Challenge: A division of one the world’s most widely respected non-profit health care enterprises needed objective assistance to develop a new program focusing on a key priority initiative.

JCS Solution: We interviewed the some of the enterprise’s most renowned world class thought leaders to better assess the evidence-based science that could be used as the foundation for developing this initiative. We worked with the division leadership team to develop a strategy that focused on building collaborative relationships with other internal divisions that were also working independently on this initiative.

Results: This initial structure we developed for this initiative has been positively received by all involved. Our consulting work has resulted in developing the foundation for a collaborative effort that now links four divisions of this enterprise together on this priority initiative that will soon be deployed.

Challenge: The board of trustees of a county-owned hospital in Kansas needed an independent review of the organization’s senior management. A variety of situations had occurred which had eroded the trust between the board and staff. The hospital had established its own HMO and the board’s attention was focused on a battle with a new for-profit hospital that was trying to come into their community. Employee relations were in turmoil because weeks after opening a newly constructed hospital wing, management eliminated 25 jobs. Its skilled nursing unit had recently failed its inspection for the third time. State inspectors were recommending cutting off Medicare payments for services and fines were mounting. The sophisticated hospital board members were extremely frustrated and embarrassed. The board included the State’s former Secretary of Health, the director of the County’s health department and the department chair of health services administration at a major State University. They needed an independent review the performance of the organization’s senior staff and a better understanding of what had actually happened to cause such turmoil.

JCS Solution: The hospital board retained Johnson Consulting Services to assist it in determining what had gone on and to address their approach to governance of the organization. Our work included in-depth interviews with all members of the board and senior management staff to determine what had transpired, as well as review of a wide variety of secondary documentation to isolate the critical tipping points and to determine what needed to be done to resolve the conflict and rebuild trust. We also provided insight into the critical issues relating to governance and defining a more appropriate role for individual members of the hospital board.

Results: We completed a candid assessment of their current governance process and insight into how these processes could be more effectively utilized to address the situation at hand. We provided both sides with a candid presentation outlining the results of our findings and our recommendations for corrective action. The board and management clarified the boundaries of their respective roles and made critical changes in how they worked with each other.

Challenge: A non-profit, acute care general hospital located in New York was looking to update its strategic plan. This JCAHO-accredited community-owned hospital owned an ambulatory care clinic and had recently purchased a laboratory from the county in which it was located. Intensive physician recruitment efforts were paying off and construction of a new 80-bed skilled nursing facility was to start soon. The hospital was financially viable, however, the region had experienced a significant loss of its industrial base and as result unemployment in the region was nearly 9%. The hospital was dealing with 3 unions and was going to be entering into union negotiations in the upcoming year. Financial pressures were mounting, as were concerns about the future of the State’s reimbursement system. The hospital needed to engage their board of directors, senior managers and their physicians in a discussion to clarify their future.

JCS Solution: We surveyed all board members, management staff and physicians to obtain their insight about the organization and their transition from being an acute care provider to becoming an organization providing a continuum of services. We attained a 79% response rate to our written survey and the information in it was augmented by in-depth interviews of all planning participants to obtain deeper insight. We identified the critical issues facing the hospital and gaps in the common ground of understanding and concern. We conducted a strategic planning and visioning session with the board, along with the professional and medical staff, to help them discuss the issues and prioritize what needed to be done to ensure that acute, outpatient and preventative care services met the on-going needs of their community.

Results: The planning session generated a significant level of enthusiasm among the participants and a high level of dialog among the different attendee groups. The board and staff found it to be an extremely positive and productive experience. Everyone felt that the session allowed for deeper communication and the ability to clarify critical issues with their medical staff.

Challenge: A large Midwestern metropolitan medical center with two hospitals, a skilled nursing facility, medical offices, outpatient services, an emergency center and teaching facilities involving more than 800 physicians and 4,000 staff and volunteers needed to take a more sophisticated approach to its internal planning efforts. Senior management determined that formalized business planning was to be instituted by all department heads. While these managers were skilled in their respective clinical areas, they needed assistance in understanding how to develop written business plans for their units that would be suitable to be presented to the medical center’s board.

JCS Solution: We conducted an in-depth seminar on business planning for the department heads to help them understand the components of a good plan, as well as how to prioritize material for board consideration. We reinforced that the elements of good planning connect to the overall mission statement of the organization and provided staff with a planning tool to assist them in preparing their written plans.

Results: The feedback on our program was “excellent.” Department heads enhanced their ability to develop viable plans and the organization continued to use our business planning tool as a resource for their staff.

Challenge: An acute care hospital in Iowa was contemplating a major construction project to increase its outpatient service offerings and to develop an on-site medical clinic. The organization also had a psychiatric unit and a skilled care wing. It was developing a PHO with local physicians and joint relationships with other area hospitals. Its foundation was in the planning stages to develop a senior housing project. Competitors were creating new pressures and the organization needed to develop a new strategic plan to help control all the complexity.

JCS Solution: Johnson Consulting Services assisted the hospital in taking its senior management, board and physicians through a joint strategic planning process to prioritize next steps and address the critical issues.

Results: Our work resulted in the development of a plan with broad-based support from these diverse stakeholder groups. The successful implementation of the plan was achieved 6 months ahead of schedule and we were subsequently retained by the board to update the strategic plan.

Challenge: A primary acute care hospital covering a 2,200 square mile rural service area was engaged in a major construction and remodeling project. The hospital employed nearly 300 FTE’s and operated two nursing homes, as well a home health care agency and hospice. The hospital was profitable, but to ensure that it maintained on-going fiscal responsibility, senior management needed assistance in conducting a department directors’ retreat to discuss the complex issues currently facing the organization.

JCS Solution: We developed a collaborative planning process to include input from all key stakeholders and an open dialog between the department heads. We incorporated a variety of external information about competition and changing demographics to help them better understand the issues and deal with the changing priorities established by the hospital’s board of trustees. This process ensured that there was a common understanding of the critical issues and a coordinated agreement on the next steps.

Results: The retreat enabled the department heads to discuss the common issues and prioritize the major issues they would all work on in the up-coming year. This process also ensured that they focused their efforts to implement the priorities established by the organization’s board of trustees.