Strategic Leadership and Future Delivery Models

Table of Contents

HCAHPS Scores for Intermountain Medical Center 4

Analysis of the HCAHPS Scores. 9

Comparison of HCAHPS Scores to State and National Averages. 9

Comparison of Intermountain Medical Center and Two Other Hospitals. 10

Comparison of Response Rate. 13

Intermountain Medical Center Patient Demographics and Services. 14

Environmental and Community Factors and Impact on HCAHPS Scores. 14

Cultural dynamics. 15

Educational dynamics. 15

Socioeconomic dynamics. 16

Short Term and Long Term Financial Impact 16

Quality outcomes. 16

Potential Causes of the Hospitals HCAHPS Scores. 17

Organizational Strategic Plan. 18

Significance of Organizational Change. 18

Quality Strategic Framework. 19

Incorporation of Evidence-Based Practice (EBP) and Shared Governance. 21

Shared Accountability. 22

Incorporation of Technology. 23

Improving Care Delivery System.. 23

Financial Stability. 24

Implementation Plan and Timeline. 25

Roles and Responsibilities of Stakeholders. 25

Stakeholder Accountability and Involvement 26

Staff Training. 26

Plan Timeline. 27

Evaluation of the Strategic Plan. 28

Stakeholder Involvement 28

Communication of Evaluation Results. 28

References. 30

Strategic Leadership and Future Delivery Models

Healthcare is an integral pillar in the development of an economy. A country with a high health index tends to record better workforce performance, and this explains why there has been a significant focus on the improvement of the quality and reliability of the American healthcare sector (Grustam et al., 2020). As the demand for quality, affordable, and reliable medical care increases in the country, hospitals are restructuring their operational models to meet emerging needs. According to Cox and Amin (2020), the coronavirus pandemic has put immense pressure on the performance of the healthcare industry. The authors assert that hospitals with enhanced operational structures and facilities are better equipped to meet the needs of their clients. A cross-sectional survey conducted in 2013 found that hospital utilization is a major challenge in many countries in the world – equitable utilization of medical care is a challenge (Grustam et al., 2020). Like many other hospitals in the country, Intermountain Medical Center, holds the view that engaging patients in their personal choices leads to improved outcomes – improved care and enhanced patient satisfaction. While the hospital has satisfactory results based on its Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) star ratings, some segments need improvement. Hence, the focus of this business plan is to evaluate the current Intermountain Medical Center’s operations and performance and develop recommendations that will facilitate the improvement of its areas of weakness while leveraging the strengths.

HCAHPS Scores for Intermountain Medical Center

            Intermountain Medical Center’s mission statement reflects its commitment and dedication to improving prevention and wellness in society. The organization strives to improve the health of the people in the community – ensuring that people live healthiest lives. At the same time, the hospital seeks to become a model of extraordinary care and superior service provision at an affordable cost to all people (Intermountain Healthcare, 2021). As depicted on its website, Intermountain Medical Center’s mission, vision, and values closely mirror its HCAHPS star ratings. Below is a description of Intermountain Medical Center’s HCAHPS scores, which not only illustrate the quality of care, but also the level of patient satisfaction compared to the national and Utah averages.

Intermountain Healthcare has an overall rating of 5/5 (five stars), and a patient survey rating of 3/5 (three stars). The overall rating is based on the hospital’s performs across different areas of medical care quality, like response to chronic illnesses, admission, and patient safety. The patient survey rating takes into perspective the experiences of the patients. Some of the critical elements considered in evaluating medical care experiences include nurses’ interaction with patients, doctors’ engagement with patients, and responsiveness of the staff to patient needs, cleanliness, and quietness of the hospital environment (Medicare, 2020, c). When compared to other players like St Mark’s Hospital (overall rating of 4/5 and patient survey rating of 2/5), and University of Utah Hospitals and Clinics (overall rating of 4/5, and patient survey rating of 4/5), Intermountain, has a relatively good rating.

For any meaningful policies and strategies to be developed for Intermountain, there is a need to delve deeper and evaluate its ratings of different medical segments. Below is an assessment of the hospital’s quality ratings that consider timeliness and effectiveness of care, complications and deaths, unplanned hospital visits, psychiatric unit services, and payment and value care. The segmentation of the scoring metrics into smaller units relating to the performance of the hospital provides a holistic view of the hospital. From a strategic and policy management perspective, it is integral in outlining the areas that need more focus or improvement and those that need to be retained for sustainability.

