The present paper is a Collaborative Learning Community Business Plan created for the American Heart Association and Hypertension (AHA). According to Topfer (2011), “Planning is one of the most important parts of running a business, no matter whether it is a large multinational corporation trying to plan an expansion or a small business launching an exciting new product” (para. 1). A business plan is a map, which sets a direction and course for where the business intends to head. The Community Health Promotion (CHP) team is tasked with creating a plan for a community health program. Everyone has completed the set task, and the project manager has gathered all the information together and analyzed it.
Product Description: Wellness Medical Vehicle
General Considerations
The Wellness Medical Vehicle (WMV) will be promoting cardiovascular awareness and heart disease prevention as well as a medical treatment for cardiovascular disease. The WMV has adopted the AHA guidelines to reduce the risk of heart disease. My Life Check-Life’s Simple 7 (MCLS7) promoted by AHA (n.d.) is available via the Internet and connects the patients with primary care providers to promote continuity of care. MCLS7 is a simple survey to obtain the patient’s heart score. MCLS7 is created to encourage management of blood pressure, control cholesterol, reduce blood sugar, get active, eat better, lose weight, and stop smoking (AHA, 2019). The WMV will be equipped with everything needed to provide medical care and health promotion to a wide range of patient populations. The WMV will provide services to inner-city and rural health patients.
The products available to our patients will include three vital sign machines, a computer station for patients, Tandberg (telehealth) monitors, educational packets for Health Promotion and Disease Prevention. Medications, such as Lisinopril, will also be available for patients that need to start medications right away. A specimen collection area will be available for the patients that require lab work. Moreover, patients will be issued blood pressure monitors to check their blood pressure daily. For patients with unstable blood pressure, appointments will be scheduled with a registered nurse weekly, monthly, or quarterly depending on a patient’s needs.
Available Staff
A nurse practitioner, registered nurse, and a licensed practical nurse will staff the mobile unit. There will be a physician available for visits via telehealth and monthly visits. Eight behavioral health practitioner will be available via telehealth appointment. Each mental health provider will reserve one-hour emergent visit while the WMV is in service. We will also have seven dieticians on board that will have the same schedule as the mental health providers. We have partnered with local 24-hour fitness and recreation centers to provide a silver sneakers package to patients aged 55 and older. Patients younger than 55 will receive gym memberships at a discounted rate. Additional services will be provided by contracted rural hospitals and cardiologists for urgent care needs.
Equipment
Employees will have two laptop workstations available in the nurse’s station that connects to the electronic health record database via a secure WiFi Hotspot. There will be hard copies of paper documentation in case of electrical outage emergencies. The EPIC software will be used for electronic medical records. The software is able to interface with laboratory, clinics, and hospitals to share patient information.
There are two exams rooms will be equipped with patient exam tables, sinks, and a laptop workstation. One automated external defibrillator (AED) device will be located in the middle of the vehicle in case of an emergency. A blood draw station with custom cabinet storage and medical refrigerator to store specimens will also be available. All the stock supplies and small, medium, and large blood pressure cuffs for patients to take home will be accessible. The laboratory will contain specimen collection containers and a centrifuge to spin blood collection tubes for processing. Three electric vital sign machines will be available to check in patients. There will be two manual blood pressure cuffs and stethoscopes in the nurse station. The WMV will have a patient waiting area to observe the HIPAA law and a 20-inch awning for those that would like to wait outside. Additionally, there will be a designated area for staff with a refrigerator.
Key Features
First, the WMV is to provide vinyasa yoga every Wednesday to promote heart health and reduce stress. These yoga classes will be held by yoga students from the community stakeholders school of Chinese Medicine. Vinyasa yoga improves flexibility, mental focus, cardiovascular conditioning, muscle development, and calms the mind. Moreover, yoga improves sleep, reduces stress, decreases anxiety, and treats addiction (Cespedes, 2018). Yoga will be a true benefit to improve heart health.
Second, a collaborative effort with Merck was developed to supply blood pressure monitors for our patients for no additional cost. This promotes involvement in one’s medical care and increases positive patient outcomes. If patients monitor their blood pressure and meet regularly with an RN, the effort can decrease the possibility of cardiovascular disease significantly among inner-city and rural health patients.
