Guide to applying for health care grants page 1 of 7
Through its health care work to strengthen organizations, The Duke Endowment invests in building the infrastructure of effective enterprises and institutions. In our efforts to improve health care facilities, systems, management and operations, we are particularly interested in supporting opportunities that show promise for long-term gains. We define as helping established not-for-profi t hospitals and health care providers better accomplish their missions, thereby improving results. We value projects and programs that increase organizational quality, effectiveness and sustainability. We assess both immediate costs and continuing expenses needed to sustain funded projects, and base funding decisions on the potential for organizational improvement. eligibility examples Applications in this category may include, but are not limited to, grants that support work force development, technology enhancements and leadership development. Those applicants approved in this category will be asked to identify specific measures of the program and overall performance of the organization. Applicants should be prepared to answer the following questions: How will the proposed program have an organizational benefit, such as increased revenue and/or reduced cost? How will the program help the organization be more effective? page 1 of 7
health care grant application questions 1: Describe the challenges or opportunities the organization faces, and describe how, if addressed, a clear impact would be made. 2: Describe how the organization plans to respond to the challenge or opportunity. Defi ne in specifi c terms the new capacity the organization intends to put into place. 3: Describe the new or improved results the project will achieve. 4: What additional benefits could result from the project success and be considered as part of the project s return on investment? Please be specifi c. 5: Identify up to five of the most critical steps in your work plan necessary to achieve full implementation and success. 6: Define any new organizational changes needed for the new capacity to achieve intended results. 7: If a new staff person or consultant is required, please defi ne the roles and expectations for each position. If the individuals have been identifi ed, please describe their characteristics or other factors that most predict success. If they have not been identifi ed, please describe what attributes are most critical in your choice. 8: Will the project produce a net increase or decrease in operating costs? Please indicate how the organization will cover the increased costs or apply the savings. page 2 of 7
guidance & examples grant profile Organization: Seeking: Objective: Background: A community hospital facing a shortage of respiratory therapists Funding for the development of a respiratory therapy training program Increase the supply of qualifi ed respiratory therapists, thereby improving the quality of care and reducing staff vacancy rates The community hospital is poised to broaden its mission as a service provider and a learning institution by partnering with local community colleges. It is in a strong position to leverage its availability as a clinical site for training programs. challenge or opportunity Question 1: Describe the challenges or opportunities the organization faces, and describe how, if addressed, a clear impact would be made. Consider this question from the perspective of capacity building. It may be helpful to link desired outcomes and timing with planning and budget elements. Explain the specifi c challenge(s) hindering the organization s work or the opportunity that, if seized, would signifi cantly expand the organization s impact. A significant opportunity exists for Eastern Community Hospital to partner with teaching institutions to reduce the shortage of licensed respiratory therapists in the northeastern region of South Carolina. Our area currently has an insuffi cient supply of respiratory therapists one therapist for every 5,280 people compared with the statewide ratio of one respiratory therapist for every 2,538 residents. Despite high demand for training and certifi cation in this specialty, there is an insufficient number of training opportunities. By establishing a respiratory therapy training program within the next 12 months, the supply of trained respiratory therapists will increase by as many as 30 per year beginning in Year Two. Within the next three years, the vacancy rates for respiratory therapists will decrease to less than 10 percent and turnover rates will be less than 12 percent. page 3 of 7
new capacity Question 2: Describe how the organization plans to respond to the challenge or opportunity. Define in specific terms the new capacity the organization intends to put into place. Be specific in defining the desired capacity. Describe the tactical accomplishment, such as new software or a five-year plan as well as the strategic objective associated with this capacity, such as greater staff efficiency, faster service delivery, more effective program implementation and measurement of results. We propose developing a new respiratory therapist training program through a partnership between Eastern Community Hospital and Eastern Community College. Academic work will take place at the community college, and the hospital will provide a clinical training site for exposing students to practical experiences. Students will have immediate access to real-world experiences, as well as the opportunity to participate in the specialty s wide range of clinical decision-making and patient treatments. The program will be certifi ed by July 1, 2008. The first class of 30 students will enter the program in August 2008. By July 2010, the hospital will: Experience vacancy rates of less than 10 percent. Have respiratory therapy staff satisfaction of higher than 90 percent. No longer utilize agency services. results Question 3: Describe the new or improved results the project will achieve. Defining expected results is essential to measuring success in attaining them. The Duke Endowment will use this information to assess its return on investment. Articulating results will also provide an organization with clear goals, as well as valuable insights into what works, what does not, and to what extent. Organizations that achieve positive change often report positive results in three areas: 1. Increased gains and benefi ts. An improvement may prompt better results in two distinct areas: a) more people realize the intended gain, and/or b) additional benefi ts are received by the same people. The latter may be especially important in situations where additional results are needed to ensure that a gain can be maintained over time. 2. Increased revenue. An organization may build income from a new capacity, such as through a new clinical service. page 4 of 7
