization (Del Giudice et al., 2018). Also in response to the evolving complexities of business operations, many organizations have invested in research and development of inventory management approaches to minimize costs and improve efficiency. Just-in-time (JIT) system, for instance, has become very popular in the management of inventory. JIT was introduced by Toyota but it has since become widespread. Today, even healthcare organization appreciate the benefits of aligning inputs with operations management. Under the JIT philosophy, inventories are held only to the level they are required 5 RUNNING HEAD: FINAL PROJECT Reaves 6 in the production of goods and services. Also, lean production has gained prominence in healthcare. It involves, for instance, eliminating unnecessary tests and procedures and forecasting only on practices that add real value to patients (Protzman, Mayzell & Kerpchar, 2018). Lean has been leveraged in healthcare to increase the quality and safety of care while at the same time reducing the overall cost of care. Another way that organizations have tried to respond to the growing complexities in business operations is through the adoption of Collaborative Planning, Forecasting, and Replenishment (CPFR). CPFR is an emerging supply chain management philosophy whereby trading partners work together through the use of standardized business procedures and information technology to increase their intelligence, planning, and forecasting of the market. As processes become complex, it had dawned on many organizations that working together is mutually benefiting. This approach encourages organizations to work closely with suppliers and customers so that all of them get the best out of the supply chain management process. Other changes include globalization, e-commerce, and outsourcing. Many organizations have assumed a global perspective in efforts to take advantage of wider markets. One of the key aspects of globalization is going digital and abandoning traditional brick and mortar stores. As a result, many companies now maintain websites and mobile applications from where customers can access goods and services. Besides having websites and mobile platforms, business enterprises are now utilizing modern means of communication and marketing through things like social media. The internet has become an important asset in marketing. Outsourcing has also become rampant. Operations managers understand the importance of outsourcing processes that the business itself does not enjoy sufficient leverage to engage in. At the same time, however, operations managers are aware of and plan for the challenges associated with outsourcing. Business operations of Community Health Center Inc. Organizational processes Community Health Center Inc. is a community-based health organization albeit with a national reach. The organization offers a variety of healthcare services including medical and 6 RUNNING HEAD: FINAL PROJECT Reaves 7 dental services, behavioral health, urgent care, and school-based health. These services are provided by a team of dedicated professionals from different disciplines such as research and training teams, medical team, and support staff. As a community health provider, the organization makes use of simple organizational processes. The process starts at the reception where a patient is observed for the seriousness of his/her conditions. After this point, a patient is invited into a triage where a doctor does a physical examination and decides the necessary tests. After these tests, a treatment plan is designed. As with most healthcare organizations, Community Health Center Inc. works under the First come first served regime. However, patients who require urgent care are given priority. How business operations support the organization’s strategic plan, mission, and vision The mission of the organization is to provide healthcare for everyone, and it is a nonprofit organization. This means that making profits is not a priority for the organization. Rather, the organization depends on grants and donations from the government, other organizations, and well-wishers. The organization focuses on providing social services and primary care especially to low-income persons who may not be able to access these services from other institutions. To achieve this mission, Community Health Center, Inc. has adopted a business model that is based on the cooperation with different agencies, commitment, and promotion of human rights and dignity, and consumer control. Also, the organization is determined to go beyond traditional care to offer and promote preventive care, treatment, and management of illnesses all in one visit. This multifaceted approach to care ensures that the organization has a wider angle to care. CHC also utilizes modern technology and innovative techniques to ensure care is taken where it is needed when it is needed. Making healthcare affordable is yet another business aspect that the organization uses 7 RUNNING HEAD: FINAL PROJECT Reaves 8 to achieve its mission. Its focus on the underserved is particularly important in designing affordable care to those who may not afford the same care elsewhere but need it to lead healthy and happy lives. Factors that affect productivity and profitability One of the factors that affect productivity at CHC is technology. The technology behind processes such as billing, patient records management, inventory management, and referrals is very critical in affecting how efficient and effective things are done. Better technologies are associated with higher productivity. Personnel factors also affect productivity. Mood, motivation, inspiration, and