PMN 604 Assessment Item 1

Table of Contents

Background 3

Initiative 5

Vision 6

Mission 6

Objectives 7

Structure Conduct-Performance-External Environment 8

Political 8

Economical 8

Social 9

Technological 9

Porters Five Forces-Industry Analysis 10

Bargaining Power of Suppliers 10

Threat of entry 10

Threats of Substitutes 11

Competition rivalry 11

Bargaining power of the buyers 11

Strategic Approach- SWOT analysis 12

Strengths 12

Weakness 12

Opportunities 13

Threats 13

Conclusion 13

Appendix 15

References 16

Background

This paper seeks to establish a strategic plan based on an identified innovative initiative in palliative care in Australia. The organization being analyzed is Catholic Health Australia which is the largest non-governmental provider of health, community, and aged services in Australia. Catholic Health Australia is comprised of 75 hospitals and 550 residential and community aged care services. It is a not-for-profit group of health and aged care services. It nationally represents Catholic health care sponsors, systems, facilities, and related organization and services. It has a capacity of about 19000 residential aged care beds, has 6253 retirement and independent living units and services apartment, offers 8000 community aged care packages (CACP), 6000 home and community care (HACC), 9500 beds in 75 healthcare facilities, 8 dedicated hospices and palliative care service, expansion of day centers and respite center. The organization boasts over 35,000 employee servicing in different capacities (Catholic Health Australia, 2017).

The Catholic Health Australia was incorporated as an association in the Australian Capital Territory under Associations Incorporation Act 1991. It plays a significant role in the Australia’s healthcare industry. The services provided under by this organization include aged care services, community care services, and other health care services and takes care of people from all age groups and all walks of life. It is indicated that for every single day, one in ever ten hospital patients is cared for a Catholic hospital. 

This strategic plan will be geared towards developing an innovative initiative to cater for palliative care. Palliative care is an approach that aims to improve the quality of patient and families facing the problems associated with life-threatening illness though the prevention and reducing suffering through early identification, impeccable assessment, and treatment of pain other problems including physical, psychosocial and spiritual. In Australia, the care is offered in different packages depending on the geographic location and expertise available. Different levels of palliative are categorized based on availability of resources. It includes a consultation by large health institutions that may have palliative care beds or standalone community-based care. Primary care is an integral part of the delivery palliative care.

In Australia, patients are said to receive palliative care, on the basis of need rather than prognosis. Patients move between services based on the complexity of their needs through services appropriate to the size of the population. Smaller services develop links with larger services where advice is made on referrals of patients with more complex needs. A need assessment tool for palliative care was developed to assist the practitioners in institutions and in non-specialist palliative care settings in the making assessment the degree to which the needs of the patient and their families are meet and a smooth transfer for referral to a specialist palliative care service if need (Mitchell, 2011, p 2).

The characteristics of the population in Australia makes end-of-life and palliative care important. The proportion of the population that is over 65 years old is noted to have increased from 12% of the total population in 1996 to 15% in 2016. It is estimated that by 2031, the proportion of the population aged 65years and above might be approximately 19%. It was indicated that most of the Australians who died in 2013 were aged 65 or more which was 81% of the total deaths.  The most likely cause of death among these aged population is mainly due to the chronic progressive diseases. This creates a need to developing end-of-life care system that meets the need and expectations of individuals and families (Australian Institute of Health and Welfare, 2016, p. 2). It is for this reason that the strategic plan on initiatives on palliative care is relevant and timely.

Initiative 

The initiative being proposed for Catholic Health Australia is an integrated palliative service that enhances collaboration with the community, adaptive to a specific region needs, reskilling of care providers, engagement in long-term settings, and youth involvement in palliative care as it can be seen on the diagram in the appendix. The model is meant to help the healthcare facilities handle the pressure from the aging population. This is meant to ensure that hospice palliative care is offered at the right time as opposed to the common situation where the care is offered in the last six months of life. The advances in treatment and time of death is less predictable and thus there is a need to have better plan for handling the needs of the aged population and the patient with terminal illness. Another pressure to palliative care originates from the wish of the patients and families to have the palliative care offered at home. There is pressure due to the need places on the health care system to minimize the inappropriate and costly hospital and emergency admission by offering plans that are cost effective to the community. Another pressure result from the fact that the specialize palliative care practitioners are not adequate to cater of the ever-increasing demand due to rising number of the aged.