Comparison to Competitors
One of the key competitors to the WMV in the area is the Mobile Wellness Unit. The Mobile Wellness Unit is a forty-foot mobile unit that screens for hypertension, diabetes breast exams, lipid profiles, and prostate-specific antigen tests (Beaufort Memorial, n.d.). The Mobile Wellness Unit is focused on a wide range of disease processes, rather than being geared toward one specific disease. Additionally, it offers blood pressure monitors at a cost to their patients. The WMV specializes in heart disease and health promotion to reduce or alleviate heart conditions. The WMV promotes care for all the elements of a person’s health including mental, physical, and dietary aspect in addition to traditional medicine.
Pictures of the WMV
The WMV is a modern and efficient way to promote and deliver heart health to inner-city and rural health areas. Figures 1-7 are pictures of the vehicle that provides a better appreciation of the proposed idea.
Industry Profile
Market Definition
The CHP of the AHA is designed to enter the Phoenix, AZ, healthcare market. The market consists of six segments: health care providers, health care insurers, ancillary providers, educational institutions, research institutions, and non-government organizations (NGOs). As AHA is an NGO, the CHP is entering the NGO market segment that is characterized to have the least amount of economic impact (University of Phoenix, 2019). Even though NGOs are employers, they do not offer as many jobs as other market segments. At the same time, despite the low direct financial impact, NGOs “play a catalytic role in growing the Phoenix metro region health care economy” (University of Phoenix, 2019, p.11). Additionally, AHA health promotions are vital for improving patient outcomes. Therefore, the health program offered in the presented business plan is expected to have a considerable impact on the community.
Industry Growth Trends
The healthcare industry in Arizona and worldwide is on the rise, as the number of job offers grows rapidly. According to the University of Phoenix (2019), every eighth vacancy in the US is going to be in health care by 2022, adding about 2.3 million new jobs. The Greater Phoenix region health care provider sector contributes $8 billion to the local economy (University of Phoenix, 2019). The first reason for the expected growth is the proliferation of technology that grants care providers and NGOs with opportunities to reach desired populations through telehealth services. The second factor is the increase of the aging population as Baby Boomers are reaching their 60s in the near future. The matter is especially relevant for the proposed CHP, as people over 65 are at a greater risk of heart diseases (“Heart disease,” 2019). The third cause of the expected growth is the emergence of new healthcare business models, such as clinics located in supermarkets. The CHP described in the present business plan can be considered one of the innovations in the sector. In brief, the three major factors described above predetermine the trend of market growth.
Customers
The customers of the proposed CHP are the people living in Arizona with increased risk of heart diseases. According to the World Population Review, the population of Phoenix is 1,626,078 making it the 6th populous city in the US (“Phoenix population,” 2019). People with increased risk of heart diseases are citizens older than 65 or with annual income below $25,000 (“Heart disease,” 2019). As the number of senior citizens is 157,110 and about 21% of the population is of low income, the potential customer count is approximately 465,500 (“Phoenix population,” 2019). The mobile unit will be especially effective for addressing the target population, as older Americans have decreased mobility and people living below the poverty line have less access to health care and related education. In short, the number of potential customers is relatively large and is projected to increase, as the population grows older.
Competitors
Competitors in the segment are scarce, and the information about their market share is not clear. As defined by the University of Phoenix (2019), the key competitors are Arizona Public Health Association (AZPHA) and Arizona Health Care Association (AHCA) as they are the largest NGOs in the community. AZPHA is a membership organization that aims at improving people’s well-being through advocacy, professional development, and networking (AZPHA, n.d.). AHCA (n.d.) is an association of long-term care facilities that provides support to its members. These two organizations do not offer health promotion services and, therefore, represent weak competition to the proposed CHP. At the same time, Mayo Clinic, one of the largest health providers in Arizona offers health promotion services and patient education as stated on their official webpage (“Mayo Clinic,” n.d.). However, the organization values any help in achieving a common goal. In summary, the proposed CHP is projected to meet mild competition.
Critical Success Factors
The major success factors identified for the present CHP are as follows:
- Providing quality patient-centered care. Without this element, the project will be considered a failure, as all stakeholders’ value the matter as crucial.
