Introduction to the APN Professional Business Plan

Executive Summary

1.1 Business Summary

I intend to set up a Practice Clinic where I will serve as an Advanced Practice Nurse alongside other members of staff, both medical and administrative, to better serve the needs of the community within which it is based. The business will be owned and managed by me, APN, as a sole proprietorship. I will take on the responsibility of the general health of the patients my clinic takes on, and also the responsibility of creating a viable medical practice. Throughout the first year, which will be the hardest in terms of finance and patient uptake, I will work to get the clinic on a sound financial and operational footing.

The clinic will ideally focus on diagnosing and treating conditions of all ages, with support from a nearby lab, while emphasizing preventative medicine and the overall health of the patients we see. The clinic will make use of all new equipment and a trained staff in order to optimize the care available for the patients.

I and the staff will perhaps carry out minor procedures in our offices, but this is perhaps a consideration that can be set aside until the second year, and of course even if we do begin to offer these services, they will only be carried out after both risks and benefits have been explained and understood and written consent has been obtained from the patient. The clinic staff will, when it is appropriate, refer our patients to specialists and/or hospitals for tests, further treatment and therapy.

In the clinic, I will lead and be involved in a group of Advanced Practice Nurses and a specialised administrative staff who will ideally already have training in clinic work, but who will also undergo on-going training and support for the first year at least.

Our marketing strategy will involve a combination of website development, networking, and promotional events, which will all be aimed at the residents of the immediate and closely surrounding community. We estimate that our patient load will gradually increase over the first few years, as we carve out a space within the community.

We expect to operate at a loss for at least the first three years, but we have planned a strong cash balance to keep the business running. We should begin to make a profit in the fourth year.

I and my colleagues will use all our experience and knowledge to create a successful practice. I will use our training and time spent in solo practice to help form our new business. Our pooled experience and our current approach should allow us to expand our practice quickly (Belbin, M, Forsyth, P, Kourdi J et al, 2013, pp. 116-118).

1.2 Business Aims

To create a medical practice that will exceed patients' expectations

To provide high-quality health care in different areas to residents of the area (Community Advanced Practice Nurses, 1998)

To create a medical practice that helps serve the community's needs

To form a health care practice that is able to survive off its own cash flow within a year

To develop a comprehensive website that includes online booking capability, as well as additional information about the practice, hours, demographic information, health information and much more

Collections of 95% or more and missed appointments under 5%

Average visits per month of 300 to 350 patients within the first 10 months and 400+ patients by the beginning of the second year

1.3 Financial Summary

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Owner’s Background

2.1 Why Do You Want to Run Your Own Business

By setting up a clinic, I hope to expand the medical options which are available to the community the clinic will be in (Community Advanced Practice Nurses, 1998). In running this clinic, I will have more options available to me in the choice of the services we as a clinic could offer to the people who use our services, and also have more control over the services I myself use in the course of my duties, such as the medical billing services, laboratory services and equipment, to name three. I think that running my own business will be a good use of my education and talents, as well as the education and talents of those who I will be working with.

2.2 Qualifications and Education

I and my staff will have the training necessary to qualify us for work as Advanced Practice Nurses, allowing us to treat patients to a very high standard. We shall all have:

An Undergraduate Degree in Nursing of at least 2ii

A Master’s (MS or MSN) or Doctorate Degree (DNSc, DNP or PhD) in Nursing (O’Grady, 2008).

Board Certification.

Any administrative staff who works with us will of course have gone through stringent criminal record and background checks, due to the confidential nature of the information they will be working with on a daily basis and will also meet high standards in their own education. They would hold at least an undergraduate degree in business administration, and also preferably a Masters in the same subject.

2.3 Further Training and Qualifications

Perhaps the administrative staff could pursue further training in medical billing at some point. It would be a costly outlay to train the staff, but in the long run it would save the clinic time and money, as we would no longer have to contract an outside service to do it for us.

In addition to the proposed training for the administrative staff, as mentioned above I would like the medical staff themselves to undergo training throughout the first year of business at least. I propose that at least one other nurse undergoes management training of some kind, so that he or she can take over in the event of my absence (Heller, 2002, p. 181), and I also propose that all the nursing staff undertake counseling training, in order to be better able to provide a truly holistic healing approach with their patients (Community Advanced Practice Nurses, 1998).

In the same vein as training administrative staff to handle medical billing, training some members of the clinic to handle small (possibly non-invasive?) procedures would perhaps be beneficial to the clinic. It would mean significant outlay at first, which the clinic will not be able to truly afford, but I think the expense is worth it and will eventually pay for itself in terms of the extra services we can offer through our clinic.

Products and Services

3.1 What are you going to offer

Our clinic will provide general care for all ages, as well as eventually offering many types of non-invasive procedures to help create a complete health care solution for the patients involved. While we will offer blood tests, and vaccinations among other things, after additional training the procedures we will eventually offer will include wart\corn\callus removal, mole removals and trigger point injections. The costs will depend upon the materials used, the nurse’s time and the amount of time each procedure will take.

Our clinic takes the view that health is best acquired through completely holistic means – with a good diet and exercise being just as important as actual medical intervention - so our goal will be to educate our patients as well as treat them.

