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Strategic Management of Sharp Healthcare

Setting the Stage

Terry D. Vincent

University of San Diego

HCIN-558: Strategic Planning and Management of Health Systems

Dr. Joseph F. Burkard

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Step One: Setting the Stage

I selected Sharp Healthcare facilities comprised of four acute-care hospitals, three

specialty hospitals, three affiliated medical groups, a health plan with more than 18,000

employees. The hospital was initially called the Donald N. Sharp Memorial Community

Hospital, named after a fallen San Diego U.S. Army Air Forces pilot that lost his life in 1944

fighting against Germany. His father, Thomas E. Sharp, a successful businessman and radio

broadcasting pioneer wanted to do something that would honor his son's death, so he donated

$500,000 to the San Diego Hospital Association. His only wish was to have a place dedicated to

the fallen soldier and would be there to help the people in the community and operate as a

nonprofit facility.

Since Sharps induction, its mission has not changed much since 1950. Their mission

statements state that their mission is to "improve the health of those we serve with a commitment

to excellence in all that we do" (Sharp, 2020). Their main goal is to give quality care and service

while at the same time making their form of healthcare the benchmark for all health facilities to

immolate, at the same time, making access to healthcare more accessible and cost-effective for

all.

Sharp's vision is to remodel the healthcare experience by ensuring that it is based on the

most basic of human needs. Their core values stem from providing patient-centered care, so

caring, quality of healthcare, patient safety, service to the community, innovation, and excellence

is part of their DNA. They want to be recognized by all as the best place to work, practice

medicine and receive care, no matter their location in San Diego county (Sharp, 2020).
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The Sharp Healthcare system is run by an executive team headed by the President and

CEO, comprised of the directors of its facilities and board of governors. This collection of

individuals represents all of Sharp's corporate officers from all its facilities. Still, it does not

include divisional, organizational, and unit level representation to start the planning phase of the

strategic plan. To continue with the process, a representative from each division and the

organizational unit must be identified and urged to participate in the planning. Once all the

planning team members have been identified, they must have complete and total buy-in on the

improvement process. Additionally, they must be willing to work on the items delegated to them

and provide responses back to the committee promptly.

The Executive Team will head and layout the hospital's business strategy and provide the

needed resources to get the process completed on time. The Divisional level facilities will take

the business plan from the Executive level and apply it to the individual facility to allow the

entity to compete in the community. The Organizational level units will follow the lead from the

Divisional level facilities and apply those practices to their specialty facility. Finally, the Unit

level will support the upper levels and do whatever is required for the hospital system to work

and promote the hospital and its services to the public.

The process is expected to take approximately one year to get the entire process

implemented and have the whole workforce onboard with the new plan. My team and I have

been given full access to the Executive Team, board of directors, board of governors, Sharp

facilities, and their staff members for a complete evaluation. We will meet monthly with the

entire team to evaluate the progress of the process and redirect the planning stage's direction.

It is assumed that the Seven Pillars of Excellence will be changed in any way during this

process. These are the Sharp system's building blocks, and everything they do derives from the
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pillars. Other than that, there are no specific items that can't be put into play for renewing or

changing.

Step Two: Doing the Homework

The general impression of Sharp Chula Vista from the focus groups is their dedication to

providing the best medical care possible and improving the health of those they serve. The

organization echoes that sentiment as they proceed in their daily duties and roles in each of its

facilities. This mantra is part of its seven pillars of excellence and is a way of life if you work for

Sharp Healthcare. The organizations' primary strength is its willingness to incorporate change

and innovation throughout the facilities to improve patient outcomes (See Table 1). Sharp

promotes a community of change, and it has permeated the entire Sharp Healthcare organization

from the CEO down to the environmental services personnel in all its facilities. It does help that

most of Sharp Chula Vista's employees live in the community they serve, so there is a sense of

ownership and dedication to the facility. This dedication to Sharp Chula Vista has catapulted its

hold on the majority market share of healthcare in south bay. The opening of the new

technology forward tower with single-person rooms has made Sharp Chula Vista an even more

desirable facility to get their medical treatment.