satisfaction, for instance, affect how productive the medical and support staff will be. It is for this reason that the organization has taken time to develop effective leadership to ensure the working environment is conducive for everyone. Financial factors also affect productivity. Access to experienced staff and the best technology depends on the availability of financial resources. CHC is a non-profit organization. However, some of the factors that affect profitability include salaries and wages, rent in places where the organization does not own premises, and other expenses. The number of patients served is also a factor of profitability whereby many people served attract higher profits. Trends in production, quality, resource, and information management and their impact on business operations One key trend in healthcare is telehealth. This is the provision of healthcare services over electronic media as opposed to physical contact between a patient and a doctor. Telehealth is increasingly changing the healthcare environment, and it remains to be seen how CHC will incorporate it into its operations. If successfully used, telehealth could create new opportunities 8 RUNNING HEAD: FINAL PROJECT Reaves 9 for serving many people and reducing traffic at the physical health centers. Drug management is yet another trend that is slowly taking shape in the healthcare industry. The Internet Of Medical Things (IoMT) technology, for instance, is expected to assist in the administration of drugs. This technology will make it possible for practitioners to know exactly when a patient took a particular drug or even alert the hospital when a wrong prescription is given to a patient. The impact of drug management is that it will increase treatment monitoring and adherence while also reducing medical errors associated with the wrong prescription. There is also a trend in patient safety as a way of minimizing costs. Patient safety, defined as the prevention or reduction of patient harms, is expected to reduce the cost of care. It will reduce the level of readmission and the need to use extra resources to address issues of patient harms. Smart biosensors, big data, AI, and medical record accessibility are all trends that are expected to revolutionize information management. Conclusion In summary, Community Health Center Inc. has experienced the impacts of operations management first hand. Developments in TQM and information systems are some of the forces behind operations management. Some of the obstacles brought about by developments in operations management include unstable technological environment and environmental consciousness. However, CHC has established systems and mechanisms to turn these obstacles into assets. Some of the adjustments CHC has had to make in response to the complexities brought about by operations management include the adoption of business process management techniques, just in time philosophies, collaborative planning, forecasting and replenishment, globalization, and e-commerce. Factors that affect productivity include personnel, technology, 9 RUNNING HEAD: FINAL PROJECT Reaves 10 and financial factors. Some of the trends that have an impact on business operations of CHC include drug management, telehealth, and patient safety. Operationalisim The Community Health Center focuses on delivering high-quality services to consumers who are patients in the healthcare sector. Total quality management (TQM) is a significant area of interest that the organization focuses on to ensure that it improves its services and operations so that it can meet the objectives. Meeting the objectives includes high customer satisfaction and developing a healthy society. To ensure total quality management, CHC employs new technologies that will boost the operations. In this case, the organization has transformed most of its services that are now computerized. Over many years, CHC changes its operations from manual to digital platforms in the areas of communication, diagnosis, data storage, analysis, billing, among others. This has led to efficiency in the organization. Currently, CHC will go-ahead to implement the Entity-Relationship management (ERP) system that will help in integrating all other systems in healthcare. In this case, the applications needed for the case management service will be integrated with the rest of CHC’s operations. The above will allow the services to continue flowing efficiently as before despite the inclusion as a new unit. Generally, TQM is supported by the elements that include training, ethics, teamwork, leadership, communication integrity, and trust. The organization will apply the statistical process controls. It’s recommendable to use the fishbone procedure that allows it to create the problem statement and brainstorm the leading causes of the issue being addressed. In this case, CHC will be able to determine the methods to apply, materials needed, determine the equipment and machines, human resources, and the environment. 