In last week’s assignment, using the Hoshin-Kanri Model, you laid the ground work for your strategic plan by addressing model items 1.1, 1.1.1, and 1.1.2. The next part of you

Operational Analysis Review Form

Administrative Information

New Healthcare Program

Medically-Supported Street Outreach for Behavioral Health in Homeless Population

Agency Sponsor for this New Healthcare Program

NYC Health + Hospitals

Date of Sponsor’s Operational Analysis

5/02/2024

2. Vision Statement

The strategic plan for this new healthcare service aims to further the following organizational vision:

To be a fully integrated health system, extending comprehensive, personalized behavioral health services to all New Yorkers, including the under/uninsured homeless, fostering dignity and well-being.

3. Mission Statement

The mission of _____________NYC Health+ Hospitals___________ is to:

“Extend equally to all New Yorkers, regardless of their ability to pay, comprehensive behavioral health services of the highest quality in an atmosphere of humane care, dignity, and respect. To promote and protect, as both innovator and advocate, the health, welfare, and safety of the people of the City of New York. To join with other health workers and with communities in a partnership that enables each institution to promote and protect health in its fullest sense, i.e., the total physical, mental, and social well-being of the people.”

4. Program Description

Provide a brief summary of the planned new healthcare program and a description of the business processes it supports.

This program focuses on delivering behavioral health services through medically-supported street outreach. Its team will engage with homeless individuals, meeting them where they are to address mental health challenges and provide a bridge to ongoing care.

5. Customer Satisfaction

5a. Identify the end-users of the investment in this new healthcare program.

Homeless individuals with behavioral health needs.

5b. Briefly describe the process used to assess end-user/customer satisfaction (i.e., decreased ED usage, improve primary care access, satisfaction surveys, etc.)

In order to assess end-user/customer satisfaction within the "Medically-Supported Street Outreach for Behavioral Health" program, regular satisfaction surveys will be distributed to individuals engaged in the program. These will capture feedback on the quality and effectiveness of the services provided as they will address factors such as accessibility, communication, and the impact on mental health. The feedback obtained will be used for continuous improvement and adaptation of outreach strategies to better meet the specific needs of the homeless people in NYC. In addition, decreased ED usage will be assessed. This will be done by monitoring the frequency of hospital visits among program participants. A reduction in ED visits will show success in preventative and community-based care. This will demonstrate the program's effectiveness in addressing behavioral health needs before reaching crisis points. Improved access to primary care will also be assessed. This will be done by checking the frequency and ease with which individuals engaged in the Medically-Supported Street Outreach for Behavioral Health program can access and utilize primary care services. This assessment will involve monitoring appointment attendance, response times for urgent care needs, and establishing ongoing relationships with primary care providers.

6. Strategic Goals

6a. How does the investment in this new healthcare program support to the Organization’s strategic goals?

· By enhancing overall community well-being.

· By alleviating strain on emergency services.

· By strengthening partnerships with community organizations.

6b. How could this investment be combined with others to better meet the Organization’s strategic goals?

· Collaborating with existing outreach programs within the NYC Health + Hospitals network.

· Integrating with mental health initiatives to support the mission and vision.

6c. Discuss any potential risks associated with this new healthcare program.

The program may face resistance from the homeless population. This may be due to distrust of healthcare systems or competing priorities. The distrust of healthcare systems often comes from negative past experiences, stigma, or perception of judgment from healthcare providers (Becker & Foli, 2021). Many individuals experiencing homelessness have faced discrimination or marginalization, leading to skepticism about the intentions of outreach initiatives. Additionally, competing priorities such as finding shelter and food or addressing immediate survival needs are prioritized over healthcare concerns. This may make individuals hesitant to commit time to engage with the program. It is therefore necessary for the program to prioritize building trust, minimizing judgment, and aligning services with immediate needs in order to overcome this resistance. The program may also face the risk of operational challenges. This is due to the varying geographical and environmental conditions that characterize the homeless. This may impact the consistent delivery of services.

7. Financial Performance

7a. Discuss any budgetary constraints/issues associated with this new healthcare program and how they will be managed.

The "Medically-Supported Street Outreach for Behavioral Health" program faces budgetary constraints coming from the need for initial investments in outreach staff, supplies, and ongoing operational expenses. Budget constraints may arise from limitations in securing adequate funding for these essential components. The diverse needs of the population may also introduce uncertainty in predicting the scale and scope of the program. This may lead to budgetary shortfalls. These constraints can be managed by implementing strategic financial planning that entails establishing a flexible budget allocation mechanism to accommodate the changing needs of the homeless population and mitigate the risk of insufficient resources. They can also be managed by seeking diverse funding sources, including grants, community partnerships, and government support and conducting regular financial assessments and real-time monitoring to identify shortfalls in order to address them (Siersbaek et al., 2021).

7b. What is the potential for unexpected costs, cost savings, or cost avoidance?

