TRG supported an academic medical center in Kentucky in developing and implementing strategic and operational initiatives designed to revitalize its role in the regional marketplace, while improving its ability to serve its urban population base. TRG’s work resulted in the following:

• Creation of a new faculty practice organization, including restructuring of the hospital-based clinics.
• Realignment of the ambulatory care strategies of the Hospital and Faculty Practice.
• Development of an incentive structure to support the substantially improved performance of ambulatory care.
• Restructuring of the relationship of the Hospital and Medical School with regard to ancillary services.
• Development of the methodology for reallocation of education and clinical funds, restructuring the flow of funds between the Hospital, Medical School and Medical Departments.
• Conversion of the Hospital and Medical School from a position of annual subsidy to a position of economic viability.
• Development of the corporate governance and management structures for the organization.
• Identification of opportunities for improvement in the System’s non-labor and materials management expenditures.

• Development of a strategic plan and specific initiatives designed to demonstrate the value of the medical center to the State of Connecticut
• Strategic positioning of the clinical enterprise to align with the priorities of the Medical Group and Schools of Medicine and Dental Medicine
• Medical staff development and business and financial/resource plans to support the medical center’s strategic initiatives in cardiology, neuroscience, orthopedics, and primary care services
• Reorganization of the management of ambulatory care and recruitment of the executive for ambulatory operations
• Reallocation and re-budgeting of the funds flow for the entire medical center
• Operational improvement plan that resulted in sustained annual improvements of more than $20M.  The medical center transformed itself from an annual deficit of more than $16 million to a positive margin of more than $4 million.

TRG worked with a Texas medical center to conduct comprehensive planning for the development of a new 250-300 bed teaching hospital. TRG’s work included:

• Working with leadership to develop a model for the character of the new hospital (e.g., vision, mission, goals)
• Developing a clinical program plan including identification of the services to be provided by the hospital and the projected inpatient and outpatient volumes
• Supporting an assessment of the strategic and financial feasibility of the new facility and its associated success factors (e.g., critical volumes, capital requirements, etc.)
• Identifying the equipment requirements for the new facility
• Developing a comprehensive functional and space program for the new hospital, including identification of appropriate non-revenue producing/support services, bed projections/inpatient support services, a departmental space plan, a model for patient and work flow, and an estimation of square footage requirements, parking requirements, and land/site requirements
• Developing a financial model for the new facility, including identification of the key underlying assumptions and associated implications
• Developing a pre-opening operations plan which addressed human resources, equipment, IT, medical staff organization, supplies, and hospital departmental policies and procedures

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