Cardiovascular Wellness Program For Women Over 50 example essay topic

Cardiovascular Wellness Program For Women Over 50 Running head: CARDIOVASCULAR WELLNESS PROGRAM FOR WOMEN OVER 50 Cardiovascular Wellness Program For Women Over 50 Patti E. French University of Southern Indiana School of Nursing Nursing 616 Cardiovascular Wellness Program For Women Over 50 A Business Plan Executive Summary Each year, approximately 36% of Denver, Colorado's female population experience some form of cardiovascular disease, and 700 of these women die from it. The Cardiovascular Program for Women Over Age 50 has at its main goal the reduction of morbidity and mortality rates associated with cardiovascular disease. Statistics show that cardiovascular disease is on the rise in women over age 50, further mentioning that it is also the leading killer of America's women, taking the lives of more than 500,000 women per year, which tops deaths from cancer and lung disease combined. The Cardiovascular Wellness Program for Women Over Age 50 is a professionally led, voluntary group which is available for minimal cost to women over age 50 who are interested in learning about cardiovascular disease. Additionally, participants will be screened for the presence of cardiovascular disease and referred to physicians or nurse practitioners for follow-up if needed. Throughout the program, prevention will be stressed.

This program will provide low-cost, quality educational services to these at- risk women. The target population will be female veterans and non-veterans over the age of 50 who are either inpatients or outpatients at the Denver Veterans Administration Medical Center, or are visitors therein. By improving the cardiovascular wellness of this population, this program proposes that participant's quality of life will improve and that health care expenditures related to cardiovascular disease will be minimized as a direct result of course participation. The Cardiovascular Wellness Program for Women Over Age 50 is the only of its kind in the Denver and the Denver VA Medical Center. As such, this program will address an unmet need and market. The program will meet monthly at the Denver VA Medical Center.

The meeting place on the premises has been donated by the Nursing Education Department of the Denver VA Medical Center. Course leaders will be an RN, MSN candidate, and an LVN, RN candidate who have considerable experience in cardiovascular nursing. Financial assistance in the form of seed-money for the program's start-up will be supplied by both course leaders. The first year's projected budget is $4,500.00, which would have been an investment of $15.00 for each of the course participants who are interested in achieving optimal cardiovascular wellness.

See Appendices 1, 2, and 3 for detailed financial statements and projections. Description of the Business - Overview The Cardiovascular Wellness Program For Women Over Age 50 is a professionally led, voluntary group which is available, for minimal cost, to women over the age of fifty who are interested in learning about cardiovascular health. Additionally these women will be screened for indicators of cardiovascular disease and will be referred as necessary to appropriate providers. Risk factor identification and modification will be discussed, as well as referral to smoking cessation, weight reduction, and stress management programs as indicated. This program will be directed towards female veterans and the female family members of male veterans who are either inpatient or visiting the outpatient clinics located on the premises of the Veterans Administration Medical Center located in Denver, Colorado.

This program will be an extension education program offered by the VA Medical of Denver, Colorado. It will be the only program addressing the needs of said population within the facility. The program will be service-oriented with the purpose of targeting the unique needs of women within the VA environment. The program will be not-for-profit and non-mandatory.

It is felt that there will be ample opportunity for growth and expansion, as this program is the only of its kind within Denver county and the surrounding communities. This program will be offered on the second Saturday of each month, with classes being held between 12: 00 p.m. and 2: 00 PM at the Denver V.A. Medical Center. As most veterans receiving care at this facility are male, women make up approximately 5% of all inpatient and outpatient visits to the Denver VAMC. Most women veterans seeking care at this facility are veterans of the Vietnam War and thus fall within our guidelines for class admittance. Therefore, this program will specifically spearhead efforts to address the needs of these women.

It is also felt that women visitors to the VA, who also happen to be mostly elderly, will benefit from program participation. In general, the program objective is to help women live longer, healthier lives. Business Plan - Product & Service The product of this business plan is the promotion of cardiovascular wellness for women over age 50, for veterans and non-veterans. The service provided will consist of promotion of cardiovascular wellness, education regarding cardiovascular disease, identification of cardiovascular disease with referral as necessary, and risk factor identification and modification measures. As the incidence of cardiovascular disease in women over age fifty is increasing, this program will address this at-risk population within the VA Medical Center. Business Plan - The Location Upon approval, classes will be held within a conference center located within the basement of the VA Medical Center in Denver, Colorado.

