Saturday, March 10, 2012

PeaceHealth Business Research


BA 101 Introduction to Business

PeaceHealth Business Researchers
Final Paper


Prepared By:
Emily Laing
Patricia Wells
Lauren Berg


March 10th, 2012



TABLE OF CONTENTS 

Introduction

Part 1: Business in a Changing World
Chapters 1, 2 & 3
Lauren Berg

Part 2: Starting and Growing a Business
Chapters 4 & 5
Patricia Wells

Part 3: Managing for Quality and Competitiveness
Chapters 6, 7 & 8
Emily Laing

Part 4: Creating the Human Resource Advantage
Chapters 9 & 10
Emily Laing

Part 5: Marketing: Developing Relationships
Chapters 11, 12 & 13
Lauren Berg

Part 6: Financing the Enterprise
Chapters 14, 15 & 16
Patricia Wells

Summary

Bibliography

Appendix




Introduction

            PeaceHealth is a large nonprofit corporation that provides healthcare within Washington, Oregon, and Alaska. Because it is a nonprofit corporation, it focuses on providing it’s healthcare services rather than earning a profit. It all started in 1890 when two members of the Sisters of St. Joseph of Peace left their convent in New Jersey to build a hospital in the small logging town of Fairhaven, Washington. The hospital started through donations with a mission to help those with physical aliments through Jesus Christ. Their use of a mission without a formal business strategy proved to be sufficient in the early years of the business, but as the business grew they reinforced their mission with a full business strategy. By 1916 the business had expanded to five hospitals in Washington, Alaska and British Columbia. It expanded to Oregon in 1936, and today has a total of seven hospitals. The sisters in charge of the hospitals decided to form a separate framework in the early 1970s. This change was implemented in order to more successfully meet the challenges their business faced with contemporary healthcare and also to partner with other professionals. They were granted status as a Private Pontifical Juridic Person in 1997, which grants them certain legislative rights. Today PeaceHealth is a striving business comprised of 9,600 employees, 1,133 hospital beds plus 46 long-term beds, and has net revenue of $824 million.















Business in a Changing World

Lauren Berg





            PeaceHealth dominates the healthcare market in several regions. In the Eugene/Springfield area it is the largest healthcare provider and offers the most verity of services, including everything from heart transplants to mental health counseling. Although it dominates the healthcare field in the area and has enough clients to sustain its self, it still does have competitors. PeaceHealth’s competitors include McKenzie Willamette hospital of Springfield, private medical businesses throughout the area, and larger hospitals that clients travel to. Although still surviving, McKenzie Willamette has experienced less business since the opening of PeaceHealth’s RiverBend hospital in 2008. They even started a lawsuit against PeaceHealth claiming that they were attempting a monopoly, but did not win.
            Many clients complain about the high prices that PeaceHealth charges for its services. PeaceHealth is not alone with this complaint; almost all hospitals and medical providers receive the same complaints. The high prices that medical providers charge are the result of combination of factors. Medical professionals must be highly skilled and go through many years of schooling; because of this they require high pay for their services. Another reason for the high cost of healthcare is the monopolistic competition of the health related services. Another reason for the high prices is the governmental regulations and laws regarding healthcare and health insurance. Also, many professionals who work at PeaceHealth don’t actually work for them directly, but are hired through a subcontractor, which is a large factor on the cost of their services. For example, the physicians who work in the Emergency Department at PeaceHealth are employed by a for-profit business called Eugene Emergency Physicians (EEP). Prices also must remain high to help pay off PeaceHealth’s debt that has acuminated throughout the years. One more reason for the high price of healthcare is the never-ceasing demand for their services; people will always continue to get sick or injured and seek assistance. Even though PeaceHealth is a nonprofit organization, their prices remain high and not everyone can afford their services, especially during the economic contractions.
            PeaceHealth has pride in its business ethics and social responsibility. It’s mission is to “carry on the healing mission of Jesus Christ by promoting personal and community health, relieving pain and suffering, and treating each person in a loving and caring way”. PeaceHealth’s core values are respect, stewardship, collaboration, and social justice. They believe in providing the most “exceptional medicine and compassionate care” that they can, and they expect their employees to comply with these core values. Although they take great strides to help their patients, some may argue that they are unethical in other ways, such as how they generate a large amount of waste or how they charge high prices for their services.
            Misuse of company resources, like in most businesses, is a problem at PeaceHealth. Some employees take home supplies, ranging from pens to expensive medical supplies, which puts a financial burden on the organization. Another problem that PeaceHealth faces is misuse of on-the-clock time, which puts an even greater financial burden on the company. PeaceHealth also occasionally has to deal with abusive and intimidation behavior, conflicts of interest, and behavior that is not fair or honest. PeaceHealth deals with these issues in several ways, including the implication of greater supervision. Managers and supervisors at PeaceHealth are expected to comply with the businesses mission and core values when reprimanding employees. If the behavior is not too extreme, the employee will usually receive at least one warning before termination.
            I recommend that PeaceHealth make strides to have health insurance available to more of the population. This would increase their customer base and bring in more profits to the company. One example of a region that provides good healthcare options to people who cannot afford insurance is the PeaceHealth Siuslaw Region. This program, called Bridge, helps pay medical bills for people depending on their financial circumstances. Bridge receives their funding’s through donations. With this, many patients from different areas come to Florence for their healthcare. Since PeaceHealth is a “system wide” corporation I would expect each region to have the same program. I believe, because PeaceHealth is a nonprofit and that healthcare should be a human right, they should work on lowering their prices. Overall in this case analysis we will discuss how the business started, the nature of their management, how they motivate their employees, along with their marketing and financial strategies.










