D511 TPMC Affiliation Recommendation 2024/2025, Assignments of Nursing

D511 TPMC Affiliation Recommendation 2024/2025/D511 TPMC Affiliation Recommendation 2024/2025/D511 TPMC Affiliation Recommendation 2024/2025

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2024/2025

Available from 10/29/2024

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A. Discuss the goals and rationale for an affiliation by doing the following:
1. Explain critical goals for the affiliation and specific criteria a candidate affiliate must meet.
The Twin Pines Medical Center (TMPC) serves northern Louisiana's low-income,
uninsured, insured, and underserved populations. Pine Parish’s population is just under
48,000 community members that the TMPC serves. At least 33% of the population is
uninsured, and 36% is enrolled in Medicaid. The population comprises 93% Black, White,
and Native Americans; the remaining 7% is Hispanic, Asian, and two or more races. There
is a higher incidence rate for diabetes in the non-Hispanic black population and the
Native Americans, equaling 57%. (Profile: Twin Pines Medical Center, n.d.)
The goal to improve these services would mean that critical care cases related to diabetic
conditions could be monitored and managed before emergency medicine needs to be
administered if the preventive treatment is improved for the population. If complex care
can be avoided from the start, that would increase the patient's outcome and the quality
of care they receive. The patient outcome when the affiliation adds an endocrinologist,
nutritionist, health educator, telemedicine, case management, and educational resources
for diabetic care will improve drastically.
The organization must choose an organization that fits its mission and adds more value
to its partnership. The organization selected should be able to fuse with close values and
organizational culture. The corporate culture, management, decision-making, and
governance must be compatible. (Grube, M. E., & Finnerty, M. J., 2011)
2. Identify three specific advantages a well-aligned affiliation would provide for TPMC.
TMPC and the affiliate will improve the quality of services, starting with primary care,
family medicine, and emergency medicine for the diabetic community. Adding specialty
care for the diabetic population and adequate equipment in the emergency department
will help decrease the number of cases seen and increase preventative care.
The patient outcome when the affiliation adds an endocrinologist, nutritionist, health
educator, telemedicine, case management, and educational resources for diabetic care
will improve drastically. The advantage of the affiliation would be that it will grow and
expand services to the community.
An advantage would be shared budget and resources between the two facilities. An
upgraded integrated medical record system will positively impact the organization by
providing an improved way to create and monitor the comprehensive care plans that the
local communities will benefit from.
3. Analyze the current state of TPMC and the projected market segmentation for TPMC
anticipated from the proposed affiliation. Your analysis must be supported by demographic
data and include the following elements:
The center offers primary care services with a few specialties: outpatient services,
inpatient services, family medicine, and women’s health. “The mission and values to
provide accessible, affordable, comprehensive, and quality services to the communities it
serves.” (Profile: Twin Pines Medical Center, n.d.) However, the center lacks the diabetic
care specialty that the community desperately needs. The preventive care for diabetes
and health education is inadequate for this location. The emergency room sees diabetic
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A. Discuss the goals and rationale for an affiliation by doing the following:

  1. Explain critical goals for the affiliation and specific criteria a candidate affiliate must meet.  The Twin Pines Medical Center (TMPC) serves northern Louisiana's low-income, uninsured, insured, and underserved populations. Pine Parish’s population is just under 48,000 community members that the TMPC serves. At least 33% of the population is uninsured, and 36% is enrolled in Medicaid. The population comprises 93% Black, White, and Native Americans; the remaining 7% is Hispanic, Asian, and two or more races. There is a higher incidence rate for diabetes in the non-Hispanic black population and the Native Americans, equaling 57%. (Profile: Twin Pines Medical Center, n.d.)  The goal to improve these services would mean that critical care cases related to diabetic conditions could be monitored and managed before emergency medicine needs to be administered if the preventive treatment is improved for the population. If complex care can be avoided from the start, that would increase the patient's outcome and the quality of care they receive. The patient outcome when the affiliation adds an endocrinologist, nutritionist, health educator, telemedicine, case management, and educational resources for diabetic care will improve drastically.  The organization must choose an organization that fits its mission and adds more value to its partnership. The organization selected should be able to fuse with close values and organizational culture. The corporate culture, management, decision-making, and governance must be compatible. (Grube, M. E., & Finnerty, M. J., 2011)
  2. Identify three specific advantages a well-aligned affiliation would provide for TPMC.  TMPC and the affiliate will improve the quality of services, starting with primary care, family medicine, and emergency medicine for the diabetic community. Adding specialty care for the diabetic population and adequate equipment in the emergency department will help decrease the number of cases seen and increase preventative care.  The patient outcome when the affiliation adds an endocrinologist, nutritionist, health educator, telemedicine, case management, and educational resources for diabetic care will improve drastically. The advantage of the affiliation would be that it will grow and expand services to the community.  An advantage would be shared budget and resources between the two facilities. An upgraded integrated medical record system will positively impact the organization by providing an improved way to create and monitor the comprehensive care plans that the local communities will benefit from.
  3. Analyze the current state of TPMC and the projected market segmentation for TPMC anticipated from the proposed affiliation. Your analysis must be supported by demographic data and include the following elements:  The center offers primary care services with a few specialties: outpatient services, inpatient services, family medicine, and women’s health. “The mission and values to provide accessible, affordable, comprehensive, and quality services to the communities it serves.” (Profile: Twin Pines Medical Center, n.d.) However, the center lacks the diabetic care specialty that the community desperately needs. The preventive care for diabetes and health education is inadequate for this location. The emergency room sees diabetic

patients need complex care that they cannot provide properly. Suppose the patients had diabetic preventive care and education. In that case, the population may have a decrease in diabetes, and the patients who already have diabetes deserve to become healthier. (Profile: Twin Pines Medical Center, n.d.)  The affiliate and Twin Pines Medical Center will operate in an integrated network, creating a solid clinical and healthcare business affiliation. The importance of remaining independent for both affiliates means that they integrate clinical services but remain separate from the other institution controlling the other institution. Both institution's missions align by providing care to all regardless of their ability to pay and offering quality care.  The success of the affiliation will ensure that the collaboration between them will carry out the mission and vision of the affiliation. The strength of the affiliations operations is that each emergency department and endocrinologist can share information on the best standards of care to be offered to the patients. B. Discuss the affiliate recommendation by doing the following:

  1. Recommend an affiliate based on your goals and rationale from part A and include critical attributes of the proposed organization that support the affiliation.  Twin Pines Medical Center should join Duke Health as an integrated network affiliation. By creating a solid clinical and healthcare business affiliation. The importance of remaining independent for both affiliates means that they integrate clinical services but remain separate from the other institution controlling the other institution. Both institution's missions align by providing care to all regardless of their ability to pay and offering quality care. Duke Health advocates for quality care for all patients, irrespective of their ability to pay. Their commitment to their patients ensures those uninsured or low-income receive treatment. (Community Health | Duke Health., n.d.). Reducing cost and providing diabetic care is the goal for TMPC, and integrating with Duke Health will allow both institutions to improve diabetic care, reduce cost, and provide endocrinology, nutrition services, and primary care.
  2. Identify the significant benefits of affiliation with this organization and describe how these benefits strategically align with TPMC’s goals.  Creating an affiliation with the Duke Health System would immensely help the TPMC population as reviewing Duke Health System, they both would benefit from the quality of care that both organizations provide, and the network of innovative care that is offered through a partnership would bring the population better health outcomes with the programs that Duke Health System provides. Research experts with extensive knowledge of complex cases would bring more resources to the TPMC community and provide care to all, regardless of their ability to pay. This will eliminate any health disparities created through the lack of willingness to see patients because of their economic status.  The initiative Duke already has for the endocrinology department is precisely what the TPMC is looking for. The affiliation would be most beneficial because the organization already has a strong expertise in complex cases and would provide the highest quality of

have to be restructured, which could cause the employees to feel that they have no place or require more motivation to stay with the medical clinic through the merger. The Mayo Clinic is an integrated, not-for-profit medical group. They are committed to a team-based approach across the network, specializing in medical practice and research. (Mayo Clinic,