Although Sharp Chula Vista opened its new tower, it still has some facility deficiencies

that it must overcome. Sharp Chula Vistas main hospital and original tower are aging structures

and failed the last state seismic safety inspection. Sharp Chula Vista has until 2025 to meet these

retrofitting requirements, but this would be just one of its weaknesses. The next would be Sharps

snail's pace at which they are replacing antiquated equipment in some of its departments;

radiology, cardiology, E.R., and the laboratory. Their unwillingness to quickly improve these

areas leaves an opening for competitive or supporting organizations to take most of the market
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share in those departments. Due to the lack of graduates or retention, the reduction in Sharp's

nursing staff is a significant dilemma that all facilities must overcome. However, Sharps nursing

wages are one of the lowest in San Diego County, excluding Paradise Valley Hospital. The final

weakness of Sharp Chula Vista is its technology, primarily internet connectivity for patients and

staff members. Sharp has limited availability for remote access to medical records and

appointment-making ability. This is a highly desired capability desired by all healthcare seekers

and providers alike.

Sharp Chula Vista has the opportunity to make changes to its facility to grab a more

significant portion of the market share in Chula Vista by improving several things. The first

would be to improve their technology by increasing their medical records and charts through

wireless services to the staff and patients and allowing patients to remotely enter changes to their

medical history and medications and remotely schedule appointments when they need them. The

next would be to increase specialty services in the facility that are or will be required by the

community due to aging. Specialties such as Cardiology, Audiology, Orthopedics, and

Nephrology would highly desire a few, to name the local stakeholders. Finally, wage increases

that competitively compete with other local healthcare organizations would help increase staff

retention and keep learned knowledge within the facility.

The immediate threat to Sharp Chula Vista derives from its ability to reimburse funds

from insurance companies, Medicaid/Medi-Cal, changes in the Affordable Care Act, and other

healthcare payee systems. With the current reduction in the average patient flow in the facility

due to COVID-19, every penny that they spent must be recaptured in reimbursements. The final

threat would be an increase in competition from other healthcare facilities in the south bay.
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Although this seems very unlikely, it is crucial that Sharp Chula Vista continues to monitor

innovation in the healthcare field and apply them when appropriate.

For Sharp Chula Vista to continue its growth in the community, it must apply some

strategies that could help keep it ahead of its competitors in healthcare. These are not all-

inclusive but just suggestions that would improve Sharp Chula Vista's growth. They are:

 Hospital Staff wage assessments

 Structural and visual improvement of the facilities

 Continuously update procedures and policies; when they are needed

Sharp Chula Vista, as stated before, is a thriving facility within the south bay, and they

are continuously improving their patient treatment procedures. Their goal is to become the

leading healthcare facility in all south bay by increasing their market share of the customers. To

do this, they must take advantage of several of the weaknesses of their competitors. Scripps and

Paradise Valley Hospitals, respectfully, lack variation in the types of inpatient specialties that

can be treated at their facility. Finally, increasing several outpatient and clinic services at Sharp

Chula Vista would increase profits and provide the funds needed to remodel the other sections of

the hospital and attached clinics.

Table 1

SWOT Analysis

Internal Factors External Factors

Strengths: Opportunities:

 Recognized Culture of Excellence  Innovation in Technology

 Newly opened tower  Increase Specialty Services
Positives  Long history in the community  Competitive pay for employees
 MAGNET Status
 High-Reliability Organization
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 Stroke Center
 Improved Cardiology Center
 Staff dedication to the community

Weakness: Threats:

 Not earthquake retrofitted/aging  Increased competition from other

buildings
Negative  Antiquated equipment throughout
s the old building
 Potential reduction in nursing staff
due to aging, choosing the
profession, or retention
 Technology
healthcare organizations
 Changes in insurance payees
 Reduction in Medicaid/Medi-Cal
reimbursements
 Continued COVID-19 Pandemic

Step Three: Describe Your Culture

Institutional Business Plan:

Sharp Chula Vista Healthcare is a nonprofit organization that focuses on improving the

community's health that they serve with a commitment to excellent healthcare in all that they do.