Starting and Growing a Business
Patricia Wells







            When you or someone you care about enters a PeaceHealth facility as a patient you are probably not concerned about the legal formation of the corporation status.  However, for a case analysis it is a starting point to understand how the corporation began. A corporation is a legal entity created by a state in order to keep many of the rights, duties and powers of a person protected from its business. So basically rather than a person entering into a contract it is the corporation and the individual person is legally protected.
To become an incorporated business a person or group of people must file legal documents called articles of incorporation with the secretary of state in which they would like to do business.  A corporation can file articles of incorporation in as many states as they would like to operate businesses.  A corporation must elect a board of directors to oversea and manage the corporation. Members of PeaceHealth’s board of directors embrace a leadership style that reflects their mission and values of the Catholic health care system. The board of directors leads in every aspect of their work and overseas the responsibilities of the corporation. When filing the articles of in of incorporation the corporation must provide the state with the information listed below:
1.     Name and address of corporation
2.     Objectives of the corporation
3.     Classes of stock and the number of shares
4.     Expected life of the corporation
5.     Financial capital
6.     Provisions of transferring stock or shares
7.     Provisions of regulation of internal corporate affairs
8.     Address of the business office registered with the state
9.     Names and addresses of the initial board of directors
10.  Names and address of the incorporators
         PeaceHealth is registered with the State of Oregon as a foreign nonprofit corporation. The fact that it is a foreign entity means that the original articles of incorporation were filed in another state other than Oregon. In PeaceHealth’s case the articles of incorporation were filed in Washington State in July of 1976 under another name of “Sisters of St. Joseph of PeaceHealth and Hospital Services”. The corporations name changed to PeaceHealth in October 1994. PeaceHealth also has 22 assumed business names registered in the State of Oregon. Assumed business names are separate business that work under the larger corporation. PeaceHealth operates many small businesses in order to make an effort to make their businesses more flexible, resourceful, and innovative. There can also be demographic reasons to operate many smaller businesses through assumed business names so that they can meet more people’s needs in different regions of the state. Also the technology advances in the medical field has increased the opportunities for PeaceHealth to serve the community with new medical services.  Sometimes large corporations think small in order to meet the growing needs of the state in which they operate their corporation.
         There are some differences in non-profit and for profit corporations. The non-profit corporations focus on providing a service rather than earning a profit.  It doesn’t mean that they do not need to make a lot of money to operate the corporation.  PeaceHealth earns millions of dollars so that it can meet all of their expenses and provide a service to those who cannot afford to pay for their medical expenses.
PeaceHealth success may have something to do with the fact that they consider ethics and social responsibility to their corporation.  They have a great since of compassion to the community that they serve. The also have strong morals and ethics that are the backbone of their corporation. 















