Brooklyn Hospital Center was founded in 1845 in Brooklyn, New York, USA. It is a non-profit institution with the main goal of improving healthcare services to the community and New York as a whole. It was named Brooklyn City Hospital under the influence of Mayor Smith at that time (Ball, Weaver & Kiel, 2013). After many years of operation realizing the increase in the number of admissions, the name was changed to Brooklyn Hospital. It has faced the advanced growth from initially specializing in essential and outpatient services to being one of the crucial healthcare institutions that was recognized in terms of the Prevention Agenda in the time frame 2013-2017. In other times, Brooklyn Hospital Center has been advancing in its healthcare program covering chronic diseases that include: cancer, HIV/AIDs, diabetes and obesity among others (Uchendu et al, 2014).
Brooklyn Hospital has been recognized and won prizes in most cases for its excellent performance aimed at the improvement of healthcare in its immediate community and New York as a whole. The awards it has received include: the American Heart Association recognized it and gave its Gold Plus Achievement Award for containing cases of stroke (Uchendu et al, 2014). It was also awarded for practicing crucial quality measures and diabetic control among others. At the moment, Brooklyn Hospital has greatly grown to the level that it provides many healthcare services such as family medicine, pediatrics, orthopedics, radiology, surgery, internal medicine and comprehensive outpatient services among others.
Brooklyn Hospital Center has been employing effective strategies for its growth that have accelerated its rate of expansion in offering different healthcare services (Uchendu et al, 2014). The management of the hospital has understood the significance of forming partnerships and affiliations with other institutions in order to realize a meaningful growth. In 2014, it formed partnerships with Cornell University medical college, Mount Sinai Health System and American Dental Association among others (Uchendu et al, 2014). It has also greatly facilitated the education in medicine with close to 250 residents that are absorbed any time in the program. In so doing, it has been so crucial in empowering its local community and New York as a whole (Ball, Weaver & Kiel, 2013). It has also formed partnerships with various community based organizations and community health work groups among others.
Brooklyn Hospital Center’s vision
To be the most compassionate and highest quality healthcare services provider in Brooklyn and in the whole New York.
Brooklyn Hospital Center’s mission
Brooklyn Hospital Center provides the highest quality healthcare services as well as education and state-of-the-art research to ensure a healthy New York population.
Brooklyn Hospital Center’s core values
The core values of Brooklyn Hospital have been substantially fundamental in driving the work culture in the institution including its branches. They have ensured that the code of ethics for healthcare services provision has been complied with. The following are the core values of Brooklyn Hospital Center:
Community service- The hospital is committed to the improvement of the healthy lifestyles of the residents of Brooklyn and New York on the whole.
Respect – Brooklyn Hospital Center treasures the honor and diversity of all its stakeholders such as patients, employees and New York residents among others.
Efficiency – the institution economically utilizes the resources that it is entrusted with by various stakeholders for the improvement of service delivery to its patients.
Accountability – the management of Brooklyn Hospital is totally in charge of all the activities done and can stand up to explain any question when necessary.
Teamwork – all the departments and stakeholders work cooperatively to make Brooklyn Hospital Center grow according to the strategic plan that has been set.
Excellence – Brooklyn Hospital’s management is committed to offering the highest quality healthcare services to patients of entire New York.
Market Environment
Brooklyn Hospital Center has become a place, where there is a high competition among various hospitals. Being one of the leading cities in the world, New York experiences a high competition in the healthcare sector due to the modern demands of healthcare services (Uchendu et al, 2014). With the population that is highly educated, there is an increased consciousness and requirements of patients in regard to the quality healthcare services they receive (Ball, Weaver & Kiel, 2013). In order to compete efficiently, various hospitals have to offer excellent services and diversify their activities in order to be more beneficial to the community they operate in. The competition that is felt rises from both hospitals and healthcare centers within the private and the public sectors (Swayne, Duncan & Ginter, 2012).
