Establishing New Services

 A growing demand for a comprehensive approach to health as well as changing health and wellness needs of the student population may necessitate the addition of services such as gynecology, mental health, pharmacy, lab services, x-ray, complementary and alternative medicine (CAM), physical therapy, and others.

Depending on available funding and resources including space, the establishment of new services may be a long-term project. This may be especially true if the existing center has outgrown its current location or extensive renovation is required to accommodate more services. If a new building or renovation requires capital investment, the timeline may also be dependent on the university’s priorities and schedule. Once a needs assessment has been performed and a business plan developed, university officials should be consulted to determine the university’s process for moving forth with the project. Some universities may not have a role if the goal is to add new services in existing space but others may require approval for any new service regardless of scope.

ACHA Connect, the online community and discussion forum, is an excellent resource to query colleagues who have experience in establishing similar services.

Developing a thorough process prior to implementing a new service may avoid unnecessary expense and rework. The process of implementing new services ideally includes the below areas.

Assessing the Need for New Service(s)

A formal needs assessment does not necessarily need to be conducted as the need for new services may be addressed through other means, such as:

  • Feedback from patient satisfaction surveys
  • Focus groups
  • Student health advisory committee (or similarly named group) recommendations
  • Clinician/staff referral patterns
  • Staff feedback
  • Performance improvement activities
  • Need for additional revenue
  • Use of evidence-based practices
  • Ability to fulfill the organizational mission/vision

Developing a Business Plan

A business plan details the proposed service and its financial and operational impact on the health/wellness center, including information about the service, how it will be structured, funding required and financial projections. The plan is a living document and should be regularly updated and maintained. The formal business plan is usually standardized with the following sections:

  • Executive summary
  • Timeframe for implementation of new service
  • Description of new service(s) and reason for need
  • Market analysis (may or may not be applicable depending on the location of the campus)
  • Start-up costs
    • Staff training
    • Staff certification
    • Equipment
  • Physical space requirements
    • Renovation of existing space
    • Addition of space (internal vs another site on campus)
    • New facility
    • Licensing/certification for location for services such as pharmacy, lab, x-ray
  • On-going costs
  • Funding
    • Student fee based vs. fee for service
    • Insured vs non-insured service (medical insurance)
    • Other (i.e. university funds, bonds if new construction, etc.)
  • Pricing strategy
  • Projected return on investment (ROI)
  • Marketing strategy

The U.S. Small Business Administration’s template may be useful for writing the plan.

Communication with Key Stakeholders

Campus Administration and Student Leadership

Communication with campus administrators and students is essential in generating support and enthusiasm for the proposed new service. Utilize your communication channels and chain of command as a starting point to present the key elements of your business plan. If student fees are the primary funding source for the new service(s), a presentation should be made to appropriate campus student leadership. Ideally, the student health advisory committee (SHAC) or other student leaders from the health center can demonstrate support by actively participating in presenting the plan, writing a letter of support, or attending presentations.

Health Center Staff

Buy-in from the health center staff is critical. Communication with health center staff should be early, frequent, and timely and utilize several channels of communication ranging from informal discussions to formal presentations. Begin to seek staff input prior to finalizing the business plan. Encourage staff participation throughout the process; their input may prove invaluable.

Key plan elements to present include:

  • Impact, if any, on providers, schedulers, billing, IT, HR, and support staff
  • Impact on existing services
  • Financial impact
  • Benefit to the student/patient experience
  • Benefit to the organization(i.e., financially, reputation, meeting mission and goals, meeting best practice standards, etc.)

Identifying Operational Tasks

In addition to developing the business plan, administrators must assign and identify functional tasks such as creating policies and procedures for the new service(s) drafting or updating position description for those staff who will perform the new service(s), credentialing staff, and developing performance measures for on-going evaluation. On-going evaluation of the new service includes evaluation of the service’s utilization, quality, financial status, and whether the goals established in the business plan are being met.

If there is minimal to no in-house expertise, policies and procedures can be drafted as and then finalized after the new staff member(s) is hired. Alternatively, reach out to college health colleagues who currently provide the service to review their documentation and tap their knowledge, experience, or expertise.

Recruitment and Hiring of Staff

If the new service requires additional staff, prepare a job description documenting duties and requirements for licensure, certification, or credentialing per state regulations and/or accreditation standards. Begin the recruitment process once the business plan has been approved and an estimated date for implementing the service has been established; this may also be contingent on recruiting and hiring practices for the university. For example, if it takes three to four months to normally recruit and hire someone, begin the recruitment process at least that many months prior to the anticipated implementation date.

Follow the university’s recruitment and hiring policies. Consider using recruiting tools such as Indeed, LinkedIn, and ACHA’s Career Center to post the new position(s). Hiring an individual experienced in college health is a plus.

Purchase and Install Equipment

Equipment should be ordered with enough lead time to schedule professional installation, thoroughly test the equipment, and train the staff prior to service implementation. The timeframe for ordering can be established when obtaining cost information for the business plan. Depending on the type of equipment and its availability, delivery times can range from overnight to a couple of months. Additional supplies should be obtained as close as possible to the start of the new service. For example, massage cream for massage therapy can be ordered from a variety of vendors and does not need to be ordered far in advance. Be sure to comply with the university’s procurement policies, especially when ordering capital equipment.