• An assessment of the financial condition of the Hospital, an estimation of the size of the hospital’s need for financial improvement, scenarios related to internally generated financial improvements, alternative capital funding sources, and alternative clinical configurations and service development initiatives.
• Financial projections and review of the implications related to the cost of an organized closure and bankruptcy of the hospital.
• Identification of opportunities for financial improvement and rationalization of services, both for the Hospital as an independent entity and in a relationship with a local healthcare system.
• Development of a comprehensive business plan related to clinical configuration and market development initiatives, including specific growth initiatives that would transform the Hospital into a viable healthcare enterprise.
• Specific tactical plans for clinical volume and medical staff development in key service lines.
• A plan for faculty–community physician integration.
• A plan for the rationalization of clinical services and service line discontinuation.
• Capital from the State to bridge the Hospital’s immediate funding needs and additional capital to support the Hospital’s long-term business plan initiatives.
  
  

TRG assisted a Connecticut academic medical center in an operational performance improvement initiative and financial turnaround, which resulted in:

• Reorganization of the management of ambulatory care and recruitment of the executive for ambulatory operations.
• Greater alignment of economic interests and the flow of funds among the Hospital, the Faculty Practice, and the School of Medicine.
• Sustained annual operational improvements of more than $20 million.
• Significant financial improvement, from an annual deficit of more than $16 million to a positive margin of more than $4 million.
• Better than break even performance for 3 years running.
• Increased internal capital and State funds to remain competitive and independent.

TRG conducted an assessment of the effectiveness of and opportunities for improvement in the manner in which a Minnesota hospital utilized its CRNA resources. TRG’s assessment led to the following changes within the hospital:

• Creation of a Department of Anesthesia, which incorporates CRNA’s and MDA’s.
• Establishment of clear reporting relationships and accountability for anesthesia issues in the operating rooms.
• Creation of a single point of contact to improve communication for managing anesthesia resources.
• Integration of the Department of Anesthesia into the existing operating room governance structure.
• Greater surgical capacity without increasing CRNA resources.
• Establishment of standards for operating room performance and CRNA productivity.