Research Paper on Hospital Corporation of America

Published: 2021-08-02 01:56:24
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Carnegie Mellon University
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Research paper
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Hospital Corporation of America (HCA) is one of the largest for- profit hospital systems in the US. It was founded in 1968 by father- son duo of Dr. Thomas Frist Sr. and Dr. Thomas Frist Jr. alongside Jack Massey (HCA, 2017). When starting, the first hospital that HCA owned was Park View Hospital which is located close to Downtown Nashville. After first listing on the New York Stock Exchange (NYSE) in 1969, the company has undergone a series of ownership changes, oscillating from a privately- held firm to a publicly traded corporation. In March 2011, the company went back to being publicly traded with an initial public offering (IPO) on the NYSE that then became the largest ever private equity- backed IPO in the US. As at 31st December, 2016, HCA managed 170 hospitals and 118 freestanding surgery centers both in the US and the UK. HCA is based in Nashville, Tennessee (HCA, 2017).

System Integration

HCA has for years been ranked as one of the most wired institutions in America owing to the fact that it has managed to integrate its facilities throughout the country. The firm has a team of leading health IT professionals who have been responsible for automating integrating clinical technology (HCA, 2017). One of most important factors in the quest for integration is having a data warehouse that stores clinical data from all its facilities. Another aspect of the integration is the companys Healthcare Information Exchange that allows the company to share clinical information across its facilities in real time and that enhances patient outcomes.

Corporate Structure

As a publicly traded company, HCA is headed by a board of directors that is in charge of the companys policy direction and strategy. The company is chaired by Milton Johnson who serves as both the firms board chair and CEO. The entity also has Samuel N. Hazen as its President, and he also doubles up as the chief operating officer. The day- to- day running of the institution is the task of the executive team that is led by Mr. Johnson and Mr. Hazen. The hospitals board in turn has several committees that are in charge of various functions in the firm. They include audit and compliance committee, compensation committee, and patient safety and quality of care committee.

Legal Entity

According to its filings with the Securities and Exchanges Commission (SEC), Hospital Corporation of America is an incorporated company or a body corporate. Therefore, that means it is a separate legal entity from those who formed or own it. As such, it is seen as a distinct legal person with the ability to enter into legal contractual arrangements, sue and be sued. In the year ended 31st December, 2016, Hospital Corporation of America earned gross revenues amounting to $41.49 billion. The companys net income was $2.89 billion (HCA, 2017).

Services Offered

Throughout the years, the Hospital Corporation of America has expanded its services to cover 20 states in the US while also having its presence in the United Kingdom. The offering is made possible by the 240,000 employees that the entity employs and who include 37,000 physicians as well as 80,000 nurses (HCA, 2017). The institution offers a variety of services across its facilities. The type of services that HCA offers is reflected in the variety of facilities that the company owns across the places where it operates.

Out of the 170 hospitals that Hospital Corporation of America operates, 166 of them general acute care facilities. They offer a wide range of medical and surgical services. First, they provide inpatient care, intensive care, cardiac care, emergency and diagnostic services (HCA, 2017). They also provide outpatient care such as laboratory and radiology care, cardiology, respiratory therapy, outpatient surgery, and physical therapy services. Apart from that, HCA operates three psychiatric facilities designed to provide therapeutic services for diverse populations. They include child, adolescent, as well as adult psychiatric care. The facilities also treatment and counseling to both adults and adolescents struggling with drug and alcohol abuse.

HCA also has a wide range of outpatient facilities that include freestanding ambulatory surgery centers, walk- in clinics, urgent care services, and freestanding emergency care services. It also has rehabilitation and physical therapy centers, diagnostic and imaging centers, radiation and oncology therapy centers, and physician centers. In the UK, HCA also has several facilities including the Princess Grace Hospital that is known to specialize in breast cancer and surgery.

Technology Used

Since its inception, HCA has always strived to be a leading provider of care in the nation. Part of the institutions quest is driven by the technology it uses across its operations. As an institution that has operations in diverse locations in the US and the UK, it is important for HCA to have systems that enable it to assure its patients of the same standards of care across all its facilities. Moreover, it also needs a system that will enable it to manage its facilities and ensure that they are up to standard at all times.