The room must accommodate up to twenty-five course participants, two instructors, and an overhead projector, room for flip charts, and a large table for course materials, and cardiovascular health screening equipment. The conference room will be equipped with heating and air conditioning, and handicap bathroom facilities will be nearby. Public transportation via Denver Area Rapid Transit is available to provide "front- door" service for participants and parking is accessible onsite. Maps will be provided before hand and there will be signs directing participants to the class. Business Plan - Objectives The purpose of the Cardiovascular Wellness Program for Women Over 50 is to provide education and professional intervention by nurses for women at risk for cardiovascular disease, with the ultimate goal being women achieving heightened awareness of what cardiovascular disease is, what it can do, how to treat it, and how to prevent it. To these ends, the program objectives are as follows, 1) To provide education to women at risk regarding cardiovascular disease and treatment 2) To discuss modifiable risk factors for cardiovascular disease in women 3) To provide screening for the detection of cardiovascular disease in program participants, with referral as indicated 4) To present information on the prevention of cardiovascular disease 5) To discuss the importance of prevention for these at-risk women National statistics indicate that heart disease is the leading killer and disabled of women and that each year approximately 2.5 million women nationwide are hospitalized for cardiac illness - and 500,000 of these women die.

Women are twice as likely to die from heart disease than all cancers combined, and at least 39% of women suffering from their first myocardial infarction do not survive it. Women also have different symptoms than men and respond differently than men to treatment, along with being frequently misdiagnosed because of atypical presentation. Additionally, the vast majority of studies reflect that as women age, incidence for cardiovascular disease increases. Measures to address the unique needs of women regarding the prevention and treatment of cardiovascular disease are therefore necessary to decrease the morbidity and mortality associated with this this killer targeting our nation's women. Marketing Plan Mission Statement The Cardiovascular Wellness Program for Women Over 50 will provide cost- effective education and screening services for women proven to be at increased risk for cardiovascular disease. The goal of this program is to help reduce the morbidity and mortality rates associated with this disease in at-risk women.

This program will fully utilize the experience of nurse-presenters within the realm of cardiovascular nursing. Additionally, this program, the only of its kind in Denver, Colorado, will address the otherwise unmet need for cardiovascular wellness education in this population. My customers will be women, veterans and non-veterans, who are visiting the Denver VA Medical Center, either as outpatients, inpatients, or as visitors. These women must be over age 50 to participate in my program. The Cardiovascular Wellness Program for Women over 50 is a service-oriented, educational program, whose participants will be targeted by identification and voluntary means. The geographical area served will consist on both clinic and inpatient settings within the VAMC.

As said program is solely geared towards women over age fifty, our goal is to continue to offer classes without anticipated extension into the community or by collaboration with surrounding Denver hospitals. Since the program will be held at the DVAMC, approval via proper authority will be sought. The Cardio- vascular Wellness Program for Women Over Age 50 will provide education regarding what cardiovascular disease is, what it can do, how to prevent it, and how it is treated. As there are no programs in existence in the Denver area providing our unique service, competitive presence is not a concern.

The program will offer cardiovascular disease education, cardiovascular wellness promotion and disease preventative measures for our at-risk participants. It is planned that this program will improve the wellness of women over age 50, veterans and non-veterans, thus lessening the morbidity and mortality associated with cardiovascular disease within this at-risk population. Doing so will improve these women's quality of life and reduce their health care expenditures related to this disease. As the Denver VAMC doesn't currently offer a program such as mine, doing so will address an unmet need and market. This marketing plan will strengthen my identity as a student advanced practice nurse. Market Audit a) Target Markets- My "first-line" customers are women over age fifty who are in need of education regarding cardiovascular wellness.