3. Reduced costs. Improvements in effi ciency support an organization s sustainability. For example, as a result of strengthened internal operations, an organization may reduce overhead costs, freeing up funds for investment in other critical areas. We expect results in two areas: An increased number of licensed respiratory therapists practicing in our area. We seek a minimum of 25 graduates each year from the new program, with at least 15 remaining within our service area for their fi rst two years of practice. The hospital will experience higher patient satisfaction rates, higher employee satisfaction rates, reduced vacancy rates and fewer costs associated with agency services. Year Two Patient satisfaction rates greater than 95 percent Respiratory therapist satisfaction rates greater than 90 percent Respiratory therapist vacancy rates less than 10 percent Year Three Patient satisfaction rates greater than 95 percent Respiratory therapist satisfaction rates greater than 90 percent Respiratory therapist vacancy rates less than 10 percent No agency costs for respiratory therapist staffi ng Question 4: What additional benefits could result from the project success and be considered as part of the project s return on investment? Please be specific. Explain any additional benefi ts or gains. These may be consequences that fall outside the realm of direct impact, but reflect the fullest potential of the work. Broader impacts of the program include opportunities to develop additional health care professional training programs with the community college and other institutions of higher learning in the future. tracking success Question 5: Identify up to five of the most critical steps in your work plan necessary to achieve full implementation and success. Please indicate the most critical activities for this project. This will refl ect the essential activities in the organization s work plan. page 5 of 7
The critical steps are: December 2007: Gain approval from the community college system to development the program and hire two instructors to provide education, training and mentoring of students. December 2007 April 2008: Upfi t academic space, including a respiratory care simulation lab, for training and education. December 2007 May 2008: Recruit 30 students in Year One. Place the fi rst class in area institutions. Identify any training or preparation defi cits requiring adjustment in the program. August 2008: Launch the fi rst class and evaluate to ensure students emerge with strong proficiency. August December 2008: Gain accreditation for longer-term operation of the program. August 2009: Recruit second class. May 2010: Graduate fi rst class and place in positions. Question 6: Define any new organizational changes needed for the new capacity to achieve intended results. In many cases, an improvement in capacity requires a change in some aspect of organizational practice to become fully effective or effi cient. The director of respiratory therapy services and respiratory therapist staff at the hospital will be essential to the training component of the clinical rotation. The director will serve as a mentor and advisor to the students. Staff will assist students with application of academic concepts to patient care. key people and groups Question 7: If a new staff person or consultant is required, please define the roles and expectations for each position. If the individuals have been identified, please describe their characteristics or other factors that most predict success. If they have not been identified, please describe what attributes are most critical in your choice. In capacity-building programs, key staff people or consultants are as important as plans and funding. If these individuals have been identifi ed for the program, please describe their characteristics or share other factors that predict their success. If they have not been identifi ed, please describe your criteria for qualifi ed candidates. The director of the respiratory therapy program at the community college has not been hired yet. This position will hold a joint appointment at the hospital and at the community college. The selected candidate will have experience with successfully operating and managing respiratory therapy training programs and will have excellent interpersonal skills. The job description is enclosed. The director of respiratory therapy at the hospital has been in her current position for five years. She has implemented new programs and has a hands on approach in mentoring employees. page 6 of 7
costs Question 8: Will the project produce a net increase or decrease in operating costs? Please indicate how the organization will cover the increased costs or apply the savings. In addition to a one-time cost to develop a new capacity, some new capabilities involve ongoing maintenance expenses. In these situations, identify how the organization will develop the capacity to sustain the change. In some cases, the cost of the new capacity, such as a new clinical service, may be covered by the additional revenue that results. We anticipate no net increase in operating costs. While the provision of space and time is a cost to the hospital that will not be fully covered by tuition revenues, the savings from no longer paying agency-provided respiratory therapists are expected to offset that expense. The hospital will add and support costs for 0.25 full-time equivalents (FTE) for additional respiratory therapy staff to allow adequate time for the director to support students during their clinical rotations. This expense is expected to be offset in subsequent years. As newly trained respiratory therapy graduates are recruited to the hospital, there will be less reliance on agency services and reductions in staff turnover. By Year Three: The hospital will no longer require agency services. Unexpended funds (due to no longer requiring agency services) will be utilized to purchase new respiratory therapy equipment for patient care (years two through four). Longer-term savings will support general hospital operations and promote optimal patient care. page 7 of 7
The Duke Endowment, located in Charlotte, N.C., seeks to fulfi ll the legacy of James B. Duke by enriching lives and communities in the Carolinas through higher education, health care, rural churches and children s services. 100 north tryon street, suite 3500 charlotte, north carolina 28202-4012 telephone 704.376.0291 2009