***This is a TWO-PART- assignment paper and financial excel sheet***
2-3 pages APA 6 format, in-text citation, Use at least two (2) scholarly references to substantiate your work. Please provide a copy of all references used.
Spreadsheet is attached.
The links to the mentioned articles are provided below
**youtube video to help with completing spreadsheet**

Assignment Details:
As a member of the finance team, you have been asked to forecast the upcoming years operational budget for Krona Community Hospital. Click here for last years budget. After reviewing specific data, internal input, and external input from various sources, you find that the executive management team would like the budget to reflect the following:

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10% increase in inpatient revenue
15% increase in outpatient revenue
5% increase in pharmacy revenue
15% increase in home health and hospital revenue
10% increase in payroll and benefits

(explanation of assignment from professor)

The assignment is to take the number that its here and increase it by whatever percentage or decrease it by whatever percentage theyre asking you to do. So, you just have to do a math problem. So in the columns right next to it. Come up with the new budget. So youre going to as part one of the individual project submit this excel spreadsheet with the new numbers on it.

Additionally, provide discussion on the following:

How do you think that revenue would increase in each of the areas? Think outside of the box, and perform research to determine current trends in those areas.
Why would there be a forecasted need to increase payroll and benefits?
Explain the role of key leadership in the budgeting process, from the chief executive officer down through to the staff level of a financial analyst.





$ 25,000,000



Emergency Room






Home Health and Hospice


Ambulance Services


Substance Abuse





$ 60,050,000

Less Chartiy Care


Net Revenues

$ 42,050,000


Payroll (including nursing salaries)

$ 12,500,000



Contract Labor




General Services (laundary, security, etc)




Interest Expense


Professional Services


Total Operating Expenses

$ 30,700,000

Net Income

$ 11,350,000




Reflective Project

Reflection: Health Care Information Systems

Throughout this course, there are various concepts that I have gained and which I hope will help me in my future position as a health care manager. First, I have learned that health care information systems have improved the quality of medical services in a variety of ways. First, they have enhanced interoperability. Interoperability means that doctors can easily communicate with patients even from their homes, share their medical information and history and also help them follow their medical procedures. Moreover, I have also learned that health care information systems such as Decision Support Systems (DSS), Telemedicine systems, and Electronic Health Records (EHR) have also been crucial in managing big data in health care. Big data in health care is the vast patient information that is produced daily in various health care centers. In this course, I learned that health care information systems help to store and secure patient data for future reference. Nowadays, patients can seek medical services from any healthcare facility once their data is captured in the systems. This is a major milestone for health care organizations in managing patients information and also providing quality health care. On the other hand, I have also learned that health care information systems have also helped to reduce the costs of medical services. In less serious cases, patients can communicate with their doctors through teleconferencing systems or the EHR or DSS systems. Doctors can still provide medical advice to patients. This helps them to save the transportation costs that they would have otherwise used in case the systems were not in place. The knowledge gained from this course would be crucial in helping me in the future. As an aspiring medical provider, I will ensure that I effectively utilize the systems to improve the quality of care and also improve the quality of medical experience for the patients. Reflection Part 6

CSBI Course 6: Relationship, Change Management and Consulting skills

Leading Change

Finding Opportunity

Communicating Within the Industry

Proving Value

Leading Change

Consultants leverage knowledge,expertise and communications competency to support
decision-makers in considering data and information in ways that reveal robust opportunities for
organizations. Some of these opportunities have not previously been envisioned at an
operations level because meaningful information has not been available or presented.

Exercising Influence and Stimulating Action

A well-considered and integrated use of emotional intelligence, a variety of leadership styles and
appropriate use of power will be valuable to the BI/Analytics consultants as a change agent in
times of turbulence. We will describe each of these attributes and then discuss how their
integrated use creates strong leverage for influence.

Much has been written over the past fifteen years about the success of those who work with
emotional intelligence(EI). High-EI people can understand and read, in real time, their own
emotions while simultaneously understanding those of others and subsequently advancing their
positions by interacting with greater skill and influence than others. This capability is present
even in the heat of the moment, when most individuals would turn to more base-level
interpretations of and reactions to themselves, others and a situation.

Daniel Goleman, a well-known author on EI, finds that leadership performance is affected by
ones ability to work within the two EI competency sets- personal and social. Specifically, ones

ability to engage certain personal and social competencies yields stronger leadership
performance and subsequent results as a change agent.

