Discussion
ACO i.e. Accountable Care Organization is a healthcare organization that links payments to quality metrics and the cost of care. In United States of America, ACO is formed as a group of coordinated healthcare practitioners such as doctors, hospitals and other healthcare providers who come together to provide high quality care to patients. The alternative payment models such as capitation are adopted by healthcare practitioners. We have already discussed above in this report that several competitive hospitals have already started formation of ACO to participate in new payment models that are helpful in cost reduction and to improve health of population. So now our hospital wants to implement ACO formation and in this segment of report we will emphasize on execution plan of ACO and its impact on performance of organization (Ctb.ku.edu, 2017).
It is a major thing that how we can align ACO with strategy of our organization, but before discussing about alignment of ACO with strategy of our organization it is necessary to about aims of ACO. From this we can understand that why Accountable Care Organization (ACO) is important to implement. Following are major aims of Accountable Care Organization:
- To know about advanced understanding of ACO implementation that includes a focus on the treatment of patients, management of high costs, management of needs of patients and analyze data from the National Survey of Accountable Care Organizations by using a mixed method approach and in-depth qualitative interviews.
- Another aim is to analyze the local areas and the providers that forms ACOs on Medicare claims data and other data sources to know about characteristics of ACOs and why it is necessary to form (Reinke, 2001).
From aims of the ACO, it is cleared that this organization do everything for providing better services and medical care to patients. So if we will align these aims with strategy of our organization then this will raise profile of our hospital and also establish a culture of excellence in regard to the delivery of healthcare. As a healthcare administrator I found that, in establishment of this culture of excellence, it is necessary to engage necessary stakeholders of hospital throughout the formation of ACO in our hospital and these stakeholders must be doctors, nurses and other healthcare providers that upholding this culture of healthcare. In this way, we can align ACO with strategy of our hospital (BusinessDictionary.com, 2017).
Our hospital has decided to implement ACO and before its implementation, I have evaluated impact of ACO on performance of our hospital and I got following outcomes:
- The responsibility of Accountable Care Organization is to accept financial and quality outcomes for a defined population. It has positive impact on physicians that they find new opportunities with some challenges (RWJF, 2017).
- ACO puts impact on practice of medicine that include care coordination, prevention and disease management, care protocols and technology.
- All hospitals that want to adopt an accountable care organization (ACO), it is essential for them to invest in advanced health information systems, rise up quality reporting, improvement and also need to make alignment with physicians of goals.
- In case of Accountable Care Organization (ACO), the quality measurements and initiatives for improvement processes requires significant investments of time and efforts by clinical and administrative staff members of hospital. It is necessary to get full benefits from implementation of ACO in hospital (org, 2017).
- Another impact of ACO on hospital’s performance is that physicians of hospital has to more concentrate on leadership and operational challenges for quality improvement that also involve reassessing the role of physician and obtaining a balance between organizational standardization and physician autonomy (berkeley.edu, 2017).
- The implementation of ACO enhances profile of hospital in which it is implemented.
These are some substantial impacts of ACO that can put impact on our hospital and it is necessary for our hospital to be aware about these impacts of ACO. After knowing about alignment of ACO with strategy of our organization and impacts of ACO on performance of hospital, now we will emphasize on evaluation of our plan for execution of Accountable Care Organization (Wranx.com, 2017).
Before start discussion about measurements and methods for evaluation plan, it is necessary to know that what evaluation plan is. The evaluation plan is a written document that describes we will monitor and evaluate our programs and how result of evaluation is used for improvement and decision making. Through evaluation plan we can clarify “What”, “How” and “Why” about different concerns. The evaluation plan is considered important because it creates a shared understanding of purposes, users and uses of evaluation results. It also raises program transparency to decision makers and stakeholders and it is also a way to connect multiple evaluation activities. In this way, various other activities can be performed with the help of evaluation plan (Forbes.com, 2017).
Evaluation of Impact of ACO on performance of organization
For developing an evaluation plan following measurements and methods will be used.