A key feature of the proposed palliative care initiative is the extent by which it integrates the approach to palliative care in the community. The initiative will provide a platform to successfully shift the hospice care offered from a specialized service to on that is available to the people of even economically challenged life setting. The initiative will offer an opportunity to accommodate students in the capacity of volunteers in the organizing from the provision of affordable support program for the palliative care needy. The students will be involved in the grass-root level campaign to provide information to the communitive on palliative care and also participate in the patient care activities and mobilize resources. The uniqueness of the proposed model can be assessed using VRIO framework provided in appendices B.

Vision

This strategic plan on the initiative being proposed will guide Catholic Health Australia in offering effective and sustainable program that will be affordable, accessible and adaptable to needs of a certain community group.

Mission

The proposed initiative program will aim to achieve the following;

  1. Adopt a person-centered care

Under this plan, the palliative care program will put emphasis to the person and family as core components of program. The program described in the strategic plan will seek to align the care offered and the wishes of the patients and families in receiving the care at their place of wish or whichever place they call “home.” The initiative will focus of provided a better life for the patients in their preferred place as opposed being focused in the place of death.

  1. Developing capacity in the community.

The initiative will be geared towards providing high-quality and integrated palliative care services to an aging population, increase the possibility of the hospice palliative care being offered in the community, and strive to reduce unnecessary and undue hospital admissions. 

  1. Changing the organizational culture

Adopting the integrated palliative care will require initiating some changes in the organizations’ culture. Changes in the organizational culture require the employees to adjust their attitudes towards offering of the palliative care. This is a critical component for the success of the project and a stage which takes time and needs patience. 

  1. Executive management support

This initiative will be structured in manner that allows it to involve the buy in of the idea by the senior management. This is geared towards assuring the funding of the project and commitment. This will ensure that the plan can be scaled up for sustainability (Canadian Hospice Palliative Care Association, 2013, p. 7). 

  1. Youth involvement in palliative care

The initiative will involve structured sensitization in colleges and training programs being Offred to the student who engage themselves as volunteer. The vibrant youths will be included from the development stages in an attempt to ensure maximum inclusiveness and sustainable participation (Saifu, 2015). These youths will be essentially useful in spotting a genuine opportunity that may be necessary for the improvement of the lives of the community at large. 

Objectives

The strategic objective of the initiative will target three main areas:

  1. The initiative aims at addressing the community need in the provision of the aged served and expanding the responsibility of the organization to the general Australian health system and community.
  2. Include the participation of the church in offering support to the care of aged in the community through its different branches and programs.
  3. The initiative will seek to build the capability of the people in organization to put them in a position of making positive impact to the program of providing care to the palliative and end-of-life patients.

Structure Conduct-Performance-External Environment

Political 

Palliative care is affected by political factors due to the development of policies that seek to either regulate the palliative care to the end-of-life and the aged patients. The political factors have been considered as a being a major barrier to health reform. This is regard to the powers of providers especially their assumed power. It has been observed that even after the succession of Australian health minister, not much have come these positions of powers. This represents the generic problem in the sector of development of public policy. It has been noted that the model that has been prescribed by the ministries and various departments have note resulted. If the model is to be adopted as a nation-wide palliative care, a lot of politics come into play including lobbying.

Economical

Even after extensive literature seeking to establish cost-effectiveness of hospice care in comparison to the curative-oriented conventional care, there has been clear similarity on the findings that it has been difficult to maintain such models due to lack of clear methodological approaches. In some studies, it has been noted that hospice care causes a 25-40% of cost savings in the last month of life land only 10-17% in the last six months (Almgren, n.d., p.5). Studies in the implementation of hospice care in different places have produced mixed results with some showing significant reduction in the cost while other indicates increased cost. The resulting ambiguity may affect the adoption or trust among the users and other relevant stakeholders.

