SAINT SOPHIA
COMMUNITY HOSPITAL
OPPORTUNITY REPORT
BENZ, CUNNINGHAM, HOGAN, URBAN
1
CONTENTS
1
Executive Summary
2
Introduction
3
Market Overview
4
Competitive Differentiators
5
Physical Specifications
6
Financing Plan
7
Medical Services Plan
8
Patient Demand Forecast
9
E-commerce
10
Equipment Requirements
11
Inventory Management
12
Human Resources Overview
13
Revenue Analysis
14
Three-Year Financial Analysis
15
Process Maps
16
Overview of Data Sources
17
Final Summaries
18
Related Works
19
Appendices
2
1 EXECUTIVE SUMMARY
Saint Sophia Community Hospital is scheduled to open its doors on February 1 st,
2015 in Flushing, New York. The hospital, spanning 70,000 square feet,6 will include
both general hospital amenities as well as a specialized children’s section filled with
talented and experienced professionals in pediatrics. Saint Sophia’s will be a
revolutionary flagship in the healthcare industry, featuring only the latest in information
technology and sustainable practice standards. This document outlines the investment
opportunity to you, the investor.
Market Overview
Saint Sophia will implement a wide and shallow approach to a market. This
approach will be essential due to a large population in the Queens Country area. The
merits of this tactic are further confirmed by a need for a Children’s specialty hospital in
which Saint Sophia is able to offer both.
Competitive Differentiators
Saint Sophia recognizes the increased desire among people for luxurious long
term care units, green initiatives, as well as an opportunity within the market to develop
a nursing program within the hospital in partnership with a local university. The need for
a Children’s hospital is supported by a lack thereof within the market and proceeding
Queen’s area. Saint Sophia will use these opportunities to differentiate itself from
competitor hospitals like Saint John’s, located three miles north-west.
3
Physical Specifications
By purchasing what was previously called the Forrest Hills Hospital, Saint Sophia
will be conveniently located between three major roadways. Thirty percent of the
building will be dedicated towards children’s care and the other seventy percent will be
split between the hospital and the emergency room. In general with 70,000 square feet
to apply, there will be a total of 218 beds, as well as pharmacy for the convenience of
our patients.
Financing Plan
All first year expense for Saint Sophia will be raised through debt in the form of
approximately 300,000 one-thousand-dollar bonds to give the hospital a total of 300
million dollars. This will give patients the best care without issuing dividends to
shareholders.
Medical Services Plan
Saint Sophia will be divided into four main categories, including the General
Hospital, Emergency Room, Laboratory and Clinical Services department, and the
Pediatric Center. Each of these components provides services that are ensured to
decrease wait time, increase efficiency, and offer an interrelated system of staffing and
resources.
4
Equipment Requirements
There will be a large initial investment in order to purchase the medical supplies.
This amount totals to roughly 4.1 million dollars.
Patient Demand Forecast
Inpatient inflow for Saint Sophia will be estimated by using Little’s Law, which
applies census data and industry constants. This is used to break down demand both
by month as well as demand by day of the week. The data from Maine medical is used
to determine demand by medical service.
E-Commerce
Data hosting will be outsourced through the company Rackspace in order to
allow for Saint Sophia to focus on its medical responsibilities and ensure that its data is
safe and secure. Saint Sophia will utilize an electronic triage system in order to increase
efficiency and cut down on wait time. Saint Sophia will also apply biometric scanning to
protect client and personnel secured information. There will also be electronic payment
plans to benefit the customers. Saint Sophia will apply an intranet system for the fast
and efficient communication of hospital messages. For marketing services, Saint Sophia
will also have a professional Twitter as well as hiring a small digital agency Room 214.
5
Supply Chain and Inventory Management
The supply chain and inventory management is broken down by ordering,
purchasing consortium, suppliers and distributors, delivery, inventory storage, easy
access kits, stocking and resupplying inventory, and training for inventory and supply
management, and food supplies and inventory. Each of these subheadings explains the
different procedures used to determine that which must be used.
Human Resources Overview
Human Resources overview explains how employees will be motivated, as well
as the recruitment and selection of employees. From the demand forecast the number
of employees employed as well as staffing schedules is determined. Saint Sophia will
also have several different service providers, customer representatives, management
team executives, and other personnel. The cost analysis of the proposed staffing plan is
also included.
Revenue Analysis
The revenue analysis breaks down most of the sales and profits by each service.
This includes a wholesale cost, a forecasted quantity of sales, and a gross profit
breakdown analysis. In addition, there is also a total gross profit.
6
Three-Year Financial Analysis
The income and balance sheets included are applications of adjusted financial
statements, which were retrieved from Maine Medical. These numbers were adjusted by
using a ratio that has been consistent.
Process Maps
Process flows in hospitals are quite complex and therefore need to be broken
down and monitored effectively through visualization techniques such as alerts and
reminders. Therefore, several process maps are included.
7
2 INTRODUCTION
At Saint Sophia Community Hospital, our mission is deeply rooted in a
commitment to quality care and ethical business practice with an emphasis on
environmental sustainability. Our primary mission is to assure that through
patient intimacy, people from all walks of life are able to receive high-level,
comprehensive care in support of both their physical and emotional needs.
Saint Sophia Community Hospital is scheduled to open its doors on February 1st,
2015 in Flushing, New York. The hospital, spanning 70,000 square feet6, will include
both general hospital amenities as well as a specialized children’s section filled with
talented and experienced professionals in pediatrics. Saint Sophia’s will be a
revolutionary flagship in the healthcare industry, featuring only the latest in information
technology and sustainable practice standards.
The purpose of this document is to outline the initial plans pertaining to Saint
Sophia’s operations including a comprehensive financial map detailing how Saint
Sophia will be funded. By reading this document, one will understand the master plan of
the hospital and recognize the financial viability of investing in Saint Sophia’s cause.
8
3 MARKET OVERVIEW
Saint Sophia will take a wide and shallow approach to the market. In doing this,
the hospital will be able to give a wide array of general medical care to both children
and adults within the Queens community. This decision is supported by consideration of
the high number of specialized medical centers within driving distance of Saint Sophia.2
There are ten other hospitals in Queens County. Of these ten, five are teaching
hospitals. These are Jamaica Hospital, Long Island Jewish Medical Center, New York
Hospital, Queens Hospital Center and Saint Johns Episcopal Hospital, and none of
them are affiliated with Saint Johns University. This presents the opportunity for Saint
Sophia to partner with Saint Johns University. Of these ten, none of them offer an entire
wing for children’s care. This also presents an opportunity for Saint Sophia, due to a
large population of children within the area.
The market that we have decided to enter is comprised of the residents of
Queens, New York, which has a population of about 2.2 million people.
Demographically, the area is mainly white and black with 40% and 19% population
shares, respectively.5 The current trend in this market is presenting an increased desire
among long term patients for more comfortable and luxurious care rooms. Private
rooms have been said to lower infection rates and allow patients to rest more as they
heal. For this reason, Saint Sophia will be providing these types of rooms in the Long
Term Care Unit of the Hospital to remain competitive in this market with this trend.
Also, 23% of the population is 19-years-old or younger, which means that 23% of
the population qualifies for care through the Children’s Hospital.5 For these reasons, our
9
hospital will be home to two wings, one of which will be a general hospital complete with
a level-two trauma center. This trauma center will offer 24-hour immediate care by
general surgeons as well as coverage by the specialties of orthopedic surgery,
neurosurgery, anesthesiology, emergency medicine, radiology and critical care. This
wing will also be home to the emergency room. The emergency room will offer the
following care:

Basic treatment for minor to major illnesses

Definitive treatment of minor to moderate traumatic injuries

Attention to major trauma and major illnesses such as heart attacks, strokes,
seizures, and internal bleeding

Medical emergencies such as drug interaction, chest pains,
obstetrical/gynecological emergencies, as well as emergency psychiatric
treatment

Pediatric ailments

Treatment for injuries in occupational and industrial medicine (such as on the job
injuries or illnesses),

