Almost every organization has a mission and vision statement. But how does each department manager ensure that the departmental strategic plan is working toward the organization's stated mission and vision? One way is to ensure that each department has its mission and vision statements aligning with the organization's.

You will be faced with this question as a new manager, and you are also, in the case study, tasked with making strategic decisions that will unify the mission and vision of the three hospitals under one HIM department.

Prompt

a short paper that evaluates the mission and vision of each hospital's HIM department. Then, taking the best from each of the three mission and vision statements and adding whatever you believe needs to be added, develop a new mission statement and new vision statement for the unified Gateway Healthcare Systems HIM department.

Specifically, the following critical elements must be addressed:

1. Evaluate the mission and vision statements of the HIM departments for each of the three hospitals:
   1. What elements do they have in common that might help move toward a unified mission and vision for the merged HIM department?
   2. What are they missing? What improvements to suggest?
2. Develop a mission statement for the Gateway Healthcare Systems HIM department.
3. Develop a vision statement for the Gateway Healthcare Systems HIM department.

HIM 440 Gateway Healthcare Systems Case Study St. Catherine's Medical Center recently announced it will be merging with St. Luke's Hospital and Hickman Community Hospital to form Gateway Healthcare Systems, all located within the same metropolitan area in the Midwest. You have just been hired as the healthcare system's HIM director overseeing all three hospitals. Each facility's department manager or supervisor will report to you. Hospital Profiles St Catherine's Medical Center HIM Department Mission: Grounded in the Catholic mission of service, we strive to provide accurate patient health information services to all patients with care, concern, and dignity. HIM Department Vision: Provide patients with their health information with sensitivity and respect to their privacy. Profile: St. Catherine's is affiliated with the Catholic faith and includes an active convent on its campus. It is an 850-bed acute care level-one trauma facility located in the suburbs. The staff and patients come from a variety of ethnic backgrounds and are linguistically diverse. About 60% of St. Catherine's staff is Catholic, but the hospital abides by legal hiring practices and insists that all employees are treated with respect, including those who fall outside the tenets of Catholicism. In fact, the HIM department has two staff members with hearing impairment who work in the coding section. They have been investigating ways to offer more opportunities to potential employees with physical needs, but with the high volume of reading and direct customer service provided to patients, it has been difficult to accommodate. St. Catherine's has a reputation of providing quality care to all patients and will not turn away a patient based on ability to pay. It is located in one of the wealthier suburbs of the city and has a strong record of employment retention, even though the average salary level is lower than those of its competitors. St. Catherine's implemented a new EHR last year and continues to work out new policies and procedures for the new system. Its dictation system was implemented seven years ago. The productivity level has been critically low since implementing the new system. Due to recent budget cuts, St. Catherine's cannot offer overtime to staff. The HIM department has many long-term employees that do not have formal health information education or credentials. The current coding productivity level is, on average, two inpatient charts per hour per coder, and 10 outpatients (including ED patients) per hour per coder. The coding quality consistently exceeds 95%, per the internal coding auditor. Southern New Hampshfg University Coding productivity standards were established six years ago using ICD-9 standards, at four inpatient charts per hour. The productivity standards remain at four inpatient charts per hour, despite complaints from coders that the standards are unreasonable. St. Catherine's last TJC site visit was in October of last year. Overall, the hospital fared well on inspection; however, the HIM department was cited for not having a time stamp on orders in the EHR. (For more information, review regulations RC.01.01.01, EP19 in The Joint Commission E-dition Manual). There have been complaints in the department that some staff do not abide by the break schedule, and some take longer lunches than allowed. Management has not addressed this with staff for fear of losing some of their most knowledgeable and credentialed staff. It has been reported that some of the seasoned coders who have been on staff for more than 25 years are still using the manual coding book rather than the encoder that was implemented five years ago, stating that this saves them valuable time; however, the more recently hired coders are using the encoder system. St Luke's Hospital HIM Department Mission: To provide providers, residents, and staff with timely access to patient health information for purposes of treatment, research, and reimbursement. HIM Department Vision: Promoting research through state-of-the-art health information management and technology. Profile: St. Luke's, established in 1942 as a Methodist hospital but no longer a faith-based facility, is a very busy, 400-bed inner-city teaching hospital that provides critical care services to many patients without healthcare coverage. It services the most diverse patient population in the city in terms of ethnicity, religion, class, ability, sexuality, and age; however, its