st. vincent hospital, management plan - final submission [bcor 2300]

The University of Colorado at Boulder

Leeds School of Business

Introduction to Operations Management and Technology

Final Project Submission

Spring 2014

Caleb Britt, Hannah Chandler, Taylor Craven, Katherine McManus

Table of Contents

I. Executive Summary 1 II. Introduction 5 III. Physical Location and Financing Plan 16

IV. Medical Services Plan 20

V. Medical Service Demand Forecast 30

VI. E-Commerce Plan 42

VII. Equipment Plan 56

VIII. Supply Chain and Inventory Management 61

IX. Human Resources Staffing Plan and Cost Analysis 69

X. Revenue Analysis 91

XI. Simple Three Year Financial Analysis 93

XII. Process Maps 98 XIII. Final Summary 109

XIV. References 115

I. Executive Summary

The Problem: St. Vincent Hospital has a history of providing health services to the

citizens of Leadville, CO and the surrounding towns in Lake County, Colorado for over 125

years, a proud tradition that the doctors and practitioners of St. Vincent continue to uphold.

However, due to the ever changing healthcare market - in conjunction with technological and

medical advancements that are not only assisting the healthcare business, but increasing

competition between hospitals and healthcare providers - St. Vincent stands at the precipice of

possibly being left behind in the wake of necessary, sustaining change. In the first four months of

2013, more than nine major hospitals from around the United States were forced to close due to

financial reasons and “the pressures of the new healthcare environment” [1]. This included

Stewart-Webster Hospital in Richland, Georgia, which - like St. Vincent - had a history of

healthcare provider-ship with the local community, serving the region for over 60 years [2].

Vincent Hospital currently lacks any differentiating factors that would enable it to compete with

surrounding general hospitals in not only Lake County, but in comparison to nearby population

hubs such as Aspen, Breckenridge and Vail.

The Solution: St. Vincent needs to adapt to the technological and medical changes

occurring, in order to adapt to an increasingly competitive industry with an increasingly tech-

savvy patient base, while also keeping prices low to continue to appeal to the current Lake

County population and bring in new patients from surrounding regions.

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Due to its isolation and a slow, steady declining number of patients per-year (attributed to

the decline of Leadville as a tourist location in favor of Aspen, Breckenridge and Vail), St.

Vincent will have to adopt a certain number of competitive differentiators to not only avoid

closure, but to thrive and compete. There are several specific obstacles that must be addressed in

order to achieve the compelling vision for St. Vincent, the most important of which are the

following:

The integration of a specialized sports therapy and rehabilitation center, which will

become the new focus of St. Vincent on a level that extends beyond the local community and

draw in a national attention and clientele.

The assimilation of advanced medical technology to increase patient output, patient

success rates, while simultaneously decreasing expenditures.

The incorporation of e-commerce and e-business strategies into St. Vincent’s day-to-day

activities to appeal to an increasingly tech-savvy clientele, while simultaneously decreasing

expenditures and increasing hospital efficiency.

Improving upon the current human resources and staffing plan, supply chain and

inventory management plan, equipment plan and medical services plans to decrease spending

and increase efficiency, as well as economic and environmental sustainability.

St. Vincent will become one of the premiere sports therapy and rehabilitation centres in

not only Colorado, but the rest of the United States, as well, taking advantage of some of the

state’s greatest resources - such as the Olympic Training Center in Colorado Springs - in

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combination to the incredibly active lifestyle that Colorado has to offer. Adapted from some of

the most successful hospitals in the country, and combining research and studies from hospitals

that have successfully adapted to fit the current medical market, St. Vincent will provide state-of-

the-line medical care one both a sports and general level, while also bringing business, attention

and vitality to Leadville.

St. Vincent will bring premiere sports therapy and health services to a potentially ideal

market. Leadville, Colorado, stands in the midst of one of the most “active” locations in the

country; Colorado being one in the top five healthiest and most active states in the United States

[3]. Though Leadville, Colorado remains in a relatively isolated region of the Rocky Mountains

(comparatively to surrounding settlements), with a lower than average yearly income per resident

than most Coloradans ($38,491 against Colorado’s $55,387), and yet a younger average age per

resident (36.7 to Colorado’s 40.6), the possibilities for growth are endless [4]. Hospitals in

Aspen, Breckenridge and Vail have sports therapy and rehabilitation centers, but nothing as

extensive or medically and technologically advanced as what St. Vincent will have - St. Vincent

will be the first hospital of its kind on the region. St. Vincent will capitalize on this unique and

promising market, offering value beyond an annual checkup. St. Vincent is also committed to its

partnerships in the community; aware of the impact that these changes will have on the

environment as well as the citizens of Leadville. The hospital’s operations will move towards

sustainability, both economically and environmentally.

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Key decisions at all levels of St. Vincent’s move towards sustainability and premier,

competitive healthcare fall under St. Vincent’s current “Mission Statement”:

“The mission of St. Vincent General Hospital is to provide the best possible continuum of

healthcare services to meet the health needs of persons in Lake County and surrounding

areas. These services will be provided in a quality, cost-effective and accessible basis,

and achieve a balance between community needs and available resources. We will reflect

the caring and noble nature of this mission in all that we do.” [5]

In addition, St. Vincent will adopt a new platform for its sports therapy and rehabilitation

center - that of “We’re pros with the pros!” St. Vincent will be professional in every aspect of our

sports therapy and rehabilitation program, to offer expert care to professional, competing athletes

from around the United States. St. Vincent hopes to become the premier sports rehabilitation

center for any athlete competing at the next level.

Sustainability - combined with economic and environmental awareness -requires prudent

financial decisions that allow St. Vincent to serve the community (and beyond) on a long-term

basis. Our team of financial analysts meticulously researched the best products, methods,

advancements and equipment for the best value. From this, they have developed and projected a

budget that forecasts long-term solvency.

Additionally, an updated human resource plan ensures employees will perform at a level

befitting St. Vincent’s current and future mission, and also ensures that they will be compensated

fairly for their service. This will work in conjunction with the implementation of medical

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technology (e-business and e-commerce) that will increase patient output and success, decrease

confusion and streamline the patient-seeing process; this process will decrease spending and

increase productivity. St. Vincent sees profitability in the future and anticipates continuous

growth.

The following report is a comprehensive guide to St. Vincent and its current and future

operations. The guide outlines the various ways that St. Vincent plans to serve Leadville, Co and

the surrounding Lake County community, deliver superior services at a competitive and general

level, and grow sustainably into the future to become a competitive medical provider in the

Colorado Rocky Mountains.

II. Introduction

1. General Introduction of the Project to the Investor

The vision for the future of St. Vincent’s Hospital - in beautiful and accessible Leadville,

Colorado - is ambitious, yet practical, economic, and entirely profitable. Our team can expand

and improve upon St. Vincent, with faithful capital support, into a profitable business through

sensible and knowledgeable models, core values, and key decisions. This “General Introduction

of the Project” will serve as a thorough overview of the information provided to our stakeholders

in the following comprehensive report.

Currently, St. Vincent’s is a 25-bed, critical access hospital that “provides general medical

services for a wide variety of acute illnesses, as well as post-operative surgical care, long term

care, home health care and emergency services (1).” St. Vincent provides these services to a

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variety of patients from not only Leadville, but the surrounding cities, as well. We have no

intentions of completely remodeling St. Vincent’s into an entirely different medical facility, or

acquiring the hospital to merely destroy and remodel its medical and community foundations.

Instead, we will expand and transform St. Vincent’s into a multi-faceted facility, specializing in

sports therapy and emergency care, whilst also retaining the basic medical capabilities that have

been provided to the various communities of Lake County, Colorado since St. Vincent’s

establishment in 1879.

First and foremost, we will offer emergency services to Leadville just as St. Vincent’s

always has. Emergency room services give our hospital a large target market and a lot of

opportunities for profit. Because there are so many types of illnesses and injuries that lead people

into the ER, we want this to be the largest and most central aspect of our hospital. We will

purchase St. Vincent’s Hospital as it currently stands, and both incorporate and expand its current

facilities and lands into a hub for the highest-quality professional sports medicine and therapy,

targeted at a market of professional winter-sport and summer-sport athletes training in the Rocky

Mountains. St. Vincent’s is located between three foremost locations for sports training -

Breckenridge, Vail and Aspen - and will, therefore, find potential patients with incredible ease.

Leadville is easily accessible from these three locations.

Furthermore, the expansion and refitting of St. Vincent’s into a specialized athletic

therapy facility will not only expand St. Vincent’s as an upstanding medical establishment - both

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economically and professionally - but will simultaneously expand and enhance the city of

Leadville, Colorado’s commercial and economic appeal and opportunity.

2. Chosen Approach to the Market

a. Target Market

St. Vincent’s Hospital will target elite athletes, primarily professional skiers and

snowboarders. Since our hospital is in a town close to major ski resorts, we are creating a

hospital that can treat accidents that happen on the slopes. We can also target cyclists, hikers,

rock climbers, and other outdoor enthusiasts who encounter injuries requiring our services on a

constant basis. The focus of our practice is to give professional athletes the specialized

treatments they need to continue to train and compete. In order to provide adequate care for the

professional athletes, St. Vincent’s will focus primarily on an emergency room service, as well as

a physical sports therapy and recovery center. Our goal is to get each citizen taken care of and

moved on to their daily lives, and each athlete back to the sport they love. We do not want our

patients to feel discouraged about their injury. Our team will provide quality professional health

care to get our patients back to optimal performance.

b. General Overview of Services Provided

St. Vincent’s will contain an emergency center, physical therapy rehabilitation center,

flight for life and cafeteria service. As a specialty hospital our mission is to provide the top sports

therapy, rehabilitation center in the nation. Humans have roughly 206 bones in their body and

more than 660 muscles in the body and we provide treatments to almost all of them (2). The

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cafeteria will provide patients and guests meals from the hours of 7am to 7pm. All staff will have

access to the cafeteria at any time of the day in case of emergencies and vending machines will

be place around the hospital as well. Also, our flight for life service will provide our patients will

quick transfers from the scene of their accident to the ER. Our hospital will be equipped with a

helipad, which in turn, will create an efficient way of traveling to and from the accidents

occurring in the mountains and elsewhere. We strive to create the best possible services for our

patients.

Our emergency center with our top surgeons will provide services including:

• Surgeries

• Transplants

• Cardiac care

• Emergency center includes x-rays, ambulance service, helicopter service,

paramedic service, first aid squad, and emergency squad

• Flight for life - helipad

• Basic emergency room services such as flu and strep testing and treatment of acute

illness and injuries

Our sports therapy center will include treatments involving:

• Neurological and orthopedic injuries and pain.

• Sports injuries.

• Injuries including writs, head/face, shoulder, knee, ankle, spine and back

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• Treatment of fracture, laceration, sprain, joint injury, contusion, concussion

• Post-surgical rehabilitation

Our focus on post-surgical rehabilitation will work with patients to quickly recover.

The post-surgical rehab will include:

• Treatment of post surgeries

• Working with patients on total joint replacements

• Ligament and tendon repairs

• Amputations

• Nerve compression release

• Tendon transfers

• Joint fusion

• Post-surgical ACL/MCL

c. Details - “Why This Market?” and “Why These Services?”

There are multiple ski and snowboarding injuries occurring in the Unites States today and

many people suffer severe consequences when their injuries are not getting the right treatment.

According to the National Ski Areas Association, in 2011/2012 there were 510 serious injuries.

Serious injuries include paralysis, as well as head and spine and injuries (3). We want to offer our

physical therapy services to seasonal skiers and snowboarders and we feel that our close

proximity to the mountain resorts of Colorado will give people the view that we are the best

place to go. We also want to attract professional athletes who are competing in the Olympics and

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X-Games. These athletes often train in the mountains of Colorado where Leadville is centered.

With our specialized hospital equipped with a helipad, athletes will have close, fast access to the

care they need. Having a hospital that specializes in sports therapy and recovery creates an area

of specialty and difference within the marketplace. Our specialists will provide the athletes with

the acute and chronic treatments that other local hospitals cannot provide.

We decided to purchase St. Vincent’s because we wanted to expand on a location that did

not provide medical options in the area. Our focus on Sports Therapy was inspired by the

multiple injuries of elite athletes in their training and competing stages. In order to create a

hospital that had a point of difference we wanted to focus on not only the emergency center but

also a specialized practice where elite skiers and snowboarders could be treated with the best

rehabilitation services. Not only can St. Vincent’s hospital treat normal emergency cases but also

it can treat injuries such as fracture, sprains, concussions and joint injuries. After the injuries are

treated in the emergency room, our sport specialists will work closely with the patient to help

them recover quickly in physical therapy as needed.

3. Competitive Differentiators from Current Hospital

There are several different hospitals in the Lake and Summit Counties of Colorado, all

within throwing distance of popular sports training hubs. Each of these hospitals offers

emergency services, along with specialized and high quality surgery services and basic medical

care. Our acquisition of St. Vincent’s would not affect these particular services - it would expand

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and improve upon them, providing crucial medical care to Leadville and Lake County as a whole

to a general population of patients.

Currently, St. Vincent’s Hospital remains the only hospital of any kind in Leadville,

Colorado. Additionally, Colorado is home to one of the largest facilities aimed towards training

American winter sports Olympians (located in Colorado Springs, Colorado). These factors

provide a unique and incredible opportunity for the state of Colorado, and for St. Vincent’s as a

potential epicenter for advanced medical research and sports rehabilitation.