Because it is a nonprofit, all its resources are dedicated to delivering the highest quality of

patient-centered care, the latest medical technology, and superior service.

Institutional purpose:

Their purpose in healthcare is rooted in the belief that they do more than care for the

community; they are a part of it. Their goal is to continue offering quality care and serves that

set community standards, exceeds patient's expectations, and are provided in a caring,

convenient, cost-effective, and accessible manner.

Institutional values:

The company's core values of integrity, caring, safety, innovation, and excellence are

important to them personally and professionally. These principles form the basis of every

interaction they have with patients, family members, and San Diego people. Without these
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values, Sharp Chula Vista as an organization would be indistinguishable from any other

healthcare facility in San Diego.

Step 4: Framing the Questions: Identify the Strategic Areas

According to Ebener and Smith (2015), identifying the critical strategic areas from an

organization's SWOT is very important because it determines the crucial strategic areas to be

addressed to form a strategic plan. Each strategic area is further broken down into subheadings

that describe the strategies needed within each area to make sure that the process is fully

completed. To be strategic Sharp Chula Vista must remember that each strategic area must be

controllable, changeable, and critical to the organization's advancement in the service area. The

three strategic areas Sharp Chula Vista must address are:

Seismically Retrofitting aging buildings:

All non-seismically retrofitted buildings at Sharp Chula Vista must be retrofitted by

2025. The retrofitting makes the buildings safe and provides an opportunity for Sharp to

increase its total inpatient capacity, increasing the facility's whole revenue stream. This will be a

positive change to the community because more treatment rooms and space will accept more

customers at Sharp Chula Vista. This retrofit is an activity that is controllable by Sharp Chula

Vista Medical Center, and it will be extensive use of the available and usable land at the Chula

Vista campus.

Updating Antiquated Equipment throughout the old building:

This is a crucial change that must take place at the Chula Vista campus. Upgrading the

antiquated equipment and amenities; in the patient rooms, laboratory and radiology allows Sharp

Chula Vista to step into the new millennium. Updating the rooms and equipment would show

the customers that Sharp is genuinely committed to patient care and comfort by providing the
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latest and greatest technology in every patient care space. These upgrades are controllable

activities that Sharp can take on slowly or as fast as they'd like.

Technology:

Upgrading Sharp Chula Vista's technology infrastructure should have been updated

gradually while upgrading other facility sections. This is another crucial upgrade for the facility;

it enables the patients and staff to access the electronic health record system via personal

handheld devices or landline-connected devices to update or schedule appointments. This

additional point of access will allow for a more seamless means for patients and healthcare

providers alike to gain access to the healthcare system to provide the healthcare Share Chula

Vista is hoping to provide in the future. This change in access to patient care would be a positive

change that would thrust them into the future of healthcare.

Step 5 and 6: Answer the Questions and Get Specific

As outlined in the SWOT report, Sharp Chula Vista has three strategic goals that must be

addressed to meet the desires of the growing digitally savvy potential customers in the Chula

Vista service area. Strategically tackling these deficiencies by developing decisive actions could

substantially boost Sharp Chula Vista's future financial growth in the south bay.

Sharp Chula Vista's strategic goals and action plans are:

Strategic Goal #1: Seismic Retrofitting

Strategy: To redesign, restructure, and retrofit the old 5-story tower to improve the room
layout, update the utilities, and meet the California Seismic Safety Law by 2030.

