Description of how strategy will be executed and measured



Partnerships and Quality Improvement

Arroyo Fresco Community Health Center (AF) is a non-profit organization that is serving western Arizona from eleven clinics and four mobile service vans. Community health centers are established over the past forty years in undeserved areas in all fifty states, are community-owned health care organizations that offer patients high-quality primary care and preventive services regardless of their ability to pay (Arroyo Fresco Community Health Center Case Study, 2016). There is a stigma that the care and treatment of patients is underwhelming and are not treated with the proper care of the clinical staff. All community health centers face many challenges to serve the uninsured mainly due to funding and financial limitations. Thus, a new strategy to improvement and promote better care within the community health centers is through providing clinical staff with better training and helping them be more aware of the patient they will care for.

By developing a quality improvement process, this will help improve the patient’s care and encourages a better outcome for the community and revitalize the philosophy of patient-centered environment, also known as a Medical Home (Health Affairs, 2010). Patient-centered is a partnership among practitioners, patients, and their families ensures that decisions respect patients’ wants, needs, and preferences, and that patients have the education and support they need to make decisions and participate in their own care (Patient-Centered Primary Care Collaborative, 2017). When caring for uninsured or low-income families, it brings the risk improper diets and chronic illness which leads to having to seek medical attention from specialist. The new restructure strategy is the driving force in the foundation of better primary care and prevention.

The development of a quality improvement process should consist of the use of experiential learning, provision of feedback, effective peer and colleague relationships, well-designed interventions following principles of teaching and learning and diversity of educational methods within single interventions (Merillat, L., & Scheibmeir, M., 2016). Physicians, nurses and clinical staff want to learn in order to meet the needs of their patients. Grol and Leatherman (2002) suggest that the most important ingredient in achieving successful implementation of quality improvement methods is the professional values of individual clinicians in association with a collective professional ethos. Continuing medical education consists of educational activities which serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public, or the profession.

AF’s mission statement is “provide residents of Yuma, La Paz, and Mohave counties easy and timely access to high-quality and safe health care services, responsive to their diverse cultural and socioeconomic needs, regardless of their ability to pay” (NSIT, 2006). AF has been able to advance its population and services throughout the last several decades because there is a need for enhancement in order for the organization to reach its full capacity. A new structural organization was designed to improve the operations of the health center to lead to its success. AF’s current strategic plan is designed to satisfy their overarching vision of “through leadership on health care design and delivery, education and training, and community involvement, the people of western Arizona will become the healthiest in the state” (NSIT, 2006). According to AF’s report, the plan was developed after determining strengths and weaknesses using a SWOT (strengths, weaknesses, opportunities, and threats) analysis. The below demonstrates the design to support the mission. AF has acknowledged several challenges in their strategic plan. But would like to offer additional objectives as action steps to support the plan in particular categories. The suggestions are as follows:

Financial Performance
Current Objective: “increase income by decreasing overall cost-to-service through reductions in administrative and indirect patient costs” (NSIT, 2006).
Analysis: Because AF primarily serves an uninsured population, they rely heavily on funds from grants, private donations, and payment from Medicaid and Medicare for insured patients. Due to changes in health care policy, AF may see a decrease in payments received.
Revised objective: increase income by decreasing overhead costs; in addition to increasing fundraising efforts.
Clinical Excellence
Current Objective: “Increase the overall ratio of patient visits to staff. Develop internal and external resources to address unmet health care needs in the service area to increase the number of new patients served” (NSIT, 2006).
Analysis: The current objective lacks a focus on preventative services.
Revised objective: Improve relationships with community organizations and vendors. Host health fairs that include free screenings and consultations with clinicians. Increasing the number of staff available in order to create more appointment availability. Offer increased evening and weekend hours. Considering tele medicine as a way to reach patients with no access to transportation.
Current Objective: “Improve satisfaction levels on staff survey

Improve satisfaction levels on volunteer survey

Improve stakeholders’ satisfaction” (NSIT, 2006).

