Question;Jiranna Healthcare owns and operates a 268-bed hospital in;the San Jose area. The hospital is Jiranna Healthcare%u2019s main facility and;is home to more than 80 on-site specialty and surgery clinics, employing over;5,000 staff. In addition to the main hospital, Jiranna Healthcare has 18;satellite clinics, containing primary care services such as pediatrics, family;medicine, and geriatric health. These facilities (hospital plus outlying;clinics) serve a total enrollee population of 97,000.;Currently, Jiranna Healthcare%u2019s centralized call center;schedules primary care appointments and handles an average of 1,500 to 2,000;calls daily with a staff of 20. Patients routinely have difficulty obtaining;access to urgent or acute care (primary care) in a timely fashion.;Additionally, the majority of Jiranna Healthcare%u2019s primary care centers;are unable to meet access standards in three out of four cases. These access;issues have a secondary effect on the call center, which experiences a much;higher call rate because members have to call back multiple times to find;available appointments. The existing process leads to overutilization of;emergency departments for urgent care and primary care concerns. In addition;patient satisfaction has steadily declined as a result of the continued lack of;appointment availability.;To address this problem, there is a proposal to implement a;centralized nurse triage line, an off-site phone center that would be staffed;by registered nurses with a multitude of specialties (including ER nurses;critical care, surgical, and even some nurse practitioners). These nurses are;able to offer callers medical advice encompassing the treatment of fevers;wound care, and emergent conditions such as chest pain. The nurses are trained;to triage conditions to the appropriate level of care be that at home, at an;urgent care center, or at an emergency department.;The major cost impact is the increased salary requirement;for the phone center staff, which will entail approximately 33 multi-discipline;employees, based on workload and enrollment data. Additional elements of the;proposal include hiring an IT specialist to manage the triage line%u2019s;computer system, and facility renovations. The main benefit of this proposal is;projected cost reductions in patient care as a result of moving primary care;out of the expensive emergency-room setting.;Assignment;The Capital Project Case Study, Part 2 spreadsheet provides;cash flow data (costs and benefits) for the proposal. Download and save this;Excel spreadsheet, and use the information provided to complete the following;1. Determine the cash inflows and outflows for each year.;2. Evaluate the capital project by calculating the following;metrics;a. net present value (NPV);b. internal rate of return (IRR);c. modified internal rate of return (MIRR);d. payback period;e. discounted payback period;3. Indicate whether the project is acceptable, assuming;Jiranna has a corporate policy of not accepting projects that take more than;3.5 years to pay for themselves, and assuming an 11% cost of capital.
Paper#51067 | Written in 18-Jul-2015Price : $42