Managing for Quality and Competiveness
Emily Laing




Management at PeaceHealth is very important and plays a key role on how the company is operated today. Management is considered “Leadership” at PeaceHealth and is based on their day-to-day mission, values, ethics and desired culture. To carry on their mission PeaceHealth’s management strives for great organization, teamwork and good communication. The services PeaceHealth provides has good inputs and great outputs to make sure, “every patient will receive safe, evidence-based, compassionate care; every time, every touch.”
            PeaceHealth’s management has many areas for this non-profit organization. PeaceHealth involves top management, which includes their President, CEO and Vice Presidents. Middle management involves department managers, and first-line management, which involves their supervisors and office managers. The reason why there are so many types of management is because this structure makes it easier to coordinate the use of the organization’s resources. These three types of management not only help with the organizations resources but with the structure of how each department is set up and makes it easier on employees when they need to come to management for a problem or situation.  Leadership at PeaceHealth is based off a model. This leadership model expresses the view that the role of leaders is to serve and inspire rather than simply motivate. This model reflects PeaceHealth’s mission, values, ethics and desired culture. PeaceHealth’s desired culture includes the values, attitudes, beliefs and behaviors that are the essence of the organization. PeaceHealth’s organizational culture has a strong impact on day-to-day work because it achieves their main goal. PeaceHealth’s main goal is making sure patients are taken care of and are satisfied.  
            Teamwork is used everyday at PeaceHealth. Every department uses teamwork in order to accomplish their goals. With teamwork comes good communication. Each department is required to have meetings and have audits to make sure there is always room for improvement. To improve work at PeaceHealth or make-work more efficient management makes sure to approach problems as opportunities for innovation.
            PeaceHealth has a great example of the transformation process which inputs are converted into outputs. The labor, money, materials and energy at PeaceHealth are converted into pleased patients who received satisfactory healthcare. Management makes sure that this goal is met. If this goal is taking to long to meet PeaceHealth’s management will go to Lean thinking. What is Lean thinking? Lean thinking is the dynamic, knowledge-driven and customer-focused process through which waste is eliminated and the goal of created value is achieved. This is a great example of quality control and total quality management at PeaceHealth because it is insuring that the patients are pleased and satisfied with their healthcare. PeaceHealth management does not only commit to one department but all areas of the organization to make sure everyone is improving patient satisfaction.
            PeaceHealth has established great management. By establishing this PeaceHealth has a reflected their mission, values, ethic and desired culture. It is important for the organization to have satisfied patients because this means the healing mission is complete. PeaceHealth continuously learns and improves not only just in management but also as individuals, as teams and as an organization.
            I recommend that PeaceHealth management should work on improving their customer relations. One way they could work on this would be to give their employees consistent schedules that are appropriate in length. This will make employees more satisfied and help with showing and improving on compassionate care towards patients. PeaceHealth should evaluate their administration to ensure that it is functioning as well as it can.  If PeaceHealth implements these changes the corporation will be more profitable and better functioning. I feel PeaceHealth has done a wonderful job on sticking to their mission and core values. They make sure every patient gets the care that they need through the healing mission of Jesus Christ. With being an employee at PeaceHealth, I really appreciate that no patient leaves without the care and medical attention they need.