Brooklyn Hospital Center has been obtaining the biggest part of its revenue from Medicare (40%) and Medicaid (35%), with the other 25% being derived from other sources (Uchendu et al, 2014). The hospital has been offering quality services according to its core value of excellent services to its patients. This has led to the increased bed capacity of 464 patients in 2013 and the introduction of other related beneficial services. The annual budget that the management of the hospital uses towards serving its more than 300 000 yearly patients is $ 390 million (Ball, Weaver & Kiel, 2013). Mr. Guarracino, who is the vice president of the institution, clearly explains how the management is accountable in their budgeting process (Ball, Weaver & Kiel, 2013). They are economical in minimizing the associated health costs as they maximize healthcare services to their clients and stakeholders.
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The core values of Brooklyn Hospital Center have been so instrumental in leading the institution to compete favorably against its competitors in Brooklyn and entire New York (Uchendu et al, 2014). The management is committed to offering excellent services to its patients. Their accountability enables the management to avoid any corrupt cases or wastage of funds that have been allocated to the institution. Through the effective management of finances, it has had a competitive advantage against other healthcare institutions that are not committed to meeting the needs of their patients excellently.
The other competitive advantage that Brooklyn Hospital Center has includes the strong and competent leadership team. The strong management of Brooklyn Hospital Center has been able to formulate a strategic plan that covers the 5 year period (Ball, Weaver & Kiel, 2013). The management always involves other employees as they come up with the strategic plan. The involvement of the employees and the junior staff members has motivated the work team. It has also reduced any kind of resistance that the employees may have towards the implementation of the formulated strategic plan.
One of the challenges that Brooklyn Hospital Center has been facing is how to refinance its debt, so that it may maintain its solvency state in the market. The institution has been accumulating debts totaling to $80 million which has been difficult to refinance (Uchendu et al, 2014). There are risks associated with such repaying with the annual budgetary allocation, since other services will not be able to be accomplished as outlined in the strategic plan. The management designed a two-stage method of refinancing the debt with the first stage achieved through the disbursement of $45 million (Smith, 2012). This is a weakness within the organization that still has the opportunity to be strengthened so that all the services are not derailed due to settling debts. The management has been committed to ensuring the debt is refinanced and, at the same time, the services are offered excellently as dictated by the strategic plan.
The hospital has made huge strides in the healthcare sector due to strong partnerships and affiliations that it forms with various stakeholders. One of the key stakeholders who have helped Brooklyn Hospital Center is the lender of investment capital (Smith, 2012). The management has always relied on the achievements that its leadership has had in the past to convince lenders that they are able to generate high returns with the capital pumped. Through the comprehensively designed strategic plan, they have been able to persuade lenders to finance other beneficial projects in terms of the Brooklyn Community (Swayne, Duncan & Ginter, 2012).
The leadership of the hospital has also been able to strike a balance between the achievement of high returns on capital and meeting the mission of the hospital (Swayne, Duncan & Ginter, 2012). The balance is highly significant, since the main vision of the hospital is to improve the healthcare needs of the community. The enhancement of healthcare comes first before the profitability of the hospital. The balance enables the institution to accomplish its vision and, at the same time, run on the profitability (Ball, Weaver & Kiel, 2013). In the past, the hospital made a proposal for projects for donations from various international health institutions with the sole aim of bettering the lives of the community and entire New York.
Among the hospitals in Brooklyn that have been offering a competition and alternative healthcare services to Brooklyn Hospital Center are: Long Island College Hospital, Interfaith Medical Center, St.Mary’s Hospital and Victory Memorial Hospital among others (Uchendu et al, 2014). The intense competition for the improved healthcare in Brooklyn coupled with the struggle for financial resources have led to some of the hospitals being closed down. At the moment, Victory Memorial Hospital and St. Mary’s Hospital have been closed down by the government due to the failure to offer quality healthcare services that are desired (Hans, Houdenhoven & Hulshof, 2012). Interfaith Medical Center has proved to be one of the quickly growing hospitals with the bed capacity of 287 among others. Interfaith Medical Center has been considerably fundamental in treating cases of mental illnesses (Ball, Weaver & Kiel, 2013). Brooklyn Hospital Center has to be highly strategic to ensure that it does not lose its patients to alternative health centers. Through the compliance to achievement of a comprehensive strategic plan, they are able to maintain lead in the market, especially in the health sector.
