Download STRATEGIC PLAN for The Midwife Center for Birth

STRATEGIC PLAN for The Midwife Center for Birth & Women’s Health 2007. Updated 2012.
Midwife Center Mission
The Midwife Center provides exceptional woman-centered pregnancy, birth, and well-woman care in southwestern Pennsylvania’s only independent birth
center.
Midwife Center Vision
The Midwife Center (TMC) will provide exceptional, personalized, woman-centered care to a large, diverse clientele while also conducting extensive
advocacy and education. Recognized for providing the highest quality care, TMC will participate in research, provide midwifery education to future
providers, and advocate for improved midwifery regulations and reimbursements. These activities will further the field of midwifery and meet the
growing demand for midwifery services.
Operating Model and Philosophy
 Women and families are active participants in their care at The Midwife Center (TMC). Midwifery care maximizes birth’s potential as a peak
experience for the family by stressing education and personal responsibility of all family members.
 Our staff recognizes that pregnancy, childbirth, and maturation are normal life processes, in which a provider should not intervene without
evidence of a problem.
 TMC maintains licensure, accreditation, and a program of quality assurance for our practice and facility. Our practice is based on the most
current medical knowledge and our model of care fosters continual improvement to our clients’ care.
 TMC’s midwives provide care in accordance with the American College of Nurse Midwives Standards and Code of Ethics.
 TMC recognizes that birth is a powerful and life-changing experience. We provide a trusting, private, and respectful environment for our clients
to be empowered and celebrated.
 TMC provides postpartum support with emphasis on establishing successful breastfeeding.
 The highest standard of care is achieved when certified nurse-midwives are first line care providers in collaboration with excellent physicians and
other area service providers.
 We provide care and education to women of all ages, races, sexual orientations, religions, and socioeconomic status.
 We believe that birth centers are part of the solution to the nation’s crisis in rising rates of unnecessary c-sections and increased infant mortality.
 Each exchange with the health care system should leave the consumer more knowledgeable about maintaining and maximizing one’s health. To
that end, TMC offers education during appointments and classes at the center and in the community.
 Excellent care is best achieved with a financially secure center and a stable, high-quality staff. To this end, TMC combines careful business
practices with fundraising to implement new programs, keep services available to all, and to improve our facility to best serve our clients.
 TMC educates the broader community and maintains a dialogue with policy-makers about the unique benefits of midwifery and birth center care
in order to maintain and increase accessibility to midwifery and birth center services.
 TMC educates future CNM’s and RN’s in the birth center model of care, and participates in research, as appropriate, to further the field of
midwifery and ensure access to birth center care in the future.
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Midwife Center Strategic Priorities
Long-Term (10 years)
 Continue to serve a culturally and economically diverse clientele, while maintaining the agency’s financial well-being
 Continue to improve the quality of care, including both adequate staffing and educational resources to ensure the retention of highquality staff, as well as operational improvements with technology and the physical facility
 Position The Midwife Center as a first-choice women’s health care facility that is both highly-regarded and respected by local providers ,
policy-makers and the public at large
 Develop alliances with major Pittsburgh hospitals to provide or supplement their midwifery services and encourage collaboration with
TMC instead of investing in additional midwife facilities
 Changed as of January 2012 Board Retreat to: Continue to partner with hospitals, family practice residency and nursing school programs
to teach upcoming health professionals about the benefits of midwifery and birth center care and while providing training opportunities at
TMC and advocating for more educational programs for midwifery.
Phase I (2008 - 2011) Completed as of 2011
 Building and Technology
 Staffing Model and Compensation
 Advocacy and Awareness
Phase II (2012 – 2015?)
 Staffing model to accommodate growth
 Building expansion to accommodate growth
 Plan for long-term financial stability for TMC
 Fundraising plan for the above
Midwife Center Business Plan:
The Midwife Center (TMC) has outlined five services lines that currently comprise its business model:
Childbirth services, and more specifically birth center births, are the key economic driver to TMC’s business model. These services provide the largest
profit for the organization, as well as providing for mission delivery though women-centered pregnancy and birth care. Attracting more clients for birth
center births, as well as encouraging more clients to choose a BC birth is of primary importance for the sustainability and growth of TMC. In order to
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accomplish this, comprehensive market research and a marketing plan need to be developed and enacted, including developing methods for midwives to
promote the BC birth option to tentative clients.
