In the Bridge Planning process  it is important to have the managers and directors to prepare a “Bridge PlanTM” to identify specific activities to accomplish incremental net revenue or cost efficiencies over a predetermined time period. These activities list the nature of the specific initiative, the responsible individual(s), the timeframe to accomplish, roadblocks to accomplish, financial impact on operations in the fiscal year, the cost of accomplishing the initiative (capital & operating) and the financial impact in subsequent years. The Bridge PlansTM are shared with the entire or organization via company intranet. The financial impact is calculated on a monthly basis and updated with year- to-date progress.
The Bridge Planning process establishes clear financial targets, outlines specific actionable initiatives, assigns specific individuals as accountable, identifies roadblocks for achievement, encourages collaboration across departments and generates a strong common attitude towards teamwork among leadership as well as a sense of accomplishment as goals are achieved.

In a good process, transparency and collaboration are a must. Eliminating silos of operations and encouraging “best practice” is a focus. In establishing targets, being clear that they are not scientific, but a “best guess”, with an understanding that it is the collective target that is the real focus. As long as individual shortfalls are met by equal or greater achievements by others the group has achieved its goal. This is particularly important as department targets are based on “best estimates” including revenue loses or comparisons to “best practice”.

Mr. McManus joined St. Raphael’s hospital in New Haven CT. as Chief Financial Officer on Monday August 4th, 2008. By Thursday, August 7th, a Bridge PlanTM process and target of $11 million in financial improvements was discussed with the senior leadership, physician leadership, managers and directors for the fiscal year 2009, beginning October 1st. The process included “breaking down” the $11 million between clinical and financial operations, and agreement among the vice presidents of a further breakdown of targets between major functional areas – revenue cycle, managed care and reimbursement in finance; nursing, medicine, surgery, radiology etc. in clinical operations.
The Bridge Planning process at St. Raphael’s helped unify the staff, focused the managers and directors on accountability and fostered teamwork and “best practice in process evolution. Change became less frightening.

The financial results were consistent over four years (2009 – 2012) with approximately $30 million each year on a $500 million net revenue base. At the end of each year, the accomplishments are rolled into next the year’s budget – so new initiatives must be identified. The results achieved by St. Raphael’s were owned and personalized by the staff – across clinical services and the business enterprise. This was a transformative event, for the management group of several hundred individuals, and for the corporation.