As women over age fifty are at increased risk for the development of cardiovascular disease, these women have a vested interest in group participation to help lessen their risk of morbidity and mortality associated with this disease. Secondary "customers" will be the administrators of the Denver VA Medical Center. Community Demographic Profile- a) Population to be served- women over age fifty, veterans and non-veterans, visiting either as inpatients, outpatients, or visitors. b) The service area for the Denver VAMC is a 197-bed tertiary hospital / clinic facility. c) Census data for Denver, Colorado- Age: Percent: Race: Percent 5 6.81 White 65.3 5 - 9 6.22 Black 11.1 10 - 14 5.65 Asian 1.31 15 - 19 5.82 Pacific 20 - 24 8.21 Islander 0.12 25 - 34 20.5 Native 35 - 44 15.58 American 1.31 45 - 54 12.8 Hispanic 19.36 55 - 59 4.07 60 - 64 3.1 65 - 74 5.52 75 - 84 4.21 85 1.52 Median Age = 33.1 years Income: Percent: Denver Co. Causes of Morbidity for 2001 Gender: Percent: Cardiovascular Disease 36% Male 50.09 Pulmonary Disease 6% Female 49.91 Cancer 22% Diabetes 2% Other Causes 34% d) Transportation to the DVAMC is provided at reduced rates to seniors by Denver RTD, a public transportation service, and also by numerous taxi companies. All provide "curb-service" to the main entrance on the hospital, where the classes will be offered. Business and Industry- The Cardiovascular Wellness Program for Women Over Age 50 will be taught by myself and another DVAMC registered nurse.

The program will be provided for a nominal fee of $15.00 charge to all participants, which will cover the costs of materials, supplies, and payment for the nurse educator's time. It will entail minimal overhead, thus being fairly cost-contained. The Denver VAMC will provide the conference room without charges for set-up. As advanced practice nurses have been proven to deliver exemplary cost-effective care to patients, their families, and their communities, we are key players in meeting the health care needs of all.

Trends- As the VA Medical Center system is the largest employer of advanced practice nurses in the United States, it is apparent that APNs are used to meet the health care needs of many of its patients and their families As such, APNs are key players within the DVAMC and are consequently frequently utilized within all realms of the VA system. As the health care system evolves and the need for high-quality, cost-effective health care delivery becomes even more important, APNs will continue to assume more responsibility for meeting the health care needs of Americans. Competition- After analysis of services provided by hospitals located in and near Denver, there are no programs offered, inpatient or outpatient, dealing specifically with the unique needs of women over fifty. There are, however, numerous web- based cardiovascular wellness sites offered by Denver hospitals, but none deal specifically with my population. Additionally, there are numerous websites discussing women's cardiovascular health, such as those of the American Heart Association, the National Institute of Health, the Center for Disease Control, WebMD, Medline, and MedScape.

As such, women over age fifty who reside in Denver and its surrounding areas are without access to the internet are at a loss for relevant information addressing their heightened risk for morbidity and mortality related to cardiovascular disease. As such, my program would help address an otherwise unmet need for these Denver women. Internal Analysis Strengths of the student APN and fellow APN presenters include an eagerness to exercise an advanced practice educator role, the APN's approach to practice, and clinical practice background in cardiovascular nursing, and a commitment to meeting the health care needs of women. Instructor weaknesses include being in an unfamiliar role, which entails public speaking and lack of experience of developing a formal educational program. As the program will be offered at the DVAMC and because it will be taught by nurses employed therein, strengths include the VA image, its strong commitment to patient and nurse practitioner education, its dedication to being the primary agency for meeting the health care needs of veterans, and its provision for cost- effective educational courses to patients and health care providers.

Weaknesses of providing the classes at the DVAMC could include difficulty obtaining permission due to multiple chain of commands to go through to obtain approval. I do not foresee any threats, either personal or business, during this process. Actual Marketing Plan Product- The product of this marketing plan is educating and preliminary screening of women over age fifty for cardiovascular disease. The product will include information on what cardiovascular disease is, how it is treated, how it can be prevented, and risk factor modification. The product will be addressed by two nurse-educators, one an APN student and the other being and advance practice RN.

