| Overcoming The Challenges | What lies ahead for the new pediatric satellite clinic |

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Abstract
The purpose of this document is to discuss the opening of a new pediatric satellite clinic in a place of my choosing. For this document, I will be choosing Charlotte, NC; which is close to my hometown. This essay will discuss several challenges that lay ahead with this project, such as; recruiting and retaining staff; types of services and resources; building rapport with the community and surrounding counties; finances and profitability of the clinic; technology; and compliance with local, state, and federal laws and regulations. These challenges will also be further broken down and explain ways that administration can overcome these challenges so that the project is successful. Lastly, there will be a discussion on specific skills and knowledge that administration needs to utilize when opening the new clinic and to manage staff.

The decision to expand the Pediatric Community Care Center has provided other communities the chance to receive quality care close to their home. This decision also poses great risks and challenges. Overcoming these challenges will be no easy feat; however, with careful consideration and implementing the right course, this project should be a success. The new Pediatric Satellite Clinic will be located in Charlotte, North Carolina. This area has a population of around 773 thousand, with around 20% of that population being children between the ages of 0-15. Charlotte is a melting pot of individuals. Around 59% of the population is white, 33% of the population is African American, 4% is Asian, and around 8% is Hispanic or Latino. (n.a., 2012). Now that you are aware of some of Charlotte’s demographics, we are going to discuss some of the challenges with opening this clinic within this community. One of the biggest challenges that we will face with opening this new clinic is recruiting and retaining staff. This is a huge challenge in the fact that it pulls resources and takes a long time to fulfill. Not only do we need to find qualified individuals, but we also need to have a diverse workforce that meets the needs of the community. This helps with breaking down barriers such as language, cultural beliefs, and values. There is an eight step process that will be followed to recruit and retain a diverse workforce. These eight steps are listed and detailed below. 1. Clear Business Mandate
Senior executives of the company (Pediatric Community Care Center) have created a clear business mandate that diversity recruiting is a requirement which distinctly outlines measurements and objectives. HR managers have a considerable amount of their annual increase attached to efficaciously diversity hiring. This practice is measured and progress reported periodically to upper management. 2. Diversity Attached To Company Goals
Staffing diversity takes careful targets the organizations goals. Effective diversity hiring initiatives are attached to the company’s objectives of the business. Upper leaders need to: * Have a vision for diversity and grasp demographic variations within the workforce * Make sure that all levels of management buy-in with diversity and understand the need * Instruct hiring managers to interview diverse applicants and urge them to study cultural standards of diverse applicants * Give cross cultural instructing for the whole workforce. Boost retaining by fostering a diversity-friendly culture * Understand and propagate the significance of honest feedback. Assure parity and equality in job advancement * Guarantee that the company website and advertising programs show a diverse mix of individuals * Persuade upper management that the structure of the board of directors needs to mirror diversity of the population, the workforce, and the community base. 3. Planned Hiring Process
This process has to be effectively planned, successfully executed, managed, and measured. The diversity recruitment plan has to obtain feedback from all shareholders. A Diversity Staffing Advisory Committee will be established and make up of human resources managers to foster reception, resolve issues, and attain victory. Performance profiles use need to be urged. Inventive methods and resources need to be employed to entice diverse applicants; for example, train recruiters to utilize applicant research; develop methods to entice and sell multicultural applicants to the company; and expand the applicant pool- persevere on a diverse slate of applicants. The outcomes should be aligned with the company’s goals and growth. 4. Remove All Obstacles
Near the start of the process, all complications need to be removed. Barriers need to be removed directly before the actual hiring starts. Everyone that is included with the hiring process need to be aware that the company is dedicated to a diverse workforce. 5. Cultural Competence
Create and reinforce cultural competency and multicultural veneration. Cultural competency is the aptitude and skill to collaborate with diverse individuals and to manage this process. Companies that are cultural competent have a competitive edge in hiring and keeping the best talent and growing and indorsing a diverse workforce. Organizations that are conscious of diversity reap the advantages of hiring diverse applicants by gaining shares in developing ethnic markets. Cultural competence boosts market share; enriched PR; improved retention; productivity; and improves dealings with ethnic communities. Inclusive environments entice to the brightest and best candidates. 6. Cast A Broad Net
Construct a lasting bond with minority businesses and effectual recruiting companies. Network for strategic associations to ease and sustain diversity hiring; for example, proffer company residencies and scholarship, support and partake in diversity job fairs; and develop associations and alliances with diversity professionals and community organizations. 7. Timely Feedback