10 RUNNING HEAD: FINAL PROJECT Reaves 11 Project the potential costs, risks, and benefits of operationalizing your business idea CHC has set its operational costs at an amount of $100,000 that will be used initially. The value of the option will come in two divisions. The first portion is considered in the start-up. The healthcare extension to newer services will get motivated by its ability to bring together trained employees under CHC. The above will be managed by the company wing that will mandate to focus on the new move. The infrastructure will be planned for and probably needs more value with the current prices. This approach for urgent care unity. With the critical care unit, CHC will get to compete with the hospitals that have always been ahead in competition. The new operations in case management will promote the care centre to gain more partnership with other insurance and government-funded plans such as the affordable care act. The above will benefit the company leading to more funds at this disposal as more patients will seek medical services with it if they cause several care plans. However, construction of case management in the different locations it operates will consume huge funds; this leaves the CHC at risk of suffering a financial problem. Possibly, it could take at least a year to get back to its current financial position. Another chance will include resource commitment to the will be limited by the fact of cost-sharing in the initial stages (Meredith, Mantel, and Shafer, 2017). The above will need the organization to secure new resources, including the human resources for case management. Failure to do so will affect efficient and waiting times in CHC. The vendor commitment to deliver the needed funds will also be a risk where delays can occur. Work breakdown structure 11 RUNNING HEAD: FINAL PROJECT Reaves 12 The hospital will need to break in its services and operations. With broken tasks to different tasks, healthcare can accomplish it on time. The jobs are decomposed in a hierarchical structure that will be followed as an essential guide in working on the extension of the healthcare services, which is treated as a project (Kerzner, 2017). The project team will use the structure to create its deadlines, schedules and other plans to ensure that the project is ready on time. CHC has already set aside the funds for the construction as well as other infrastructure this making it read to commence with the project. Case management development project Premises construction Aquiring equipment and machines Technology installation ,implementaion and aquiring of human resources Planning for the work determination of required equipment and machines Reserach and development Delegation of work Budgeting and procurement Determination of required technologies Contruction of the care unit Purchase Designs and development Implementation Justification of task and subtask in work breakdown structure The duties will be assigned to the different persons that will be assigned various roles during the development of the project. In this case, both the right team that will handle the project and the persons appointed to follow-up with the project will need to have a good focus on it. Some of the company officials assigned will include the financial officer who will be responsible for 12 RUNNING HEAD: FINAL PROJECT Reaves 13 ensuring the locations are done right. Also, they will work as an oversight team that will determine whether the organization is on the right track and if the projects are worth the cost. The project team will be the most interested in the work breakdown structure; in this case, it will provide an essential guide that will help in dividing the tasks and subtasks. Handling tasks and smaller subtask makes the project more efficient in its building since small units are manageable. Interestingly, task allows the organization to make an assignment of roles that will allow parallel working on a different mission by different persons who belong to the overall project team (Kerzner, 2017). The building of the case management service premises with having a sub-team that will handle the construction work. Another group will hand the determination of the equipment to have case management service. In this case, the CHC will not just wait for the completion of the premises to determine and procure the needed resources and equipment for the case management units. Key milestones, deliverables, and resource requirements associated with operationalizing your business idea based on your breakdown structure The organization has three main milestones that may get considered concerning the operationalizing of the CHC. In this case, the set milestones include as follows; 1. Set up a case management facility building that will be the permanent location of the service. 2. Equip the facility with the necessary equipment, machines and all other necessary technological equipment that will be needed (scanners, printers,etc.) 3. Market the care centre and ensure there is the installation of all necessary inputs such as technologies that will aid in various things such as communication with the rest of the CHC 13 RUNNING HEAD: FINAL PROJECT Reaves 14 units. Also, the IT will include connection of the health applications operating in it to be integrated with the other systems of organization. This might requires it to consider implementing an ERP system in the future. The main deliverable, in this case, will be as a result of the second and third milestones that will include the equipment and technologies installation. The best outcome, in this case, will be excellent service delivery. Being a non-profit organization, the CHC main aim is to deliver efficient and satisfactory services that will lead to the saving of lives. In this case, the major part of its mandate will be ensuring high customer satisfaction. However, despite being a non-profit, it will also need to consider the returns made so that it can continue growing as well as maintaining the service delivery. Moreover, this will allow it to pay its staff lead by the medical unit. Fortunately, in the case where it receives caseworkers from the government, the wage burden will reduce, and the organization will have more funds at its disposal. The care unit cannot estimate how fast it will peak. Thus