AMT2

Task 4
Demand

Among the three service lines which all had the great potential to be developed, we are

choosing the priority of developing the cardiovascular service line should be given priority this

time. Again, based on the forecast of the principal, there will be a huge spike in cardiovascular-

related diseases in the next five years. The spike pertains to a 21.6% growth for those who are

projected to have coronary artery disease. As per hospital prediction, the cases will blow up from

54,000 to 65,700 in five years alone. Not only this, but procedures needing diagnostic

catheterization would also increase from 10,800 to 13,140. Finally, procedures requiring

angioplasties would also add up from 4,000 to 5,032. Based on these numbers alone, the demand

to establish an excellent cardiovascular program is undeniable. Looking at this from an ethical

standpoint as well, the hospital does not have to refer patients we diagnosed to other hospitals

now that Trinity Community Hospital could treat them. This is also in line with the fact that

cardiovascular diseases are, more often than not, cases that entail that time is of the essence.

Patients suffering from such would have more chance of survival if they were diagnosed and

treated immediately.

However, if resources would permit, we suggest developing the two other service lines as

well because they are equally as important as the cardiovascular service lines. As evidenced by

the five-year forecast of the hospital the oncology and orthopedic service lines, both have

alarmingly rising cases in the following years to come. To note, half of the male population and a

third of the female population are expected to have cancer in their lifetime. Again, the projected

growth of cases which would require the service from oncology would be 34% and this is

alarmingly high from a figure of 3,200 ballooning to 4,282. Next, the highest rate of increase in
demand for the next five years belongs to the orthopedic services which has 46% growth from

11,800 cases this year growing to 17,338. Other special procedures such as joint and spine

procedures would also be in demand in the following years to come. Lastly, the current

outpatient services would not be able to handle the growth of 350% in cases coming from

orthopedic cases in five years if the hospital will not establish a service line for this. 

Current International Healthcare Trends

Some of the current international healthcare trends Trinity Community hospital can adapt

in order to acquire a number of competitive advantages over other hospitals are the following:

One of the known international healthcare trends that started in Japan is the integration of

robotic technology in the medical field. Robotic surgery is also known as robot-assisted surgery

and is defined as a surgery that aids the doctors to operate on complex procedures “with more

precision, flexibility, and control than is possible with conventional techniques” (Robotic

Surgery, 2021).  Generally, this type of surgery is minimally invasive because this involves

performing operations via tiny incisions (Robotic Surgery, 2021). Robotic surgery does not only

benefit the patients to be operated upon but the surgeons as well. In a short article found on the

website of MedStar Franklin Square Medical Center, one of the outstanding outputs of robotic

surgery is that it minimizes blood loss during the procedure. Compared to traditional procedures,

robotic surgeries inflict less pain on the patients and result in a shorter stay at the hospital and a

quicker recovery period (n.d., Minimally invasive or laparoscopic: Benefits of robotic surgery).

From a surgeon’s perspective, robotic surgery enhances the visual field on the operating area

through the assistance of an HD camera thereby leading to a more precise procedure. Not only in
the visual field but robot-assisted surgery also facilitates dexterity in a procedure that humans

have limited access to and the ability to access operating areas that are difficult to reach during

manual surgery (n.d., Minimally invasive or laparoscopic: Benefits of robotic surgery). 

This trend would definitely go well with the new service lines especially with the

cardiovascular and oncology service lines. These two service lines involve sophisticated and

complicated operations when necessary. Patients who undergo robotic surgery would also have

the chance to resume their lives post-op more quickly with the help of this new trend.

Another known international healthcare trend is the deviation from using perioperative

antibiotics. This is because many people have developed, if not resistance, an allergic reaction to

antibiotics over time. As such, research and development teams from around the world have

devoted their time to find alternatives to address this concern. With the high demand for the new

service lines and the boom in the number of incoming patients in the following years, the

hospital must adapt to this trend in order to cater to the needs of all the patients to deliver quality

healthcare. The study conducted by Phloegmakers, Olde Damink, and Breukink (2017)

concluded that recommendations in reducing surgical site infections or SSIs have a general lack

of evidence in terms of their effectiveness during perioperative. However, despite this is the case,

the hospital still must pursue alternatives because as pointed out by Salkind & Rao (2011), the

usage of prophylactic is commonly used on clean-contaminated surgeries such as (but not limited

to) cardiothoracic, gastrointestinal, orthopedic, vascular, or gynecologic - all of which are

operating procedures provided in the three service lines.

Existing Programs and Service Lines

which could serve as complements to the new service lines. Here are the most notable ones. 

First, Trinity Community Hospital has a dedicated nursing home for aged patients. This

setup would be helpful to take care of the elder patients who are admitted to the oncology service

line since we know that the majority of those who have cancers fall on the older population. The

geriatrics department is also a big help in such a case.