St. Vincent’s can expand its current market and utilize its easily accessible, prime location

to not only continue with its current daily functions, but also expand to include a specialized,

world-class sports rehabilitation program that is both technologically and medically advanced.

This particular aspect of St. Vincent’s would be specifically unique to the area, targeted towards

a distinct market of professional athletes and trainers. And, by hiring the best and the brightest -

and providing resources to allow for constant technological and medical innovation - St.

Vincent’s could become one of the premier sports medicine specialists in the nation. As of 2012,

the population of Leadville is approximately 2,594 (4), which is equivalent to the current

hospital’s market size. As we transform St. Vincent’s into a physical therapy and recovery center,

we can begin including the surrounding cities and areas into that market size since the appeal of

having a general hospital combined with physical therapy services is immense. Adding the

expanded market gives the new and improved St. Vincent’s 19,091 (4) possible patients on an

annual basis, not including the excess population that the surrounding areas face during peak

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athletic seasons (summer/spring for hikers, rock climbers, and cyclists; winter for skiers and

snowboarders).

Although St. Vincent currently provides exceptional care to its customers, we plan to

more effectively and efficiently serve the St. Vincent community by constantly measuring a

specific set of Key Performance Indicators. We believe that staying up to date on the data that

our KPI’s can provide to us will give us a better understanding on how the hospital is operating

on a daily basis. We can easily look at problems or glitches in our functional areas and solve

them to the best of our abilities. Our current KPI’s are as follows (5):

Figure 1:

From the operational point of view, we need to measure the daily occupancy rate of

patients so that we can better forecast traffic on each day of the week. It is easy to suspect that

some days will be busier than others and once we get some solid data about which days are our

Functional Areas Key Performance Indicators

Operations *daily occupancy rate *average length of stay *machine deficiency rate *bed turnover *current ER occupancy

Marketing/Customer Support *inpatient satisfaction *re-admission rate *average cost per patient visit *yearly endorsements

Management *staff discrepancies *employee turnover *department performance

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busiest, we can then prepare the hospital staff for certain days of the week based on traffic. This

will help us with staffing and analyzing rather we have enough rooms and space in our hospital

to meet demand. Measuring the average length of a patient’s stay can help us in many

operational ways as well. If we can get a good grip on how long our patients are staying in the

hospital, it will help us determine waiting times and rather we need to experiment with ways to

speed up the time of our patient visits or elongate them by putting further analysis into their

injuries and symptoms. The machine deficiency rate will allow us to keep a closer eye on how

our various medical machines throughout the hospital are performing. If we can see a trend in

how often some of our machines are having malfunctions, it can help us determine when we

should schedule routine maintenance check-ups and hopefully decrease the amount of errors we

are seeing. Bed turnover is one of our key performance indicators because it allows us to

examine how long (on average) it is taking us to get our patients feeling better and ready to go

home. Hospital patients are not interested in hanging around for days or even hours, waiting to

see results. We want our patients to come back and see us because they know we have their best

interests in mind and are doing everything possible to make their stays short and as enjoyable as

possible, encouraging them to come back again and generate more profit for St. Vincent’s.

Current ER occupancy is one of our only KPI’s that will be looked at on a constant basis.

Keeping up on how many patients are visiting the ER at all times of the day will allow staff to

determine waiting times, how fast they need to be moving through patients, and if we are lagging

in occupancy - what can we do to fill free time to improve the hospital or figure out ways to draw

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in more patients. The average cost per patient visit is a way for our marketing team to examine

how the hospital is doing from a financial aspect. We need to look at how much our patients are

paying us to perform our services and rather we are bringing in enough profit to keep the

business going.

From a marketing and customer service standpoint, inpatient satisfaction is the most

important KPI on this list. Our number one goal in opening this hospital is to satisfy patients and

make them want to come back to St. Vincent’s for all of their medical needs. If we can track

which patients are not liking the services we are providing and which ones are, it will allow us to

look at what we are doing wrong and correct it, as well as what we are doing good and make it

even better. Measuring readmission rate is also a really good way to look at how we are doing as

a hospital overall. If the same people keep coming back to us for their medical needs, we must be

someone they can trust. It is also a good way to measure the health of our patients. If a patient is

being admitted several times a month or even several times a year, it is an indicator that there

may be more that our medical staff needs to be looking at in order to help these patients.

Endorsements are one of our biggest marketing strategies. We want elite athletes such as Shaun

White and Lindsey Vonn to be advocates for how great of a medical center St. Vincent’s truly is.

Our team needs to be sure that we are always bringing in new endorsements as well as renewing

old ones. This is why we have chosen to measure our yearly endorsements and how much they

are boosting our profits.

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The management KPI’s mostly focus on our staff. We want to measure staff discrepancies

so that we know how often our team is getting off course. A hospital is supposed to be a place

full of trustworthy people, after all our patients are entrusting us with their health and wellness. If

there is an employee who is having recurring problems, or even a department in which

discrepancies keep happening, we know that actions need to be taken to fix the situation.

Employee turnover is a great way to measure not only the success of our HR team, but also the

environment of the hospital. If the turnover rate is high, it either means that our HR team is doing

a poor job of hiring and selection, or our workplace environment is unfriendly. Department

performance is a critical KPI. We want each of our departments to excel in the jobs they are

performing so that we can be sure our patients are receiving top-notch service. Departments, as

separate functional areas of the hospital, need to be running with a unanimous understanding of

what is expected of them and how they are to perform day to day functions. Once this general

understanding starts to disappear, the department will not function efficiently and effectively.

In tandem with our team’s dedication towards technological and medical advancement,

St. Vincent will also differentiate itself from surrounding competitors by dedicating itself to eco-

friendly practices that are not only environmentally beneficial, but sustainable on a business and

professional level. Being environmentally aware and sustainable has become a top priority for

businesses - and even hospitals - globally, and St. Vincent will continue along that same path by

adopting environmentally responsible and sustainable practices, such as 1) a reduced use of

chemical pollutants, 2) efficient energy generation, 3) reduced fuel consumption and 4) safer

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waste disposal. These practices are easily implemented with the assistance and expertise of a

“green team,” and will by no means disrupt daily hospital operations and practices. These

practices are not only environmentally friendly, but economically wise and beneficial in the long

run, and promote a sustainable business and working environment.

Consistent with previous hospital goals and views held by St. Vincent and the community

of Leadville, CO, the new St. Vincent is a reliable resource and business in the community,

working with individual patients and the community as a whole to create an environment of

togetherness and trust. Thus, our customer-oriented strategy will be the second major

differentiator. Our medical services will not only be consistent with those held by St. Vincent in

the past, but will go further by reaching out to the community by means of fundraisers, volunteer

and outreach opportunities that all members of the community can participate in. St. Vincent

wants to give back to the community in every way possible, and is committed to being a positive

partner in the Leadville, Colorado community by dedicating ourselves to engaging in a variety of

social responsibility efforts.

III. Physical Location and Financing Plan

1. Financing Plan

St. Vincent’s is being priced at $10,000,000. This number was found by averaging the

per sq. ft. cost of hospitals in Colorado at $200 (6). We are looking to split this cost 60/40 with

the Venture Capitalists. We would like $4,000,000 to be paid back in full from the investors. For

the other $6,000,000 we will take out a mortgage for 30 years at 5% (7).

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Figure 2:

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2. Space Requirements:

Emergency Room: St. Vincent’s is a 50,000 sq. ft. hospital. This number is found by

multiplying the total number of beds the hospital currently has by 2,000 sq. ft. per bed needed

(6). St. Vincent’s had 2,497 emergency room visits over the past year (8). This number

correlates to 7 ER visits per day. Given this number we will delegate 25 of our 35 beds to the ER

specifically. The rooms will be 13x10, with a 40 sq. ft. bathroom. As a rule of thumb we are

going to delegate 400 sq. ft. per room, which will result in the ER accounting for a measly

10,000 sq. ft. of our hospital (6). This 400 sq. ft. number is higher than the size of the room

because of nurse’s stations, the lobby and the check in area.

Operating Room: We will have 5 operating rooms, at 600 sq. ft. each. These will be not

only for life flights, but for the citizens of Leadville as well. The operating rooms will be

conveniently located near the exits of the hospitals for direct access of the arriving ambulances,

and will include a waiting room and check in desk. They will be in a straight, wide hallway for

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maximum flow and speed to get patients where they need to be. Because of the other

components of the rooms, such as the supply and break room, we will delegate 1000 sq. ft. per

room to this area, to total 5000 sq. ft.

Inpatient Rooms: The other 10 of our beds will be dedicated to inpatient stays. As

medical procedure quality has risen, the amount of inpatient stays has lowered significantly (9).

Last year St. Vincent’s had 1 inpatient (8). Given only 7.6% of hospital visits are inpatient stays

and the low volume of inpatient stays in the previous years, 10 rooms will be adequate at any

point (8). 5 of these 10 rooms will be slightly bigger than the ER rooms, at 20x15, also including

a 40 sq. ft. bathroom. The overnight rooms are first and foremost for patients undergoing serious

surgeries that simply cannot leave that night. These rooms will also be open for use by the

patients participating in physical therapy, who may want to stay for longer periods of time. The

other 5 rooms will be suite style, and used to incentivize the elite professional athletes we are

seeking. These rooms will all be roughly 1000 sq. ft. The athlete or patient’s family and friends

are encouraged to stay with them in these suites rather than travel to a nearby hotel. Given that

we are doing life flights, we also see the number of inpatient stays rising a bit from previous

years, where this wasn’t previously an option. Given how close in proximity these rooms are to

the ER, they will use the same waiting room and check in area. The inpatient rooms will account

for 6,700 sq. ft.

Physical Therapy Rooms: Because we are focusing on physical therapy, we will have 6

rooms dedicated strictly to it. This number was chosen because of the possibility of high volume

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periods when there are events in the neighboring resorts. Each room will have its own massage/

stretching table, small free weights, a treadmill, weight machines and a stationary bicycle. We

need plenty of room for the patient and trainer to move about, so each room will be 40x25. We

will also include a men’s and women’s changing room located close to the PT rooms, each will

have multiple changing cabanas and be 50x20. We will delegate 1800 sq. ft. per room to this

area for hallways and a trainer’s office. This area will account for 12,800 sq. ft.

Aquatic Center: We will also have an aquatic center/pool, which will be used in the

physical therapy process. The pool will be 65.6x35.8 with 7.5 feet to spare on every side as a

safety precaution (10). This will account for 4,095 sq. ft. of our hospital.

Simulation Rooms: We will have 2 snowboarding and skiing simulation programs in very

close proximity to the physical therapy rooms. These machines are roughly 8x4, and need to be

3 feet from a projector (11). We will put all of the simulators in 16x8. We will put them all 5 feet

away from each other to keep a comfortable atmosphere, where the trainer can direct you from

the side. This room will be 13x55 to give them adequate space. We will delegate 1250 sq. ft. to

this area.

Cafeteria: At St. Vincent’s we will be putting in a full size cafeteria and kitchen for the

patients and families. The cafeteria, including the kitchen, will be 100x75. The kitchen will be

30x10 to give the cooks sufficient space to work. We will also have a 20x20 pantry/storage room

for the food. This area will make up 7900 sq. ft.

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Offices: The final areas of our hospital will be made up of 2 conference rooms and offices

for the doctors and surgeons. The conference rooms will be 30x15 which will account for 900

sq. ft. We also will have 8 offices at 10x8 sq. ft. which will account for another 640 sq. ft. This

will account for 1540 sq. ft. We will leave about 1000 sq. ft. of space free to use as storage for

now and as a possible addition later in time.

IV. Medical Services Plan

1. Detailed Service Menu:

Emergency Room: We are planning to offer the residents of Leadville and surrounding

areas an emergency room service. St. Vincent’s is one of the only major hospitals in this area,

giving us a strong competitive advantage. An ER service will give us year round business for an

abundant number of injuries and illnesses. We plan to offer X-ray services, overnight stays,

illness testing (flu, strep, bronchitis, etc.) and other basic services - for full list see: General

Overview of Services Provided section. Last year St. Vincent’s had 2,497 ER visits in total. On

average, your typical ER visit costs around $2000. That amounts to around $5,000,000 in

revenue coming from emergency visits alone.

Physical Sports Therapy and Recovery: Leadville is a town surrounded by three of the

most popular ski and snowboarding resorts in the country. Besides the emergency room

offerings, the rest of the hospital building will be dedicated to a physical therapy and recovery

service for elite athletes who have been injured during their time at one of these resorts. We have

an infinite number of customers who are waiting to receive treatment from some of the best

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physical therapists in the country, all specializing in outdoor sports therapy. Outdoor enthusiasts

hate to be put down, and they don’t like taking time off from the activities that they love. St.

