Medical Music Therapy Business Plan:
A patient and staff based program model
Seneca Paul Block, MT-BC
INTRODUCTION
This project has been designed as a set of guidelines for music therapists to
gain critical business insight and utilize provided resources along with their described
rationales in order to successfully propose and present music therapy programming to
a medical facility’s administrative bodies. The following content is made up of a
background description to provide baseline knowledge for the therapist, followed by
an annotated model business plan outline describing the critical insight for each
section, a description of program data collection and rationale, program model
objectives along with a timeline of implementation and a program expense
description. In addition to these sections, an annotated bibliography is included to
provide a means of increasing the therapist’s business acumen and understanding
along with an appendix that is referenced throughout this project when applicable. It
is hypothesized that upon the utilization of this project’s philosophies and model
materials, a music therapist will increase their required skillsets enabling them to
successfully prepare, propose, present and implement a medical music therapy
program.
BACKGROUND
Medical centers require cost-effective means of improving patient pain
management, employee engagement, and environmental noise, in order to clarify
1

the clinical rationale and financial justifications for investing in holistic treatment
modalities, specifically, music therapy programming.
Music therapy is an evidence-based practice that uses music to address pain
management, employee engagement, and environmental noise, among other issues.
Through music therapy programming, a trained clinician (board-certified music
therapist MT-BC) is able to adapt services that account for patient and employee
wellness and provide a highly cost effective, non-invasive and research-informed
form of holistic treatment. This project is in the form of a business plan that
articulates improvement goals and defines music therapy service delivery, in
addition to providing supporting materials including sample assessments, plans and
presentations including analyses of average program outreach. In addition to these
documents, sources in the form of meta-analysis and published literature for both
medical music therapy program development and business culture will be provided
along with their summaries of key points and rationales for inclusion and
significance.
Historically, music therapy is an aspect of patient care that is often utilized
on an interdisciplinary (ID) team of medical providers in order to meet patient’s
goals of optimum health in body, mind and spirit. Like many integrative medicines,
music therapy’s philosophy is built from a humanistic framework and approach that
accounts for the whole person. Furthermore, when recognizing the responsibility of
providers and clinicians in the medical field to address not only physiological
aspects of patient care, but also the psychological aspects of patients and their
family members.

2

In recent years, medical centers nationwide have taken on a more holistic
approach, making music therapy services more common place among the accepted
medical treatments. The growing need for facilities to meet the demands for alternative
therapies and treatments to avoid potentially harmful side effects of medications has
fueled the expansion of music therapy programs. This shift in philosophy may be
attributed to the rising opioid epidemic, which now has healthcare providers searching for
alternative and safe methods to manage pain, without exacerbating the rising issue of
patient drug seeking behaviors that have resulted in an opioid crisis.
In addition to providing well-documented and safe means of pain and stress
management, music therapy has become an integral member of the ID team, serving
multiple functions while addressing patient’s ever complex emotional needs. With
this said, music therapy serves several key developmental domains through its
offered services, with a continued focus on addressing patient stress and pain
management, while additionally addressing patient needs of coping, anxiety,
depression and related negative emotional responses common in hospitalized
inpatient populations. With a balance of providing emotional, social and physical
support for patients and their families, music therapy’s service efficacy appears
most beneficial within the medical setting when integrated into the medical staff’s
daily rounding and treatment teams primarily consisting of pharmacists, medical
residents, nursing staff members and social workers.
Personal Perspective
This rationale of systemic integration has aided my work and the
development of several successful music therapy programs within my hospital

3

system. These developed programs now encompass the span of four hospital
facilities, each with the expansion of a fulltime music therapy staff member in
addition to four programs in developmental phases. The development of this multifacility music therapy program took place over the course of a three-year period
through an integrative health network within a large northeastern Ohio hospital
system.
With my background as a lifelong musician, performer, sound engineer and
MT-BC, the opportunity for program growth was found within a series of
community hospital settings during my part time employment within them.
Although training in music therapy services and program design provided an
excellent framework for service expansion, there was an apparent lack in skills
related to business culture and acumen. However, through the discovery of several
recourses including business literature highlighting strategic thinking, leadership
and communication, this lack of business understanding was supplemented through
the provided readings along with real life proposal experience. These highlighted
recourses aided in the business culture awareness including presentation skills and
effective focused communication techniques, as well as concrete strategic planning
and program implementation.

