CASE STUDY: Developing a Strategic and Operational Plan for a Tribal Health Client

April 19, 2022


Client’s Challenge

Our Tribal Health client was seeking guidance and assistance with mobile health and telehealth service offerings. In preparation for their implementation of these services, they secured John Lynch & Associates as their consulting firm to help develop a comprehensive strategic and operational plan with an overarching policy for their program.

In addition, we guided our client’s efforts in their Connected Care Initiative that would serve as the framework for interorganizational collaboration coordinated through the Tribal Healthcare Administration, which was acting as the backbone organization for the network.


Our Solution

John Lynch & Associates’ consulting team spent a week onsite and met with several program leaders to discuss their desired state and current needs.

During the discovery process our consultants found that each healthcare program currently functioned in a separate silo as far as systems, processes, and approach. In addition to these siloes, it was stated in several meetings that there is a significant disconnect with the Indian Health Services hospital and the tribal community members receiving services. This “gap” is where mobile and telehealth services will help better serve the tribal community.

Our client had two mobile units to date, however neither was being utilized in a regular capacity. Additionally, they had three mobile trailer units on order and scheduled to arrive before the end of the year. To date, there had not been any sort of needs assessment within the various Tribal communities and efforts to pull supporting data from the hospital’s electronic health system had not been successful.

Community Needs Assessment

Planning for a Community Needs Assessment is just as critical as conducting the actual assessment. Ensuring our client had the right people to assist, identifying the logistics and the content of the assessment, determining what data to collect, how to collect the data and from whom was all essential. Representation from the various Tribal communities and partner organizations was critical to the success of the mobile health/telehealth service offerings and programs. Including all members of the community in either an active or passive role provides equitable access and informed knowledge of the program, thereby solidifying their support.

Together with John Lynch & Associates guidance, the Community Team and Project Stakeholders determined what information was pertinent within each community to assess. This led to the most important and relevant areas of evaluation and in turn to the most useful recommendations for the program offerings. Formalizing this information to make quality decisions began with good data gathering.

Data comes in many forms; varying the data-collection methods provided a more comprehensive assessment of the Tribal community. John Lynch & Associates focused on qualitative data; however, realized it was important to use both qualitative and quantitative data collection methods to obtain a more in-depth, reliable assessment of the community needs.

Community Health Opinion Assessment

The Community Health Opinion Assessment was also determined as a priority in this project. This process of assessing health status and needs at the community level and developing community-based strategies to address health problems allowed the community’s opinion of health-related needs, concerns, and problems to be heard.

Outcomes Reporting

Healthcare outcomes improvement can’t happen without effective outcomes measurement. Given the healthcare industry’s administrative and regulatory complexities, and the fact that health systems measure and report on hundreds of outcomes annually, this article from CMS adds much-needed clarity by reviewing the top seven outcome measures, including definitions, important nuances, and real-life examples. The top seven categories of outcome measures are:

    1. Mortality
    2. Readmissions
    3. Safety of care
    4. Effectiveness of care
    5. Patient experience
    6. Timeliness of care
    7. Efficient use of medical imaging


CMS used these seven outcome measures to calculate overall hospital quality and arrive at its 2018 hospital star ratings. This article also reiterates the importance of outcome measurement, clarifies how outcome measures are defined and prioritized, and recommends three essentials for successful outcome measurement.”  The Top 7 Healthcare Outcomes Measures (

It was critical that our client work directly with Indian Health Services to obtain patient outcomes reporting. During our visit onsite, John Lynch & Associates consultants met with the CEO of the IHS hospital and discussed the need for this type of patient reporting and how to strengthen this working relationship. Solutions were discussed at length with our client.

Strategic Roadmap – Goals, Objectives, and Initiatives

Following discussions onsite and review of foundational items, the start of our client’s strategic planning had been centered around developing a set of goals and objectives.

To finalize and fine tune the overall objectives, our consulting team recommended and met with the Leadership Team to review in detail and make appropriate edits. As strategic goals and objectives were unified across the various communities and programs, a Strategic Roadmap was also created. This roadmap provided a visual depiction of the goals and objectives developed during this overall process.


Risks are inherent with any new project or program. However, bringing awareness to risks is the start toward mitigating threats and increasing the odds for success.

To ensure the successful implementation of our client’s mobile and telehealth program, we recognized the following risks that could negatively impact the success of these important goals.

  • The need for adequate, qualified, and motivated staff (often mitigated with strong policies).
  • Community trust (to mitigate, manage timing and effectiveness of community outreach, transparency, and solid, consistent communication).
  • IHS partnering (mitigation by strong relationship building, growing trust, providing an organized and quality strategic plan).
  • Funding stability (mitigate through strong funding sources, conservative budgeting, and efficient/quality processes for care giving, billing, and staffing).

Final Steps

Our client’s leadership team, working with John Lynch & Associates, finalized a transformational strategic plan to guide the organization into the future. Throughout the planning process, our consulting team was able to guide discussions and exercises while the leadership and stakeholder teams provided in-depth content for their goals, objectives, and initiatives. Together we ensured that the goals and overall strategic plan truly pointed toward achieving the requirements of the Connective Care Initiative while adhering to tribal culture and norms.

A set of organizational values were also put in place to guide the organization, bring accountability to leadership and staff actions, and to ensure a healthy and thriving culture.

Moving forward our client’s completed strategic plan provided the path toward future successes. The plan was implemented through strong leadership, excellent communication, and daily activities across the client organization and will be used to guide the organization’s priorities, resources, and operational steps through future years.

For more information regarding this case study or if you would like to discuss how we can assist your tribal healthcare needs, please contact us at 623.980.8018 or by email

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