Category: Orthopedics

This paper provides a detailed report of the bathroom modifications answering to the clinical needs of the patient, Mrs. Edwards. The recommendations comply with the Australian Standard 1428.1 (2009) for bathroom modifications as to the requirements of the patient based on her medical history. Also, the proposed modifications are aligned with the layout and size of the patient’s bathroom and with the SWEP regulations as to the subsidizing.

Patient Information and Condition Requirements

The patient is Mrs. Betty Edwards, a 79-year old woman undergoing orthopedic rehabilitation after a left total hip joint replacement (THJR), secondary to osteoarthritis. The prior medical history of Mrs. Edwards included such conditions as depression and anxiety, and gastroesophageal reflux disorder (GORD). Besides, fifteen years ago, Mrs. Edwards had the right total hip replacement. Also, she has suffered multiple fractures of her left and right wrists as well as left patella.

According to Messinger-Rapport and Thacker (2003), at least 5% of injuries received by individuals older than 65 years occur due to falls. Due to the diminished healing capacity of the senior people falls are associated with increased morbidity and mortality (Messinger-Rapport & Thacker, 2003). The individuals with OA are characterized by such abnormalities of balance and gait as difficulty rising, poor balance while seated, instability while walking or standing, the need for support; as a result, such individuals are in need of environment modifications and tools that would help them sit, stand, and walk with more confidence and less fear (Messinger-Rapport & Thacker, 2003).

As pointed out by Stevens (2010), the CDC suggests measuring the hazards present at the patients’ homes using a specialized checklist; the prioritized rooms include those used by a patient during a normal week. Based on this approach, the bathroom is one of the first and most important home environments in need of modifications. The guidance outlined by Care and Repair (n. d.) mentions that persons with walking difficulties are to create more space in their homes for better mobility. The Australian Standard 1428.1 (2009) specifies that no objects should be situated within the circulation space in the patient’s bathroom.

Also, the Australian Department for Communities and Social Inclusion (n. d.) insists that a combination of slippery and hard surfaces is a potential hazard for senior citizens with mobility issues. The Department (n. d.) provides a list of easy to apply interventions such as benches and chairs for shower and tubs, handheld showerheads to direct the stream of water, and slip-resistant mats. Another recommendation concerns the taps that may be difficult to turn for a patient such as Mrs. Edwards with multiple fractures in the wrists – a level-style handle and quarter-turn taps are recommended (Department for Communities and Social Inclusion, n. d.).

In addition, Absher (2016) provides the following instructions for the caregivers of the elderly persons in need of support due to mobility issues: the improvement of lighting in the bathroom for better visibility, the elimination of slipping-hazard via the removal of floor rugs that are not slip-resistant, the appropriate marking of the hot and cold water taps in order to avoid scalding that can cause spontaneous fast movements and result in falls.

Finally, the author also recommends removing all the doors that complicate a person’s entrance of the tub or shower, the placement of mirrors on the level suitable for the seated individuals, and to ensure that no objects are on an individual’s way around the bathroom. Since Mrs. Edwards uses a pick-up-frame for support while walking, she requires a sufficient amount of space in order to move without freely.

Risks, Needs, and Modifications

When it comes to bathing toileting, Mrs. Edwards requires a more spacious showing area and some supportive tools such as chairs, rails, rubber ramp, and holders. Mrs. Edwards is able to walk as long as 20 meters independently and without support. That way, the main modifications that are required in order to satisfy her needs involve the provision of support, elimination of the obstacles preventing her movement around the bathroom, and removal of the objects that may carry threats and risks contributing to falls.

Bathroom Layout

The bathroom of Mrs. Edwards is rather small. It contains a single shower cabin, a washbasin, and a toilet. According to the effects inflicted by the condition of the patient, the main areas of problem in her bathroom are the shower cabin and the toilet.

The main inconveniences of the shower involve the step Mrs. Edwards is to manage entering the cabin, the need to stand for a significant amount of time while showering, the small size of the cabin that limits the patient’s movement, the unstable construction of the cabin that may present danger in case of a fall, and the absence of a surface preventing the risk of slipping on the wet floor. As to the toilet, the major challenges for Mrs. Edwards are the absence of rails and holders and the need to lift herself up and sit herself down without reliable supportive tools. Also, the height of the toilet is to be adjusted so that the patient did not have to bend 90 degrees to sit down.

Implementation of the Modifications

Shower

The cabin that is currently present in Mrs. Edward’s bathroom is to be removed completely. It is possible that the patient is able to use it to date, manage the step, and even stand for several minutes. However, the risk of falling is extremely high. Besides, OA is a progressive condition that may deteriorate at any moment, so the need for modification is realistic. The small shower cabin limits the movements of the patient and may cause a fall.

That is why its walls are to be removed. In order to create privacy and also to prevent the water from splashing on the floor wound the shower, the walls are to be replaced by a surrounding curtain. According to the Australian Standard 1428.1-2009, the overall wet areas of the shower is to be 1160 by 1100 mm minimum. The size of the shower cabin is 820 by 830 mm. The wet area surrounded by the curtain is to cover a perimeter of 1100 (the wall where the shower is attached) by 1600 mm.

Also, the wet area should be surrounded by a rubber ramp on the floor for the safer transition from wet to dry floor. Besides, the inside of the shower is to be adjusted to the Australian Standard 1428.1 (2009) and include only the permitted and necessary objects (taps, holders, and showerhead support located at least 600 mm above the grabrail and 900 mm above the floor). The shower hose length is to be at least 1500 mm. The floor of the wet area should be retiled, and have a self-draining waste outlet with a slope in the floor between 1 in 60 and 1 in 80 in the wet area and 1 in 80 and 1 in 100 in the bathroom area.

Also, a self-draining and slip-resistant upwards folding chair with the rounded front corners (10-15 mm radius) is to be installed in the shower. The grabrail and the hooks for clothes are to be within the reachable distance from the seat.

Toilet

Mrs. Edwards’ toilet requires some minor modifications. According to the needs of the patient such as the complicated and painful movement and sore limbs, the height of the toilet seat is to be raised with the help of an over-toiler frame or an elevated toilet seat equipped with the rails for the patient to be able to lift herself up and sit down easier. The proposed model of the seat is called Extra Wide Tall-Ette Elevated Toilet Seat. It comes in two designs – with aluminum and steel frames (the latter is suitable for overweight patients and can support the weight of 274.2 kg). The overall width of the seat is 570 mm, and the width between the grab bars is 460 mm. the seat adds 100 mm to the overall height of the toilet and weights 4.1 kg. SWEP provides the maximum subsidy amount of 90 dollars for all the basic and shower equipment (shower chair and toilet seat).

Conclusion

The modifications proposed for the bathroom of Mrs. Edwards are relatively minor and do not require much intrusion and change. Toiler equipment is easy to install and use. The shower modifications are more complex and time-consuming; however, they ensure the patient’s safety preventing falls and accidents that could endanger her life and health.

References

Australian Standard 1428.1. (2009). Web.

Care and Repair. (n. d.). Making your home a better place to live with arthritis. Web.

Department for Communities and Social Inclusion (n. d.). Bathroom Safety. Web.

Messinger-Rapport, B. J. & Thacker, H. (2003). Mobility: A practical guide to managing osteoarthrosis and falls. Geriatrics, 58(7), 22-29. Web.

Stevens, J. A. (2010). A CDC Compendium of Effective Fall Interventions: What Works for Community-Dwelling Older Adults. (2nd ed.). Atlanta, GA: CDC. Web.

