Affiliation Structure Worksheet (Assignment 4)
Instructions:
Use this worksheet to gather information needed to complete the assessment, the Affiliation
Recommendation.
Helpful resources:
“How to Make the Strategic Partnering Decision”
“Choosing the Right Affiliation Structure”
“Model Affiliation Agreement”
Organizational Plan
1. Establish governance structure. How will the new organization/affiliation be
structured?
Since both Intermountain and TPMC have similar governance structures, this aspect
should be fairly simple. Both entities will continue to have separate governance with
individuals from the community and individuals from each entities board of trustees to
form a third party governing entity. This entity with be the integrative committee board.
A. The integrative committee board will be responsible for:
Maintaining a collaborative relationship between both parties
Creating solutions for issues that arise and discussing them with both parties
The board will consist of 6 members, two from each party and 2 individuals
from the community
One individual will be the chair of the board and this will rotate annually
The board is responsible for ensuring all parties involved in this agreement
adhere to the agreement.
B. To ensure data is being used appropriately, the data sharing committee will:
Consist of 3 individuals- 2 from each party and one from the community
Ensuring and maintaining the privacy of patients
Deciding what data is useful and what data does not need to be shared
2. Strategy. Describe the overarching vision and mission of the affiliation.
The mission is to continue to provide the best care through integrated clinical practice,
education and research. This involves helping people lives the best lives possible.
The vision is to provide the best quality care at an affordable cost, while ensuring the
needs of the community are met.
3. Sources and resources. How will people and financial resources be allocated to
accomplish these goals?
1
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, TPMC employees will be encouraged to continue providing assistance to patients
whenever deemed necessary, as well as to monitor and provide feedback based on
patient experience. The ability for TPMC to provide the best care requires that specialties
provided by Intermountain are also offered at TPMC. Additional staff will be hired and
trained in the specialties that TPMC does not currently offer, especially relating to
endocrinology, internal medicine, and diabetes prevention. TPMC will follow the
procedures Intermountain currently has relating to community outreach. This will involve
TPMC hiring or allocating current employees to be responsible for certain aspects of the
procedures for this.
As long as TPMC has the financial ability to cover the costs needed to add additional
specialties and the employees needed for them, they will be the main source for funding.
However, TPMC will likely need financial assistance from Intermountain and will also help
Intermountain financially in the future if needed. Any excess funding generated may be
contributed toward community outreach.
4. Accountable processes. Who will be assigned accountability to ensure completion of
the specified goals?
The executive board will be responsible for completion of the specified goals. This board
will consist of the CEO and COO of both TPMC and Intermountain.
5. Measurement of success. How will success be measured?
Success will be measured by 4 phases. Phase I will include discussing the procedures and
policies needed to be prepared for the new specialties that will be added to TPMC, as well
as allocating who goes where. This phase also includes mapping and planning what
clinical spaces will be used for the new specialties. Phase II includes hiring the necessary
staff and training the current staff that will be relocated to the other specialties. This
phase also includes preparing the clinical space to be used. Phase III includes ensuring all
staff are trained and ready for the new specialties in regards to how they will work. This
time will also be used to begin scheduling patients for the new specialties. Phase IV
involves adding the new and trained staff to the new clinic specialties and beginning
treating patients in the new specialties, while monitoring the integration. With each
phase that is completed, success will be increased. Success will also be measured via
patient satisfaction surveys, and employee satisfaction/feedback surveys.
6. Communication plan. Develop a communication plan to proactively mitigate potential
risk points, such as miscommunication and negativity surrounding the affiliation. Include
responsible parties, stakeholders, and time frame.
Each party will be contacted with updates weekly. The integrative committee board and
the CEO/COO will be responsible for monitoring the progress. Department managers and
clinic managers will be met with weekly to discuss any issues or concerns that arise, as
well as their feedback relating to any recommendations to make the process run more
smoothly. Intermountain will be contacted with a weekly report of any updates or
concerns that are communicated. The integrative committee board will also be
responsible for proactively searching for possible risk points and providing remedies for
the risk points discovered.
Leadership Plan
2
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Instructions:
Use this worksheet to gather information needed to complete the assessment, the Affiliation
Recommendation.