Vincent’s is here to make sure that these athletes are on their way to a speedy recovery in no time

at all. With in-house therapy rooms and plenty of overnight recovery rooms, St. Vincent’s can be

the place for these athletes and outdoor enthusiasts to take care of all their recovery needs. Elite

athletes such as Shaun White train in the snowy Colorado Mountains all the time! If they

experience an injury during their training, they do not have to quit early and give up. They can

come to St. Vincent’s for the best physical therapy and personalized recovery plans that will get

them back to the slopes. We want to appeal to these elite athletes to potentially gain

endorsements and put value towards St. Vincent’s. Each of our 6 therapy rooms includes a

massage/examination table, a treadmill, free weights, select weight machines, and a stationary

bicycle. Recovering athletes can have their own private space every day to start feeling better

without the pressures of your average gym. Another appeal that our hospital can offer to these

athletes is spending their recovery time at our in-house pool and aquatic center. Swim therapy is

the number one recommended treatment for several injuries in which it makes it difficult for

people to exercise on hard-padded surfaces or while standing. Some of these injuries include

lower back and neck pain, and muscle strains or tears (12). For our athletes who chose to be

inpatients, we will be offering two types of living areas. We have 5 suites and 5 general rooms.

The suites are designed for our patients who may be having family members staying with them,

or just want to upgrade their space during their time at St. Vincent’s. Our general rooms are a

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little bit smaller but still provide all the aspects of a comfortable living space. Both suites and

general rooms with have basic cable and WIFI access. We want St. Vincent’s to become a one-

stop-shop for skiers, snowboarders, and other outdoor athletes in the Rocky Mountains. If we

become the only place they need to go, we can earn loyal patients and in turn, profit to help us

grow and become even bigger and better.

Flight for Life: Every good mountain town hospital needs a helicopter service. In the

Rocky Mountains of Colorado, it can often be difficult to travel to a town that is even 20 miles

away. This can cause people to not want to come all the way to St. Vincent’s if the time it takes

to get there is too long. With a helicopter service, all of those troubles disappear. By having a

helipad, Helicopter Emergency Medical Services can get to the victim 3 to 5 times faster than

road units (13). This provides patients with quicker treatment and transportation to other

hospitals if further treatment is needed. Having a hospital-based helipad will not only reduce the

time it takes to transport patients, but will also minimize complications associated with the

transporting process. Transportation to a hospital by helicopter is linked to a 1.5 percent

increased rate of survival compared to transporting by ambulance or other ground vehicles (14).

The flight for life service is a huge advantage for those athletes needing medical attention out on

the slopes. We can pick them up right on the mountain, bring them to our ER for an initial

examination, and send them on their way to the physical therapy and recovery department if

necessary and desired.

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Cafeteria Service: Since the nature of our physical therapy and recovery services

sometimes require patients to stay several nights in the hospital, we will offer a full cafeteria

service. Also, this will be good for patients in both the ER and the physical therapy and recovery

who may be having visitors (friends, family).

a. Requirements for Each Service:

Below is a table explaining the types and amounts of equipment we will need for each service

area of the hospital.

Figure 3:

Hospital Service Area Equipment Type Amount

Emergency Room Ambulance Vehicle 4

Patient bed 75

X-Ray Machine 5

Bed Linens Set 100

Patient Gowns 100

Oxygen Machine 30

Electrocardiograph Monitor 25

Defibrillator 29

Operation Room Anesthetic Machine 7

Surgical Tool Set 9

Cardioplegic Machine 7

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X-Ray Viewing Board 5

Operating Table 5

Airflow and Temperature Controller

5

Neurophysiologic Monitor 3

Vital Signs Monitor 7

Defibrillator 6

Physical Sports Therapy and Recovery

Snowboarding Simulation Program

1

Skiing Simulation Program 1

Massage Table 6

Free Weight Set 6

Stationary Bike 6

Bed Linen Set 15

Futon 5

Queen Sized Bed 15

Trigger Point Dry Needling Set 6

Hot Stone Set 6

Heating Pad 6

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In the emergency room service area, we have chosen to put patient beds in all 25 of the

rooms. The extra 50 will be placed in storage and used in case an emergency were to occur, or

for any reason we ended up needing extra beds. Linen sets for each bed have been accounted for

as well as 75 extra sets to be accessible when sets become dirty after patient visits. We have used

a similar method in determining how many patient gowns we will need (25 for each room and an

extra 75 for laundry purposes). We will be placing oxygen machines in 10 of the emergency

patient rooms and will put an extra 20 in storage for emergency purposes or technical failures.

Because there are many patients who do not need the services provided by an oxygen machine,

we do not feel it is necessary to put one in each room. Defibrillators will need to go into all 25 of

the emergency patient rooms. According the Emergency Care Programs’ website, defibrillation

machines are one of the most important machines in an operating hospital. They can help in any

type of cardiac arrest problems or failure - which can be brought on by a vast number of things

Flight for Life Helipad 1

Cafeteria Service Food N/A

Cooking Utensils N/A

Cookware 30

Dishes 250

Trays 250

Tables and Chairs 20

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(15). For this reason, we need one for each room as well as 4 extra for each ambulance vehicle.

We want to ensure our patients are constantly taking care of and our teams have access to the

medical machines that will help them be successful in any situation.

Each operating room will need an anesthetic machine. As mentioned on the Agency for

Healthcare Research and Quality website, anesthesia is used in nearly every operation so that

surgery can be performed without unnecessary pain (16). This is why every room will need

access to these machines. We will also put 2 extra in storage for emergencies or technical

failures. We will also have surgical tool sets, cardioplegic machines, and vital signs monitors in

each room with extras of each placed in storage.

In our physical sports therapy and recovery service area, as previously mentioned, will

have 5 general rooms as well as 5 suites. The general rooms will have one queen sized bed for

the patient and a futon for any guests. The suites will each have 2 queen sized beds (15 in total).

The snowboarding and skiing simulation programs are special machines that allow our

snowboarding inpatients to get their groove back before hitting the slopes again; they can

practice their moves and make sure they have a really good hold on their discipline from the

comfort of our simulation room; this will also give our therapists a chance to examine the

athletes while they are practicing to determine if they are getting any better or need

improvements. Dry needling has become one of the fastest growing forms of physical therapy in

the world. TDN is aimed to release the tension that builds up from muscular tightness and

spasms. The technique uses small thin needles that get inserted into the muscles at the trigger

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points causing a replication of the pain referral (pattern). The muscles then contract and release.

This contracting and releasing improves muscle flexibility, removes the source of irritation,

promotes healing (produces local inflammation which is necessary to produce healing), and

decreases the spontaneous electrical activity at the trigger points (17).

b. Labor Hours:

Below is a table taken from the Ontario Ministry of Health and Long-term Care’s

website. It shows the average peak wait times in the ER by day and hour. The results are based

on October 2013 - December 2013 visits. As you can see at any given day of the week, the

highest wait times occur in the middle of the night from midnight to 3 in the morning. Even

throughout the day, hospitals still experience decent patient volume and higher wait times. It is

never completely dead (18).

Figure 4: (Per Hour Wait Time)

Based on the information given above, our emergency and operating rooms will be

open 24 hours a day, 7 days a week. We want to be able to maximize our profits and there is no

Time Gap Sun. Monday Tuesday Wed. Thursday Friday Saturday

12:00-2:59am 4.8 4.7 5.1 4.8 4.9 4.8 5.0

3:00-5:59am 4.8 4.4 4.5 4.1 4.5 4.4 4.5

6:00-8:59am 3.5 3.6 3.7 3.7 3.8 3.7 3.5

9:00-11:59am 3.6 4.1 3.9 4.0 4.0 4.1 3.5

12:00-2:59pm 3.9 4.4 4.1 4.0 4.1 4.2 3.8

3:00-5:59pm 3.9 4.2 3.8 3.9 4.0 4.1 3.7

6:00-8:59pm 3.7 3.9 3.8 3.8 3.8 4.0 3.7

9:00-11:59pm 3.9 4.1 3.9 4.0 4.1 4.2 3.8

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simpler way to do this than making sure we are available to serve any patient, with any

emergency, at any time.

The physical sports therapy and recovery operating hours will be from 9am-5pm,

Monday through Friday and Saturdays by special appointment. During this time, inpatients and

outpatients can come into our therapy rooms and aquatic center to get their kinks worked out.

Nobody really wants to spend their weekend in physical therapy, and we want to be able

to give both our patients and doctors time off to get collected and relax. Sometimes, however,

we realize that a patient may need to schedule an extra Saturday session for various reasons.

Inpatients will have access to their rooms and suites at all times of the day.

The cafeteria will be open from 7am-7pm, 7 days a week to serve patients and guests

breakfast, lunch, and dinner throughout the day. Nurses will have kitchen access at all times of

the day in case patient needs any kind of food or hydration accommodations.

c. Expenses:

Figure 5:

Item Cost Amount Total Cost

Anesthesia Machine $5,000.00 7 $35,000.00

Defibrillator $1,000.00 6 $6,000.00

Vital Signs Monitor $2,000.00 7 $14,000.00

Airflow and temperature Controller $2,000.00 5 $10,000.00

Operating Tables $7,000.00 5 $35,000.00

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Figure 6:

Figure 7:

X-Ray viewing boards $300.00 5 $1,500.00

Heart-Lung Machine $10,000.00 7 $70,000.00

Neurophysiologic Monitor $3,000.00 3 $9,000.00

Total Cost

$180,500.00


Beds $750.00 75 $56,250.00

X-Ray Machines $50,000.00 5 $250,000.00

Defibrillators $1,000.00 29 $29,000.00

Oxygen Machine $1,000.00 30 $30,000.00

Bed Linens $15.00 100 $1,500.00

Hospital Gowns $5.00 100 $500.00

Ambulance $40,000.00 4 $160,000.00

Total Cost $527,250.00


Ski/Snowboard Simulator $1,250.00 4 $5,000.00

Massage Table $150.00 6 $900.00

Free Weights $190.00 6 $1,140.00

Stationary Bike $250.00 6 $1,500.00

Futon $250.00 5 $1,250.00

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V. Medical Service Demand Forecast

Forecasting demand is a very crucial step for the proper running of St. Vincent’s hospital.

Estimating future demand will allow a company to increase overall efficiency and take the

necessary precautions to be successful. St. Vincent’s will use demand forecasting to purchase the

proper amount of equipment, and to staff the right amount of people at the right times. The

forecast will make sure enough inventory is on hand to sustain daily activities, while not

exceeding the inputs necessary for day-to-day activities. Without this forecast St Vincent’s

would also risk having too few or too many employees, both potential revenue risks. These are

both risks that are unnecessary to take and can be avoided by accurately forecasting demand.

Queen Sized bed $400.00 15 $6,000.00

Trigger Point dry needles $150.00 5 $750.00

Towels $2.00 100 $200.00

Total Cost

$16,440.00


Cafeteria Tables $600.00 20 $12,000.00

Trays $1.50 250 $375.00

Silverware set $2.00 250 $500.00

Dish Sets $10.00 250 $2,500.00

Cookware $40.00 30 $1,200.00

Total Costs

$16,575.00

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St. Vincent’s will use qualitative methods to predict future demand. This is done by

anticipating growth of Leadville and the surrounding areas, and the HealthCare industry. By

looking at this data historical comparisons can be made. The Health Care industry is ever

growing, and is only predicted to grow more. From 2000-2009 hospital admissions went up

almost 2.5 million, and with a rapidly growing population that number is ever rising (19).

Figure 8: (2010 Health Care)

The first step taken in forecasting demand was to determine population growth over the

next 3 years. While Leadville has had a very stagnant population over the last 20 years, the

surrounding areas are always growing. The population of Leadville has been slowly declining at

a rate of -.3711% per year. While Vail, Aspen, and Breckenridge have all experienced positive

growth rates over the past 10 years (20). These positive growth rates will foster St. Vincent’s

having an increased admission although the population of Leadville is declining.

Figure 9: (Annual Population Growth)

Amount

Number of Hospitals 5723

Number of Admissions 34422071

Employment Growth (2000-2010) 2.6%

Hospital Care Expenditures $7.59B

City Population Growth

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Leadville currently has a population of 2584 (20). Through US News, we found that last

year St. Vincent’s had 268 inpatient admissions, 16,582 outpatient visits, and 2,497 ER visits (8).

Given these numbers it was very easy to calculate the demand for Leadville only. By dividing

each of these numbers by the total population, the average number of visits per person is given.

For example, to find average number of inpatient visits per person the calculation is 268/2594.

Multiplying the growth rate by the population gives next years population. Then multiplying the

population by the average number gives the demand per year.

Figure 10: (Annual Estimated Demand from Leadville)

Leadville -0.3711%

Aspen 1.4697%

Vail 0.9630%

Breckenridge 3.0600%

2013 2014 2015 2016 2017

Population of Leadville 2584 2574 2564 2555 2545

Average number of inpatient visits per person 0.10177 0.10177 0.10177 0.10177 0.10177

Average number of ER visits per person 0.9626 0.9626 0.9626 0.9626 0.9626

Average number of outpatient visits per person 6.3924 6.3924 6.3924 6.3924 6.3924

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Although this does give the total demand of Leadville, St. Vincent’s is expecting

admissions from injuries at the surrounding resorts. In 2013 51 million people snowboarded,

20% of which did in a major resort in Colorado (21). This means that roughly 10.2 million

people snowboarded in Colorado last year. 3 out of every 1000 skiers and snowboarders receive

an injury serious enough to require medical treatment (21). This correlates to 30600 injuries in

Colorado alone per year. If St. Vincent’s can get a measly 10% of these people to come in, that is

3060 people in the first year strictly from injuries. After the first year St. Vincent’s believe this

number will grow 1% annually because of recognition and word of mouth. This number is then

multiplied by 15%, which is the amount of people predicted to go to physical therapy after the

ER or OR. This number was decided simply by assuming that some injuries do not require

physical therapy, and some patients may prefer another provider.