Statement of opportunity

Orthopedic surgery practice intends to start MRI services to cater to the increased population in the local community and offer high-quality services which are not available from other MRI service providers. The main aim of Orthopedic surgery practice is to provide a portable MRI service that reaches all populations at an affordable price and of high quality with intend of reducing the congestion among the service providers.

The administrator’s vision

The administrator is the advantage of the failures of existing MRI service providers to deliver quality services. This will give them a competitive advantage as compared to other service providers. As described current service provider in the local community is not portable and not of high quality. The administrator has visualized a portable MRI, which is good for the community as it will reach the remote areas where there will be people requiring medical services. The population has grown drastically due to the movement of people to the area; thus, they need an MRI service provider who will reduce congestion among the service providers and offer quality services. The increased target market that varies from young to old requiring the services.

The organizational structure will change drastically since a new product will be introduced. The portable MRI will require new employees to handle the portable services, which changes the organization’s structure. The organization may be at the moment being structured in a manner that they provide services only to orthopedic surgery. However, the MRI service will increase the number of departments within the organization. It will also require the acquisition of new equipment and increasing office space for the extra staff; the parking space will also be increased within the organization. If funds are available, there will be an increase in building and construction for the purposes of the project. The capital structure will be also be affected depending on the requirements and the mode of raising capital.

However, the most affected structure of the organization will be the human resource structure, where there will be an increase in human resources introducing a new department for handling the service. The other structure that will be affected is the capital structure; extra money will need to be injected to support the new equipment, new employees, and construction of other facilities.

Organization structure defines how tasks and jobs will be carried out formally among groups or employees and how it is coordinated. Therefore work specialization departmentation and formalization of activities within the organization will be affected drastically.

Environmental factors

Many environmental factors will affect the business before they start. The environmental factors that affect the business will include competition, political, legal, employment, economics, and many others.

Competition

Currently, there are companies operating and offering MRI services to the local community. The local communities are used to manage medical care services and the main aim at the moment is to provide reduced health care cost services, and each company is reducing the services. This company will face stiff competition from the existing service providers who will leave no chance without causing many problems.

Another established competitor of MRI service will be medical providers from outside the local population who provide low-cost medical care services with a more established customer base with a huge financial cash outlay. This could give the company a challenge and a run for their money. In addition to the medical care service provided by the local and foreign company, the government also provide medical services. However, if they do not offer a provider-based delivery portable MRI service, the will cause a challenge.

Most of these companies have already achieved their vision, and a new service provider to the market should be able to look at the future so that they will be inspired in satisfying the customer by working extra hard to convince their customer about their services. The main focus for the company should be to offer unique MRI services that are not found in the existing service providers to help them get, motivate and retain customers.

Reimbursement

One of the most challenging environmental factors in this business is reimbursement. Being a portable facility, some of the customers may come in to reimburse their money, which is used somewhere else. However, the world is full of people with ulterior motives who may come to demand reimbursement for what actually is not theirs. This may cause many financial losses for the company, and this may not be good for the company. Before reimbursing, the company should try as much a possible to ensure that they have been implemented a system that identifies genuine reimbursement claims.

Employment

Once the company starts operating, it’s expected to hire the local population. The local population that has been hired is expected to work within the organization and deliver good services expected to society. Employment will be used to increase service delivery. However, at the same time, it will increase expenses to the company, which in turn will be expensive in the long run.

Political

A company that will be operating in this environment should update itself with issues relating to the rules and regulations governing the MRI services. They should also be able to know the rules and regulations governing employment and competition among the players in the industry.

Economical

There is an increase in the cash flow within the local population since most companies have moved in, and therefore the company expects to have a stable cash flow that will sustain its activities.

Social

The company should be able to deal with threats emerging from customers moving to oppose the idea of portable MRI services. There is a change in lifestyles and life patterns among the residents, which means people have changed their culture and will wish to have a service that takes care of their needs.

Technology

The company, by offering portable MRI services, will be staying up to date with technological factors, which are important in service delivery to the population of the world today. It is vital for any company operating in this industry to be up to date with technological changes.

Risk analysis

There are many risks and benefits associated with this opportunity. This includes the SWOT analysis.

Strengths

It will be the best company to launch a portable MRI service in the area, thus increasing the customer’s confidence. The company will have high operational margins as compared to other companies operating in the market. There is also the uniqueness of the product that is being offered by the company. The company is situated in a good location that offers good services.

Weaknesses

There are too many companies operating in the industry offering the same services. The company also will be faced with the problem of trying to sell unknown products in the market. There is also a lack of manpower at the moment since they will be required to increase manpower.

Opportunities

There is large increasing market due to the moving in of companies from other areas to the local population. There is also a demand for health services in the area, which is also increasing in the area.

Threats

The threat here is the increase in competition from other industry players.

Human resource planning

The new product that is being introduced in the market will need an extra human resource for successive service delivery. The company should strive to increase human resources by selecting, motivating, and retaining the best human resource in the market. We need to increase the human resource and a full department that will be handling the service. The human resource required, which will be a full department, will need extra funding to be successful. We will need a head of the department for MRI services, two deputies who will handle:

• the portable MRI services, and the other
• will handle the non – portable section of the MRI services.

The company will need extra technical staff who will handle different sections of patients’ or clients’ data. The human resources chart will change as follows;

Line budget

Line budget for personnel services.

Functional budget.

The projected number of MRI services is 10,000. Therefore, the cost per MRI service is :

920,000/10,000 = $ 92 per MRI SERVICE

Therefore, the cost per MRI will be the US $92.

A program budget

If the clinic is projecting to have 3,000 visits, the MRI services will be charged at 920,000/3000

$307 per MRI service.

Note. This cost does not take into account the cost associated with the equipment purchased. However, the cost will be higher than this if depreciation is taken care of.

References

Armstrong G. & Kotler P. (2007). Consumer Markets: Influences on consumer behavior, Principles of Marketing.

Economist, (2007), Factsheet. Web.

Johnson, G., Scholes, K., Whittington, R., (2006) Exploring Corporate Strategy, 7th edition, Prentice Hall.

Kotler, P. (2005) Principles of Marketing. New York.Melbourne Press.

McTaggart D Finlay C & Parkin M (2003); Economics, Pearson education Australia.

New role of hospital collaboration and specialty services

In this regard, the general hospital will focus on providing specialty services. Collaboration among hospitals is the recent development in reducing the cost health care (Sullivan, 2009). Moreover, the general hospital can reduce operational costs associated with a wide range of services. Collaborating with other hospitals will provide the general hospital with an opportunity to deal with specialty services and maintain high quality in the same. In normal circumstances, community general hospitals can significantly reduce costs when they focus on specialty services. From the underlying context, the general hospital can specialize in orthopaedic surgery and rehabilitation services. Therefore, special skills and knowledge will be harnessed by the hospital, as well as competent medical staff associated with the services.

Assuming the role of a specialty hospital is critical if optimizing on available resources is a core objective. In addition, the probability of obtaining positive outcomes from services delivered is higher than when operating a community hospital.

Specialty hospitals benefit from reduced interdepartmental conflicts. Apparently, general hospitals operate several departments that are of diverse nature. In most cases, an inter-departmental conflict among departments and the respective staff members is inevitable. Consequently, the inter-departmental conflicts affect service delivery in terms of quality and efficiency. In this regard, the general hospital can attain its objectives through the concept of team players. Research studies have indicated that patient satisfaction and increased infection rates are evidenced among hospitals offering specialty services.

