Hospital Comparisons Hospital Comparisons Understanding the Understanding the

MarketplaceMarketplace

HCA 399HCA 399

November 1, 2005November 1, 2005

Hospitals Comparison Hospitals Comparison AssignmentAssignment

► Introductory paragraph on hospitals visited. List names Introductory paragraph on hospitals visited. List names and titles of hosts. Give separate paragraph for each and titles of hosts. Give separate paragraph for each hospital to include other participants in the meetings. hospital to include other participants in the meetings.

► Go on-line and get additional information:Go on-line and get additional information: Mission statementsMission statements Ownership information (e.g., HCA)Ownership information (e.g., HCA) Where is headquarters to organization.Where is headquarters to organization.

► Describe similarities and differences. Analyze primary, Describe similarities and differences. Analyze primary, secondary and tertiary service areas. Make sure to secondary and tertiary service areas. Make sure to include any major affiliations that they may have.include any major affiliations that they may have.

► Include the following table on the landscape chart on Include the following table on the landscape chart on next page. You may attach additional pages as next page. You may attach additional pages as necessary. If you do not know the information necessary. If you do not know the information requested, you may have to make some phone calls.requested, you may have to make some phone calls.

Hospitals Comparison Hospitals Comparison AssignmentAssignment

► Summarize your table findings.Summarize your table findings.► Other pertinent information you would like Other pertinent information you would like

to include about the hospital. Among some to include about the hospital. Among some of the topics you might want to address in of the topics you might want to address in this area are availability of emergency this area are availability of emergency rooms, trauma centers, specialty areas, new rooms, trauma centers, specialty areas, new construction activities, nursing shortage construction activities, nursing shortage issues, etc.issues, etc.

► ConclusionsConclusions► Which, if any, of the hospitals interested you Which, if any, of the hospitals interested you

the most.the most.

Service Area Competitor Service Area Competitor AnalysisAnalysis

Define the Service Categories

Define the Service Area and Create Service Area Profile

Conduct Structure Analysis

Conduct Competitor Analysis and Map Strategic Groups

Synthesize Analyses

Service TypeUsage RatesBrand PredispositionPreferred Image

Personal ValuesSocial ValuesEpistemic ValuesPast Experiences

Personal State of Health

Consumer Determinants

Service Area

Location•Drive Time•Transportation•Parking Ease/AccessConvenience•Hours of Operation•Safety•Way-findingPrice LevelImage

Services AvailableService•Friendliness•Caring•Wait TimeQuality of Information•Phone Consults•Brochures•Instructions

Market/Organization Determinants

Understanding Geographic Understanding Geographic BoundariesBoundaries

► Services may be in an entire area or regionServices may be in an entire area or region May depend on the type of services provided to May depend on the type of services provided to

determine boundariesdetermine boundaries Opportunities and threats may differ because of Opportunities and threats may differ because of

thisthis► Service areas will be different for different Service areas will be different for different

organizationsorganizations► Geographic boundaries may be subjective Geographic boundaries may be subjective

and based on several factorsand based on several factors Available technologyAvailable technology Patient historyPatient history Physician recognitionPhysician recognition

Structural Analysis: Forces Driving Service Area Structural Analysis: Forces Driving Service Area CompetitionCompetition

Service Area Competition

Rivalry AmongExisting Firms

Suppliers

PotentialEntrants

Substitutes

Buyers

Threat of new entrants

Bargaining power of buyers

Bargaining power of suppliers

Threat of substitute products or services

Vegas Area Competitor Vegas Area Competitor Strengths and WeaknessesStrengths and Weaknesses

Potential StrengthsPotential Strengths► Distinctive CompetenceDistinctive Competence► Financial resourcesFinancial resources► Competitive skillsCompetitive skills► ImageImage► Acknowledged market Acknowledged market

leaderleader► Proprietary technologyProprietary technology► Proven management Proven management ► Ahead on experience curveAhead on experience curve

Potential WeaknessesPotential Weaknesses► Lack of strategic directionLack of strategic direction► Deteriorating competitive Deteriorating competitive

positionposition► Obsolete facilitiesObsolete facilities► Sub-par profitabilitySub-par profitability► Lack of managerial depth Lack of managerial depth

and talentand talent► Vulnerability to competitionVulnerability to competition► Weak market imageWeak market image► Below-average marketing Below-average marketing

skillsskills► Unable to finance needed Unable to finance needed

changeschanges► High overall costs relative to High overall costs relative to

competitioncompetition

Role of Community Health Care Role of Community Health Care Management Partners in Management Partners in

Evaluating the Health Care Evaluating the Health Care Administration PracticumAdministration Practicum

Chris Cochran, Ph.D.Chris Cochran, Ph.D.Associate ProfessorAssociate Professor

University of Nevada Las VegasUniversity of Nevada Las VegasSchool of Public HealthSchool of Public Health

