Changing Environment of Health Care – Mayo Clinic

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As a manager in health care, you must understand what environmental factors can affect your organization.

Identify a healthcare organization of your choosing.

Using the table below:

Identify a combination of 10 internal and external factors that affect this organization.
Describe the potential impact of each of these factors on the organization.
Describe strategies that a manager can take to minimize or control the impact of these factors.

Note: Each response should consist of 50-100 words.

Selected Organization: MAYO CLINIC

Factors (Internal and External)	Potential Impact of Factors on the Organization	Strategies to Minimize or Control the Impact of Factors
Internal Factors
1. Staffing (the number of professionals in each department)	Mayo Clinic has a total of 63,000 employees as of 2018, including 4,500 scientists and physicians and 58,400 allied health staff and administrators. The number of staff members can essentially impact the facility’s ability to deliver quality care promptly, as well as the number of patients that can be served in a calendar year. In 2018, it was reported that the Mayo Clinic attended to more than 1.2 million patients across 50 states of the U.S. as well as in nearly 138 countries globally (Mayo Clinic, n.d.).	Employee turnover is one of the main factors impacting the number of care providers in most healthcare institutions in the U.S., often resulting in understaffing. One way of motivating staff members to stay is by providing financial incentives, including bonuses. Also, providing a work environment that promotes individual development as well as work-life balance can help workers stay (Hoeve, Brouwer, & Kunnen, 2020).
2. Competency skills and experience of staff members	Competency and the experience of physicians and other care providers are necessary to ensure that patients receive quality and safe healthcare. This can also reduce the spread of nosocomial or hospital-acquired infections and, thus, reduce the length of hospital stay for patients, the rates of medication errors, and the cost of care.	The first strategy to minimize the hiring of incompetent clinical staff members is through competitive recruitment that is based on merit. The second strategy is to hire staff members from diverse backgrounds rather than discriminating based on gender, race, sexual orientation, and so on.
3. Leadership structure and style	Mayo Clinic is a non-profit institution governed by a Board of Trustees. The Board’s overall function includes educational, scientific, clinical practice, and charitable purposes and missions. Michael Powell is the current chair of the Board of Trustees (Mayo Clinic, n.d.). The Board can impact the leadership style of the institution and its expansion strategy.	The most appropriate way of ensuring that the Board remains transparent and trustworthy is by ensuring leaders are elected democratically and in accordance with the set procedures. Also, Mayo Clinic must institute a bottom-up leadership model to ensure that all staff members participate in decision-making and that all-around policies are accepted.
4. Presence of Codes of Ethics	Mayo Clinic has a set of “Values” that guide the professional conduct and behavior of all staff members. This includes respect, compassion, integrity, healing, teamwork, excellence, innovation, and stewardship. The organization’s “primary value,” however, is to ensure that the needs of patients come first or are prioritized. The institution also has an Ethics policy that aims to protect against unlawful and unethical behavior (Mayo Clinic, n.d.). Organizational values influence employees’ performance and the performance of the organization (Gorenak & Ferjan, 2015).	One way of ensuring that the Codes of Ethics are observed is by forming an Ethics Review Team that serves to draft, amend, and enforce ethical principles across all departments of the facility. The team also works to discipline errant workers and ensure that the code of ethics is adhered to.
5. Presence of health IT (such as electronic healthcare records or EHRs)	Deployment of health information technology (health IT) is one of the achievements that have essentially improved the delivery of care services across various departments in Mayo Clinic. Electronic healthcare records (EHRs), for example, have been installed in all departments and have played an integral role in improving communication and sharing of patient data in real-time and quickly. This has reduced medication errors and improved the delivery of quality care (Monica, 2018).	All health information technologies should be regularly monitored to ensure that they comply with or meet federal standards. They should be highly secured to guarantee the confidentiality and security of patient data shared across all networks. Above all, health IT should be easy to use but detailed enough to achieve meaningful reporting (Alotaibi & Federico, 2017).
External Factors