For a general hospital to achieve specialty hospital status, an effective collaboration with other hospitals is required. This collaboration should include sourcing of skilled physicians to coordinate orthopaedic surgery and rehabilitation services at the general hospital. In addition, the general hospital will refer patients seeking other health care services to the collaborating hospitals. From this perspective, partnering hospitals will benefit from a collaborative marketing strategy. The collaboration approach will improve consistency of service delivery in the general hospital. This consistency will be exhibited by control and management of resources, service standardization, employee competency and patient education.

Once the hospital achieves the specialty status, it will benefit from differentiation as a marketing goal. In this regard, the hospital will offer differentiated health care programs compared to is competitors and partners. The differentiation factor is critical in marketing, as well as maintaining competitiveness. In addition, maintaining focus in an individual program such as total joint center in orthopaedic surgery signifies competitiveness of the facility. Moreover, the focus and physician-centrism derived from specialty programs are appealing to patients. Patients tend to trust specialty hospitals that offer improved and patient-based services.

New mission and vision statements

Mission statement

The orthopaedic and rehabilitation center delivers innovative, quality and cost- effective services in the region. The orthopaedic and rehabilitation center provides both inpatient and outpatient surgical services. The center also provides rehabilitation, consultation, counseling and patient education services. The center identifies a safe environment for patients’ recovery and improvement. The orthopaedic and rehabilitation center offers educational and research facilities to the public and health care experts.

Vision statement

The orthopaedic and rehabilitation center’s vision is to become a regional teaching hospital, as well as a medical facility for orthopaedic surgery and rehabilitation services. The center will specialize in acute and chronic orthopedic surgeries. The center is to provide orthopaedic and rehabilitation services to adults and children. The center is to maintain quality standards in specialized surgical and medical programs.

Reference

Sullivan, E. J. (2009). Effective Leadership and Management in Nursing. Upper Saddle River, NJ: Pearson/Prentice Hall.

Demand Evaluation

The selected service line for Trinity community hospital will be an orthopedic center, where the evaluation showed that the overall demand for such a service would be the highest in the near future. The given center was selected by primarily evaluating and comparing the expected demand for other types of centers, which are cancer center and a cardiovascular center. In the case of oncology services, there is an estimated growth of new cancer cases of 34%, and for cardiovascular services, the number is 21-25% (Trinity Community Hospital., n.d.a). However, it is stated that: “orthopedic cases are expected to climb from 11,800 to 17,338 (+46%)” (Trinity Community Hospital., n.d.a, p. 2). In other words, the selection was mainly conducted on the basis of the largest demand increase in the next five years. Therefore, it is evident that the new service line should be an orthopedic center because the general capacity increase is mandatory in order for Trinity community hospital to be able to accept and treat the growing number of patients. It is stated that: “with current resources, physicians and hospitals will be unable to meet the growing demand for orthopedic services” (Trinity Community Hospital., n.d.a, p. 2). Thus, it should be noted that launching and opening a new orthopedic service line will greatly boost the hospital’s future ability to serve the marker area or community.

Analysis of Current International Healthcare Trends

It is important to note that the current international orthopedic healthcare trends revolve around the process of minimal invasiveness. One of such trends includes a bendable medical screw, which can be highly useful in conjunction with a continuum manipulator in order to fixate the bone fragments by drilling curved tunnels (Alambeigi et al., 2019). Such a novel approach is necessary to provide clinicians with more levels of freedom in regards to the selection process of a drill entry point (Alambeigi et al., 2019). In other words, bendable medical screws enable more complex operations with less invasive techniques, which ultimately benefit both patients and doctors.

Another international orthopedic healthcare trend, which revolves around a notion of minimal invasive surgery, is the use of orthopedic surgical robots. Robot-assisted surgeries and general orthopedics surgical robots market is expected to grow up to 47% in the near future (“Top 3 trends impacting the global orthopedic surgical robots market through 2021: Technavio,” 2017). In other words, robots can prove to highly useful in the new orthopedic service line due to their advanced precision and full-on automation. Integration of automation in the center will be a plausible solution for the ever-growing demand for orthopedics surgeries at Trinity community hospital. In addition, the integration of such assistive technologies will reduce the general need for medical specialists, which opens up opportunities to focus on existing professionals by improving their satisfaction levels.

Existing Programs

The existing service lines and programs at Trinity community hospital revolve around the recent initiatives by Fred alongside the Five-year Program. In the case of the latter, it is evident that the general plan of the hospital is to focus on four key areas, which are growth and profitability, staff achievement, service excellence, and quality and safety (Briscoe, n.d.). The growth and profitability section sets objectives, such as having 2100 surgical cases, 6500 physical therapy visits, and $2171500 margins (Briscoe, n.d.). Staff achievement-related outcomes are orthopedic staff retention rate higher than 90% and orthopedic nursing staff certification higher than 75% (Briscoe, n.d.). In regards to service excellence, the goals are based on reaching the physician satisfaction larger than 90th percentile with the likelihood of recommending percentile equal to or bigger than 90th. Lastly, the quality and safety segment strives to achieve pre- and post-procedure class attendance to be around 75%, where the CMS orthopedic indicator set higher than 90th percentile (Briscoe, n.d.). In addition, Trinity community hospital wants to build a new 5000-square-foot rehab/physical therapy center for $600000 – 700000 and purchase a second MRI for $3000000 (Briscoe, n.d.). Therefore, these modifications can serve as complimentary components to the new service line.

Moreover, Fred’s proposal can also be utilized as an adjacent element of the new service line and even be incorporated into it if he cooperates with the CEO. Fred claims that he and his team secured office space near Trinity hospital in order to open a branch orthopedic center (Fred, n.d.). Therefore, such a proactiveness can be used to jump-start the orthopedic service line because the only requirement from the CEO is to build and develop an outstanding orthopedic program.

Financial Feasibility

The financial feasibility of the new service line introduction is primarily derived from the CFO’s estimates. They are based on the fact that the projected payer mix, volume increase, operating efficiency improvement, and reimbursement trends will take place (Mike, n.d.). The Five-year Projection of Mike states that the ratio to cost to charges will be equal to 31%, whereas the collections rate will be at 35% (Mike, n.d.). In addition, the gross charges per physical therapy treatment are equal to $275, and gross charges per orthopedic surgical case are equal to $25000 (Mike, n.d.). The demand estimates from the community health needs assessment show that the number of orthopedic cases will increase from 11800 to 17338 (Trinity Community Hospital., n.d.a). In other words, 5538 additional cases will occur in the near future annually, which means that in the fifth year, the gain in revenue will be around $138450000. Such an increase in conjunction with proper operational modifications will make the hospital profitable again since the patient volume will increase due to the opening of a new orthopedic service line.

Marketing

In order to secure referral services, it is important to properly target and market to physicians. The key strategy will revolve around building a certain form of brand image and separate identity from Trinity hospital. It will be useful for non-Trinity-based physicians since in-Trinity ones will be easily accessible due to the CEO’s position and influence. The marketing will attract referrals by posing as a high-tech advanced service line, where automation, robotics, and novel approaches are being integrated. For example, in order to adhere to the current international orthopedic healthcare trends, the center will implement robots, which will assist the medical experts during their surgeries. Therefore, it can be used as proof of the center is on the edge of advancements. In addition, the essential and vital key performance indicators will also be addressed, such as satisfaction. Bendable medical screws can also be used as a point of marketing, where the mere rarity of these improvements can attract physician referrals. Therefore, the appeal and attraction for physician referrals will be based on the mere quality of service provided by the orthopedic centers, which will be unmatched due to an aggressive integration of novel technologies.