Table 1

Timely and effective care (Medicare, 2020, c)

DescriptionIntermountain ScoreNational AverageUtah Average
Sepsis care42%60%62%
Cataract surgery outcomen/a99%n/a
Appropriate recommendation for colonoscopy follow-up98%89%95%
History of polyps receiving follow-up for colonoscopy within appropriate timeframe96%93%90%
Time for heart attack patients transfern/a58 mins36 mins
Drugs to heart attack or chest pain patients within 30 minsn/a58%80%
Patients left ED before being seen1%2%1%
Patients in ED with stroke symptoms who received brain scans within 45 mins37%72%74%
ED volumeVery high – 60,000 + patients  
Time spent in ED before admission73 mins134 mins86 mins
Time spent in ED before leaving189 mins169 mins170 mins
Preventive Care – Healthcare workers given influenza vaccination92%91%93%
Cancer Care – Radiation therapy85%89%83%
Pregnancy and delivery care – Early and unnecessary schedules3%2%2%
Use of medical imaging – MRI without try of recommended treatment44.2%39%46.6%
Double scans1.2%6.4%4.5%
Imaging stress tests before low-risk outpatient surgery7.9%4.2%4.6%

Table 2

Complications and death (Medicare, 2020, c)

DescriptionIntermountain ScoreNational AverageUtah Average
Rate of complication for hip/knee replacement patients3%2.4%n/a
Serious complications0.951.00n/a
Deaths among patients with serious treatable complications after surgery169.46164.15n/a
CLABSI in ICUs and select wards0.7431.000n/a
CAUTI in ICUs and select wards0.8931.000n/a
SSI from colon surgery0.1311.000n/a
SSI from abdominal hysterectomy0.8161.000n/a
MRSA blood infections0.4061.000n/a
C.diff intestinal infections0.5501.000n/a
COPD patients death rates8.5%8.4%n/a
Heart attack death rate10.3%12.7%n/a
Heart failure death rate12.8%11.3%n/a
Pneumonia death rate16.4%15.4%n/a
Stroke death rate13.1%13.6%n/a
CABG surgery death rate2.6%3%n/a

Table 3

Unplanned hospital visits (Medicare, 2020, c)

DescriptionIntermountain ScoreNational AverageUtah Average
Rate of readmission13.6%15.6%n/a
COPD rate of readmission17.9%19.6%n/a
Heart attack rate of readmission14.4%16.1%n/a
Heart failure rate of readmission16.7%21.9%n/a
Pneumonia rate of readmission14.7%16.6%n/a
CABG rate of readmission12%12.7%n/a
Hip/knee replacement rate of readmission4%4%n/a
Rate of unplanned visits after colonoscopy15.916.4n/a
Rate of readmission for chemotherapy11%12.5%n/a
Rate of ED visits for chemotherapy5.8%6%n/a
Ratio of unplanned visits after outpatient surgery0.9n/an/a

Table 4

Payment and value of care (Medicare, 2020, c)

DescriptionIntermountain ScoreNational AverageUtah Average
Medicare spending per beneficiary1.010.990.97
Payment for heart attack patients$23,153$25,526n/a
Payment for heart failure$17,476$17,670n/a
Payment for hip/knee replacement patients$22,970$20,959n/a
Payment for pneumonia patients$19,508$18,322n/a
Death rate for heart attack patients10.3%12.7%n/a
The evaluation of the value of compare compares the cost of care for the various ailments and the associated complications, deaths, and unplanned visits after care as illustrated in tables 2 and 3 above.

Analysis of the HCAHPS Scores

Comparison of HCAHPS Scores to State and National Averages

The objective and goal of any business is to operate within or above the industry average. Like any other business, Intermountain Hospital aims to become better by enhancing its scores to match or become better than the industry averages – state and national averages. The evaluation the hospital’s HCAHPS scores show that there is a mixed outcome – those within, below or better than the state and national averages (see tables 1-4). The elements under timely and effective care with above the state and national averages include colonoscopy follow-up, preventive care, and double scans. Those below the state and national averages include sepsis care, emergency department (ED) care, cancer care, MRI use, and imaging stress tests before low-risk outpatient surgery (Medicare, 2020, c) (see table 1). The elements in the complications and deaths segment had scores no different or better than the national averages (see table 2). The unplanned hospital visit scores were either no different or better than the national averages (see table 3). Medicare spending per beneficiary was no different from the national average, and payment for heart attack less than the national average. Payment for hip or knee replacement and pneumonia were greater than the national averages (see table 4) (Medicare, 2020, c).