Sports medicine
The nursing staff of Saint Sophia’s will be specially educated in the areas of
Critical Care, Trauma Nursing and Ambulatory Services. All nurses will be ACLS
(Advanced Life Support) and PALS (Pediatric Advanced Life Support) certified.
10
The second wing of our hospital will be specialized in care for children. It is
customary for Children’s Hospitals to offer resources such as social workers,
therapeutic recreation, medical interpreters, as well as chaplain and spiritual care.
Clinical social workers will give emotional support to families and children in crisis
or during a long hospital stay. They will also assist with problems associated with
healthcare issues, including financial pressures. At Saint Sophia’s families may request
the involvement of a clinical social worker at any time during their children’s stay. The
Therapeutic Recreation/Child Life program will be staffed by specialists who help
patients and families adjust and cope with the hospital or clinic setting, illness or injury
and the treatments involved. 13
Saint Sophia’s will take advantage of its specialists’ knowledge in using play,
recreation, and educational techniques to assist children and families. Therapeutic
Recreation/Child Life services will also be available to patients at Saint Sophia’s
Children's Hospital at no extra charge. The Children's Hospital will offer interpretation
services to patient families who do not speak English or who are deaf or hard of
hearing. Our interpreters will help to ensure that families understand their child’s care
and medical circumstances. Nurses will act as ambassadors for this service.13
The Spiritual Care Department and nondenominational chapel will be located on
the first floor off of the main lobby of Saint Sophia’s. Patients and families can meet with
a pastor for counseling and spiritual support. Pastors will help with difficult questions
involving ethical principles, religious or cultural beliefs.13
11
The Children’s Hospital wing will offer comprehensive care and rehabilitation in
all clinical areas for infants, children and young adults. The Children’s wing will offer a
wide variety of services including treatment for immunology, pulmonology, pathology,
hematology, endocrinology, pediatric cancer and blood disorders, and baby nursery.13
4 COMPETITIVE DIFFERENTIATORS
Saint Sophia Community Hospital shall be deeply devoted to the diagnosis and
treatment of pediatric cases and have on staff professional personnel especially
qualified in the diagnosis and treatment of the diseases of children. This means the
introduction of a two-winged hospital with one unit being the Emergency room and the
other a designated Children’s Wing. Saint Sophia is offering kids and their families a
more intimate, comfortable, and unique healing and treatment process than found in
traditional hospital settings. 23% of the population of Queens is made of people under
the age of 19, which means that almost one quarter of the population can be treated in
pediatric care.5 The facility will include rooms, staff, technology, and equipment to be
able to cater to a more personalized and enjoyable experience for the patient. The
children’s wing will remain as a separate entity to the main hospital, and will include
separate entrance doors and emergency room. This will provide less congestion to the
emergency department, which is a common pain point to hospital visitors. This will also
provide a faster patient processing method so the time of arrival and seeing a doctor
can be cut down.9
12
The children’s wing will provide an experience that is unique, including rooms
with color therapy, a bright atmosphere, and pediatric specialists. The following passage
by Colorado Children’s Hospital captures the importance of pediatrics:
“Children’s Hospitals are known for their incredible care. There are over 5,750
hospitals in the United States, but fewer than 250 specialize in pediatrics.
Pediatric experts are also more likely to have seen even the most rare diseases,
illnesses a doctor who works mainly with adults may never see in an entire
career. Illnesses and symptoms are influenced by the age and size of a patient.
Diagnostic tests and treatments are also different. Blood lab work is also
different. Children have less blood—a lab set up to test with smaller samples
helps a child avoid possible multiple draws. Another example would be x-rays.
Kids' bones have growth plates, making their x-rays harder to read and setting
the bone properly more critical. Getting the x-ray right the first time and with as
few films as possible help protect your child's long-term health. Reading the x-ray
correctly and setting the bone properly when a growth plate is involved are
critical to normal growth in that bone. There are also differences in language and
cognition. Often a child can't express or explain what's wrong, which makes
diagnosing a child very different from an adult. It's also common for kids to
confuse fear with pain, but a professional with the training and practice to
recognize the difference between fear and pain in a child—and the skills to ease
that fear—may be able to avoid unnecessary medication.”13
13
Saint Sophia Community Hospital will be Leeds Certified, acknowledging the
sustainability the hospital will maintain. The hospital will be recognized for its advanced
standards for measuring building sustainability. The overarching goal is to maintain
sustainable sites, water efficiency, energy and atmosphere, materials and resources
and indoor environmental quality throughout the whole facility. Achieving Leeds
Certification is the best way for you to demonstrate that our building project is truly
"green." The certification shows the patients, employees, and all other stakeholders that
our hospital is not only protecting the people it serves, but also the planet in which we
live.4
There will be a green garden on the roof of the hospital that provides fresh
produce and vegetables to the patients, and staff throughout the entire complex. The
structural elements and production of the green garden are shown in Appendix M4. This
fresh produce will enhance the conditions of the patients, by furthering their nutritional
benefits, and provide them with the cleanest and freshest ingredients possible. The
cafeteria, kitchen, and break rooms will all be well supplied by nutritious and tasty fruits
and vegetables grown onsite. The garden partially eliminates distributor and supplier
costs that would have been incurred through outside sources for food. This will help to
achieve cost savings up to 22%. The hospital would also incur fewer costs and other
side effects related to the travel and transportations of food products.4
The Hospital will be designed to take advantage of as many environmentally
beneficial resources as possible. New York’s high skylines will make the implementation
of solar panels viable.5 The prospected program would be created in order to extend all
14
over the East Coast, where green initiatives and sustainability are currently lacking. 14
The design of the hospital will also involve a vast number of windows to provide natural
light. This will reduce the cost of lighting and provide the patients and staff with a higher
level of psychological capacity due to natural lights effectiveness at improving
happiness, alertness, and overall health. This will provide costs savings of up to 30%63.
Saint Sophia will be able to tell if these efforts are being achieved due to the existence
of payback on the efforts. The current market trend for payback on the reduction of
energy consumption is present within six months.64 The hospital will also utilize as many
ways possible to cut down on waste. This includes using recyclable products where
substitutes are available, but making sure to not reduce the quality of the product. This
will be seen with paper towels, cloths, plates, bowls, petri dishes, and anything else
possible, that does not adhere to the spreading of diseases or infection.14
Saint Sophia Community Hospital will have a premier Nursing Program that
would create a strategic partnership to expand the nursing education programs. This
would not only be a competitive differentiator for the hospital, but also the surrounding
universities. The hospital will explore innovative and effective collaborations that expand
traditional clinical education boundaries and lead to new opportunities for nursing
education and practice. This initiative helps our hospital in creating a brand image
across the country, in turn increasing the amount of traffic to local colleges/universities
such as SUNY schools. Expanding on the brand of Saint Sophia, one of the largest
ways in the present market to create brand awareness through social media. "Patients
are bonding with their network of providers, and wellness programs are deploying
social apps for activity and calorie tracking with inspiration coming from healthcare15
based rewards to gamification. And, patient-to-patient dialogue has never been greater
through social health networks” states a KBM Group whitepaper.65 Through these sites
Saint Sophia will be able to measure the success of the branding efforts. The hospital
would act as a feeder program to supply future nursing jobs to the students who
complete the program. Saint John’s University in Queens currently offers degrees from
its College of Pharmacy and Health Sciences. Available majors include Clinical
Laboratory Sciences, Paramedic Program, Pharmacy, Physician Assistant, Radiologic
Sciences, and Toxicology.24
However, adding another distinguished program to attract students could be
done through a nursing program partnership which would give them a competitive
advantage. This partnership markets the hospital to the public, creating a positive image
of the hospitals values towards the community. In return for partnering, donors and
alumni are more inclined to donate and help fund programs in the hospital and provide
more resources.24
Access to an acute care setting is ideal for implementing faculty-led research
programs. Collaboration could result in grants, contracts, and income to the hospital,
while the college will benefit from an annual substantial gift from the hospital to support
college personnel. The long-term goal of the hospital relies on graduating more nursing
students and improving attrition rates. Saint Sophia will be able to measure the success
of the program’s efforts based on increased graduation and placement rates.
Implementation of a nursing program helps with the transition from student to staff. This
helps smooth out bumps that occur in training new employees because they will already
16
know the ins and outs of the hospital and its operations. The creation of a partnership
affects all stakeholders who are involved with the hospital.24
The creation of a nursing program helps address the current nursing shortage by
providing members of the community and surrounding college opportunities for job
growth and development. This is a sustainable strategy needed by the nursing
profession. The program will assist in facilitating the design of new models of care and
requisite training to reflect consumer needs and efficiently manage nursing practices.
Saint Sophia Community Hospital will have an advanced state of the art triage
system that will allow the process to be completely digitized. The health burden on
emergency services throughout the world is increasing, patient expectations are rising,
and all organized care systems are having to cope with the problems of increasing
demand, increasing financial pressures, limitations on staff, and an ability to apply ever
more complex medical processes to save the lives of patients who previously would
have been non‐survivors.24
A computerized version of the current triage process has been developed to
include additional parameters, such as location data, and provide a way to easily
transfer the data collected. This system allows for more rapid and efficient management
of victims in disaster areas, and thus, increases the potential for saving lives. This factor
will lead the way for our Emergency Room to make the Honor Roll, distinguishing the
hospital as a premier leader in healthcare across the nation.16
17
The general hospital wing of our hospital will offer superior long term stay care.
We will accomplish this by providing our customers with extraordinary rooms and 24hour staff to ensure that our patients are receiving consistent and quality care. as
mentioned earlier, luxurious long term care units are becoming a demand in the current
market. The Long Term Care Unit offers professional skilled nursing services in
protected and home-like rooms. The Long Term Care Unit will also offer medically
supervised health care, as prescribed and ordered by your family physician,
consultations and participation in your care plan by a professional team of care givers,
activities program which includes physical therapy, family gatherings, outings, and
activities to enhance mental, emotional and physical well-being and easy access to
other medical services (co-located in hospital facility).
18
5 PHYSICAL SPECIFICATIONS
Saint Sophia Community Hospital will be located at 102-01 66th Road in Forrest Hills,
NY, which is in Queens County. The building, previously called Forrest Hills Hospital
and LaGuardia Hospital, will be purchased using the money raised by the sale of bonds
for the price of $22 million. Saint Sophia’s new home is ten stories tall and
approximately 70,000 square feet. The hospital is conveniently located between three
major roadways: Queens Boulevard, Grand Central Parkway, and Long Island
Expressway, as depicted in the map below.6
SPACE PROFILE
As stated earlier, Saint Sophia will be home to both a general hospital portion as
well as a portion of the hospital dedicated to children’s care. Census data indicates that
23% of the population is 19 years or younger, showing that 23% of the population
19
qualifies for care through the Children’s Hospital.5 For this reason, Saint Sophia will
allocate approximately 30% of the hospital space to the Children’s Hospital. This
decision was made in order to offer families larger rooms in order to ensure comfort
during the duration of a child’s stay. The Children’s Hospital wing of Saint Sophia will
receive 21,000 square feet of the 70,000 square feet available for use. This space will
be divided amongst the children’s rooms, the operating room in the children’s wing, and
additional room for waiting areas and nurses’ stations. Each of the children’s rooms will
be single room suites measuring approximately 500 feet in size. Saint Sophia will offer
35 single children’s rooms for overnight guests totaling 17,500 square feet. The
children’s operating room will be 1000 square feet. This is larger than the operating
rooms within the emergency room and the adult portion of the hospital in order for more
specialty surgeons and doctors to be present for the children’s care. There will be 2500
additional square feet within the children’s portion of the hospital for nursing stations,
offices, and waiting rooms.1
The remaining 70% of the entire hospital space will be split between the general
hospital and the emergency room. The general hospital wing will also be home to an
operating room which will be 800 square feet. There will be a total of 85 overnight
rooms in the general hospital wings with 50 of those rooms being semi-private,
measuring 400 square feet each. These semi-private rooms will occupy 20,000 square
feet. The other 35 overnight rooms will be single rooms measuring 300 square feet,
totaling 10,500 square feet. Saint Sophia will also offer a small pharmacy for the
convenience of the patients. This will be approximately 1200 square feet. There will be
5500 additional square feet remaining within the wing for other uses.1
20
The emergency room will contain an operation room which will measure 800
square feet. The emergency room will also be home to 24 double rooms measuring 400
square feet each. This will account for 4,800 of the square feet available. The remaining
2,800 feet will be used for other uses.
6 FINANCING PLAN
The following table details the operating expenses and capital expenditures for
Saint Sophia’s first year, 2015. These numbers are based on Main Medical’s 2013
budget report, adjusted for Saint Sophia’s by square footage.1
Departments
Operating Room
Routine Services*
Emergency Room
Maintenance
Equipment
Salaries
Supplies
Energy
IT
Industrials
Healthcare
Materials
Food Services
Laundry Services
Pediatrics
Grand Total
Total Expenses/Year
$43,719,884
$55,108,204
$10,936,640
$4,540,263
$136,995,853
$143,900,667
$45,412,612
$1,218,333
$2,448,667
$1,330,667
$1,375,667
$801,333
$2,500,000
$68,016
$9,488,333
Capital Expenditures/Department
$11,804,369
$14,879,215
$2,952,892
$1,225,871
$36,988,880
$38,853,180
$12,261,405
$328,949
$661,140
$359,280
$371,430
$216,359
$675,000
$18,364
$2,561,850
$124,158,188
*Adults, Pediatrics, ICU, Neonatal, Coronary Care, Nursery
The next table details the wage expenses of Saint Sophia’s. Again, these numbers are
based on Main Medical’s 2013 report, adjusted for Saint Sophia by bed count. Number
of employees per department was based on floor area for each department. 1
21
Hours/ Hourly
Department
Week wage
Total Wage
Expense/
Week/
Employee
Number of
Total
Total Wage Expense
Employees/ Hours/Week/
/Department/
Department Department
Week
Pediatrics
54
$79.67
$4,302
36
1944
$154,878
Surgeons
60
$108.36
$6,502
7
420
$45,511
Emergency
Medicine
46
$17.00
$782
12
552
$9,384
General
52
$84.00
$4,368
66
3432
$288,288
Nurses
55
$32.56
$1,791
340
1870
$608,872
Internal
Medicine
57
$52.59
$2,998
20
1140
$59,953
Physician's
Assistants
55
$42.00
$2,310
34
1870
$78,540
Other
Personnel
(Maintenance,
Janitorial)
42
$9.50
$399
95
3990
$37,905
Grand Total
$1,283,331
Funds for acquisition, renovation, purchase of capital medical equipment, hiring,
and all first-year expenses for Saint Sophia’s will be raised through debt in the form of
approximately 300,000 $1000 bonds, amounting to a total proceed of $300 million. In
issuing bonds instead of equity, Saint Sophia will be able to prioritize the best care
without the pressure of issuing dividends to shareholders. The bonds will be
underwritten by Goldman Sachs and will yield payment semiannually. An overview of
the bond offering can be found in Appendix A.
22
7 MEDICAL SERVICES PLAN
Saint Sophia Community Hospital will be divided into four main categories with
various services provided under each category. The break-up of the hospital and the
breakdown of services is created to ensure decreased waiting time for patients,
increased efficiency of all operational elements, and an interrelated system of staffing
and resources that expands the entirety of the hospital itself.
The first component is the General Hospital, which will maintain and operate
organized facilities and services to accommodate one or more non-related persons for a
period exceeding twenty-four (24) hours. This department includes the diagnosis,
treatment or care of patients and will provide medical and surgical care of acute illness,
injury or infirmity and obstetrical care. All diagnosis, treatment and care will be
administered by or performed under the direction of persons currently licensed to
practice the healing arts. In addition, the general hospital will provide a Medical/Surgical
unit, a separate surgical unit with, one operating room, a sterilizing room, a scrub-up
area and workroom. The general hospital will also include Obstetrical facilities, with one
delivery room, a labor room, a newborn nursery, an isolation nursery, and patient rooms
designated exclusively for obstetrical patients.24
The detailed services provided in the General Hospital include both inpatient and
outpatient care in the forms of Primary Medical Care, Acute Care, General Surgery
Podiatry, Prenatal, Radiology and Diagnostics, Renal Dialysis, Maternity, Coronary
Care, Lithotripsy, Medical Social Services, and Pharmaceutical Services. The General
Hospital is set to include an onsite Pharmacy, which is to be utilized for all of the
23
patients in every department in order to provide consistent- quality oriented service by
trained medical pharmacists throughout the hospital.24
The second component of the hospital is the Emergency Room. The Emergency
Room unit includes and participates in the services of, Ambulatory Surgery, a Trauma
Center, Surgical and Orthopedic care, Outpatient Surgery, an ICU, Accident and
Emergency Room and application of the Anesthetics department.24
The third component of the hospital is the Laboratory and Clinical Services
provided within the general hospital wing. This department covers Blood draw, EKGs,
Kit draws, STATs, and Urine collection. Accompanying the Laboratory will be the
Diagnostics unit. This unit will house X-ray facilities, a complete diagnostic, Radiology,
Radiographic unit and Magnetic Resonance Imaging services. The fourth and mostextensive department will be the pediatric center inside Saint Sophia Community
Hospital. This will be a comprehensive pediatric practice providing compassionate care
to children of New York and surrounding areas, from birth through age 21. The
Children’s wing will have a friendly and dedicated staff to keep patients and their
families in the best of health. There will be many ancillary services, including access to
an onsite radiology department, and full laboratory services within the office. The main
services provided in Pediatrics will include: Immunology, Immune system deficiencies,
Pulmonology Services for patients suffering from lung-related and respiratory conditions
including asthma. Pathology and attributed lab services, Hematology, Endocrinology,
Pediatric cancer and blood disorder, and a Baby nursery.24
24
8 PATIENT DEMAND FORECAST
Inpatient inflow for Saint Sophia will be estimated using Little’s Law24 which forecasts
hospital demand by using census data and industry constants. In the model, the
hospital will use the following constants:

