In the recent Community Health Needs Assessment (CHNA), orthopedic cases are projected to increase in the Trinity Hospital over the next five years. The assessment displayed that orthopedic cases are likely to flow from 11,800 to 17,338 (+46%); joint and spine procedures by 30%; and outpatient joint and spine procedures are expected to rise by 350%. The assessment highlighted the orthopedic services and the needs of the Trinity community. Some of the needs were shortage on physicians and specialist, gear, physical therapy services, and surgical suites. When looking at the business side of things you must understand supply demand. When demand rises and supply goes unchanged, a shortage will follow leading to greater costs equilibrium and if demand does not change and supply drops a short happens. This means there will be an increase in the overall revenue because of the rise in the demand for the orthopedic services. The community has a high demand for orthopedic services so it is and the population size for the aging community is growing so it is likely these services will be at an all-time high in five years.
A recent needs assessment displayed that the current orthopedic cases are expected to rise 46%, with a 30% growth in inpatient joint and spine procedures. As expected outpatient joint and spine procedures are projected to grow by 350%. The orthopedic center is in a high demand area and the numbers show a defined market area within. There are also two private local hospitals in competition with very good orthopedics programs, which makes the need for Trinity’s to have a strong orthopedic program. Research shows that the main location is within the community with a projected population growth of 4%, this sets the demand for a quality orthopedic program to cover the growing community. The needs assessment shows that with an established orthopedic center, it is possible that we are able to provide everyone in the Trinity community with quality service for. It would be very feasible to develop the new center right away in order to meet the demands of the community and provide adequate treatment and services with adequate equipment.
The orthopedic center development should allow us to incorporate an international trend of providing quality healthcare for all citizens in the community and spending less money. Regardless of the ability to pay we must also look into ways to reduce spending and still providing quality healthcare. The development of a plan that will allow patients to be treated despite financial ability and health insurance could also help us meet the demand in the community. While our country does not offer a national healthcare system, our facility can incorporate the international trend. In addition to developing an integrated health system developing a selective groups of physicians and healthcare workers to provide adequate services. Currently there are two groups that are moving in the area. Fortunately one group has recently secured office space to open a branch of orthopedic practice on campus with the Trinity community, which helps us move to the integrated healthcare system. This benefits the Trinity community by providing more services and quality programs to assist more patients.
The ultimate goa at Trinity is to provide quality healthcare to all citizens of the Trinity community Robotic surgery and current digital equipment would be complementary to the new orthopedic center in surgical units. In addition to this we are able to accommodate the demands of orthopedic cases we deal with in the facility within our surgical units adequately. The development of the surgery facilities provide the advantage to recruit orthopedic groups that desire to be closer to Trinity and apply for privileges for the facility. There are currently twenty operating rooms that are equipped with the basic setup necessary to accommodate the orthopedic program. The rooms are equipped with two CT scanners, MRI scanner, X-ray, nuclear medicine, mobile PET scanner, and ultrasound services. The nursing staffs at Trinity are devoted and skilled which helps increase orthopedic nursing certification rate to 75% showing that this is a strong area in the facility.
Although we may not be highly recommended the drive towards patient quality care it is a major part of the increase in demand of services. Even though all our service lines compliment the orthopedic program, it is clear that we can work hand- in- hand to develop a valued healthcare system and meet the demands, not only for patients but all hospital staff as well. The recent research shows that we could cut cost by building a new 5000 square foot physical therapy/rehab center adjacent to the Trinity campus. The new building costs estimates to about 600,000 verses 700,000 to purchase the space adjacent to the Trinity campus. In order to expand the services by adding a radiology department and have two MRI machines could cost approximately $3,000,000. Currently in the capital reserves we have 25,000,000 so this would be feasible for this service line expansion.
Adding an orthopedic center could potential gain approximately 2100 new surgical cases and also gaining about 6500 visits in physical therapy. This can bring the profit margin to about $2,171,500. According to the five year projection plan, it is projected that there will be about $25,000 in gross charges per orthopedic surgical case. It is also clear that there is a $275 in gross charges per physical therapy treatment. 31% is the ratio of cost in charges when calculated. The Medicaid, Medicare and self- pay patients are at an all-time high right now so it is projected that the orthopedic program will increase in revenue and gain more pay-in patients. Developing a bundle payment program can allow the patient insured and uninsured an opportunity to get quality care and treatment in an affordable manor.
A community hospital with the orthopedic center in it will be great in the future to help increase utilization, and also make-up for the decreased volume seen with the damage of the OB program and decay of general surgery volumes. An increase in the utilization could help our key financial indicators and also develop an effective profit plan for years to come. In order to increase the amount of specialists that are in the center we will need to target the patients who need total joint care. Developing a patient navigation system for these pacific patients can be a huge way to market the new service line to the community also coordinating care and appointments for the patients. This will also be a chance to provide physicians with the ability to sustain private practices and still work in the facility and have hospital privileges.
It is suggested that we continue to work closely with those practices that are moving in the same direction as Trinity help outline the exact plan that has been developed for the marketing. A key marketing strategy that can be used in the marketing area is advertising. Highlighting the high quality services and giving the physicians satisfaction rate which is 90% could convince new patients to come to Trinity. Adding the orthopedic group adjacent to the Trinity campus, a referral service could be developed. The system should be set up as Trinity refers the orthopedic cases to the physicians group who will then in return refer all of their patients to the new orthopedic center for surgery, physical therapy, etc.
Working directly with the physicians can give a more unified unit where everyone is able to benefit and also help increase their revenue equally among the practices and the hospital. Marketing can weigh in on the expanding growth of the orthopedic specialists that are on staff and the new orthopedic center. Patients will be provided with referral information if the patient is in need for physician’s services on Trinity campus. We can also give referral for physicians who are not directly connected to the Trinity facility but have privileges at the facility. These physicians are able to use the referral services and in return refer patients to our facility and the new orthopedic center.
Kohn, L. T., Corrigan, J., Richardson, W. C., & Donaldson, M. S. (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press. McLaughlin, C. P., & Kaluzny, A. D. (1999). Continuous quality improvement in health care: Theory, implementation, and applications. Gaithersburg, MD: Aspen Publishers
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