The nurses in the clinic will focus on each individual medical case that is presented to them and after where appropriate, each patient will be offered education in nutrition and exercise if it is found to be an appropriate response to the medical case they have been presented with. Our goal is to create the most well-rounded experience for each patient in order to optimize their health.

The clinic will maintain privacy according to HIPAA rules. All patients will be welcome, including the ones with no insurance – we will not turn anyone down if they need medical care. Our clinic will hold no prejudice to race, creed, color, or socioeconomic status.

3.2 Describe the basic services on offer

Primary Healthcare Services

Immunizations and Vaccinations

STD Testing and Treatment

Referrals for Obstetrics\Pregnancy

Dental Care Referrals

Vision Care Referrals

Emergency and Special Treatment Referrals

Assessments and referrals for mental health care

Assessments and referrals for substance abuse (Community Advanced Practice Nurses, 1998)

Non-Invasive Procedures – corn and callus removal, electrocardiogram, earwax removal etc.

3.3 Is every service going to be available at the beginning? Why or why not? If not, when will the services be brought into use?

As said above, the training and retention of ur nursing staff will continue after the clinic is up and running. Hopefully this training will continue to a greater or lesser extent through their time at the clinic, but for the purposes of this plan, we are focusing on the training that could be undertaken within the first year or two of the clinic.

Our idea was to have the range of skills needed to provide basic medical care when the clinic opened, and then gradually bring in the new skills and training required to perform the procedures outlined above over the next year to year and a half. This would allow us to provide a basic level of care at all times while continually being able to offer new services to our patients.

The Market

Our clinic will focus on the local community when it comes to medical care. This segmentation of the area’s population will be essentially geographic for a number of reasons (Belbin, M., Forsyth, P., Kourdi et al, 2013, p. 212):

Our clinic is a general family practice. We will treat patients of all ages, incomes, physical abilities, races, and ethnicities. As a family clinic, there is no need to create marketing materials targeted at only one or two of these groups, but we can appeal to all with a similar message.

The expected growth of the local population, at 3.5% a year, makes this an ideal location for a broadly geographic marketing approach.

Any potential patients who are in the lower socio-economic rungs will probably prefer not to come to the clinic unless the matter is truly urgent. We in the clinic would better serve these people if we keep our services within the community, thereby making it easier for them to be able to access our services.

Conclusion

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It is estimated that start-up expenses will be $22,732. This amount of money will be used to purchase office equipment, medical supplies, furniture, stationary, and other start-up expenses. This amount, and a starting cash balance of $10,000, should hopefully be financed by General Medical Center.

(Table omitted for preview. Available via download)

7.1 Payment Methods

Payment will be done through either the patient’s own funds, or a variety of insurance companies, such as 21st Century Insurance; Acuity; ACE Limited; Combined Insurance; Conseco; FM Global and Encompass Insurance Company. Medical billing, until such time as our administrative staff can take over those duties, will be handled by the company AccuMed Inc.

7.2 Suppliers

We will require our own medical and office supplies outside of the technological equipment provided by the companies listed below: we will need pens and paper for the administrative staff, toilet roll and soap for the toilets and a variety of miscellaneous equipment for the medical staff such as gloves and sample bottles, among other things. We are still searching for suppliers who can give us these items in the quantities we think we will need.

7.3 Premises

We are in the process of acquiring a building worth $225,000 with a 15 year mortgage, which will be repaid from the company's cash flows. Since the clinic will be a sole proprietorship, this initial outlay will be covered entirely by separate funding.

7.4 Equipment

Equipment will be bought through one of the country’s foremost medical equipment providers, Johnson & Johnson. This is a particularly good choice for our clinic, since Johnson & Johnson offer medical computers as well as other equipment, thus eliminating the need to seek out a separate company for them. Our backup for Johnson & Johnson will be the General Electric Co.

7.8 Legal and Insurance Requirements

We will of course require extensive legal and insurance actions before we can accept clients into our premises – our legal coverage is yet to be confirmed, and our insurance coverage will be handled by the Federated Mutual Insurance Company, who we feel will give us the best coverage possible.

7.11 Additional Information

Since our clinic will most likely be handling a variety of situations where it may be necessary to take samples of nails, urine and blood, for three examples, we will need to be affiliated with a laboratory which is able to process those samples. We are in the process of choosing between Sunrise Medical Laboratories and ACM Medical Laboratories. If money allows, we may have an affiliation with both, to allow for times when we may be overwhelmed, or when our patient list grows.

References

----, (2010). “Changing the Paradigm of Nursing Through Policy, Regulation and Legislation” Carson Company LLC. Retrieved from http://media.wix.com/ugd/304311_4d651c95846bf2d14dcc4ff4948caa71.pdf

Belbin, M., Forsyth, P., Kourdi, J., Landsberg, M., McDonald, M., Ries, A., Ries, L. & Sadler, P. (2013) Good Small Business Guide 2013 (7th ed.). London: Bloomsbury.

Community Advanced Practice Nurses. (1998). CAPN Inc: Community Advanced Practice Nurses, Inc. Retrieved from http://www.capn.org/

Heller, R. (Ed.). (2002). Manager’s Handbook. London: Dorling Kindersley.

O’Grady, E. (2008) Advanced Practice Registered Nurses: The Impact on Patient Safety and Quality. In Hughes R. G. (Ed.), Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality (US). Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK2641/