staff diversity is low except in the area of age diversity. The youngest employee is 19 years old and the oldest is 72. St. Luke's has experienced a high volume of staff turnover during the past three years and does not currently have a HIM manager or director on staff. While it does have credentialed HIM staff, it has difficulty keeping them on board for more than two years. St. Luke's is using a first-generation EHR that was implemented seven years ago and has difficulty communicating with the other systems in the department and organization. Because of the issues with interoperability, the lab sends down daily batches of paper lab reports that are scanned into the EHR. The encoder was just implemented last year; however, only one coder was thoroughly trained on the new encoder, and she resigned over a year ago. Coding staff frequently use the manual coding books because they cannot seem to find the accurate codes with the encoder. They spend a great deal of time looking up codes in the coding book, Southern New Hampshfg University then going to the paper binders with the coding clinics to ensure that they are assigning the correct codes. Coding productivity standards were revised after the implementation of ICD-10. Current productivity standards are set at two inpatient charts per hour. The coding supervisor is a new graduate with less than a year of inpatient coding experience. She does not get along well with her subordinates, who are older and have much more experience. Coding productivity is being met per the performance expectations established ten years ago; however, coding quality is consistently rated at 85%, per the external auditing firm. Hickman Community Hospital HIM Department Mission: To assure protection of patient health information at all times. HIM Department Vision: Committed to serving the local community's health information needs and ensuring patient information is secure. Profile: Hickman is a non-faith-based, 90-bed community hospital located in the oldest part of the city. It has historically served a predominantly low-income, Caucasian patient population, which is comprised mostly of Medicare and Medicaid payers. It has recently been seeing a rise in Muslim patients due to a new mosque in the neighborhood. Hickman Community Hospital has provided services to its local community since 1922, and it is the oldest facility of the three merging organizations. This facility has accessibility issues and was deemed noncompliant with ADA guidelines during the last Joint Commission accreditation survey. Since the hospital staff and patient population are primarily of one ethnicity, the hospital has not seen the need to address cultural diversity training, and therefore it was found noncompliant with TJC standards on leadership. The employees of Hickman are like familythey stick together. While Hickman is the lowest- paying hospital in the area, the family culture has contributed to the longevity of its staff. The HIM department does not currently have any AHIMA-credentialed staff members and does not have any coding quality or quantity expectations in place for the part-time staff members responsible for coding the charts. Hickman is still using paper-based records and manual coding books and resources for coding and billing resources. Hickman currently has a ten-day turnaround time from discharge to final bill dropped, and there is currently no specified number of charts that should be completed on an hourly or daily basis by coders. The acting HIM manager has been employed by Hickman for 35 years and is very fond of her staff; she insists they do the best job in town. Her job as acting HIM manager was meant to be temporary while Hickman searched for a credentialed replacement. The one candidate who met all qualifications was determined \"not a good fit\" by the hiring committee. He was a 32- Southern New Hampshfe' University year-old African American male and a wheelchair user. Currently, the HIM department does not have any diversity in ethnicity or physical ability among staff members. Preliminary Observations During the first month in your new position as HIM director of Gateway Healthcare Systems, you spent a week at each hospital getting to know staff, reviewing policies and procedures, and making general observations. While visiting with staff at St. Catherine's, you noticed a few staff members were discarding paper forms with patient-identifying information into the trash can underneath their desks, instead of disposing of the forms in the document shredder located in the front office. You also noticed that the \"release of information\" staff did not log out of their computers when they were away from their desks. At St. Luke's, you overheard a discussion in the main lobby elevator between two nurses discussing patient Mary Smith's prognosis. When you arrived in the HIM department, there were stacks of paper forms and old paper records scattered throughout the department with the patient information openly displayed. In the connecting hallway that patients frequently travel through, you found several carts of records that revealed patient-identifying information. At Hickman Hospital, you arrived to find the staff sitting around having coffee while several patients were waiting to be assisted with obtaining copies of their health records. The release- of-information clerk came running into the office with a paper copy of a record to hand to one of the patients in line, and said, \"Here you go, Mrs. Brown; here's the copy of your record from Dr. Taylor's office. He's our best psychiatrist on staff! You're in good hands!\" Once all of the patients had been waited on, the staff began discussing each patient's requests along with their diagnoses, medical treatment, and prognosis. At this point, you called an urgent staff meeting