As the trend for cardiovascular disease in women over age fifty is increasing, this market must be targeted. Promotions- Advertisement and promotion of this program will be accomplished by strategically placed flyers and posters throughout the Denver VA Medical Center inpatient and outpatient settings. Also, the program dates, times, and overview information will be listed in the DVAMC monthly newsletters. A reminder for DVAMC employees to offer the course to women meeting the criteria for program inclusion will be posted on the DVAMC intranet in hopes that course availability will not be overlooked. By making women over age fifty aware of their heightened risk of cardiovascular disease, my hope is these women will become interested in attending this program geared to address their particular health care needs. Placing- The program will be held on the second and fourth Saturday of each month between the hours of 12: 00 and 2: 00 PM in the DVAMC conference room (basement room# B-101).

Pricing- Costs for course participation will be $15.00 per person. As this is a nominal fee for a 2-hour course, it is hoped that many women will choose to participated. Course postings, which will be strategically placed throughout the both inpatient and outpatient settings at the DVAMC. Monthly budget, which will include costs of printing handouts and brochures, nourishments, and necessary material and supplies is not expected to exceed $100.00. Additionally, the RNs presenting the course will do so on a voluntary basis. Overall, this program is a cost-effective means for addressing the needs of course participants.

Resource Needs Materials and supplies needed for this program will include these items provided by the Denver VA Medical Center: tables and chairs (enough to seat 25 partici- pants and 2 nurse-presenters), one overhead projector with transparencies, one flip- charts and stands. Nurse course-presenters will develop and be responsible for the printing costs for twenty-five pamphlets per course. These pamphlets will cover hypertension, hypercholesterolemia, smoking cessation, exercise, nutrition, stress reduction, and health maintenance. Nourishments for participants will be provided by nurse presenters. Signs developed by nurse presenters, reflecting the course, date & time, will be strategically placed throughout the DVAMC. Pre- and Post-course questionnaires designed to assess participants newly acquired knowledge will be developed by the nurse presenters.

Pencils and scratch paper for note taking will be furnished by nurse-presenters. Total monthly budget is expected not to exceed $100.00. Approval allowing the program to be provided at the DVAMC will be obtained from administration. Also, administration will be informed of the anticipated benefits this program will offer regarding overall facility budgeting. Implementation of the Marketing Plan The Cardiovascular Wellness Program for Women Over 50 will initially begin on August 23, 2003.

The program will held in a moderately sized conference room accommodating 25 course participants, 2 nurse educators / presenters, equipment, materials, supplies, and necessary furniture. This conference room is not being otherwise used on course dates and times. The room is climate- controlled, and is located adjacent to handicap-accessible restrooms, pay phones, and vending machines. The conference room location is also close to parking and public transportation drop-off. Marketing Plan Evaluation The program's effectiveness will be evaluated six months after initiation by mailing questionnaires to former course participants addressing their retention of course material and also by assessing their cardiovascular wellness behaviors and risk-modification activities. The program may be revised as necessary to better accomplish course objectives.

Present Situation 1) Geographic Area Served: a) As the Denver VA Medical Center is a regional referral center for Colorado, Utah, Wyoming, Nebraska, and Kansas, there is a definite need to address the cardiovascular wellness needs of women over 50 at this tertiary care facility. It is further anticipated that my program will meet the needs of its target population. b) The city of Denver has more than doubled its population since 1960. Since 1990, Denver's annual growth rate has remained about 2.4%. Women make up 49.91% of Denver's population and women over age 50 make up 12.37% of same. Given this data, females over 50 residing in Denver are also expected to experience a 2.4% annual growth rate. This data considers the increased life expectancy of the target population, as well as those included who qualify as "baby-boomers". c) It is expected that as more area inpatient and outpatient health care facilities become aware of the need for cardiovascular wellness education for women over 50, competition for course participants will occur.

However, since my program is only being advertised within the V.A. inpatient and outpatient clinic settings, it is unlikely that any outside competitive problems will arise. d) As insurance premiums and co-payments are expected to spiral upward, while coverage for inpatient, outpatient, and prescription coverage plummets, I foresee less accessibility to needed health care resources based primarily on inability to pay for services. As a direct result of these anticipated reimbursement changes, I expect that many members of my target population will be unable to maintain optimal cardiovascular health. Many of these women will consequently experience higher morbidity and mortality from cardiovascular disease. e) Denver is among the most prosperous city in the U.S., ranking 8th in the nation, as well as being among the most highly educated. It is anticipated that its inhabitants will continue to value financial gain and advanced education.

