Strategic Objective Of The Health System

Case Study: VVH
VVH has a serious problem: A major strategic objective of the health system
was to grow its ambulatory care network, but the organization is facing a
number of challenges. Although a new billing system was installed and var-
ious reimbursement-maximization strategies were executed, total costs in
the system exceed revenue. This was occurring even though the clinic staff
felt busy and backlog appointments were growing. Analysis of clinic data
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Putting It All Together for Operational E xcellence
also indicated an increasing number of patients were canceling appointments
or were “no shows.”
In addition, a new group of multispecialty and primary care physicians
had been created from the merger of three separate groups; this clinic is
aggressively competing with VVH for privately insured patients. The new
large clinic is making same-day clinic appointments available and heavily
advertising them.
The board of VVH asked the chief executive officer (CEO) to develop
a plan to address this growing concern. The CEO first formed a small strat-
egy team to lead improvement efforts; its first step was to assign the chief
operating officer, chief financial officer, and medical director to direct the
planning and finance staff on the improvement team.
VVH ultimately decided that it needed to increase the number of
patients seen by clinicians and begin to implement advanced access in its clin-
ics. Because VVH believes in knowledge-based management and sharing in
improved methods of delivering health services, the organization has made
its data and information available on the companion web site. VVH invited
students and practitioners to help them improve this system.
1. Frame the original issue for VVH. Mind maps and RCA may be useful
here.
2. How would you address the no-shows and cancellations issue?
3. Develop a project charter for one project associated with VVH’s problems.
4. Develop a balanced scorecard for VVH’s clinics.
5. If VVH decided that it should focus on increasing throughput in the
system, how would you go about doing this? Be specific.
6. Would simulation be a useful tool in VVH’s quest to implement
advanced access? Why or why not? How would you go about imple-
menting advanced access? Be specific.

6 years ago