N = Neighborhood (Forrest Hills) population served: 84,0005

M = Neighborhood market share: 100%

P = Additional outside population served (surrounding areas): 75,0005

H = Hospitalization Rate: 9%24

L = Average length of stay: 524
Little’s Law tells us the average number of inpatients (denoted as I) for a given day is
given by the following equation:
I = [(N+M)*H*M*L] / 365
Using the constants and equation above, we see that on the average day, Saint Sophia
can expect to have 196 beds filled, or approximately 89% capacity
DEMAND BY MONTH
Using this number (I) as an average baseline, Saint Sophia will use Google search data
for the keyword “hospital” (depicted below) to estimate seasonal fluctuations by month.
Keyword “hospital” search relevance from Google Trends26
25
Here we see a cyclical pattern tied to the months of the year
Through harnessing the data and making the chart above, we can project the daily
number of inpatients at Saint Sophia by month. The results are shown in the table
below.
"Hospital" keyword search index - Google Trends26
January February March April
May
June
July
August September October November December
2004
95
94
94
92
90
98
98
100
99
94
87
86
2005
95
96
95
95
95
98
99
99
100
97
92
84
2006
98
95
95
94
97
97
95
99
94
94
91
81
2007
95
92
92
92
91
96
97
96
93
92
88
79
2008
94
91
90
91
88
89
94
88
90
91
83
80
Overall
Average
92.9
92.9
92.9
92.9
92.9
92.9
92.9
92.9
92.9
92.9
92.9
92.9
Month Average
95.4
93.6
93.2
92.8
92.2
95.6
96.6
96.4
95.2
93.6
88.2
82
Difference
2.69%
0.75%
0.32%
(0.11%)
(0.75%)
2.91%
3.98%
3.77%
2.48%
0.75%
(5.06%)
(11.73%)
Projected
number of
inpatients
201
197
196
195
202
204
197
186
197
203
201
Consulting the table above, we see that we can expect the higher-than-average
demand January through March and June through October. In these months it will be
necessary to staff extra medical personnel (discussed in the HR overview below). Also,
it will be important to always have access to extra medical staff in case of flu outbreaks
and other emergencies that cannot be pinpointed to a certain month.
Historically, the number of outpatients of a hospital is about three times the
number of its inpatients.24 In order to find projected number of outpatients on a given
day, one simply multiplies the number of inpatient admissions (I / L) by three.24
26
173
DEMAND BY DAY OF WEEK
Using the graph and table below (collected from a hospital study by Lapierre et
al27), Saint Sophia will be able to adjust its forecasts to consider fluctuations in demand
that occur throughout the seven days of the week.
Average demand (Lapierre), by day of week
M
T
W
R
F
S
Su
Average Peak Demand
37
43
52
51
54
57
45
Deviation from average
-23.60%
-11.21%
7.37%
5.31%
11.50%
17.70%
-7.08%
Using this borrowed data, we see that the busiest times for the hospital will be
Wednesday through Saturday, with lower volume Sunday through Tuesday. This
information will be especially handy in projecting demand in the emergency room.
DEMAND BY MEDICAL SERVICE
Using and scaling the service data provided by Chris Sprowl of Maine Medical 1,
Saint Sophia can generate the service demand table found in Appendix B.
27
9 E-COMMERCE
In terms of data management, Saint Sophia will outsource its data warehouse
through a company called Rackspace, which is located in Texas.28 There are several
reasons Saint Sophia will be outsourcing the data warehouse management. The first
reason is due to the sheer amount of data. The data will include patient information
such as treatment, records, and most importantly, the personal information regarding
payments such as credit card information.1
As a hospital, Saint Sophia’s primary objective will be focusing all its energy on
the treatment and care of its patients. Saint Sophia should focus on treatment and
operational efficiency and not expend its own resources managing the mass amounts of
patient information and data. In addition, Saint Sophia will be outsourcing its data
warehouse, because building a data warehouse is a very complex venture; the
technology is not something that can just be bought off a shelf and installed.1, 28 Also,
this technology can be very expensive and difficult to implement and maintain. This
technology is also constantly updating, and Saint Sophia doesn’t want to spend energy
outside its expertise trying to keep astride with ever-advancing technology.1
Outsourcing data management to Rackspace will remove this stressor and make
sure professionals who specialize in this technology are tending to Saint Sophia’s
technological needs. The third reason Saint Sophia will be outsourcing a data
warehouse is to mitigate risk: Saint Sophia is already a high-risk business involving the
treatment of its patients, and the last thing the hospital needs is increased risk involved
with maintaining client information. Outsourcing will allow a company who specializes in
28
the protection of information do what it excels in and allow Saint Sophia to focus its time
and energy of the treatment of its patients. Another risk avoided through outsourcing is
the possibility that our own trained personnel could leave the company and leave Saint
Sophia without any experts in data warehousing, thus leaving Saint Sophia in a bad
position.1
Rackspace also provides both exceptional online security and physical security.
In terms of online information security, Rackspace will help Saint Sophia by using their
online security model consisting of four main steps: Plan, Do, Act, Check. 28 Rackspace
will also help Saint Sophia develop a disaster recovery plan, which helps back up all the
data and information Saint Sophia collects and also compensates Saint Sophia for any
data lost in the event of a natural disaster. Another reason Saint Sophia will be using
Rackspace is the service’s provision of great physical security, which is commonly
overlooked when choosing a data warehouse location. Saint Sophia will use Rackspace
based on its geological location in Texas, where there are relatively fewer natural
disasters or hazardous events than the rest of the nation. 1 There are other companies
that provide similar services, but they are located on the West Coast by fault lines that
are prone to earthquakes. Other companies located on the coast and are in the danger
zone of hurricanes and are prone to flooding.1
During hurricane Katrina there was a massive loss of information that to this day
has not been recovered, all do to the improper and unsafe physical location of many
data warehouses, Saint Sophia will be sure that a situation like that will never occur. 1
Rackspace provides a safe location and has great physical security including guards
29
and gated entrance that requires specific identification to get into. Rackspace also has
many safety measures including backup generators in case of power outages to ensure
that their clients’ information is never lost due to electrical malfunctions.28
Finally, Saint Sophia will outsource its data warehousing to Rackspace because
it will cost significantly less than managing its own data. Investing in enough people with
the right skills to manage Saint Sophia’s data and data warehouse can take away a
great amount of funds and resourcing away from other important hospital operations.
Outsourcing to Rackspace is much more cost effective because they already have the
scale, technical skills, resources, and experience necessary to run a smooth data
warehouse operation. The cost for services including use of database, load balancer,
cloud backups, and Cloud Monitoring will come out to about $250 a month. 28
Another important aspect of e-commerce and technology that Saint Sophia will
utilize is an electronic triage system. This system will be similar to the system used by
Kaiser Permanente. Patients will be able to fill out information using their smart phone
or tablet on the way to the hospital. This information will be forwarded to Saint Sophia
where medical teams will have access to this information via tablets that are located in
high traffic areas throughout the hospital. This will allow medical teams more time to
prepare rooms such as the ER and OR before the patient arrives. This system also
provides time to find medical professionals who are available at the time and assemble
them quickly and efficiently based off the descriptions of the situation and the patients’
symptoms. This increased efficiency will also help cut down the wait time and lower the
number of people in the waiting room.
30
Another system Saint Sophia plans to utilize is a biometric scanning system. This
biometric system will consist of finger print scanners that will be located in various parts
of the hospital where high security is needed. This will create a safer environment within
Saint Sophia hospital by making sure specific medical professionals have access to
certain patient files, rooms, and supplies depending on their qualifications. This will
allow doctors and specific medical personal access to rooms such as the ER and OR.
This will also ensure client information is only accessed by certain medical professionals
and is another step in the protection of client information.
Saint Sophia will also be able to record and track which medical professionals
have accessed certain rooms and information. Saint Sophia plans of having one in each
ER and OR as well as at each nursing or main station. This will be an average of six
fingerprint scanners on each floor, or 60 fingerprint scanners total. The cost of each
fingerprint scanner is $150. In total the cost for fingerprint scanners is going to come to
about $9,000.30
One client-specific service Saint Sophia will offer is electronic payment plans.
This will include convenience services such as an account tracker for patients to
manage payments and allow them to pay online quickly and easily. These accounts can
also be linked to patients’ insurance providers so that insurance companies can see the
costs being incurred and allow the companies to help with payment through the same
system. In order to implement this system, Saint Sophia will purchase a domain name
through GoDaddy.com and hire a web development company to build and manage the
site. This will cost approximately $6500 a month.31
31
Another E-system Saint Sophia plans to employee is the use of KPIs or Key
Performance Indicators. These KPIs will help Saint Sophia track what it is doing well
and what areas of the hospital operations need more work. These KPIs will cover a list
of different factors spanning from Emergency room conditions, patient care, and facility
management. One of the KPIs Saint Sophia will track is ER wait time. This KPI provides
a detailed analysis of how long it takes from when patients arrive at the ER till when
they are met by an ER physician.
This analysis can be done on both a micro and macro level. On a micro level this
will show Saint Sophia the status of the ER in real time and on a macro level this
analysis will show ER wait times over days, weeks, months, quarters, and years. More
importantly this KPI serves as an indicator to the public on how well Saint Sophia
provides quality health care. Another KPI involving the emergency room that Saint
Sophia will record is the number of patients in the ER. This metric will provide data on
several factors such as patient room number, current wait time, case urgency, and if
they’ve been attended to by nurses or other medical staff. This information will be given
to all the ER staff to show how well performance is within the department.
The final KPI used in the ER will be Current ER Occupancy. Just like the name
suggests, this KPI keeps track of how many beds within the ER are being used at any
given moment in time compared to the amount of total beds. It is essential that this KPI
be monitored in real-time to ensure the Saint Sophia staff is aware of the current
situation and can adjust, adapt, and prepare for developing situations regarding the ER.
This KPI will be useful in situations where a sudden increase in patients occurs. Using
32
this KPI the Saint Sophia staff will know that they are near capacity and will know to
reroute incoming patients.
Another KPI Saint Sophia will keep track of is the average length of stay for
patients. This KPI measures the average number of days a patient stays in the hospital
after a certain procedure. This KPI allows Saint Sophia to accurately predict the length
of stay of a patient. It also allows the hospital staff to pinpoint potential faults or errors. If
a patient is discharged earlier than normal it is a sign that the care provided by Saint
Sophia is outstanding, but if a patient is in the hospital for longer than average it may
indicate there is some sort of error in treatment. Finally, Saint Sophia will use another
KPI called lab turnaround time. This KPI measures how fast Saint Sophia can process
lab results. This KPI is the base KPI for any labs and is a key component and indicator
of patient satisfaction. To perform this KPI each different type of test must be broken
down into its own section. This is typical because different types of tests take different
amounts of time to complete. After these breakdowns are established it will be up to the
Saint Sophia to determine what the acceptable norms are for certain tests.
In addition to the other systems, Saint Sophia will also utilize an intranet system.
This system will allow for the fast and efficient communication of hospital messages to
all the employees working in the hospital. The messages may include information
regarding weather warnings such as heat waves or messages regarding viruses and
infections that are coming up within the past few days, weeks, or months. This will allow
all medical personal to be updated on current trends and help them to be better
prepared for what’s to come. This intranet system will also allow different units or teams
33
from different departments in the hospital to coordinate efforts and make ensure all
teams are on the same page. This intranet system will cost Saint Sophia about $5000 to
create.32
In terms of marketing and exposure, Saint Sophia will create a professional
Twitter page that patients can follow in order to keep up with current events in the
medical field that Saint Sophia will be working on. This Twitter page will also provide a
medium where Saint Sophia can post current trends involving viruses, infections, and
symptoms that patients should be looking for in order to keep healthy. Another
dimension a professional Twitter account will give Saint Sophia is the ability to track and
see what patients or former patients are saying about the hospital in regards to
treatment and overall service. This will allow Saint Sophia to address issues or
complaints patients have as well as retweet the positive feedback patients are saying
about Saint Sophia. Saint Sophia will also use this Twitter page in conjunction with its
official website to advertise the nursing program offered through the hospital.
As Saint Sophia continues to grow and gain popularity, it will hire an outside
company that specializes in search engine optimization. The company Saint Sophia will
hire is the small digital agency called Room 214, located in Boulder, Colorado. Room
214’s objective will be to make sure Saint Sophia appears on the first page of Google
search results based on key phrases like “forest hills hospital,” with the ultimate goal of
being in the top three listings for hospital searches within the Queens area. This will
ensure that the local community is aware of Saint Sophia’s presence in the area and
that awareness grows in potential patients. The cost of services for Room 214 will come
34
out to around $29,999 per year.33 Again, Saint Sophia doesn’t plan on enlisting Room
2014 in the beginning but will rather wait until it has been operating for a few years and
has the discretionary funds to afford this service.
10 EQUIPMENT REQUIREMENTS
The equipment that is being purchased is what is necessary in order to revamp
the Forest Hills Hospital which has been purchased. Forest Hills Hospital was gutted
upon our purchase and all new equipment is needed. Saint Sophia was able to make
these purchase decisions based on the current equipment in place seen in the
documents provided by Maine Medical. The number of units of each item currently
being used at Maine Medical was multiplied by a ratio which reflects the size
comparison of the two hospitals in order to purchase the correct number of units for the
size of Saint Sophia. The equipment is being purchased from large medical distributors
including Cardinal Health, Baxter International, and McKesson. These suppliers are
being used because they are known for their ability to provide quality equipment at
reasonable prices. They are currently used by Maine Medical as well, and this was able
to assist Saint Sophia with consistency. The table included in Appendix C outlines the
detailed equipment needs of Saint Sophia by department.1
35
11 SUPPLY CHAIN AND INVENTORY MANAGEMENT
I. Ordering
The hospital will use requisition forms to create a supplies list, which will be listed
alphabetically and categorized into three sections: drugs, equipment, and consumables.
Requisition forms will be accompanied by specification forms, which will list the
purpose, design and feature, material, accessories, quantity, and safety of each item.
This allows the personnel to customize various equipment kits to include precautions for
patient allergies to specific drugs or materials and to ensure the equipment is
assembled properly and includes all necessary components.46
II. Purchasing Consortium:
Saint Sophia hospital will engage in a purchasing consortium with Forest Hills
Hospital as a part of the North Shore-LIJ System. This will be a vertical consortium in
which major medical equipment and supplies through companies including Siemens,
Cardinal Heath, Guthrie Medical Supply, and Baxter International will be purchased
together.1 This supply chain strategy will allow better purchasing decisions that enable a
higher quality of care in a more cost effective and efficient manner.55 Since 40-45% of
the hospital’s total operating expenses are represented by supply chain and as much as
80% are equipment costs, these cost reductions will allow a flow of funding into other
parts of the hospital for staffing, e-commerce, equipment, and improvements in
innovation. This purchasing alliance allows Saint Sophia to network with other leading
procurement organizations to benchmark best practices and supply market expertise. 47
36
III. Suppliers/Distributors:
Saint Sophia will use a GPO business model to acquire suppliers and create
distribution processes. GPOs allow the hospital to bend the healthcare cost curve by
using high volume purchasing power to secure significant price discounts for the
hospital.50 GPOs aggressively compete with other GPOs to further lower costs and
introduce new and innovative devices to market. GPOs seek to promote historically
underutilized and minority-owned small business; and effectively use competitive
bidding to determine the highest quality device for the best value. Saint Sophia will
partner with the GPO organizations Novation and Premier to institute a collective buying
and cost effective supply process.1
Saint Sophia Community Hospital will obtain the majority of the supplies and
equipment needed, from major distributors including the large medical distributors
Cardinal Health, Baxter International, and McKesson. Saint Sophia will also partner with
and become members of the independent specialized distributors including the
Independent Medical Distributors Association and Health Industry Distributors
Association. This will allow the hospital to receive all of their products from trusted and
nationally owned corporations who work in the premier healthcare sector. 1
Saint Sophia will acquire its major drug and pharmaceuticals from Pfizer, along
with the pharmacy services provided by McKesson, and Cardinal Health. These
providers also include an Asset Management program that contributes directly with the
hospital to:

Free up pharmacy staff time for more productive tasks,

Capitalize on increased cash flow to fund other important investments,
37

Eliminate duplicate or obsolete inventory and reduce waste

Incorporate McKesson and Cardinal Health technology to drive maximum
inventory turns and achieve optimal contract item pull-through56
Below displays a process map for obtaining pharmaceutical supplies from an
outsourced vendor: (Figure 1.1)
(Figure 1.1)
IV. Delivery:
Saint Sophia will use just-in-time programs, which will streamline the receiving
functions. The use of a (JIT) and (LUM) low-unit-of-measure, processes will allow the
hospital to order and receive product in the appropriate unit of measure for direct
transfer from loading dock to point of use. JIT and LUM services will be charged through
the supplier either by the line charge method or overall volume cost depending on the
38
product and quantity needed. These two processes rely on the use of electronic and
automated systems, which will already be integrated into the hospital on either MMIS,
point of use, or ADU platforms. Internal process costs for procurement and ordering are
lower through using a distributor as opposed to purchasing direct from the
manufacturer.52
The order delivery schedule in Appendix D will be filled out and placed on both
Tuesday nights and Saturday nights. The order will be placed on Tuesday in order to
stock supplies for the increase in patients that is expected on Wednesday. From
Tuesday to Wednesday, the demand is increased by roughly 7 percent. The order will
be placed on Saturday night in order to replenish the supplies used during the busy
period between Wednesday and Saturday. This order will be smaller because the
demand is expected to decrease by approximately 25%. Ordering on these two days of
the week will benefit the just-in-time ordering plan because the orders are planned and
placed with regards to the demand of the specific time of the week that they supply
for.57
39
V. Inventory Storage
Saint Sophia will use Advanced Analytics to create a cloud-based inventory
management and supplying process. Saint Sophia will use an advanced point of use
station to allow clinicians to capture critical usage information at the point of care,
automatically adjust inventory, send products to clinical documentation systems and
billing systems, and creating implant logs. The easy-to-use system consists of a
touchscreen with an RFID reader and barcode scanner as shown in (Figure 1.2).49
(Figure 1.2)53
The system connects with existing workflows, which makes it easy to train nurses and
various technicians. The nurse or physician will input patient information at the point of
40
use station by scanning the patient barcode or using an ADT feed, then select the staff
and procedure type. The inventory will be RFID-tagged products that will be linked
directly to the inventory interface to be tracked and accounted for.1
The cloud-based software platform will implement Integrated Advanced
Analytics. This will allow the inventory manager to uncover actionable information to
drive major supply chain savings. Using real-time data delivered via a web browser, so
they can identify inventory cost reduction opportunities by IDN, hospital and product
view year-over-year product utilization changes, trends, waste and savings
opportunities. It will also let them monitor market share of medical devices by physician,
by product type, by cost and by quantity.51
The inventory will be stored in four separate storage rooms built into the general
hospital, emergency unit, surgery, and pediatrics wing. The inventory room will be
organized in a simple and logical way so that items can be found quickly and easily. The
inventory manager will be in charge of securing, packaging and maintaining the
equipment. The equipment has to remain in an area that is clean, free from pests, not
too hot or cold, and well ventilated. The storage room will also always require card
access to not have any of the equipment tampered with, and to make sure the correct
inventory levels are up to date and correct although special personnel will be allowed
access in critical scenarios. Stock cards will be kept in the storeroom. This enables the
person responsible for stock control to update the cards after every transaction
(ordering, receiving and issuing stock). They will then write each transaction on a
separate line, even if there is more than one transaction on the same day. 54
41
VII. Easy-Access Kits
The equipment will be properly packed and checked into easy access kits for
individual procedures and operations. The kits will be color coded by department and
will be checked and maintained regularly by the Inventory manager in order to ensure it
contains all tools and instruments necessary. This process will allow doctors, nurses,
and surgeons to receive their necessary items in a timely and efficient fashion, therefore
decreasing wait time and increasing customer satisfaction.
VIII. Inventory Management:
The inventory will be organized into different sections for different categories of
supplies, for example, drugs, dressings, instruments, medical stationery, equipment and
spare parts, laboratory supplies, disinfectants. The stock will be divided into regular use
and reserve stock, placing the reserve stock on the same shelves behind the regular
use stock. The hospital will keep a reserve stock of instruments that are used
frequently, such as scissors, suture needles and forceps. Stock will be rotated
according to the expiry date using the SLFO (Shortest Life First Out) and FIFO (First In
First Out) rules.46 The items that have the latest expiry date will be at the back and
items with the earliest expiry date at the front.
Inventory Control maintains the Inventory Ledger, which will provide a detailed
audit trail of all inventory transactions. It stores information regarding stock items and
associated quantities, but includes the buyers' accounting distribution for report writing
purposes. All accounting transactions produced by inventory transactions are recorded
and posted to the General Ledger.52
42
IX. Stocking and Resupplying Inventory:
The inventory control system will be will completely digitalized and will be linked
by an intranet connection throughout all departments of the hospital. The system will
track the total amounts of inventory, and will allow staff to monitor the inventory levels.
The head of the department will set limits on the amount of supplies used and needed
so when a piece of equipment is in short demand, a notification will be sent to the
supplier to send over a new order.49 Although there will be resources on reserve, this
process will make sure there is not too little or excess inventory occupying space. This
process will also allow individual department heads to input and customize orders for
inventory based on increased demand or special patient specifications. This will cut
down wait times to receive equipment, cut costs from holding too much inventory, and
allow a better connection between the patient and physician who is responding to their
needs more efficiently.53
Saint Sophia Community Hospital will employ a max-min system, in which the
hospital will set the max and min levels high enough to avoid stock-outs, yet low enough
to not increase the risk of expiration or damage. The system will ensure that emergency
orders are rarely placed, because such orders are time-consuming and, generally,
expensive. The min level will be determined by lead-time, review period, and safety
stock. The min will include the lead-time stock level, based on how much time is
required to unpack and utilize the new inventory. Products with seasonal consumption
will require a continuous review system to ensure that products are not always ordered
unless they are at the min level. Products that are particularly bulky will require higher
min and max stock levels, which require more storage space. For products with an
43
extremely short shelf life—for example, laboratory reagents with a shelf life of three
months—a standard system may not be the best, as the min and max stock levels are
higher, requiring more inventory to be kept, which could increase the chance of
products expiring.55
The use of automation to create purchase orders increases efficiency. The
distributors will provide high velocity commodity items such as dressings, needles,
syringes, catheters, and routine sterile products used in procedures. The majority of
these items is used across multiple clinical areas and is maintained via periodic
automated replenishment (PAR) levels. These systems will be run by automated
distribution units (ADU) to manage the PAR locations. These systems will be interfaced
to their material management information system (MMIS) and automatically generate
purchase orders for routine stock times.47 The sheer volume of the PO lines resultant
from these practices significantly reduces the average per line cost to process orders to
distributors.
In order to effectively forecast the demand for the supplies needed the hospital
will use the following equations:
44
Equations for determining stock levels:
max stock quantity = average monthly consumption × max stock level average
monthly consumption = average of the quantities of product dispensed to users or
patients in the most recent three months, as appropriate.55
Inventory will be monitored on a monthly and yearly basis in order to track and properly
forecast demand. The inventory manager will analyze the current supplies and follow
the following procedure:

Choose products for the patient standardized to the (IC-9) procedure codes;

Assess the need for backup contingency supplies and product options based
on physician product preference and historical data;

Pick the supplies appropriate for that individual case, and groups those
supplies with all other supplies needed for prep, recovery, and follow-up;

Verify the latest contract price and ensures synchronized pricing accuracy
among all supply chain stakeholders;

Determine whether there is a need to replenish supplies either at on-site
stock locations or in the off-site warehouses of a distribution partner;

Aggregate the product replenishment requirements and automatically places
an order;

Communicate usage data to the manufacturer and other stakeholders for
predicting future demand.55
45
The Quantification and forecasting procedure is also shown in (Figure 1.4) below:
(Figure 1.4)50
Training for Inventory and Supply Management:
The hospital will develop training materials to teach the staff how to use the
cloud-based system, manual and job aids; and how to use the corresponding forms to
order, monitor, and manage their health commodities. A logistics system is dynamic and
needs to be flexible to accommodate changes that occur within the program or system.
Continuous quality monitoring, re-evaluation, and improvements to the system will be
fixed processes. To ensure that the system can be adapted to accommodate changes
with minimal disruptions to the supply chain, early identification of issues or changes is
essential.46
46
Food Supplies and Inventory:
Sysco will provide the following food products:
Each product category also has a different supplier that Sysco is contracted with.
1. Seafood
a. Portico brings foodservice operators the highest quality standards in the
industry, in delicious healthful seafood selections. Portico offers a
selection to meet every foodservice operator’s need. And Sysco
guarantees and lists true net weights and species for every Portico
product
2. Dairy
a. Wholesome Farms farm-fresh cream, eggs and other dairy offerings are
typically produced at dairies located closer to our foodservice customers,
resulting in fresher, more dependable products with longer shelf lives. The
Wholesome Farms line includes milk, cream, cottage cheese, sour cream,
butter and ice cream, shell and pre-scrambled eggs and more.
3. Bakery and Desserts
a. BakerSource offers prebaked and finished artisan breads, rolls, muffins
and cookies, as well as dry, mixable ingredients perfect for from-scratch
baked goods.
4. Beverage
a. Citavo coffees and beverages encompass the flavors and traditions of the
coffee-producing world. A variety of roasts is available in both caffeinated
47
and decaf versions, along with creamy European-style cappuccinos, hot
chocolates and fair-trade Citavo organic coffees.
5. Additional Produce to supplement our garden
a. Sysco Natural fruits and vegetables commodity items are the freshest
products available in the marketplace. Inspected daily to ensure optimum
quality and supported by Sysco mandated specifications insuring peak
flavor, color and yield. Similarly backed with Sysco specifications explore
our wide variety of labor saving fresh cut fruits and vegetables.
48
12 HUMAN RESOURCES OVERVIEW
MOTIVATION FOR EMPLOYEES:
Saint Sophia will have four goals for motivating its employees:
1 PROVIDE MEANINGFUL AND CHALLENGING WORK
2 SET CLEAR TARGETS AND EXPECTATIONS WHILE MEASURING
PERFORMANCE
3 GIVE REGULAR, DIRECT, AND SUPPORTIVE FEEDBACK
4 DESIGN PEOPLE’S ROLES SO THEY CAN USE THEIR STRENGTHS
1 PROVIDE MEANINGFUL AND CHALLENGING WORK
Regardless of the actual work that is being done, employees generally want to
feel a sense of:

Achievement

Responsibility

Enjoyment

Recognition
Providing challenging work is motivating for people – the majority of people want
to feel that their potential is being challenged.
49
2 SET CLEAR TARGETS AND EXPECTATIONS WHILE MEASURING
PERFORMANCE
Setting targets, goals, and expectations for behavior and performance needs to
be done, and people need to get regular and timely feedback on how they are
performing against those goals.
3 GIVE REGULAR, DIRECT, AND SUPPORTIVE FEEDBACK
Feedback is needed for continuous improvement and motivates and inspires
people to continually move toward using more of their potential.
4 DESIGN PEOPLE’S ROLES SO THEY CAN USE THEIR STRENGTHS
The goal is to give people specific tasks and assignments that play to their
strengths. Research has shown people who are able to make use of their
strengths on a regular basis while at work are more likely to work in teams that
perform at higher levels.24
RECRUITMENT AND SELECTION OF EMPLOYEES:
Saint Sophia plans to recruit and hire the majority of nurses from nurses within
the nursing program with Saint John’s. This will act as an incentive to encourage nurses
to join the program, as well as go on to teach within the program after graduating. For
the remainder of the staff, Saint Sophia will follow a successful recruitment and
selection plan that enacted by Louisiana Community Hospital and listed below.38
50
1 REVIEW
Following receipt of a resignation or the creation of a new job posting, the manager
must review:





The role of the post
Pay band
Job description
Person specification
Knowledge and skills framework outline.
2 PLAN
The Appointing Officer establishes the selection panel and plans the recruitment
process. This must include:



Advertising dates
Short listing date
Interview arrangements.
3 AUTHORIZE
The manager commences the vacancy authorization (VA) process and notifies
Recruitment Services when approval is given.
4 ADVERTISE
Recruitment Services places the vacancy on the web following the manager’s approval
of the advert.
5 JOB FILE
Recruitment Services manages the applications, closes the job file and informs the
Appointing Officer that the job file is ready for collection.
51
6 SHORT LIST
The Appointing Officer returns the job file along with the completed short listing grid and
interview arrangement form, allowing ten working days to contact candidates and
referees.
7 INTERVIEW
Recruitment Services prepares the interview schedule, sends interview pack to
selection panel and applies for references. The manager should pursue references if
not received prior to interview.
8 SELECT