Next, it is also perfect that Trinity has an existing physical therapy center nearby. This

already would aid in the treatment and recovery of the patients who have undergone procedures

from the orthopedic or cardiovascular service lines. Patients do not have to go to further PT

centers to accommodate such service which would be a logistical nightmare for most patients

and their families.

The current dietary department of the hospital which is known for its award-winning and

excellent service is a huge asset that would complement the new service lines of the hospitals,

especially of the oncology department. Patients admitted and currently recuperating from

procedures related to oncology and even cardiovascular require strict monitoring in their

nutrition and diet which makes the dietary department beneficial to the existence of these new

service lines.

Financial Feasibility

The following service lines would have the following financial projection in the next five years:

Oncology Department

Item  Amount
 projected number of cases = 1,082

Gross Charges per oncology discharge $70,000 x 1,082 = $75,740,000

Gross Charges per radiation oncology $450 x 1,082 = $486,900

treatment

Gross Charges per chemo treatment $600 x 1,082 = $649,200

Gross Charges Billable $76,867,100

 (total of three)

Receivables $76,867,100 x 0.35 = $26,906,635

 (Billable x 35% collection rate)

Costs  $76,867,100 x 0.30 = $23,062,830

(Billable x 30% cost projection)

EBIT $76,867,100 - $23,062,830 =

 (Receivables - Costs) $53,804,270

Ortho Department

Item  Amount

 projected number of cases = 5,538

Gross Charges per orthopedic surgical $25,000 x 5,538 = $138,450,000

case
 Gross Charges per physical therapy $275 x 5,538 = $1,522,950

treatment

Gross Charges Billable  $139,972,950

(total of two)

Receivables $139,972,950 x 0.35 = $48,990,532.50

 (Billable x 35% collection rate)

Costs  $139,972,950 x 0.31 = $43,391,614.50

(Billable x 31% cost projection)

EBIT $$48,990,532.50 - $43,391,614.50 =

 (Receivables - Costs) $5,598,918.00

Cardiology Department

Item Amount

*projection only

Gross Charges per diagnostic $30,000 x 2,340 = $70,200,000

catheterization

Gross Charges per peripheral vascular $25,000 x 2,000* = $50,000,000

procedure

Gross Charges Billable $120,200,000

Receivables $120,200,000 x 0.35 = $42,070,000

 (Billable x 35% collection rate)

Costs $120,200,000 x 0.30 = $36,060,000

 (Billable x 30% cost projection)

EBIT $42,070,000 - $36,060,000 =

 (Receivables - Costs) $6,010,000

Total Hospital

Item  Amount

*projection only

Gross Charges per hospital $80,000 x 12,000 = $9,600,000,000

discharge

Receivables  $9,600,000,000 x 0.35 = $3,360,000,000

(Billable x 35% collection rate)

Costs $9,600,000,000 x 0.30 = $2,880,000,000

 (Billable x 30% cost projection)

EBIT  $3,360,000,000- $2,880,000,000 =

(Receivables - Costs) $480,000,000

In order to secure referral services from physicians, it is important to remind and to

emphasize the relationship that has been established and maintained between them and the

hospital. The board can arrange an Open House for the hospital in order to catch the attention of

new physicians and our current partners alike. It is important that during the Open House there

would be void of any sign that would appear that the hospital has favoritism over primary care

physicians. As much as possible, the hospital should give extra attention to physicians who have

specialties because they are the ones the hospital needs most considering that we will be needing

more manpower to fill in the positions in the new service lines that will be established. Most

importantly, the Board could also assign someone to discuss marketing strategies with target

physicians and send the person to visit them and discuss incentives to acquire referral services

from them. Incentives may include the granting of more control over their jobs such as being

able to do rounds or sit in during a surgery.

Minimally invasive or laparoscopic: Benefits of robotic surgery. (n.d.). Retrieved May 01, 2021,
from https://www.medstarfranklinsquare.org/our-services/surgical-services/treatments/
robotic-surgery/benefits-of-robotic-surgery/
Ploegmakers, I. B., Olde Damink, S. W., & Breukink, S. O. (2017). Alternatives to antibiotics
for prevention of surgical infection. The British journal of surgery, 104(2), e24–e33.
https://doi.org/10.1002/bjs.10426
Robotic Surgery. (2021, March 26). Retrieved May 01, 2021, from
https://www.mayoclinic.org/tests-procedures/robotic-surgery/about/pac-20394974
Salkind, A., & Rao, K. (2011, March 01). Antibiotic prophylaxis to Prevent Surgical Site
Infections. Retrieved May 01, 2021, from https://www.aafp.org/afp/2011/0301/p585.html