Social

In most palliative care plan, it has been observed that some of the most ignored factors are psychological and social aspects. Patients with terminal illness are indicated to endure significant psychological social order. About 59.3% patients undergoing palliative care are known to experience psychological issues. It is noted that a third of the palliative patients experiences emotional and psychological distress characterized by anxiety, depression and adjustment disorder (Mehboob, 2016, p. 3). The psychological distress has been known to lead to social issues. It is there indicated that an individual’s psychological condition of an individual influences their social ability. A depressed person is more likely to experience a social abandonment. Such are the factors that the proposed initiative will consider in its formation. Another social aspect that affects a palliative care is the contribution of the family members. Family members’ role is critical is making a choice of the place where the palliative care would be offered   

Technological 

One aspect that will be an important factor to be considered in the proposed palliative care initiative is on the technological aspects. It has been observed that a shortage of palliative specialists, technological advancements such as telemedicine and remote monitoring offer relief. One important thing to cautious about in this aspect relates to perception among the palliative care patients. The introduction of technological instruments at first seem odd and strange to the patients. The technological gadgets may feel as impersonal and cold to the needs of the patients. However, the capabilities of the technology will be harnessed to improve communication between patients and caregivers. The technological aspects to be considered in the palliative initiative will be use of telehealth that allows the monitoring of patients remotely. Videoconferencing using gadgets such as laptops and iPads allow the practitioners to advice the patients or caregivers on how to address the problems experienced. Use of videoconferencing is known to offer an opportunity for multidisciplinary team to conduct meetings and deliberate on ways of improving the care given. However, one technological factor that need to be considered is the digital divide. This is a challenge that occurs when there is a gap in computer and internet access between various population groups differentiated on the basis of income, age, and education level. This then affects whether the different groups will be in position to access the internet-based technologies (Demiris, et al. 2011, p. 3). 

Porters Five Forces-Industry Analysis 

Bargaining Power of Suppliers

The success of the initiative depends on various elements being presented at the required time. An important supplier with a high bargaining is the drugs supplier. Pharmacists understand their importance is ensuring that the benefits expected from the initiative on hospice management. This is because the use of medication is important to the success of the program. 

Threat of entry

It can be noted that the threat of entry can be considered as low. This is because of the high capital cost requirement for the development of such an initiative. The threat for entry is also associated with the benefits of from the demand side, customer switching costs, government restrictions, and government policies and laws. The presence of these barriers makes the threats to new entry as low. In this case, Catholic Health Australia has patient loyalty is an important fact that can discourage new entrant into entering in the new the industry that the organization has already established itself. With years in the healthcare sector, the organization has accumulated cumulative experiences and competencies and can thus easily access distribution channels and economies of scale from the supply side. 

Threats of Substitutes

Substitutes are important threat that can need to be discusses as it may affect the profitability of the initiative. This may reduce the dominance of the initiative by the organization. Having been prominent for medical services, the palliative care by the organization. Other substitutes include acupuncture, homeopathic therapy, cognitive therapy and biological based therapies. 

Competition rivalry 

Competitors rivalry is another important element that need to be considered. Rivalry from other traditional forms of palliative care models are likely to be a major issue. It is worth noting that even other similar products from the same organization may provide competition. The competition may make in nonlucrative to join the care delivery. High exit barrier may make it impossible for competitors to leave the industry. In this case, it is important for the organization to position itself in a manner that helps it differentiate itself from the other providers in the market. the is essential in helping it anticipate any market changes in the market and react according before the competitor act. This will be essential in claiming a new strategic position in the market.

Bargaining power of the buyers

This affects the choice of the program by the patients or their families. The patients of palliative care have wishes that mainly related to their most preferred place of death. In this case, the decision of patient is to respected as provided in the ethical principles guiding operations in the healthcare sector. This implies that the buyer of the program has a high bargaining power into whether they want to be enrolled in the program. This is entirely true especially with the new program. There will be need sensitize patients and their families on the benefits of the proposed initiative and make to deliver on the value promised.  

Strategic Approach- SWOT analysis

Strengths

The first strength to the proposed initiative is based in the fact that Catholic health Australia has a wider reach within the company there its community based, national and regional facilities. This will make it easy for the penetration of palliative care model all ever the country. Being a catholic based non-profit-organization, the company has the trust among the people on their capability with regard to developing high-impact opportunities for the community members. The nature of the program itself is an important aspect as it is comprised of a comprehensive program where each element is important to support the others thereby ensuring a palliative end-of-life that is offered in a holistic approach. The aim for the initiative will be to offer the care at a deeply discounted price. The program will be essential as it will offer an opportunity for the nurses, physicians, nurse counsellors, and pharmacists an opportunity to sharpen their skill in the optimal method for offering palliative care and playing the responsibility as a team. 