- Improving patient outcomes. The primary goal of the CHP is to prevent heart diseases, and without proper results, the project will be considered unsuccessful.
- Finding adequate funding. As the project is not for profit, it will be impossible to continue operating without outside financial help.
- Building a strong relationship with the community. Without the support of the people, the proposal will fail to reach the target population.
Strategic Opportunities
The strategic opportunities for further business growth lie in better market penetration. As the services and market of the CHP are strictly identified, and there are no opportunities to expand to other markets or add new products, the opportunities are stated as follows:
- Ensuring financial sustainability. All the other endeavors will fail if there is no adequate financial support.
- Providing reliable services. In terms of customer objectives, it is the best strategy to increase customer satisfaction.
- Improving technical and analytical skills. Without this knowledge, the project will not be able to develop.
- Increasing team productivity. This aspect will allow the mobile unit to provide service to an extended number of communities improving market penetration.
Marketing Components
Marketing Overview
The relevant components of the marketing plan for the CLC project include the following (Fleishner, 2017):
- Target market;
- Services;
- Marketing strategies to be utilized;
- Budget;
- Marketing goals;
- Contingency plan.
Target Market
The targeted market for this program will focus on communities consisting of, the elderly, obese, people with a chronic health condition, smokers, and people with unhealthy lifestyles.
Services
The CHP is geared towards achieving significant and rewarding results, which can profoundly impact the lives of the participants, both at the local and regional levels. Hypertension, otherwise known as high blood pressure, is a situation where the blood pressure falls outside of the normal range of 120/80. The community will be made aware of the harmful, and devastating effect of hypertension and how to prevent, control, and manage hypertension. They will learn about the contributing factors of hypertension and clinical measures needed for the follow-up. The participants will also receive useful information on how to detect evidence of pre-hypertension among family members. The community will be educated on the safe blood pressure range, signs, and symptoms of hypertension, and appropriate action to take with the help of a qualified and trained health care professionals. Community members involved in this program will be educated on proper steps to take, in case of emergency, which will help to improve the overall quality of lives of both the local and the regional community.
Marketing strategies to be utilized
The marketing strategies to be utilized include direct marketing, which will provide a connection with the community, through advertising the program over the radio, television, billboard, and print media.
Budgeting
A budget will be prepared to adequately fund this program, which will involve the local and the regional community. Some of the areas that the funds will be allocated are staff training, health information promotion, purchasing of medical equipment like the sphygmomanometer also known as blood pressure meter, monitor or blood pressure gauge, and educational material. Funds will be made available through grants, governmental subventions, donation, and sponsorship, will be from private sectors organizations, non-governmental organization, and non-profit organizations, affordable user fees. Overall, the funds obtained will be carefully allocated, and responsibly utilized by adopting prudent fiscal policies so that the program will be sustainable.
Marketing goals
The goal of this program is to create awareness of the devastating effect of hypertension and to provide the participants with tools necessary to lead a healthy life.
Contingency Plan
To ensure that the goals of the programs are met and fully achieved, emphasis will be placed on training and cross-training of staff members, so that staffing issues and other administrative issues will not adversely affect the program. Any disruption in staffing issues will not affect the plan.
Permitting
The CHP aims at providing a program that is comprehensive, efficient can serve a useful purpose within the ambits of the law. As such, it will be ensured that all health care workers and staffs are in possession of valid certificates, and licensing referencing first aid, CPR, and other certifications relevant to their role, duties, and responsibilities.
Social Media
High tech can be used to organized a marketing campaign for the WMV. One way to use technology for marketing is through social media. Social media marketing is a powerful way for businesses of all sizes to reach prospects and customers (“Social media marketing for businesses,” n.d.). There are many social media sites that can be used as a platform for the business. Some of those social media platforms are Facebook, Twitter, and Instagram. Social media marketing can help:
- Increasing website traffic
- Building conversions
- Raising brand awareness
- Creating a brand identity and positive brand association
- Improving communication and interaction with key audiences
A business page can be easily set up in the majority of social media websites. WMV will use its logo as a profile picture. The page itself of the CHP will include background information and information about the offered services. Photos of the vehicle will be provided, as it is vital for social media pages to have pictures so the audience can get a glimpse into what is being offered and how the business looks. All special events for the promotion of cardiovascular awareness will also be announced through social media. This will include the location of the mobile unit and the time and date the mobile unit will be at a certain location. On the social media site, the WMV page will provide links to the local and regional hospitals and cardiovascular specialists where the patients can continue to monitor their health.