Well-Woman services are needed services to grow TMC client base as well as to serve the organization’s mission; and are most cost effective when
provided by a Nurse Practitioner. It is important to always have a clear analysis of both insured and uninsured/underinsured clients to determine the cost
of serving each type of client for financial and staffing planning.
Client education services are taught by TMC professional staff, with an emphasis on offering classes that increase the likelihood of clients having births in
the birth center. Additionally, planning for this service line will include market expansion beyond TMC clients, as well as infrastructure needs.
While professional education offerings are needed and necessary to fulfill the mission and vision of TMC, there is currently no direct financial benefit to
providing such programs, although there has been a demonstrated benefit for attracting staff to TMC. Professional education will be focused on providing
lectures at area hospitals, serving as a site for student nurses, midwives and other health professionals. The Ruth Stifel Fellowship will serve as our
primary professional education program as it is a cost effective way to staff for growth and also contributes to the future of our birth center and others
across the country.
Advocacy efforts will be pursued as long as there is funding available and outcomes realized from these efforts, with a focus on joining our sister state and
national organizations to improve regulations and legislation for midwives and birth centers. A fundamental part of TMC’s vision, advocacy is necessary
for the continued functioning of both the birth center and the practice. Funds for these efforts must be strategically placed and traction in pursuit of our
outcomes regularly monitored.
Three goals have been identified to achieve the three strategic priorities of the Phase II Business Plan:
1. Plan for staffing and facility needs to accommodate growth
a. Develop, fund and implement relevant staffing and compensation model to accommodate growth up to 500 births a year
b. Develop a plan for space needs to accommodate growth up to 500 births a year
2. Ensure long term financial stability of TMC
a. Create plan for clearly identifying financial impact of each service line (Carried over from last Business Plan):
i. Include revenues and expenses generated from each operation
ii. Create regular financial reports outlining position of each unit
b. Analyze costs and reimbursements from Bubbe Hannah programs including Adagio and identify current funding gaps
c. Maximize reimbursements for all service lines
3. Fundraising
a. Develop a fundraising strategy to finance the following:
i. Marketing Plan
ii. Programs of the Bubbe Hannah Fund
iii. Fellowship and other Professional Education activities
iv. Expansion
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The following summarizes the specific objectives of each of the three goals above and how they will be achieved.
Goal 1a: Develop, fund and implement relevant staffing and compensation model to accommodate growth up to 500 births a year.
Objective
Data Elements
Increase salaried
nursing staff to give
more tasks to
increase client
contact, satisfaction
and organizational
efficiency
Continue to increase
compensation to be
competitive
List of possible
tasks from staff
and potential
reimbursements
Cultivate diverse
recruitment strategy
reach number goals
and to meet mission
2008 business
plan
“2013 Goals to
Reach”
Birth Center and
United Way
Wage and
Benefits Surveys
Responsible
Persons
Ann, Cheryl,
Christine
Christine, Ann,
Chris
Operations
Committee
Process
Timeline
Outcomes
Tasks identified
& approval for hiring
March Board
meeting
Done
Implementation
By Summer 2012
Complete goal for
CNMs
ED, OM, and RNs
Compare TMC salaries
and compensation to
other birth centers and
United Way Wage and
Benefits Survey
By 2013 budget
Decisions
Evaluation
August
By 2016 budget
Ongoing
Q3 or before next
hire
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Staffing Plan up to
420 births – see
below*
Midwife time
studies
AABC and ACNM
staffing
guidelines
Staffing Plan up to
500 births – see
below**
Develop plan for
Centering Pregnancy
for long-term staffing
/service strategy
Continue to ensure
adequate funds for
professional
development for
entire staff
Same as above
Ann
Develop staffing
models using the
fellowship and
increasing PT CNMs
before hiring another
permanent midwife
Q2
Ann
Bayer Center and
other resources
for admin.
