Summative Assessment: Capstone Project

Capstone Project

This course is centered around a Capstone Project that requires you to synthesize the information you have learned in the Master of Health Administration Program. There are 5 progressive parts to the project, and you will complete and submit 1 part of the project each week.

Note: This document serves as your project guide and template, and you will submit the majority of the project deliverables on this document.

For each item that requires a response, enter your response on a new line.

Scenario

Assume you work in health administration in a hospital system in a metropolitan area in the United States. The board of directors and CEO of the hospital system have established a goal for the year to better address the health care needs of the community. You have been tasked with establishing a physician outpatient clinic focused on treating an endemic health concern in your county.

Objective

You are to examine county health data to determine a health problem of prevalent need and to design a program that can help alleviate these concerns in the community. Integral to program design are factors and considerations such as cost, staffing, facility, policies, and its potential impact on vulnerable populations. The executives also want to ensure that the physicians, staff, and administrators are held to ethical and leadership standards that align with the practices to promote a supportive work environment governed by transformational leadership. You are to research, design, and create a proposal for a program that meets the stated expectations of the board and CEO.

Overview

  • Week 1 – Part 1: Defining the Health Problem and Identifying the Affected Population
  • Week 2 – Part 2: Program Design
  • Week 4 – Part 3: Program Finances
  • Week 5 – Part 4: Organizational Structure
  • Week 6 – Part 5: Program Proposal and Presentation

Part 1: Defining the Health Problem

In Week 1, your task is to identify a public health issue in a locale of your choice based on an analysis of public health data for the demographic area. Based on your research, you will conceive of a program at the local hospital, health system, or clinic to improve health outcomes for the population.

Instructions

Use this project template to complete the requirements for Part 1 of your Capstone Project, detailed as follows:

  1. Use the data to identify 2 endemic health issues among populations in the county. Your project will focus on only 1 of the issues, but you will need to identify a second issue if your first choice is determined to be unfeasible for this project. Your instructor will assist you in making that determination. Since county-level health data in most states is more detailed than city-level data, it is recommended that you choose a county, rather than a city. You can locate health data from the following sources:
  • County Health Rankings
    • County Health Department websites
    • State health dept

  • Describe the conditions and the extent of these health problems and why you feel they warrant a program or service to address their impact on the population. Support the results of your analysis using charts or graphs that include demographic, morbidity, and mortality data.

  • Provide and analyze demographic information on the county population including age, gender, income, employment and other relevant information for your program.

  • Summarize the health issue you want to work on and explain your idea for a program to accomplish this objective.

Sources of Data

Cite using APA guidelines. Enter text below.

County and Health Profile

County and Hospital / Health System / Clinic

Select a county for the location of your project. County level data is kept by most states and is usually more detailed than city-level data. Include a rationale of why you selected the city, including if you have any prior experience or knowledge about the existing health care system in that city. (175-250 words) Enter text below.

Health Issue 1

Description and Analysis of Data

Explain the source(s) of your data and the types of analyses you conducted to reach your findings. For example, how does this data compare with other counties, states, or at the national level? (250-350 words) Enter text below.

Description of Condition(s) (primary interest)

Describe the condition(s) you have identified in your data analysis. Describe the extent of these health problems and why you feel they warrant a program or service to address their impact on the population. Provide demographic information on the county population including age, gender, income, employment and other relevant information for your program. (250-350 words) Enter text below.

Health Issue 2

Description and Analysis of Data

Explain the source(s) of your data and the types of analyses you conducted to reach your findings. For example, how does this data compare with other counties, states, or at the national level? (250-350 words) Enter text below.

Description of Condition(s)

Describe the condition(s) you have identified in your data analysis. Describe the extent of these health problems and why you feel they warrant a program or service to address their impact on the population. Provide demographic information on the county population including age, gender, income, employment and other relevant information for your program. (300-350 words) Enter text below.

Part 2: Program Design

In Week 1, you conducted research on health data of a population to identify an endemic public health issue and proposed a program to help improve health outcomes for this population.

In Week 2, further develop your program idea by researching existing programs that address to some degree the health problem you identified in this population.

Goals and Objectives

Develop a goal and 2 related objectives for your program. Enter text below.

Description of Program and Facility

Describe the facility and its services, including the target population and demographics. (300-350 words) Enter text below.

Impact on Marginalized Groups

Examine the impact of this program on uninsured, low-income populations. How will these groups of people get access to the services? (250-350 words) Enter text below.

Staffing and Support

Provide an initial estimate of the staff required to operate this facility, including physicians, nurses, receptionist, and other support staff. Apply standards on the ratio of clinical and support staff per physician. (250-350 words) Enter text below.

SWOT Analysis

Evaluate the potential strengths, weaknesses, opportunities, and threats that can impact the targeted outcome of this program. (250-350 words) Enter text below.

Internal

Strengths

Weaknesses

External

Opportunities

Threats

Policies, Procedures, Incentives

Describe policies, procedures, and incentives that would make the program a transformative work environment. (250-350 words) Enter text below.

Literature Review

Conduct a literature review and list at minimum 5 sources (e.g., trade or industry publications, government or agency websites, scholarly works, or other sources of similar quality) to identify programs that exist that address at least to some degree your identified health problem.