- Clarification of program objectives and goals
- Development of evaluation questions
- Development of evaluation methods
- Setting up for a timeline for evaluating activities (Canada Business Network, 2017).
In this first method of making evaluation plan for ACO implementation, all objectives and goals of our initiative will be defined. Here we will be defined that what are main things are required to accomplish and how we will accomplish them. The clarification about these points will help us to identify major components of program. This can be achieved by making a table of program and elements.
This is another method to make an evaluation plan. Under this method, from different categories, evaluation questions are found and these questions can be related to planning and implementation issues, assessing fulfilment of objectives, impact of participants and impacts on the community.
Once we have found out questions that are required to answer during evaluation plan, the next step is to decide best method to address those questions. The common evaluation methods that can be considered under this process are monitoring and feedback system, Surveys of member about the initiative, report of goal attainment, behavioral surveys and interviews with major participants. Through these methods it is possible to get required information for implementing ACO.
The settlement of a timeline for evaluating activities is necessary to identify that when will we start development of evaluation plan, when feedback and other progress reports must be provided and when whole evaluation plan will be completed. Once this timeline will be decided then it will become easier to implement each activity appropriately.
These above listed methods and measurements will help us to make a good evaluation plan and it will become easier implement ACO on time and important decisions can be made on the behalf of available information.
It is an important segment to discuss in this report regarding development of a timeline for evaluation plan. By developing a timeline, it will become easier to manage and implement each activity. The development of a timeline is not an easier task to perform and some essential points are necessary to consider. The development of an effective timeline is also a part of our evaluation plan that we have already discussed above in this report. We have set nine to eighteen months to significantly run execution plan of ACO. Our timeline for ACO projects is divided in following ways among different steps (Cms.gov, 2017):
- Main evaluation for key questions that will be related to planning and execution regarding major issues, evaluation of achievement of objectives and impacts of ACO implementation on participants and community. This process will take time of three months (SearchHealthIT, 2017).
- After completing first step, next step is related to type of evaluation measures that what kind of data will need to answer questions that are found in first step. This step will be completed within five months.
- Next step is related to type of data collection that what kind of evaluation methods we will use to collect data. To complete this step properly there is requirement of four months (Effective Managers,2017).
- Last step is an important step and it is related to experimental design. It is a way of ruling out threats to the validity and it will include comparison of information that is collected to a similar group that is not doing exactly same things like our group. This step will take time of five to six months to complete.
In this way, with the help of above timeline set up, we can implement and evaluate plan successfully. As a health care administration, I would recommend to project manager to implement project according to above discussed steps and timeline to implement ACO significantly in hospital.
As we have already discussed about timeline for implementing project of ACO in our organization. It is not easy to develop an effective timeline to complete a significant project. Some challenges are faced while developing this proposed timeline and that challenges are listed as below (Punke, 2017):
- The main challenge that we have seen in development of proposed timeline is to calculate actual time to complete a particular step. Every step is important in ACO implementation, so it is necessary that every step should be completed with its requirements on a specified time (com, 2017).
- Other main challenge in development of proposed timeline is management of variations that was occurred in every step such as lack of particular information source, difference in number of identified issues and in actual issues, delay in some jobs assigned to associated team members etc. (Stannard, Aaron, 2017).
To overcome these challenges while developing timeline, it is necessary to maintain coordination in each and every aspect. Otherwise, a small problem can cause big conflicts in whole process. If we have faced some challenges in development of proposed timeline then on another side, some opportunities have also got. The main opportunities are listed as below:
- With the development of proposed timeline we are cleared with whole schedule to complete evaluation plan.
- For every step a deadline has decided. Therefore, everyone has to complete that step in given time. This will reduce chances of delay.
- An effective and accurate timeline reduces the chance of cost-overrun and time overrun in every project and also ensure on-time completion of project (TechRepublic, 2017).
Measurements and Methods for Evaluation Plan and why these methods are selected?