4

MODEL BUSINESS PLAN OUTLINE
(Section Rationale Provided)
A. Music therapy program tactical breakdownSection Rationale: In regards to this suggested music therapy programming model, it
is hypothesized that improvement in program goal areas will justify the inclusion of
Music Therapy services in hospital facility fiscal year budget. Specifically, hospital
administrators will incorporate music therapy programming into their yearly budget
as a result of the presentation of a music therapy business plan that outlines music
therapy clinical benefits, program structure details, and associated costs. The
development of a business plan is the first phase to test this hypothesis, along with the
review of suggested business literature which impacts the effective communication
and appropriate representation of this business plan.
When presenting an outline to an individual or group for proposed programming,
the first step is providing a breakdown of music therapy programming overview, goals,
objectives and details. The following several sections of this model are provided to offer
talking points for the therapist to guide the conversation in the moment and to serve
as material to leave with decision makers for further review. This model may serve as
a framework, though it is suggested that the therapist relate the need for the research
of facility needs and the individualization of specialized goals and objectives for the
specific hospital or medical facility.

5

Music Therapy Program Model Focus & Overview includes:
I.

Patient experience-

Section Rationale: Patient experience is considered a top priority for hospital
administration due to the reimbursement of insurance carriers, Medicare and
Medicaid’s incentivizing of HCAHPS scores. HCAHPS is an acronym that stands for
“Hospital Consumer Assessment of Healthcare Providers and Systems” and is the first
nationally introduced means of both measuring and publicly reporting hospital facility
quality standards in the United States of America. This assessment comes in the form
of a survey that patients receive upon discharge to their homes which ask questions in
regards to patient perceived quality in these domains:
Overall rating of hospital- assessing the patient’s perception of overall facility
quality and their experience

Recommendation of hospital- assessing if the patient would refer others to the
same facility

Communication with nurses- assessing how well nursing staff treated patients
with courtesy and if they appropriately explained their plan of care

Communication with physicians- assessing how courteous doctors explained
care and treated the patient

Hospital environment- assessing how clean the patient room was and how quiet
the hospital was at night

Transition of care- assessing how well the staff prepared the patient for discharge
and the transition to their home or next facility

6

Communication about medication- assessing how well the patient’s medications
and side effects were explained by staff
Discharge planning- assessing the timeliness of the patient’s discharge from the
facility

Responsiveness of staff- assessing how quickly staff answered patient’s room
calls

When the HCAHPS surveys are received by Centers for Medicare and Medicaid Services
(CMS), they are averaged against all hospital systems nationally and ranked via
percentile. Hospital facilities are then assigned reimbursement rates for their rendered
services at a percentage rate based off of their HCAHPS standings. The higher the
HCAHPS standing, the more a hospital will be reimbursed, as well as the reverse. For
this reason, administrators and music therapists alike must understand that services
that have documented impact on patient perception of hospital quality and experience
(particularly music therapy), also may positively impact the profitability of the
hospital facility over time.
Implementation:
-Pain management- music therapy inpatient sessions utilizing techniques such as
mindfulness and guided imagery with passive music reception and listening or
active music engagement via instrumental play

-Stress management- music therapy interventions to build stress management
strategies which may include techniques such as songwriting and active lyric
7

discussion to increase expression of thoughts and feelings, promoting positive
coping skills via music instrument play and enriching life style via instrument
learning or designing of music playlist to manage mood state and promote daily
relaxation habits for stress management
II.

Employee Engagement-

Section Rationale: Employee engagement has been described as another extremely
important aspect of hospital workplace culture. The staff are on the front lines, not
only acting as main contact points for patient care, where they greatly impact patient
experience, but they also are receptive to caregiver fatigue and burnout. This leads to
the diminishing of employee morale and their feelings of wellbeing, along with the
decrease of job satisfaction over the course of time. For this reason, the second largest
emphasis within in this business outline next to patient experience is employee
engagement.
Implementation:
-Staff wellness – Caring for the caregiver via employee in-services and education on
music-facilitated stress management and the use of music to enrich lifestyle

Deleted:

Formatted: Indent: Left: 0", Hanging: 0.06"

-Staff stress management - Group music therapy events including drum circles and
instrument learning workshops to promote positive coping strategies and stress
management plans

III.