the organization can only work with an estimation of the group, making enough returns that will lead to, repayment of the expenditure in at least two years. Assessing potential obstacles and impediments to meeting scope-time-cost objectives of the project, supporting your assessment with rationale The new plans will be successful with the well-organized project teams that are dedicated to seeing the case management service a reality. However, the financial obstacle is a significant issue to the company where the CHC has no income-generating avenues as it targets the persons who cannot get the services elsewhere. Generally, poor and lower incomes limit patients to access medical services from many healthcare organizations. In this case, it targets both the insured and 14 RUNNING HEAD: FINAL PROJECT Reaves 15 uninsured persons. The small returns made from its 14 primary care services, and its many other service locations across the state. Thus, the low returns rate may affect its operations in the next few years before the case management service peaks. Again, in the case where the project costs raise, the organization will need to seek more funds where it will have to apply for more grants from the government or find credit from a financial organization or any other lending organizations. Failure to do so will bring the project to a halt, and the time estimated to complotion will be affected (Kerzner, 2017). The issue can also delay the commencement of operation of the case management service unit since it will also need to meet the operational costs such as costs for resources, wages, and salaries. Risk mitigation strategies to address the obstacles, impediments, and risks identified The barriers identified many results to delay of the project commencement. Thus, the company needs to employ various tactics that will ensure that it does not fail (Shenhar and Dvir, 2017). Majorly, all the mitigation plans are directed and aimed at ensuring that the CHC meets its financial requirements. In this case, it will need first to ensure that the funds currently set aside for the construction work as well as buying of the necessary equipment are well utilized. One way to ensure that it does not find the challenge of changing market value is to estimate the changes that night occurs. In this case, it will be essential to determine whether the cost of materials will rise in the coming years. Same will be done in the affairs of equipment and machinery. Thus, in the case where the trends and estimation show a possible rise in prices, then CHC will better procure and purchase the materials and equipment likely to rise in price values. The organization has enough stores that can keep the machines and equipment. Again, it will need to consider the costs of the materials required for the construction site. Thus will also eliminate the expenses that might arise in the future. 15 RUNNING HEAD: FINAL PROJECT Reaves 16 Additionally, each of the care centres will be supposed to submit specific small fractions or their revenues to support the new plans. This approach will ensure the case management service unit will have enough funds for its immediate commencement on completion. In the case where the mitigation plans are well followed, then the CHC new pans will succeed. Life Cycle Management Product/service lifecycle refers to the different phases of a product/service from the time it is conceived as an idea to the point it grows into a saleable commodity and finally declines and is abandoned. Understanding the lifecycle of a product/service is crucial in determining which marketing strategies to employ at different stages of the commodity’s life. For example, different marketing strategies are used when a product/service is in the introductory phase and when it is in the maturity phase. At the introductory phase, we expect a lot of product promotion to create awareness about the existence of the product/service. During maturity, however, product promotion may be reduced to focus on increasing quality for established markets. The healthcare service industry follows a similar trend whereby products/services are developed, allowed to grow, mature, and finally begin to decline before they exit the market. Luckily for Community Health Center Inc. (CHC), services have been evolving and keeping up with new demands and trends in the healthcare industry. Services only exit the market once a disease has been eradicated, and this is a big win for the organization considering it is a nonprofit organization. This paper will examine CHC’s product/service lifecycle management including supply chain management and the related technologies, profit generation and cost-saving opportunities associated with the product/service lifecycle, and outline a phase-out plan for its services. 16 RUNNING HEAD: FINAL PROJECT Reaves 17 Supply chain management From suppliers to CHC Supply chain activities at CHC include procuring inventories and storing them until they are used. Typical inventory items include medications, sutures, surgical equipment, hospital beds, and other equipment used to provide healthcare. These items have to be sourced from different vendors, and the entire supply chain has to be properly managed to ensure there are no shortages. Besides making sure there are no shortages, it is also crucial for the hospital to ensure there are no excesses as these may attract additional costs. As a nonprofit organization, keeping costs low is of paramount importance. As part of its supply chain activities, CHC has embraced technology in terms of predictive analytics for inventory management. This technology helps the organization to plan