Creating the Human Resource Advantage
Emily Laing




The Human Resource Department at PeaceHealth makes up the workforce and diversity of this non-profit organization and is responsible for motivating their employees. Historically and today’s day and age everyone that works at PeaceHealth is considered a Caregiver. The Human Resource Department at PeaceHealth is to make sure every employee feels as a part of the caregiving team regardless of role or title. Human Resources follow their leadership model at PeaceHealth, which is deeply rooted in their identity as a Catholic healthcare system, their mission, values and ethics. Human Resources have embraced the model by committing to growing and developing their own leadership skills. This model expresses the view to serve and inspire rather than to just simply motivate. Throughout the years at this non-profit organization and great management there has been no employee outrage or strikes. Patients are generally happy and employees stay with the organization for many years.
            A great way of motivating employees and increasing productivity is by giving the employees extrinsic rewards, which are benefits the employees receive from the organization. PeaceHealth offers employees health benefits including dental and vision, as well as employee assistance program and referral service, life insurance, disability coverage, pre-tax flexible spending accounts, paid time off, paid leaves of absence, tax deferred account plan, retirement plan, and transportation benefits. PeaceHealth also offers a 457(b) savings plan, educational assistance program, training and development, fitness facilities, alternate/flexible work schedules and telecommuting, employee referral bonuses, relocation assistance and lastly childcare assistance. Benefits and incentives give employees intrinsic rewards with gratitude that they have done a great job. With that PeaceHealth does not have much of a turnover.
            With such great benefits, incentives and many opportunities, PeaceHealth attracts a substantial amount of internal and external employment. Human Resources and senior executives make a promise to engage caregivers in orientation and get them motivated to work for the organization and become successful. Once they give the orientation, employees are trained and developed into a great caregiver to ensure their corporations promise is fulfilled. PeaceHealth holds this promise in the highest regard to make sure it is delivered consistently and with every interaction. PeaceHealth states, “What is our promise? Our promise is”…
·            What everyone in the organization delivers on.
·            It is the unique approach to what we do.
·            It drives what we want to be known for.
·            It is the everyday shortcut to our brand experience.
·            It sums up who we are in a few words.
·            It is the driver for our actions, decisions and messages.
·            It is authentic, believable, differentiating, enduring, relevant and true.
With this promise caregivers are able to achieve their goals through patient care.
            PeaceHealth has done a phenomenal job with treating employees well and making sure every employee is motivated and has a sense of job security. Job security is an important key factor due to the economy today.  PeaceHealth offers many opportunities for employees to excel and do better not only for the patients, but also for themselves. Providing as many benefits and incentives that they have, has kept PeaceHealth growing and succeeding employment wise. Human Resources helps foster the pursuit of knowledge and skills among all those who serve in order to provide quality healthcare. Without such good leadership PeaceHealth would not be where they are at today. With this, I feel PeaceHealth does not have much to work on with their leadership skills.














Marketing: Developing Relationships

Lauren Berg




PeaceHealth is a chain of hospitals that provide healthcare to communities. The main product that they market is of course their healthcare services. They advertise in a variety of ways, including billboards along highways, sponsoring events, giving away products that have their logo, hosting health presentations, and hosting banquets for practitioners and other important people to the business. They also frequently receive publicity on news stations, radio, the Internet, and newspapers. PeaceHealth has several strategies to creating and maintaining both customer relationships and business relationships.
Maintaining a positive view to the public is crucial for the business, and they take the steps necessary to keep their public reputation. Because they are a large business, they receive a substantial amount of publicity. PeaceHealth receives publicity when it undergoes a significant change in business strategy, hospital development, when they have severe malpractice of physicians, when a large lawsuit occurs, and many other occasions. They also can receive positive publicity occasionally. PeaceHealth won the Eugene Area Chamber of Commerce “Best Business of the Year Award” because of its focus on running sustainability with regard to finances as well as the environment. They also were picked because of their charity care and their support to local organizations. PeaceHealth, the largest employer in Lane County, makes a noticeable impact on the community with its good business ethics. This has helped it gain a better reputation and overcome competition.
PeaceHealth has a strong marketing mix that has given it the completive edge to be successful for many years. The business offers better dimensions of their service than do other companies. Their business mix, which includes their appealing business ethics, has a greater variety and perhaps greater quality of services than their competitors offer. The hospital has a large number of specialists who perform technical medical and psychiatric services. They also have advanced medical technology to help them perform better. They have a set standard on how clients are treated and in some sectors of the hospital they try to build a trusting relationship between the client and the caregiver. This marketing mix gives the business a stronger competitive edge.
Technology provides PeaceHealth with many important tools for communication and efficiency throughout the corporation. Almost every employee uses email for numerous purposes, some of which include: developing and achieving business plans, developing and maintaining business relationships, notifying employees about important news, scheduling shifts, and communicating information about patients. PeaceHealth also uses digital communication to administer much of its financial, legal, and human resources. Many other forms of technology are used at PeaceHealth, some of which have been mandated by the government. The government has been imposing upon hospitals throughout the country and instructing them to become more reliant on technology. One example of this is the digitalization of doctors’ notes. Although disliked by many of it’s users, the system of digitalizing notes provides many benefits: there is no longer any struggles to read patient files, notes and files are less likely to be lost, the information can more easily be transferred to a different department or hospital, and the electronic note taking devise also provides doctors with important medical information that they may have not known for each specific patient. PeaceHealth is also doing well through their interpreter services. They use web cameras to facilitate interpretation with interpreters from different areas. When new products are introduced to the PeaceHealth system, including most of their technological products, they are often tested for quality at one hospital before the other hospitals start using them.
            PeaceHealth has been implementing their advertisement and technological strategies perfectly. They have a strong marketing system which, which has given the business a great advantage over the market. Their technology advancements have given the company greater efficiency, profit, and customer satisfaction. With new technological advances I foresee PeaceHealth making even greater strides towards becoming an excellent business.