Figure 11: (Annual Admissions from Ski Injuries)

Total estimated Demand from Leadville 19268 19194 19119 19052 18977

Year Admissions from Injuries at Colorado Resorts Physical Therapy

2014 3366 505

2015 3672 551

2016 3978 597

2017 4284 643

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Through the earlier given population growth numbers, St. Vincent’s then found the total

increase in population in Leadville, Vail, Aspen, and Breckenridge. This number is shown by

285 in Figure: 12. The increase in population was then multiplied by the average number of

visits to give additional demand per year because of an increase in population. The additional

demand per year was then added to the total estimated demand from Leadville show by Figure:

12 and admissions from injuries in Figure: 11 to reach St. Vincent’s Total Estimated Demand.

Figure 12: (Annual Total Demand)

The next step St. Vincent’s took was to demand forecast on a month-by-month basis. It is

assumed that on a year-by-year basis demand per month will not be uniform, but this is not

2013 2014 2015 2016 2017

Number of people by which population will increase

N/A 285 291 293 305

Average number of inpatient visits per person

0.10177 0.10177 0.10177 0.10177 0.10177

Average number of ER visits per person 0.9626 0.9626 0.9626 0.9626 0.9626

Average number of outpatient visits per person

6.3924 6.3924 6.3924 6.3924 6.3924

Additional Total Demand per year N/A 2125 2170 2185 2274

Total estimated Demand 23552 24685 24961 25215 25536

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predictable. St. Vincent’s did the months demand based on a nurse’s blog, allnurses.com, and a

table given by scielo.org. Each month was delegated a base percentage of demand for the year

by dividing 100%/12 months. A small percentage was then added or subtracted based on the

findings from the references. It was very unanimous that March is the busiest month of the year

because of people working out for the summer and an increase in vehicle accidents. The same

goes for the rest of the spring, but not to the same extent. The summer has a much lower demand

and most admissions are related to the heat. The winter also has a very high admission rate.

During winter everyone is in much closer quarters and everyone transfers sicknesses much

easier. Most of the admissions are respiratory related. The fall has many of the same injuries as

the spring on a lower scale, and is the lowest demand season of the year (22)(23). The first

year’s admissions are shown by Figure: 13. To find the demand for the following years St.

Vincent’s will simply multiply the total estimated demand by the percentage per month.

Figure 13:

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Figure 14: (2014 Total Admissions)

The next step to take in forecasting demand is to forecast by day of the week, and time of

the day. For both of these forecasts the table from scielo.org will be used (22). Some minor

trends were also found in the allnurses.org blog. “Medical Monday” was found to be the busiest

day of the week. Saturday night and Sunday morning are busy from party and bar admissions.

Midnight to 3 was also found to be the busiest time for almost any day of the week. Tuesday

through Thursday was found to have a pretty uniform demand. Figure: 4 was also used, as wait

times directly correlate to how many patients are being admitted. To find the per day demand

the wait time per hour was added up to find the total wait time per day. That wait time per hour

was then divided by the total wait time per day to find the percentage that each day accounts for.

The total demand was then divided by 52 weeks per year and multiplied by the percentage per

hour.

Figure 15: (2014 Percentage of total weekly demand)

Month January February March April May June

Total Admissions 2715 2469 2962 2222 1975 1728

Month July August September October November December

Total Admissions 1481 1234 1728 1975 1975 2222

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

14.02% 14.59% 14.32% 14.20% 14.50% 14.63% 13.76%

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Figure 16: (2014 Demand per day)

To find the hour-by-hour demand St. Vincent’s took the hourly wait time and divided it

by the total wait time from that day. That gave the percentage of the day that each time frame

took up. This was done with Figure: 4 given in the detailed service menu section.

Figure 17: (2014 Demand per hour of day)

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Sunday Monday Tuesday Wednesday Thursday Friday Saturday

66.55 69.26 67.98 67.41 68.83 69.45 65.32

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Using historical data from health.usnews.com the demand can be projected on a

department-by-department basis. St. Vincent’s 2013 admissions are given by Figure 24.

Figure 24: (St. Vincent’s 2013 Admissions)

St. Vincent’s is expecting a very large change in how many visits we see per department

given the specialization. There is an expected demand of 3366 from Skiing injuries in Colorado

alone, 15% of which will do rehab, which is shown by Figure 11. To find the demand per day the

calculation is 3366/365, and to find per month the calculation is 3366/12. Physical Therapy will

account for 14% of admissions. Outpatient visits previously consumed 85.7% of all demand; St.

Vincent’s is expecting that number stay about the same, while the percentage of total demand

falls to 65% because of the specialized services. In 2013 ER patients were 12.1% of the total

demand. St. Vincent’s is expecting an increase in this number because of recognition as a top tier

hospital. ER Visits will be assumed at 18% of admissions in 2014. Operation Room demand

will rise because of the increase in ski injuries seen, and will account for the remaining 3% of St.

Vincent’s demand. The calculations to find per day and per month were the same as previously

done.

Admissions Inpatient Surgeries Outpatient Visits ER Visits

268 1 16582 2497

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Figure 25: (2014 Demand per Department)

VI. E-Commerce Plan

1. E-Commerce/E-Business Strategy

In the current world of evolving technology and rapidly expanding technological

globalization - where the Internet now stands as the premier resource for information - the

importance of e-commerce and e-business in the corporate business environment remains crucial.

Business owners can no longer afford to ignore the numerous benefits of have an online

presence, which has become a critical business and operational factor in the twenty-first century

globalized environment (24). In regards to hospitals,

medical providers are “losing valuable revenue by

failing to implement low-cost and valuable resources

to optimize the health care experience for an

increasingly tech-savvy, Internet-oriented consumer

Operating Department

Emergency Department

Physical Therapy/Recovery

Outpatient Visits

Demand Per Year 831 4443 3366 16045

Demand Per Month 69 370 281 1337

Demand Per Day 2 12 65 44

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base.” Additionally, research demonstrates that 83% of consumers are visiting hospital websites

prior to converting into patients, and “poorly optimized hospital websites may be losing up to

$34,000 in annual patient revenue opportunity cost every day or approximately $1,020,000 per

month (25).” Therefore, it remains absolutely critical that St. Vincent create a positive, effective

and technologically savvy internet presence. “... The future will belong to the [medical]

institutions that aggressively direct their services and products at consumers who are

technologically and Internet savvy (26).”

Though e-commerce originated as a means to sell retail products online, it has since

evolved to offer services such as healthcare to the general public. St. Vincent will improve upon

its current website to create a functional, easily navigated platform that effectively communicates

our central mission, customer service experience and services offered. Additionally, the St.

Vincent website will implement a platform to offer select healthcare services to the public, while

also implementing strategies to increase current (and future) customer satisfaction, streamline

hospital information into an easy-to-manage and easily understood and accessible format,

increase hospital revenue and decrease operating expenses.

By utilizing e-commerce and e-business methods, and adapting them into a medical and

healthcare-service-provider atmosphere, we anticipate St. Vincent will experience (1) increased

patient satisfaction, (2) boosted hospital revenue and profits for providers and investors, (3)

heightened operating efficiency, (4) remissions prevention and overall patient quality (4) a

potential 200% increase in potential patient conversion (25). “Making medicine accessible online

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not only benefits doctors and their patients, it could also improve relationships between

hospitals, clinics, suppliers and customers” (54).

2. E-Business / E-Commerce Development and Operating Costs

First and foremost, St. Vincent will improve the quality of its website’s layout and

navigation. Primarily, a full breakdown of the various St. Vincent medical services will be

provided in detail in an easily accessible location. Services will also include biographies for the

head of each Department, along with contact information for each department if necessary (i.e.

the Emergency Room would not have specific contact information, as any potential patients

should call 911), in case any potential patient would want to call St. Vincent for further

information. A SWOT Analysis of the current St. Vincent website emphasizes certain key areas

whereupon the St. Vincent website currently excels, and can be improved further:

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St. Vincent Current Website / E-Commerce / E-Business Strategy - Basic SWOT Analysis:

Figure 26:

Strengths • Incredibly simple layout, easy to navigate. • Emphasizes the community and volunteer

opportunities for Leadville, CO; great connections with surrounding communities and Lake County.

• Visitors often chose to view this site as returning customers / patients, who have no doubt of St. Vincent’s services offered; St. Vincent already has a strong base of patients who visit regularly.

• Biographies and contact information for all practitioners and doctors are offered under the Services Section, and can be accessed through a search database. Easy and informative.

• A Search Tab at the top of every web page makes everything easy to search and find.

• Updated News Section, to keep patients up to date with Foundation board meetings, events, etc.

• Contact information is easily accessible and simple.

• They have a frequently updated Facebook page and presence, mostly posting in regards to seasonal shots, doctor retirements, and St. Vincent Foundation events (volunteering).

Weaknesses • “Boring” layout; not “eye-catching” -

slightly outdated logo and website design.

• Website is not completely compatible with mobile devices (tested using an iPhone 4).

• Too little information in regards to services offered; service descriptions are analytical enough - require a more clinical, straightforward explanations for services provided, along with (perhaps) statistics that support

• The website in its current form does not attract new patients; its layout and description has much to be desired for a new, tech savvy patient crowd with low attention spans.

• No platform for current / returning patients to “login” to schedule appointments, pay medical bills, or view past appointments, etc. o No option for payment online. o No online scheduling platform for

patients to schedule appointments. o No option / application to view

Emergency Care / Urgent Care times.

o No option to purchase and facilitate pharmaceutical needs through the website.

• No articles or lectures by current practitioners or doctors / from outside sources for returning patients to return to (semi-common on other hospital websites) - can be on a separate forum.

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Through the SWOT analysis, it is strikingly apparent that an emphasis on technological

innovation is necessary in the future of St. Vincent, especially in regards to its e-business and e-

commerce strategy. St. Vincent, while currently a stable business with a returning and satisfied

clientele base, needs to turn towards technological innovation in order to be able to compete with

surrounding, more advances hospitals - especially taking into consideration St. Vincent’s

proposed, specialized Sports Therapy and Rehabilitation program. Online appointment

scheduling - for general medical health, check-ups, drop-in appointments and continuing

physical / sports therapy - is crucial to the development of St. Vincent’s e-commerce and e-

Opportunities • With a tech- and Internet-savvy clientele, an

updated logo and web design will attract the interest of current and potential patients. o The website should also be able to be

accessed through any and all mobile devices.

• First and foremost, an emphasis on online-payment, scheduling, wait-time applications and pharmaceutical facilitation needs to be made. These aspects are essential to the future of not only St. Vincent, but the medical field at large. o Telemedicine is crucial, especially in

regards to the future of St. Vincent as a center for high quality, premier sports therapy.

o As much as possible, St. Vincent needs to apply itself to adapt to the technologically evolving medical environment, by providing certain, necessary services online.

• Long-term, we hope to not only keep our current clientele by continuing to offer services and information regarding St. Vincent, but we hope to attract a wider variety of clientele by utilizing technology using effective and universal methods.

Threats • St. Vincent has a history steeped in

traditional medical methods; the small Leadville community might be resistant to certain technological changes implemented.

• St. Vincent’s competitions from surrounding town hospitals (Aspen, Breckenridge, Vail, etc.) have already implemented many of these methods, which are being used (successfully) at large.

• Changing technology isn’t threatening the St. Vincent website, but the website itself cannot remain as simple and unimaginative as it currently stands.

• Certain monetary concerns face some of the e-commerce and e-business strategies, especially in regards to the implementation of telemedicine - and taking into consideration the massive task of creating a Sports Therapy center.

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business strategy. A national survey conducted in 2012 reported that patient satisfaction with

hospital websites has dropped to 74 out of 100 in 2012, showing patients have “growing

expectations” regarding the types of resources that are made available on hospital websites that

are not being met. Likewise, most hospital websites “read like brochures” by advertising

facilities and practitioners rather than actually facilitating online appointments so patients can

efficiently access transactional care (26). Therefore, appointments at St. Vincent be scheduled

online, adding flexibility and customer convenience to schedule appointments outside of

operating business hours. Online calendars - specifically tailored to each patient’s practitioner -

will be available through the St. Vincent website, offering an easy and efficient platform for

flexible scheduling. A system of prioritization will ensure that patients with more pressing

ailments or injuries will receive medical attention first from any particular practitioner.

Appointments made online will automatically be saved into the St. Vincent schedule database,

accessible by all doctors and practitioners. Customers that make appointments online will receive

an immediate confirmation e-mail, text-

message and/or voicemail to eliminate

any uncertainty. St. Vincent will

implement this appointment and

scheduling planning through a popular

medical appointment-scheduling

database, Appointment-Plus. On the

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right is an example of the login page and online server that patients will use once the St. Vincent

online appointment scheduling system is fully implemented. By implementing the My Health

Connection scheduling database, hospital productivity and patient satisfaction is expected to

increase exponentially.

An on-the-phone consultation with an Appointment-Plus representative informed us that

an “Enterprise Level Solution” would be necessary to handle an appointment stream of this

magnitude. The payment method for a hospital the size of St. Vincent could vary from $30,000 -

$150,000 per year. We estimate that, with the size of St. Vincent and inconsideration with its

“Medical Demand Forecast,” an annual contract (entitled to monthly professional services) of

$100,000 would be paid up front every year - an average of $8,333.33 per month.

