At some point, a healthcare provider takes on additional responsibilities. In their new role, they find themselves interacting more with managers and senior leaders who speak the language of business. Even if you have no aspiration to become a healthcare business leader, you will have to learn how to speak their language if you are to influence the implementation of a project such as a clinical performance improvement program.
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Take Captain Jenny Shatz, for example. Captain Shatz was newly promoted within her EMS organization into a role with responsibility for quality improvement. A paramedic with 12 years of experience, Shatz hadn’t taken business classes in college – she majored in Physical Therapy.
So, when the opportunity to champion a program that could help save lives came to her, she was both enthusiastic and nervous. Enthusiasm for saving lives is easy to understand. The nervousness came from the fear of the unknown. She knew the project would require approval at a high level. She also knew that the program would incur costs well beyond her small budget authority. She believed in the benefits of the program and had a strong desire to get the attention of her leadership. Preferably, without embarrassing herself.
As an experienced paramedic, Shatz could easily see the clinical benefits of the program. She could see a clear connection between improving quality of care and its impact on outcomes. It was the operations and business side of the program that had her feeling unprepared. She appreciated her program would require investment of people, equipment and time – none of which did she directly control.
Things started to look up for Captain Shatz when one of her mentors, a senior Assistant Chief, shared an article containing Tips to Improve a Business Case. It contained 10 steps to make a make a business case more compelling.
What is a Business Case? A business case provides justification for a proposed project on the basis of its benefit to the organization. No matter the type of organization (for profit, not-for-profit, or government), strategic projects usually require a business case.
Even if you have no experience writing business cases, you can make a compelling argument on behalf of your project.
10-Steps to Improve the Effectiveness of Your Business Case
- Does the case contain a sense of urgency? Why now? Describe an opportunity that appeals to individual’s hearts and minds. What are the stakes if you are successful? What are the stakes if no action is taken?
- Have you described the problem in measurable clinical and business terms? Who is affected by this problem? Describe the burden created by the program. What is the economic implication of the problem? Let’s use cardiac arrest as an example. Median age for cardiac arrest 67 years. Life expectancy in the U.S. is approximately 77 years. A life year may be valued at (for the sake of simple math) $100,000. Thus, ten people dying unnecessarily at age 67 from cardiac arrest collectively loose 100 life years valued at $10,000,000 in aggregate. Healthcare economists can go much deeper than this example. However, using this approach is a solid start.
- Is the case linked to organizational strategy, industry standards or best practices? Projects that may be linked to the organization’s existing strategy have a better chance of succeeding than projects that are not aligned. Bring additional credibility to linking your project to industry best practices.
- Does the case including benchmarking data? Yes, the grass may be greener in other organizations. Comparing your organization’s performance against similar size and type organizations shows what’s possible for your organization.
- Is the solution clearly described and does it contain statements about the solution’s benefits? Important to use simple language without technical jargon – your business case may be read by non-clinical managers who don’t understand the problem like you do. Explain the relationship between the proposed intervention and the benefits you expect to see.
- Does the case include options? Simple. Managers like options. Especially when a proposal is risky. Having an option to prove the concept, or start small, might persuade a skeptical manager to lend their support.
- Does the case include graphs that are easy to interpret? Use simple graphs to tell the “as is” and “proposed” state. Label the graphs and cite the graphs if the data was published.
- Does the case include a budget or explanation of project-related costs? Consider the cost of people’s time, materials, licenses, and equipment necessary for the project. Also consider describing the cost to sustain the program after the initial proof of concept phase.
- Does the case include a return on investment statement? Mathematically speaking, return on investment may be simply calculated by dividing the amount of the return by the initial investment. For example, a program costing $15,000 to potentially save 100 life years, or $10,000,000, would be considered an incredible ROI. Calculating healthcare cost ROI can be incredible complicated as costs may be incurred at several points over a period of time. However, for the sake of illustration the above example should get your creative thinking started.
- Have you assessed your organization’s capacity to take on a new project? OK, every organization has its limit of how much it can do at any time. Even if you have a great idea, it doesn’t mean your organization is culturally, or operationally, ready to implement your idea. So, important to take a pulse check before proceeding.
After reading the article on improving the effectiveness of a business case, Captain Shatz felt more informed when she wrote the first draft of her proposal. With increased confidence, she shared the proposal with her mentor. The discussion with her mentor went well and it resulted in their identifying a couple areas to strengthen. They both smiled when they simultaneously said their favorite mantra, “Measure and Improve.”