Also, its poverty rate has fallen by almost half since 1990, (Denver Chamber of Commerce, 2003). Social values of Denver residents also include political conservatism, environmentalism, and a commitment to family. Social concerns include over-population, urban sprawl, worsening traffic congestion, public education, and a rising cost of living. I expect that these problems will continue to grow as the city continues to experience growth and evolution. 2) Physical Plant: The business (Cardiovascular Wellness Program for Women Over 50) will be located in the basement-level conference room of the Denver V.A. Medical Center.

The conference room is a 2500 sq. ft. enclosure providing adequate space for course conduction. No charges will be incurred for the conference room by the DVAMC. It is expected that some lag time will occur as potential course participants (customers) become aware of the course offering and of the health benefits it will provide. 3) Resources: Materials and supplies, which are, free-of-charge or are provided by nurse- instructors include: 30 chairs, 2 tables, 30 clipboards, 2 stethoscopes, 2 sphygmomanometers, 1 overhead projector, and 1 file cabinet. Initial Start-Up Budget: Advertisement posters 5.00 Pamphlets 10.00 Pre- & Post-Tests 5.00 Risk Questionnaires 2.50 Objective Statements 2.50 Overhead Projector Supplies 5.00 Nourishments 10.00 Total 1st Course Out-Of-Pocket Expenses: 40.00 Initial course out-of-pocket expenses will be incurred by nurse- presenter and nurse co-presenter. We will utilize just-in-time inventory measures to maintain cost-containment, to keep out-of-pocket expense to a minimum, and to ensure low operating and overhead costs associated with course provision.

After the initial start-up phase (i.e. the first month of course conduction), course-related costs will be funded by course registration fees provided by participants ($10.00 per person). Computer, fax, modem, telephone, word processor, spreadsheet, and printer access will be provided by the DVAMC Medical Library free of charge. This access will help nurse-instructors access course-related information, as well as maintain course income and expenditures. Course documents will be kept in in a locked file cabinet donated by the DVAMC nursing education department. Management & Personnel a) The course leader and coordinator will be Patti French, RN, BSN, CORN, Acute Care Nurse Practitioner / Masters of Science in Nursing candidate. She is pursuing her advanced nursing education and the University of Southern Indiana School of Nursing.

She has 14 years of adult critical care nursing experience and currently works in the ICU at the Denver VA Medical Center. She is committed to educating women regarding their risk for cardiovascular disease, modes of therapy, prevention, and risk factor modification to reduce the mortality and morbidity associated with this disease. b) Amy Mahaffey, LPN, RN candidate, will be the course co-leader. She has extensive experience as a paramedic and mental health professional. She currently attends the Community College of Denver School of Nursing. She is employed by Cedar Spring Behavioral Health. She too is committed to educating women about cardiovascular disease.

Ms. Mahaffey will assist the course coordinator in all endeavors pertaining to the program's activities. c) No additional personnel will be required for course conduction. d) Referral to cardiovascular physicians and nurse practitioners of participant's choosing will be provided in the following situations: 1) women untreated for current CHF, HON, CAD, PVD, and cerebrovascular disease, 2) women in need of risk factor modification (i.e. smokers, those who are obese, those with prior diagnosed cardiovascular disease, those with a strong family history of C.V. disease, and those abusing ETOH), 3) women found to be hypertensive, with pulmonary edema, peripheral edema, with cardiac arrhythmias, or with S 3/S 4 or murmurs upon individual screening by nurse- leader and co-leader. Marketing Strategy Product / Service: The Cardiovascular Wellness Program for Women Over Age 50 is a service- oriented educational program, which addresses the topic of cardiovascular disease in women over age 50, how it is detected, how it is treated, and how it can be prevented. As there are no competitors in the Denver area providing this unique service, my product has Unique Selling Advantage (USA). It is expected that course participants will recognize their need for my service as they begin to realize their own age-related risk for cardiovascular disease, as well as their need to maintain and improve their individual cardiovascular wellness. My program will address this need. Price: As mentioned elsewhere in this paper, course participants will be required to pay $10.00 for inclusion in the program.

