Cracks in the Plan?

Many of us in the San Francisco Bay Area are following the news of the unexpected crack found in the Bay Bridge. We fear the need for additional repair may delay our commutes tomorrow morning, and we've already been without the Bridge all weekend.


Business plans and grant proposals can also suffer fatal flaws, which can cause serious problems. I typically discuss these problems in terms of project feasibility.

Sometimes business plans with major cracks in them take on a life of their own. It can save the institution money, and save you a lot of wasted effort, if you can identify feasibility issues as early in the plan development as possible. You can then stop or modify an unworkable project idea into something that benefits your institution and your patients.

I have some suggestions for ensuring feasibility as you develop your business plan. Is there any interest out there in discussing this topic further?

The Summer's Over!

It's time to stop putting things off...the fall semester's starting this week, with another course to teach in financial management. I'll have 25 or so graduate nursing students coming up with creative ideas for business plans and grant proposals.

Until I start seeing some comments, it will take a real leap of faith to start posting regularly. However, I'm determined to see whether nursing and other health care managers are interested in learning and discussing about this topic.

At any rate, I'm back from vacation! Let's see where these ideas take us...

HACs and Business Plans

How are the HAC provisions related to costs?

• added treatment costs, for example, the added cost of a pressure ulcer that develops after hip surgery
  
• increased length of stay
  
• potential fines or litigation
  
• potential accreditation, reputation and referral problems

How are the HAC provisions related to revenues?

• Medicare will withhold additional payment for these conditions if they were not present on admission, resulting in lost revenues.

What about quality?

• The Centers for Medicare and Medicaid (CMS) is proposing additions to the current list of HACs:

Surgical Site Infections Following Elective Procedures:

• Total Knee Replacement


• Laparoscopic Gastric Bypass and Gastroenterostomy


• Ligation and Stripping of Varicose Veins

Legionnaires’ Disease

Glycemic Control:

• Diabetic Ketoacidosis


• Nonketotic Hyperosmolar Coma


• Diabetic Coma


• Hypoglycemic Coma

Iatrogenic Pneumothorax

Delirium

Ventilator-Associated Pneumonia (VAP)

Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE)

Staphylococcus aureus Septicemia

Clostridium difficile-Associated Disease (CDAD)

How does this relate to writing business plans?

If you're trying to make a business case for your idea, showing that you will improve quality, reduce costs and capture revenue makes your plan convincing. We can use HACs (current and proposed) as examples of ideas for business plans.