Self Awareness
Emotional awareness
Accurate self-assessment
Self confidence

Self Management
Self control

Achievement drive

Understand others
Develop others
Service orientation
Leveraging diversity
Political awareness

Social Skills
Conflict management
Change catalyst
Building bonds
Collaboration and cooperation
Team capabilities

Exercise Influence and Stimulating Action

It can be surmised that building bonds would be helpful in the complex healthcare environment.
A key in building bonds is to develop extensive informal networks where mutually beneficial
relationships are carefully cultivated. The networks are chosen based on expertise that each
member brings to the table and willingness to extend knowledge or expertise when needed.
Innovation is not seen as a necessary change agent competency because the change agent
helps others unlock their ideas and work through them.

Leadership styles and competencies

Goleman asserts that one can develop higher EI competency through practice. Self tests are
available to see where one stands compared to others. EI can be practiced by learning to use
the six leadership styles listed. Practice of each style sharpens ones EI in specific
competencies. They should all be used at points where such an effect is needed. Use in
combination is appropriate.

The Power Bases

The social skill influence is an EI competency that leaders leverage to get things accomplished.
Influence is grounded in the power individuals exercise, according to Kenneth W. Thomas, PhD.
Thomas presents six power types along with the influence effect each type produces.

The key aim for the BI/Analytics consultant related to influence is to build commitment to an
idea, an approach, a KPI or a new way of looking at or making decisions.

Note the commitment effect is related to personal power bases expertise and information, which
the BI/Analytics consultant should have or can build in abundance. Also needed is compliance
from those outside ones direct control to successfully conduct experiments and launch new
analytic approaches. Goodwill should also be used to build commitment. Successful use of
these power bases relies on communication.

6 Power bases are:

1. Authority-ones formal right to direct others in certain matters and others obligation to
follow those directions.

2. Reward-ones control over things others desire.
3. Discipline-Ones formal right to punish others.
4. Information-Facts or reasoning that one possesses and is able to share convincingly

with team members.
5. Expertise-Ones superior judgment or knowledge in a specific area.
6. Goodwill-Feelings of support and respect that one has built with others.

The influence effect that each power base produces is presented here. Some sources of power
base production are presented here. Some sources of power are positional, while others are
personal. Positional power bases often are not available to the BI/Analytics consultant, as they
require one to be in position of direct authority over another. Positional power bases are not
needed to build commitment. However, ensuring compliance is necessary, along with
occasionally overcoming resistance, and these do not come from commitment alone.
Depending on the situation, one may be available to wield positional power when acting in
project management capacity, though this is difficult. Whennot in a positional power position,
one can exercise personal power to reward individuals that fosters compliance. Mechanisms
need to be in place to make this happen. It is essential to have the ability to use all power types
as appropriate to spur progress.

Source of Power Power Base Influence Effect
Position Authority Compliance

Discipline Resistance
Reward Compliance

Personal Information Commitment
Expertise Commitment
Goodwill Commitment

Fostering Commitment

Now one has a tool set for action. However, conscious use of the tools must be engaged. The
stakeholder provides insights into the interests and needs of individuals involved at all
organizational levels. From this analysis, one should have a keen appreciation of how to
engage EI social competencies. This strengthens political awareness. Action steps, if
developed carefully in the stakeholder process, can address political issues and act as power
mechanisms of reward and goodwill to foster compliance and commitment. For example, set
up the plan for someone who wants a say and participation, so they can participate and talk.
They will feel rewarded. Enrolling them in the process through participation because you
can(exercise goodwill) engage team capabilities. In turn, those drawn in will now exhibit goodwill
to others as it has been extended to them, which leads to commitment.

Other Tools-Sponsorship

One of the other tools to engage in the process is sponsorship. Sponsorship can be defined as
fostering transparency and accountability in the group process, again fitting with necessary EI
competencies of political awareness, initiative and influence. Although one may not be engaged
in a formal project management (PM) situation, the PM tool of sponsorship ensures that enough
organizational executive influence is available to exert pressure against possible resistance.

Others Tools-Communication

Communication is another tool. Its important to understand ones own communication style and
preferences and be sensitive to the styles and preferences of others. A number of self-scoring
tools are available that can be used to master interpersonal communication skills. Some of
these are:

DiSC profile-this tool illuminates ones communication preferences(dominant, influencer,
steadiness & conscientiousness). When these preferences are known, one can work to
understand and interact with others in the context of their preferred styles of

Myers Briggs Temperament Index: This tool helps individuals and groups understand
the basic differences in the ways they prefer to use their perception and judgment.