Comparison of Intermountain Medical Center and Two Other Hospitals

The performance of Intermountain Medical Center is compared against that of University of Utah Hospitals and Clinics and St Mark’s Hospital. While closely related, these three institutions exhibit some differences in terms of their performance and quality of care. The three healthcare institutions are rated as acute care hospitals that provide emergency care services and able to receive lab results electronically (Medicare, 2020, a-c). In terms of the overall rating, Intermountain (five stars) has the highest score, with the other two having four stars (University of Utah Hospitals and Clinics and St Mark’s Hospital). Patient survey rating differentiates the three hospitals. The HCAHPS scores show the University of Utah Hospital has the best patient experiences for medical care (four stars), followed by Intermountain Medical Center (three stars), and the least is St. Marks Hospital (two stars) (Medicare, 2020, a-c). The scores demonstrate that when it comes to patient experiences to medical care, Intermountain is an intermediate performer; hence, management needs to adopt strategies to enhance the impact of medical care and improve client experiences.

Timely and effective care is an integral factor in the provision of medical care. Hospitals that can provide timely and effective care reduce the rate of readmissions, deaths, and complications. An evaluation of the three hospitals HCAHPs scores shows that the three hospitals have varying performance indexes. St. Marks Hospital has the best sepsis care (58%), followed by University of Utah Hospitals and Clinics (48%), and the least score is recorded by Intermountain (42%). The common factor between these hospitals is that their scores are below the national average (60%) and Utah average (62%) (Medicare, 2020, a-c). The scores demonstrate that more needs to be done to boost performance in the industry.

Intermountain Medical Center has the best colonoscopy follow-up, and it is above the national and Utah averages (98% – recommendations on time; 96% – patients with polyps receiving follow-up). Unlike St. Marks Hospital (53% – recommendations on time; 57% – patients with polyps receiving follow-up), the University of Utah Hospitals and Clinics also has a colonoscopy follow-up that is above the national and Utah averages (96% – recommendations on time; 95% – patients with polyps receiving follow-up). Emergency department (ED) care is a critical factor in enhancing patient recovery and complications. When comparing the three hospitals, St. Marks Hospital stands out as the best provider of ED care – it has the lowest wait time at the ED and no patients leave the ED before being seen by a physician (Medicare, 2020, a-c). Although Intermountain has a relatively good score when compared to the national average than the University of Utah Hospitals and Clinics, it needs to do more to improve ED wait time and ensure that patients do not leave the ED before they get professional assistance.

Apart from St. Marks Hospital, the University of Utah Hospitals and Clinics, and Intermountain have effective preventive care strategies since their scores are above the national average. However, the two organizations (Intermountain and University of Utah Hospitals and Clinics) struggle when it comes to cancer care, as their scores are below the national average. Pregnancy care and delivery is a matter that ought to be addressed in Intermountain. While the other two institutions of care have 0% of mothers being admitted too early than scheduled, Intermountain has 3% early schedules, above the national and Utah average. Further, Intermountain tends to prioritize MRI over other treatment options. The percentage of double scans is below the national and Utah averages. However, the use of cardiac imaging stress tests needs to be addressed as it is above the national and Utah averages. Like Intermountain, St. Marks Hospital is struggling with enhancing MRI efficiency, as it tends to ignore alternative treatment options. Nevertheless, it has a positive outlook when it comes to double scans (below industry averages), and cardiac imaging stress tests (near industry averages). The University of Utah Hospitals and Clinics perform well in the utilization of MRI (within industry averages) and double scans (below industry averages), but falter greatly in the use of cardiac imaging stress tests (above industry averages) (Medicare, 2020, a-c). From the scores, it is imperative to note that Intermountain and the two other institutions need to adopt strategies that prioritize various treatment options to enhance the efficiency of medical imaging.