Additionally, St. Vincent will implement an online waiting service, which will provide

potential Urgent Care and Emergency Room patients (with non-threatening medical conditions)

with wait-time estimations, based upon previously gathered data. “Patients can view available

estimated treatment times, check-in online, and provide visitor information to begin waiting from

an environment other than the waiting room,”

thus increasing patient satisfaction (25).

Additionally, this strategy will increase St.

Vincent’s service zone, thereby bringing in

more potential patients and increasing hospital

revenue. Urgent Care and the Emergency

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Room will also be able to find a balance of “flow” and manage patient loads with greater

efficiency, thus increasing St. Vincent’s productivity as an Emergency Services medical provider.

This service will be provided by the Emergency-Room Check-In company, InQuicker and will

be allocated to an easy-to-reach and easy on the St. Vincent website. On the right is an example

of an InQuicker application that will estimate treatment time. This program could also be utilized

with a smartphone “app”.

“Hospital officials agreed to pay $3,000 a month for the service. They charge patients

$14.99 and expect to recoup that money over time as appointments increase, said spokesman

Patrick Houston” (27).

Telemedicine is a “cost effective alternative” to traditional face-to-face medical treatment

the use of telecommunication and information technologies to provide clinical health care at a

distance while simultaneously decreasing St. Vincent’s medical cost, and increasing efficient

time- and patient-management (28). A relatively new medical invention, telemedicine “helps

eliminate distance barriers and can improve access to medical services that would often not be

consistently available in distant rural communities,” and can also be utilized to save lives in

urgent or emergency situations (28). “Telemedicine and telehealth have the potential to increase

access to care, improve quality of care and decrease costs” (29). Telemedicine also increases

access to health care, improves health outcomes, assists in addressing shortages and miss-

distribution of healthcare providers, improves organizational productivity and supports clinical

education programs (30). Telemedicine is split into three distinct categories, all of which can be

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easily utilized by St. Vincent by implementing the proper technological and administrative

modifications:

1. Store-and-Forward Telemedicine involves gathering medical data (like medical images,

biosignals, etc.) and transmitting this information to a medical specialist at a convenient

time for assessment.

2. Remote Monitoring Telemedicine enables medical professionals to monitor a patient

remotely using various technological devices; this is used primarily for chronic illnesses,

such as heart problems, blood pressure, diabetes or asthma.

3. Interactive Telemedicine provides real-time interactions between the patient and the

provider, which includes phone conversations, online communication and visits.

Telemedicine - while important - remains a complicated process, one that requires

planning and careful thought before proper implementation. According to Mark VanderWerf,

Vice President for eHealth and OEM, Nonin Medical, outlines ten essential steps to properly

execute telemedicine: (1) establish a vision, (2) build a long term financial plan, (3) create a

convenient and effective work environment, (4) mainstream telemedicine into the standard care

process, (5) plan and assure effective training, (6) make

sure you have a full-time coordinator(s) and an effective

leader and cheerleader, (7) a Project Plan = Manageable

Milestones = Reasonable Expectations, (8) valuate

horizontal v. vertical implementation, (9) “good

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marketing is critical”, and (10) publish or perish? More specific steps are necessary for

successful telemedicine implementation.

Telemedicine is not a separate medical specialty - it is often a part of a larger investment

by medical or healthcare institutions in either information technology or the delivery of clinical

care (31). Telemedicine is a long-term investment in St. Vincent’s future, which will be an

essential component to our e-business and e-commerce strategies.

Below are several estimated monthly costs related to telemedicine through a hospital.

This cost analysis - from the National Institute of Justice - is based on 100 internal specialist

encounters with telemedicine implementation costs around the country (32). While this study

was performed upon telemedicine practices in a prison, it is a somewhat related study that can be

applicable to hospitals such as St. Vincent. The telemedicine industry is universal.

Figure 27:

Number of Events (per month)

Cost (per month)

Total Monthly Cost

Average Cost per Encounter

Operational Telemedicine

Equipment N/A $23,693

Coordinators N/A $10,939

Consultants 104 $10,229

Total Cost $44,861 $431

Conventional Care

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“Excluding the costs of equipment but including savings on transfers and external

consultations, each telemedical encounter saves an average of $142. At this rate, 1,544

encounters would save an amount equal to the purchase cost of the telemedicine

equipment” (32).

St. Vincent will have an average of 1,625.166 visits per month (see “Medical Service

Demand Forecast”), which will result in an average of $230,773.57 savings per month. This will

more than make up for any expenses gathered from implementing telemedicine into the St.

Vincent medical program, and will save money exponentially in the future. Telemedicine is not

only technologically advanced, but is a sustainable initiative to promote St. Vincent’s future as a

medical institution.

The pharmaceutical e-commerce industry is one of the most rapidly growing online facets

of the medical world. In less than 20 years (from 1998 to 2003), online pharmaceutical sales

skyrocketed from less than $1 billion, to over $50 billion (33). Pharmaceutical e-commerce is

perceived as a research intensive industry on one hand and a prescription driven and dependent

retail medicine business on the other (34). St. Vincent will utilize both aspects, but most

Consultations Inside the Hospital

100 $10,800

Avoidable External Consultations

2.83 $2,274

Avoidable Transfers to FMCs

1.17 $4,928

Total Cost $18,002 $173

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especially the one involving the retail medicine business. As a research facility in the

advancement of physical sports therapy and rehabilitation, St. Vincent will improve upon

relationships with local and national pharmacies in the study and improvement of sports therapy

and rehabilitation. Primarily, however, St. Vincent will improve upon its current Pharmacy

Department by applying certain e-business aspects to improve upon administrative and

organizational management of the in-hospital pharmacy, while simultaneously streamlining

pharmaceutical services for a growing, tech-savvy clientele.

“Deployment of e-commerce in the pharmaceutical industry centers around significant gains

in business transactions by utilizing e-commerce to circulate information in order to build an

integrated network for both the industry and the users by shrinking the geographical distances

and make timely access to medical information and latest biotech knowledge, thereby

providing better services to the users and to the pharmaceutical community as a whole” (34).

The pharmaceutical industry is amongst the most strictly controlled and regulated

industries in the world, especially in regards to legality; specialist layers and regulatory

professionals check every word or statement made online or offline, for any discrepancies that

might cause harm to the medical profession,

hospitals, and most especially the patients. Therefore,

there will be several components to St. Vincent’s

pharmaceutical e-commerce strategy (35):

1.Non-Prescription Medication will continue to be

sold through the St. Vincent Pharmacy; however,

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these are typically drugs that patients would want immediately. They can be bought

online through the St. Vincent Pharmacy. However, while delivery will be option, it will

probably not be utilized, as patients looking for these kinds of medications (i.e. Advil,

Tylenol, etc.) would probably walk in and get the medication themselves, rather than wait

for delivery.

2. Prescription Medication can and will not be sold online through the St. Vincent

Pharmacy; medical professional should assess the condition in full, making the decision

for the patient. However, patients who are currently using prescription medication will be

able to make payments online, as well as request refills for their prescription, which will

be verified online through signature and approval by the patient’s current medical

practitioner.

3. B2B (Business to Business): St. Vincent will continue to develop relationships with

wholesale pharmaceutical companies, such as A.F. Hauser Inc. through an e-commerce

and e-business strategy, to provide timely and frequent delivery of pharmaceutical goods

to the St. Vincent Pharmacy.

Summarily, patients will be able to (1) refill their prescriptions automatically online

(through the login also used to make medical payments and schedule appointments).

Prescriptions will be able to have (2) online, virtual verification by the patient’s current

practitioner and / or doctor, in order to protect and verify doctor-patient confidentiality and

ensure that the proper steps are taken to ensure proper and legal medicinal distribution. However,

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in order to ensure this, prescriptions will still be required to be picked up from the St. Vincent

pharmacy, until a safe and reliable system is invented and put into place to ensure that the

medicine only goes into the hands of the patient. Finally, (3) delivery services will be provided

for selected pharmaceutical - most especially non-prescription drugs.

While it is recommended that patients pay for medical services through St. Vincent

directly, certain services - such as general check ups, ongoing physical therapy - can be paid

through an online payment database and platform. To protect patient privacy and identity, and to

promote security, St. Vincent will not keep any method of payment stored on file. Confirmation

emails or phone messages will be sent to the patient to confirm payment. Payments can be made

through a secure St. Vincent’s server, which requires a login and password specific to each

patient - this ensures privacy and security, and also allows patients to personalize and monitor

their payments; this platform can also be the one used for patients to schedule appointments and

refill any of their prescriptions drugs. To the right is an example of the website platform wherein

patients will be able to login to the St. Vincent database to access payment methods.

Online payment will be offered

through Appointment-Plus, which offers a

“Payment Process” module in addition to

their Appointment Scheduling platform.

Appointment-Plus will “ask customers to

pay when they book, and process sales

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transactions through the POS module”(36). The cost for an online payment module, therefore,

will be taken into consideration under the cost for the program, Appointment-Plus. Payment for

certain medicinal means is also optional, and will be taken into consideration if Appointment-

Plus does not meet all of the necessary requirements for St. Vincent.

VII. Equipment Plan

Having an equipment plan is essential to the success of our hospital. In order to maintain

quality patient care, the equipment at St. Vincent’s will be managed and the staff will be

educated on the major operations. The staff will be educated about safety and proper handling of

each piece of equipment in order to reduce safety risks (37). The purpose of having an equipment

plan is to ensure that the equipment provides reliable information to the patients and that the

working environment is safe for both the patients and staff. The plan also makes sure that the

equipment is utilized to the highest capacity in order to optimize patient care (38).

The first step of the equipment plan is selection and acquisition of the highest quality

equipment. Choosing the right equipment is essential to the patient care and quality of our

services. St. Vincent will work closely with different suppliers of each department in order to

maximize our hospitals quality. The supply chain and inventory management team will

collaborate and research certain pieces of equipment looking at product recalls, monitoring

approved capital equipment, monitoring hazard alerts, equipment requests, and reactively

replacing equipment based on inability to further maintain (38). Assistance provided in the

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equipment, coordinating clinical trials and negotiating with vendors (38). Assistance that is

provided during the acquisition process includes preparing the hospital for the arrival of

equipment, installation, acceptance testing and providing training for the staff to learn about the

equipment (38).

The next step in the equipment plan is the evaluation of the purchased equipment. It is

important to make sure the equipment is up to standards and can be safely managed by the staff.

One evaluation method that St. Vincent will use to evaluate the equipment is the American

Hospital Association method that factors in equipment maintenance, patient and staff impact if

the equipment were to fail, clinical application and supplier and manufacturer recommended

preventive maintenance (38). Using this method the equipment can be assigned a risk category of

1 (high risk), 2 (less risk), 3 (no risk) (38). These methods can determine the physical risk and

hazards of the equipment if the utility were to fail.

After purchasing and evaluating the equipment the inspection process is the most

essential part of the equipment plan. All equipment within St. Vincent will be inspected before

use in order to insure less risk and high reward for the patients. Equipment is inspected to insure

physical condition, functionality, accuracy, patient/operator safety, electrical safety, and proper

documentation (38). After the inspection, the inventory is given an inspection label based on the

risk category and is registered back in the Virtual Item Master and the Enterprise Research

Planning system. For the large pieces of equipment in the emergency and operating room such as

the X-ray machine, oxygen machine, electrocardiograph monitor, anesthetic machine,

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cardioplegic machine, X-ray viewing board, operating table, airflow and temperature controller,

neurophysiologic monitor there will be an inspection upon purchase before use and an estimate

of two inspections per year afterwards. There will be two inspections per year for the Physical

Sports Therapy and Recovery department of the equipment’s including, massage table, stationary

bikes and treadmills.

Preventive maintenance inspections are needed along with incoming inspections. Most

preventive maintenance inspections are interval-based meaning that the inspections depend on

manufacturer recommendations, risk levels and past organizational experience (38). They are

usually generated on a monthly basis (38). Preventive maintenance is needed in order to correct

the initial stage of equipment problems before they become actual or major failures.

Lastly, repairs are performed on equipment when needed and in prioritized timely

manner. In order to prevent problems within the hospital, backup devices will be available incase

of an emergency. The backup devices will be located in each department for quick easy access to

ensure continuity of patient care if a piece of equipment fails. However, in order to prevent

system or equipment failures, a hazard alert will be sent to the computer system to inform the

staff of the problem before it becomes a major issue. (38) This will provide the hospital with

time to fix the problem or switch to a back up device without taking focus away from the patient.

Records will then be filed about the problem and stored for future reference (38).

When staff members are hired or start a new job they will be required to go through a

training/ orientation about equipment they will be working with. During the orientation,

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employees will learn how to operate or repair the equipment in their departments. Supervisors

will educate the employees and they will engage in cross training in order to develop certain

skills required for the operation of each piece of equipment (38).

The following list shows various equipment and inventory items that St. Vincent will

have in the different departments of the hospital (39). It is important that our employees are

trained to operate the equipment, inspections are made and the disposable inventory is accounted

for and kept up to date in order to provide quality care to our patients.