Department of Health Care Administration and PolicyDepartment of Health Care Administration and PolicyNevada Public Health Association 2005 ConferenceNevada Public Health Association 2005 Conference

October 13-14, 2005October 13-14, 2005

Student Practicum SitesStudent Practicum Sites

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

35.00%

Spring 2005 Student Roster Spring 2005 Student Roster and Assignmentsand Assignments

St. Rose Dominican Hospital St. Rose Dominican Hospital ► Market Development Plan for San Martin Market Development Plan for San Martin

Preceptor: Vice President of Business Preceptor: Vice President of Business DevelopmentDevelopment

University Medical Center University Medical Center ► Point of Service Policy for utilization of Point of Service Policy for utilization of

Emergency Department Emergency Department Preceptor: Chief Preceptor: Chief Operations Officer Operations Officer

► UMC Fitness and Wellness Program UMC Fitness and Wellness Program Preceptors: Senior Associate Administrator; Preceptors: Senior Associate Administrator; Manager, Workmen’s Compensation and Manager, Workmen’s Compensation and BenefitsBenefits

► Improving the Staffing Process Improving the Staffing Process Preceptor: Preceptor: Chief Nursing OfficerChief Nursing Officer

NevadaCareNevadaCare ► Federal and State Legislation Tracking Federal and State Legislation Tracking

Preceptor: Director of Public AffairsPreceptor: Director of Public Affairs► Data Transfer Corruption Prevention Data Transfer Corruption Prevention

Preceptor: System Administration Dir Preceptor: System Administration Dir Boulder City HospitalBoulder City Hospital ► Multi-Task Management Project: HIPAA Multi-Task Management Project: HIPAA

Security Compliance and Physician Security Compliance and Physician Recruitment Recruitment Preceptor: Chief Executive Preceptor: Chief Executive OfficerOfficer

Las Vegas AnesthesiologistsLas Vegas Anesthesiologists ► Project Title: Project Title: Developing a Risk Retention Developing a Risk Retention

Group Group Kindred HealthcareKindred Healthcare ► Quality Improvement Activities and Quality Quality Improvement Activities and Quality

Award ProjectAward ProjectPreceptor: Executive DirectorPreceptor: Executive Director

Sierra Health ServicesSierra Health Services ► Quality Improvement and Research Quality Improvement and Research ► Developing the Baseline Assessment Developing the Baseline Assessment

Tool for HEDISTool for HEDIS Preceptor: QIR Manager Preceptor: QIR Manager► Corporate Credentialing Project Corporate Credentialing Project

Preceptor: Dir. Of Credentialing MSN, Preceptor: Dir. Of Credentialing MSN, RNRN

► Medicaid Dental “Insourcing” Medicaid Dental “Insourcing” Preceptor: Preceptor: Senior Project Coordinator, Provider Senior Project Coordinator, Provider ServicesServices

Veterans AdministrationVeterans Administration ► Quality Improvement Research for the Quality Improvement Research for the

VHA Geriatric ClinicVHA Geriatric ClinicPreceptor: Martha Preceptor: Martha Shaffer, Clinic DirectorShaffer, Clinic Director

Sunrise Medical CenterSunrise Medical Center ► Employee Retention Project Employee Retention Project ► Translation of Forms into Spanish Translation of Forms into Spanish ► Preceptor: Chief Operations OfficerPreceptor: Chief Operations OfficerWestcare Nevada, Inc.Westcare Nevada, Inc. ► Marketing the Community Triage Marketing the Community Triage American Cancer SocietyAmerican Cancer Society Project Title: Project Title: Relay Relay

for Life for Life Preceptor: Executive DirectorPreceptor: Executive DirectorDr. John Wechsler, Internal MedicineDr. John Wechsler, Internal Medicine ► Financial Reconciliation of a Group Financial Reconciliation of a Group

PracticePracticePreceptor: Practice Preceptor: Practice AdministratorAdministrator

Participants by Ownership Participants by Ownership TypeType

► One of the unique One of the unique characteristics about the characteristics about the Las Vegas environment is Las Vegas environment is the large number of for-the large number of for-profit health care profit health care organizations compared organizations compared to non-profit or to non-profit or government government organizations. As the organizations. As the figure above describes, figure above describes, most of the student most of the student projects were in for-profit projects were in for-profit organizations.organizations.

For Profit

Non-Profit Govt.

0

10

20

30

40

50

60

Organization Type

Types of ProjectsTypes of Projects

Finance Anal.7%

Event Planning9%

HR Planning9%

Contract Dvlp.11%

Regulatory 12% New Service Planning

16%

QA/QI 16%

Marketing18%

Program RequirementsProgram Requirements

► Pre-Practicum CoursePre-Practicum Course Introduction to the Introduction to the

practicum through site practicum through site visits.visits.