  1. This could be a misalignment detrimental to the Twin Pine Medical Center community and employees. Mayo Clinic’s strong reputation in the medical community would bring TPMC more resources and networking partnerships to create a solid network to help eliminate disparities in TPMC’s location. The affiliation's challenges are the complications of the structure and communication between the two organizations and the patients. C. Discuss the affiliation plan for the proposed affiliation structure by doing the following:
  1. Describe your proposed affiliation structure and include justification for the selection.  The affiliation will be structured as a clinically integrated network with Duke Health. Both organizations can remain independent, continue the current governance and assets, and create an alliance that connects healthcare organizations to share clinical expertise, IT, and infrastructure costs. (Spees, J.,2014) This will allow Twin Pines Medical Center (TPMC) to remain independent from Duke Health to integrate more resources and care through the local diabetic community. This affiliation governance would require no change to the current structure-preserving the current leadership, such as the CEO and other leading officers. The collaboration between the affiliates' leadership is critical to the success of the affiliation plan. The executive board and officers from both affiliations will be at the top. The structure will be created in each department and separate clinics. The financial reporting will be the CEO, COO, and CFO’s responsibility to maintain the organization’s financial aspects and affiliation expenses. The financial department will have a financial associate maintaining each department's budget and billing to keep financial reporting in line with regulations. The CFO oversees the financial associates and meets with them regularly to monitor the operations. Each clinic will have office managers and team supervisors to monitor the department's daily operations, such as staff or required resources. Each department reports to the executive officer, communicating authority and responsibility overseen by the executives. The affiliate and Twin Pines Medical Center will operate in an integrated network, creating a solid clinical and healthcare business affiliation. The importance of remaining independent for both affiliates means that they integrate clinical services but remain separate from the other institution controlling the other institution. Both institution's missions align by providing care to all regardless of their ability to pay and offering quality care.
  2. Create new organizational, vision, mission, and value statements for the proposed affiliation structure. Organizational Statement: Twin Pines Medical Center and Duke Health partners to provide cost- effective, high-quality, and innovative care for all. Vision Statement: Our vision is to promote healthier living in the community through experienced and specialized care.

Mission Statement: Our mission is to cultivate an inclusive culture, providing a sense of equity to all that we serve. Value Statement: Our value is to provide individualized care through high-quality and innovative treatments committed to each person.

  1. Develop a leadership plan for the proposed affiliation structure that includes the following elements:
  • The leadership and management should be discussed and established before the transition of the affiliation. The organizations’ politics include the executive officers such as CEO, COO, CMO, CNO, etc. With a clear leadership role, the organizations must create an executive on both sides of the affiliation to communicate directly with both institutions. Clinically integrated network officers will maintain their current positions. However, their responsibilities may be shifted to fit the affiliation goal. There should be clear roles that each leader plays in the affiliation to manage policies, create resolutions for operation, and ensure that clinical and non-clinical staff members are increasing performance. The Twin Pines Medical Center aims to reduce the number of patients seen with diabetic complications with complex cases in the Emergency Department. Each institution would involve the executives and other officers in making decisions and allocating resources with the new affiliation structure.  This process includes the emergency department staff and specialty teams such as endocrinology, nutritional, primary care, and any supportive departments in this transition. Many teams will monitor and manage the diabetic patient’s conditions. While the executive board representing both institutions makes decisions for the affiliation, they will meet in person or via online video sources such as Zoom or any professional. Protected visual/audio conference call software. Meeting minutes will be recorded in each meeting, and if changes need to be made, they will be released to department leaders to convey to the employees. The changes that will be occurring or will affect processes or employees must be communicated promptly. With this strategy, the decisions will be documented and communicated clearly to the whole affiliation.  Communication clearly and efficiently will be the key to a seamless integration between the affiliates to avoid any errors or complications that will cause harm to patients or operations. The executive board will continuously communicate any concerns or issues that must be addressed. The executives and human resources should rely on each other to set policies, procedures, and guidelines for the organization.
  1. Describe how to maintain and improve employee satisfaction, engagement, and retention in a culture of positive change.  Motivation drives a person to work and makes the person feel committed and focused on a goal. Maslow’s theory of hierarchal needs summarizes that people do not work just for money but to contribute and use their skills toward a goal. Maslow’s theory is in a pyramid of needs to show how motivation works for people. When the needs of the employees are fulfilled, the team members will have higher performance. (Knowledge Hut, 2019)  This theory is critical to leaders and their employees. As leaders, understanding what the needs are of their employees will encourage the employees to buy in. Without motivation, satisfaction and engagement will decrease the retention rate. Creating inspiration for the employees, internal or external, will show the employees that they are