Emergency Room and Operation Room Equipment:

• Patient Bed

• X-Ray Machine

• Oxygen Machine

• Electrocardiograph Monitor

• Defibrillator

• Anesthetic Machine

• X-Ray Viewing Board

• Airflow and Temperature Controller

• Neurophysiologic Monitor

• Vital Signs Monitor

• Cardioplegic Machine

• Bed Linens Set

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• Patient Gowns

• Syringes, Cannulas, Needles- various sizes and kits

• Catheters

• Blood Pressure monitors, gauges, cuffs, aneroid

• Surgical Tool Set

• Operating Table

• IV sets, bags, and arm boards

• Medical penlights

• Stethoscopes

• Medical scissors

• Endoscopic devices

• Reflex hammers

• Otology sponges

• Splints

• Patient Wheelchairs, crutches

• Thermometers

Physical Sports Therapy and Recovery Equipment:

• Snowboarding Simulation Program

• Skiing Simulation Program

• Massage Table

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• Weight Set

• Stationary Bike

• Treadmill

• Trigger Point Dry Needling Set

• Hot Stone Set

• Heating Pad

• Parallel bars

• Balance pads

• Electrotherapy Machines

• Manipulation boards

VIII. Supply Chain and Inventory Management

Optimizing quality, costs and control begins and ends with a highly competent Supply

Chain Management team (SCM). The SCM is led by an Executive Vice President (EVP) or Vice

President. St. Vincent's EVP of Supply Chain Management is responsible for overlooking the

operations of the supply chain and inventory. They constantly report to the hospital CEO about

the ongoing activities. Their organization, or team, is responsible for all SCM activity. The

following graphic shows a functional overview of the SCM’s functions and activities within each

category (40).

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Figure 28: (Supply Chain Management)

!

The department of goods and services planning are primarily responsible for creating a

forecast for the supply chain in regard to the inventory that will be needed to operate on the daily

basis. Demand Management uses a planning methodology to forecast and manage the future

products and services needed in St. Vincent. Lastly, the SCM team is used to establish priorities

of the hospital and recognize needs in order to enhance Supply Chain Management by using

collaborative planning.

The Procurement and Contracting department is in charge of the strategic sourcing and

product strategy, in order to optimize St. Vincent’s supply base and improve overall value of the

inventory used in the hospital. Contract and Pricing Strategy involves finding suppliers that

provide the best quality products and prices to ultimately create contracts with certain

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manufacturers. Operational procurement is designed to purchase and obtain the goods and

services within St. Vincent Hospital. It is important that all supplies purchased meet government

regulations and standards.

Once the inventory is purchased from the suppliers the materials management department

inventory management control is essential. Inventory management is the process of overseeing

the constant flow of units into and out of an existing inventory. The management of inventory

maintains a system that makes sure the inventory does not exceed (overstock) or dwindle (under

stock) to certain levels that will jeopardize the hospital. There needs to be warehouse and

inventory management along with in hospital materials management.

The last department of working capital management focuses on a managerial accounting

strategy to maintain good levels of both components of working capital, current assets and

current liabilities. Working capital management ensures that a company has sufficient cash flows

in order to meet its short-term debt obligations and operating expenses (41).

The term supply chain can be divided into two areas: inventory management and

distribution. Recent studies show that tremendous cost saving and potential revenue can be

generated with the enhanced management of distribution and inventory. It was estimated that a

hospital could reduce its total expenses by at least two percent through better inventory

management and distribution of medical materials (42). To have efficient inventory management

St. Vincent will use a requisition framework from McKesson technology to manage the current

inventory and the delivery schedule. A Virtual Item Master (VIM) is an online sourcing website

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used in various organizations

including hospitals. The VIM is a

system that can track inventory

throughout the hospital, provide

accurate information on the current

number of each piece of inventory

and allows staff members of St. Vincent to purchase items from our suppliers at any given time.

“15% of the time, different price are paid for the same product, 12% overpayments are made on

costly PPI items. 24% of supply chain staff time is spent on fixing errors and 8.7% of nurses’

time is spent on searching for supplies” (40). By using the VIM system time and cost expenses

are greatly reduced. The VIM system exchanges information with an e-commerce marketplace,

an artificial intelligence engine that contains the industry data set. In this case, the marketplace is

our supplier. Since our suppliers are connected in the VIM system, we are able to repurchase

supplies when needed. The benefits of the VIM system include three factors: find, compare and

control (40). For people working in hospitals it is important that they can find what they need

quickly and easily. For the SCM team, it is important people select products from the pre-

selected manufacturers. This is critical for the management of cost and quality.

Along with the Virtual Item Master, the Enterprise Resource Planning (ERP) system will

be used in the hospital. This is the “item master” software that keeps track of who is supplying,

what products are being supplied, what the product number and description is, how much it costs

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and how much inventory is on hand. Once the strategic sourcing team decides the specific

manufacturers and suppliers they prepare contracts with them for a specific number and payment

of inventory for the hospital. They are then entered into bother the ERP and VIM system. In

order to track the inventory throughout the hospital, barcodes will be used on the products. When

a barcode is scanned or the item number is searched the system will automatically bring up the

data of the specific inventory. The use

of ERP and VIM systems will

provide St. Vincent with an efficient

system of tracking inventory to avoid

overstocking and under stocking,

therefore reducing the costs (43).

This system creates a closer relationship with the suppliers. By being constantly

connected with the suppliers St. Vincent will have a competitive advantage in the medical field

because the system reduces the number of suppliers needed per hospital department. A good

relationship with suppliers creates an atmosphere with similar values and technological

similarities.

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Figure 29: (Suppliers per Department)

!

The supplies of St. Vincent will work with the hospital through the VIM and ERP system

to supply the best quality products. The supplier of the emergency department is Owens&Minor

is a head distributor of medical and surgical supplies. Owens&Minor will supply emergency

room and operation room equipment. Owens&Minor was selected to supply for our emergency

and operations inventory because they are a very reliable and high quality distributor. On their

website at www.owens-minor.com they state: “We have established a great reputation for

providing superior, world-class service and continually strive to exceed our customers’

expectations.” For the detailed list of the inventory they are supplying, see emergency and

operation room equipment list in appendix. The Physical Sports therapy and Recovery

department will get the equipment from ProMed Xpress. ProMed Xpress is a supplier that has

been providing physical therapy equipment supplies for almost 20 years. They strive to deliver

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high quality and competitively priced products to the hospital in a timely manner. Supplier for

computer software and Pyxis system will be Oracle and Care Fusion. Oracle is a highly

committed company using their resources to increase opportunity, protect the environment,

advance education and enrich community life. CareFusion is a medical technology corporation

that specializes in reducing medication errors and prevention of healthcare-associated infections.

Computer supplier is Dell. Dell is a very high functional computer supplier. They strive to create

a company based off of corporate responsibility and create the best service for their customers.

Herman Miller will supply the office furniture. Herman Miller provides a wide variety of

healthcare furniture and focuses their efforts on ensuring reliability. Sysco is the food supplier

while Food Service Resources will supply items such as trays, non-food items, mugs and storage.

Sysco Company strives to obtain and build on customer relationships in order to provide a

valued service. BH Medwear will supply clothing/laundry inventory such as the gowns, linens,

sheets, pillowcases, scrubs and socks. “HBmedware.com is the number 1 leader in high quality

healthcare and medical apparel” (www.HBmdewar.com). Lastly, Diversey Care will supply the

cleaning and laundry supplies. They are a company that is committed to a cleaner, healthier

future in healthcare organizations.

Receiving and Storing Process: With the use of the VIM and ERP system, the inventory

will be delivered to the hospitals address. The system will be able to alert the staff if low

quantities of certain items occur therefore instantly contacting the supplier to replace the item in

order to avoid under stocking and shortages. Since St. Vincent is located in a small town in the

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mountains, it is important that the hospital has a good amount of storage so more inventory can

be ordered and stored in case of an emergency. It might take more time for the inventory to get to

the hospital because of the location but we expect our inventory to arrive 24-72 hours of

ordering. That way our inventory will never reach zero.

Once the inventory has arrived, barcodes will be placed on the items and placed into the

VIM system. In order to create an efficient storing system with low error St. Vincent will use the

Pyxis inventory management systems to automate the center's logistics. Pyxis is a technology

dispersed throughout the hospital that combines automated, computer-linked inventory cabinets

and remote open-shelf technology in order to track the use, reorder, and issue of medical and

surgical supplies at the point of use (44). "The cabinets hold and manage the inventory. When

clinicians need a product, they access the system, identify the patient, select the item and

quantity, and remove the product. The Pyxis system keeps track of inventory and, when a

quantity on hand gets low, the system automatically reorders it when an extract is run" (44).

When cabinets become low they are replenished from the hospital stock room. The cabinets can

also send a signal to the VIM system to report a shortage of a certain item. This system reduces

the time cost of restocking by hand and the supplies are always being restocked so nurses and

physicians have supplies where and when they need them which improves patient care (44).

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IX. Human Resources Staffing Plan and Cost Analysis 1. Number and Type of Personnel Required by Shift and Time of Year

a. Service Providers Personnel by Department, Job Title, Job Description

Figure 30:

Emergency/Operating Room

Job Description Number of Personnel to

be hired

Paramedics The paramedics of our hospital are going to be responsible for providing immediate response to any emergency 911 calls. They are the first healthcare professionals to be on the scene and will need to asses the conditions of the patients and provide treatment prior to hospital admission (45).

16

MDs (Doctor of Medicine)

Responsible for examining, diagnosing, and treating any patient that may be referred to the hospital. They may be required to refer patients to other doctors and/or hospitals.

3

Nurses Must provide general care services for patients that have been admitted to the hospital. They should be focusing on the needs of the patient rather than the actual illness or injury. They will often be the main point of contact for patients during their visits. May also be responsible for educating patients on good-health and wellness.

8

Physician Assistants Contributes to the effectiveness of the physician by identifying long and short-term patient care issues. Often determines the patient’s health status by conducting interviews and examinations (46).

4

Radiologists The focus for a radiologist is medical imaging. They are responsible for interpreting the results that come from an X-Ray. They will never provide treatment, however they work very closely with the surgeons and other doctors to help determine a course of action (47).

3

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Radiologist Technician The radiologist technician is the one who will be taking the actual X-rays. They will then pass their results onto the radiologist (47).

3

Surgeons Surgeons operate on patients to treat injuries, such as broken bones; diseases, such as cancerous tumors; and deformities, such as cleft palate. They are responsible for ensuring the patient’s complete safety during any kind of operation (48).

4

Pediatricians Pediatricians are responsible for the health of infants, children, and teenagers. They specialize in the diagnosis and treatment of young people (49).

2

Anesthesiologist The anesthesiologist will work very closely with the surgeons. They will determine the dosage and type of anesthesia that each patient will need when going into the operating room. They should remain in the room for procedures to be sure that the condition of the patient is always good. Most importantly, they should make the patient feel as comfortable as possible; educating them on the anesthesia that will be given to them.

4

Cardiologist The cardiologist deals with treating and diagnosing injuries and diseases of the heart (50).

4

Physical Sports Therapy and

Recovery


be hired

Sports Physical Therapist

Sports therapists give advice to sport and exercise participants on how to train and compete safely, as well as treat injuries and assist with rehabilitation (51).

4

Orthopedic PT Orthopedic physical therapists diagnose, manage, and treat disorders and injuries of the musculoskeletal system as well as rehabilitate patients after orthopedic surgery. They are trained in the treatment of postoperative joints, acute sports injuries, arthritis, and many other musculoskeletal system disorders.

1

Geriatric PT Geriatric physical therapists help elderly patients achieve or maintain high levels of physical health as they age by focusing on ailments like arthritis, osteoporosis, and joint soreness. They evaluate each patient and design a custom activity and exercise plan that will allow the patient to remain as physically fit and active as possible (52).

1

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Personnel Shifts by Time of Year, Day, and Time: January - April

Figure 31:

Neurological PT Neurological physical therapists focus on working with individuals who have a neurological disorder or disease; these therapists work with patients to improve these areas of dysfunction. These disorders or diseases include but are not limited to brain injury, cerebral palsy, multiple sclerosis, spinal cord injury, and stroke; they can lead to multiple physical problems such paralysis, vision impairment, poor balance, inability to ambulate, and loss of functional independence.

1

Pediatric PT Pediatric physical therapists are physical therapists that specialize in treating and caring for patients who are toddlers, babies, children, teenagers and young adults. They treat conditions related to genetic, neurological and orthopedic disorders (53).

1

Sun. Mon. Tues. Wed. Thurs. Fri. Sat.

Paramedics

Shift One 12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00am - 12:00pm

# of personnel 7 7 8 7 7 7 8

Shift Two 12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

# of personnel 6 6 6 6 6 6 6

MD

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Shift One 12:00am - 9:00am

12:00am - 9:00am

12:00am - 9:00am

12:00am - 9:00am

12:00am - 9:00am

12:00 am - 9:00am

12:00am - 9:00am

# of personnel 1 1 1 1 1 1 1


12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00pm - 12:00am

# of personnel 1 1 1 1 1 1 1

Nurse


12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00am - 12:00pm

# of personnel 3 2 2 2 2 3 3


12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00pm - 12:00am

# of personnel 2 2 2 2 2 2 2

Physician Assistant


12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00am - 12:00pm

# of personnel 1 1 2 1 1 1 2


12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00pm - 12:00am

# of personnel 1 1 1 1 1 1 1

Radiologist

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12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00am - 12:00pm

# of personnel 1 1 1 1 1 1 1


12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

# of personnel 1 1 1 1 1 1 1

Radiologist Technician


12:00am - 9:00am

12:00am - 9:00am

12:00am - 9:00am

12:00am - 9:00am

12:00 am - 9:00am

12:00am - 9:00am

# of personnel 1 1 1 1 1 1 1


12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00pm - 12:00am

# of personnel 1 1 1 1 1 1 1

Surgeon


12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00am - 12:00pm

# of personnel 1 1 2 1 1 1 2


12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00pm - 12:00am

# of personnel 1 1 1 1 1 1 1

Pediatrician


7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

! 73

!

