Assessment 2 and final project for the capstone course

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Assessment 2 and final project for the capstone course “Hospital
Strategic Management and Planning”
Assessment 2: Development of a research proposal on a “Business Model”: The
learners are required to write a proposal for a business model for improving the
operation / adding value for a specific service within a hospital department.
Final Project: The final project (week 15, 40 marks) will take the form of a pilot study
whereby at least aspects of the research proposal are trialed/implemented and
evaluated
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Sections of the proposal
I. Situational Analysis – hospital assessment
The internal and the external environments of the hospital will be analyzed
1. External environmental analysis components of the health care environment
that currently affect or are likely to affect the study hospital in the near future.
(Assignment 1)
2. Internal environmental analysis: the internal environment will be analyzed
through a value-based healthcare delivery system
a. Major strengths and weaknesses across the value chain of service delivery
will be recognized. Strength and weakness should be stated in terms of
 service delivery; pre-service, point of service and after service.
 support activities; organizational culture, structure and strategic
resources
b. Strengths and weaknesses’ competitive relevance based on value,
rareness, imitability and sustainability will be evaluated
c. Strengths, weaknesses, opportunities and threats analysis will be
conducted through organizing internal environmental weaknesses and
strengths and external environmental opportunities and threats.
II. Service background and description
Based on the results of external environmental and internal environmental
assessments and building on a recognized competitively relevant strength to capture
a market opportunity or to face a threat, a specific service / quality improvement
initiative in a specific hospital department will be selected.
This section describes the service profile namely;
Service description
A selected service will be described in terms of
a. service location
b. service boundaries
c. Demand level for the selected activity e.g. number of outpatient visits for
a specialized clinic per month, number of operations for a selected type of
operations per month
d. Performance indicators for the selected service
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III. Proposed interventions / strategy
1. General goal
a. The general goal of the strategy which should fit with the hospital strategic
direction represented in the hospital mission and vision.
b. The proposed strategy should aim at improving the outcomes, value, and/or
cost.
Examples for service improvement ideas within different hospital departments
• Improving flow of patients presenting with acute coronary syndrome
• Providing a model for “patient-centered-care” for diabetic patients
• Providing a vertically integrated model of care for pregnant females
• Improving patient flow and reducing waiting times for patients presenting to
the emergency department
• Reducing operation cancellation rates and maximizing the efficiency of
utilization of operative theatre
• Improving patient experience and continuity of care in outpatient settings
through reducing the internal and external waiting times with application of
open access appointment scheduling
2. Specific objectives
The objectives of the strategy need to flow from the general goal. They are statements
indicating the key outputs for the service to achieve and therefore form a basis for
assessing the performance of the selected service. The strategy is expected to improve
outcomes in monetary and non-monetary terms relative to the cost invested in the
proposed strategy
The objectives of the service will need to be aligned to hospital goals and stated in a
measurable time-bound, specific and attainable terms. Specific objective for
Example for a specific objective to one of the aforementioned goals;
a. Implementing a scheduling system in the operation room to

i. ii. iii. iv.

increase OR utilization from ……% to …….% reduce overtimes by …..% reduce delayed operations by ……..% reduce cancellation by ……%

v. Reduce start time tardiness by …..%
b. Financial performance of the proposed strategy will be based on estimates of
the financial gains when compared to the costs of implementing the proposed
intervention. Estimation will be based on reviewing the relevant literature on
cost saving from applying similar strategies.
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IV. Implementation plan
a. A work breakdown structure for the proposed new strategy will be developed
together with estimation of the needed resources.
b. Estimate the cost of implementing and operating the proposed strategy in
terms of direct capital cost for purchased material and supplies, if any, and
indirect cost of personnel time. Costs will be estimated based on interview
with personnel from the financial accounting department.
V. Measuring the anticipated outcomes
Performance evaluation for the selected service / quality improvement initiative will
be assessed based on a Balanced Score Card system, linking the performance
measures to the hospital strategic directions across four pillars; financial performance,
internal business process, customer satisfaction and training and education. Learners
may utilize other methods (e.g. before-and-after study) if more appropriate for their
selected topics.
For the pilot project, the indicators will be measured after one month of application
of the proposed intervention
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Suggested Grading Scheme for Assessment 3