Kolbe Conative Index-this tool offers a measure of how people are hardwired to take
action in one of four ways(fact finder, follow through, quick start or implementer).

Exercising influence and Stimulating Action

Whether using these or other tools, its helpful to understand communications preferences and
styles in oneself and in team members. The aim is to carefully build a team that is balanced in
communication styles to achieve diversity of thought and action. Then continue to hone these
skills across the course of the work.

Is it this simple? No. Conscious action is required along with careful and forward-looking
networking and preparation. There is no substitute. There are those who might eschew this
process as contrived and surreptitious. However, goodwill-the most powerful of the power bases
due to the broad spectrum of activities and methods. Goodwill is easily dissipated where
transparency and open action are not in force.

Finding Opportunity

Focus on performance

Using the approaches discussed earlier for working across the organization at all levels, one
can uncover areas and issues of importance that need to be addressed. Here the organization
can see if attainment of the benchmark is possible and what it might take to achieve it based on
the what if findings. And the organization can see what is possible today. So decision-making
related to targets is in line with the 5 key power decision attributes-more targeted, replicable,
expeditious and lower in cost.

Are Policies and rules in Place?

Also revealed in this type of analysis is whether the organization has the policies in place, and
whether actual practice and compliance are in line with these policies, to perform at desired
levels. As the predictive analytic experimentation process requires ia set of rules by which to

make predictions(this is how the organization wants or should operate), the set of rules by which
the organization actually operates becomes clear.

Then the what if questions always prompt the questions: So what are you doing now? Often it
has been found that significant issues with compliance exist and, frequently enough, policies
and rules do not exist. They must be built.

So experimentation reveals 2 things:
The data needed(ADT, clinical, financial, etc or process performance)
The policies and rules by which the predictions and prescriptions must be developed and

implemented with any analytics.

Who is responsible?

As part of moving along this path, one will have performed a stakeholder analysis. This analysis
will have revealed another important area of information: Who is involved in the chain of events
that makes up the item in question? Who is ultimately responsible? Who executes the item on
a daily basis? For example, staffing on nursing floors, collection decisions or how the marker
for high 30-day readmit risk is actually addressed. Or regarding outpatient demand
management activity in Primary Care- to manage identified chronic healthcare users with
diabetes. After building a new very expensive construct dashboard with very detailed metrics
as requested-does the operating areas use it? Do the metrics move?

One can easily surmise the highly sensitive situation that begins to present itself. The capability
and willingness of operating managers at several levels may be called into question. This is the
reason for advance engagement of the stakeholders analysis and plan, EI building bonds and
networking and sponsorship tools, along with involving the operating managers in the
experiment development process.

However, this uncovers the need for sponsorship and in some situations where distributed
decision-making is required, this need is absolute. This a model to ensure the aims planned are
actually executed down the line.

In particular, the sponsorship tool calls for finding a sponsor at the highest level who can hold
accountable all actors involved in the work. The CFO cannot hold the COO or CNO
accountable, therefore the CEO must be the sponsor. If this is not possible, then the initiative
should not be engaged.

Case study

Consider this real case regarding outpatient demand management activity in Primary Care. The
initiatives aim is to manage identified chronic condition healthcare users having diabetes. After
building an expensive dashboard with detailed metrics(as requested) to support operating
managers(those responsible for execution) to address the issue, does the outpatient primary

care office and clinic facilities use it? Do metrics move? The senior leadership team is asking
questions to validate the use of the tool to address the issue as the metrics are not moving

Case Study-Answer

CEO-Correct. No. Not necessarily intuitive, yet the initiative involves clinical staff(medical &
nursing) along with the support of administrative staff. All of these positions stop with the CEO.
It might be considered below the CEOs work, yet as in the chart presented, the sponsor must
have the authority to mobilize action. In this case the clinical teams and administrative team
must become and remain mobilized.

Chief Admin Officer-Incorrect. This position has no leverage over the CMO, when push comes
to shove in organizational politics.

CNO-Incorrect. The CNO is the usual suspect for clinical accountability. However, what about
the medical team? What about the necessary support of the clinical staff by administrative
team? The CNO has no leverage here.

VP of Primary Office Admin: Incorrect. This individual has no authority or leverage over clinical

CFO: Incorrect. This individual has no authority or leverage over clinical execution.