HCAs Engineering and Facility Management Department (EFM) entered into a contract with TMA systems to provide computerized maintenance management systems (CMMS) using TMAs WebTMA CMMS platform. The scope of the technology provided covers several aspects of the HCAs operations including project management, data standardization, reporting and data analysis, and training (HCA, 2017). In opting for the CMMS, HCA hoped to achieve several objectives relating to its quest to achieve efficiency and improved service delivery. First, the aim of the CMMS would be to provide consistency and reduce variations in the system of operations, thereby leading to increased savings for the company. Apart from that, the firm hoped to improve the way it managed its assets, adhere to Joint Commission and Regulatory Compliance Standards, as well as manage requests for facility maintenance. Apart from that, Hospital Corporation of America also hoped to achieve gains in productivity and by better employing resources and monitoring key performance indicators.

The implementation of the TMA system has had innumerable benefits to HCA and enabled the company to streamline its operations. First, it enables the consolidation of reports that would have otherwise required work by personnel at the headquarters. Secondly, the use of the CMMS makes it easier for the field management personnel to manage their operations in a much more effective way. Most importantly, utilizing the TMA system makes it possible to accurately predict and forecast inventory as well as labor requirements for each location. While allowing for consolidation of information, the WebTMA also allows for the various hospitals that HCA manages to act independently of each other (HCA, 2017). Finally, the technology also allows for the generation of trend analysis reports both at the headquarters and various other locations as the need may be.

Another important aspect of technology that Hospital Corporation of America employs is in the electronic management of its health records. In 2009, the passage of the American Recovery and Reinvestment Act brought to effect the Medicare and Medicaid incentive payments for hospitals and facilities that adopt certified electronic health records (EHR) technology (HCA, 2017). HCA has since then remained compliant in this area in following the requirements laid out by the act. However, the adoption of electronic records started way back before that in 2006 when the firm rolled out its hCare project in 2006 (HCA, 2017). The aim of the initiative was to establish electronic health records at all HCA facilities including hospitals and surgery centers. The main advantage of the system is that it allows for data integration. It allows for the connection of HCA clinical systems to physician practices while also providing the physicians with remote access and capabilities that mimic actual hospital capabilities.

Facility Design

The overreaching goal for HCA is to provide quality and cost- effective care. The company realizes that the way its facilities are designed plays a huge role in helping it achieve its objective (Miller & Miller, 2013). Therefore, the firm has a team that is in charge of the design of all its facilities and it is known as HCA Design and Construction. It is led by a Vice President and is tasked with coming up with high- performing facilities that HCA can use for the long- term. The team is comprised of experts in various fields including equipment, design, construction, corporate facility management, engineering, and bulk purchasing. The combination of knowledge, competencies, and idea is what drives this team and enables it to deliver on its mandate.

While HCA has the centralized design and construction team, it also has a director of plant operations for each of its facilities. The individual is in charge of the hospital or surgical facility and takes instruction from the central design team. The dual approach to facility design and construction has benefited HCA immensely. For example, it uses a kit of parts prototype for its facilities whereby it uses a standard design for its facilities while also allowing for flexibility and customization depending on the facility needs (Miller & Miller, 2013). Apart from that, HCA is able to benefit because of its size whereby the company buys in bulk and benefits from economies of scale.

Ambulatory Care Services

HCA provides ambulatory care services as part of its operations alongside acute care. Ambulatory care is typically provided where procedures may require recovery that typically does not require more than 72 hours at the facility (HCA, 2017). This kind of care is provided at HCAs 118 freestanding surgery centers. They are designed to provide outpatient services and for short stays while the longer stays are meant for the hospitals.

Emergency Operations Plan Structure

Like any other hospital or health facility, HCA is expected to have an emergency response protocol. The nature of emergencies could range from car accidents to devastating natural calamities such as hurricanes. The company follows the guidelines of the Joint Commissions Emergency Management Standards (HCA, 2017). The first parameter is a plan for mobilizing resources and assets to respond to the emergency situation based on hazard vulnerability analysis. The second aspect has to do with how the companys hospitals establish safety and security protocols for patients, staff, structures, and the entire operation. Thirdly, the plan also involves communication protocols with local hospitals, local and state authorities, emergency responders, and the media. Other aspects of the emergency plan include roles and responsibilities within the context of an incident command structure, support activities, and utilities.

Materials Management Strategy and Design

HCA requires materials ranging from medical, stationery, and other supplies for its hospitals and other facilities to function. It is only prudent for the institution to come up with a system that ensures that it has all the materials that it needs whenever they are needed, and in the most efficient manner. For that reason, HCA utilizes the perpetual inventory system for its materials management. The main feature of the system is that it automatically updates the inventory records to account for any changes such as addition or subtraction. The system accounts for such movements as received inventory, goods sold, items moved across different locations, and those that may be scrapped. Not only does the system provide up- to- date inventory balance details and reduce the need for physical inventory counts. The computerization of HCAs inventory tracking ha...

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