Brooklyn Hospital Center has been experiencing the increased ratings for its facility among the 5 000 hospitals in the US that offer pediatric and adult health services. The hospital has faced growth in its services, with the emergency room receiving more than 67 782 patients annually, 16 759 admissions with over 60% outpatient services and 40% inpatient services (Hans, Houdenhoven & Hulshof, 2012). Various minor and major surgeries were done in the hospital. This clearly shows the growth that the compliance to the strategic plan has been realizing by Brooklyn Hospital Center.
The hospital has also been diversifying its portfolio through introducing various medical services. The introduced range of the offered service, which make the institution top, include: cancer treatments, diabetes, internal medicine, geriatrics, orthopedic and pediatric services among others (Hans, Houdenhoven & Hulshof, 2012). It has also been offering opportunities for doctors and health professionals to research and be educated. The team of doctors is also composed of more than 250 competent and specialized professionals that are able to address many health problems under one roof (Ball, Weaver & Kiel, 2013). Due to the growth that Brooklyn Hospital Center has been experiencing, its level of competition has gone beyond New York to external big hospitals such as New York City Health, Brookdale Hospital and Maimonides Medical Center among other top hospitals (Hans, Houdenhoven & Hulshof, 2012). Currently, the annual revenue Brooklyn Hospital Center receives is $328.318. It has had various medical services improvements such as having fewer cesarean births (38%) than normal vaginal births (61%) (Zheng et al, 2014). Maternal deaths have also been reduced due to the improved health care; moreover, babies can be fed on the breast milk that has more health benefits.
Strategy Formulation
To achieve the vision of becoming the most kindhearted and excellent healthcare service provider as well as accomplishing the mission of ensuring a healthy New York population, Brooklyn Hospital Center maintained its vibrancy and independence (Grigoroudis, Orfanoudaki & Zopounidis, 2012). The healthcare needs a precise center of attention to uphold and enhance areas that have competitive potentials. Thus, there is a need for a comprehensive analysis of manifold factors that influence the long-term achievements. In the view of attaining the concrete information concerning the strategic planning, Brooklyn Hospital Center has performed a cohesive assessment over a reliable number of months. Besides, the health organization utilized the relevant quantitative and qualitative data to evaluate several aspects and situations impacting it. The hospital also performed a concrete analysis regarding markets that relate to behaviors in the home care and services offered by the Brooklyn Hospital Center. The manifold results from the assessments and analysis of all the qualitative and quantitative data revealed that Brooklyn Hospital has a strong background to maintain its competitiveness in terms of the strategic objectives.
Strategies
Critical issues 1 – The need to improve the quality of life of the Brooklyn patients
The prosperity based on the quality of life
1.1. To guarantee the public health reaction and attentiveness
1.1.1 Project Plan Healthy Ready (PPHR)
The PPHR is relevant for the Brooklyn Hospital Center, because it is a tool that the healthcare organization utilizes to examine the programs indicating the emergency attentiveness compared to the standard of the nation. The preparedness plan has to adhere to the meticulous criteria for coordination, education, and practices to be recognized, while also maintaining the competence regarding the emergency attentiveness for all professionals in the public health. In other words, the tactics are to illustrate the functions of the public health in all categories of hazardous urgent situation reactive incidences as well as highlight the organization’s plans of action in case of any emergency. Secondly, it illuminates the individual based and family plans of action suppose there is an urgent situation. It also depicts the sequence of command and occurrence management scheme for the authority.
1.1.2 Medical set aside corps
Brooklyn Hospital Center sustains some units of team connections in New York City, comprising of around fifty health center and non-health center volunteers. The volunteers have the capacity to support the Brooklyn Hospital’s employees in case of any health actions that are done on a daily basis as well as offering necessary health assistances, for instance, intensive immunizations and screening during pre-hospital scenarios. However, there must be specific trainings to all volunteer before they are recruited and screened at the Brooklyn Hospital Center.