strategy. The consequences are if the affiliation does not meet the promised goals. The organization did not deliver its commitments to the patients and would have a reason to dissolve the contract. Not providing high-quality care to patients will be a determinant of the community. This could lead to higher readmission rates and increased costs for personnel and resources.  Another concern is whether the employees are satisfied; the retention rate and employee engagement will decrease. If the employees do not feel valued in the affiliation, it would likely cause the affiliation to have no reason to continue the contract. If employees are not satisfied, patient care quality will also decrease, and they will be unable to keep their promises to the community.

  1. Provide a potential exit strategy that is actionable and includes three action steps. Suppose the affiliation fails to meet the organization's leadership’s success measurements. The leadership will have to discuss and implement an exit strategy.  A proposal for termination will have to be drafted and presented to the executive board for review.  The executive board will review the proposal and begin to initiate the termination of the affiliation if it is necessary. The financial and resource aspects of the affiliation will be determined and distributed to the owning organization.  The Chief executive officer and Chief operation officer will help facilitate the termination process for the organization. If the affiliation has an exit strategy, terminating the partnership will have a clear position and a step-by-step approach to dismiss the contract. The whole process will be passed down once the termination is in progress and the human resources facilitate the transition to the employees. Risk management will help monitor and manage the risk of the other teams during the transition and offer solutions to alleviate issues involving risks that will cause determent to the organization. All employees must understand that the steps moving forward are essential for the organization’s survival.
  2. Discuss future challenges and opportunities that could result from the affiliation regarding the evolving community healthcare landscape.  Healthcare faces challenges constantly because of the evolving industry around patient- centered care. The healthcare industry continuously improves innovations to provide quality care to the communities. Some companies still fail to upgrade their resources or procedures to deliver quality care. If the medical center joins the affiliation, the positive results will come from the fact that fewer diabetic patients will require the emergency department’s intervention. While the endocrinology specialist is monitoring their complex cases. Another challenge the affiliation will face is that both affiliates will need clear communication and shared resources. If they fail to have a structured communication system, such as electronic EMRs, testing documentation, consult referrals, and any other physician resources needed between the two affiliates. The affiliation gives Twin Pines Medical Center the financial and technical resources it needs to take advantage of the opportunities it offers. The affiliation would offer comprehensive care that the medical center could not provide. D: References Community Health | Duke Health. (n.d.). Corporate.dukehealth.org. Retrieved September 22, 2023, from https://corporate.dukehealth.org/communityy

Endocrinology. (n.d.). Duke Health. Retrieved September 22, 2023, from https://www.dukehealth.org/treatments/endocrinology Grube, M. E., & Finnerty, M. J. (2011). How to make the strategic partnering decision: What we’ve learned from recent merger, acquisition, and affiliation activities. Kaufman, Hall, & Associates. 1-11. Knowledge Hut. (2019, February 27). Motivation Theories - 5 Famous Motivation Theories | KnowledgeHut. KnowledgeHut Tutorial. https://www.knowledgehut.com/tutorials/project- management/motivation-theories Profile: Twin Pines Medical Center. (n.d.) Master of Healthcare Administration. Western Governors University. 1-10. Spees, J. (2014, October 9). 2015 AHLA health care transactions: A resource guide. The Camden Group. 1-4. http://cdn2.hubspot.net/hubfs/161605/Choosing_the_Right_Affiliation.pdf? __hssc=48229496.1.1580456635421&__hstc=48229496.dee2e8648587f1ca074a562fa3fb2096. 80456635419.1580456635419.1580456635419.1&__hsfp=1733251557&hsCtaTracking=f8ac7eb -a0b7-4315-9616-33ebf8f1037c%7Ca2b989d1-175f-45da-b4d5-d6b3c72f0ea Waymack, P., & Lohse, G. (n.d.). Exit Strategies: Planning for Managed Care Contract Termination - HGExperts.com. Www.hgexperts.com. Retrieved October 7, 2023, from https://www.hgexperts.com/expert-witness-articles/exit-strategies-planning-for-managed-care- contract-termination-