Interviews held.
The completed pre-employment health questionnaire for the successful
candidate is sent to Occupational Health (OH).
The Appointing Officer makes a conditional offer to the successful candidate
(subject to references, OH, Right to Work, professional registration etc) by
telephone, with written confirmation using template letter.
Unsuccessful candidates are informed by telephone / letter.
9 CONFIRM
The Appointing Officer completes an offer confirmation and returns this to Recruitment
Services with all candidate documentation.
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EMPLOYEES
The following estimate on number of employees staffed is a base number.
However these numbers will increase or decrease based on demand which can be
estimated by month and day of week. The percentages in the table below will be applied
to the base number of employees in order to meet demand.
a. Primary Care, Medical Specialties, and Surgical Specialties
The nurses and physicians will work on 8-hour shifts. These shifts will go from
7a.m to 3p.m., 3p.m. to 11p.m., and 11p.m. to 7a.m. The nurses and doctors will
work within teams. These teams are established in order to promote redundancy.
Redundancy within the medical field builds accuracy. This accuracy cuts down on
time and in turn cuts down on waste. This also allows for patients to receive the best
possible care through well-functioning teams at a more efficient time.1
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By staffing our medical experts in these 8-hour shifts we cut down on exhaustion.
Exhaustion within the medical field is one of the biggest causes of errors: errors that
lead to unnecessary expenses and lawsuits.1
Our surgeons will be on a block schedule of 60-hour weeks. This schedule will
include office hours where they will meet with patients, both pre- and post-operation
as well as time that they will be serving in the operating room performing surgeries,
and time that they will be on call in order to perform emergency operations. 1
The average salary for our nurses is $53,000 yearly. There will be one nurse
staffed for every 4 patients. Based on demand, the hospital will have roughly 50
nurses on staff at one time, should the hospital be at capacity. The average salary
for the physicians is $133,000 yearly. The average salary for the surgeons will be
$275,000 yearly. The staffing plan for physicians and surgeons is based on the
demand of the population of Forest Hills neighborhood plus an additional 75,000
people in the surrounding areas getting captured, as seen in Appendix E. Note: PSA
stands for Primary Service Area.40
b. Service Providers
Saint Sophia will have several different service providers. The dietary and
nutrition services are the first. This will include everyone involved in providing our
patients and staff with food and all that entails. There will need to be roughly 104
people on staff for these purposes. There will be a cycle of three 8-hour shifts which
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will be worked. The shifts will go from 7a.m. to 3p.m, 3p.m to 11p.m, and 11p.m to
7a.m. There will be 104 people on staff for the 7a.m to 3p.m shift, as this time period
will include both breakfast and lunch services. The 3p.m to 11p.m shift will consist of
75 staff to assist with dinner and late night snacks. The 11p.m to 7a.m shift will
contain 45 staff in order to assist overnight patients and staff. These staffing
numbers include the agriculturalists that will work on the garden on the roof. These
staff members will be cross trained to both work in the cafeteria as well as in the
garden in order to ensure that there will always be enough staff to meet the
demands. The average salary of a dietary and nutrition staff member is $43,000. 39
Saint Sophia will outsource its security needs by using Healthcare Security
Services. We have decided to outsource this service because it will save us 10-25%
as well as allow us to put our focus more towards customer care. The estimated cost
for these services is $650,000. We will also outsource the services necessary for
cleaning linens to Image First Healthcare Laundry Specialties. This will cost
approximately $50,000 per year.1
Saint Sophia will also be outsourcing the services for our pharmacy. This will be
done through Cardinal Health and should be an expense of roughly $2,500,000.44
c. Customer Representatives
Customer service representatives are available both in-house and in the
Emergency Department 7-days-a-week: Monday through Friday from 8 a.m. to 12:30
a.m. and weekends from 11 a.m. to 11 p.m. There will be two shifts for this position.
During the week, one shift will go from 8a.m to 4p.m. and the second will go from
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4p.m. to 12:30a.m. On the weekends the shift will go from 11a.m. to 5p.m. and 5p.m.
to 11p.m.38
If Saint Sophia were to have a maximum of 218 inpatients, and each staff
member were to attend to roughly 10 patients, there would need to be 22 people
staffed for each shift. This would require that at least 44 be employed. The average
salary of a customer service representative is $52,000.
d. Management1
Saint Sophia will have several top-level executives. These staff members will
work from 7a.m. to 6p.m. daily. Their titles and salaries are as listed in Appendix F.
e. Other (e.g. administrative support, facility maintenance)
The other staff necessary for Saint Sophia will be broken down between what is
necessary for the general wing of the hospital, the pediatrics wing, and what will be
needed in both. This is due to the different specialties offered in each wing.
GENERAL WING37
Within the General Wing of the hospital, there is the long term health care unit.
This unit offers care givers. These care givers receive a median salary of $10 an hour.
These staff members will also be employed to work 8-hour shifts beginning at 7a.m as
explained earlier. There will be 15 staff members working for each shift. This requires
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that at least 45 care givers are employed to fulfill this need. This would make for a total
salary of roughly $30,000 per year. Within the long term care unit, there are also
activities program leaders. These employees will only work during the day, 9a.m to
5p.m. There will be 10 on staff at a time, and there will be 15 employed in order to deal
with demands. The average salary of an activities program leader is $50,000. The long
term care unit will also offer therapy for the patients. There will be five therapists on staff
at a time and they will also work 9-to-5 days. The average salary of a hospital therapist
is $55,000.37
PEDIATRICS WING
There will be social workers offered within the Pediatrics Wing. There will be ten
social workers employed but on a given day, five social workers will be staffed for a
9a.m. to 5p.m. There will be five on staff at a given time so that if the wing is at
maximum capacity of 35 patients, each social worker will be dealing with a maximum of
seven cases. The average salary of a hospital social worker is $55,000. This wing will
also offer a specialist for the therapeutic recreation program that will help patients and
their families adjust and cope. These staff members will also work from 9a.m. to 5p.m.
There will be five on staff at a given time for the same reasons as with the social
workers. The average salary of these specialists is $50,000.35
ENTIRE HOSPITAL
For the entire hospital, there will be a total of six inventory managers. Three of
the inventory managers will be in charge of managing inventory and the other three will
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be in charge of managing deliveries and working with the suppliers. These managers
will work from 9a.m to 5p.m., 7 days a week. The average salary of these inventory
managers is $92,000.
There is also a need for the entire hospital to have medical interpreters. There
will be six medical interpreters staffed for the pediatrics wing on a given day. There will
be two for each of the 8-hour shifts as explained earlier. The general wing will have
twelve medical interpreters staffed throughout the course of the day because there will
be four staffed during each 8-hour shift in order to meet the needs of the patients. The
average salary for these employees is $85,000.36
Saint Sophia’s will also have chaplains and spiritual care. There will be a total of
22 spiritual aids on staff to assist with our patients. This would mean that should Saint
Sophia be at maximum capacity, each spiritual care provider would have a maximum of
ten patients. These staff members will work from 7a.m to 11p.m. Eleven employees will
work from 7a.m. to 3p.m., and eleven will work from 3p.m. to 11p.m. The average salary
of these employees is $52,000.
There will also be facility maintenance workers. A team of three can cover 10,000
sq. ft. per hour. There will be three workers for every 10,000 square feet per every eight
hours, meaning that Saint Sophia will need to employ at least 63 workers. The average
salary of these workers is $50,000.35
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Cost analysis of proposed staffing plan including labor/benefit costs by employee
type
Saint Sophia will be self-insured but will work with a third-party administrator,
Anthem, to assist with insurance plans for employees. Saint Sophia will offer employees
a group of benefits including health insurance, unemployment insurance, dental
insurance, disability insurance, and an option for life insurance. Based on what are
costs to have each of these benefits offered, an aggregate estimate as to what it cost
for each employee is an additional 34% of their salary. The cost to provide benefits for
per employee is listed in Appendix G.
13 REVENUE ANALYSIS
The revenue analysis table for operations of Saint Sophia can be found in Appendix H.
These documents.
14 THREE-YEAR FINANCIAL ANALYSIS
The projected financial statements for Saint Sophia in 2015 – 2017 can be found in
Appendix I.
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15 PROCESS MAPS
Process flows in hospitals are quite complex and therefore need to be broken
down and monitored effectively through visualization techniques such as alerts and
reminders. Alerts and reminders can be used to support some of these activities. More
specifically, they can be used to monitor which tasks have been completed, which tasks
are still outstanding, and which tasks will still have to be completed in the future.
Following the breakdown of processes into their three main process views, and also
following the breakdown of visualization techniques into their elementary components, it
is possible to meaningfully apply certain alerting and reminding techniques to each
process view.
Every process requires special preparation and customization and must cater to
the needs of the patients, nursing and floor staff, and physicians. Patient needs include:
cleanliness, safety, privacy, peace and quiet, dignity, access to bathroom and shower,
sense of being observed, entertainment, access to nurses, comfort, lighting, and
accommodations for visitors. Nurse and floor staff needs require: easy access to
patients, patient information, minimize walking distances, communication with patients,
ability to move beds and equipment, security, easy disposal of supplies, privacy, and
access to medications. Lastly, physicians needs include: patients and information easy
to find, spaces to confer privately, proper equipment, access to clerical support, and
most importantly communication.
The process maps featured below and the increased use of techniques benefit
the hospital; they improve patient care, optimize hospital equipment and reduce costs
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significantly. Logistics management greatly impacts its cost and as technology becomes
more advanced, medicines become more expensive and human resources come at a
higher price, rendering advanced health care with modern diagnostic tools, medicines
and trained professionals comes at a very high cost.
Patient Call Center
The patient call center is a fundamental process to the customer experience and
is necessary for an efficient hospital. This process begins with information specialists.
Then the call is transferred to get more information, then to a telephone consult, then to
a telemedicine consult. This can also be passed along to a nurse, which give a
diagnosis or pass the call along a physician for more information. This process is shown
in Appendix J1.
Admissions Process
The admission’s process, shown in Appendix J2, is where the patient checks in,
fills out necessary forms, and is admitted to the hospital. This process is essential
because it leads into all of the other process flows throughout the hospital, after the
patient has been admitted. This process must be done in a timely fashion to ensure an
efficient flow of patients in and out of the waiting room.
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Patient Check-in and Flow Process
Patients will check in, shown in Appendix J3, and immediately be entered into the
system and assessed to move treatment and analysis along efficiently. Their documents
will be sent to the physician and a copy put on file for the computer system. Once a
patient has checked in they are carried through the triage system, evaluated, and sent
into the treatment processes and channels.
Triage System
The patient triage system, located in Appendix J4, begins as soon as the patient
arrives. As you move through the patient assessment, sequentially the nurse evaluates
the current status for respirations, perfusion, and mental status (RPM). A physician
either assigns the victim a classification or moves to the next level of the flowchart. The
triage system dictates the treatment needed for the patient and the extensive next steps
that follow. Saint Sophia is implementing electronic systems so that patient wait-time will
decrease and the hospital processes will run more efficiently.
Physician Rounds Process
The physician round, diagrammed in Appendix J5, begins and a computer is
necessary. The physician reviews the chart and sees the patient. If medication is
necessary, an order is placed and the nurse must approve the order. Then a pharmacist
must receive, approve, and complete the order. The areas highlighted in yellow are
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focal points the hospital will specify in order to make the process more efficient and
timely.
Medication Procurement Process
The medication procurement process is one that is used for getting medication
for patients. This process is displayed in Appendix J6. The medication is ordered on the
patient’s chart. It is then routed and given to the nurse. The nurse then gives the
medication to the patient and must document it on the MAR.
Operating Room Patient Flow
The operating room patient flow process is diagrammed in Appendix J7. It begins
in pre-admission, which consists of scheduling and registration. Next, the patient goes
through intake and admission. This process consists of payment, screening, weight
checks and blood test. Next the patient is taken for treatment. At this time materials
must be purchased, anesthesia is given, and physicians come in for support. The last
stage is discharge. This relies heavily on the family and the physician must be
consulted.
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Lab Test for Patient Procurement
If a patient needs a lab test they will go through this process map, shown in
Appendix J8. The physician will circle the test on the charge chart, which will be given to
the nurse. The nurse will fill out necessary forms and escort the patient. The specimens
will be collected and the lab staff will complete the tests. Then the results will be sent to
the clinic and the physician will review the results. These results will dictate further care.
The yellow areas highlight where current delays occur, and then emphasize
adjustments in order to streamline and make the process more efficient.
Patient Record Procurement
The following process will occur for patient record procurement, diagrammed in
Appendix J9. The patient’s records will be pulled the previous day. Then the records are
delivered to the lab and more lab tests will be performed. These results will be placed in
the record via computer. These results are key to placing orders and inquiring into
results.
OR Assembly Process
The decontamination of instruments will be done through the following process,
shown in Appendix J10. They will begin in the OR and will be separated. Then they will
be placed on racks and necessary washing processes will occur. The instruments will
then be taken to the assembly room.
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Assembly Room Flowchart
The assembly process for the OR is outlined in Appendix J11. Supplies will be
placed in the washer. Then they will go to the waiting rack before going to the assembly
station. Once in the assembly station, it will be decided if more instruments will be
needed and the necessary tasks will be performed. The instruments will then be placed
on the cart and taken to sterilization.
Simple Patient Discharge Process
The patient discharge process is shown in two diagrams in Appendix J12. The
patient discharge begins with a multidisciplinary team. If the team decides that
traditional care must occur, then the nurse will perform the assessment for traditional
care. Then the traditional care team will assess the patient needs and confirm the
traditional care service. Next the doctor will generate a discharge summary, which must
be confirmed by a ward pharmacist. Finally the process will come back to the nurse
whom will run through discharge checklists and discharge the patient.
Sterilization Process
The sterilization process will begin in the assembly room, referenced in Appendix
J13. Then paperwork will be processed and quality tests will be performed. If the
instrument will not melt, the sterilization will be done through steam. If it will melt, it will
be done by gas. Then the supplies will be stored.
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Room Cleaning
The following process map, shown in Appendix J14, is the procedure for cleaning
the patient’s room. This begins with preparation of the cleaning solutions. The first thing
to be cleaned is the bathroom which has three steps, then cleaning the floor which has
two, then cleaning the windows, which also has two steps.
Emergency Room Patient Flow
The Emergency Room patient flow, displayed in Appendix J15, involves a broad
array of services customized to specific patient needs. The patients are then triaged and
flow through the various channels and departments depending on the stage of care and
physician attention needed. Through taking into account resource needs as well as
urgency, triage information can be used to prioritize patients for purposes of efficiency
and exigency.
Sales Ordering
The process for sales ordering is broken down by sales order, standard order,
and warehouse order. This process is broken down in Appendix J16. These different
types of orders affect the pricing as well as the expected dates of delivery. This is
explained in the process map below.
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Marketing- Complaint Management Process
Should there be a complaint, there is a process map to explain how to handle the
complaint, shown in Appendix J17. After the complaint is made, it will be measured for
severity. If the complaint is sever, the patient and family members will be talked to
immediately. It will also be necessary to see if the complaint will require another
authority. There will also need to be a legal consideration. If the patient needs to be relocated, this will also be performed in this process. Finally we will look to see if the
complaint has been handled and perform follow up.
Ordering process
The ordering process, displayed in Appendix J18, is broken down into either
sales order or work order. The sales order is either done through cash and carry out, or
on account and carry out. These both lead to an invoice. The work order goes to an
order entry for on demand inventory. This then leads to purchasing then receiving,
which leads to stock and then to invoice.
Product Recall
Should there be a product recall, the following process, diagrammed in Appendix
K will be enacted. There will be a case report filed. Then the BFAD Product Recall
Committee will be involved. They will make a recommendation and there will be an
issuance of a product recall. The Secretary of Health and Concerned Parties on
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Issuance of Product Recall Orders must be informed. Then, depending upon the type of
the recall, information must be disseminated. There will need to be a recall operation
plan with the concerned parties. This will be monitored until complete.
Revenue Cycle Management
The following process map, detailed in Appendix L1, will be used for revenue
cycle management. Upon admission to the hospital the patient will have eligibility
verification, an authorization check, and will open an account. Upon treatment, there will
be a medical transcription as well as a capture of the charge and coding. During
discharge there will be medical billing and claims generation. Post discharge, there will
be an account receivable follow-up, cash posting, and patient follow up.
Financial Accounting Process
The financial accounting, outlined in Appendix L2, is broken down between daily
procedures, period end procedures, and financial reporting procedures. For daily
procedures the source documents and journal ledgers must be prepared and posted.
These posted documents carry over to the period end procedures where they are added
to the general ledger and used to obtain closing balances. The general ledgers carry
over to financial reporting procedures and are used to create balances and financial
statements.
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Accounts Receivable
Accounts receivable, shown in Appendix L3, begin with an invoice via email. If
the invoice is paid a statement is mailed to the customer with an amount due. If not, the
invoice is entered with a reminder and after 30 days the statement is mailed to the
customer with an amount due.
Patient Billing Process
The billing process, explained in Appendix L4, starts with the admission of the
patient, eventual discharge, and ends with the procurement of a payment. This process
includes submitting charges to third party players, posting patient transactions, and
following up on outstanding accounts.
HR Payroll
The following process map, shown in Appendix L5, will be used for payroll. The
Human Resources department will be responsible for entering employees with all of the
correct personal information. Then the employee will be responsible for entering hours
for that period. The manager will need to review and approve these hours. The payroll
will then be analyzed and hours along with overtime will need to be approved and
corrected. This will be processed and sent to the payroll vendor, which will produce
payments.
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Cafeteria
The food process through the cafeteria, shown in Appendix M1, begins in the
storage center and makes it way into the kitchen and preparation area. From here the
food flows into the various categories of foods including meat, fruits, vegetables, and
grains. The food is then cooked, plated, and distributed to patients and staffing
personnel throughout the hospital.
Leed’s Certification
The Leeds Certification is one of the competitive differentiators for Saint Sophia.
The process is diagrammed in Appendix M2. The process begins with building designs,
which are given to a coordinator. This then begins to get formulated and documents
must be created. Next the design is critiqued and then must be accredited. After
accreditation the LEED certification can be awarded.
Green Garden
The rooftop garden process, displayed in Appendix M3, begins with the
procurement of space on top of the hospital and ends on the plate of the patient or staff
member. The garden flows from the garden itself, to the cafeteria and ends in the
various patient rooms. This process takes out the various middlemen that impose
delays in distribution and supplier costs.
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16 OVERVIEW OF DATA SOURCES
The data for this project came from a plethora of sources. The majority of our
data was obtained from documents provided to us by Maine Medical. This data included
both qualitative and quantitative data. The quantitative data was applied by using ratios
in order to roll up the data to apply to the size of Saint Sophia and the qualitative data
was relevant to the human resources department. This secondary data source was
used because it contained multiple years of reliable data that would have been difficult
to procure elsewhere. The data was raw which also proved to us that it was more
reliable and successfully served the construction of Maine Medical, and was therefore
suitable for our project. We also applied Google Trends, a type of big data, to assist with
demand forecasting and inventory management, and staffing requirements.
From the documents acquired from Maine Medical, Saint Sophia was able to
apply their consolidated financial statements, checklist of required schedules,
statements regarding IRS and other tax forms, compensation of employee documents,
statements of revenue, statements of functional expenses, balance sheet, facility
information, and projected budget. We used this information because it was relevant
and reliable. Although it was a secondary source, it was consistent with a primary
source because it was raw. We were unable to conduct primary research ourselves due
to cost constraints however we held many meetings with our mentor Chris Sprowl
where we gathered pertinent primary information.
The book provided a wide expanse of information that although interesting, did
not provide enough depth for us to relate the information back to our hospital. The book
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offered the basics of what we needed to know, especially coming into an unknown