Patients admitted to healthcare institutions may develop serious complications and sometimes die. It is the responsibility of every hospital to safeguard the patients and foster their recovery. The evaluation of the scores recorded by the three hospitals shows that the complication and death scores are either within or above the national averages. The scores demonstrate that the three hospitals have put immense strides to enhance the quality of their services and protect the safety of the patients. Unplanned hospital visits are a major concern to patients and other stakeholders in the healthcare industry. Unplanned visits not only cost money, but also increases the risk of harming patients. Hospitals that provide quality care significantly lower the rate of unplanned visits. A critical evaluation of the three unplanned visit scores for the three hospitals shows that they are within or better than the national averages. However, St. Marks Hospital and Intermountain need to improve the unplanned visits after hospital outpatient surgery – the University of Utah Hospitals and Clinics has excellent results.

The success of a healthcare facility is intertwined with its ability to provide quality care relative to the cost incurred by the patients. Patients would want to feel that the care provided meets the amount of money they are spending – value for money. Medicare spending per beneficiary is highest at St. Marks Hospital and lowest at Intermountain Hospital – in all the three cases, it is slightly above the national and Utah averages (0.99 and 0.97 respectively). Across all the three healthcare facilities, the value of care is high and stable as depicted by the measurement metrics. Although there are some segments where the hospitals charge higher costs compared to industry averages, the outcomes are positive – no different or better than the national averages. From a cost perspective, University of Utah Hospital and Clinic has only one segment that exceeds the national average (payment for heart failure). St. Marks’ costs in heart failure, heart attack, and hip or knee replacements exceed the national average. On its part, Intermountain has costs that exceed the national average in hip or knee replacement and pneumonia treatment (Medicare, 2020, a-c). Overall, the scores show that there is a positive outlook in the value of care in the three hospitals.

Comparison of Response Rate

The evaluation of the HCAHPS scores relies on the analysis of responses from selected participants. While in conventional studies, an equal number (sample size) of participants is required to conduct analysis and develop recommendations, the HCAHPS procedure utilizes varying number of responses from one hospital to another. The healthcare institution with the largest number of response rate is Intermountain Medical Center, followed by the University of Utah Hospital and Clinic, and the least response rate was recorded by St. Marks Hospital (Medicare, 2020, a-c). The variation in the response rate not only indicates the number of patients served by the medical care facility, but also the connectedness between the hospitals and their patients in the community.

Intermountain Medical Center Patient Demographics and Services

Intermountain Hospital is the largest non-profit healthcare provider in Utah and serves the needs of all people in the region. The hospital provides a wide range of services, including acute care (Medicare, 2020, c). Intermountain targets both adults and children in need of medical care. Due to its size and history in the country, the healthcare facility has a multidimensional market approach – it does not target people based on income, age, race, religion, or nationality. The organization has developed a holistic approach of dealing with the needs of all people in the country; it does any discriminatory practices in the market. Through its community health programs, Intermountain conducts assessments to identify the areas that need healthcare interventions and develop implementation strategies to meet the needs of the people. Further, the hospital has a dedicated emergency service that provides services to adults and children. The teams under the emergency department include adult, pediatric, neonatal, respiratory, search and rescue, and LVAD teams. Intermountain also provides laboratory services in the community to facilitate the treatment and management of illnesses.

Environmental and Community Factors and Impact on HCAHPS Scores

HCAHPS scores indicate the satisfaction of patients in a healthcare setting. In the survey, patients provide feedback on the experience they have had with a hospital in a specific area. Thus, these scores are influenced by factors that affect the experiences of the patients, including environmental and community variables.

Cultural dynamics. Modern medical institutions are providing care to cultural diverse populations (Tang et al., 2018). As explained by Lee et al. (2020), patients have a right to access culturally aligned and quality care from hospitals across the country. Besides, a culturally competent workforce enhances the experiences of the patients in a hospital environment. In lieu to the changing healthcare dynamics, culture is becoming a pivotal tool in evaluating the experience of patients in healthcare facilities. Culturally diverse care facilities can effectively address the unique needs of their patients than those that do not provide such services. It means that cultural dynamics can either increase or lower HCAHPS scores. If Intermountain adopts a culturally driven, quality care strategy, its HCAHPS scores will increase. However, if it fails to address the specific needs of people from different cultures, the scores will decline since patient experiences will be rated poorly.