1.1.3 The Neighboring Emergency Preparedness Program (NEPP)
The NEPP is meant to assist the nearby communities to have the capacity of curbing any emergent hazard in the area as they provide a training to the local society on organization and response skills regarding different urgent scenarios. The other role that the NEEP will play is to sensitize all the community members and coordinate with other international organizations and groups, for example, the American Red Cross and MRC. The main education opportunities that the local citizens get include the first aid, best methods for the information dissemination, examination of possible damages and team management.
1.2 To advance the health performance indicators
1.2.1 Merging paramount Healthy Start programs to Assurance Best Care Clinic
It is fundamental for Brooklyn Hospital Center to integrate the Assurance Best Care (ABC) clinics, which were majorly used for referrals, with the Healthy Start programs to people who require connected services in one place. Furthermore, the emergence of the programs is fundamental to pregnant women in discovering complications at the early stages of pregnancy, application for Medicaid and handling cases of domestic violence.
1.2.2 The immunization of children
The purpose of vaccination of children initiative is to make sure that at least 90% of all children bellow two years old are vaccinated according to the county’s immunization schedule, while following a protocol that is based on the evidence. In order to achieve the abovementioned goals, the Brooklyn Hospital Center staffs have engaged in educating the parents of the children as well as cross-checking the records for immunization, when a child has a pediatric slot.
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Critical issue 2 – The need to have a competitive health center and financial competence
The business advancement and economic competence
2.1 To guarantee a fiscal sustainability
2.1.1. Partnership with Regional Consortia to control intellectual capital
Brooklyn Hospital Center utilizes the philosophy of sharing the information and expertise to leverage the possible cost of intellectual capital. In proving a significant healthcare to the entire New York City, the health center requires more than one hundred thousand staff members; therefore, the regional consortia are fundamental in enhancing the efficiency and optimum use of the intellectual resources. For example, Brooklyn Hospital identified an administrative manager that is proficient in accounting and organization skills, thus, coordinated with him to manage the medication chambers.
2.2 To promote the efficiency and effectiveness in the health sector venture
2.2.1 Achieve the National Health Accreditation
According to the voluntary Public Health Accreditation Board, a hospital must meet all the international standards, namely the ten fundamental services of public health in addition to two vital facets that tackle the organizational administration, management, and governance. In commencing the hectic application process regarding the accreditation, a hospital must possess current strategic plans, updated health enhancement program and the recently accomplished community health evaluation. Brooklyn Hospital Center has prepared the entire requirement; thus, it is planning to review and revise the development plans regarding the laborers as well as the submission of the “Statement of Intent.”
Critical Issue 3 – There is a substantial concern on how the hospital can partner with the clients
Partnership with Clients or other community members in regard to the health engagement
3.1 To improve the community joint venture on health issues
3.1.1 Community Health Needs Assessments
Brooklyn Hospital has been engaging in health needs evaluations relevant to the specified community, but as from 2016, it has embarked on an intensive health assessment regarding all the communities in focus. The areas of concern include the reduction of substance abuse, lessening cancer mortality rates, enhancing the access to dental care and formulation of resource tools that are relevant to a particular neighborhood.
3.2 To enhance the focus of the health center to the clients
3.2.1 Engagement with the customers using the touch screen processes
There is a high demand for the client’s contentment with reference to the time management and efficiency in the operation procedures within Brooklyn Hospital Center. The hospital, therefore, plans to implement touch-screen tools of survey to achieve their need to offer quality services to all patients at a minimal time possible. Thus, clients will be able to indulge in the inquiry that takes a maximum of thirty seconds, while offering the Brooklyn staff members opportunity to interact with customers and respond to emergency cases.