industry, however, the external data that we found proved to be much for efficient and
helpful.
Because the data received from Maine Medical was so raw and extensive, and
was also being applied to an institute of larger size and stature, a significant portion of
the data needed to be rolled up to be used for our hospital. At a basic level, Maine
Medical is such a large institution, we were not able to offer all of the same operations
and procedures, and services therefore elimination certain data pieces. More
specifically, with the financial statements most of the information was broken down to a
much smaller level than what was provided by Maine Medical.
We began our data analysis by reading the book in order to gain an overview and
a basic knowledge of the hospital industry, processes, and factors to begin the project.
From this point we used what we learned in class to help direct us in our pursuit of
information. We each gathered information about our assigned areas of interest, and
then collaborated to narrow down the information that we could apply. This application
was done mostly through Excel ratios, and the reliance on Google Trends.
We sliced the data within Google Trends by looking at the different data variables
to understand why these trends were occurring. We sued this data to help us with our
demand forecast which assisted us with supplies, inventory, and staffing. We used
OLTP to look at the overall trends, an example such as the weekly demand, to be able
to relay this information to the needs for staffing, inventory, and patient volume. In
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general, this ad-hoc analysis was essential to applying both the documents from Maine
Medical as well as the Google Trends observed to fit our needs.
We utilized multidimensional analysis where we took data and turned it into
highly organized and more easily analyzed structures. This then provided a
multidimensional view of the data, such as what does of the week produces the most
outpatients. This view gave us greater insight into the hospital sector and helped us
make more informed decisions. Through multi-dimensional analysis we were then able
to take the data we collected and classify it into separate dimensions. These
dimensions could be broken down by time, process, service, patients, and discharges.
This then allowed us to answer questions such as how many patients can we expect
within the next year, or how many people will use each service. We could then break it
down even more to get a count on each patient and even each day of the week,
representing ways to measure success or failure in an organization.
17 FINAL SUMMARIES
ELIZABETH BENZ
This project has taught me more than I ever expected. Coming into this class, we
all knew about this big, scary assignment that would force us into several late nights,
many frustrating group meetings, and push us way beyond our comfort zone of
knowledge. However, what I did not expect to get from this project was to gain even
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more appreciation for my friends that served as my partners, confidence in my abilities
to learn and tackle new things, and pride in something that I have never worked so
diligently on in my life.
Working with my group was truly a gift. All of my group members are in my
business fraternity. We have always called ourselves brothers, but this project showed
me an even truer brotherhood within each of them. I was able to put all of my faith into
them and their abilities, and it was an honor to have them do the same. I think that
being brothers with my group members provided a greater deal of responsibility. None
of us ever once slacked off or neglected to do our fair share because not only would it
be letting down a group member, it would also be letting down a brother.
Process mapping was something that was unknown to me before beginning this
project. I have a lot of experience with enacting the processes that are exemplified in
process maps with my experiences of being a manager in the food industry, however I
had never laid one out. Doing these maps was a great way of seeing how each part of
the operation played a specific role. This helped to identify where there was need,
opportunity, strength, and weakness within our hospital and all of its parts. Without the
process maps, I feel that a lot of things would have been forgotten that are essential to
each part of the operation. Although these maps seemed tedious at times, they really
assisted our group in making sure that each function was fully performed.
The first interim we did a great job of dealing with time and project management.
We were ahead of the game and successfully assigned tasks as well as worked
together on several aspects of the project. We did this so well, that we ended up getting
second on the first Interim. I believe this made us cocky because on the second section
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there was a great deal of procrastination. This procrastination actually ended up being
beneficial though because we were forced to do more as individuals. This helped me to
rely less on others, and push myself more. Because of this, I was able to discover more
talents and abilities that I didn’t know that I had. After the second interim, we were able
to trust our fellow group members more. This aided us to successfully complete the final
section with more time to review the sections and make sure that we were presenting
the best possible project.
My suggestion for future BCOR 2500 students is to work with people that you
know AND trust. Don’t work with your best friends just because you are their best
friends. Only work with your best friends if you trust them to get the job done. Don’t be
afraid to be selfish when it comes to this. Also, never leave without giving it your all.
Come to work nights ready to work, always have snacks, and always keep a positive
attitude.
TAYLOR CUNNINGHAM
This project has been extremely time-consuming and complex. Through it I have
learned the value of time management and delegation of tasks in a team setting.
Another important aspect of teamwork in this project was communication. Technology
like text messaging and Facebook allowed my group to stay in touch throughout the
entire process.
As a senior, I was so pleased to see younger students step up as leaders on this
assignment, especially Paris and Liz. Their commitment and organization throughout
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the entire project proved key to our group’s success, and we couldn’t have done it
without their leadership.
This project proved especially challenging on the front of data analysis. Finding
relevant data in this industry was fairly difficult, so I had to change my way of thinking
and dig deep into the resources available to me. Finding a mentor in the hospital
industry became our saving grace on many fronts, including data sourcing.
The beauty of working in a team setting is the ability for each team member to
specialize. Having said that, process mapping was not part of my assigned duties,
therefore I am by no means an expert in that field.
To future students, I would recommend careful selection of teammates. You’ll be
spending a terrible amount of time with these people, so be sure to choose people you
enjoy working with and will accomplish their work. I would also urge future students to
research the different project themes form various sections, making sure to choose the
topic that is most relevant and interesting to you. Don’t be afraid to change sections
during the first week of class to get the best topic. The last piece of advice I’d leave is to
seek out and secure a mentor that will be able to guide you through this complicated
process.
PARIS HOGAN
Throughout this semester I have learned many things about myself, the field of
business, the hospital sector, and teamwork. On an academic level this project taught
me about all of the various facets of a hospital and how they relate to the individual
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sections within business. This includes how marketing, finance, operation,
management, accounting, and customer service work together to perform the necessary
requirements and obtain the resources needed to run a multi-billion dollar industry. I
personally learned that I am a very driven and organized person who thrives in a group
setting.
The best and hardest part of the project was working in a group. My team worked
very well together to make time to meet and went above and beyond the requirements
of the project. All of our team members contributed their best work and we are all very
proud of our achievements in the class. The hard part about the group was when to
meet due to our hectic schedules. Luckily we were all very flexible and found times that
worked for everyone, despite some extremely long nights spent in the business school.
Teamwork was the most critical factor of the project because everyone was needed in
order to complete every part, and the input and different perspectives of team members
lead to our successful completion of the project. Through working with others, time and
project management were essential for completion of the project. There were so many
different parts that made up the hospital project, and so organizing roles and divvying
up the work was key. It was also important that everyone on the team had a clear
understanding of the project and its desired outcome. All of this was accomplished
through clear and consistent communication. Good project management involved no
shortage of dialogue between team members, which offered constructive criticism for
everyone to do their best and makes expectations clear whenever possible. The project
management sheet we filled out together at the beginning of the semester helped
77
outline the critical project milestones. We also had regular checkpoints each week on
Mondays and Wednesdays that let us monitor the work at every step.
All of the work that we did was mainly comprised of big data that we had to find,
analyze, sort, and apply to our hospital, Saint Sophia. I learned that because of the
amount of data that exists, there are so many resources to assist people seeking the
information however this also makes it difficult to find specific data. I spent hours
combing through documents, power points, and the hospital operations book in search
of data and realized that having a specific question and understanding of what you are
trying to find is of the upmost importance.
Another strategy that was new to me was working with process maps. The
process mapping helped us organize the complex flows and systems within a hospital,
to make improvements, and decrease inefficiencies. The process maps really gave me
a better understanding of how things worked and I learned how every process is
connected and needs to be created properly. Processes such as inventory management
and operation room discharge were related and need to be planned accordingly for the
patient to be released on time and the hospital to ensure efficient results. I enjoyed
using process maps and will now be able to use them in the future for other projects and
apply them in my own life as well as the world of business.
78
My suggestion for future BCOR 2500 students is to plan ahead and be prepared.
The most critical part of the project is finding a group that you are able to work well with
and who can get their work done on time. That being said, time management and
planning out the project beforehand is essential to your success. The entire project is
already outlined so there are not any surprises, but being able to strategize and divvy
up the work before you dive in will help out in the long run. I would also highly suggest
finding a mentor. The greatest asset for our team was our mentor Chris Sprowl. Chris is
an existing partner at Maine Medical and was able to provide us with a large amount of
background and other information that would not have been accessible in any textbook.
Also by being able to hear real life examples in the hospital industry, and how the
complex processes work, we were able to apply it to our project. The last suggestion I
would make would be to really research and take advantage of the vast amount of
information already at our fingertips. The internet, archives, textbooks, peers, and
mentors all have incredibly valuable information not only about the hospital industry, but
also about the wide world of business which is extremely useful to us as students and
eventually the fields of work we will enter.
BENJAMIN URBAN
This project has taught me several things. First is how valuable it is to have a
team you can trust and count on. This project is going to be stressful no matter what,
but there are many ways to minimize the stress level. Having a team you can count on
to hit the deadlines is vital. When everyone is accountable for his or her own work all
you have to worry about is your section, and that makes the project seem a lot more
79
doable. On the flip side, if a team member doesn’t do their work on time and isn’t
consistent it adds the stress of wondering if they’re going to perform their work. Also, if
they don’t do their work it puts a lot more pressure on the team to pick up the lacking
member’s slack. The second thing I learned it how valuable time management is going
to be in the real world. Without meeting every week and consistently doing work, this
project would not be possible. This to me is a lot more like the real world projects you
will be expected to do on the job. Without efficient time management this project will
catch up with you and make your life miserable.
Working with a group over a semester was a great experience. It gave me a taste
of what it will be like to work with a solid team for an extended period of time much like it
will be like in the real world. Again, I can’t stress selecting a strong team from the
beginning. I was fortunate enough to have a group of friends in the class that I could
count on and got along with. This is even more essential because it is inevitable that
you will be spending a lot of time with them over the semester and a lot of late nights.
Throughout the semester I saw all of these team members/friends that their highest
stress level. I found that peoples’ true colors are revealed when you see them at their
breaking point. It is important that the team keeps a positive attitude throughout the
whole process and that every time you meet up with the team you bring a positive
attitude and come prepared.
Working with data is very tedious. A lot of my time was spent doing research and
finding reliable figures and sources. Then I had to categorize the data, find trends, and
make it meaningful. Overall the greatest challenge was taking the mass amounts of
data and stripping the useful information.
80
Working with process maps was both fun and tedious. Personally I am a much
more visual person, so seeing and creating a visual representation of the operations of
the hospital was a lot more fun. However, there were some difficulties along the line. It
is important to be very meticulous and take your time with the process map because if
you miss a step in the process you will have to go back and sometimes change a
multitude of operations associated with the step you missed. Overall not too bad, but
they take a lot of time and should be treated just as seriously as the other parts of the
project.
Time management is the most important skill in regards to the project. I’ve
always been told to manage my time effectively and how valuable a skill time
management is, but this project really put it in perspective. Without effective time
management this project would be impossible and a hundred times more stressful. The
only reason I survived this project was because I kept a weekly calendar and made a
point to hit all my deadlines. This made the project seem a lot smaller than it really was
and kept me motivated.
My greatest suggestion and advice for future BCOR 2500 students is to be very
selective and put a lot of thought in creating your team. It is so important to start with a
strong base because you are going to be spending a lot of time and late nights with
these people. It can also mean the difference between hours and hours of work. Look
for people who have great time management and who seem like they will get the job
done to the best of their ability, not just get it done. A good trick for this is to see who
posts their bio first. While the bio is a simple and small thing, it reveals which students in
the class are proactive and take care of work soon after it is assigned. These are the
81
people who you will most likely be able to count on to get their work done, and you can
trust them to be proactive rather than reactive.
82
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37) Smick, N. (2013). Caregiver, hha, & cna pay. Retrieved from
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46) USAID | DELIVER PROJECT, Task Order 1. 2011. he Logistics Handbook: A Practical
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49) Ziel, P. (2013, June 15). Infor lawson supply chain management for healthcare.
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90
APPENDIX A
SUMMARY OF THE OFFERING25
Issuer
Saint Sophia Community Hospital
Securities Offered
$152,000,000 12% Taxable Bonds, /Series 2014A due July1, 2015
Interest Accrual Date
Interest will accrue from the Settlement Date
Interest Payment Dates
January 1 and July 1 of each year, commencing January 1,
2015
Redemption
The Series 2014A Bonds are subject to optional redemption in
whole or in part by the Institution prior to maturity, on any
Business Day, at the Make-Whole Redemption Price, as further
described herein. The Series 2014A Bonds are also subject to
purchase in lieu of redemption. See “THE SERIES 2014A
BONDS – Redemption” herein.
Settlement Date
1-Jul-14
Authorized Denominations
$1,000 and any integral multiple thereof
Form and Depository
The Series 2014A Bonds will be delivered solely in book-entry
from through the facilities of DTC
Use of Proceeds
The Institution will use the proceeds of the Series 201 3A Bonds
(i) to pay the costs of facility purchase, various construction,
renovation and equipping projects, (ii) for working capital and
other eligible corporate purposes, and (iv) to pay costs of
issuance of the Series 2013A Bonds.
Rating
Moody's: "A3"
S&P:
"A-"
91
APPENDIX B
PROCEDURE DEMAND TABLE
General
Procedure
Percent of
Overall
Estimated
Procedures/Day
Estimated
Procedures/Year
Primary Medical Care
11.5%
22
8157
Acute Care
1.3%
2
906
General Surgery Podiatry
0.6%
1
453
Prenatal
2.2%
4
1586
Radiology
7.0%
12
4249
Diagnostics
7.4%
14
5212
Renal Dialysis
2.1%
4
1487
Maternity
4.0%
8
2832
Coronary Care
2.4%
5
1699
Lithotripsy
0.6%
1
408
Medical Social Services
6.3%
12
4461
Pharmaceutical Services
19.5%
38
13822
Ambulatory Surgery
1.6%
3
1133
Trauma Center
1.7%
3
1224
Surgical and Orthopedic care
2.9%
6
2039
Outpatient Surgery
3.5%
7
2493
ICU
5.1%
10
3603
Accident and Emergency Room
2.6%
5
1813
Anesthetics
3.4%
7
2379
Laboratory and Clinical
4.4%
9
3127
X-ray
3.8%
7
2719
Emergency
92
Radiology, Radiographic
2.2%
4
1586
Magnetic Resonance Imaging
2.2%
4
1586
Immunology
6.0%
12
4215
Immune system deficiencies
5.1%
10
3625
Pulmonology Services
1.7%
3
1224
Pathology
2.9%
6
2039
Hematology
4.8%
9
3399
Endocrinology
1.9%
4
1360
Pediatric cancer and blood disorder
1.6%
3
1133
Baby nursery
2.9%
6
2039
Pediatrics
93
APPENDIX D
SUPPLY DELIVERY SCHEDULE
Product
Product Model
40mm
EO574
50mm
EO575
60mm
EO576
70mm
EO577
80mm
EO578
90mm
EO579
Ambu, Adult
P-545
Ambu, Ped
P-546
Banded
SHBW14387
Bath
SHWBW14388
Biohazard Red
PD1200
Drainage w/ Catheter
PD1201
Enteral Fdng w/ Grvty Tbng PD1202
Fecal Incontenance
PD1203
Fexible Enema
PD1204
Ostomy Drainage
PD1205
Ace bandage
5761578
Coban
5776134
Conforming
5776136
Esmark
5761579
Kerlix/Kling
5761589
Roll Cotton
5796897
Surgical #10-22
5788068
IV Blunt
303345
Nasal
N2-S145
Trach
547923
Injection site IV
HGF-456
Foley
33841-IK
Red Rubber
9807
Male external
2013-0533
IV
SR-OX1451CA
Suction
13063S
Glucometer
OK-7N
Lancets
3.38415E+11
Insulin syringes
5JCZ1
Adult
UNSPSC
Child
UNSPSD
Product Category
Airway
Airway
Airway
Airway
Airway
Airway
Bag
Bag
Bag
Bag
Bag
Bag
Bag
Bag
Bag
Bag
Bandages
Bandages
Bandages
Bandages
Bandages
Bandages
Band-aid
Cannula
Cannula
Cannula
Cannula
Catheters
Catheters
Catheters
Catheters
Catheters
Diabetic Supplies
Diabetic Supplies
Diabetic Supplies
Diaper
Diaper
94
Manufacturer
Bioland Technology
Bioland Technology
Bioland Technology
Bioland Technology
Bioland Technology
Bioland Technology
Charter Medical Ltd.
Charter Medical Ltd.
Charter Medical Ltd.
Charter Medical Ltd.
Charter Medical Ltd.
Charter Medical Ltd.
Charter Medical Ltd.
Charter Medical Ltd.
Charter Medical Ltd.
Charter Medical Ltd.
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Bioland Technology
Bioland Technology
Bioland Technology
Bioland Technology
Bioland Technology
Bioland Technology
Bioland Technology
Bioland Technology
Bioland Technology
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Infant
Adhering
Sterile
Non-sterile
ABD Combine
Adhesive Surgical
Alleven 8x8
Bioclusive
Collagen Aginate
Hydrocolloid Duoderm
Sm
Hydrogel
Hydrophilic
Non Adherent, Lg, Md or
Sm
Tegaderm
Vaseline Adaptic
Wound Care Primapore
Wound Care Exu Dry
Adson Dressing 43/4”
Serrat
Allis Tissue 6”
Allis Tissue 4x5 Teeth
Cord Bipolar
Halsted Mosquito 5” Curv
Malis 7” Bipolar
Micro-Adson Dressing
43/4” Ser
4x4 nonsterile
3x3 nonsterile
2x2 nonsterile
4x4 sterile
3x3 sterile
2x2 sterile
Lap sponge
Raytec sponges
Roll
Exam – XSm
Sm
Md
Lg
UNSPDD
UNSDGF
70890655
70890654
B25
B54
B67
B34
B89
B20
B21
B23
B64
Diaper
Drapes
Drapes
Drapes
Dressing
Dressing
Dressing
Dressing
Dressing
Dressing
Dressing
Dressing
Dressing
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
B65
BS9
BS7
BD43
BD33
Dressing
Dressing
Dressing
Dressing
Dressing
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
A2101
A2878
A2879
A4560
A3289
A2678
Forceps
Forceps
Forceps
Forceps
Forceps
Forceps
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
A2654
SM140012
SM140013
SM140014
SN140023
SN140024
SN140025
SS1650677
SP1430033
SR5486700
YO86246-30
YO86246-31
YO86246-32
YO86246-33
Forceps
Gauze
Gauze
Gauze
Gauze
Gauze
Gauze
Gauze
Gauze
Gauze
Gloves
Gloves
Gloves
Gloves
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
95
XLg
Fabric
Paper Exam
Surgical
IV Administration
Sets
Start Kits/Dressing Change
kit
Solutions
NaCl
Dex 5%
Catheter Foley
Catheter Suc
IV Start
Minor Surgical
Blood Collection
Sets
Tourniquets
Adult O2
Face Resusc Adlt
Face Shield
Neonatal
Surgical
Gauge
Surgical Lg
Strip IO 1”
Vaginal
Soap
Toothpaste
Toothbrushes
YO86246-34
CG-0051
CG-0566
CG-0456
SB23526U
SG45923J
SD76853K
YH
610-1187
630mm-630mm
HJG-908-7194
B009MNOZ4
B109MNOX7
00-KJ54
567-KHG
TNFeR DTX
4567-HG
85954
3M1860
3R13445
3S12789
3N45348
3S12786
RDF872
RDF875
YTK324
YTJ908
917750220
91711458
1440
Alcohol
802711
Pads
RLS-32
Swab Sticks
HD-CSM03
Betadine
HD-CSM03
Bottles
HD-CSM03
Pads
HD-CSM03
Gloves
Gowns
Gowns
Gowns
IV Supplies
IV Supplies
IV Supplies
IV Supplies
IV Supplies
IV Supplies
IV Supplies
Kit
Kit
Kit
Kit
Laboratory Supplies
Laboratory Supplies
Laboratory Supplies
Mask
Mask
Mask
Mask
Mask
Pack
Pack
Packing
Packing
Personal Care Items
Personal Care Items
Personal Care Items
Prep Pads/Swab
Sticks/Bottles
Prep Pads/Swab
Sticks/Bottles
Prep Pads/Swab
Sticks/Bottles
Prep Pads/Swab
Sticks/Bottles
Prep Pads/Swab
Sticks/Bottles
Prep Pads/Swab
Sticks/Bottles
96
Alfa Medical
Alfa Medical
Alfa Medical
Alfa Medical
Bioject Inc.
Bioject Inc.
Bioject Inc.
Bioject Inc.
Bioject Inc.
Bioject Inc.
Bioject Inc.
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Atrium Medical
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Swab Sticks
Curved
Straight
Surgical
51/2” Strght Suture
Endoscopic
Iris Strght 41/2”
Knowles Bandage 51/2” Str
Mayo 51/2” Straight
Metzenbaum
Blood Collection
Enteral Feeding Kngr
Extension
Gravity Feeding
Infusion
IV Administration
Hospital Fitted
Hospital Flat
Water Sterile 10ML
Povidone – Iodine .75oz
Nasal
Vaginal Disp Lg
Vaginal Mtl Lg
Drain Sof-Wick
Tonsil 1”
1cc
3cc
5cc
10cc
20cc
30cc
60cc
Bulb Ear
HD-CSM98
605-BLK
607-HJK
608-GYB
667-typ
668-UHB
656-654
636-IKJ
607-BKY
673-UXR
360213
340589
346789
324561
317856
YTG-675
LMD-1530MD
LMD-1540MD
174-548
175-678
95001
94567
94568
76432109
76435621
300613
300614
300615
300616
300617
300618
300619
300630
Prep Pads/Swab
Sticks/Bottles
Scissors
Scissors
Scissors
Scissors
Scissors
Scissors
Scissors
Scissors
Scissors
Set
Set
Set
Set
Set
Set
Sheet
Sheet
Solution
Solution
Speculum
Speculum
Speculum
Sponge
Sponge
Syringes
Syringes
Syringes
Syringes
Syringes
Syringes
Syringes
Syringes
Cloth
86066
Tape
Paper
86067
Tape
Silk
86068
Tape
Digital
TEM-8593
Thermometers
97
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
Johnson and Johnson
ISPG
ISPG
ISPG
ISPG
ISPG
ISPG
ISPG
ISPG
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
Catheter Introducer
10125
Tray
Catheterization w/ Foley
10367
Tray
Catheterization w/o Foley
10679
Tray
Irrigation
12876
Tray
Laceration
15678
Tray
Skin Prep Pre-Op
14567
Tray
Suture
19234
Tray
Suture Removal
15309
Tray
Trach
YO-06833-00
Tube
Oxygen
OX-0987-04
Tubing
Bag
601105
Urinary Supplies
Bag
601106
Urinary Supplies
Bag
601107
Urinary Supplies
Urine meters
RK11-623
Urinary Supplies
Bed pans
RTLPC23212
Urinary Supplies
Urinals
DYND80235H
Urinary Supplies
Foley Trays
Blue Top
Green Top
Grey Top
Lavender Top
Red Top
Tiger Top
Duoderm
Vaseline gauze
Non-adhering
Tegaderm
896300
367856
367857
367857
367858
367859
367888
B205
B560
B432
B236
Urinary Supplies
Vacutainer
Vacutainer
Vacutainer
Vacutainer
Vacutainer
Vacutainer
Wound Care/Dressing
Wound Care/Dressing
Wound Care/Dressing
Wound Care/Dressing
98
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
American Medical
Systems
Bard Access Systems
Bard Access Systems
Bard Access Systems
Bard Access Systems
Bard Access Systems
Bard Access Systems
Leeder Group, Inc
Leeder Group, Inc
Leeder Group, Inc
Leeder Group, Inc
APPENDIX D
STAFFING PLAN
99
APPENDIX F
EXECUTIVE STAFFING PLAN
 President & Chief Executive Officer
o Salary $200,000

