Competitor Analysis: St. John Hospital Orthopedic Surgery

Competitor Analysis: St. John Hospital Orthopedic Surgery
Paula Grundy
Siena Heights University
Strategic Planning & Implementation
LDR 660
Professor Frank Veltri
April 23, 2013
Competitor Analysis: St. John Hospital Orthopedic Surgery
Health care organizations must identify changes that are occurring in the environment
and adapt to those changes in order to remain successful. Currently, the health care industry is
undergoing a major change in regards to legislative reform and these regulations have had a
major impact on the operations of hospitals. St. John hospital is losing millions of dollars due to
decrease volume, Medicare pay backs and physician management. Because of these losses the
system has the challenge of implementing a strategic plan to combat these problems before the
operations of the hospital are negatively affected.
With the decrease in patient volume St John Hospital has implemented several strategic
plans to increase the delivery of health care services. The system decided to focus on orthopedic
surgeries specifically Hip and Knee surgeries. According to the American Academy of
Orthopedic Surgeons between 200,000 and 300,000 hip replacements are performed in the
United States each year, most with patients over 60. It also states that 362,000 knee surgeries are
also done annually (Surgery, 2009, para.1). This is a significant amount of surgeries and one
could project that this number will increase in future years; it has been projected that by the year
2040 there will be over 80 million elderly in the United States alone. This data supports the
assumption that the increase in the elderly population will increase hip and knee surgeries. The
data also suggest that people are choosing to have this type of surgery because it improves
quality of life and risks although still present are small in comparison to other type of surgeries.
The use of current technology and equipment that lower length of stay is also an important
factor. This type of environmental analysis is difficult but it is the framework in which St. John
Hospital has chosen to develop its Hip and Knee program.
In the fiscal year 2010 only 491 hip and knee replacements (DRG 470) were completed
at St. John Hospital Medical Center and in 2011 there were only 500 replacements; in
comparison to our highest competitor Beaumont Hospital who completed 2526 in 2010 and 2429
in 2011 (Talking with Badali, personal communication, April 20, 2013). The data shows that the
hospital is behind the competitive edge when it comes to these types of surgeries. In 2012 it was
identified by the hospital administration that because the hospital was in a 26 million dollar
deficit that the system needed to close the gap and identify strategies to compensate for the lost.
They would accomplish this through increase general surgeries, bone and joint surgeries and
primary care physician recruitment. But how is this accomplished?
St. John Hospital has identified a strategic plan that would capture hip and knee surgery
patients it would benefit the organization by bringing in revenue from an elective surgery
prospective. A program has been instituted that would position the organization within the
competitive market. The scope of practice incorporates a program initiating in pre-surgical
screening and ending in a discharge plan. After the pre-surgical screening process the patients
attend an educational session. This session includes lectures from a physician assistant,
orthopedic nurse, physical therapist, occupational therapist, social worker, case manager and
orthopedic technician. The physician assistant initiates the lecture; they educate the patient on the
different types of surgery answering specific questions for each patient. This session incorporates
a lecture, with a slide show, written material and visual aids including the surgery hardware used
in the operation. The orthopedic nurse instructs the patient on the process from recovery room to
their stay on the unit. This includes pain control methods, the continuation of home medications,
medications used for nausea and vomiting, and antibiotic treatment. The physical therapist
educates the patient on the types of therapies used in the recovery phase and the different types
of equipment used. This includes the equipment available for home use after discharge. They
also inform the patient of the therapy program which is initiated on post-operative day 1; the
expectations from the therapists prospective is explained so that the patient is aware of the
process. The occupational therapist lectures on types of skills needed for movement into cars,
stairs and other modalities. They also speak to the patient regarding their home structure which
will affect their activities of daily living. They also assist the patient on making decisions
regarding what will be needed at home upon discharge. The social worker gives information on
possible placement or assistance after discharge, and they address any other concerns or issues
during the patient’s stay or discharge. The case manager informs the patient of why home health
care is ordered and what services they offer upon discharge home: some of these services include
placement into a rehabilitation facility or nursing home. The orthopedic technician teaches the
patients on the different types of equipment used after the surgery, for instance some patients
will come to the floor and be placed on a continuous passive motion (CPM) machine which is
used to keep the knee in constant motion; ice therapy is also used as a treatment modality. The
purpose of this educational session is to educate the patient on the process and procedures prior
to surgery; the objectives are to encourage participation, and increase knowledge leading to an
optimum and shorter stay of recovery. Another strategic area of focus is on the environment of
the orthopedic unit; the system offers private rooms with wide screen televisions there is also an
area where the coach can sleep if they chose to stay overnight. The educational sessions, therapy
treatment, and spa services are held in the new Valade spa, gym and educational center. This
area has new state of the art equipment that assists the physical therapists with treatment
modalities and the patients are given shirts and shorts with the hip and knee logo to wear during
their sessions. This area is also where the educational sessions are performed. The spa area offers
hair and nail services; and message therapy sessions it is reminiscent of a high quality spa. These
services are given with no additional costs instead it is used as a marketing strategy in hopes of
allowing the organization to obtain a competitive edge.
