Case Study Analysis
Number of words: 1929
Healthcare organization management requires establishing informed strategies effective in promoting performance. The complexity of healthcare organizations’ management based on the processes involved and the evolution of the healthcare system increase the potential developments of disparities among populations. The tools for addressing health disparities in healthcare organizations require organizations to devise plans to assess and implement initiatives that prioritize and focus on community needs as the critical consumers of healthcare organizations. Frederick Memorial Hospital (FMH) is among the facilities that have demonstrated these strategies based on the approach employed in addressing the critical disparities at the organization. This paper will describe the FMH approach to inequalities and how the strategy relates to the Healthy People 2020 MAP-IT approach to community health development programs.
Population Health Issues at the FMH
Frederick Memorial Hospital has been proactive in addressing critical disparities among the community based on purpose following an identified need. One of the issues associated with the community needs at FMH is cultural competence in the organization (CMS, 2016). The diversified population of patients consuming the services at the organization prompted the need for cultural awareness to ensure patients can communicate effectively and assisted with interpreted services for patient-centered care. Additionally, caring for patients with chronic conditions was associated with critical disparities, where approximately 70% of chronically ill patients had unmet behavioral health needs (CMS, 2016). Dental care was also an issue among the community due to the lack of primary dental care services. This resulted in critical disparities among the community where there were increased visits to the emergency department due to poorly managed dental infections and dental pain. As a strategy to improving the competencies among the community health providers, FMH developed a community health worker program for training all the health workers.
Solutions to the Population Health Concerns
The FMH established solutions to the identified health issues concerns by establishing community-focused initiatives. According to White and Griffith (2019), establishing initiatives that focus on an organization’s internal and external environments is a promising strategy for healthcare organization management. One of the initiatives launched was the interpreter services to address cultural competence and cultural awareness issues. This solution was developed after assessing the community needs based on languages commonly used at the facility. Assessment is a recommendation by Healthy People 2020 as a MAP-IT approach in developing community programs. Cultural competence is among the managerial issues that affect healthcare organizations (White and Griffith, 2019). According to Kaihlanen et al. (2020), training clinicians on cultural competency enhances equality and quality care delivery among diverse communities. It requires healthcare organizations to consider cultural sensitivity, attitudes, communication, and practices of a given society. The FMH approach of establishing interpreter services addressed communication issues associated with cultural competence disparities, enhancing wellbeing among deaf patients and the adult inpatient psychiatry unit. The initiative enhances patients from diversified cultures, conditions, and languages to receive quality services at the organization.
To address the community disparity of managing chronic illnesses effectively, the FMH established a three-day-a-week clinic to care for patients with severe chronic diseases. According to White and Griffith (2019), community health services must be sized to meet the demands of the community to eliminate the disparities experienced. The FMH observed the lack of behavioral health care and associated impacts among the community. Managing health behaviors is a critical approach to addressing the quality of life among patients with non-communicable diseases like hypertension and diabetes (Jeon et al., 2020). In establishing these services, the FMH identified the unmet behavioral health needs among patients with chronic illnesses by encouraging the staff and community members to work collaboratively to determine the actual requirements. According to Whie and Griffith (2019), implementing community initiatives at an organization requires collaborative efforts to ensure all the teams are involved in evidence-based strategies. The combined efforts characterize a well-managed healthcare organization by enhancing developing comprehensive community services strategies for improvement. Tracking the progress of implemented strategies is a recommendation by the Healthy People 2020 MAP-IT of developing and implementing community programs.
The FMH tracked the success of the three-day-a-week clinic impacts on the communities, enhancing improvements in the previous years. According to Haldane et al. (2019), engaging community members is a practical approach to planning, developing, and implementing programs for community services. The Healthy People 2020 MAP-IT recommends mobilizing community members and leaders to establish satisfactory services. This approach enhances the effectiveness of the developed programs by creating awareness among the community members, leading to utilization. White and Griffith (2019) claim that engaging the community in developing programs serves as the tool guide for healthcare organizations developing community-focused programs or initiatives.
The FMH established a primary dental care center with center fees levied on a sliding scale to eliminate the disparities in dental care. The facility targeted all patients earning up to 200% of the federal poverty level. The center receives funds from government grants and the State of Maryland. Consequently, the facility managed to reduce the number of visits to the emergency department, reflecting the initiative’s success. The FMH established mobilization approaches to get adequate funds for opening primary dental care centers with low operating costs in developing this program. This is an approach recommended by the Healthy People 2020 MAP-IT community development programs.
Health organizations should aim at achieving the best by mobilizing and involving all the necessary stakeholders. According to White and Griffith (2019), stakeholders in healthcare organizations have a critical role in developing and implementing initiatives to address disparities among populations. The governing board must establish the agenda for every program while involving the stakeholders through close relationships. This approach was applied at FMH, where external and internal stakeholders were engaged in developing the initiatives to address community health concerns. After the agenda, the strategies can then be developed by engaging and mobilizing specific authorities and the communities for support (Lewis et al., 2020). The Healthy People 2020 MAP-IT recommends establishing a program and evaluating its goal by addressing a health problem among the community. The FMH applied this approach to create the dental care facility, leading to reduced emergency visits and healthcare spending.