its inventory activities and processes so that supplies are received in time. The technology utilizes data from history to predict future demand. For example, the hospital may use its knowledge of the number of patients using a particular drug and estimate how much of that drug to procure. The same approach applies to all inputs sourced by the organization. In times of disasters and emergencies, however, the organization caters for them by using an emergency reserve. The supply chain of healthcare organizations is very different, and many of the approaches that work in other industries may not automatically apply in the healthcare industry. As Morris (2019) notes, supply chain elsewhere is different from the supply chain in the healthcare industry. One of the key differences between supply chain in other industries and supply chain in healthcare is that the end product in the latter is more complex. The human body is very complex such that it is not easy to predict what will be required to plan procurement 17 RUNNING HEAD: FINAL PROJECT Reaves 18 activities. Also, the entire process of caring for people is very sophisticated and cannot be compared with the processes involved in creating a product for sale. There is also a lack of transparency between healthcare providers and the suppliers of medical equipment and medications, and it makes the work of procurement department a lot more difficult. The economic environment of the healthcare industry is very tough. Many regulations are governing the healthcare industry, and the supply chain has to comply. While companies such as Amazon and Walmart have tried to enter the healthcare supply chain, the road has been bumpy. One of the reasons why these companies, regardless of their financial muscles, have not been able to replicate their successes in the area of supply chain elsewhere is because supply chain in healthcare is a different kettle of fish altogether. The healthcare industry is made up of multiple intermediaries who operate under different frameworks. CHC and other healthcare organizations have to use state of the art technology to manage the supply chain. CHC utilizes e-procurement which is a B2B requisitioning, ordering, and purchasing approach that uses electronic means (Alor-Hernandez et al., 2011). One of the direct benefits of e-procurement in healthcare is that it promotes the centralization of purchasing activities. When purchasing activities are centralized, it becomes easy to monitor and track inventories. Additionally, it creates economies of scale and costs savings for the organization (Millington & Bhardwaj, 2017). It also improves efficiency in procurement by eliminating downtimes and human errors. Furthermore, it increases transparency by reducing corruption and financial misappropriation (Millington & Bhardwaj, 2017). Having a centralized e-procurement system also increases purchasing power. For example, it enables CHC to better contact and negotiation with different vendors of medical supplies and equipment. 18 RUNNING HEAD: FINAL PROJECT Reaves 19 Besides e-procurement, CHC also uses a manual system of tenders. This process involves inviting tenders for particular supplies or equipment. Vendors submit their bids and the organization selects the best bids. After successfully winning a tender, vendors may be instructed to deliver supplies at designated times. It is a manual process but it does come in handy for equipment that requires installations. From CHC to consumers Once the supplies have reached CHC, the next point is the consumer. Thus, the organization does not utilize middle persons to get its services and products delivered. The organization, however, has over 200 distribution centers across the U.S. These are community centers that offer the organization’s services. CHC does not have to worry about how its products are going to reach its target market because patients themselves come to the hospital to get treatment. It is the patient who seeks healthcare services, and CHC does not have to be concerned about intermediaries. CHC, however, must ensure it has enough capacity at all time. While it may seem easy because the company only waits for customers and does not necessarily have to look for them, it does require a lot of patience especially when admissions are low as well as intense preparedness when admissions are high. It requires the organization to be alert at all time since it is not easy to predict when someone will get sick and seek medical assistance or when an emergency requiring medical services will occur. The rationale for brick-and-mortar locations and internet services CHC has for a long time provided its services through brick-and-mortar locations, and this has been necessitated by several reasons. First, the nature of its industry requires a physical location. Although online healthcare services have advanced in the name of telehealth, the role 19 RUNNING HEAD: FINAL PROJECT Reaves 20 played by physical locations is immense and can never be replaced. Physical examinations, laboratory tests, treatment, and a host of other healthcare services are better delivered when a patient visits the hospital as opposed to then internet technologies are used. Additionally, having a physical presence is very important because as much as when the world has evolved in terms of adopting modern communications technology, not everyone is using them to access healthcare services. Moreover, many healthcare services cannot be delivered without the physical presence of the patient and the physician. In addition to physical locations, CHC also has a website where patients can get information on various aspects of health. The