Rubrics
Criteria	Excellent (86-100)	Good (71-85)	Poor (0-70)
Situational analysis
Steps for undergoing situational analysis	All steps precisely described	Some elements are missing	Most of the steps are missing
Elements of the internal environment described	All elements for analyzing the internal environment across the value chain are mentioned	Some elements for analyzing the internal environment across the value chain are mentioned	Major elements in the value chain are missing
Data sources	Adequately described	Inadequately described	Not described
Service description
Elements for service description	All elements mentioned	Some elements missing	Most of the elements missing
General goal for the service
Stating the general goal for the service	Correctly stated, justified by the results of the hospital’s environmental analysis and consistent with the hospital overall mission	Correctly stated, relevant to the results of the hospital environmental analysis but inconsistent to the hospital overall mission	Poorly stated, irrelevant to the results of the hospital environmental analysis and inconsistent to the hospital overall mission
Specific Objectives for the service
Description	All objectives are clearly stated with well-defined time frames and performance target	Some objectives are clearly stated with well defined time frames and performance target	Objectives are poorly with no time frames and no performance target
Consistency with the hospital mission	All objectives are consistent with the hospital mission	Some objectives are consistent with the hospital mission	All objectives are in consistent with the hospital mission
Implementation plan
Activities included	Comprehensive	Missing few essential activities	Missing most essential activities
Implementation plan elements for each activity	Includes all elements	Missing 1-2 elements	Missing more than 2 elements
Relationship between elements for each activity	Logical relationship between elements	Mostly logical relationship between elements, with few exceptions	Relationship between elements not logical
Anticipated outcomes

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Set of indicator	Balanced set of indicators covering structure, process and outcome measures in case of Donabedian model or the four pillars of a Balanced Score Card (at least 2 indicators per area)	Some areas are not adequately covered by the set of indicators	Some areas are completely not assessed by the indicators set)
Indicator threshold	All indicators have a precise threshold, which is evidence based	Some indicators have a precise threshold which is evidence based	There is no threshold for the indicators or threshold is mentioned without sufficient evidence
Report
Communication	The report is well organized and well written. It includes accurate use of terminology, grammar, and spelling.	The report is generally well-written/well organized, but includes some linguistic errors, including inaccurate use of terminology, grammar, and spelling.	The report is not well organized and includes significant linguistic errors that impact on its coherence and clarity.
References	All the references used are important, and of good scholarly quality. There is a minimum of 3 scholarly resources that are used effectively. Almost all the references are correctly cited (>90%) and correctly listed in the reference list according to APA style.	Most of the references used are important, and are of good scholarly quality. There is a minimum of 2 scholarly resources that are for the most part used effectively Most of the references (>70%) correctly cited and correctly listed in the reference list according to APA style.	Most of the references used are not important, and/or are not of good scholarly quality. There is <2 scholarly resources, and/or they are not used effectively. References are not correctly cited and/or correctly listed in the reference list according to APA style.

 

Grades
Steps for undergoing situational analysis	1
Elements of the internal environment described	1
Data sources for situational analysis	1
Elements for service description	1
Stating the general goal for the service	1
Description of the specific objectives of the service	4
The specific objectives are consistent with the hospital mission	1

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Activities in the implementation plan	2
Implementation plan elements for each activity	2
Relationship between elements for each activity in the implementation plan	1
Set of indicators selected	4
Indicator threshold	1
Total Grade	20

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Suggested Grading Scheme for the Final Project