Implementation Plan
| TASK | LEAD SUPERVISOR | FRONTLINE WORKER | START DATE | STOP DATE | ||||||||
| 1.0 Prosperity on the quality of life | ||||||||||||
| 1.1. To guarantee public health reaction and attentiveness | Dr. Richard B.Berker | Dr. Shimatula Shur | 5/4/2016 | 6/10/2016 | ||||||||
| 1.1.1 Project Plan Healthy Ready (PPHR) | ||||||||||||
| examine programs | ||||||||||||
| adhere to the coordination criteria | ||||||||||||
| maintain the competence | ||||||||||||
| illuminate individual based & family plans | ||||||||||||
| 1.1.2 Medical set aside corps | Dr. Paul Albertson | Dr. Paul Albertson | 6/4/2016 | 5/10/2016 | ||||||||
| intensive immunizations and screening | ||||||||||||
| training recruits and screening to all volunteers | ||||||||||||
| 1.1.3 The Neighboring Emergency Preparedness Program (NEPP) | ||||||||||||
| Curbing any emergent hazard in the area | ||||||||||||
| sensitizing all the community members | ||||||||||||
| coordinating with international organizations and groups | ||||||||||||
| 1.2 To advance the health performance indicators | Dr. Joseph Guarra | Dr. Sonia Vina | 6/4/2016 | 7/10/2016 | ||||||||
| 1.2.1 Merging paramount Healthy Start programs to ABC Clinic | ||||||||||||
| connected services will be in one place | ||||||||||||
| discovering complications at the early stage of pregnancy | ||||||||||||
| Medicaid application and handling domestic violence cases | ||||||||||||
| 1.2.2 The immunization of children | Dr. Welington Sharp | Dr. Sonia Vina | 6/4/2016 | 9/11/2016 | ||||||||
| 90% of all children bellow two years old are vaccinated | ||||||||||||
| educating the parents of the children | ||||||||||||
| cross-checking the records for immunization | ||||||||||||
| 2.0 The business advancement and economic competence | Dr. Richard B.Berker | Cathrine Derr | 6/4/2016 | 8/11/2016 | ||||||||
| 2.1 To guarantee a fiscal sustainability | ||||||||||||
| 2.1.1. Partnership with Regional Consortia for the intellectual capital | ||||||||||||
| utilizing the philosophy of sharing information and expertise | ||||||||||||
| enhancing the efficient & optimum use of intellectual resources | ||||||||||||
| 2.2 To promote the efficiency and effectiveness in the health sector venture | ||||||||||||
| 2.2.1 Achieve the National Health Accreditation | Dr. Paul Albertson | Dr. Paul Albertson | 8/4/2016 | 10/11/1016 | ||||||||
| meet all the international standards | ||||||||||||
| process current strategic plans | ||||||||||||
| review and revise the development plans | ||||||||||||
| submit the “Statement of Intent.” | ||||||||||||
| 3.0 Partnership with Clients or other community members in regard to the health engagement | ||||||||||||
| 3.1 To improve the community joint venture on health issues | Dr. Shimatula Shur | Dr. Robert Keli | 4/5/2016 | 1/10/2016 | ||||||||
| 3.1.1 Community Health Needs Assessments | ||||||||||||
| embarking on the intensive health assessment | ||||||||||||
| reducing cases of substance abuse | ||||||||||||
| lessening cancer mortality rates | ||||||||||||
| enhancing the access to dental care | ||||||||||||
| 3.2 To enhance the focus of the health center to the clients | Dr. Berka Kurl | Dr. Bernard Shum | 4/4/2016 | 5/11/2016 | ||||||||
| 3.2.1 Engagement with the customers using the touch screen processes | ||||||||||||
| implement touch-screen tools of survey | ||||||||||||
| indulge in the clients with inquiry |
Appendix A
SWOT Analysis
Strengths
- Has over 300 professional doctors with diverse specializations
- Excellent and quality health care due to its excellent core values
- Diverse benefits to the community such as research, educations and better healthcare services
- Comprehensive strategic plan to ensure goals are achieved
- Ranked one of the best hospitals in New York
- Strategic location in New York, where patients can access services
- Good reputation in terms of healthcare to the stakeholders
Weaknesses
- High debts that are expensive to service
- Not well developed psychiatrists section for mental illness cases
- Increased costs due to more functions such as research, education and healthcare among others.
- Inability to effectively serve the increasing number of patients
- Poor waste management techniques
- Compliance to 8 am to 5 pm work time contributing towards ineffectiveness during night shifts
- Over-reliance on Medicaid and other insurance companies may paralyze the hospital
Opportunities
- With highly developed reputation more funds can be sourced using new techniques
- Increasing demand for specialized treatments, such as mental illnesses, provide the opportunity for growth
- Ability to improve the service delivery in order to be rated the best hospital in USA
- Possibility to serve patients at all times, even weekends
- Improve marketing so that it becomes known worldwide
Threats
- High competition from other hospitals
- Increased debts may lead to inability to meet the budgetary essential requirements
- Failure of the poor patients to pay for healthcare services
- Advancements in technology may make the current instruments obsolete.