Due to these positive outcomes, every organization prefers to use timeline in every project. Besides developing effective strategies and timeline, there are some additional strategies that can be used to ensure implementation and evaluation plans are completed on time. In next segment of report we will discuss about these additional strategies.
For utilizing project resources and to achieve goals of project, it is necessary to select a right person with sufficient knowledge and skills. Equally, it is also important to find right project manager that can provide accurate guidance for project implementation and growth. The selection of wrong person may lead to loss in project, but a right person can help to complete project successfully within predefined cost and timeline. Therefore, as a system manager in hospital, I would suggest to top management of hospital to be very intuitive about this decision of selection of right person.
The business cases and proposals are determined by a different group. If in building the project plan and schedule, we involve project execution team then it will be a considered a fundamental way to ensure team buy-in.
In many business organizations it is commonly seen that both internal and external projects are implemented simultaneously. Due to this, resources of organization are used in very project. Too many projects in production cause conflicts in management of projects at organizational levels due to unavailability of resources for every project at one time. So it will be better for project manager to focus on one project at a time rather than multiple projects. This thing will allow project managers to be more efficient to provide better quality work without delay (Management, 2017).
The scope of project should be defined clearly by project team and this scope of project includes information about specific tasks, critical deadlines and end goal. The clear definition of these factors helps everyone to maintain track of project, heading the same schedule and to end goal.
If we include above listed points in our business strategy report then we can also ensure completion of project on time.
The feedback loop is a feedback that is provided by environment of organization to it. A feedback loop can be positive or negative. Our evaluation plan contributes to the feedback loop in our hospital in a way that with the implementation of effective plan, we can get feedback of employees, stakeholders and other members of hospital about outcomes and impacts of this plan. This feedback can be in favor in execution plan or maybe not. On the behalf of available feedback, we can make decisions that execution plan is successfully implementing by project manager or not. Feedback Loop is considered as an important element of theory of system management. With the help of an example we can express importance of feedback loop for effective management. For example, in our hospital, if we implement Accountable Care Organization project and after a week, we got some negative feedback from employees and stakeholders of hospital regarding impact of ACO. Then in this case, we can make decision for doing new changes and modifications to get satisfactory feedback (Study.com, 2017). It will help our organization to achieve expected outcome (Fisher, E., Shortell, S., Kreindler, S., Van Citters, A., & Larson, B, 2017).
Proposed and Developed a Timeline for Implementation and Evaluation Plan for ACO
In our proposed evaluation plan, we have mentioned every important factor that is required to run and complete project successfully. To make a project successful, there are some points that need to keep in mind such as clearly define goals and objectives of a project, make a strategic plan to use all resources and funds properly, set up of an adequate timeline and selection of a right persons for project development. In previous section of report, we have focused on these essential points and added these point in evaluation plan of ACO implementation. This plan is aligned strategically with mission of ACO because this plan is made by emphasizing on every requirement of Accountable Care Organization and other strategic needs of successful project execution. Besides this, appropriate timeline setup and use of appropriate methods and measurements for execution plan implementation also ensure that we can achieve mission of implementing ACO in our hospital (Pinnaclemanagement.com, 2017).
Conclusion
As a system administrator I have tried to discuss every essential topic in this report that is required to come into knowledge of board of directors of our hospital to implement Accountable Care organization project in our hospital. The measures and methods that we can use for the evaluation plan, timeline for project implementation and contribution of execution plan to feedback loop etc. are important topics that we discussed in detail in this report. Therefore, on the behalf of this substantial information about project execution, it will be easier for top management to make decision regarding implementation of ACO. In my reviews, with this project plan we can take initiative to implement ACO in our hospital. This will provide a new direction to our hospital by enhancing is performance among its competitors. As we know that some challenges have to face in this whole process, but with a strategic plan and potential efforts, this goal can be achieved. At last we recommend that while implementing this project, it will be good to maintain co-ordination among every single step so that project tracking of project can be done easily.
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