Analysis: AF should focus on staff retention by promoting attractive packages, offering in-house continuing education, and designing a collaborative interdisciplinary team approach to patient care. This category should include patient satisfaction.
Revised objective: Arroyo Fresco can improve employee satisfaction by providing staff with the needed tools to be successful. This includes offering attractive compensation packages, proper training before going into the field and promoting a team approach to patient care. In addition, by implementing new technology such as EHR’s, and tele medicine, AF will be creating a more comfortable work environment for employees. In addition, AF should take advantage of social media as a way to recruit both patients and professionals. Patient satisfaction initiatives should include expansion of appointment availability, decreased wait times, more time with patient to thoroughly explain diagnosis, prescriptions, etc. These are all concerns that were expressed on patient satisfaction surveys at AF.

Not For Profit Organization

The new organizational structure will be assess through the partnership with the greater surrounding hospitals in Yuma, Arizona where majority of the AF community health center will be located. A healthcare partnership is a relationship where two or more organization come together to reach goals of balance, quality, providing patient services and meeting the needs of the community. The growth of AF and the hospital partners depends of the effectiveness of building a culture of health. By building a culture of health around a community brings awareness to each individual of an equal opportunity to live a healthy lifestyle regardless of their ethnicity, races, socioeconomic status, demographics or physical circumstances. Through the analysis of the healthcare partnership, the outcome will be to increase patient awareness, being asses-sable with the best technology, increase in revenue, and growth with patient satisfaction. However, there are some challenges that are faced with a new organization structure such as limited of funds, change management with leadership, and limited control of decisions structure. The key to overcome these challenges will bring positive impact to a community and to vision a development in the health care community.

The goal in a healthcare partnership is pulling together a strategic plan to improve the health of the community. Schifferdecker and Bazos (2016) research supports the community health improvement process (CHIP) model following the core process developed through the healthy cities movement:

1. Gathering together a diverse group of community members

2. Developing a shared vision of community health

3. Assessing the current realities and trends

4. Planning action

5. Performing strategically

6. Monitoring and evaluation

Through the CHIP model, the leadership from both side can determine the best ways improve and target the health trend to bring in more patients (Schifferdecker and Bazos, 2016). The effective of partnership through a collaborative action has gain traction in the healthcare field, many hospitals and health systems have been working with community partners for many years. Leveraging existing assets in the community is an effective way to strengthen partnerships. An asset-based development plan focuses on identifying available resources within the community and building stronger relationships between all community organizations. Assets can be people, physical structures or places, community services and community organizations, which can be used to improve the quality of life within a community (Allen, Finnerty, Gish, et al., 2016).

The major challenge in a healthcare partnership is the financial aspect of supporting multiple hospitals and clinics and being able to make a decisions on how to reduce cost but not limiting services to patients. Risks to the decision-maker partner may include a substantial investment, both financially and in kind, and uncertainty of committing to a partnership without knowing what the full impact will be on the organization (Jagosh et al, 2012). Alterations to the administration (for example, restructuring, relocation), budget allocation, and strategic plan could all affect the importance and possibility of the partnership, thus shifting decision makers’ priorities and needs (Traynor et al, 2015). The reality of any new organization will bring the loss of employees due to change management. Change management will implement new policies and procedures that staff are not willing to compile with. Changes in any organization will see staff turnover, priority shifts, and unforeseen events are expected to happen but it takes time and commitment to see the success of a healthcare partnership.

The overarching goal with the AF community center partnership is to provide better healthcare services to the underserved and uninsured patients. For an effective healthcare partnership, the main focus is on leadership within the partners. The leadership team must have a respect and understanding as a basis foundation. There are different governance requirements for hospitals and clinics that can cause disagreements but by having a common understanding will help a partnership expand. The second main goal is building trust and communication around leadership, staffs and patients. By being receptive, helps the partnership to be transparent with everyone who is involved in the change. Lastly, a successful hospital-community partnership should result in more services for patients, improve coordination of care, and improve financial stability.

Part 3: Specific goals and recommendations for the future, new and unique ideas or research supported rationale for continuing or changing current practices. Expanding to different – Specialty/ Telemedicine

Part 4. Description of how strategy will be executed and measured, including financing, revenue and expense. How will you pay for the changes you recommend? This is a critical part of the exercise. Application? Do not place a heavy assumption on donations or grants from federal or state governments.


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