# of personnel 1 1 2 1 1 1 2

Anesthesiologist


12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00am - 12:00pm

# of personnel 2 2 2 2 2 2 2


12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00pm - 12:00am

# of personnel 1 1 1 1 1 1 1

Cardiologist


12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00am - 12:00pm

# of personnel 1 1 2 1 1 1 2


4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00 am

4:00pm - 12:00am

# of personnel 1 1 1 1 1 1 1

Sports PT OFF 9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD

# of personnel 3 3 3 3 3 TBD

Orthopedic PT OFF 9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD


Geriatric PT OFF 9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD

! 74

!

Personnel Shifts by Month, Day, and Time: May - August

Figure 32:


Neurological PT OFF 9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD


Pediatric PT OFF 9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD



Paramedic


12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 5 5 6 5 5 5 6


12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 4 4 4 4 4 4 4

MD


12:00am - 9:00am

12:00am - 9:00am

12:00am - 9:00am

12:00am - 9:00am

12:00 am - 9:00am

12:00 am - 9:00am

# of personnel 1 1 1 1 1 1 1

! 75

!


12:00pm -

12:00am

12:00pm -

12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 1 1 1 1 1 1 1

Nurse

Shift One 12:00 am -12:00 pm

12:00am -12:00 pm

12:00am -12:00 pm

12:00 am -12:00 pm

12:00 am -12:00 pm

12:00 am -12:00 pm

12:00 am -12:00 pm

# of personnel 2 2 2 2 2 2 2


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 2 2 2 2 2 2 2

Physician Assistant


12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 1 1 1 1 1 1 1


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 1 1 1 1 1 1 1

Radiologist


12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 1 1 1 1 1 1 1

! 76

!


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 1 1 1 1 1 1 1



12:00am - 9:00am

12:00am - 9:00am

12:00 am - 9:00am

12:00 am - 9:00am

12:00 am - 9:00am

12: am - 9:00am

# of personnel 1 1 1 1 1 1 1


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

Surgeon


12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 1 1 2 1 1 1 2


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 1 1 1 1 1 1 1

Pediatrician


7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

# of personnel 1 1 2 1 1 1 2

Anesthesiologist

! 77

!


12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 2 2 2 2 2 2 2


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 1 1 1 1 1 1 1

Cardiologist

Shift one 12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 1 1 2 1 1 1 2


4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00 am

4:00pm - 12:00 am

4:00pm - 12:00 am

4:00pm - 12:00 am

# of personnel 1 1 1 1 1 1 1


9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD



9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD



9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD

! 78

!

Personnel Shifts by Month, Day, and Time: September - December



9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD



9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD



Paramedic


12:00am - 12:00pm

12:00 am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 5 5 6 5 5 5 6


12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 4 4 4 4 4 4 4

MD


12:00am - 9:00am

12:00am - 9:00am

12:00am - 9:00am

12:00am - 9:00am

12:00 am - 9:00am

12:00 am - 9:00am

# of personnel 1 1 1 1 1 1 1

! 79

!


12:00pm -

12:00am

12:00pm -

12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 1 1 1 1 1 1 1

Nurse

Shift One 12:00 am -12:00 pm

12:00am -12:00 pm

12:00am -12:00 pm

12:00 am -12:00 pm

12:00 am -12:00 pm

12:00 am -12:00 pm

12:00 am -12:00 pm

# of personnel 2 2 2 2 2 2 2


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 2 2 2 2 2 2 2

Physician Assistant


12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 1 1 1 1 1 1 1


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 1 1 1 1 1 1 1

Radiologist


12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 1 1 1 1 1 1 1

! 80

!


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 1 1 1 1 1 1 1



12:00am - 9:00am

12:00am - 9:00am

12:00 am - 9:00am

12:00 am - 9:00am

12:00 am - 9:00am

12: am - 9:00am

# of personnel 1 1 1 1 1 1 1


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

Surgeon


12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 1 1 2 1 1 1 2


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 1 1 1 1 1 1 1

Pediatrician


7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

7:00am - 5:00pm

# of personnel 1 1 2 1 1 1 2

Anesthesiologist

! 81

!


12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 2 2 2 2 2 2 2


12:00pm - 12:00am

12:00pm - 12:00am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

12:00 pm - 12:00 am

# of personnel 1 1 1 1 1 1 1

Cardiologist

Shift one 12:00am - 12:00pm

12:00am - 12:00pm

12:00am - 12:00pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

12:00 am - 12:00 pm

# of personnel 1 1 2 1 1 1 2


4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00 am

4:00pm - 12:00 am

4:00pm - 12:00 am

4:00pm - 12:00 am

# of personnel 1 1 1 1 1 1 1


9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD



9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD


! 82

!

This shift schedule serves as an absolute reference for how our staff will be scheduled

throughout the year. It was created by looking at the demand forecast for our hospital and

deciding when we would need which type of staff to be present, how many of them should be

present, and for how long. These shifts and hours will give St. Vincent’s the ability to operate

efficiently and effectively at the lowest staffing cost that we feel is possible.

b. Customer Representatives

Personnel by Department, Job Title, Job Description

Figure 33:


9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD



9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD



9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

9:00am - 5:00pm

TBD


Cafeteria Job Description Number of Personnel to be

hired

Cooks The cooks will be responsible for providing delicious and nutritious meals to all of our patients, guests, and staff.

4

! 83

!

Figure 34:

Figure 35:

Cashier The cashier will need to provide prompt and friendly service to anyone who buys food and/or drink from the cafeteria.

4

Busser/Dishes Need to be sure that the dining and kitchen areas are clean and presentable at all times.

4

Patient Check-In


be hired

Secretary The secretary at the patient check-in center will be responsible for getting the patient in the hospital system and filing important paper-work and documents. They should keep all patient information in an organized manner and transport it to the departments of the hospital that will need it at any time.

3

Nurse We have decided to place a nurse at patient check-in for various reasons. They can inform patients about the admission process and what will be happening during their stay at St. Vincent’s. Also, they can be around in case a patient were to come in with a severe emergency and needed immediate treatment. The nurse will decide where the patient needs to go in the hospital and who they are most likely to see.

3

Information Desk

Job Description Number of Personnel to be

hired

Secretary The secretary at the information desk will be responsible for answering patient and guest inquiries both in-person and over the phone.

3

Guest Navigator

The guest navigator should know the hospital inside and out. They will be able to point anyone who walks in the front door to where they need to be.

3

Hospital Security

Job Description Number of Personnel to be

hired

! 84

!

Personnel Shifts by Day and Time:

Figure 36:

Security Guard

The security guards will have the duty of maintaining safety at all times for the staff and guest of St. Vincent’s.

4


Cook


7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

# of personnel 2 2 2 2 2 2 2

Shift Two 11:00 am - 7:00pm

11:00 am - 7:00pm

11:00 am - 7:00pm

11:00am - 7:00pm

11:00am - 7:00pm

11:00am - 7:00pm

11:00am - 7:00pm

# of personnel 2 2 2 2 2 2 2

Cashier

Shift One 7:00am - 1:00 pm

7:00am - 1:00 pm

7:00am - 1:00 pm

7:00am - 1:00pm

7:00am - 1:00pm

7:00am - 1:00pm

7:00am - 1:00pm

# of personnel 2 2 2 2 2 2 2

Shift Two 1:00pm - 7:00pm

1:00pm - 7:00pm

1:00pm - 7:00pm

1:00pm - 7:00pm

1:00pm - 7:00pm

1:00pm - 7:00pm

1:00pm - 7:00pm

# of personnel 2 2 2 2 2 2 2

Busser/Dishes


7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

# of personnel 1 1 1 1 1 1 1

Shift Two 11:00 am - 7:00pm

11:00 am - 7:00pm

11:00 am - 7:00pm

11:00 am - 7:00pm

11:00 am - 7:00pm

11:00 am - 7:00pm

11:00 am - 7:00pm

# of personnel 1 1 1 1 1 1 1

! 85

!

Secretary (Check-In)

Shift One 12:00 am - 8:00am

12:00 am - 8:00am

12:00 am - 8:00am

12:00am - 8:00am

12:00am - 8:00am

12:00am - 8:00am

12:00am - 8:00am

# of personnel 1 1 1 1 1 1 1

Shift Two 8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

# of personnel 1 1 1 1 1 1 1

Shift Three 4:00pm - 12:00 am

4:00pm - 12:00 am

4:00pm - 12:00 am

4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00am

# of personnel 1 1 1 1 1 1 1

Nurse


12:00 am - 8:00am

12:00 am - 8:00am

12:00 am - 8:00am

12:00 am - 8:00am

12:00 am - 8:00am

12:00 am - 8:00am

# of personnel 1 1 1 1 1 1 1


8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

# of personnel 1 1 1 1 1 1 1


4:00pm - 12:00 am

4:00pm - 12:00 am

4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00am

# of personnel 1 1 1 1 1 1 1

Secretary (Info Desk)


7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

# of personnel 1 1 1 1 1 1 1

! 86

!

The schedule for the customer service representatives was created using a different

method than our medical staff. We do not rely on forecasting for this scheduling because most of

the positions require the shift times to be based on hours of operation rather than patient demand.

We have made sure that there is an adequate number of staff to fill each position and ensure that

our customers are always taken care of.


2:00pm - 9:00pm

2:00pm - 9:00pm

2:00pm - 9:00pm

2:00pm - 9:00pm

2:00pm - 9:00pm

2:00pm - 9:00pm

# of personnel 1 1 1 1 1 1 1

Guest Navigator


7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

7:00am - 2:00pm

# of personnel 1 1 1 1 1 1 1


2:00pm - 9:00pm

2:00pm - 9:00pm

2:00pm - 9:00pm

2:00pm - 9:00pm

2:00pm - 9:00pm

2:00pm - 9:00pm

# of personnel 1 1 1 1 1 1 1

Security Guard


12:00 am - 8:00am

12:00 am - 8:00am

12:00am - 8:00am

12:00am - 8:00am

12:00am - 8:00am

12:00am - 8:00am

# of personnel 2 2 2 2 2 2 2


8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

8:00am - 4:00pm

# of personnel 1 1 1 1 1 1 1


4:00pm - 12:00 am

4:00pm - 12:00 am

4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00am

4:00pm - 12:00am

# of personnel 1 1 1 1 1 1 1

! 87

!

c. Management:

Figure 37:

Position Title Job Description Number of Personnel to

be hired

CEO - Chief Executive

Officer

The CEO provides CEO-level administration, direction, and coordination for hospital activities, with the support of facility and personnel, to carry out the facility’s objectives in the provision of healthcare and the improvement of community health status in a financially appropriate way, and executes policy formulated by the hospital Board of Directors, in conjunction with St. Vincent’s, the medical staff and operational entities within the facility.

1

CMO - Chief Marketing

Officer

Oversees how the hospital is doing in terms of relating to our market. Will come up with ways to make St. Vincent’s the number one hospital in the nation and should put extra focus into earning credibility for our sports physical therapy and recovery department.

1

CFO - Chief Financial Officer

Handles all of the numbers and financing that goes on in the hospital. This is an increasingly important job because a lot of the equipment needed throughout our hospital is very expensive and needs to be purchased at the right time in the right way. They should keep an eye on how we are allocating our resources and ensure that the hospital is in a place of sound financial security to please investors.

1

CIO - Chief Information

Officer

The CIO will be important to our workforce because they will be the fundamental person in collecting data to analyze our key performance indicators mentioned in the competitive differentiators section of this document. They can obtain and manage vast amounts of information that can help us progress as a business.

1

COO - Chief Operations

Officer

The COO is the meat of the hospital. They oversee each of the departments in the building and ensure that there are effective and efficient processes in place all across the board. They will also be responsible for handling equipment management and information flow throughout the hospital.

1

! 88

!

d. Other:

Figure 38:

2. Human Resources Labor Cost Analysis:

Figure 39:

CTO - Chief Technical

Officer

The CTO is responsible for obtaining and maintaining the various types/amounts of technology that will be required for the hospital. They should ensure that we have the best systems on our computers and the latest medical technology that will provide our patients with top-notch care.

1

Housekeeping

We will be outsourcing the housekeeping of the hospital. We feel that hiring an outside company to keep up on the cleanliness of our hospital will be beneficial because we do not need to concern ourselves with what we do not know. HR should focus on the staff that resides within the hospital.

Maintenance We will also be outsourcing the maintenance of the hospital. This will require us to find a company that can provide us with basic plumbing and electrical services.

Per Hour Per Year Quantity Total Cost

Paramedics 14.91 31,020 16 496320

Doctors 90 187,200 3 561600

Nurses 31.38 65470 11 720170

Physicians Assistants 43.72 90930 4 363720

Radiologists 26.88 55910 3 167730

Radiologists Technician 26.88 55910 3 167730

Surgeons 90 187200 4 748800

Pediatricians 80.59 167640 2 335280

Anesthesiologists 111.94 232830 4 931320

Cardiologist 196.875 378000 4 1512000

Physical Therapists 18.96 39430 8 315440

! 89

!