Comprehensive Considerations During Community Program Development
The FMH applied effective strategies defined for developing community programs to address the disparities observed. One of the considerations was budgeting and finances. According to White and Griffith (2019), financial consideration is critical for healthcare organizations when developing community initiatives. The governing body should engage all stakeholders in developing informed decisions regarding financing the programs and preparing the budget. A financial review is necessary to enhance stakeholders’ decisions on which initiative requires more investment than the other based on the initiatives (White and Griffith, 2019). Financial considerations in program development enhance identifying strategies for affordability, equity, and accessibility. For instance, the FMH evaluated the financial needs for every program to establish their affordability and impacts after establishment. Healthcare leaders have a significant role in prioritizing programs based on the available finances and strategies for engaging the community and stakeholders. Effective management of healthcare finances requires establishing guiding policies that enhance transparency in the distribution and utilization of resources (Venkataramani et al., 2020). Lack of transparency is a critical managerial issue facing healthcare organizations (White & Griffith, 2019). Developing public policies in healthcare organizations has demonstrated effective outcomes in managing and coordinating resources for community initiatives for a healthcare organization.
Another consideration is the data collection and engagement of organization leaders. The FMH developed and implemented the programs by involving the CEO through inclusion and decision-making. The CEO coordinated the activities at different departments, encouraging staff to collect adequate data regarding the intended initiatives for quality improvement. The CEO is an agent of the governing body holding the entire formal accountability (White & Griffith, 2019). The FMH applied the correct guideline by engaging the CEO and assigning them the responsibility to ensure all the initiatives have been developed and implemented based on planning and decision-making, a Healthy People 2020 MAP-IT recommendation for developing community health initiatives. According to Barden et al. (2020), leaders possess the competencies and skills regarding organizational and consumer needs. Engaging them in developing healthcare programs enhances connectedness and personalization of the initiatives, prioritizing patient wellbeing. The population disparities at FMH were addressed through programs developed and implemented by leaders collaborating with organizational stakeholders. Collaboration is significant in decision-sharing and the implementation of quality projects (Reid et al., 2019). This involvement had substantial impacts on addressing the critical challenges that could have prevented the performance of the multiple programs such as dental care, interpreter services, behavioral care for chronic diseases, and improving knowledge among providers through the community health worker program.
The FMH case study has demonstrated the effectiveness of the Healthy People MAP-IT recommendations in developing community programs. Developing initiatives require identifying the disparity, mobilizing the resources, assessing the required programs, planning and implementing the well-thought initiative. These steps need engaging healthcare leaders, the community, and staff to develop comprehensive strategies for community-focused programs. The multiple population health disparities in various healthcare organizations can be addressed by involving the healthcare management team, including leaders and stakeholders. Engagement is a critical aspect that promotes success in developing programs by enhancing motivation, idea-sharing, and resources. Healthcare organizations should follow evidence-based recommendations to address population health disparities for successful implementation.
Barden, A., Giammarinaro, N., & Petrosino, L. (2020). Perspective Shifting: Engaging Leaders-of-Leaders in Patient and Caregiver Experience. Journal Of Patient Experience, 7(6), 994-997. https://doi.org/10.1177/2374373520942405
Centers for Medicare & Medicaid Services, CMS (2016). Building an Organizational Response to Health Disparities: Case Study of Frederic Memorial Hospital, pp. 1-15.
Haldane, V., Chuah, F., Srivastava, A., Singh, S., Koh, G., Seng, C., & Legido-Quigley, H. (2019). Community participation in health services development, implementation, and evaluation: A systematic review of empowerment, health, community, and process outcomes. PLOS ONE, 14(5), e0216112. https://doi.org/10.1371/journal.pone.0216112
Healthy People 2020. MAP-IT: A Guide to Using Healthy People 2020 in Your Community Program. Healthypeople.gov. https://www.healthypeople.gov/2020/tools-and-resources/Program-Planning.
Jeon, Y., Pyo, J., Park, Y., & Ock, M. (2020). Health behaviors in major chronic diseases patients: trends and regional variations analysis, 2008–2017, Korea. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-09940-7
Kaihlanen, A., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: a qualitative study of nurses’ perceptions about cultural competence training. BMC Nursing, 18(1). https://doi.org/10.1186/s12912-019-0363-x
Lewis, J., LeBan, K., Solomon, R., Bisrat, F., Usman, S., & Arale, A. (2020). The Critical Role and Evaluation of Community Mobilizers in Polio Eradication in Remote Settings in Africa and Asia. Global Health: Science and Practice, 8(3), 396-412. https://doi.org/10.9745/ghsp-d-20-00024
Reid, A., Abraczinskas, M., Scott, V., Stanzler, M., Parry, G., & Scaccia, J. et al. (2019). Using Collaborative Coalition Processes to Advance Community Health, Well-Being, and Equity: A Multiple–Case Study Analysis from a National Community Transformation Initiative. Health Education & Behavior, 46(1_suppl), 100S-109S. https://doi.org/10.1177/1090198119838833
Shrank, W., DeParle, N., Gottlieb, S., Jain, S., Orszag, P., Powers, B., & Wilensky, G. (2021). Health Costs and Financing: Challenges and Strategies for A New Administration. Health Affairs, 40(2), 235-242. https://doi.org/10.1377/hlthaff.2020.01560
Venkataramani, A., O’Brien, R., Whitehorn, G., & Tsai, A. (2020). Economic influences on population health in the United States: Toward policymaking driven by data and evidence. PLOS Medicine, 17(9), e1003319. https://doi.org/10.1371/journal.pmed.1003319
White, K., & Griffith, J. (2019). The well-managed healthcare organization (9th ed., pp. 95-362). Health Administration Press.