VP of Finance: Incorrect. This individual has no authority or leverage over clinical execution.

Director of BI/A: Incorrect. This individual has created a tool according to specs but does not
have authority or leverage over clinical execution.

Communicating within the organization

The BI/A consultant must present the results data effectively in a general sense. In addition,
however, he or she must present results in terms to which others in the organization will relate.

The typical return on investment(ROI) findings leave many cold. Often the first thought is that
ROI means loss of jobs. This can easily be the case in clinical areas, since labor is largely the
only visible expense. ROI to many is based on cost reduction only. To mitigate this tendency, it
is critical to involve not only the unit director or manager when starting with the experiment
design process. Stakeholders, specifically staff members involved in the process should
participate. It is helpful to have staff members who are vocal about the need for change
because they have an invaluable ground-level viewpoint that should be taken into consideration.

Communicating of Analytic Process and Information

This complement of participants provides the base of information about how things are done to
engage the foundational discovery work needed at the start of designing the experiment, such
as process flowcharting, value stream mapping and policy/operating practice identification. At

the same time, the BI/Analytics consultant can teach participants about the work being done and
its meaning.

The real payoff of involving this larger group threefold:

An outcome will be defined in advance in terms the stakeholders understand(negotiating
with key stakeholders and managing expectations)

Policies and practices, whether they are good, absent or lacking in performance, will
become transparent and can be appropriately addressed

The group will have a greater level of understanding and analytics sophistication

An additional benefit of this process is the advisory role one can develop with the team over the
time of the working relationship. The transparency of the process called for the assistance of
analytics in developing solutions.

This process leverages EI competencies, leadership styles and robustly leverages power
bases. It is also well known as part of the Total Quality Management process, lean processes
and similar implementations used over the last 20 years.

Proving Value


Because everyone else is” is, of course, not a reasonable statement for winning approval. The
question regularly asked is how does one show ROI? Consider, first, that ROI means many
things. Straight dollar costs or revenues, care quality and process improvement cover the
major functional concerns.

Regarding costs, consider the following:
First, look at performance against known benchmarks. Organizations normally track a

number. Tracking against benchmarks is fraught with disagreement as to
appropriateness and applicability, often depending on who is speaking and how the
benchmark makes their area appear. Remember that with cost being the predominant
indicator of performance, defending a position often revolves around how thethings
driving cost in our business look nothing like the others in the benchmark cohort. And it
is best not to spend a great deal of time arguing about this. The benchmark is not an
absolute, it is a relative position with all other things being equal. Benchmarks provide
needed directional information( i.e., is the organization on the right highway?).

For example, lets look at the biggest organizational expense, labor. Suppose one finds
labor cost related to revenues to be in excess of benchmarks determined by a cohort of
best-practice organizations, or even the benchmark overall, by upwards of 10%. Are
there differences in a host of operating conditions?

Yes, maybe. Do they account for a difference of 10%? One may be a different road
altogether. More importantly, one has a tremendous opportunity for return even with a
few points improvement, as the dollar amounts are so large. Careful simultaneous use
of analytics across all three types discussed( descriptive, predictive & prescriptive) will
unlock this potential.

Similarly, related to supply expense, best-practice organizations run these costs in the
very low 20% range. Calculate what these mean for your organization in excess dollars

Quality and return

The relationship between clinical quality and return is becoming obvious when one
considers the cost savings of fewer re-hospitalizations, lower numbers of MRSA cases
and earlier detection of high blood pressure, for example. These are not necessary soft
costs. The challenge will be for the BI/Analytics consultant to set up straw-man
experiments using predictive models that look at the possibilities in advance and obtain
agreement on the range of outcomes. Then compare these to a cost table. Again, likely
the 3-year return will show clearly.

The question is, how does one monetize some aspects of performance that need to be
considered, such as clinician coverage or process redesign? Again, careful
experimentation is called for. As part of the experiment, one will first need to flowchart,
measure the value and stream map the processes involved, looking carefully at the time
needed for performing tasks(resource consumption), timing of tasks and the time
wasted between tasks. This gives a comparison baseline to see if any clinical changes(
such as length of stay), result from processes of coverage change. And what changes
are likely to be related to improvements in healthcare user condition?

Working with clinical informaticists can lead to much richer experimentation and
analysis, such as investigation of particular clinical factors, interventions, processes,
outcomes, etc. related to operational


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