References

Alambeigi, F., Bakhtiarinejad, M., Sefati, S., Hegeman, R., Iordachita, I., Khanuja, H., & Armand, M. (2019). On the use of a continuum manipulator and a bendable medical screw for minimally-invasive interventions in orthopedic surgery. IEEE Transactions on Medical Robotics and Bionics, 1(1), 14-21. Web.

Briscoe, M. (n.d.). Five-year program plan [PDF document].

Fred. (n.d.). Branch orthopedic office [PDF document].

Karuppiah, K., & Sinha, J. (2018). Robotics in trauma and orthopaedics.Annals of the Royal College of Surgeons of England, 100(6_sup), 8-15. Web.

Mike. (n.d.). Five-year financial estimates presentation [PDF document].

Top 3 trends impacting the global orthopedic surgical robots market through 2021: Technavio. (2017). Web.

Trinity Community Hospital. (n.d.a). Community health needs assessment [PDF document].

Trinity Community Hospital. (n.d.b). Trinity community hospital fact sheet [PDF document].

Newmaker, C. (2019). 7 companies transforming orthopedics with robot-assisted surgery.The Robot Report. Web.

Changes that could be made to maximize patient throughput, surgeries and revenue without compromising the quality of medical care.

There are several changes and options that could help maximize patient throughput and revenue without compromising the quality and standards of medical care at Dr. Christopher’s orthopedic clinic. These options include hiring more surgeons, reducing the length of changeover time for the two surgeons, increasing the amount of hours the surgeons’ work every day and creating some time to see patients on Fridays and weekends.

These changes could enable the surgeons attend to more patients and increase their revenue without compromising the standards of quality care. To avoid compromising the quality of medical care, the surgeons could hire a professional to review the medical records of patients and draft reports on their specific needs.

First, the clinic could hire additional surgeons to cater for the large number of patients in need of surgeries. With more surgeons working at the clinic, more patients will be attended to, and that will increase the revenue of the clinic. The quality of the medical care will not be compromised because the surgeons will have enough time to rest and review the records of patients.

Increasing the number of surgeons to attend to the large number of patients being served by the two surgeons will improve effectiveness and efficiency. However, they should not hire more than two surgeons because they will incur high expenses and the number of patients might not change.

Secondly, Dr. Christopher could reduce the changeover period by few minutes to create additional time to attend to an additional patient every day. In addition, they could reduce the length of time for lunch by a few minutes. Combining these minutes that they cut off from their other schedules, they could create enough time to attend to an additional patient at the end of the day.

For example, Cartilage knee repair and Achilles tendon repair take 30 minutes each. If they reduce the changeover time by 15 minutes and lunchtime by 20 minutes, they could have time to operate on one patient at the end of the day.

Thirdly, they could increase the amount of time they work every week by one or two hours. The surgeon changeover time and surgery time for the orthopedic surgeries are different. For example, Achilles tendon repair and ACL ligament repair require 50 minutes each to complete the procedures.

They require surgeon changeover time of 20 minutes and surgery time of 30 minutes. If they increased the amount of time they work each day by one hour, they could be able to attend to an additional patient with a requirement that needs a little time. They could either choose to come to work earlier than they do or leave work later than they currently do.

Fourthly, they could create some time on Fridays and weekends to attend to additional patients. The two surgeons do not work on Fridays and weekends. Therefore, if they could set aside some hours to attend to patients, they could increase their productivity. For example, they could set aside two hours on Friday and Saturday.

On Sunday, they could use it to rest and spend time with their families but in case of an emergency, they could spare some time to attend to the patient. These hours could be used to carry out the complex surgical procedures that lack sufficient time to be carried out on weekdays. They could also dedicate Fridays and weekends to orthopedic procedures that require more time because of their complexity.

They could hire a professional to conduct patient reviews and prepare reports on the different needs of various patients. This professional could be useful in making the work of the surgeons easier by saving them time and assisting them during surgeries. The surgeons need sufficient changeover time because they are usually very tired after surgeries.

This professional could assist them during surgeries so that they are not overworked or highly tired after the surgery. This could help in reducing the changeover time they require for rest and review of patients’ medical records. They could also consider synchronizing their work schedules so that they can work together on certain days.

Orthopedic surgery procedures such as shoulder replacement, hip replacement and knee replacement require a lot of time. The surgeons could consider carrying out these procedures together. It is difficult and tiresome for one surgeon to conduct a surgery for three hours without getting excessively tired.

Final recommendations

First, Dr. Christopher should hire additional surgeons, may two or three. They should hire highly qualified surgeons to ensure the quality of medical care is not compromised. Their tight schedules do not allow them to focus all their time on patients at the clinic because they have other responsibilities. In addition, they need time for their families and sufficient rest.

They should hire a surgeon who does not have many responsibilities and who is highly qualified. The additional surgeon could attend to patients who require simple surgeries such as cartilage knee repair and Achilles tendon repair that are not very demanding. Dr. Christopher and his fellow surgeon could then attend to patients who require complex surgery procedures.

This will ensure that the quality of medical care is maintained and patients do not lose confidence in the quality of services offered at the clinic. Secondly, they should consider setting aside time on Fridays and weekends to attend to more patients. The time they dedicate to patients at the clinic during weekdays is not sufficient. For example, surgeries are only carried out from 7 am to 12 noon only. The surgeons dedicate their afternoon time seeing patients at the clinic and hospital.

They should consider setting aside two or three hours in the afternoon for surgeries so that patients who are unable to come during the first half of the day can also be attended to. Thirdly, they should decrease the changeover time between surgeries by hiring an assistant. The assistant’s job will be reviewing patient medical records and making reports on the various needs of different patients. This could help the surgeons save some time that they could use at the end of the day to attend to some patients with minor cases of surgery.

In addition, the assistant could help them during surgeries in order to make their work easier and less tiresome. This will improve their efficiency and productivity because they will not be overly tired at the end of the day. The most important aspect of ensuring improved efficiency and productivity is to create more time to attend to more patients at the clinic. In addition, getting more help by hiring additional surgeons and an assistant is necessary.

Introduction

Trinity community hospital is located in the southeast of the United States with a bed capacity of 150 patients plus an intensive care unit of 14 beds. The hospital offers all the basic support services which include internal medicine, radiology, pharmacy, urology, general surgery, gynecology, neurology among other services. All these services are offered by a team of 89 staff members who are qualified and registered by the board. The campus on which the hospital sits measures about 25-acre that is easily accessible. Trinity community hospital has a main hospital and an addition of four medical office buildings (MOBs) with an area of 60,000 square feet.

The management of the hospital is faced with the possibilities of constructing on its land, purchasing or to lease the area where the orthopedic service line will be established. All the three options available for putting up the orthopedic service line have pros and cons as it will be analyzed.

Building Orthopedic Service Line

The strategic plan of the hospital stipulates that over 5000 square foot of physical therapy and rehabilitation center is required in order to set up a regional orthopedic service line. In addition to this, a renovation of an empty space in MOB 1 is required to cater for oncology center.

Advantages of Building Orthopedic Service Line

In building, the hospital will get a style and exact design required of orthopedic service line. The constructed service center will be integrated right inside the hospital compound and interrelated with other core functions of the hospital. It will also enhance proper utilization of space and put into use vacant space like that in MOB 1. The hospital already owns the 25-acre piece of land, this translates to few legal requirements and procedures when setting up the orthopedic center as the buildings will be constructed on own land. This will lead to the realization of the strategic plan within the stipulated time.