1. Accreditation Bodies	The Joint Commission (TJC) and the Healthcare Facilities Accreditation Program (HFAP) are two of the main accreditation bodies that certify Mayo Clinic and other healthcare facilities in the country. Accreditation is necessary to ensure that hospitals comply with quality measures, reduce liability risks, and streamline operations.	There are several ways in which Mayo Clinic can ensure it meets the accreditation requirements set by the TJC and HFAP. This includes starting to measure infection control quality, providing patients with separate consent forms, creating daily logs, enhancing monitoring of pathology results and specimens, creating SOPs (standard operating procedures), and so on.
2. Regulators	The major federal regulators that Mayo Clinic faces in the U.S. include the CDC, FDA, and CMS – which all operate under the HHS (Brooks, 2014). The other institutions that oversee the operations of hospitals include the AMAP (the American Medical Accreditation Program), NCQA (the National Committee for Quality Assurance), JCAHO (the Joint Commission on Accreditation of Healthcare Organizations), and so on. Regulators impact the future direction of an organization as changes in regulations change how the organization operates and the relation between the organization and its employee (Abdin, 2009).	Mayo Clinic must ensure that it complies with all the regulatory requirements set by different agencies to avoid cancellation of its practicing license or facing any kind of punishment. This includes providing a Code of Ethics, Standard Operating Procedures (SOPs), infection control procedures, quality measurement protocols, Human Resource Policies, and so on.
3. Policymakers (Congress)	Policymakers (especially Congress) also play a huge role in determining the operations, practices, and type of services Mayo Clinic and other healthcare facilities offer to citizens. Most essentially, policies impact the cost of care, and the type of health insurance plans that specific populations, such as those earning below the poverty line, can pay. The Affordable Care Act is a perfect example of legislation that has essentially impacted the access and delivery of care in the hospital.	Mayo Clinic must educate its staff members about the current policies applicable, from insurance coverage to legal medical procedures allowed by law. This will ensure that all staff members work within the legal framework without going overboard. Mayo Clinic can also lobby for laws it feels can positively impact the delivery of quality care.
4. Insurers	Health insurance is another external factor that affects patient access to care in the facility. Presently, Mayo Clinic has formed arrangements with several insurers, including HMOs, Tricare, Medicaid, Medicare, and Contracted Insurance Plans. Others include prescription card plans, motor vehicle insurance, disability insurance, and so on (Mayo Clinic, 2016).	To ensure that all patients are covered, Mayo Clinic should renew or maintain its current arrangement with the different insurers it has engaged with, including HMOs, Medicaid, and so on. The facility should also consider expanding into other insurance plans that are not so far covered, point-of-service (POS) plans, Exclusive provider organizations (EPOs), and so on.
5. Sociopolitical forces (e.g., the economy)	Sociopolitical forces can also essentially destabilize the operations of Mayo Clinic. This includes things like recession, global pandemics (such as the current COVID-19), political unrest, higher inflation rates, importation tariffs, and so on. For example, the current COVID-19 pandemic has stretched and overwhelmed the facility’s emergency department and staff members. Tariffs can also impact the facility’s ability to import medical suppliers from foreign countries like China.	Mayo Clinic can effectively address external factors through lobbying. For instance, the facility can champion the government to increase funding of non-profit hospitals to improve their capacity to handle pandemics and other healthcare disasters. The facility can also lobby congressional representatives to push for changes through legislation.

References

Abdin, J. (2009). The Impact of Government Policies & World Order on Business. Retrieved 27 April 2021

Alotaibi, R. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal, 38(12), 1173-1180.

Brooks, M. J. (2014). Risk evaluation and mitigation strategies the answer? Mayo Clinic Proceedings, 89(12), 1673-1684.

Gorenak, M., & Ferjan, M. (2015). The influence of organizational values on competencies of managers. Retrieved 27 April 2021

Hoeve, Y., Brouwer, J., & Kunnen, S. (2020). Turnover prevention: The direct and indirect association between organizational job stressors, negative emotions, and professional commitment in novice nurses. Journal of Advanced Nursing, 76(3), 836-845.

Mayo Clinic. (2016). Insurance types accepted at Mayo Clinic. Retrieved from https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance

Mayo Clinic. (n.d.). Centers and Programs: Biomedical ethics research program. Retrieved from https://www.mayo.edu/research/centers-programs/biomedical-ethics-research-program/overview

Monica, K. (2018, Oct 9). Mayo Clinic completes a $1.5 B epic EHR implementation project. HER Intelligence. https://ehrintelligence.com/news/mayo-clinic-completes-1.5b-epic-ehr-implementation-project.

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