Perpetual mercy hospital: Intro 600 bed, independent nonprofit general hospital. 1 of 6 general hospitals in city and 20 in country.

In 1998 the board of trustees authorized a study to determine whether to open an ambulatory facility in the downtown area about 10 blocks north of the hospital. In mid April 2000, Sherri worth , assistant administrator at PMH in charge of hospitals Downtown health Clinic, uncovered an unsetting parcel of news. She was told that firm was conducting a study whether sufficient demand existed to establish a clinic five blocks north of PMHs DHC. Planned opening date is May 1999. After this Worth called Dr. Roger Mahon PMHs administrator. And Dr. expressed concern for 2 reason: 1) a competitive clinic would attract existing and potential patients of Downtown 2) a clinic that provided similar services could hamper the DHCs progress toward achieving its services and profitability objectives. THE HOSPIATL INDUSTRY AND AMBULATORY HEALTH CARE SERVICES: HEALTH CARE AND hospitals industry has undergone a dramatic transformation in the past four decades. 1960 hospitals charitable institutes Federal legislation in 1960 created boom time for hospitals. HILL BURTON ACT PROVIDED BILLION dollars hospital construction. FEDERAL INTERVENTION HAD CHANGED THE CONCEPT OF HEALTH CARE SERVICES FROM PRIVILEGE TO ENTITLMENT.

1980 SKYROKETING HEALTH CARE costs had forced the FEDERAL govt to reassess its role in
health care. In early 1990 hospitals hard hit by the changes. On 1 hand: FEDERAL govt sought to reduce health care costs through cutbacks in subsidy porg. And cost control programs such as BALANCED BUDGET ACT 1997. On other hand innovations in health care delivery severely reduces the # of patients serviced by hospitals.

(First) Preventive health care INNOVAIONS PROGRAMMS: 1) HMO health maintenance org.( providing care at fixed monthly fee) 2) PPOS prefferd provider org.(offer incentives for preferred users) (Second) innovation about ambulatory health care services. Treatments and practices that consumers use an episodic or emergency basis. Example cuts, bruises, minor surgery cold flu.

2 CATEGORY OF ambulatory health care: 1) minor emergency centers, known by acronyms as FEC( FREE STANDING EMERGENCY CLINIC) 2) CLINIC THAT focus on primary and episodic care. THREE FACTORS FOR GROWTH OF ambulatory health care: 1) more advances the madical technology. 2) consumers have adopted a more proactive attitude 3)

the mystique of medical and health care has been altered with the growth of paramedical professionals and standardized treatment practices. CHARACTERESTICS OF ambulatory health care AS UNIVERSAL: Branding Extended hours Lower fees than emergency rooms No appointments necessary Minor emergencies treated Easy asses and parking Short waiting times Credit card accepted DOWNTOWN HEALTH CARE: 4 objectives of DOWNTOWN HEALTH CARE: 1)to expand the hsptl referal base.

2)to increase referrals of privately insured patients. 3)to become self-supporting three years after opening. 4)to establish a liaison with the business community by addressing employer's specific health needs. Specific services offered by DOWNTOWN: Preventive health care, minor emergency care, referral for acute and chronic health care problems, specialized employer services, primary health care services, basic X-ray & lab tests. DHC would be open 260 days in year (mon-fri) frm 8:00 to 5:00 Location: grater west office and shopping complex. Location was chosen by # of board of trustees.during 1998 construction plan was under way. Budget is annual expenditure $ 510,048. PERFORMANCE: MAY 1999-MARCH 2000 Phm revealed that tha DHCs referral objectives was being met, since the DHc han mad 105 referrals to PMH and produced $378000 more than revenue.