Action Step #1 Action Step #2 Action Step #3

Analysis and evaluation of
the 5-story tower will be
conducted by the CEO, the
Executive Team, Strategic
Planning Team. As well as a
designated Seismic
Retrofitting of the building
will begin after the Seismic
Compliance Team has
developed the plan and how
to do it. The method and
process will not be carried out
Remolding of the internal
spaces will begin after
approval and completion of
the seismic retrofitting and
the updating of all internal
utilities (hospital gases,

Compliance Team. The
Seismic Compliance Team
will include a hired structural
engineer firm, Sharp Chula
Vista Engineering, and an
interior design firm. The
team will visualize the
structure and review the
California Seismic Safety
Law to determine what is
needed to comply with the
law. The team will be given
12 months to develop a
retrofitting plan for the tower
and a redesigned layout for
each floor for patient care,
office space, and utility
rooms. The CEO and the
Executive will be responsible
for collecting the funds
needed to proceed with the
improvements.
Strategic Goal #2: Update Antiquated Equipment
Strategy: To upgrade all radiology, laboratory, and auxiliary patient care equipment to the
latest safest technology to reduce injury to customers.
Action Step #1
Radiology, Laboratory,
Respiratory, and Biomed will
develop a list of equipment
needed to replace any devices
that have exceeded their life
expectancy and are
considered obsolete. Each
department will write up a
needs-based request with
justification for each piece of
equipment needing
replacement. Finally, a cost
analysis for each piece of
replacement equipment will
be compiled, comparing the
prices from two vendors.
This information will then be
until the executive team has
approved it of Sharp Chula
Vista. The team will be given
eighteen months to complete
the entire retrofitting process.
The Seismic Compliance
Team will report to the CEO,
the Executive Team, and the
Strategic Planning Team
monthly with progress reports
and earlier if there are any
delays in the project. The
designated date to start the
retrofit will be determined
after the Sharp Organization
has secured funding. All
departments have been
moved elsewhere, and all
patients located in the old
tower have been relocated to
the new OVT Tower.
Action Step #2
Once the CEO and the
Executive Team (Sharp
Organization) approves the
plan to upgrade the
equipment. Each department
will reach out to their
individual Purchasing
Department representative to
start the development of the
purchasing agreement with
the two competing vendors.
The purchasing department
will deal directly with the
vendors and determine which
one falls in lines with Sharp
Chula Vista's budget and
inline with the needs of the
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electrical wiring, plumbing,
phone, alarms, patient
communication system,
etc.…) and installation of the
exterior walls per floor. The
redesign team will be given
12 months to install the room
design plan for all five floors
in the tower. They will report
to the CEO, Executive Team,
and Strategic Planning Team
every month on the project's
progress and earlier for any
delays that they may incur
during implementation.
Action Step #3
Prior to equipment arrival:
Engineering will verify that
all the necessary electrical
connections and placement
requirements are made for
installation. Engineering and
Biomed will also be setting
up the removal and the
disposal of all the old
equipment.
Installation will be done one
piece of equipment at a time
once they have been certified
and checked by Biomed.
Engineering, Biomed and