Educational dynamics. Healthcare systems are complex and continuously changing within various service levels (Figueroa et al., 2019). Healthcare leaders need to respond to these changes by enhancing their capacities and improving the knowledge and skills of their workforce. As explained by Maier et al. (2018), nurses need to keep abreast of the changes through educational programs. Further, education is viewed as a tool to empower the patients to establish their independence in healthcare management. A highly educated workforce in a healthcare setting enhances the experience of the patients as it provides quality and reliable medical care services. Similarly, an educated or empowered community can bolster the experience of individual patients. Therefore, educational dynamics have an impact on the HCAHPS scores- presence of educational programs enhances the scores and absence of it lowers the scores, as the experiences of the patients are affected.

Socioeconomic dynamics. The socioeconomic factors that affect healthcare include education, income, and employment (McMaughan et al., 2020). Access to quality and reliable care is a major factor that affects the experiences of patients. People who can access quality care are more likely to have positive experiences than those who cannot. Medical care accessibility is influenced by such factors as income and awareness on when to seek for such services. Hence, employed and educated individuals are more likely to access better care compared to unemployed and uneducated counterparts (Aloh et al., 2020). The accessibility to medical care influences the experiences of patients, and this translates to the changes in the HCAHPS scores. A positive socioeconomic indicator enhances the scores and a negative one lowers the scores.

Short Term and Long Term Financial Impact

Quality outcomes. The success of any organization is influenced by its ability to meet the needs of the target customers. Like any other entity in the market, Intermountain needs to ensure that it enhances the experience of its patients. As explained by Al-Damen (2017), there is a strong relationship between patient experiences and quality of care. A positive patient experience is an indicator of quality and reliable care in a healthcare setting (Al-Damen, 2017). The HCAHPS scores recorded by Intermountain Medical Center indicate the provision of quality and reliable care in the community. By maintaining these scores, the hospital will increase its short and long-term financial performance. In the short term, the hospital will likely register an increase in the number of patients visiting to get various services, especially acute care. An increase in the flow of patients will translate to a positive financial performance in the short-term. With sustained improvement of patient experiences, the hospital will capture a large market of loyal clients. A large loyal client base will improve the organization’s financial sustainability in the long-term. From a quality perspective, the scores will compel the company to embrace innovative and creative strategies to improve the clients’ experiences. Hence, quality outcomes will become a priority both in the short and long-term. The facilitation of quality outcomes can be enhanced by improving communication, patient-nurse engagements, responsiveness, pain management, and cleanliness – these factors influence patient experiences.

Potential Causes of the Hospitals HCAHPS Scores

Intermountain Medical Center’s five star rating is an indication of the organization’s commitment and dedication to meet the needs of the patients. The healthcare organization has excelled when it comes to patient experiences, timeliness and effectiveness of care, management of complications and deaths, reduction of unplanned hospital visits, and effective use of medical imaging tests (Medicare, 2020, c). The five-star rating is linked to the commitment of the staff to enhance patient safety and quality of care. The caregivers in the institution are focused on continuously improving healthcare outcomes and this has resulted to positive patient experiences. Further, the organization’s success in the industry is anchored on its historical development aligned towards quality care. As a nonprofit entity, the hospital is dedicated to meeting the needs of all people by limiting discrimination and enhancing the role of healthcare professionals as the point of contact for the patients. At the same time, the organization has integrated innovative and creative practices in its workplace to ensure that it meets emerging needs in the marketplace. Generally, the medical center’s score is because of improved patient engagement, innovation and creativity, continuous knowledge and skill development among employees, and adoption of technology to boost efficiency and reliability.

Organizational Strategic Plan

Significance of Organizational Change

Organizational change empowers entities to confront problems and demands in their market – internal and external issues. Change is integral to the success of any business as it assists management to focus on issues that affect performance (Zarandi et al., 2017). Through organization change, Intermountain Medical Center can enhance the quality and reliability of its services. At the same time, organizational change will ensure that the healthcare organization will be in a position to address emerging issues in the community. For example, with organizational change strategies, Intermountain will be better positioned to handle the challenges bought about by the COVID-19 pandemic. As explained by Zarandi et al. (2017), organizational change is critical in addressing quality, leadership, employee engagement, technology, and financial issues – these factors influence the quality of care in a hospital setting. An improvement in the relevance of the services will lead to enhanced patient experiences, which will ultimately affect the HCAHPS scores. With the right leadership, technological tools, employees, and policies and regulations, Intermountain can enhance its patient experiences.