ACNM, AABC, and
others for clinical
staff
July
Christine, Ann,
Chris
2013
Ensure adequate
funding in budget
every year
Requirements for staff
to take advantage of
trainings
Ongoing
* Current FTE with TS doing .1 administrative = 4.2 FTE
1. Capacity based on 7 births per month per midwife and 4.2 Clinical FTE midwives
2. With fellow for 9 months: 4.2 FTE + .75 FTE = 4.95 FTE
3. With fellow & 3 mos. w/ fellow appts, increase PT CNM, decrease CNM GYN, & RN or NP do PP visit =5.2 FTE
= 353 births yr
= 416
= 437
**Increased CNM with current FTE 7 births per month per midwife configuration
1. Capacity based on 7 births per month per midwife and 5.2 (increase PT CNMS to FT) clinical midwives
2. With fellow for 9 months: 5.2 FTE + .75 FTE = 5.95 FTE
3. 3. With fellow & 3 mos. w/ fellow appts, increase PT CNM, decrease CNM GYN, & RN or NP do PP visit =6.2 FTE
= 436.8
= 499.8
= 520.8
OR
** Increased CNM with lower births per FTE to accommodate more births IF percentage of call worked goes above current FTE configuration
1. Capacity based on 6.5 births per month per midwife and 6 (increase some PT CNMs plus hire 1 FTE) clinical FTE CNMs= 468 births/yr
2. With fellow for 9 months: 6 FTE + .75 FTE = 6.75 FTE
= 526.5
3. With fellow & 3 months w/ fellow appts, decrease CNM GYN, & have RN or NP do PP visit = 7 FTE
= 546
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Add 1 FTE Billing/Client Service Assistant (when more appointments are added to the schedule outside of current hours)
(Anticipated income for births over #1 with each scenario would go towards funding the fellow. Ideally, births should cover about 50% of the cost of
the fellow, with fundraising to cover the remaining).
Goal 2b: Identify space needs to accommodate growth up to 500 births a year
Objective
Data Elements
Responsible
Process
Persons
ID Needs
Survey staff and
Christine and
other birth centers Chris
Short term for
Contact facilities in Christine
classes
area for
possibilities
Plan for exam rooms
before expansion is
complete
Appt. schedule
Staff availability
Ann, Christine
Long term
considerations for
expansion
Cost estimates
Staff survey
Other birth centers
Ann,
Christine,
Chris
Jason
Facility needs for
420 and 500 births
Acquire Lot
Student plans
Current avg. $ per
sq foot
Consider additional
services; otherwise
plan should be
sufficient for 500
Research comps in
area
Campaign
readiness survey
Survey providers and
front office staff for
who could work
outside currently
scheduled hours
Timeline
Done – Q1
2012
Done – 4.12
Outcomes
Decisions
Evaluation
PBT for most of
CBE, BF, and
possibly some
Refresher
When we
need to
increase
clinical FTE
beyond
current
Q2
Q2
Q2
Christine,
Chris, Board
Determine financial
and fundraising
capabilities
Q2
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Goal 2: Ensure long-term financial stability of TMC
Goal 2a. Implement financial strategies for responsible growth
Objective
Maintain a cash
reserve of at least 1
½ times one month
of operating
expenses
Reduce construction
debt loans
Identify financial
impact of each
service line - Include
revenues and
expenses generated
from each service
line
Analyze costs and
reimbursements
from Bubbe Hannah
programs including
Adagio and identify
current funding
gaps
Create regular
financial reports
outlining position of
each unit
Data Elements
Responsible
Persons
Chris
Chris
Chris
Process
Timeline
Outcomes
Q1 and
ongoing
Done
$20K by end
of 2012
All of 2nd loan
by end of
2013
Q2
$10K paid
down in Q1
2012
Chris and
Christine
Q3
Chris
Ongoing after
Q2
Decisions
Evaluation
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Consider impact of
insurance and
hospital
environment
Continue to
improve insurance
contracts
TMC client roster
Chris and
Christine
Analysis of TMC
client insurance and
Pgh market
Chris
Ongoing
Ongoing
Goal2b: Develop a fundraising strategy to finance the following
Objective
Data Elements
Responsible
Persons
Expansion
See above
Fundraising
Committee
“
“
Fellowship
Professional
Education
Programs of Bubbe
Hannah Fund
Marketing
Campaign
Determine
Campaign
readiness
Timeline
Outcomes
Decisions
Evaluation
Q3
“
“
Organizational
Assessments
Plan to increase
“treasure” and
diversity of board
Past effect on FR
operating
Readiness Survey
Plan for next
capital campaign
Process
Costs of above
Christine and
Board Devel.
Committee
Review to ID
weaknesses
Analysis of donations
during Beg. Camp.
Q2
Q1
Q2
Weaknesses
assigned to
committees
to address
Christine
Fundraising
Committee
Fundraising
Committee
Q3
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