It is vital to give timely feedback when working with recruiting companies. Many companies are looking for the same talented individuals. Outside recruiters cannot regulate the focus, quality, or quantity of the applicants they are presenting without quick and thorough assessment of the application submitted. A no interest is intolerable. Companies that work directly with established recruiting companies often get the hires. 8. Effective Retention Program
Use the employees input to design retention programs. If diverse employees are satisfied and get the same chance as the rest of the staff, they announce this to the community, friends and family. Afterwards, diverse hiring takes off. The best recruiting happens by word of mouth. Inclusion and respect work every time. (n.a., 2003). Another challenge that we need to address with the opening of this new clinic is the type of services and resources that will be provided by the clinic. To determine the services that are going to be provided by the clinic, we need to analyze the market share of the community, what are the needs to the population? Examination of the competition in the surrounding area needs to be conducted and see what they charge for their services, that way our organization can stay competitive in the market. Looking at the areas demographics and epidemiological data, we can narrow down our services. While we want to project an image of acute care, we also need to provide services that are unique so that we can pull a larger market. This means special services that are not offered with competitors in the area. Charlotte’s demographic shows the need for services that cater to young children. Almost 30% of the population consists of children, therefore services for acute care need to be provided by the clinic. Looking at Charlotte’s epidemiological data through the DHSS website, there is also a need for substance abuse for the area. Resources and services need to be provided by the clinic to help prevent and help children who have substance abuse problems. These types of resources and services can help decrease the statistics of children who have substance abuse problems and will also decrease the number of accidents, injuries, and deaths that occur due to the abuse. Counselors and specialized physicians need to be recruited to help children who have these issues or those that are at risk. Creating these types of services and resources will help the clinic reach out more to the community and be a beacon for specialized care for their children. (RTI International SPF-SIG Contractor, 2009). The third challenge to discuss is building rapport with the community. There are many strategies that can be implemented to help get the word out about the new clinic. One strategy that will be a good implementation with our new clinic and build rapport with the community is having a mobile clinic. This will provide free of charge health care to underserved children within the community. The mobile can go to schools and neighborhoods where children who would otherwise not receive proper health care. This will get the attention of the community and build the name of the new clinic. Clinic volunteers will assist the parents of these children with the process of applying for low-cost health insurance. The ultimate goal of this is to find every child within the community a permanent medical facility by helping those families apply for health insurance. Not only will this strategy build rapport, but it will also increase our market share and initially profitability. The next challenge is ensuring profitability. Profits are heavily relied upon to compensate workers and to keep the facilities doors open. Increasing profitability takes a lot of work and strategic planning, but is achievable. Some steps to address this challenge are listed below. 1. The insurance company needs to be contacted which the facility is contracted through and request an increase in reimbursement. Many insurance companies will obey with this request because they are afraid of losing you as a provider if they refute the request. 2. Decrease the number of staff to the minimum required. Consideration of hiring staff to work PRN, in contrast to employing full time staff. 3. Increase revenue by raising the amount of patients that the clinic sees a day. Use free or low cost approaches of marketing to be sure that the public is aware that the facility is there. Make sure that the staff has business cards to give to others. 4. Raise rates of private paying patients by a small percentage. This can be a difficult balancing act because if rates are increase to much, the facility will run the risk of losing that patient. We need to be ensuring that the raise is small enough that most patients can pay for it. 5. Propose payment plans to private paying patients. Many patients do not pursue the aid of the facility for the reason that they do not have enough money to pay for treatment. By providing a payment plan, the facility will improve the overall revenue by appealing to a population of patients that would have not use the facility. 