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Harvard Case - Offering the Right Service in the Right Place: Growing Orthopedics at the Brigham and Women's/Faulkner (BW/F) Hospitals

"Offering the Right Service in the Right Place: Growing Orthopedics at the Brigham and Women's/Faulkner (BW/F) Hospitals" Harvard business case study is written by V.G. Narayanan, Michael G Wilson, Rachel Gordon. It deals with the challenges in the field of Accounting. The case study is 18 page(s) long and it was first published on : Oct 16, 2007

At Fern Fort University, we recommend that Brigham and Women's/Faulkner (BW/F) Hospitals implement a multi-pronged strategy to expand its orthopedics service line, focusing on strategic partnerships, targeted market expansion, and operational efficiency improvements. This strategy should be underpinned by robust financial analysis, incorporating activity-based costing to accurately assess the profitability of different service offerings and identify opportunities for cost optimization.

2. Background

The case study focuses on Brigham and Women's/Faulkner (BW/F) Hospitals, a leading academic medical center facing increasing competition in the orthopedics market. The hospital's leadership is seeking to develop a strategy to grow its orthopedics service line, considering factors such as market demand, patient preferences, and cost considerations.

The main protagonists are:

  • Dr. David Levine: Chief of Orthopedics, responsible for developing and implementing the growth strategy.
  • Dr. William Harris: Head of the Joint Replacement Program, advocating for a focus on high-volume procedures.
  • Mr. Michael O'Connell: Hospital administrator, concerned about the financial viability of different service offerings.

3. Analysis of the Case Study

This case study presents a complex scenario requiring a multi-faceted approach. We can analyze it through the lens of:

Strategic Analysis:

  • Porter's Five Forces: The orthopedics market is characterized by high competition from other hospitals, increasing bargaining power of payers (insurance companies), and a growing demand for specialized services. This indicates a need for BW/F to differentiate itself through quality, service, and cost-effectiveness.
  • Competitive Advantage: BW/F's strengths lie in its reputation for quality care, strong physician network, and academic affiliation. However, it needs to leverage these strengths to create a sustainable competitive advantage in the orthopedics market.
  • Growth Strategy: BW/F can pursue a growth strategy based on market penetration, market development, product development, or diversification. The case study suggests a focus on market development and product development, targeting specific patient segments and offering specialized services.

Financial Analysis:

  • Activity-Based Costing (ABC): Implementing ABC is crucial to accurately assess the profitability of different orthopedic services. By allocating costs to specific activities, BW/F can identify cost drivers and areas for improvement.
  • Financial Performance Measurement: Key performance indicators (KPIs) should be established to track the financial performance of the orthopedics service line. These KPIs could include revenue growth, profitability, patient satisfaction, and operational efficiency.
  • Investment Analysis: BW/F should conduct a thorough financial analysis of potential investments in new equipment, facilities, or staff to ensure a positive return on investment.

Operational Analysis:

  • Process Improvement: BW/F can improve its operational efficiency by streamlining processes, reducing wait times, and enhancing patient flow. This can be achieved through lean management techniques and process mapping.
  • Technology Adoption: Investing in technology like electronic health records (EHRs) can improve data management, facilitate communication, and enhance patient care.
  • Employee Engagement: Engaging employees in the growth strategy is crucial. This can be achieved through clear communication, employee empowerment, and performance-based incentives.

4. Recommendations

To achieve sustainable growth in orthopedics, BW/F should implement the following recommendations:

1. Strategic Partnerships:

  • Joint Ventures: Explore joint ventures with other healthcare providers, such as physical therapy clinics, home healthcare agencies, or specialized orthopedic centers. This can expand the service offerings, reach new patient segments, and leverage complementary expertise.
  • Physician Recruitment: Attract and retain top orthopedic surgeons by offering competitive salaries, benefits, and opportunities for professional development. Consider recruiting specialists in high-demand areas like sports medicine or minimally invasive surgery.
  • Community Outreach: Build strong relationships with local community organizations, physician referral networks, and patient advocacy groups to increase awareness of BW/F's services and attract new patients.