Rubrics
Criteria	Excellent (86-100)	Good (71-85)	Poor (0-70)
Situational analysis
Data collection methods	Sufficient, appropriate, and well described	Partly sufficient, some inappropriate or not well described	Insufficient, most inappropriate and/or not well described
Number of strengths/weaknesses identified	Not less than 12 strengths/ weaknesses	9-11 strengths/ weaknesses	Less than 9 strengths/ weaknesses
Use of organizational values chain	Used correctly	Used with few errors	Not used, or used incorrectly
Discussion of strengths/weaknesses identified	All points discussed, supported by evidence	Most points discussed, partially supported by evidence	Less than half of points discussed, not supported by evidence
Evaluating competitive relevance	The 4 criteria used appropriately for each point, conclusion valid	The 4 criteria used appropriately for most points, conclusion valid for most points	The 4 criteria not used appropriately for most points, and/or conclusion not valid for most points
Service description
Service location	Location is well described with any potential strategic implications and accessibility factors	Location is described inadequately and with no link to the strategic implications and service accessibility	Location is poorly described and with no link to the strategic implications and service accessibility
Service boundaries	The geographical area for the proposed service is well delineated and profiled	Evaluation based on few criteria, conclusion and refinement partly logical	Evaluation not based on criteria, conclusion and refinement not logical
Service demand level	The level of demand is precisely determined based on the previous year statistics	Evaluation based on few criteria, conclusion and refinement partly logical	Evaluation not based on criteria, conclusion and refinement not logical
Performance level	Performance for the selected service is well described in terms of a balanced set of indicators	Performance for the selected service is partly described in terms of an imbalanced set of indicators	Performance for the selected service is poorly described in terms of a few, unbalanced set of indicators
General goal for the service
Stating the general goal for the service	Correctly stated, justified by the results of the	Correctly stated, relevant to the results of the hospital environmental	Poorly stated, irrelevant to the results of the hospital environmental

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hospital’s environmental analysis and consistent with the hospital overall mission	analysis but inconsistent to the hospital overall mission	analysis and inconsistent to the hospital overall mission
Specific Objectives for the service
Description	All objectives are clearly stated with well-defined time frames and performance target	Some objectives are clearly stated with well defined time frames and performance target	Objectives are poorly with no time frames and no performance target
Consistency with the hospital mission	All objectives are consistent with the hospital mission	Some objectives are consistent with the hospital mission	All objectives are in consistent with the hospital mission
Implementation plan
Activities	All activities written in the proposal are implemented on a narrow scale	Missing few essential activities	Missing most essential activities
Anticipated outcomes
Set of indicator	All indicators mentioned in the proposal measured for a pilot of 10 patients before and after application of the proposed intervention	Some indicators are not measured or measured for one phase	Most of the indictors are not measured in either phases
Report
Communication	The report is well organized and well written. It includes accurate use of terminology, grammar, and spelling.	The report is generally well-written/well organized, but includes some linguistic errors, including inaccurate use of terminology, grammar, and spelling.	The report is not well organized and includes significant linguistic errors that impact on its coherence and clarity.
References	All the references used are important, and of good scholarly quality. There is a minimum of 3 scholarly resources that are used effectively. Almost all the references are correctly cited	Most of the references used are important, and are of good scholarly quality. There is a minimum of 2 scholarly resources that are for the most part used effectively Most of the references (>70%) correctly cited and	Most of the references used are not important, and/or are not of good scholarly quality. There is <2 scholarly resources, and/or they are not used effectively. References are not correctly cited and/or correctly listed in the

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(>90%) and correctly listed in the reference list according to APA style.

correctly listed in the reference list according to APA style.

reference list according to APA style.

 

Grades
Data collection methods for situational analysis	2
Number of strengths/weaknesses identified in internal environmental analysis	3
Use of organizational values chain	3
Discussion of strengths/weaknesses identified	2
Evaluating competitive relevance	2
Describing the service location	1
Service boundaries	1
Service demand level	2
Performance level	2
Stating the general goal for the service	–
Description of specific objectives of the service	–
Consistency of the specific objectives with the hospital mission with the hospital mission	–
Implementation of activities in the implementation plan	10
Indicator measurement	8
Communication	2
References	2
Total Grade	40

 

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