6. Use electronic charting when probable. It does need an upfront equipment cost, it can significantly decrease the overall cost of running the clinic ultimately. (Wittman, n.d.). Another challenge is IT. Technology is booming, and the healthcare industry is jumping on it. The set back to this implementation is the price tag of the systems. However, there are several ways to address this challenge and have the system installed with little or no problems. First and foremost, this is considered a ‘project’. Therefore, a project team will be devised to implement the system within the clinic. This entails that individuals within this team will need to take careful consideration on the type of system that is needed for the clinic, one that meets the demands and requirements of the facility. They also need to ensure that the system is a verified electronic medical record and meets the requirements set forth by state and federal regulations. Incremental implementation will be utilized to ensure that the staff are not overwhelmed by the transition and also ensures buy-in by all of the staff. The cost of the system will be a huge challenge. There are many government programs that are available that can assist with the upfront cost of the equipment. By taking advantage of these programs, the system can be installed so that we can increase productivity and increase our ROI. The last challenge that needs to be addressed is compliance with the regulatory agencies. There are strategies that can be implemented to address this challenge and keep the clinic in compliance with the various regulatory agencies. These are going to be listed below. 1. Standardize practices- Standardizing approaches, sharing best practices, and benchmarking can help facilities stay compliant. Standardizing processes and sharing best practices help make sure system-wide devotion to safe and effective care. Benchmarking lets facilities to assess themselves with comparable organizations, which can offer perception into what the organization does well and what needs development. 2. Make a compliance program- Leaders within the organization need to measure the company’s existing regulatory environment as part of creating a compliance program. A compliance program can comprise of an internal system of monitoring and auditing that sets up leaders for regulatory agencies’ audits and recognizes areas of development. One of the most significant parts of mixing compliance into the company’s culture and business practices is being transparent with the medical staff, board, and employees. Hospital leaders can also mix compliance into the company culture through education. Leaders need to stress the significance of honesty to staff to help better consciousness of the meaning of compliance. 3. Build appropriate infrastructure- Create a team of in-house experts on regulations and appoint compliance officers within different departments. In addition to compliance committee, compliance workgroups are used and meet bi-monthly to discuss new regulations. The visibility of compliance efforts, officers, and training can help establish compliance as part of the culture and business practices of the facility.\ 4. Access appropriate resources- An effective strategy for meeting regulatory requirements is having sufficient resources, including incident management and tracking systems, periodicals and reference materials for education as well as seminars and conferences trainings. Networking through seminars and conferences provides a benchmark that helps the facility track its progress. Important resources for managing regulatory issues also include people. Access to internal and external counsel who has sufficient subject matter expertise is a significant resource for the health system. Knowledge of STARK, HIPAA, and language in clinical trials billing and Medicare reimbursement takes time to acquire. Multidisciplinary committees are another important resource that helps leaders gain different perspectives on regulatory issues and potential strategies. (Rodak, 2011). The role of the administrator is demanding and complex, therefore having a professional development plans helps to prioritize areas for professional growth. Below are skills, knowledge, and information that will aid in accomplishing diverse tasks.
Knowledge-
* Community needs * How to build and support the community * Grant information * Resources available * State and local laws, state licensing, and local codes * Management systems and methods * Staff development * Monitoring, self-assessment, and community assessment
Information
* Working with diverse populations * Coaching and mentoring * How to develop systems * How to empower and motivate teams * Legislation and regulation
Skills
* Ability to delegate * Problem-solving and conflict resolution * Leadership * Time management * Ability to set goals and create goals to meet them * Networking. (DHSS, n.d.). There are many challenges when starting a new practice, but being able to address those challenges effectively and efficiently can make the new clinic a success. By ignoring the challenges will only lead to poor business practices and failure of the clinic. Utilizing the skills, information, and knowledge of an administrator; these challenges can be overcome and a successful pediatric clinic can be possible to the community.

References
DHSS. (n.d.). Knowledge, Information, and Skills Needed. Retrieved from http://eclkc.ohs.acf.hhs.gov/hslc/tta- system/operations/Management%20and%20Administration/Human%20Resources/Leade rship%20%26%20Supervision/KnowledgeInform.htm
(n.a.). (2003). Ten Keys to Successful Diversity Recruiting. Retrieved from http://www.diverseworkplace.com/tenkeys.pdf
(n.a.). (2012). Charlotte Population and Demographics. Retrieved from http://charlotte.areaconnect.com/statistics.htm
Rodak, S. (23rd, May 2011). Regulatory Challenges, Strategies for Hospital CEOs. Retrieved from http://www.beckershospitalreview.com/hospital-management- administration/regulatory-challenges-strategies-for-hospital-ceos.html
RTI International SPF-SIG Contractor. (April 2009). Substance Abuse Data Inventory-2009. Retrieved from http://www.ncdhhs.gov/mhddsas/statspublications/Reports/substanceabusedatainventory4 -7-09.pdf
Wittman, L. (n.d.). How to Improve Urgent Care Profitability. Retrieved from http://www.ehow.com/how_6302210_improve-urgent-care-profitability.html