Weakness

The reliance of the organization to the management of the Catholic Church implies that there might not be enough resources to meet the needs of the program as it may deserve. Being a new program, there is a possibility to functioning with restricted budget despite the demand for the services. The increased requirements on documentation and administrative issues might increase workload for the staff.

Opportunities

There is an opportunity in the increased number of the baby boomers. In 2016 the population comprised of older population in Australia was estimated to be about 15% of the entire population. This figure was projected to increase steadily over the coming days there providing an opportunity for the adoption of the initiative. There is a great opportunity in the development of multi-disciplinary teams will be easier as the organization already has the practitioners who would only need to be pooled together to make the relevant teams. 

Threats

The adoption and widespread proliferation of the initiative may be affected by the lack of shortage in the number of practitioner especially the nurses. The lack of consensus on acceptable therapies to be used in palliative care may be detrimental to this program due to the risk of being dismissed as a just another model without sparking an interest (Mylan, 2005, p.27). 

Conclusion 

This paper seeks to establish a strategic plan working based on an identified innovative initiative. The organization being analyzed is Catholic Health Australia which is the largest non-governmental provider of health, community, and aged services in Australia. This strategic plan will be geared towards developing an innovative initiative to cater for palliative care. Palliative care is an approach that aims to improve the quality of patient and families facing the problems associated with life-threatening illness though the prevention and reducing suffering through early identification, impeccable assessment, and treatment of pain other problems including physical, psychosocial and spiritual. The proportion of the population that is over 65 is noted to have increased from 12% of the total population in 1996 to 15% in 2016 thereby making it an important initiative to be considered. The initiative being proposed for Catholic Health Australia is an integrated palliative service that enhances collaboration with the community, adaptive to a specific region needs, reskilling of care providers, engagement in long-term settings, and youth involvement in palliative care. The initiative being proposed initiative will be to develop a strategic plan the will guide Catholic Health Australia in offering effective and sustainable program. Under this plan, the palliative care program will put emphasis to the person and family as core components of program. The initiative will be geared toward providing high-quality and integrated palliative care services to an aging population.

Appendix

Appendices A- Integrated Palliative Service Visualization 

Appendix B- VRIO framework 

The is tool used to analyze firm’s internal resources and capabilities to find out if they can be a source of sustained competitive advantage.

VRIO Framework is illustrated, which tests if a resource or capability is valuable, rare, costly to imitate and if a company is organized to catpure value from it. If an answer is yes to all of the questions than the resource can bring sustained competitive advantage.

(Adopted from Rothaermel’s (2013) ‘Strategic Management’, p.91)

Appendix C: Checklist for Palliative care

References

Almgren, G.R., Palliative Care with Older Adults Section 3: Policy Issues Related to Aging and Palliative Care.

Australian Institute of Health and Welfare, 2016. End-of-Life. [Online]
Available at: https://www.aihw.gov.au/getmedia/68ed1246-886e-43ff-af35-d52db9a9600c/ah16-6-18-end-of-life-care.pdf.aspx

Canadian Hospice Palliative Care Association, 2013. Innovative Models of Integrated of Integrated Hospice Palliative Care, The Way Forward Initiative: an Integrated Palliative Initiative. [Online]
Available at: http://www.hpcintegration.ca/media/40546/TWF-innovative-models-report-Eng-webfinal-2.pdf

Demiris, G., Oliver, D.P. and Wittenberg-Lyles, E., 2011, August. Technologies to support end-of-life care. In Seminars in oncology nursing (Vol. 27, No. 3, pp. 211-217). WB Saunders.

Mehboob, A., 2016. A Closer Look at the Psychological and Social Aspects of Palliative Care. Journal of Pioneering Medical Sciences, p. 2.

Mitchell, G.K., 2011. Palliative care in Australia. The Ochsner Journal11(4), pp.334-337.

Mylan, M.M., 2005. The Application of Strategic Planning Tools for Enhanced Palliative Care Services at the Minneapolis Veterans Affairs Medical Centre. MINNEAPOLIS VA MEDICAL CENTER MN.

Rothaermel, F. T. (2013). Strategic management. McGraw-Hill Education.

Saifu, M., 2015. WA43 Because I care: an innovative initiative by students in palliative care.

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