Most private physicians have leased office blocks at the expense of hospital scramble for space. The physicians can be relocated to create space and room for the orthopedic service line. One major reason for the hospital to construct an orthopedic service line is to boost its financial performance and at the same time maintaining confidence in the surrounding community. The established orthopedic service line will have a major impact only if the building facilities are brand new to create a positive perception to the community.

Buying Space for Orthopedic Service Line

The location of the hospital gives it an advantage of availability of unoccupied land adjacent to the hospital which can be acquired for the construction of orthopedic service line.

Advantages of Buying Space for Orthopedic Service Line

The Chief finance officer of Trinity Community hospital in his letter to the hospital’s chief executive officer has clearly stated of lack of enough space to expand existing facilities and has rooted for off-campus options for some facilities in the hospital. This is a clear indication that buying space is preferable than building on the hospital campus grounds. The cost of building orthopedic service line next to the hospital is approximately $ 700,000 as compared to that of constructing which amounts to about $ 600,000. The marginal difference of $ 100,000 is not much considering the need of space for hospital’s future expansion.

The hospital’s management could still negotiate with the owner of the adjacent land and settle for better deal that is less expensive. Another advantage of purchasing space is that it comes up with its competitive structure whereby the community will develop a positive attitude towards the hospital as the acreage it occupies will increase hence expansion. The development of orthopedic service line requires a physical layout with consideration of traffic flow, speed and operational efficiency which can only be achieved on an ample space acquired through buying (Langabeer, 2008).

Leasing Orthopedic Service Line

Leasing is acquiring an asset, equipment or piece of land for an agreeable period of time with the lessor. Trinity community hospital has an opportunity to lease its development space for setting up an orthopedic center instead of building on its own land.

Advantages of Leasing Orthopedic Service Line

Leasing will save the hospital the cost of purchasing or building new hospital buildings which may be left redundant if the orthopedic service line proves not economic viable. This is possible in cases where the hospital’s competitors which include tertiary medical center and regional hospital decides to set up a more superior orthopedic center that may overshadow the one set by Trinity community hospital making it redundant.

The chief finance officer clarifies that triple net lease is the type of lease available in hospital’s case. This has an advantage whereby the taxes, maintenance cost and insurance on the leased property are deducted from the total tax payable. Leasing also saves on the capital outlay as less money is used as compared to purchasing and buying. The hospital may also decide to redesign the leased property when renovating to make it suite the planned design and adhering to all the rules and regulations required (Atkin & Brooks, 2009).

Disadvantages of Building Orthopedic Service Line

It will cost the hospital about $ 600,000 for constructing 5,000-square foot. This amount is far much more as compared to the budgeted amount. The construction of new buildings on the hospital campus will crowd the hospital and strain free space allocated for future expansion. This is evident where the chief finance officer advised the chief executive officer of the need to preserve some space for future expansion of the hospital. Building an orthopedic service line requires a lot of planning and designing, this takes considerable effort and more time. There is always additional cost apart from the one planned for the purpose of construction, these includes cost for decoration, landscaping and other minor fittings.

Disadvantages of Buying Orthopedic Service Line

The hospital may be forced to demolish the current structures in the bought space as they may not fit with an orthopedic center thus incurring more cost. Buying a constructed building space denies the new owner an opportunity to design the layout of the building to suite the purpose its intended for as it may sometimes be uneconomical to demolish some building structures on site. It requires a lot of capital investment to buy orthopedic service line space; this capital will have to take time for it to be recouped back. When buying a building, the new owner becomes the sole caretaker of the property and must comply with all the set regulations such as firefighting equipment, health and safety precautions inflating the operational cost.

Disadvantages of Leasing Orthopedic Service Line

One major disadvantage of leasing is that the property under question does not change ownership regardless of the leased duration. This denies the hospital the opportunities that come with acquiring a new asset. The lessee has to bear taxes, maintenance cost and insurance as part of expenses associated with the leased premises. Trinity community service hospital may lose the benefit of potential capital gain in case the property value increases during the leasing period. It may not be possible for the hospital to terminate the contract before the end of the lease period and heavy fines are imposed if the contract is terminated prematurely

Recommendations

Trinity community hospital currently has a land of 25-acre plot. This land is limited as compared to hospital and the need to expand as more needs arise. It is not advisable to start congesting the hospital land space of 25-acres and the adjacent land is available for purchase or lease. In most of the cases, land is an asset that keeps on appreciating. There is a need to purchase it before it gets to extreme price levels and also the availability of land in prime areas.

Buying land space adjacent to the hospital to put up orthopedic service line center is the best way to go about it as this will give more space for future expansion. The main hospital will also be left with an ample space for expansion and putting up medical office buildings as the need arises. This may be necessitated by the increase in the number of patients who may require the hospital specialized services.

References

Atkin, B., & Brooks, A. (2009). Total Facilities Management. New York: John Wiley & Sons.

Langabeer, J. R. (2008). Health Care Operations Management: A Quantitative Approach to Business and Logistics. London: Jones & Bartlett Learning.

Executive Summary

The main objective of Rocky Mountain Valley Hospital is to introduce a new product, Orthopedic Service Line, into the market. The marketing plan aims to apply the evidence-based approach in creating a comprehensive way of analyzing key performance indicators, designing care pathways that diminish undesirable differences in care delivery, and increasing patients’ outcomes and satisfaction. Subsequently, the plan would reduce healthcare costs by increasing the effectiveness of healthcare delivery, reducing readmission rates, decreasing the duration of hospital stay, and checking complications.

The attainment of the objective would enable WHS to improve its status and take part in Bundled Payments and Accountable Care Organizations (ACO). Moreover, the plan would enable patients with high-deductible insurance plans to access orthopedic services offered by WHS.

Essentially, the marketing plan of the new Orthopedic Service Line aims to:

1. Improve patient outcomes and satisfaction through the delivery of patient-centered quality services and collaborative relationships.
2. Streamline and synchronize processes and operations for nurses, physicians, and orthopedic teams to provide optimal orthopedic services to patients.
3. Reduce the cost of providing quality healthcare services to patients.
4. Augment brand awareness and expand the market share of the new service line of WHS.

In streamlining the process of service delivery, the service line categorizes similar services and products for the orthopedic team to synchronize operations and get optimal patient outcomes. The streamlined process and synchronized operations enable WHS to provide quality orthopedic services and boost patient satisfaction. As orthopedics need services from surgical, nursing, physiotherapy, and rehabilitation departments, the service line focuses on developing a comprehensive healthcare product to provide care before, during, and after the provision of orthopedic services to facilitate patients to benefit from the entire treatment cycle. Essentially, the service line is beneficial because its goals are to establish leadership in orthopedic service delivery through the adoption of quality care and increase patient inflow and market share.

In the aspect of actionable programs, WHS ought to satisfy the marketplace by employing adequate healthcare providers, establishing a robust communication system, and expanding the scope of the service line. Another program is the exploitation of competitive advantage by ensuring the expansion of the facility to accommodate an increasing number of patients. Additionally, WHS would reduce costs of supplies by comparing vendors and identifying one that offers affordable rates.