website does not directly offer healthcare services but it is a good place to begin when looking for specific healthcare services. The website provides information such as services and produces offered, the different locations where the healthcare organization has clinics and health centers, as well as a host of patient-related information that can help patients know what to expect and how to maneuver within the organization. The product lifecycle of CHC’s healthcare services and products Services undergo various stages which can be categorized into four phases including introduction, growth, maturity, and finally, decline. These can be subdivided further into seed stage, startup phase, growth, maturity, expansion, decline, and exit. These are elaborated as follows: Seed and Startup phases In the seed stage, the idea is conceived. CHC was established in 1971 by one Mark Masselli. He was inspired by a lack of affordable and quality care among the residents of 20 RUNNING HEAD: FINAL PROJECT Reaves 21 Middletown, CT. It is from the problems that Mark observed that inspired him to come up with the idea. It initially started as a mobile clinic. The seed stage is one of the most important stages in a product’s lifecycle. The idea has to be timely and aimed at meeting one or more needs of the people. At the time, there were no enough hospitals for the poor and Mark saw the gap and developed an idea out of it. A startup is a phase where an enterprise is legally registered to operate. The first CHC clinic opened in 1972, and it started offering free dental care. This is the stage where the idea is put into action and tested. CHC started offering free dental services, and it was registered to do so. It was registered as an NGO and has remained so ever since. Startup phase may also include defining the product lines. Growth and Maturity At this stage, the enterprise has overcome the challenges of entering into the market and it has become stable. For for-profit organizations, growth is seen in increased revenues. For nonprofit organizations such as CHC, however, growth is seen in an increased number of people served and brand image. Also, it may be seen in the number of grants the organization starts to receive that investors knocking on the company’s doors. Demand begins to rise steadily at this stage, and sales increase. CHC has experienced a lot of growth since it was founded many years ago. Its growth has occurred in different ways. For example, it grew in terms of the capacity of patients it could admit by building bigger buildings and acquiring more beds. It also grew in terms of human resources whereby it began to hire more qualified personnel while also creating new positions and hiring more staff. It also grew in terms of product/service mix. It started as a dental care provider but has grown to include other healthcare services. 21 RUNNING HEAD: FINAL PROJECT Reaves 22 At the maturity stage, the product/service has attained maturity. It has become a household name. Its services are known and respected, and revenue streams keep on improving. For CHC, maturity was represented with stabilization of incomes and sales. The organization became a household name since it was closer to the people and offered affordable and highquality care. Expansion At this stage, the product/service has reached maturity and is now exploring other avenues of investing its profits. Expansion at CHC has been seen in the opening up of more centers. Currently, the organization has over 200 healthcare centers spread across the United States. Its healthcare services are offered at different centers, and this represents expansion efforts. Decline and exit These two stages represent the end of a product/service. In the healthcare sector, services often begin to decline especially when a disease is eradicated or when preventive measures become more effective. Services may also decline due to competition whereby competitors are offering similar services more affordably and with better quality. A decline occurs when sales begin to go down. There are many ways through which an organization can respond to declining sales, and they depend on the cause of the decline. For example, the company may opt to intensify marketing to beat competitors if the decline is caused by competition. Many services have declined and abandoned at CHC because the disease was either eradicated or preventive measures became effective hence many people did not require treatment. Profit generation and cost-saving opportunities 22 RUNNING HEAD: FINAL PROJECT Reaves 23 CHC is a nonprofit organization. It charges products and services at a level just adequate to keep services running. A lot of the funds it uses come from grants. Thus, the organization does not focus on profits. Regardless, there are several opportunities for saving costs. For example, the organization saves costs through e-procurement. This process enables the organization to reduce inefficiencies. Additionally, the organization tries to introduce new services every often to replace declining services. CHC aims at eradicating diseases and when service intake begins to decline as a result of diseases becoming extinct, it is not a problem but something to celebrate. This is further supported by its nonprofit model which does not emphasize profits. Developing new services, however, is not only aimed at ensuring continual survival of the organization but is usually in response to emerging diseases. CHC further invests in research and development which enables it to continuously improve its services to ensure they continue to deliver valuable care to people. A phase-out plan for healthcare