presented to the Strategic
Planning Team at a
designated time and date for
review. The Strategic
Planning Team will then
present this information to the
CEO and The Executive
Board for approval and
direction on how to proceed
with the upgrades. The
departments will be given 3
months' notice to develop the
list and to provide an accurate
account of the department's
needs. The budget and
funding for the upgrades will
be handled by the CEO and
the Executive Team.
Strategic Goal #3: Technology
Strategy: To upgrade the campus' wireless infrastructure to provide wireless access to the
electronic health records by staff and patients via wireless computers and personal handheld
devices. This upgrade of technology will also offer patient's the capability to self-schedule
and check-in to appointments at the facility via handheld devices or kiosk.
Acton Step #1
The Strategic Planning Team
will designate members from
the Admissions Department,
Engineering, Informatics, and
I.T. Department to establish
the Wireless Infrastructure
Team (WIT). This will be
done at the direction of the
CEO and The Executive
Board only. The WIT team
will evaluate the entire
campus, complete a wireless
needs analysis, and present
requesting department. Once
a decision has been made, the
vendor and the department
will be notified, and the
equipment will be purchased
(or leased, whatever is or was
agreed upon).
Engineering and Biomed will
also be notified before
purchasing the equipment to
ensure it can be supported by
Sharp Chula Vista's electrical
system and Biomed personnel
for maintenance.
Purchasing will keep the
Strategic Planning Team
abreast each month of all
equipment ordered and those
received as they arrive and
are paid for.
Action Step #2
The WIT team will develop a
plan that explains where,
how, when and what is
needed to start the
installation. They will
provide to the Purchasing
Department a complete list of
possible vendors, needed
equipment from each vendor
and an itemized price listing.
The Purchasing Department
will contact each vendor and
determine which vendor fits
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each department will setup an
installation plan prior to the
equipment arrival. That
schedule will be coordinated
with the Strategic Planning
Team and implemented with
patient care in mind.
After installation is
completed and it is
determined that all the
equipment is operating
appropriately. The CEO and
the Executive Team will be
notified of the status for this
strategy to be marked as
completed.
The time allocated for
installation will be
determined by the speed at
which the equipment is
delivered and available for
installation.
Action Step #3
The installation plan is put
into action by the WIT team.
The WIT team will keep the
Strategic Planning team
informed of the status of
installation monthly and
earlier if there are issues that
may delay the installation.
The installation of the
technology, application
testing and testing of all of
the hardwire should take
approximately twelve months
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their findings to the CEO,
Executive Committee, and
Strategic Planning Team.
The WIT team will be given
three months to complete
their survey and recommend
how to upgrade the facility.
The CEO and the Executive
Committee will be
responsible for acquiring the
funding for the installation,
and the Strategic Planning
Team will monitor the
progress of the installation.
With monthly reports
provided by the WIT Team in
their monthly Strategic
Planning Meeting.
the needs of Sharp. The
vendor is selected, and the
WIT Team will begin
planning the installation after
informing the leadership.
They will let the WIT team
know when it is appropriate
to proceed and when funding
is available. The Purchasing
Department will draw up the
purchasing agreement then
pay them to begin the
process.
to be completely integrated.
If additional time is required,
it will be approved by the
CEO and the Executive
Committee.
Once the installation is
completed, tested and
working correctly the CEO,
the Executive Committee,
and Strategic Planning Team
will be notified, and the
strategy will be removed
from the list.

Step Seven: Discovering the Vision

Sharp Chula Vista Medical Center has begun the rigorous chore of expanding its' footprint by

building a new five-floor inpatient tower. This endeavor also afforded them the ability to

increase their facility work, inpatient and outpatient care spaces. Sharp Chula Vista has devoted

a substantial amount of its financial resources to improve this facility by looking into the future.

These improvements in the facility and an increase in the service areas will ensure Sharp Chula

Vista can continue to accommodate the needs of the growing aging community. Our vision for

Sharp Chula Vista is to:

 Retrofit the old five-story tower and transform it into a thriving inpatient and outpatient

care space desired by the community.

 We aim to upgrade all our radiology, laboratory, and ancillary patient testing equipment

to the current leading-edge available in healthcare.

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 We will increase our patients, customers, and staff's ability to access our electronic health

records by installing a technically advanced wireless network system.

These improvements will ensure Sharp Chula Vista will continuously meet the growing needs of

its' community. Sharp Healthcare is a leader in innovation and change within the healthcare

system in San Diego County. By 2030, Sharp Chula Vista will have completed all necessary

improvements and will be able to officially say that they are the best place to work, practice

medicine, and to receive care.

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References

Ebener, D.R. & Smith, F.L. (2015). STRATEGIC PLANNING: An Interactive Process for

Leaders. Paulist Press.

Ginter, P.M., Duncan, W.J. & Swayne, L.E. (2018). STRATEGIC MANAGEMENT OF HEALTH

CARE ORGANIZATIONS (8th ed.). John Wiley & Sons, Inc.

Seismic Performance Rating: SPC/NPC Ratings of Acute Care Hospital Buildings. (2020).

https://oshpd.ca.gov/ml/v1/resources/document?rs:path=/Construction-

Finance/Documents/Seismic-Compliance/SPC-NPC-Ratings-List.pdf

Sharp Healthcare. (2020). https://www.sharp.com/about/our-story/mission-vision-values.cfm

State of California Seismic Compliance and Safety. (2020).

https://oshpd.ca.gov/construction-finance/seismic-compliance-and-safety/