Background

As a famous hospital accredited by the American Osteopathic Association (AOA), Webster Health System has grown over decades as a profit-making organization. Due to its substantial growth, the hospital changed its name from Webster Hospital to Webster Health System (WHS) and affiliated itself with the Osteopathic Hospitals of America, Inc. (OHA). Moreover, WHS enjoys consulting services from healthcare providers from Osteopathic Medical Center (OMC). OHA and OMC support WHS by providing the management system, offering logistic services in the supply chain, and making investments. Currently, WHS has grown and become an ambulatory clinic that offers timely healthcare services.

Lifestyle changes and technological innovation have altered the delivery of orthopedic services in the modern hospital setup. Sedentary life and technological advancement create opportunities for growth in the orthopedic service industry. To enhance the quality of service, organizations must involve all other stakeholders in the service industry through collaborative ventures. Service line managers must adopt good marketing plans in developing strategies to enhance market penetration, collaboration, and cost control. The marketing plan involves the SWOT analysis, the evaluation of economic projections, market assessment, trend analysis, competition and opportunities, organizational objectives, and the action program WHS intends to take to achieve the objectives.

Target Market

To expand its market share and improve service delivery, WHS seeks to create a new Orthopedic Service Line, which targets adults aged between 55 and 75 years. Adults in this target group participate actively in skiing, hiking, cycling, and skating, and thus, prone to sustain injuries that demand orthopedic services. Moreover, these adults are conscious about their health for they understand the essence of physical activity and healthy lifestyles in improving health. Since the annual household income is above $75,000, healthcare services are affordable.

Vision and Mission

The vision of WHS is to be the best provider of orthopedic services in the Rocky Mountains. To achieve its mission, WHS will provide quality healthcare services that are not only affordable but also meet the expectations of patients. The following is the mission statement:-

“To be a modern orthopedic center that is well-equipped, adequately-staffed with highly-trained personnel, and effectively-specialized to provide the best orthopedic services to improve patient outcomes and the quality of life.”

SWOT Analysis

SWOT analysis depicts factors that directly contribute to the current WHS’s revenue position and the capacity to respond to the issues surrounding its business activities. From the 2X2 SWOT table below (Table 1), it is apparent that WHS enjoys an already established brand name, adequate expertise, and its urban location as its strengths. However, the shrinking reimbursement from third-party payers has significantly led to losses in the orthopedic service line presenting a weakness, which negatively influences WHS’s future in the orthopedic business. Additionally, threats from the external environment such as intense competition, high-barriers from established collaborative ventures, private clinics, and implementation of regulatory policies on value-based payment models critically affect the orthopedic service industry.

However, the presence of opportunities such as the lack of all-patient-needs one-stop facility, and service line expansion facilitates the delivery of patient-centered and cost-effective high-quality services, making the orthopedic service industry attractive for investment

Table 1. SWOT Analysis.

Management Summary

The formulation and adoption of a marketing plan for the orthopedic service line in the facility is a key success factor for the enhancement of the competitive edge and sustained the development of WHS. The strategic objective involves enhancing the market share of WHS through the delivery of patient-centered quality services and collaborative relationships. As a strategic approach, the marketing plan seeks to develop a model to align the orthopedic service program with WHS’s perspective and make it a quality-oriented one-stop facility for all patient needs.

The basic factors driving the development of the marketing plan include price transparency, technological innovations, new revenue opportunities, and controlled management. Price transparency involves the adoption of a value-based payment model in line with the Patient Protection and Affordable Care Act to promote the delivery of economically sustainable healthcare. This model supports the development of quality of care that is commensurate with the cost. Intense competition in orthopedic service delivery has a negative influence on the profitability of WHS. The reduced income of WHS requires the identification of new opportunities to widen the scope of care delivery and expand opportunities for revenue generation.

By adopting the marketing plan, WHS expects to expand its market share, increase revenue, and sustain its growth. By expanding its market share, WHS will adopt collaborative relationships with orthopedic physicians, other hospitals, and vendors in the delivery of quality orthopedic services and ensure mutual financial success. Additionally, to enhance the competitive position and achieve sustained growth, the strategy of WHS aims to implement continuous market analysis and internal evaluation of services to identify specific areas that need improvement and embrace dynamic healthcare needs. Overall, the marketing plan significantly guides WHS to benchmark and establish all-inclusive, quality, and patient-centered services.

Economic Projections

Marketing Cost

Reduction of operational costs is essential to maximizing the profitability of WHS. The provision of orthopedic services faces great challenges involving the existence of a relationship between the quality of service and product marketing. Patients largely depend on the choice of healthcare service, the availability of information on an organization’s service, and the associated cost (Manning et al., 2017). Therefore, the provision of affordable services targets extensive markets and allows patients to choose appropriate services. The medium for the promotion of the service significantly affects the accessibility of information. High cost and low-market reach medium would negatively affect the marketing of the service. Thus, WHS must consider a wide-market, moderate-cost medium to enhance orthopedic service market appeal and projected income.

Population Economic Conditions

Inflation, employment, and social-cultural environment influence the consumption of services within the market. Improvement of population revenue significantly affects the population’s lifestyle and the choice of the communication channel. The rise in social media usage, consumer activism, and diverse demographic characteristics is essential in augmenting the ability of WHS to generate income.

These income characteristics should influence WHS’s choice of marketing channel. Since most of the young working population acknowledges online-based communication, WHS must adopt internet-based marketing strategies to enhance market awareness among this group. Additionally, this population embraces consumer activism in influencing peer choice of service. Consequently, since the young population occupies a large proportion of the target market, the adoption of printed media advertisements would negatively affect the ability of WHS to undertake marketing and generate income.

Expectations of WHS

WHS aims to enhance its competitiveness and revenue generation to expand its market share. Additionally, WHS intends to improve its market share and revenue by targeting lower socio-economic classes whose demand for orthopedic services is highly sensitive to the cost of service. To achieve this objective, WHS must target-present customer composition, access market potential, and evaluate the demographic characteristics of the population. Hence, WHS must adopt aggressive marketing strategies targeting the entire market segment. In essence, an organization’s expectation considerably influences the choice of marketing channels, budget allocation, and the projected income.

Qualitative Analysis of the Market

Outpatient services form the largest component of the orthopedic service industry. Medicare and Medicaid enjoy the largest proportion of 2.3% and 1.1 % of the total 8% medical costs, which comprise the highest third-party payer services for orthopedic patients within the industry. Third-party payers substantially determine the access of patients to care (Badley, Canizaress, Mackay, Mahomed, & Davies, 2013). Hence, the contribution of value-based reimbursement in the orthopedic service industry demands that WHS adjusts and accommodates the needs of all industry stakeholders while maintaining quality care. Other prospects for the service include vendors and orthopedic surgeons. Geographically, patients within the Rocky Mountain region form the primary patient population for the company. However, older patients within these settings are the main target population.

Quantitative Analysis of the Market

It is possible to conduct a quantitative estimate projecting the potential return on investment since most insurance plans provide some coverage for all orthopedic services. The expansion of service lines promotes quality of care in the facility, which is in line with the objectives of third-party payers, such as Medicare. Additionally, during treatment, establishing a one-stop center for all orthopedic and related care needs consolidates all income within one facility and harnesses extra income that would have been lost through referrals to other facilities. Furthermore, adopting a rehabilitation unit and home-based care after treatment expands the scope of the source of income for the facility.

Trend Analysis

The new consumer market commands the main role in shaping inclusive healthcare. Due to technological advancement and social demographics, healthcare information is readily available to the public, which influences the patient role in shaping the quality of service. However, most consumers believe that healthcare service providers barely acknowledge the needs of the patients and associate healthcare services with a one-size for approach (Manning et al., 2017). Despite this notion, contemporary consumers want a personalized, convenient, and value-based service. These consumer demands act as a benchmark that shapes future healthcare services, their measurement, and the adaptability of organizations.