Pamphlets, Newspaper Ads and Apparel
As some people, especially the older generation, may not be using social media websites, pamphlets and apparel can be used. The WMV will be promoting and bringing awareness about cardiovascular disease; therefore, a great way to bring awareness is connecting with local and regional hospitals and doctor offices and leaving the pamphlets there. The people who are waiting on the doctor or nurse can easily see the pamphlets and read them while they wait. It can give great information on why it is essential to take care of their hearts and why it is vital to get checkups. This type of marketing can also work for hospitals and doctor offices in return.
Since the mobile unit will be traveling to different locations, another way to market is by putting an ad in the local newspapers. Ads can be placed the week the mobile unit is supposed to be at a location for people to see. These ads can include the time and date of the mobile unit’s arrival and how long it will be at the location. They will also include services that are being offered. In short, in newspaper ads, it is crucial to offer all the essential information that will encourage the community to visit the WMV.
As for apparel, it will be worn by the staff members of the mobile unit. The apparel will include a polo shirt and a hat that a catchy phrase or interesting design, as it can make others ask questions wondering what the company is all about (“6 Advantages of Branded Clothing for Your Business,” 2019). The polo shirts can also have the company logo, website, and phone numbers. These polo shirts will be especially beneficial when worn by members working outside of the mobile unit greeting the patients and gathering information before the patients are seen.
The Mobile Unit
The mobile unit itself is an effective marketing tool as it can be seen while driving and when it is at a certain location for the day. The WMV will have the name of the business as well as the website information and phone number to be reached for people who may have questions. Just like the apparel for the staff, the mobile unit can have some eye-catching designs and phrases. In brief, the vehicle is the most efficient marketing tool.
Financial Data
Supply Needs
For more precise cardiovascular medicine to prevent, treat and care for patients, the American Heart Association leads the way by developing efforts (AHA, 2016). The mobile program will function with the use of necessary supplies to assist. For example, a mobile truck for patients, alcohol wipes, sphygmomanometers for blood pressure readings, seating, tables, privacy for patients, educational pamphlets, leaflets, and other resources are essential supplies needed for this mobile program. Written educational documents will be in both English and Spanish for the rural communities that will be visited. To improve the heart health of all Americans, the American Heart Association research, educate, and advocate which have been very impactful in the United States; However, more should and could be done to improve cardiovascular (AHA, 2016). Therefore, it is vital to have all the needed supplies to have a successful mobile program.
Funding: Grants, Donations, Sponsorships
The AHA (2018) states that outside of the federal government they are one of the most significant cardiovascular research contributors. For this program to be up and running, funding outside of the AHA will be needed. Grants, donations and sponsorships are all types of funding beneficial to the functioning of the American Heart Association and Hypertension mobile program. Although each may come on different forms, it is essential to seek funding. For instance, when starting something new, paying for important equipment, undertaking research or training a grant will be suitable. For exchange of marketing and advertising, sponsorships are made by corporations or other NGOs with cash or in-kind gifts. Additionally, families, individuals, and corporations give philanthropic gifts as donations. Measures to acquire either of these funding will be taken so that supplies, the WMV, and staffing can be supported financially. There will be grant proposals created to present to possible investors, lenders and car dealerships. Collaboration with two local grocery stores, such as Publix and Sam club, will be made to have $1 donated monthly for every leafy green sold.
Below are the sources of funds/grants of AHA.
Vehicle Selection and Design
Purchasing vehicles suitable to provide services to rural communities is crucial for the program’s process. These vehicles will be reliable while creating privacy for those seeking assistance and services. It will be designed for blood pressure readings to be done on the spot, filled with resources to educate the community on ways to prevent heart disease and hypertension. Funding via grants or donations will be searched for the purchase of a new or new mobile van to move around from location to location. For the pictures of the proposed vehicle, refer to figures 1-7.
Below is the associated cost of vehicles / Aircraft.