services In the healthcare industry, when a service is phased out there is usually nothing much that can be done about it but to come up with another service. This is usually because services are phased out due to a disease being eradicated from the community where the healthcare organization is located. One of the strategies that can be used to salvage a declining service, however, is to open another center in areas where the service is still required. For example, if one disease is eradicated in one region, CHC can decide to open another center in another region where the disease is still a problem instead of abandoning the related services. Also, the organization can venture into preventive care where it will sensitize people on how to stay healthy. It is also possible to replace one service by introducing new services to ensure revenues do not go down. 23 RUNNING HEAD: FINAL PROJECT Reaves 24 Conclusion In summary, understanding a product/service’s lifecycle is paramount. It enables an organization to explore different ways to make profits throughout that lifecycle. CHC offers healthcare services, and its services have undergone different phases from seed to maturity. Also, some of its services have undergone a decline. Salvaging such services will require the organization to open up new centers or introduce new services. 24 RUNNING HEAD: FINAL PROJECT Reaves 25 References Bayraktar, E., Jothishankar, M. C., Tatoglu, E., & Wu, T. (2007). Evolution of operations management: past, present and future. Management Research News, 30(11), 843-871. Del Giudice, M., Soto-Acosta, P., Carayannis, E., & Scuotto, V. (2018). Emerging perspectives on business process management (BPM): IT-based processes and ambidextrous organizations, theory and practice. Business Process Management Journal, 24(5), 10701076. Evans, R. S. (2016). Electronic health records: then, now, and in the future. Yearbook of medical informatics, 25(S 01), S48-S61. Gimenez, C., Sierra, V., & Rodon, J. (2012). Sustainable operations: Their impact on the triple bottom line. International Journal of Production Economics, 140(1), 149-159. Protzman, C., Mayzell, G., & Kerpchar, J. (2018). Leveraging lean in healthcare: Transforming your enterprise into a high quality patient care delivery system. Productivity Press. Kerzner, H. (2017). Project management: a systems approach to planning, scheduling, and controlling. John Wiley & Sons. Khan, A. (2016). Project scope management. Cost engineering, 48(6), 12-16. Meredith, J. R., Mantel Jr, S. J., & Shafer, S. M. (2017). Project management: a managerial approach. John Wiley & Sons. Shenhar, A. J., & Dvir, D. (2017). Project management research—The challenge and opportunity. Project management journal, 38(2), 93-99. 25 RUNNING HEAD: FINAL PROJECT Reaves 26 Alor-Hernandez, G., Aguilar-Laserre, A. A., Cortes-Robles, G., & Sanchez-Ramirez, C. (2011). Improving E-Procurement in Supply Chain Through Web Technologies: The HYDRA Approach. In Supply Chain Management-New Perspectives. IntechOpen. Millington, K., & Bhardwaj, M. (2017). Evidence and experience of procurement in health sector decentralisation. Morris, J.P. (2019). Healthcare Supply Chain Has Its Own Needs, Challenges: An Insider’s View. Retrieved from http://spendmatters.com/2019/04/29/healthcare-supply-chain-hasits-own-needs-challenges-an-insiders-view/ 26 RUNNING HEAD: FINAL PROJECT Reaves 27 27 RUNNING HEAD: FINAL PROJECT Reaves 28 28 Running Head: INTRAPRENEURAL OPPORTUNITIES Intrapenuerial Opportunities MBA 515 Dr. Pogue Southern New Hampshire University Briana Reaves 1 INTRAPRENEURIAL OPPORTUNITIES 2 Intrapreneurial Opportunities Intrapreneurship is the sole reason for several product innovations in the world presently. It is through the intrapreneurial opportunities that organizations released new products in the market. Resources and capabilities must be established within a company for this to be successful. In this case, the Community Health Center offers healthcare, which benefits the general population through its several product offerings in medical care, behavioral health, and dentistry. All these services are vital for the health of a population. In Connecticut, CHC has established its branches across the state. CHC is a non-profit organization whose operations are also subject to the ever-changing healthcare market. Therefore, market factors have an impact on the organization’s operations. Its sheer size and coverage of healthcare expose it to several aspects of healthcare, which can be of interest to innovative features which organizations ought to have. Intrapreneurial opportunities in healthcare may be stewards of change whereby the delivery and management of healthcare services are enhanced and patient care improved through increasing access to quality as well as affordability (Lages et al., 2017). Despite the complexities, significant obstacles and competition, the future in healthcare require collaboration in the ecosystem. Healthcare ecosystem possesses expansive reach and the reason why the intrapreneurial efforts present a paradigm shift in CHC’s future. Intraprenuerial Opportunities Healthcare leaders face several issues as the level of competition increases, technology and public policy changes, which makes collaboration a necessity. CHC can pivot prove to be agile to handle such issues. Employees within CHC would play vital roles in the intrapreneurial efforts to increase innovation and improve the organization’s competitive advantage. Healthcare leaders should encourage the intrapreneurial behaviors. Intrapreneurial behavior encourages INTRAPRENEURIAL OPPORTUNITIES 3 factors like calculated risk-taking, agility, and