Vice President, General Counsel and Secretary to the Board
o Salary $180,000

Vice President, Finance and CFO
o Salary $180,000

Vice President, Clinical Affairs
o Salary $102,000

Vice President, Human Resources
o Salary $99,000

Vice President, Clinical and Support Services
o Salary $95,000

Vice President, Patient Services and Chief Nursing Officer\
o Salary $119,000

Vice President, Ambulatory Services
o Salary $263, 000

Senior Director, Marketing & Communications
o Salary $116,000

Vice President, Clinical Excellence & Quality
o Salary $93,000

Chief Operating Officer
o Salary $154,000

Medical Staff President
o Salary $88,000

Senior Medical Director-Emergency Services
o Salary $109,000

Executive Director, Cardiac & Vascular Center
o Salary $97,000

Executive Director, Neurosciences/Spine & Rehabilitation Medicine
o Salary $186,000
100
APPENDIX G
EMPLOYEE BENEFIT COST
Nurses, Physicians, Surgeons:1
1. Nurses
$18,020
2. Physicians
$45,220
3. Surgeons
a. $93,500
Service Providers:
1. Dietary and Nutrition Employees:
$14, 620
Customer Representatives
1. Customer service representatives
$17,680
Management:
1. President & Chief Executive Officer
$68,000
2. Vice President, General Counsel and Secretary to the Board
$61,200
3. Vice President, Finance and CFO
$61,200
4. Vice President, Clinical Affairs
$34,680
5. Vice President, Human Resources
$33,660
6. Vice President, Clinical and Support Services
$32,300
7. Vice President, Patient Services and Chief Nursing Officer\
$40,460
8. Vice President, Ambulatory Services
101
$89,420
9. Senior Director, Marketing & Communications
$39,440
10. Vice President, Clinical Excellence & Quality
$31,620
11. Chief Operating Officer
$52,360
12. Medical Staff President
$29,920
13. Senior Medical Director-Emergency Services
$37,060
14. Executive Director, Cardiac & Vascular Center
$32,980
15. Executive Director, Neurosciences/Spine & Rehabilitation Medicine
$63,240
Other:
1. Caregivers
$10,200
2. Activities Program Leaders
$17,000
3. Therapists
$18,700
4. Social Workers
$18,700
5. Therapeutic Recreation Program Specialists
$17,000
6. Inventory Managers
$31,280
7. Medical Interpreters
$28,900
8. Facility Maintenance
$17,000
102
APPENDIX H
INCOME PROJECTIONS
103
APPENDIX H
INCOME PROJECTIONS
104
APPENDIX H
INCOME PROJECTIONS
105
APPENDIX I
PROJECTED FINANCIAL STATEMENTS
106
APPENDIX J1
PATIENT CALL CENTER
AP
PE
ND
IX
107
J2
ADMISSIONS PROCESS
108
APPENDIX J3
PATIENT CHECK-IN
109
APPENDIX J4
PATIENT TRIAGE SYSTEM
110
APPENDIX J5
PHYSICIAN ROUNDS PROCESS
111
APPENDIX J6
MEDICATION PROCUREMENT PROCESS
112
APPENDIX J7
OPERATING ROOM PATIENT FLOW
113
APPENDIX J8
LAB TEST PROCUREMENT
114
APPENDIX J9
PATIENT RECORD PROCUREMENT
115
APPENDIX J10
OR ASSEMBLY PROCESS
116
APPENDIX J11
ASSEMBLY ROOM FLOWCHART
117
APPENDIX J12a
SIMPLE PATIENT DISCHARGE PROCESS
118
APPENDIX J12b
SIMPLE PATIENT DISCHARGE PROCESS
119
APPENDIX J13
STERILIZATION PROCESS
APPENDIX J14
120
ROOM CLEANING PROCESS
Figure 1. Process flow diagram of the tasks performed during patient room cleaning.
Prepare cleaning
solutions
Move the cart from the
basement to the rooms
Spray
mirror
Spray
sink
Spray toilet
bowl
Wipe mirror with paper
towel
Wipe sink with paper
towel
Clean with
brush
Clean the bathroom
Wet the towel
Wipe floors
Place towel in the
mophead
Remove and collect
towels
Clean the
floor
Clean windows
Spray windows
Wipe with paper towel
APPENDIX J15
121
EMERGENCY ROOM PATIENT FLOW
APPEND
122
IX J16
SALES ORDERING
123
APPENDIX J17
COMPLAINT MANAGEMENT PROCESS
124
APPENDIX J18
ORDERING PROCESS
125
APPENDIX K
PRODUCT RECALL
126
APPENDIX L1
REVENUE CYCLE MANAGEMENT
127
APPENDIX L2
FINANCIAL ACCOUNTING PROCESS
128
APPENDIX L3
ACCOUNTS RECEIVABLE PROCESS
129
APPENDIX L4
BILLING PROCEDURE
130
APPENDIX L5
HR PAYROLL PROCESS
131
APPENDIX M1
CAFETERIA PROCESS
132
APPENDIX M2
LEEDS CERTIFICATION PROCESS
133
APPENDIX M3
GREEN GARDEN PROCUREMENT
134
APPENDIX M4
GREEN GARDEN PROCUREMENT
135