Scheduling of Staff and Locations for Events
Hiring enough personnel is vital for the successful implementation of this CHP. There will be staff assigned for events and backups when necessary. This is to avoid events from being canceled or unorganized. Staff will be created just for the mobile promotion and prevention program. All roles are vital to the functioning of this program and team.
Training and Education Materials
Tailored training will be provided for staff at various levels and in separate roles. Training will also focus on the cardinal signs of hypertension. To ensure that the community members can respond to this condition and take the appropriate actions for the safety and well-being of the community members. To enhance the effectiveness of the program, practical tools and resources will be developed for the dissemination of information such as conferences, and seminars. Workshops will be held at different venues such as health centers, town hall, churches, libraries, and other available venues.
Sanitary needs
The best way to mitigate the risk of germs spreading and nosocomial infections is by separating those germs from the rest of the hospital. Nosocomial infections are known as hospital infections and are infections that are not present in the patient at the time of admission to hospital but develop during the stay in hospital (Who, 2017). The American Heart Association will make sanitary facilities our priority and obligation to the individual we provide care to. We will have a cleaning crew that will consist of eight employees that will make sure our facilities are clean. Thorough cleaning will remove more than 90% of microorganisms that cause infection and sickness (Who, 2017).
Sterilization
It is important to make sure all equipment is clean or new before using it on patients. Sterilization is described as an object that is free of microorganisms (Who, 2017). Making sure all equipment is sterile before use will minimize the likelihood of cross-contamination. Cross-contamination can put a patient’s life in danger as well as give the organization you established a bad reputation. Reusable equipment will be sterilized with proper decontamination procedures while disposable equipment will be disposed of. The disposed of equipment will be recycled if possible.
Maintenance
Preventive maintenance is one of the most important things a health care facility can do to maintain the serviceability of their fleet. Many questions should be answered before developing a service plan for a fleet of vehicles which include how many miles the vehicles travel per month, what does typical wear and tear of the vehicle mean, and how much are repair parts for those vehicles are. One of the most important things to do when analyzing vehicle service schedules are determining what your target market will be and their location in relation to the facility. If a person is outside of that area, then they need to seek care from another facility. After a find the average miles a month each vehicle travels, a vehicle owner should refer to their owner’s manual to discover if the vehicle needs to be serviced every 3,000 miles. Most vehicles assigned to health care facilities are serviced bi-annually based on the distances the vehicles travel (Henry, 2013).
A hospital should understand their vehicles that are under warranty need to be taken to the dealership for services. For example, using the wrong oil may put the owner at risk for voiding their warranty (Henry, 2013). The person that oversees an organizations fleet needs to be knowledgeable about how long each vehicle is under warranty and the places they must go to receive services.
Automated Guided Vehicles
The American Heart Association plans to use Automated Guided Vehicles (AGV) to deliver products through our facility. There are several health care facilities that have incorporated this new product that has made every position a little easier while also saving money in the long run. This robot saves the wear and tear on employees who previously had to hand deliver all patient needs from bed sheets to breakfast.
Insurance
Ensuring vehicles are insured should also be tasked to the employee who manages the vehicle fleet. That individual needs to contact several insurance companies and determine the prices for coverage full coverage on all vehicles that are under warranty and liability for vehicles that are eight years or older. After all the prices and coverage details are established every stakeholder in the organization should work together and find out which is the best insurance company for the vehicles.
Wear & Tear
Organizations that have vehicles typically send their vehicles to different mechanics to receive services and get worked on. AHA is going to preorder parts for vehicles that usually break due to wear and tear including bolts, windshield wipers, water pumps, and tires. By having these parts on hand, work orders will be cheaper, and the organization will save a tremendous amount of money (Mcintire, 2013). Knowing that the average prices for ambulances are around 80,000 dollars, it is important to try to obtain the best warranty due to the prices for replacement parts.
Legal and Cultural Issues
The America Heart Association (AHA) is a large voluntary company committed to fighting heart-related diseases, hypertension, and stroke. It was founded in 1924 by six cardiologists and has since been on the frontline of eradicating heart diseases (AHA, 2018). Like other organization, the American Heart Association is faced with legal, regulatory and cultural issues. This part elaborates these legal and cultural issues as well as the concept of patient flow regarding the American Heart Association.
