Delta RHPI Project Performance Improvement Assessment - one approach to the onsite consultation
The following is one approach to conducting a performance improvement assessment (PIA) for the Delta RHPI Project's eligible and participating hospitals. The approach will depend on the consultants conducting the PIA.
Strategic Planning Performance Improvement Approach
The strategic planning performance improvement services begin with a review of the hospital's historical data followed by an intensive, on-site analysis of its programs, strategic options, operations and staffing. The site analysis includes interviews with the hospital board and management leadership, physicians and departmental staff. A comprehensive written report of the findings and recommendations is presented to key stakeholders determined by the hospital, with opportunities for questions and dialogue. The consultants make themselves available to provide optional follow-up implementation support as requested by the hospital administration.
Objective: The objective of strategic planning performance improvement engagement is to conduct rapid, focused analyses of the hospital organization and its market which results in the identification of concrete opportunities for clinical service line, operational and financial performance opportunities. This is completed within the context of enhancing and sustaining the critical role of the organization in its rural community.
Approach and Work Plan: The major areas of emphasis in the strategic planning/ performance improvement analysis include the following:
- Analysis of service area population characteristics and trends
- Review of clinical service programs comparing hospital programs to community needs as well as other rural hospitals
- General review of finance functions including third-party contract strategies, availability of decision support information, etc.
- Review of Medicare and Medicaid reimbursement reports to ensure optimal payments
- Benchmarking of hospital expenses with peer hospitals
- Physician practice management assistance
- Review of organizational architecture and general management principles
The work plan for this consultation is divided into four phases:
- Introductory conference call - Hospital administrator meets with the consultant team and reviews the data request, interview schedule, on-site process and reporting and follow up timeframe.
- Hospital preparation for consultation - Data request including historical operating and financial data is completed. Individual interviews with hospital staff are scheduled.
- Site visit/ consultation - Findings from the site visit will be presented in preliminary form at an exit interview with the administrator. A written draft report will follow approximately three weeks later. This will be reviewed with the hospital administrator to justify recommendations and make corrections. The final report will be sent to the administrator to be shared with staff in preparation for the implementation phase.
- Implementation assistance - following the development of the performance improvement report, the focus will turn to implementation assistance. A day long implementation workshop will be held within two weeks of finalizing the report. This "problem solving team" will include the executive management team and invitees. The consultants will present an executive summary of the report. If desired, a special presentation can also be arranged for the board. The consultants will facilitate conference call updates and will be available as needed for additional technical assistance. Recommendations in the performance improvement assessment will be evaluated by staff, prioritized by timeline and impact, and assigned to an internal leader. Action plans for major recommendations will provide further detail.
Hospitals participating in PIA will also participate in the project's outcome evaluation process with an outside, objective evaluator. This usually occurs one or more years following the PIA.