Helpful resources:
“How to Make the Strategic Partnering Decision”
“Choosing the Right Affiliation Structure”
“Model Affiliation Agreement”
Organizational Plan
1. Establish governance structure. How will the new organization/affiliation be
structured?
Since both Intermountain and TPMC have similar governance structures, this aspect
should be fairly simple. Both entities will continue to have separate governance with
individuals from the community and individuals from each entities board of trustees to
form a third party governing entity. This entity with be the integrative committee board.
A. The integrative committee board will be responsible for:
Maintaining a collaborative relationship between both parties
Creating solutions for issues that arise and discussing them with both parties
The board will consist of 6 members, two from each party and 2 individuals
from the community
One individual will be the chair of the board and this will rotate annually
The board is responsible for ensuring all parties involved in this agreement
adhere to the agreement.
B. To ensure data is being used appropriately, the data sharing committee will:
Consist of 3 individuals- 2 from each party and one from the community
Ensuring and maintaining the privacy of patients
Deciding what data is useful and what data does not need to be shared
2. Strategy. Describe the overarching vision and mission of the affiliation.
The mission is to continue to provide the best care through integrated clinical practice,
education and research. This involves helping people lives the best lives possible.
The vision is to provide the best quality care at an affordable cost, while ensuring the
needs of the community are met.
3. Sources and resources. How will people and financial resources be allocated to
accomplish these goals?
1
This study source was downloaded by 100000817935606 from CourseHero.com on 01-23-2022 11:32:25 GMT -06:00
https://www.coursehero.com/file/36660317/C982-a4-affiliation-structure-worksheet-1docx/
, TPMC employees will be encouraged to continue providing assistance to patients
whenever deemed necessary, as well as to monitor and provide feedback based on
patient experience. The ability for TPMC to provide the best care requires that specialties
provided by Intermountain are also offered at TPMC. Additional staff will be hired and
trained in the specialties that TPMC does not currently offer, especially relating to
endocrinology, internal medicine, and diabetes prevention. TPMC will follow the
procedures Intermountain currently has relating to community outreach. This will involve
TPMC hiring or allocating current employees to be responsible for certain aspects of the
procedures for this.
As long as TPMC has the financial ability to cover the costs needed to add additional
specialties and the employees needed for them, they will be the main source for funding.
However, TPMC will likely need financial assistance from Intermountain and will also help
Intermountain financially in the future if needed. Any excess funding generated may be
contributed toward community outreach.
4. Accountable processes. Who will be assigned accountability to ensure completion of
the specified goals?
The executive board will be responsible for completion of the specified goals. This board
will consist of the CEO and COO of both TPMC and Intermountain.
5. Measurement of success. How will success be measured?
Success will be measured by 4 phases. Phase I will include discussing the procedures and
policies needed to be prepared for the new specialties that will be added to TPMC, as well
as allocating who goes where. This phase also includes mapping and planning what
clinical spaces will be used for the new specialties. Phase II includes hiring the necessary
staff and training the current staff that will be relocated to the other specialties. This
phase also includes preparing the clinical space to be used. Phase III includes ensuring all
staff are trained and ready for the new specialties in regards to how they will work. This
time will also be used to begin scheduling patients for the new specialties. Phase IV
involves adding the new and trained staff to the new clinic specialties and beginning
treating patients in the new specialties, while monitoring the integration. With each
phase that is completed, success will be increased. Success will also be measured via
patient satisfaction surveys, and employee satisfaction/feedback surveys.
6. Communication plan. Develop a communication plan to proactively mitigate potential
risk points, such as miscommunication and negativity surrounding the affiliation. Include
responsible parties, stakeholders, and time frame.
Each party will be contacted with updates weekly. The integrative committee board and
the CEO/COO will be responsible for monitoring the progress. Department managers and
clinic managers will be met with weekly to discuss any issues or concerns that arise, as
well as their feedback relating to any recommendations to make the process run more
smoothly. Intermountain will be contacted with a weekly report of any updates or
concerns that are communicated. The integrative committee board will also be
responsible for proactively searching for possible risk points and providing remedies for
the risk points discovered.
Leadership Plan
2
This study source was downloaded by 100000817935606 from CourseHero.com on 01-23-2022 11:32:25 GMT -06:00
https://www.coursehero.com/file/36660317/C982-a4-affiliation-structure-worksheet-1docx/
