1. Major Risks Factors Identified
After review of the community health needs assessment, there were major risk factors identified that will affect the primary service area over the next five years. The demand for oncology services is expected to grow 34% in the next five years and primarily target men over 65. As with oncology, cardiovascular services is expected to grow rapidly over the next five years with an average growth of services to be an increase of 23%. The largest demand of service focus area will be coronary artery disease, diagnostic cath procedures and angioplasties. Since 15% of the service area will be over 65 in the next five years, the demand for state of the art, cardiovascular and oncology services will surely be on the rise. In addition to the increase in demand for oncology and cardiovascular services, the largest demand will be for orthopedic services as that area is expected to have rapid growth over the next five years. The increase in orthopedic cases is expected to grow 46%, which is a tremendous spike. Inpatient joint and spine procedures are predicted to increase 30% but the most rapid growth of all focus areas is in outpatient joint and spine procedures which is expected to increase 350%!.
2. Addressing the Demands from the Community Health Assessment
Trinity Community Hospital recognizes the need for additional practitioners as the recruitment for additional physicians is already underway. That is tremendous that recruitment is underway. However, that is about the only improvement or planning that has been determined. Medical equipment is outdated and not keeping pace with the growth in patient volume. A need for additional equipment has been recognized but it does not appear that all
needs identified have been factored in to the budget for additional imaging equipment specifically for oncology. In addition to the need for updated medical equipment, it has been determined that the facilities are not equipped to handle the growth therefore operating suites and chemo units will need to be built into the strategic plan.
The five year plan should be more detailed to determine what the expansion of the oncology center will include. The largest area that seems to have been missed altogether is the general education and screening for cancer prevention and control. There should be community education on sites to screen as well as lifestyle modification including diet, exercise and nutritional education to prevent and control disease thus improving outcomes and lowering costs. Community education has been noted in the five year plan under the strategic plan but nothing is being addressed yet.
As with oncology, the team has been already looking to recruit additional physicians for cardiovascular services. These efforts are already underway and have been established as a priority in the strategic plan. Cardiovascular services are going to have a need for additional facilities as well to house new cath labs, surgical suites and cardiac rehab areas. Two additional cath labs and cardiac rehab expansion has been budgeted as a capital investment in the five year plan. However, there is no mention of new surgical suites to support the increase in angioplasties and other cardiac procedures. Community education is another area that has not had a very specific focus and lacks quality programs to help with early prevention and detection. There needs to be specific programs that focus on lifestyle modification and nutritional education that promote healthy living and disease prevention.
Recruitment has been recognized for all services hospital wide as current resources do not support the expected growth. Interviews with orthopedic and neurosurgeons are underway and show that Trinity Community realizes the importance of planning for additional resources to treat the vast expansion that is expected in the next five years. A capital investment has been planned for expansion of a new physical therapy/rehab center and expansion for radiology and another MRI. However, there is no mention of expansion of facilities to house any surgical suites to encompass the expected demand for outpatient procedures.
There is not an established plan to hire and incorporate patient care coordinators in the orthopedic service industry to help ensure that services are scheduled in a timely fashion. Patient care coordinators could be planned for many areas of Trinity Community Hospital. Community education for orthopedics is a great need in the community and has not been incorporated in the five year plan. The subject of many activities should be targeting seniors and for accident prevention and nutritional guidance that leads to a healthy lifestyle. Educational programs targeting athletes on fitness techniques and weight management programs can be very beneficial for the community.
B. Trinity Community Hospital Health Planning Summary
The missing piece covering all three service areas seems to be community education outreach services. There is a real need for educational programs focusing on healthy lifestyles, nutritional education and disease prevention. There are a few things that Trinity Community can do to cover this need. There should be a central educational department devoted to the differing needs: nutrition, disease detection and prevention, healthy lifestyles that focus on good eating habits and exercise, fitness and accident prevention. Each month, the facility should have a main theme and have a few seminars with a speaker that discusses the need in greater detail. Having someone onsite to help facilitate the meetings and offer assistance would be a great service. The facility could team up with the local YMCA to offer other services as well like fitness classes and training techniques.
The company could offer a corporate discount membership to the YMCA to promote joining and then collaborate to offer other incentives. There could be other discounts for walking club, nutritional challenges, weight loss contests etc. In addition to the above, Trinity Community could devote a council to education and speak at different community events on different disease detection, prevention and management. The facility could really spread the educational programs throughout the community quickly and hit many key business leaders. Another area that needs focus is ensuring that all the facility and equipment needs are covered in the capital investments in the five year plan. Oncology – the $8,000,000 expansion of the oncology center needs to make sure that it covers the need for chemo units and operating suites along with being equipped to handle the 34% increase in demand that is expected.
It covers renovation of vacant space however senior leadership should make sure that five year plan is covering all the needs identified in the community health assessment. The expected demand for orthopedic services is vast and the five year plan doesn’t fully cover what it should. The need for oncology services however does not outweigh the need for orthopedic services however the amount of money being set aside does not correlate with those demands. It may be smart for Trinity Community to rethink the five year plan and transition some of the capital investment funds to orthopedics. The newly distributed funds could cover a new facility that would not only house physical therapy and rehab, but would allow for additional cath labs and surgical suites to cover the 350% increase of outpatient joint and spine procedures.
Lastly, it appears that there are issues with scheduling procedures in a timely fashion and getting patients the care they need when they need it. Trinity Community should hire a group of Patient Care Coordinators designated for each specific service to ensure that patients are getting timely scheduling of tests, treatments and other services to help the flow of the department. This is a need that was present in all these service areas identified and should be priority in the five year plan. This could help improve patient satisfaction and retention and help keep patients so that the expected demand comes through their doors and not another facility.
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