MMHA 6999 Week 6 Strategic Resourcing Plan Example

What Stops Weighs as Much as What Starts: A Resourcing Plan for Consolidating Births at Juniper Valley Health

Student Name

Walden University

MMHA 6999: Strategic Leadership Management

Instructor Name

Month Day, Year

What Stops Weighs as Much as What Starts: A Resourcing Plan for Consolidating Births at Juniper Valley Health

Purpose

Juniper Valley Health's board, deciding for the invented rural system in this capstone, approved consolidating births from Alder Creek at the regional hospital, with four commitments to protect families. This resourcing plan sets out what the decision costs and saves, gives equal attention to what stops and what starts and states in advance what would be protected if funds shrank. Figures are illustrative annual amounts once the change is complete.

Plans that list new spending in detail but treat stopped activities as a single line of savings tend to overstate savings and miss transition costs. Stopping is work: staff must be redeployed, equipment moved or sold and services wound down safely. The literature on de-implementation argues that removing practices deserves the same planning as adopting them (Prasad & Ioannidis, 2014).

What Stops

Table 1

Activities That Stop at Alder Creek and Their Annual Effect

Each stopped activity carries a task list. The largest, staffing, is also the most sensitive, because it concerns people's jobs.

What Starts or Grows

Table 2

Activities That Start or Expand and Their Annual Cost

New costs are about two-thirds of avoided costs, leaving an illustrative net annual improvement of about $710,000, before lost delivery revenue at Alder Creek and new revenue at the regional hospital, which roughly offset each other.

Transition Costs

The first year carries one-time costs not shown above: retention bonuses for nurses who stay through the transition, overlap staffing while births move, training for emergency staff and communication with the community. These total about $380,000. The plan funds them from the first year's savings, so the net improvement in year one is about $330,000. These one-time costs are not optional; cutting retention pay to improve the first year would risk losing the nurses who keep the unit safe until its last day.

How Savings Will Be Verified

Savings from stopped activities are often counted in plans and never seen in budgets, because costs move rather than disappear. The finance office will track each stopped line separately for two years. Nurse positions offered at the regional hospital will be counted as new cost there rather than netted against Alder Creek's savings, so the board sees both sides. The anesthesia contract's end date will be confirmed in writing. Equipment sales will be recorded. If any stopped cost reappears, for example through overtime in Alder Creek's emergency department, the finance office will report it rather than absorb it quietly.

Effects on Revenue

Delivery revenue at Alder Creek will end, and the regional hospital will gain most of it, since most families will deliver there. Some families may choose a hospital outside the system; the plan assumes about one in ten will, an illustrative estimate. Prenatal visits at Alder Creek will continue to generate revenue, and the nurse navigator's work is designed in part to keep families within the system for delivery.

What Would Be Protected If Funds Shrank

State Medicaid changes or a weak year could reduce the money available. The board should know now which commitments survive cuts, so that pressure later does not erode the promises that made the decision acceptable. The plan ranks the four commitments in order of protection.

First protected: emergency obstetric readiness at Alder Creek. It is the commitment that most directly protects lives when labor is rapid, and it costs least. Second: the nurse navigator, because planning delivery location with every patient prevents many emergencies before they happen. Third: the prenatal clinic, which keeps routine care local; its hours could be reduced before it is closed. Fourth: the transport and lodging program, which could be narrowed to patients with the longest distances or highest risk.

The first two protected commitments aim squarely at the danger documented by Kozhimannil et al. (2018), that closures leave more women delivering without maternity staff nearby. If funds shrank below what is needed to keep all four, the plan recommends reducing regional hospital growth spending before touching the first two.

What the Plan Does Not Fund

Consistent with the strategy, the plan does not fund a second surgical robot or a county seat office building, both declined in the current budget. Savings from consolidation are not redirected to those projects. Holding to those refusals is what keeps the strategy coherent: savings go first to the commitments that protect families, then to the system's access strengths in emergency care and primary care (Porter, 1996).

Conclusion

The consolidation saves about $2.1 million a year in stopped activities and spends about $1.4 million on what starts, with a one-year transition cost. Each stopped activity has a plan to stop it well. And the board knows in advance which commitments come first if money tightens: emergency readiness and the nurse navigator, the two most directly tied to safety.

References

Kozhimannil, K. B., Hung, P., Henning-Smith, C., Casey, M. M., & Prasad, S. (2018). Association between loss of hospital-based obstetric services and birth outcomes in rural counties in the United States. JAMA, 319(12), 1239-1247. https://doi.org/10.1001/jama.2018.1830

Porter, M. E. (1996). What is strategy? Harvard Business Review, 74(6), 61-78.

Prasad, V., & Ioannidis, J. P. A. (2014). Evidence-based de-implementation for contradicted, unproven, and aspiring healthcare practices. Implementation Science, 9, 1. https://doi.org/10.1186/1748-5908-9-1