Furthermore, the provision of advanced technology products and quality care continues to form the baseline attributes for consumer preference. Thus, a value-based reimbursement system will continue to act as an appraisal platform reflecting desired outcomes. Other factors shaping orthopedic services and future success include the development of less invasive procedures and biodegradable implants. In this view, WHS ought to align its services with this new breed of customers and develop medical products that fulfill customer needs according to patient preferences. The strategy requires consumer marketing that involves the implementation of quality outcome measures and customer experience training for staff.

The volume of business generated from current services includes income from diagnosis, treatment, and rehabilitation interventions for patients. WHS initially focused on the diagnosis and treatment of orthopedic patients and failed to align care needs with the service line. The high-volume of WHS’s business resulted from outpatient diagnosis and treatment of common medical issues and surgical services (Table 2). However, inpatient care and patient rehabilitation programs, such as joint reattachments of the lower extremities, are among the top ten diagnosis-related discharges. Consequently, the future and success of WHS require the development of an all-needs-patient product before, during, and after the provision of care services to enable patients to benefit from the entire treatment cycle.

Table 2. Trend of Services.

Competition

The major competitors in the orthopedic service industry include OHA and its affiliated companies such as OMC. OHA and its affiliate companies are nonprofit community organizations that use a joint management program. This program limits the management privileges of affiliated companies, shares patient information with OHA, and makes orthopedic purchases through WHS. However, collaborative ventures widen competitors’ patient area coverage through referrals from OHA and other affiliate organizations. Despite the advantage of patient referrals, the movement of patients through different facility settings in the network affects the quality of service and patient satisfaction. These highlighted limitations of its competitors are essential in modeling the company’s competitive strategy and market penetration.

WHS’s stance is competitive due to the changes in the orthopedic service line it has adopted. These changes include engaging physicians in management, collaborating with high-quality orthopedic device vendors, and expanding and consolidating the patient service care in one facility. The competitors limit their focus on patient care to treatment and sourcing services from affiliate companies.

Therefore, expanding the patient care to include post-treatment and rehabilitation needs would enhance the competitiveness of WHS. Limiting patient movement through different facilities in accessing care needs significantly promotes communication between physicians, resulting in patient-oriented quality care, which influences the patient perception of the choice of organization. Moreover, involving physicians in the decision-making process is essential in promoting patient scale of care, from the consultation to the hospital stay, and finally to therapy and rehabilitation.

Problems and Opportunities

Shrinking reimbursement levels and new payment models from influential third-party payers or employers such as Medicare and Medicaid directly affect the orthopedic service industry. Page, Butler, and Bozic (2013) explain that due to high-growth expectations, payers and providers seek cost-saving opportunities. As a result, the industry develops a dynamic environment in which orthopedic professionals and health systems restructure to optimize outpatient care needs. In line with this industry adjustment, orthopedic physicians engage in private urgent care and after-hour clinics, which in turn lead to intense competition in the industry.

Established organizations such as OHA and its affiliate companies have created high barriers to entry through collaborative ventures in care delivery, which also act as brand marketing channels. These collaborative programs pull a strong customer influence and retention platform, limiting penetration by new health facilities. Additionally, due to value-based reimbursements, third-party payers have significant power in influencing the quality and the cost of service in the industry. However, these service-oriented challenges are essential in shaping the opportunities for growth of new entrants.

Nonetheless, the decline in orthopedic revenue is a critical internal factor affecting the ability of WHS to adjust and adapt to the dynamic needs of patient care. Low revenue generation limits physician recruitment, the establishment of a one-stop facility, and the acquisition of high-quality orthopedic devices. Given physician-patient ratio is essential in meeting the increasing demands for personalized services and wait-time, low recruitment impairs the quality of care.

Opportunities

For WHS, the key success factor involves exploiting the opportunities in the orthopedic service industry. The opportunities include expanding the patient service line of care and consolidating orthopedic care needs within one facility. Consolidating orthopedic services requires collaborating with high-quality orthopedic device industries and staffing service lines by recruiting skilled orthopedic physicians and their assistants. Since most patient care happens outside hospitals, the expansion of patient service lines identifies an opportunity for WHS to grow its business.

Staffing helps WHS to meet extra patient demands in providing additional care to patients while collaborating with high-quality orthopedic device industries is essential in providing quality services. Additionally, expanding the breadth of service gives greater control over the quality of care significant in improving patient recovery, reducing wait-time, and providing personalized patient services. The expansion made WHS lead in the provision of orthopedic services by beating rivals who have continually offered partial care and relied on affiliate centers for additional patient needs such as OHA affiliate companies.

Objectives and Goals

Qualitative

The long-term goal of WHS is to establish its leadership in orthopedic service delivery through the adoption of quality care. To improve its services, WHS intends to modify its care through the expansion of the service line to incorporate both orthopedic needs and other services associated with orthopedics such as cardiac care, trauma, and rehabilitation services in a 3-5 year period. This process is essential in transforming the orthopedic unit of WHS into a one-stop center with the objective of establishing its market as an orthopedic referral center in the region.

The short-term objective is to modify the structure of the orthopedic service line in the first quarter. The modification involves recruiting a balanced physician-patient ratio, involving physicians in management processes, and controlling operating costs. This improvement of service processes positively influences consumer perception (Olson & Mather, 2013). Physician-patient ratio improves of consultancy services essential in the identification of emerging challenges and modification of care to the short-term needs of the external environment.

Quantitative

The goal is to increase patient inflow by 15% in the first quarter and upwardly review this percentage in subsequent quarters based on the current patient population. WHS intends to grow its market share in the industry through the expansion of the service line and the establishment of leadership as an orthopedic referral facility. The process involves quality and patient-centered service delivery. Through service improvement, WHS projects a potential increase in patient volume and facility expansion to accommodate the rise in patient inflow within six months. Growth in patient volume will lead to a growth in revenue.

On the contrary, WHS intends to turn around the negative orthopedic service revenue by controlling its operational expenses. The processes include the involvement of physicians in resource management and the generation of more income from additional patient-oriented care services before, during, and after treatment. According to Olson and Mather (2013), collaborative relationships with orthopedic physicians play a vital role in shaping the health care systems through strategy development, implementation, and improvement of the quality of care. As most patient needs processes are home-based care, the expansion of WHS’s services to include rehabilitation and follow-up services creates an immediate new source of revenue and helps in establishing market leadership.

Action Programs

Satisfy the Needs of the Marketplace

To satisfy the marketplace, within the first quarter, WHS will employ adequate and skilled physicians together with other care assistants, establish a robust communication system, and expand the service line. The market demands act as a roadmap that guides organizational strategic formulation and influences the overall industry profitability (Page, Butler, & Bozic, 2013). Organizational restructuring helps to create a balanced physician-patient ratio, which is crucial in enhancing consultancy services and reducing patient wait time. WHS will also establish a robust communication platform to enhance information exchange between the front-office staff, physicians, and the whole service line. Communication develops a relationship in the setting and accurate exchange of information enhancing proper scheduling of cases, sharing of complete patient records, and improvement of the quality of service.

Secure Advantage over the Competition

To secure an advantage over competitors, the company will ensure completion of the expansion of facility environment within three months to accommodate patients seeking extra care needs introduced in the service line that previously were home-based, such as rehabilitation services. The company must also adopt monthly appraisal of departmental services and staff through sourcing of patient and family member feedback in every step of care. The use of questionnaires, surveys, and online platforms will help identify areas where improvement is required thus shaping healthcare services and improve the quality of care.