Financing the Enterprise

Patricia Wells





         The financial records for PeaceHealth as you can imagine are not easy to access so my case analysis is going to be based on the year 2009.  The Register Guard interviewed Sister Monica Heeran was CEO of PeaceHealth, one of her comments was, "No money, No mission”. PeaceHealth may be a nonprofit corporation, but just like any business, it needs to take in more money than it spends. Over the years, PeaceHealth has been very successful in managing its finances and investments so that it is able to stay in business.  But the year 2009 may be the worst on record for PeaceHealth. According to a financial statement filed with the state of Oregon PeaceHealth lost $63.2 million on its operations for the fiscal year that ended June 30, 2009. 

PeaceHealth is doing much better financially since 2009 due to aggressive cut backs in all areas of their hospitals. The Oregon hospitals had two rounds of budget cuts and were able to trim their budget by $175 million. They did this by cutting and freezing wages and eliminating more than 100 full-time jobs.  PeaceHealth also listened to more than 1,000 employee’s suggestions that led to $2 million in savings. The economy slowly improved in the first quarter of the new fiscal year and surgeries were up 18 percent, representing people who postponed surgeries because of the recession now felt confident enough to schedule their surgeries.  Also Hospital admissions were up 4 percent. 

Here is a breakdown of PeaceHealth's two Sacred Heart hospitals in lane country that show RiverBend actually made a profit in fiscal 2009 of $2.2 million, while University District posted a net loss of $9.3 million. PeaceHealth's annual expenses for operating both RiverBend and University District totaled $518 million for the latest fiscal year. PeaceHealth had over 4,214 employees who are paid more than $50,000 a year in fiscal year. That was up 25 percent from just two years earlier, when the organization had 3,364 employees paid more than $50,000 a year. Salaries for top doctors and executives are a major expense. PeaceHealth's five top-paid doctors collectively were paid $4.3 million in fiscal 2008, according to the IRS filing. Three were based in Lane County, and two in Bellingham, Washington. 

Even with its loss in fiscal 2009, the PeaceHealth system does have a big financial bank account built up over the years. PeaceHealth's cash and investments totaled $258 million that is down from $386 million in 2008.  Below is a financial statement for 2009.