Figure 39 shows St. Vincent’s pay per employee. These statistics are given by the BLS

and are adjusted to be as generous as possible with all of our employees (55)

Benefits: St. Vincent’s will provide all employees with 3 sets of uniforms. The uniform

will be simple and professional, yet comfortable. 3 uniforms should be plenty to accommodate

for the rotating shift schedule, and the employees can wash them at the hospital.

Employees will also receive discounts on Physical Therapy services. This will be a great

way for many of the employees to ensure they do not go under too much stress. It is also a great

opportunity for employees to simply relax.

St. Vincent’s will also provide employees with extensive healthcare benefits. Healthier

employees are more productive employees. This is a very easy benefit for St. Vincent’s to

provide, with high reward. This will lower employee turnover and improve the customer

experience.

Cooks 22.39 46570 4 186280

Cashier 9.12 18970 4 75880

Secretaries 16.99 35330 6 211980

Guest Navigator 12.63 26280 2 52560

Security Guard 11.55 24020 4 96080

CEO 85.02 176840 1 176840

CFO 149.22 286500 1 286500

CMO 74.05 142169 1 142169

CIO 101.15 194212 1 194212

COO 96.23 184763 1 184763

! 90

!

X. Revenue Analysis

Figure 40:

! 91

!

As shown by Figure 40:… a hospital does have very high start up costs, but based on the

demand forecast a large majority of the start up costs should be easily covered in year 1. To find

the total cost per department the salaries of the employees that work in each department were

factored in, along with the costs of all machines and equipment required for that department to

operate on a daily basis. The costs of employees and equipment were found using Figure: 5 and

Figure: 39. The employees and equipment are already separated by department so these numbers

are simply added together to find total cost. The total cost number is then divided by total

demand for that department per year to give expense incurred per visit. St. Vincent’s will use a

tiered system to increase prices, as we expect an increase in costs incurred to the hospital as

expansion opportunities are presented. These opportunities will present themselves based on an

increase in revenue as the demand rises. For the first four years prices of all services will be

increased by 2%. In Figure:... we can see that the ER department brings in the most revenue

throughout our entire hospital. This means that we should continue to grow and expand on this

department so that we can keep our main source of revenue in tact and up-to-date. In Figure:...

we also see that the operation room department is our most expensive department to maintain.

This lets us know that we may need to look at this department in the future and figure out how

we can cut costs and maximize the profit that comes from the operating department. As seen in

Figure:… a loss will be incurred on the cafeteria. This is because the cafeteria is a pull factor

and the demand in other departments will be higher because of it. Although there is a loss in this

department, the loss results in an overall gain for the hospital.

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XI. Simple Three Year Financial Analysis

Balance Sheet December 31, 2014

Assets: Current Assets Cash $17,286,780.25 Accounts Receivable 5,048,419.75 Inventory 12,025.00 Total Current Assets: $22,347,225.00

Non-Current Assets Equipment $655,866.00 Accumulated Depreciation 72,874.00 Total Non-Current Assets: $728,740.00

Total Assets: $23,075,965.00

Liabilities: Non-Current Liabilities Long-term Loan Payable $6,000,000.00 Interest Payable 300,000.00 Total Non-Current Liabilities $6,300,000.00

Total Liabilities: $6,300,000.00

Stockholder’s Equity: Contributed Capital $4,000,000.00 Retained Earnings 12,775,965.00

Total Stockholder’s Equity: $16,775,965.00

Total Liabilities and Stockholder’s Equity: $23,075,965.00

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Total Assets: $22,899,274.00

Liabilities: Non-Current Liabilities Long-Term Loan Payable $5,000,000.00 Interest Payment 250,000.00 Total Non-Current Liabilities: $5,250,000.00


Stockholder’s Equity: Contributed Capital $1,000,000.00 Retained Earnings $16,649,274.00

Total Stockholder’s Equity $17,649,274.00


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Total Assets: $22,586,256.00

Liabilities: Non-Current Liabilities Long-Term Loan Payable $4,000,000.00 Interest Payment 200,000.00 Total Non-Current Liabilities: $4,200,000.00


Stockholder’s Equity: Contributed Capital $1,500,000.00 Retained Earnings $16,886,256.00

Total Stockholder’s Equity $18,386,256.00


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St. Vincent 2014 Income Statement

Sales $27,533,074.00 COGS 7,339,395.00 ________________ Gross Profit $20,193,679.00 Admin Expenses Wage Expense 7,417,714.00 ________________ Operating Income $12,775,965.00 Non-Operating Expenses Interest Expense 300,000.00 ________________ Net Income $12,475,965.00


Sales $31,706,383.00 COGS 7,339,395.00 ________________ Gross Profit $24,366,988.00 Admin Expenses Wage Expense 7,417,714.00 ________________ Operating Income $16,949,274.00 Non-Operating Expenses Interest Expense 300,000.00 ________________ Net Income $16,649,274.00


Sales $31,943,365.00 COGS 7,339,395.00 ________________ Gross Profit $24,603,970.00 Admin Expenses

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Wage Expense 7,417,714.00 ________________ Operating Income $17,186,256.00 Non-Operating Expenses Interest Expense 300,000.00 ________________ Net Income $16,886,256.00

By looking at the above balance sheet, our current assets consist of cash, accounts

receivable and inventory. The accounts receivable shows the number of credit sales accounted

for during the first year at St. Vincent. It is important for our hospitals liquidity and cash flows

that accounts receivable be collected quickly(56). Credit sales for St. Vincent accounted for .25

of the gross profit determined in the income statement. The invoice of credit sales will be 1/30, n/

60 meaning patients who pay within 30 days will receive a deduction of 1% of the net price

otherwise net 60 means payments are due within 60 days of the invoice date(57). The inventory

was determined by adding up the costs of the disposable income: bed linens, gowns, towels,

trays, dry needles, cookware, dishes, gloves and surgical sets. The long term assets include

equipment of the non-disposable inventory and it is being depreciated 10% straight-line every

year. The long term loan payable under liabilities started at $6 million dollars because of the 30

year mortgage at 5% interest. 300,000 dollars was determined for the interest payable in the

balance sheet and interest expense in the income statement by taking 5% of the loan payable.

After the first year, the principal lowered by $1 million each year. The money from contributing

capital under stockholder’s equity is provided by loans from our investors. Each year, St. Vincent

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is lucky to receive money from past patients and sponsors. Lasty, the net income flows over to

the balance sheet as retained earnings. The numbers shown in the income statement were

determined by looking at the revenue analysis.

XII. Process Maps

Any hospital - any business - must operate smoothly in order to maintain profitability,

sustainability and otherwise. St. Vincent’s current process model for business has so far been

successful. However, with the aforementioned implementations discussed in this proposal,

certain processes must be acknowledged, verified and/or explained in further detail. Attached

below (in alphabetical order) are examples of process maps describing the processes whereby St.

Vincent shall operate smoothly in the future:

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XIII. Final Summary

Hannah Chandler

Building a hospital was probably the most challenging assignment I have ever been

assigned to do in college. However, with that being said, I have learned an immense amount

about teamwork, time management, and communication. Although throughout the semester I was

extremely stressed out by getting each submission in and making sure we had all our parts done

on time, when I look back at the work that we accomplished it makes all those stressful nights

worth it.

Working with the same three people for a whole semester seems like a nightmare at first,

however I got extremely lucky with an amazing group. I think the most important part about this

project is getting a group of people that want to work hard and whom you can get along with

because you become attached at the hip with all of them. Teamwork is key to a successful project

and I’m grateful that we were a hard working group and were able to help each other out with

our assigned parts of the project. Overall working with a group on this project was more helpful

than doing it alone.

Working with data was probably the most difficult part of the project. Gathering and

analyzing data for financial reports, human recourses, equipment, loans etc. were extremely

difficult to do. It was very important that we talked to mentors about how to gather accurate data

and present it in a way that was understandable to our investors. Once we finished this project, I

have a better understanding of how to gather and interpret data from various sources.

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Process mapping was another difficult part of the project. I don’t think any of us realized

all the details that go into making process maps and how important it is to consider the

relationship and cross-functional maps when building a hospital. They are so many operations

that are happening in the background while patients are being helped.

Time and Project management is another key aspect to take advantage of in this project.

It is hard to keep a steady time from week to week to work on the project before the submission

is due. Our group found ourselves working extremely hard each week before the project was due.

This project would have been less stressful if we had spaced out our work in between each

submission. I did learn to be more conscious of my time management skills in the future and take

advantage of the time that is given to me.

My suggestions for future BCOR 2500 students will probably sound repetitive of what

our professor and TA’s told us at the beginning of the project. It is important to pick your groups

wisely because if you get stuck in an unmotivated group you will find the project and semester to

be a nightmare. Make sure you get to know people before you work with them and do not just

join a group because you have a friend in it. It is almost better to work with people you do not

know very well before the project. The second piece of advice is really work on time and project

management. It will take away a lot of the stress of the project and will give your group time to

edit and fix the project way in advance of the due dates. If I were to do this project over again,

time and project management is what I would do differently. Most importantly have fun with it

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because it is a great project that teaches you life lessons about teamwork, analyzing data, and

time and project management in the business world. Good luck!

Taylor Craven

This hospital project was the first major group project that I have worked on since being

at CU. It was nothing like I expected it to be and taught me a lot of things about how I work on

large assignments such as this one on an individual scale as well as how I work with others.

Working with a group showed me that not everyone is going to be on the same page 100% of the

time. Communication is key and you must be able to understand where other people are coming

from. I have found that getting frustrated with members of your group is bound to happen, but

the way in which you handle the situation will be the most important factor in finding a solution.

Working with data was one of the most painful parts of this project. It forces you to think

in ways that you never have before and open your mind to data organization. One of the hardest

parts was trying to make sense of it all and finding a way to make it relevant and worth putting

into the final product.

Although I did not do much of the process mapping, I can say without a doubt that our

process maps really helped put the inner-workings of our hospital into perspective. It gave us a

chance to look at the big picture and see how all of the little parts fit in with the big parts.

My group found that time and project management was something that we could have

improved on. Figuring out when things need to get done and how they are going to get done is of

utmost importance when completing this project. Without proper time management, you will find

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yourself rushing around the week of the project trying to make sure that every last detail is

perfect. Without proper project management, it starts to get confusing when figuring out who has

done which parts and if those parts are up to the group’s satisfaction.

One major piece of advice that I would give to future BCOR 2500 students is to obtain a

mentor. The mentor match program is a great opportunity that several students fail to take

advantage of. You are getting free and professional help on a project that is worth a healthy

chunk of your grade. Do anything and everything you can to separate yourself from the 50 other

groups that you are competing against. Also, be cautious in choosing who you work with. The

bios may be a pain and something that does not seem worth your while but just do it. Do your

research and you will end up with a group who has the same goals and mindset as you. It makes

for great synergy and cooperation.

Katherine McManus

To say that operating and completely transforming a hospital was hard would be an

incredible understatement. This was probably one of the most difficult - and yet rewarding -

experiences that I have had through the University of Colorado’s Leeds School of Business

program. It forced me to reevaluate what I thought that I knew and to recapitulate the knowledge

that I’ve gathered over my time as a student in the Leeds School of Business.

Working with a group over the semester was incredibly challenging, but also rewarding,

especially when considering that my group members were absolutely stellar. Though we were all

busy with our own commitments, other courses, jobs and the like (after all, this project was being

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done in conjunction with a lot of other stuff that college students have to do over the course of a

semester), we always found time to work on the project together, even if that required some

incredibly late nights at the library and some last minute scrambling of trying to bring together

all of the different information that we’d compiled. It was also incredibly useful in that every

member of our group was “good” at something else - i.e. while someone might have proficiency

in regards to financial statements, someone else in the group had experience or proficiency in

process mapping and e-commerce. It was a great process to work with so many ambitious

individuals that all brought something different to the table. Time management (and scheduling)

was incredibly difficult at times, but not impossible.

Working with data was one of the most painful parts of this project, especially in looking

at the data, decoding it and making it work with what we were attempting to get across in regards

to our project. Interpreting data became somewhat easier as the time went along, but for myself

the hardest part about working with data was figuring out which pieces of information and which

statistics would actually be the most beneficial to the project as a whole.

Working with process mapping was, for me, very fun - the one part about it that I didn’t

necessarily enjoy was how time consuming it really was. Creating one of the relationship maps

took at least three hours, and that was only one process map out of the ten that were created for

this project. The relationships and processes to the hospital are absolutely essential… and yet,

this is what made them incredibly difficult. Sometimes, the connections between different people

at the hospital could be incredibly intricate and complex, and was very difficult to manage.

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Managing the project was difficult at times, but it definitely could have been worse. Our

utilization of Google Docs, I think, was very useful in that we could be working on this project

while we weren’t necessarily in the same proximity. In addition, we could edit one another’s

work and add comments and criticism on parts in which we thought there should be more detail

or information. Or vice versa. Meeting up to work on the project together was, again, incredibly

difficult at times, but it was not impossible.

My advice for future BCOR 2500 students would be to take advantage of the mentor

partnership as much as possible; it’s an incredibly useful resource and is so helpful in figuring

out what direction you want to take your project. In addition to picking the right teammates, I

would also highly recommend getting started on the project as soon as possible. Deadlines really

creep up on you and, especially in regards to a project of this magnitude, it would be in your best

interests to start early now and stress less later.

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