Challenge: The Commissioner of one of Minnesota’s state agencies was working to increase the emphasis of its employees to focus more on providing quality services and to re-define the focus of the department’s customers to include a broader base. As part of a continuing quality improvement process, the Commissioner determined that the department needed to develop a new program to focus on providing critical services to meet the needs of an underserved population that was growing in size. Developing this new service was one of the state agency’s highest priority programs.

JCS Solution: Johnson Consulting Services conducted a two-part engagement to assist the Commissioner in obtaining information for decision-making. Our efforts were concentrated on conducting research to confirm the agency’s perceptions of the issues affecting needs of the underserved clients and to identify the critical success factors necessary to design this new service. We reviewed agency data to evaluate the effectiveness of current services to meet the needs of this market. We conducted in-depth interviews with key agency employees and external decision makers to determine how the new service needed to be designed and discovered that success would be limited unless existing negative attitudes held by those external to the agency could be counteracted. We offered suggestions to enable the department to better position its services efforts and address the critical issues we identified. We also developed recommendations to maximize the effect of promotional opportunities available throughout the state.

Results: Our analysis provided the impetus to restructure this program. Our recommendations provided the foundation for this restructuring effort and addressing the negative attitudes held by the community it served. Our work with senior staff helped reposition this state agency as an important resource with a targeted focus on meeting the needs of the underserved population increased the success of the new high priority program.

Challenge: The CEOs of the major hospitals and health systems located in Minnesota needed to understand why they were ineffective in shaping the State’s initial health care reform legislation that implemented a sweeping redesign of the State’s health care delivery system.

JCS Solution: We completed an exhaustive investigation of how the MinnesotaCare legislation evolved, how the industry leaders participated in the legislative process and how this participation impacted the final legislation. After presenting the negative findings of our comprehensive investigation in a candid and constructive manner, we were retained to develop a three-year strategic plan to address the issues cited in our study.

Challenge: The board of trustees of a 164-bed 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 266-bed 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 its 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: City officials in a small rural community were attempting to find an alternative use for their vacant hospital building and were considering the potential for conversion of the property into a board and lodging facility for frail elderly.

JCS Solution: We assessed the suitability of the site for redevelopment, researched the market factors including demographic characteristics of the community such as age, income and health care needs. We reviewed the competitive environment and assessed the potential market demand for the proposed project. Competitive properties were experiencing serious occupancy issues and we uncovered that one area competitive property had closed due to never exceeding 50 percent occupancy.

Result: While we determined that the site was suitable for this redevelopment, we assisted City officials in understanding how the distressed economic environment in this rural community and depressed local real estate conditions created significant challenges to the potential success of this option. We documented the high potential risk associated with this redevelopment and provided the community with objective information regarding the lack of opportunity for this project. This enabled the City to shift its focus to other redevelopment options that would have a more feasible benefit to the community.

Challenge: In an attempt to establish higher standards for the Minnesota’s system of elementary and secondary education, the Minnesota Department of Children, Families and Learning developed a new set of standards for curriculum. Staff from the Minnesota Center for Student Performance was collaborating with the Department to develop new performance assessments. They needed a professional critique of the high school level assignments that had been designed for the business planning and market research components.

JCS Solution: We were retained to review the initial draft of the assignments and assess how reasonable the content was for discussion of business concepts at a high school level. We also assessed the gap between the classroom content and what business people actually do in the real world.

Result: Our feedback and recommendations for this public sector consulting engagement resulted in the development of curriculum content that was relevant, realistic, and challenging for the students.