This income cover course expenses (i.e. course handouts, brochures, advertisement expense, etc. ). Thus, I am "charging the market will bear", (Covello & Hazelgren, 1998). The cost of course attendance is very nominal when compared with the health benefits that are expected to occur as a direct result of each individual's participation. Therefore, I feel that my program is indeed cost-effective. Place: Also mentioned elsewhere in this paper, the course will be help in a 2500 sq. ft., basement-level conference room located in the Denver VA Medical Center.

This room is large enough to accommodate instructors, all course participants, materials, supplies, furniture, and course equipment. Restrooms and vending machines are directly adjacent to the conference room. Parking, public transportation, and taxi drop-off are all within 100 ft. from the classroom. Promotion: The course will be initially promoted by out-of-pocket expenses incurred by both course leader and course co-leader. After the first held course, funds to support course promotion will come from course registration fees paid by course participants. The course will be promoted in the following ways: 1) a monthly DVAMC intranet notification from course leader / co -leader to all employees soliciting their assistance in getting the word out about the course, its dates and times, 2) website development by course leader providing updates regarding women's cardiovascular health and wellness, 3) 11 x 13 signs indicating course, date and time, developed by course leader / co -leader placed strategically within DVAMC inpatient and outpatient clinic areas, 4) brochures dealing with cardiovascular wellness, developed by course leader / co -leader, will also be placed within these same settings, 5) lastly, the course will be promoted by making physicians aware that our service is available and by eliciting their referral of female patients over age 50 to the program.

Course effectiveness will be evaluated by follow-up questionnaires mailed to prior course participants at the end of three and six months after course initiation and yearly thereafter. Revision of course content will be based upon these findings. Function of the Product / Service: The function of my service, the Cardiovascular Wellness Program for Women Over Age 50 is to provide course participants with the knowledge necessary to maintain cardiovascular wellness and to help them reduce their potential morbidity and mortality associated with cardiovascular disease. By arming these women with this newly acquired knowledge, it is expected that they will initiate risk- factor modification behaviors, that they will seek prompt medical care (i.e. ANP, MD) when signs and symptoms of cardiovascular disease occur, and that they will have a heightened understanding of what cardiovascular disease is, how it is treated and prevented, and how to maintain optimal cardiovascular wellness. Finances, Freedom, Feelings, & Future.

The initial cost of course start-up has been mentioned earlier. It is fully anticipated that any expenses incurred for course provision will be heavily outweighed by the direct health care benefits that will arise secondary to each individual's participation in this program. As most female patients over age fifty are Denver residents, they have ready access to numerous taxi companies, public transportation services, van-pooling, as well as generous parking near the course location. Therefore, it is hoped that course participants will find the course location convenient and accessible. As a result of information gained from this program, participants will hove the confidence necessary to take control of their own cardiovascular wellness, thus empowering them to live long and healthy lives. Financial Projections As the Cardiovascular Wellness Program for Women Over 50 is a non-profit, service-oriented program, it will show a profit within the first six months of operation.

Gross revenue (income) for the first year of operation will be $4,500.00 and the net profit for the same period will be $960.00. This assumption is based upon the following assumptions: 1. Course participants will contribute approximately $250.00 per month as fees for class attendance. This income will be on a cash basis, totaling $4,500.00 annually. 2. Nurse presenters will derive a total of $100.00 per month as payment for teaching the course.

3. Remaining costs for course provision average $295.00 per month. 4. Monthly, the program will experience an $80.00 net profit, resulting in a yearly profit of $960.00. 5. Profits will be re-invested in the future operation of the business.

Monthly Cash Flow Projections, Income Projection Statements, and Balance Sheet are found in Appendix A, B, & C

Bibliography

City Demographics, (2003).
Denver Colorado Statistics and Demographics Resources. Retrieved on 6/4/03 from web Covello, J. & Hazelgren, B., (1998).
Your First Business Plan 3rd. ed. pp. 46 -55. Sourcebooks, Inc., Naperville, IL. Denver Chamber of Commerce, (2003).
Welcome to Denver. Retrieved on 6/5/03 from web National Center for Chronic Disease Prevention and Health Promotion, (2002).
Facts About Women and Heart Disease- Colorado. Retrieved on 6/2/03 from web Small Business Association, (2002).
Starting Your Business. Retrieved on 6/20/03 from web Unknown Author, (2001).