Part 3: Program Finances

Factors that determine the financial feasibility of a health care program include the cost of the facility, equipment, staff salaries, patient out-of-pocket expenses, and insurance reimbursement. Referring to the concepts practiced in the collaborative assignment with your group last week, work on the following:

  1. Determine how many physicians and supporting staff are needed to operate the clinic, applying the appropriate ratio of clinical and support staff per physician.

  2. Determine the direct costs of the program. Direct costs in this case are patient expenses, and they increase as the number of patients increase. These include:
    1. Physician and procedural support staff costs per patient/procedure
    1. Gloves, sutures, gowns, equipment, lab supplies, other supplies

  3. Determine the indirect costs of the program. Indirect costs are overhead costs that include but are not limited to:
    1. General support staff and related costs
    1. Electronic medical records
    1. Insurance and taxes
    1. Facility and administration
    1. Employee benefits such as health and life insurance, retirement plans, and fringe benefits

  4. Determine the equipment costs of the program. This includes items for the physician clinic that will be used for more than one year. This is in contrast to variable costs which occur per patient and include such items as gloves, syringes, needles, and gauze, and would include items such as:
    1. Examination tables
    1. Workstations
    1. Desks and chairs in the waiting room
    1. Other equipment of this nature

  5. Determine reimbursement for clinic services based on HCPCS/CPT codes with geographical adjustment.
  6. Determine net reimbursement after variable costs per patient.
  7. Determine how many patients the clinic will need to see (a) on average per day and (b) annually to break even on expenses.

Note: Refer to the health financial instructions and sample calculations document to help you with this part of the project.

Table 1. Staffing and Salaries

Complete Table 1 by adding the staff positions including physician specialty, nurses and support staff, and the number of positions in your clinic. Multiply the number of positions by average salary for those positions to obtain total salaries.

Staff PositionNumber of PositionsAverage SalaryTotal Salaries
Primary Care Physician   
Nurse   
Support Staff   

Total Salary:

Table 2. Fringe Benefits Expense and Total Salary Expense

These expenses have been established by the hospital system at 25% of salaries and added to salaries for Total Salary Expense.  

FactorsDollar Amount
Total Salaries 
Fringe Benefit Expense 25% of Salaries 

Total Salary Expense w/ Fringe Benefits:

Table 3. Overhead (Indirect) Costs and Total Fixed Practice Costs

Begin with total salaries including fringe benefits. Multiply that amount by 40% (0.40) and combine the 2 numbers for total fixed practice costs. These costs do not vary based on the number of patients.

Cost FactorsDollar Amount
Overhead Costs 40% of Total Salary Expense 
Total Salaries Expense 
Overhead Costs 40% of Total Salary Expense 

Total Overhead and Fixed Costs:

Table 4. Equipment Costs

These items will be used by the clinic for 5 years so the costs will be divided equally over 5 years (depreciation).

Cost FactorsDollar Amount
Total Equipment Cost 
Depreciated Equipment Cost (cost for year one) 

Total Clinic Costs (for year one including salaries, overhead, and equipment costs):

Table 5. RVU and Reimbursement Calculation

The cost of physician care varies in different locations, as do the cost of operating a practice and the rates of physician malpractice claims. In addition, each year Medicare adjusts the conversion rate either up or down.

CategoryRVUGCITotal RVU
    
    
    
    

Totals

  • RVU:
  • GCI:
  • Total RVU:

Table 6. Variable Costs and Net Reimbursement

To complete Table 6, multiply reimbursement per visit by 10% (0.10) and subtract this number from reimbursement to obtain net reimbursement per patient.

Cost FactorsDollar Amount
Reimbursement per visit 
Variable cost per patient 10% 

Net Reimbursement per patient:

7. Breakeven Analysis

To calculate the number of patients needed to break even, divide total practice costs by net reimbursement. To calculate the number of patients per day, divide the total number of patients for an annual breakeven number by the number of days the practice is open. Enter text below.

Part 4: Organizational Structure

Create an organizational chart that outlines the leadership structures and clinical departments at the facility you are planning. Include all positions that are required in your health care facility. Consider the organizational structure and roles that would shape the program and promote health care in a transformational way.

Summary

Summarize the clinic’s organizational structure and provide your rationale for these decisions. (350-525 words)

Part 5: SBAR Proposal and Video Presentation

In Week 6, you submit an SBAR proposal that outlines all of the required supporting information to have your plan approved. You also present your proposal to the board and CEO as a 7- to 10-minute recorded video. Add your SBAR information below and submit your video to the Blackboard assignment.

Review the readings on writing SBAR proposals to help you with this assignment.

SBAR Proposal

(525-700 words)

Situation

Clearly and succinctly describe the situation or problem. Enter text below.

Background

What relevant factors led up to the described problem? Enter text below.

Assessment

What improvements would result from investing the resources to tackle the problem?

Recommendations

What action do you propose? How do you propose to make it happen?

Video Presentation

Record a 7- to 10-minute video in which you explain the following:

  • Pitch your program plan for approval by hospital executives.
  • Summarize and explain each part of your Capstone Project.

Submit your video to the Wk 5 – Summative Assessment: Capstone Project – Part 5: SBAR Proposal and Video Presentation.

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