Intermountain needs to address some key areas to enhance or sustain its star ratings. Some of the areas within the national average that should be addressed include mortality, patient experience, effectiveness of care, and timeliness of care. While these areas are rated as some as the national averages, they need to be improved, if the hospital is to maintain its five star ratings. However, no significant improvements will be attained without any changes in its operations, leadership, and policies and regulations. Hence, organizational change in the hospital will spearhead the provision of quality and reliable services that will address mortality, patient experiences, timeliness in care delivery, and effectiveness of care.

Quality Strategic Framework

The quality strategic framework (QSF) will enhance the quality improvement priorities of Intermountain Medical Center. Intermountain strives to meet the needs of the patients in the community by actively engaging them and their families, committing to excellence based on experiences, and fostering a culture of quality improvement. The figure below shows the organization’s quality framework.

Figure 1

Quality strategic framework

By providing quality care, Intermountain strives to enhance patient experience and improve its overall HCAHPS score. For the hospital to deliver the best patient experience, it must create a culture of continuous quality improvement, which will enable its workforce to identify, lead, and participate in quality improvement initiatives (Davidson et al., 2017). All the employees in the medical center must share clarity of purpose and support the organization’s goals. An academic focus will ensure that the hospital enhances the skills and knowledge of its workforce to provide great care to the patients. At the same time, quality improvement requires important changes in practices and processes in Intermountain. This is possible by looking at the status quo and adopting a coordinated approach to transition from processes that may hamper its performance. The figure below shows the QSF processes that will be integral in the success of Intermountain Medical Center.

Figure 2

QSF processes

The development of the QSF establishes a new approach of enhancing performance in Intermountain Medical Center. For the organization to succeed, it needs to have a vision that incorporates the expected changes, and supported by collaborative goals and objectives. The medical center’s vision is to enhance patient experience, by implementing such goals as education of its employees, implementation of technology, change in leadership, patient engagement, and continuous quality improvement. Continued support and communication among the stakeholders will guide the implementation of the action plans. Further, the creation of a strong quality improvement culture will be supported by progressive involvement of transformation leadership and sustainable quality improvement initiatives.

The strategic plan will lead to a patient-focused service delivery in the hospital. With quality improvement programs, it is expected that the healthcare facilities will improve its star ratings, particularly when it comes to patient experience. Furthermore, the plan will support and sustain system initiatives focused on quality. It will prioritize the integration of quality improvement in new activities and best patient experience will always be the target. Most importantly, the strategic plan will reduce the mortality rate, enhance effectiveness of care, and improve the provision of timely care in the hospital – areas that need urgent attention to enhance the medical center’s star ratings on patient experience.

Incorporation of Evidence-Based Practice (EBP) and Shared Governance

Evidence-based practice (EBP) is integral in the provision of patient-centered care (PCC). As explained by Lehane et al. (2018), it centers on using the available patient information to recommend medical interventions. The promotion of EBP requires organizations to have reliable infrastructure committed to supporting its delivery. The incorporation of EBP in Intermountain will start by developing supporting infrastructure, including technologies to support data collection, storage, and analysis. The second step is the development of EBP driven goals and objectives – PCC goals. With a clear vision and targets in place, the employees will be educated on the use of EBP. Finally, progressive developments will be made to use new and emerging technologies to support healthcare decisions.

Shared governance is the structure and process for accountability, partnership, and ownership. It ensures that individuals are responsible for their decisions in a work environment. The incorporation of shared governance in Intermountain starts by developing laws detailing the structure of leadership. With a redefined governance structures, leaders and employees are tasked with specific responsibilities. Further, delegation of duties will be prioritized to ensure that low-ranking employees have decision-making responsibilities. The role of leaders in the organization will include coaching and mentoring to pave the way for creativity and productivity among the employees. Acting as developmental facilitators, leaders in Intermountain will allow teams to function smoothly. At the same time, shared governance will be attained by having an open communication structure. Free flow of information will facilitate communication and reduce the bottlenecks that hamper decision-making.