innovation, which contributes to an organization’s overall health and capabilities of responding to the environment. Innovation is more crucial to health. Through the SWOT analysis, several opportunities abound for CHC. One of the opportunities for CHC involves the generation of new ideas and programs that will permit the organization to shift and gain competitive advantages. Additionally, the generation of processes and efficiencies are other opportunities around intrapreneurship. Partnering with Connecticut Children Medical Center presents CHC with an opportunity to develop programs as well as processes which will cater to the new group of patients and staff. Such programs would allow CHC to expand their services in the new location further. Another one involves empowerment of the employees towards capitalizing on their qualities and skills and use it to provide the organization with fresh insights. CHC receives grants for quality improvement. Empowerment of the employees would further improve the organization’s healthcare services in the long run. CHC can also provide unique opportunities for progression with employees who may opt to go beyond their call of duty. Another opportunity involves partnerships. Partnerships, especially in community-based healthcare, give rise to sustainable benefits to the players involved. Despite it taking a while to nurture relationships, collaborative work may result in systemic means to operate and realize health promotion when facilitated effectively (Lages et al., 2017). CHC partners with Quest Diagnostics and can add other partnerships to improve their services and care delivery. Additionally, collaboration in research is another intrapreneurial opportunity. Ideas can get generated through the partnership, and they can benefit from expertise. Intrapreneurial Assessment INTRAPRENEURIAL OPPORTUNITIES 4 CHC acquired CCMC, which specializes in children’s medical care. Through funds received from the government, the organization completed the purchase and expanded. Just like in acquisition in business, it attracts new possibilities for the organization. The rapid increase in primary care services will be expected (Wilson et al., 2012). Thus, intrapreneurial opportunities would involve working within local communities to mark the first consultation point, provision of health screening as well as education. Maternal and child health services like immunization and others can get developed. The innovative programs can be highly cost-effective and sustainable. Intrapreneurial nurses introduction would significantly assist in primary care settings. An instance is where intrapreneurial-managed paediatric clinic allows patients to have a therapeutic relationship with the NP, eliminate issues like transportation barriers through the provision of regional services and healthcare access improvement. Programs like nurse triage in emergency departments are successful (Wilson et al., 2012). Nurse practitioners operating in hospitals assist in improving services and informing the future direction for improvement. Innovations like Smart Clinic provides an enhanced and better connection to care daily through operating in a location with easy access as well as operating outside the working time (Smart Clinics, 2011). Another identified opportunity involved empowering the providers. Healthcare industry faces several critical issues when communicating with patients as well as when increasing their experience (Wilson et al., 2012). Due to the increase in customer expectations and compliance restraints, CHC’s providers can ensure compliance and efficiency through the implementation of an omnichannel contact center platform that is fully featured. Doctors can utilize channels to reduce patient effort and increase customer experience from the beginning to the end. Texts, emails, and online platforms would significantly aid in the process. Such innovations may also INTRAPRENEURIAL OPPORTUNITIES 5 help busy healthcare providers save time. Omnichannel platforms allow providers to check in with patients in a consistent way in the whole process. Automated responses would make providers be relieved from the communication tasks. Ultimately, CHC would continue receiving quality improvement grants for their provision of high- quality care. The next opportunity involves partnerships which are a promising model for financing successful healthcare innovations (Oliver et al., 2017). Partnerships like the one CHC has with Quest Diagnostics in offering laboratory services are crucial to the success of health promotion. It strengthens project capacity as well as services, achieves shared goals, and engage more stakeholders. Partnerships involve sharing expertise and resources. Such deals can involve benefits like efficient resourcing and effective service delivery. INTRAPRENEURIAL OPPORTUNITIES References Estacio, E., Oliver, M., Downing, B., Kurth, J., & Protheroe, J. (2017). Effective partnership in community-based health promotion: Lessons from the health literacy partnership. International journal of environmental research and public health, 14(12), 1550. Lages, M., Marques, C. S., Ferreira, J. J., & Ferreira, F. A. (2017). Intrapreneurship and firm entrepreneurial orientation: insights from the health care service industry. International Entrepreneurship and Management Journal, 13(3), 837-854. SmartClinics (2011). Retrieved from www.smartclinics.com.au/ Wilson, A., Whitaker, N., & Whitford, D. (2012). Rising to the challenge of health care reform with entrepreneurial and intrapreneurial nursing initiatives. Online J Issues Nurs, 17(2), 5. 6
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