2. Targeted Market Expansion:

  • Specialized Services: Focus on developing niche specialties like sports medicine, spine surgery, or joint replacement surgery. This can attract patients seeking specialized care and enhance BW/F's reputation as a center of excellence.
  • Outpatient Services: Expand outpatient services, including physical therapy, rehabilitation, and minimally invasive procedures. This can cater to patient preferences for convenient and cost-effective care.
  • Geographic Expansion: Consider expanding into new geographic markets with high demand for orthopedic services, either through satellite clinics or partnerships with local hospitals.

3. Operational Efficiency Improvements:

  • Activity-Based Costing (ABC): Implement ABC to accurately track the costs of different orthopedic services. This will allow BW/F to identify profitable and unprofitable services and make informed decisions about resource allocation.
  • Process Improvement: Streamline processes, reduce wait times, and enhance patient flow through lean management techniques and process mapping.
  • Technology Adoption: Invest in technology to improve data management, facilitate communication, and enhance patient care. This includes implementing EHRs, telemedicine platforms, and advanced imaging equipment.

5. Basis of Recommendations

These recommendations are based on the following considerations:

  • Core Competencies and Consistency with Mission: The recommendations align with BW/F's core competencies in providing high-quality, academic-based healthcare. They also support the hospital's mission of improving patient care and advancing medical knowledge.
  • External Customers and Internal Clients: The recommendations address the needs of external customers (patients) by providing convenient, specialized, and cost-effective care. They also consider the needs of internal clients (physicians and staff) by providing resources and support for growth.
  • Competitors: The recommendations aim to differentiate BW/F from its competitors by focusing on specialized services, building strategic partnerships, and enhancing operational efficiency.
  • Attractiveness ' Quantitative Measures: The financial analysis using ABC will provide quantitative measures to assess the profitability of different service offerings and guide investment decisions.

6. Conclusion

By implementing a multi-pronged strategy that combines strategic partnerships, targeted market expansion, and operational efficiency improvements, BW/F can achieve sustainable growth in its orthopedics service line. This strategy should be underpinned by robust financial analysis using activity-based costing to ensure financial viability and guide resource allocation.

7. Discussion

Other alternatives not selected include:

  • Mergers and Acquisitions: Acquiring smaller orthopedic practices or hospitals could provide immediate access to new patients and markets. However, this approach carries significant financial and operational risks.
  • Focus on High-Volume Procedures: While focusing on high-volume procedures like joint replacements can be profitable, it may not be aligned with BW/F's academic mission and could lead to a narrow focus.

Key assumptions of the recommendations include:

  • Market Demand: The recommendations assume a continued growth in demand for orthopedic services, particularly for specialized procedures and outpatient care.
  • Financial Resources: The recommendations assume that BW/F has sufficient financial resources to invest in new equipment, facilities, and staff.
  • Regulatory Environment: The recommendations assume a stable regulatory environment that does not significantly impact the delivery of orthopedic services.

8. Next Steps

To implement the recommendations, BW/F should take the following steps:

  • Form a Task Force: Establish a task force composed of key stakeholders, including physicians, administrators, and financial experts, to develop and implement the growth strategy.
  • Conduct Financial Analysis: Implement ABC to assess the profitability of different orthopedic services and identify areas for cost optimization.
  • Develop Marketing Plan: Create a comprehensive marketing plan to promote BW/F's specialized services and reach target patient segments.
  • Negotiate Partnerships: Initiate discussions with potential partners to explore joint ventures and other strategic collaborations.
  • Monitor Performance: Establish KPIs to track the financial performance of the orthopedics service line and make adjustments as needed.

By taking these steps, BW/F can position itself for success in the competitive orthopedics market and achieve its goals for sustainable growth.

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Case Description

After the merger of two local hospitals, hospital leaders much decide how to reorganize services to take advantage of newly created efficiencies. Focuses on the Orthopedics department at one of the hospitals.

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