PeaceHealth FINANCES, FISCAL 2009 

Operating revenue: $1.37 billion 

Operating expenses: $1.43 billion 

Operating loss: $63.2 million 

Investment loss: $34.7 million 

Total loss: $97.9 million 

Source: PeaceHealth consolidated financial statements 

Article by Urban Institute
By Robert Berenson and Stephen Zuckerman

How will Health Care Reform affect the Hospitals?   For the nonprofit hospitals like PeaceHealth there may not be as many changes that will affect the hospital.  One analysis results from an Urban Institute micro-simulation model suggests that 30 million newly insured Americans would generate $40 billion in new revenues for hospitals.  This would be very good for PeaceHealth’s future one area that will be changed is how Medicare and Medicaid will be paying the hospitals.  This change could be positive or negative depending on how it is implemented.  An Independent Payment Advisory Board will recommend policies to reduce Medicare spending in the future so that it does not exceed a target growth rate.
         There will be new requirements based on whether or not a nonprofit hospital provides the kind of community benefits needed to maintain their nonprofit status and the coverage expansion that will take place with the new Health Care Reform.   The new reform imposes laws that will require nonprofit hospitals to conduct community needs assessments every three years and to adopt an implementation strategy to meet the needs of the community.  The new reform also contains a number of provisions that guide hospitals’ adoption and application of financial assistance policies, including limiting charges to uninsured patients.
PeaceHealth’s general reputation has been excellent for many years and after doing research about the Washington based corporation I have found that Oregon has benefited a great deal.  PeaceHealth has provided hospitals and medical offices that have allowed our community to be cared for as well as provide jobs for so many in Oregon.  In my opinion, PeaceHealth has a mission to serve everyone who needs medical attention regardless if they can afford to pay for it.  PeaceHealth has maintained strong through our recent economic recession.  Also PeaceHealth does a great job to sustain our economy and environment and I feel it would be a great place to work for many years to come.
Summary
            PeaceHealth, founded in 1890, is a strong and competitive business that will continue to prosper for many more years to come. Sr. Andrea Nenzel, CSJP, PeaceHealth Board Chair states that, “PeaceHealth—the legacy of the Sisters—continues this spirit of collaboration and stewardship in fulfilling its mission today. This is the Spirit of PeaceHealth”. As discussed in our case analysis, PeaceHealth has shown excellent decision-making to meet their goals. They have shown strong points in their management, caregiving, motivation and technological development. PeaceHealth has been continuously growing and developing into a stronger business, and has become a leader in local healthcare.
            PeaceHealth is dedicated to providing “exceptional medicine and compassionate care” to many Northwest communities. They continuously pursue additional knowledge, skills, abilities, and experience. With the corporation going system wide, PeaceHealth seeks to learn, develop and grow substantially both professionally and personally. With many benefits and incentives PeaceHealth has made it an enjoyable environment not only for the patients but also for the employees.  



Bibliography
Sharamitaro, A. (2011). Retrieved from http://www.healthcapital.com/hcc/newsletter/1_11/aca.pdf

Mckenzie Willamette hospital vs. peacehealth. Retrieved from http://mhgm.com/cases/McKenzie-Willamette-Hospital-v-PeaceHealth

The spirit of peacehealth. Retrieved from http://www.peacehealth.org/Documents/spirit-of-peacehealth.pdf


http://myhr.peacehealth.org

Berg, Brian, G. MD. (2012, February 10). Personal Interview. About PeaceHealth.


PeaceHealth Consolidated Financial Statements

Stephen, Z., & Berensen, R. (July 2012). Time Analysis of Immediate Health Policy Issues.

Appendix
Part I. Business in a Changing World
Chapter 1-3
·   What does it mean that PeaceHealth is a nonprofit?
·   Is PeaceHealth part of competition, pure competition, monopolistic completion, an oligopoly, or a monopoly?
·   In what ways is PeaceHealth ethical or unethical?

Part II. Starting and Growing a Business
Chapter 4-5
·   What are the main differences between for profit and non-profit?  Why would a medical corporation what to be non-profit?
·   Does the government treat non-profit corporations differently?
·   How do non-profits fund their operations?
·   What type of corporation is PeaceHealth?
·   Do non-profits have officers or board of directors?
·   What are the officers and board of director’s responsibilities?
·   What is an ABN and how many do PeaceHealth own and operate?
·   Explain why many large corporations try to think small?  Does PeaceHealth?
·   What demographic, technological, and economic trends affect PeaceHealth
·   What are the advantages of being a nonprofit business?