Shared Accountability

Shared accountability involves everyone, including patients, insurers, physicians, and the community in the provision of medical care. The development of shared accountability in Intermountain takes into perspective redesign care using the available standards, engaging patients, and aligning financial incentives in care provision for all stakeholders. Medical providers are expected to engage patients on the best care plans. They should run diagnostics, prescribe appropriate medications, and follow-up on EBP driven care. Physicians and other medical care providers should be involved in held accountable by involving them in planning and tracking their activities. Payers need to be held accountable by monitoring their financing activities by adopting a feedback loop that encourages timely reimbursements. Employees in the organization will be held accountable through frequent assessment of their performance by their departments. As explained by James (2019), monitoring progress, developing accountability conversations, and having a culture of accountability will be integral in building shared accountability at Intermountain Medical Center. The overarching element in developing shared accountability is the incorporation of technology in the management process. Through technological tools, management can monitor the activities of all stakeholders involved in care provision, particularly the internal stakeholders.

Incorporation of Technology

Technology has become ubiquitous in almost every sphere of the society. Through technology, businesses can enhance the relevance and effectiveness of their services. As explained by Bove (2019), digital technology enhances the interaction between healthcare facilities and patients. The use of technology in Intermountain Medical Center can foster its star ratings by enhancing the experiences of the patients. Technology can enhance healthcare practitioners to diagnose issues quickly and prevent readmissions. Two strategies can be used to incorporate technology trends in within Intermountain Medical Center: in-house development and outsourcing. The in-house development method is vital to the adoption of specific technologies that will drive sensitive activities in the healthcare facilities. Moreover, this method is vital to the adoption of unavailable technologies in the market. An outsourcing methodology is crucial when cutting costs and saving time. The combination of the two methods will ensure that Intermountain has the best technologies to deal with emerging issues in the market.

Improving Care Delivery System

The concept of quality improvement requires change. However, without a clear plan, change often fails. Thus, improving Intermountain Medical Center’s care delivery system requires effective planning and leadership. The first step in addressing the hospital’s care delivery system is to develop policies and regulations that will set the minimum quality standards and procedures in managing patient needs. The approach takes into consideration the industry’s standards on quality. In this case, quality relates to the satisfaction of the needs of the patients. Performance benchmarking is the ideal method of managing quality in the medical center. The method uses industry standards and targets as thresholds in enhancing organizational performance. Using the method, the hospital strives to exceed the national or state averages.

Improving care delivery in Intermountain requires the management of costs. The ideal method that the organization can use is cost budgeting, which involves estimating costs of resources and allocating them to cost accounts. It means that performance is measured against the incurred costs. At the same time, industry standards will offer guidance on critical areas and the average costs expected to be incurred. By managing costs, the organization can optimize performance and enhance productivity. The long-term aim is to ensure that the hospital lowers its operating costs and maximizes patient satisfaction.

Medical care accessibility is another area that must be addressed to enhance care delivery in Intermountain. This area can be enhanced through the integration of technology in the healthcare organization. The adoption of patient-monitoring systems and off-site treatment options will lower the cost of medical care and enhance the interaction between patients and healthcare providers. Such technologies as telemedicine are vital to the success of the hospital, especially as a non-profit agency. Moreover, the adoption of technology facilitates the provision of patient-centered care (PCC). The use of wearable technologies will allow nurses to collect and analyze patient data that will be vital in assessing the needs of their patients. The incorporation of big data in the hospital will support the use of PCC approach.

Financial Stability

Intermountain Medical Center does not have a specific customer segment – it targets all patients in the community. While this is a good approach of maintaining its reputation as a non-profit agency, the organization needs to develop a marketing segmentation approach. The classification of the patients will ensure Intermountain develops strategies to meet the specific needs of a group of patients with similar interests. At the same time, it is a viable option of expanding its customer base and take advantage of economies of scale. Further, the hospital needs to enhance its customer conversation rate – build customer loyalty. By enhancing patient experiences, Intermountain can have a large pool of loyal customers who will consequently enhance its financial stability. Apart from the revenue generation abilities, Intermountain needs to focus on cost management (Samorodov et al., 2019). Instead of purchasing costly equipment, management can consider to lease, especially if they are not to be used for long periods. Reduction of overhead costs by adopting digital strategies and green sources of energy will offer the organization an opportunity to lower its operating costs.