Legal and Regulatory Issues
Every company works within a confined set of laws, rules, and regulations. These are set and mandated by the government to ensure the protection of the rights and freedom of all involved parties. The American Heart Association has conducted community training in cardiopulmonary resuscitation (CPR) for several decades. The element of CPR does have any legal, regulatory, or ethical issues. All the fifty states in America have the Good Samaritan laws/regulation which gives limited immunity to a person who attempts to provide CPR in good faith and in an honest endeavor to save a life (AHA, 2018). Many people have unsuccessfully tried to sue lay rescuers. Lay rescuers must be confident to help save lives without fear of legal action owing to the law.
Other regulatory issues affecting the company include federal laws on American diet food manufacturing, pollution control, illegal substance control such tobacco use, physical activity guidelines in schools and other well-being initiatives greatly impact the operations of American Heart Association. Active transportation is also encouraged by the company through the necessary transportation requirements. There are also regulations barring patients with implantable cardioverter defibrillator (ICD) from driving.
Cultural Issues
Unfamiliar cultures have different beliefs, perceptions, and viewpoints. Large organizations such as the AHA must always consider such varying cultural perspectives. For instance, during resuscitation attempts the diverse cultural and ethical norms must be put into consideration. Even with the dominant principles of beneficence, justice, autonomy, and non-maleficence still stand, different cultures still hold varying opinions regarding CPR. There are also underlying social determinants linked to cardiovascular diseases. The diverse range of factors may include social status, income levels, cultural activities, education, learning styles, and working style among others. Such cultural differences cause undesirable health inequities.
The company operates on a large-scale level affecting the lives of many from diverse cultural backgrounds. Additionally, its volunteers come from different ethnic and cultural backgrounds. As so, there is the issue of diversity at the workplace. It mandates cultural competence among health care providers to productively serve many patients. Also, cultural variation can cause issues of linguistic problems. This may hinder communication hence the needs to embrace diversity.
Patient Flow
Heart-related diseases are the leading causes of patient visits and admissions in many hospitals in the United States. Bidwell et al. (2018) explain that the asperity of heart failure and diseases is greatly connected to caregiver and patient outcomes. AHA gives guidelines for improving clinic flow to ensure positive health outcomes. It recommends the use of virtual memory systems and clinic flow coordinators to support and boost reduces patient waiting time and hospital resource utilization (Jefferies et al., 2013). Such efforts greatly improve data evaluating quality in outpatient cardiology. AHA is a large company that collaborates with other parastatals, agencies and the government to combat heart-related illnesses. Its efforts are not without legal, regulatory cultural and patient flow issues that it seeks to improve. The company continually complies with laws and regulations to ensure the best health outcomes.
Operational Plan
Objectives
The CHP strives to provide accessible care to both inner city areas and rural communities. In order to achieve this goal, a mobile unit will be purchased to promote awareness, prevention and disease management of hypertension. The program focuses on educating communities on the following:
- Incidence of hypertension from state and national data;
- Disease awareness and Prevention – healthy eating and healthy living (food choices and lifestyle changes);
- Disease management: medication adherence, prescribed diet, and activity level;
- Community resources: patients will be provided with informational brochures.
Operation and Capital Expenditures
- Mobile health unit (bus): $100, 000.00 one-time purchase
- Driver (2 FTEs): salary of each driver: $50,000 annually.
- Physician/Nurse Practitioner: $150,000.00 – $350,000.00 each staff, annually
- Medical Supplies: $350,000.00, annually
- Blood pressure machine
- PPEs (gloves and masks)
- Needles and syringes
- Specimen containers (urine, blood, swabs)
- Informational materials (brochures)
Organizational Structure
Below is the structure of the organization of the CHP.
Human Resources
The staff of the CHP is comprised of various health professionals, such as registered nurses and nurse practitioners who work closely with community leaders and residents to provide health care education on health promotion and disease management pertaining to hypertension. The staff is certified on Basic Life Support (BLS) and Advanced Cardiac Life Support.
Patient Flow
The WMV makes its trip to communities daily providing educational sessions and health screening (BP checks) to the community residents.
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