The system service area in which St. John Hospital is drawing most of its population is
St. Clair, Macomb, Oakland, Wayne, Lapeer, Genesee, Livingston, and Washtenaw. The east
region planning zone includes St. Clair, South Central Macomb, Northern Macomb, Lakefront
and Detroit East. The Providence Region which includes the Providence Hospital Medical
Center Zones includes Southfield Zone, East Oakland Zone, Detroit Zone, North Wayne Zone,
Western Edge Zone, and North Oakland Zone. The Providence Park zones include the Western
Zone, Central Zone and the Southwestern Zone. The population in this area are as follows;
Macomb County (849,649), Oakland County (1,225,333), Wayne County (1,820,650), St. Clair
Shores (160, 182), Lapeer County ( 1,225,333), Livingston (183,113), Genesee (436,144), and
Washtenaw County (352,102) these numbers were estimated for the year 2012 (Semcog, 2014).
This service area was identified because of its location to the St. John Providence Health
Systems and the competitors were determined based on the location, population and service
brand of the orthopedic field.
The competitors that have been identified are Beaumont Hospital in Troy and St. Joseph
Mercy Oakland Hospital. The statistics gathered from these health systems support them being
prime competitors. In 2011 Beaumont completed 375 hip replacements and 790 knee
replacements in comparison St. Joseph Mercy Oakland completed 937 knee replacements and
326 hip replacements which place both systems above St. John Hospital who only completed
500. Unfortunately, when it comes to the marketing strategies most of our promotions are done
in the same locations and are minimal in comparison (Healthgrade, 2014). St. John Health
System advertises through local news letters and offer teaching sessions that are taught by our
physicians. The competitors advertise by newspaper, television media and bill boards. So,
Marketing is a strength that is identified with both competitors. Another strength is associated
with the service line is that they advertise themselves as being pioneers in patient safety, patient
satisfaction and service excellence. They also have joint replacement excellence awards and
orthopedic surgery excellence awards. The St. John system has processes that are also focused on
patient satisfaction this includes offering private rooms, conducting hourly rounds, bedside
reporting and specialty services which are not offered at the other facilities, but one of our
weaknesses is that we have not perfected those services as of yet. St. John Hospital has been
identified as a center for excellence.
As mentioned the marketing of the competitors does put them ahead when it comes to
healthcare services and they also have perfected their service when it comes to patient
satisfaction. Offering services that even by word of mouth is beyond other health care facilities
makes them unique and desirable. Another strategy that is used is the aggressiveness of
promotions on specialized care. St. Joseph Mercy Hospital logo is remarkable medicine,
remarkable care they recognize their doctors as being recognized leaders in health care. They
also have to their credit 85 years of servicing the community and they pride themselves on being
a teaching hospital. Beaumont Hospital is also aggressive in the area of promotion they promote
themselves as having the best doctors and they pride themselves on housing physicians and
private practices which lead to great hospital services and are recognized as the nation’s leading
Upon completion of this analysis it was noted that St. John Hospital is behind on its
strategic planning objectives. As a system the marketing strategies need to be implemented and
the services need to be perfected across the continuum. St. John Hospital does have services that
are unique to specific services lines thus has the potential to lead the competitive market. Based
on the above findings the system needs to analyze its current strategic plan and enhance it
according to the strengths and weaknesses of our competitor. St. John Hospital has the potential
of leading the market for the orthopedic service line and with diligence and hard work this could
be our future.
Arthroplasty Statistics (n.d.). Retrieved April 22, 2013, from
Healthgrade. How America finds a doctor. (n.d.). Retrieved April 22, 2013, from
Semcog. Southeast Michigan Council Of Governments. (n.d.). Retrieved April 23, 2013,