Implementation Plan and Timeline

Roles and Responsibilities of Stakeholders

The stakeholders involved in the development and implementation of the strategic plan include the support staff, nursing staff, doctors, nursing leaders, administrators, regulatory agencies, and the board of directors. The role of the support staff is to identify the loopholes in the hospital that impair its performance. The support staff will provide critical information and directions on such issues as overhead costs, security, hygiene, and other issues that affect the daily routines of the hospital. The nursing staff and doctors provide crucial guidelines on dealing with patients and evaluation of their experiences. They determine the right treatment protocols and the guidelines to incorporate PCC. Administrators organize the daily routines of the hospital, including admission of patients. They are responsible for ensuring that change takes place in the hospital. Moreover, they mobilize resources to be used in enhancing change. Regulatory agencies authorize the recommended strategies to ensure that they do not violate existing laws and standards. The nursing leaders organize and mobile the nursing staff to accept and facilitate change. The board of directors approves short-term and long-term goals that may spur organizational change. They authorize the new vision and recommended strategies to enhance organizational performance.

Stakeholder Accountability and Involvement

Accountability is improved by delegating duties and setting SMART goals for the all the stakeholders. Each stakeholder’s performance is then evaluated to measure their progress and make any changes to improve their outcomes. An outcome-based approach of monitoring the work of the stakeholders will ensure that they remain accountable for their actions. Further, setting realistic timelines will ensure that stakeholders remain accountable for their roles and responsibilities. Another conventional approach to enhance accountability is to ensure that team members express their commitment either verbally or in writing to assist in the implementation of the strategic plan.

A project cannot succeed without the involvement of stakeholders (Daniel & Inim, 2020). For Intermountain Medical Center’s stakeholders to have an impact on its performance, they need to be involved in the implementation of the strategic plan. Thus, their engagement will commence early to identify their needs and expectations. The development of the goals, objectives, and timelines will involve the stakeholders. The adoption of an open communication system will ensure that stakeholders share their views on the relevance of the strategic plan and its implementation. Further, the creation of diverse teams will give stakeholders an opportunity to participate in the success of the business.

Staff Training

Staff training is crucial in increasing their awareness and reducing the knowledge and skill gap in a healthcare setting (Arain et al., 2019). As Intermountain seeks to transition towards a digitized enabled service delivery model, it is pertinent for the staff to be trained. Acquisition of technological skills will ensure that the staff effectively uses big data and the internet of things technologies to provide patient-centered care. They will also need to train on addressing diversity issues, including culture and religion. The ability to meet the needs of varying groups in the community will ensure that patient experience is enhanced. At the same time, training on working in multidisciplinary teams will ensure that the staff fosters the interprofessional collaboration for the sake of the patients.

Plan Timeline

Table 5

Plan timeline in months

Requirement gatherings         
Develop vision, goals and objectives         
Develop and disseminate plan to stakeholders         
Align processes with new plan and conduct evaluations to make any changes         
Training and deployment of the new plan         
Implementation of the plan with new changes         

As illustrated in the table above, the plan is expected to take 9 months to be implemented. Evaluations of the plan are conducted on a monthly basis, as it allows management to track any changes in all the phases. Performance measurements (comparing period before and after the new plan) are vital to track the impact of the new plan and monitor the progress of the hospital in adopting new changes.

Evaluation of the Strategic Plan

An outcome-based method is used to evaluate the success of the strategic plan. The aim of the plan is to enhance Intermountain Medical Center’s star rating by enhance patient experiences. By conducting an outcome-based evaluation, the broader impacts of the strategic plan will be investigated. The comparison of the period prior and after the adoption of the strategic plan will aid in understanding any progress attained. The evaluations will be conducted on a monthly basis – an ideal timeline to assess the provision of quality care that improves patients’ experiences. Through surveys, the hospital can determine the experiences of the patients due to the new changes. The applicable method of analysis is descriptive statistics. The choice of the method is informed by the desire to evaluate the prevalence of common experiences among the patients. Descriptive analysis offer an opportunity for management to cluster common experiences and either work to enhance or sustain the operations of the hospital.

Stakeholder Involvement

The stakeholders will be part of the evaluation teams to ensure their involvement in assessing the impact of the strategic plan. Continued involvement of the stakeholder through select teams will ensure that their feedback is adopted. Further, feedback will be shared with the stakeholders during every evaluation period.

Communication of Evaluation Results

Communication is facilitated through internal and external channels. The internal channels include the company’s intranet system, memos and website. The external communication platforms include e-mails and social media groups. The sharing of information through these communication channels will ensure that all stakeholders are informed. Sensitive information will not be shared on the external communication platforms but will be limited to the internal communication channels and shared among select individuals. Further, periodic meetings will be organized to update primary stakeholders on the outcome of the plan.


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