Additionally, WHS will engage in web-based and social media advertisements. In conducting online-based advertisements, the company will create an e-book report and encourage voluntary sign-ups by patients and family members during visits. WHS will use this platform in the advertisement, as well as collecting customer feedbacks and suggestions essential in beating its rivals and enhancing its market penetration. The budget makes 5% of the total expected revenue of $530,000 for the year (Table 3). The amount is a positive turnover from current negative revenue.

Table 3. Promotion Budget.

Create Profit

The company will reduce supply costs by comparing vendors and limiting the number of suppliers. This process helps to identify a quality device vendor at an affordable cost, leading to a reduction in expenses. Besides, the company will collaborate with an implant device company to carve out device reimbursement in third-party payments.

Conclusion

Reforms in the orthopedic service industry continue to shape customer needs and the quality of care. The component of reforms requires collaboration amongst hospitals, vendors, and orthopedic surgeons. To keep up with the pace in the industry, organizations must carefully develop and implement strategies to involve comprehensive care, identify areas for improvement, and reduce the cost of operation and patient charges. Action programs aim to satisfy the needs of the market, enhance competitive advantage, and create profits for WHS.

References

Badley, E., Canizares, M., MacKay, C., Mahomed, N., & Davis, A. (2013). Surgery or consultation: A population-based cohort study of the use of orthopedic surgeon services. PLoS ONE, 8(6), 1-8. Web.

Manning, B., Bohl, D., Saltzman, B., Cotter, E., Wang, K., Epley, C., … Bach, B. (2017). Factors influencing the patient selection of an orthopedic sports medicine physician. Orthopedic Journal of Sports Medicine, 5(8), 1-5. Web.

Olson, S., & Mather, R. (2013). Understanding how orthopedic surgery practices generate value for healthcare systems. Clinical Orthopedics and Related Research, 471(6), 1801-1808. Web.

Page, A., Butler, C., & Bozic, K. (2013). Factors are driving physician-hospital alignment in orthopedic surgery. Clinical Orthopedics and Related Research, 471(6), 1809-1817. Web.

The concept of micromarketing involves marketing processes targeted at microsegments. This policy affords greater autonomy for brand and product managers and an advisory position for micromarketing staff. In general, line companies lend themselves to decentralization. Micromarketing helps to meet the diverse or limited marketing needs and wants of a particular target audience. As greater authority passes down the line closer to micromarketing, decentralization brings a need for marketing specialists at the branch level, thus creating problems of coordination. In organizing these functions, micromarketing is confronted with the problem of timing. Such positions as a brand or product-line manager, marketing-services manager, manager of sales, or commodities manager, represent “slotting-in” of people to coordinate activities.

The example of Nike ID shows that micromarketing is based on customized products that meet the unique and diverse needs of every customer. The site allows to create unique sport shoes for every occasion and select the materials and color of the product. In addition, several micro-marketing activities have been “broken out.” They include sales forecasting, product planning, control, physical distribution, credit, manpower development, sales planning and analysis, and micromarketing research. Breaking out occurs when product features are separated from each other so that they are performed in a more effective and logical manner (Nike ID Home Page 2009). Important organizational factors arise in the process: when to break out functions, how fast they should be developed, and how they should be organized in micromarketing. The example of Nike ID places emphasis on adjustment to a dynamic external environment and the subordination of the needs and demands of customers. Externally oriented, it leads to greater service and product quality, reliance on men rather than charts and systems, and overlapping of job responsibilities and power (Boone and Kurtz 2007).

The Nike site proposes a wide range of products for different groups of consumers. Nike ID can be seen as a microbrand aimed to meet the needs of women, men, and special groups of sports professionals. Although the structure, or formal part, of a site, can be easily portrayed, the organization, the part that greatly affects behavior and performance, cannot. The site is a social system whose efficiency is influenced greatly by interpersonal communication. Thus, to understand a micromarketing organization is to understand more than its formal structure. No one scheme can be developed, or a set of principles established, that can specify the best organization for a company. But knowledge of factors influencing micromarketing, of the impact of market forces, of organization concepts, and of alternative tools for coordinating and integrating human effort, can furnish a basis for approaching the problems of the marketing organization. Micromarketing may be under-structured, operationally structured.

The proposed product for micromarketing are orthopedic shoes for elderly consumers. The uniqueness of this product is that it will help old people engage in an active lifestyle and choose cozy and fashionable sportswear. Similarly, various orthopedic models will be used to increase the effectiveness of advertising expenditures and establish microbrand policies. Yet it is true that to some extent critical micromarketing problems appear to be mathematically intractable. They lie somewhere between the problems of applied micromarketing and those of the behavioral sciences. The latter often leads to outright rejection of the idea that marketing activities can be quantified (Céspedes 2000).

The price for this product will range from $100 to 150. It is the average price proposed by Nike ID. The price is appropriate for this type of product. Many micromarketing executives have strong reservations about operations research, feeling that it is an expensive luxury that only large firms can afford; that the intelligence generated is based on data that businesses usually do not have readily available; that operations research cannot be used unless adequate records are kept; and that the underlying assumptions and restrictions made by operations-research people seriously limit the usefulness of its information in decision making.

In contrast to other groups of people, the elderly do not meet the perfect body image as a part of life. People do not identify femininity as an explicit criterion for judgments about being “Fashion In.” Femininity is tied to looking right is one criterion for being judged “Fashion In.” The costs for the pursuit of “Fashion In” remain monetarily, physically, and socially quite high. Further, the pursuit of this standard of fashion is part of a social process that relies on women’s uncritical internalization of multiple forms of racism and segregation that are circulating rather transparently within their prevalent discourse on fashion. Nonprice competition and price confusion, rather than price clarity, seem to be the rule. Elderly consumers are concerned not only with price, in their purchases, but also with service, status, and image. Low price alone does not result in a deal. Elderly consumers are not mechanical price calculators and price reactors, as so much theory leads one to believe. They do not know all the prices discounts, trade-ins, special deals, and premiums cloud the actual price (Evans and Bratton, 2008).

The case of Nike ID and the new orthopedic shows that as a result of past experience, buyers have preconceived notions or attitudes that shape their view of sport and hence their decisions. Microbrand risk is a function of the degree of product knowledge, the price of the product, visibility, and the social importance of products and their newness (Nickels, 2006).

In sum, micromarketing is a part of the traditional marketing approach followed by many large companies in their campaigns. Micromarketing reflects demand and o the willingness and ability to buy customized products. Micromarketing sellers are concerned with specifying in advance the nature and extent of the request. But customers’ willingness and ability to buy a host of products under varying market conditions is a most difficult undertaking for Micromarketing managers and their staff. Micromarketing is designed to affect and shape demand by causing changes in consumer preferences and reactions or by bringing products into line with customer needs. Micromarketing, personal selling, sales promotion, product development, pricing, and other marketing approaches endeavor to elicit favorable reactions from buyers.

References

Boone, L. E. and David L. Kurtz. (2007). Contemporary Marketing. South-Western College Pub; 13 edition.

Céspedes, J. M. M. (2000). Micromarketing. Action Learning.

Evans, D., Bratton, S. (2008). Social Media Marketing: An Hour a Day. Sybex.

Nickels, W. (2006). Understanding Business McGraw-Hill/Irwin; 8 edition.

Nike ID. Home Page (2009).