► Practicum Practicum RequirementsRequirements

Daily and Weekly Daily and Weekly DiariesDiaries

Major Project ProposalMajor Project Proposal Environmental Environmental

AssessmentAssessment Organizational Organizational

AssessmentAssessment Major ProjectMajor Project Design a websiteDesign a website

 

Two Sierra Health Services HEDIS auditors are flanked by UNLV practicum students Erica Kanda (left) and Johanna Paderna (right) as the prepare their presentation.

Evaluation ProcessEvaluation Process

► StudentStudent► PreceptorPreceptor► CourseCourse

► Each of the participants involved in the Each of the participants involved in the practicum experience participate in the practicum experience participate in the evaluation process. Students are evaluated by evaluation process. Students are evaluated by their preceptor using a 10 measure job their preceptor using a 10 measure job performance assessment. This evaluation is performance assessment. This evaluation is similar to many job performance evaluations.similar to many job performance evaluations.

► Faculty assesses the student’s performance Faculty assesses the student’s performance using weighted scales to examine their work using weighted scales to examine their work including the organizational and environmental including the organizational and environmental assessments, the project write-up, meeting assessments, the project write-up, meeting deadlines, and the maintenance of weekly deadlines, and the maintenance of weekly progress reports. progress reports.

► Students assess the practicum course, their Students assess the practicum course, their preceptor, and the health care administration preceptor, and the health care administration department. department.

Frequency distribution of Frequency distribution of Preceptor Evaluations of Preceptor Evaluations of

Students, 2000-2005Students, 2000-2005

0 20 40 60 80

Understanding ofinternal operation of org.

Interaction with others

Understanding ofexternal issues for org.

Understanding of projectconcepts

Work Habits

Poor

Fair

Good

Excellent

Frequency distribution of Frequency distribution of Preceptor Evaluations of Preceptor Evaluations of

Students, 2000-2005Students, 2000-2005

0 20 40 60 80 100

Preparation for HealthCare field

Professional Conduct

Potential to contribute

Initiative

Follows Direction

Poor

Fair

Good

Excellent

Preceptor Evaluation of Student Preceptor Evaluation of Student PerformancePerformance

3 3.2 3.4 3.6 3.8 4

Understands ext. environment

Knowledge and preparation

Understanding of internalenviron.Initiative

Work Habits

Interaction with others

Understands concepts related toprojectProfessional conduct

Potential to make contribution tofieldAccepts direction

N=92. Results based on 4-item scale (4=Excellent, 3=Good, 2=Fair, 1=Poor).

p<.05

Jobs Offered to StudentsJobs Offered to Students

► One outcome One outcome measurement of a measurement of a quality practicum is the quality practicum is the assessment of how many assessment of how many students were offered students were offered jobs at their project jobs at their project sights. A comparison was sights. A comparison was made of students who made of students who completed a full-time completed a full-time practicum (those without practicum (those without prior health care prior health care administration administration experience). The analysis experience). The analysis shows that the majority shows that the majority of students were offered of students were offered a job at their practicum a job at their practicum site. site.

0

10

20

30

40

50

60

70

Yes No

Only includes students completing full-time practicum, 2000-2005. n=64

Practicum PartnershipsPracticum Partnerships► University Medical CenterUniversity Medical Center► Sierra Health ServicesSierra Health Services► St. Rose Dominican HospitalsSt. Rose Dominican Hospitals► NevadaCareNevadaCare► Sunrise Hospital and Medical Sunrise Hospital and Medical

CenterCenter► Boulder City HospitalBoulder City Hospital► Veterans Admin.of Southern NVVeterans Admin.of Southern NV► Kindred HealthcareKindred Healthcare► LifecareLifecare► Health StrategiesHealth Strategies► Trans Health, Inc.Trans Health, Inc.► American Cancer SocietyAmerican Cancer Society► MountainView HospitalMountainView Hospital► Insight DiagnositicsInsight Diagnositics► Valley Medical CenterValley Medical Center

► Southern Nevada AHECSouthern Nevada AHEC► Nevada State Health DivisionNevada State Health Division► Sultanate of Oman Health MinistrySultanate of Oman Health Ministry► Mississippi State Health Mississippi State Health

DepartmentDepartment► John Goodman and AssociatesJohn Goodman and Associates► Goldring Sleep CenterGoldring Sleep Center► Prison Health ServicesPrison Health Services► Pahrump Family Medical CenterPahrump Family Medical Center► Lake Mead Medical CenterLake Mead Medical Center► PacificarePacificare► Westcare Nevada IncorporatedWestcare Nevada Incorporated► Clark County Health DistrictClark County Health District► Nevada AnesthesiologistsNevada Anesthesiologists► Southwest Medical AssociatesSouthwest Medical Associates► Nevada ENT, AssociatesNevada ENT, Associates

ConclusionsConclusions

►Preceptor evaluations rate Preceptor evaluations rate students high.students high.

►High performance evaluations are High performance evaluations are consistent with literature on consistent with literature on employee performance.employee performance.

►Experience provides students with Experience provides students with very good opportunity to secure very good opportunity to secure employment with practicum sites.employment with practicum sites.