The program can introduce unexpected costs due to fluctuations in outreach demand, emergent healthcare needs, or unanticipated logistical challenges. Conversely, the program offers opportunities for cost savings by reducing emergency department visits through preventative care and avoiding downstream healthcare expenses associated with untreated behavioral health issues. The program also has a potential for cost avoidance by investing in outreach efforts to address health concerns before they escalate. This will minimize the long-term financial burden on the healthcare system.

8. Technological Considerations

8a. Identify if the Organization explored technological alternative methods for achieving the same mission needs that could be met by launching the new healthcare program.

The organization has identified that utilizing mobile health apps for real-time data collection, appointment scheduling, and communication can streamline outreach efforts.

8b. Identify and briefly describe planning that may be required related to system upgrade or system re-engineering required to support this new healthcare program.

System upgrades or re-engineering that may be required to support this program include ensuring compatibility with existing electronic health record systems, enhancing data security to comply with privacy regulations, and incorporating telehealth options for follow-up care. These upgrades align with the organization's commitment to staying at the forefront of healthcare technology to deliver quality and patient-centered care.

9. Operational Analysis

Discuss availability, reliability, and maintainability for each component.

9a. Administrative support

Administrative support includes communication channels, coordination of outreach efforts, and logistical management. Its availability is addressed by establishing clear and efficient communication channels within the program. This will ensure that administrative staff can effectively coordinate outreach teams and respond to emerging needs. The reliability of this component is ensured by emphasizing consistent and accurate administrative processes, such as appointment scheduling, data collection, and communication protocols. This will guarantee the efficient functioning of the program thus ensure reliability. Lastly, the maintainability of this aspect is addressed by ensuring ongoing training and development for administrative staff. This will make sure that they are well-equipped to adapt to the changing needs of the homeless population (Fonseca et al., 2020).

9b. Financial support

Availability of financial support relies on securing initial and ongoing funding for outreach staff salaries, supplies, and operational expenses. On the other hand, reliability relies on establishing transparent financial management practices, including regular assessments, monitoring, and the ability to adapt budget allocations based on program needs. Maintainability relies on continuous efforts to diversify funding sources, engage in community partnerships, and advocate for sustained financial support from stakeholders to ensure the program's longevity and impact.

9c. Legal consideration

This entails examining the regulatory environments related to street outreach and healthcare provision for the homeless. The availability of this aspect is addressed by establishing clear legal protocols that guide outreach efforts within the boundaries of healthcare regulations and ethical standards. Reliability is addressed by ensuring consistent adherence to legal frameworks. This will ensure that the program operates within the law and across New York City jurisdictions, making it reliable. Maintainability of this aspect is addressed by ensuring ongoing collaboration with legal experts, regular updates to protocols, and proactive adjustments to legal considerations as needed to guarantee the program's ethical and legal integrity.

9d. Clinical activities

Availability of clinical activities is achieved by ensuring that healthcare professionals are consistently available for street medicine activities in order to meet the diverse needs of the homeless population. Reliability is achieved through the development of standardized clinical protocols for outreach. This provides a consistent approach to addressing behavioral health issues. Maintainability is achieved through ongoing training for healthcare professionals, updates to clinical guidelines, and flexibility to adapt to changing clinical activities in New York City.

10. Policy Examination (examining for evidence of structural discrimination)

10a. Administrative Policy

The program's commitment to administrative practices that promote inclusivity and equality will be evaluated using an "equal opportunity and inclusion policy." This policy prioritizes equal access to services, regardless of housing status, and ensures the availability of this document in all organizational materials. The program prevents structural discrimination within administrative procedures by consistently enforcing this policy.

10b. Financial Policy

Evaluation of the program's financial decisions and resource allocation for evidence of structural discrimination will be guided by an "equitable resource allocation policy." This policy outlines guidelines for the fair distribution of funds, ensuring equitable financial practices. This framework should be availed to all stakeholders involved in financial decision-making in the program in order to ensure transparency and accountability. Consistent application of these guidelines aligns financial decisions with principles of equity and inclusivity, which prevents structural discrimination in resource allocation.

10c. Legal Policy

The "anti-discrimination and legal compliance policy will evaluate the program. This policy ensures that all legal actions and outreach activities align with ethical standards and prevent inadvertent discrimination. According to this policy, the program should prioritize fair and equitable treatment of individuals experiencing homelessness. It should also emphasize that legal actions taken during outreach activities must not contribute to structural discrimination.

10d. Clinical Policy

The program's commitment to non-discriminatory healthcare practices will be assessed through a "patient care equality policy." This policy outlines guidelines for addressing the unique healthcare needs of homeless individuals, emphasizing a non-discriminatory approach. Healthcare professionals' easy access to these guidelines ensures their availability in daily practices. Consistent adherence to the policy fosters a standardized and non-discriminatory approach to clinical care, preventing structural discrimination.