Appendix B
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Porter’s five forces
Threat of new entrants
- Due to the excellence in services, there are loyal patients that will not shift.
- A high capital required for the level of Brooklyn Hospital that reduces new entrants.
- Due to referrals of Medicaid and Medicare, patients served will not be affected.
Threat of substitutes
- Due to ineffective means of handling the increasing number of patients, the surplus may switch to other hospitals.
- Due to increasing private clinics providing affordable services, some patients may shift to them based on costs.
- Generally, there is a moderate threat of substitutes due to the excellence in healthcare services provisions.
Supplier power
- Brooklyn Hospital Center’s excellent reputation has instilled the confidence in patients’ and stakeholders.
- There are loyal and established patients who cannot be swayed by other suppliers.
- There are well developed relationships with clients and follow ups; hence, they are loyal.
- Supplier power in the healthcare industry in terms of Brooklyn Hospital is low.
Buyer power
- Brooklyn Hospital Center experiences a moderate power of buyers in the industry, since the patients are well informed of the services; and it also offers excellent services.
- The reputation of Brooklyn Hospital as providing the excellent healthcare diffuses any forces from the patients, since their confidence is strong in regard to the hospital.
Degree of rivalry
- Brooklyn Hospital Center faces a moderate rivalry from national hospitals, those within Brooklyn and New York such as Brookdale Hospital among others.
- Brooklyn Hospital enjoys a large market share due to the diversity of services it provides such as research and education which quench its rivals.
- Financial strains and debt settlement may pose Brooklyn Hospital Center as weak if the rival has a strong financial base.
Appendix C
Balanced Scorecard Methodology
| In which ways can excellent healthcare services be provided to increase the number of patients and stakeholders? | Internal Business Process | |||
| Objectives | Measures | Targets | Initiatives | |
| To acquire adequate facilities for increasing clients | Funding proposals, projects and future increments plans | Increased funding for facilities that more patients require | Approach financing institutions and charity organizations for hospital funds | |
| To strengthen internal systems to increase the efficiency | Competent staff and latest technological methods | The increased expertise for more efficiency. Latest instruments for analysis and software | Intense continuous trainings as well as buying new instruments and software |
| How can the formulated vision of Brooklyn Hospital be achieved? | Learning and Growth | |||
| Objectives | Measures | Targets | Initiatives | |
| Adhere to the strategic plan | Degree of compliance to the strategic plan | Stakeholders as outlined in the strategic plan | Continuous evaluation of the accomplishments according to the strategic plan | |
| Diversify functions for a greater community benefit | Increase the capacity for the research, education and healthcare provision | Many partners and affiliates | Form partnerships with research and other like-minded organizations for more synergy. | |
| Marketing Brooklyn Hospital more | A comprehensive marketing plan | Channeled through the communication department to media organizations | Produce flyers, banners, media adverts, etc. |
| How can Brooklyn Hospital Center have more loyal consumers? | Customer | |||
| Objectives | Measures | Targets | Initiatives | |
| Customer relationship management | Creating long term business relationships with consumers | Competent, well trained customer care department | Conduct a market research in order to identify the consumer feedback | |
| Availability | Create a system where patients can easily access doctors | All sections | Employ receptionists that are well trained and have customer care skills. | |
| What can Brooklyn Hospital Center do in order to gain the financial stability? | Financial | |||
| Objectives | Measures | Targets | Initiatives | |
| Seek for more funding | Write more funding proposals | 3 funding proposals annually | Approach financiers for funding | |
| Increase company returns | Reduce wastage through the efficiency | Reducing electricity, water and recurring expenses | Mandate supervisors to take charge | |
| Increase side investments | Appreciating assets owned | Land for developments, etc. | Prioritizing investments on appreciating assets |