Instructions:  Google and review the information for Case 20: Strategic IS Planning for the Hospital ED and answer analysis questions 1, 2, 3, and 4.

List each question and answer from Q1 to Q4.

Tips for this assignment: You can also review the information by Googling this link to access information on the discussion questions: http://www.chegg.com/homework-help/questions-and-answers/case-4 -strategic- planning-hospital-ed-major-themes-strategic-planning-alignment-background-q20913631 chegg.com  : CASE 4: STRATEGIC PLANNING FOR ED Major HOSPITAL

CASE 4: ED HOSPITAL PLANNING IS STRATEGIC Key Topics: Strategic Planning and IT Alignment Overview Founded in 1900, Newcastle Hospital is today a 375-bed, not-for-profit community hospital serving more than 200,000 county residents from Newcastle, New York. The hospital is approximately thirty miles from downtown Manhattan. It provides a full range of medical and surgical services, both primary and secondary, and is affiliated with one of New York City's large hospital systems for both tertiary referrals and select residency programs. Newcastle Hospital has an independent governing body with 25 trustees; 604 active doctors; and 1,121 full-time equivalent (FTE) employees. Revenue of approximately $130 million per year comes from 15,600 inpatient admissions; 71,000 outpatient visits; and 65,000 home care visits. Newcastle Hospital operates in a difficult environment characterized by relatively low reimbursement and strong competition. There is one other acute care hospital in the county and a total of thirty-five others within a twenty mile radius. The sentinel event in the hospital's recent history occurred four years ago: a six-month nursing strike that alienated the workforce, decimated public trust and directly cost at least $19.5 million, effectively eradicating the hospital's capital reserves. Most of the senior management was replaced after the strike. When hired, the new CEO and CFO discovered extensive inaccuracies that resulted in a reduction in reported net assets by nearly $30 million and the hospital's near-bankruptcy. The new administration restated the financial statements; began resolving extensive litigation; and set about reestablishing immediate operations, future finances and long-term strategy. The new CEO states that “years of board and management neglect, plus the ravages of the strike, complicated the recovery, because rules, systems and middle management were universally absent or ineffective.” Among its many challenges, the challenges within the hospital's emergency department (ED) are particularly important to the overall recovery effort. The hospital's CEO describes the ED as the "financial, clinical and public relations backbone" of the organization. The ED sees 34,000 patients per year and admits 24 percent of them, making up 51 percent of all inpatient admissions. Additionally, the ED is a clinically distinguished Level II trauma center, with a long legacy of outcomes that compare favorably to regional benchmarks, state and national. Finally, most community members have experience with the ED and consider it a representative of the hospital as a whole, whether or not they have experienced an inpatient stay. Currently, Newcastle ED patient satisfaction compared to patient satisfaction among similar organizations ranks in the 14th percentile in the Press Ganey New York State survey and in the 5th percentile in national surveys . Since 1997, three organized initiatives to improve these results (especially with regard to stoppages and waiting times) have failed, although two involved prestigious consulting firms. Following the management change, the new CEO diagnosed two key barriers to overcoming the ED problems: first, inflexibility and unwillingness to change among the ED physician management group that had been in place since 1987, and, second, an almost total absence of the required data. to define, measure and improve ED service performance. The first barrier was addressed through an RFP process that resulted in the involvement of a new physician management group two years ago. Information Systems Challenge The current IS challenge follows directly from Newcastle Hospital's overall strategic objectives: "delight patients and staff", "support ourselves" and "get better every day" (i.e. improve performance). The ED, as currently structured, has poorly defined manual processes and no information system. The challenge is to select an ED information system with an emphasis on informing, not just automating, key ED processes, to support the organization's overall strategic initiatives. The hospital CEO identified several organizational and IT system factors that impact this IT challenge. Organizational factors Undefined strategy. Newcastle Hospital operated without a formal strategic action plan and corresponding tactics until two years ago. As a result, systematic prioritization and measurement of institutional imperatives such as improving ED did not occur. Data integrity. Hospital-wide data were indefinite and unreliable. For example, two irreconcilable daily census reports made timely bed placement from the ED impossible. Culture. “Looking good,” that is, escaping responsibility, was valued more than “doing good,” that is, substantially improving performance. Serious problems in the ED were often masked or dismissed as anecdotes, even in the face of regulatory summonses and six- to eight-hour wait times. The previous emergency contract contained no quality standards, and emergency doctors claimed to be busy “saving lives” whenever poor performance of their service was questioned. IT system factors IT strategy. In parallel with the hospital, the IS department did not have defined strategies, objectives or processes. Alignment with hospital strategy and IT performance measurement was not considered. Although some progress has been made, this is still an area that needs attention. IT governance. There is no IT steering committee at either the board or management levels. IT policies, service level agreements, decision criteria, and user roles and responsibilities do not exist. Functionality. The IT application portfolio is missing critical elements (e.g., order entry, case management, nursing documentation, radiology) that would greatly benefit the ED, even without a dedicated ED system. The hospital's central information system is three versions out of date, and users have overlooked certain features entirely. IT infrastructure and architecture. The data center and most of the IT staff are located twelve miles from the hospital, isolating IT both physically and culturally from users and patients. Software and networks have been arbitrarily and extensively customized over the years, without documentation, and inadequate hardware capability has often been given as an excuse for not pursuing an ED system. Organization and IT resources. IT spending has been, on average, less than 1 percent of the hospital budget and IT staff have lacked essential training in critical applications and tools. Newcastle Hospital has relied on multiple IT vendors for a variety of implementation and operations support activities radiology) that would greatly benefit the ED, even without a dedicated ED system. The hospital's central information system is three versions out of date, and users have overlooked certain features entirely. IT infrastructure and architecture. The data center and most of the IT staff are located twelve miles from the hospital, isolating IT both physically and culturally from users and patients. Software and networks have been arbitrarily and extensively customized over the years, without documentation, and inadequate hardware capability has often been given as an excuse for not pursuing an ED system. Organization and IT resources. IT spending has been, on average, less than 1 percent of the hospital budget and IT staff have lacked essential training in critical applications and tools. Newcastle Hospital has relied on multiple IT vendors for a variety of implementation and operations support activities radiology) that would greatly benefit the ED, even without a dedicated ED system. The hospital's central information system is three versions out of date, and users have overlooked certain features entirely. IT infrastructure and architecture. The data center and most of the IT staff are located twelve miles from the hospital, isolating IT both physically and culturally from users and patients. Software and networks have been arbitrarily and extensively customized over the years, without documentation, and inadequate hardware capability has often been given as an excuse for not pursuing an ED system. Organization and IT resources. IT spending has been, on average, less than 1 percent of the hospital budget and IT staff have lacked essential training in critical applications and tools. Newcastle Hospital has relied on multiple IT vendors for a variety of implementation and operations support activities

Discussion questions:

1. Describe the steps you would take to initiate a strategic planning process to improve the ED information system. How will you ensure this plan is aligned with the overall hospital and department strategic plans?

2. Multiple factors have contributed to the current state of Newcastle Hospital's emergency department and are listed in the case. Which of these do you think will be the most difficult to overcome? Because?

3. The new CEO had a good insight into ED's problems. Assuming his assessment of the situation is accurate, discuss how his continued support could affect the outcome of any ED IS strategic plan.

4. Assume that the CEO has appointed you to lead the ED IS strategic planning effort. What are the first steps you will take? Outline a general plan of action for the next three months. Indicate, by title, who you involve in the process. Explain your choices?