Part III. Managing For Quality and Competitiveness
Chapter 6-8
·   Why is management important at PeaceHealth?
·   Out of Planning, Organizing, Directing and Controlling, which activities does Peacehealth’s managers/management perform and or carry out everyday?
·   What is PeaceHealth’s Mission Statement?
·   At PeaceHealth is there Top Management, Middle Management and First-Line Management? How do these types of management help the organization?
·   There are other areas of management at PeaceHealth including finance, production and operations, human resources, marketing and administration. What areas are crucial for PeaceHealth to have?
·   Leadership is important to have. What type of leadership does PeaceHealth’s management have, not only towards their employees but also towards the way patients are taken care of?
·   What is PeaceHealth’s organizational culture; PeaceHealth shared values, beliefs, traditions, philosophies, rules and role model for behavior. Does this culture have a strong impact on day-to-day work and why?
·   How does departmentalization affect PeaceHealth? Explain how it helps or does not help the organization?
·   Is PeaceHealth’s management wide or narrow? Why?
·   Is PeaceHealth more of a line structure or line-and-staff structure?
·   At PeaceHealth do the employees work as a group or as a team?
·   How important is it at PeaceHealth to have good communication? What does PeaceHealth do to have better communication?
·   Does PeaceHealth use formal or informal communication?
·   What is PeaceHealth’s transformation process? Does this process make the patients happy?
·   At PeaceHealth are they analyzing work processes to find/address problems as soon as they occur? What programs does PeaceHealth have to help with analyzing the work processes?
·   How does managing quality work at PeaceHealth satisfy the patients?
·   Does total quality management play a big role at PeaceHealth and why?

Part IV. Creating the Human Resource Advantage
Chapter 9-10
·   How and why is motivation the key to success at PeaceHealth?
·   At PeaceHealth what is the extrinsic rewards and the intrinsic rewards? Do these rewards help motivate employees?
·   What theory or theories best fit PeaceHealth, Maslow’s Hierarchy of Needs, Hezberg’s Two-Factor Theory, McGregor’s Theory X and Theory Y, Equity Theory or Expectation Theory?
·   Is there good use of job rotation at PeaceHealth? Does this help with boredom?
·   Does PeaceHealth offer job enrichment programs?
·   Has PeaceHealth ever experienced any problems with picketing, strikes, or boycotts?
·   If they have had employees strike, did they hire strikebreakers?
·   Do the fees they charge have effect the number of clients they receive?
·   How diverse is their staff? Are affirmative action programs a big factor in the amount of diversity at PeaceHealth?
·   What type of orientation do new hires have?
·   Has PeaceHealth ever experienced any problems with picketing, strikes, or boycotts?
·   If they have had employees strike, did they hire strikebreakers?
·   Do the fees they charge have effect the number of clients they receive?
·   How diverse is their staff? Are affirmative action programs a big factor in the amount of diversity at PeaceHealth?
·   What type of orientation do new hires have?

Part V. Marketing: Developing Relationships
Chapter 11-13
·   What are the main things that PeaceHealth sells, apart from general medical care?
·   Does the price of their services reflect its value properly? Should they charge more or less?
·   To what extent does PeaceHealth use the marketing concept? Do some departments and locations work to satisfy the clients more than others?
·   It seams to me that, because of their dominance over the area and the never-ending demand for healthcare, PeaceHealth probably does not have to have much of a market strategy for their services. Is this true, and if not in which ways do they market?
·   When they want to try a new product or system, do they try it first just at one location?
·   Do they sell any tangible products, and if so would they be classified as convenience products, shopping products, or specialty products?
·   Who do they buy their business products from and how do they go about doing so?
·   Does PeaceHealth advertise and what type of advertising do they use?
·   To what extent do the non-administrative employees of PeaceHealth use digital technology to conduct business? Would it be financially beneficial for them to update their systems to more advanced technology in some sectors?
·   What could PeaceHealth add to their website to gain greater customer satisfaction or increase number of clients?
·   Does PeaceHealth administer its financial, legal, and human resources through digital communication?
·   Does PeaceHealth have adequate systems to protect the confidential information of clients that is stored in computers or on the Internet?

Part VI. Financing the Enterprise
Chapter 14-16
·   How large is PeaceHealth accounting department?
·   Does PeaceHealth have an in house CPA or do they hire an outside CPA?
·   What accounting cycle does PeaceHealth use on Page 444?
·   Does PeaceHealth have to provide all their financial records to the public because they are nonprofit?
·   What financial ratios does PeaceHealth use to help assess the financial health of the organization?
·   Can PeaceHealth charge interest to patients with outstanding medical bills?
·   What types of loans do PeaceHealth qualify for and can they sell bonds to fund their business?
·   How has PeaceHealth done during our current recession?
·   How does PeaceHealth balance sustainability with performance during a difficult financial time?