Environment of Healing-

8

Section Rationale: Historically, environment of healing, and more specifically night
time quietness, is the lowest rated HCAHPS score throughout the nation from hospital
to hospital. This poor environment of healing has remained a difficult issue for hospital
systems due to a combination of employees, patients and visitors along with hospital
medical equipment and maintenance machines that add to the overall noise levels
throughout the hospital. With the consideration that music therapists have a specialty
in producing, recording and isolating sounds, it has been found that this background
often allows them a depth of insight into strategies to aid in noise control in order to
increase the environment of healing. The following suggestions have been offered as a
means of mitigating unwanted noise, though it is to be noted that these suggestions
warrant review and individualization for specific facility needs.
Implementation:
-Noise audits- locating, assessing and mitigating noise sources *See Appendix E for
sample noise audit form

Deleted:

Formatted: Indent: Left: 0"

-Awareness and education- employee presentations to increase staff awareness of
noise and their role in creating a quiet environment of healing

- Noise cancelling headphones and earplugs- implementation of ear ware to
decrease patient perception of environmental noise

B. Metrics collection process–

9

Section Rationale: Metrics collection is a crucial aspect of program design that not
only serves as a means of presenting programming, but also as a means to track
program efficacy through outreach in terms of total number of individuals served
during the operation of programming. Furthermore, hospital administrative staff
require a concretely defined means of data collection to monitor program operation in
order to justify the continuance of program funding. * See appendices B, C and D for
sample rounding schedules, sample rounding cue sheets, sample assessment forms and
sample monthly report documents.
Implementation:
Program assessment and ongoing measurements to be discussed with facility on
quarterly basis and include, but are not limited to, stress & pain management along
with total patient, family and staff outreach. Staff outreach will consist of employee
wellness in-services and group interventions including stress management
presentations, staff drum circles and instrument learning workshops. *See appendix
A for sample graph of program focus areas and descriptions.
C. Program Model Objectives and Implementation TimelineSection Rationale: When presenting a music therapy program, it is helpful to
introduce a set of objectives along with an implementation timeline in order to clearly
illustrate the time frame in which the program will be initiated.
Objective 1: Quarterly employee presentations: in-service and
education to increase clinical program visibility and promote staff
self-care

10

Objective 2: Employee engagement programming targeting staff
burnout reduction
Objective 3: Clearly defined framework of service/focus with logistics
of day-to-day programming: sample schedules of service delivery
-Objective 4: Identify reporting structure: facility specific monthly
reporting to project director and quarterly summary of program
impact in terms of patients and employees served, reported to
designated hospital administration

Implementation Timeline: Quarterly Objectives
Quarter 1

Quarter 2

Quarter 3

Quarter 4

Program proposal and identifying
talent

Assessment of
program structure
and facilitation of
in-services and
wellness
initiatives

3rd quarter Report
and program
summary of impact
relating metrics of
numbers of patients,
family, staff
members reached
and functional
outcomes via
inpatient stress and
pain scores

Re-design and
continued
implementation of
programming

Implementation of patient and
employee programming
-Objective 1: Quarterly employee
presentations: in-service and
education to increase clinical
program visibility and promote staff
self-care
-Objective 2: Employee engagement
programing targeting staff burnout
reduction
-Objective 3: Clearly define
framework of service/focus with
logistics of day-to-day
programming: sample schedules of
service delivery
-Objective 4: Identify reporting

11

structure: facility specific monthly
reporting to project director and
quarterly summary of program
impact in terms of patients and
employees served, reported to
designated hospital administration

12

D. Expense and financial breakdownSection Rationale: The cost of developing the program may vary by state and the
provided breakdown may be altered if needed. However, having a price point when
entering a business meeting is extremely important as it will be required for
administrators’ consideration for funding.
- Annual cost: $75,000 total cost (salary, benefits, training, program
oversight) per FTE.
-Analysis of facility needs and required equipment

CONCLUSION
In conclusion and review, music therapy training is both extensive and
robust in order to prepare clinicians for a diverse field of work. With a shift of focus
in recent years to holistic treatment modalities and increased employment in
medical settings, MT-BCs may greatly benefit from the addition of this project’s
practical insight into areas of business proposal, project design as well as business
strategy. This project’s goal is to contribute to the field of music therapy by
providing a clear means for a practicing MT-BC to propose, create and successfully
continue music therapy programming within the medical setting by utilizing these
provided plans and sample materials.

13

Annotated Bibliography
Allen, J. (2013) Guidelines for music therapy practice in adult medical care. Gilsum,
N.H.: Barcelona Publishers.
This book offers an outline of music therapy programming and offers specifically
useful information in regards to pain management and treatment approaches. In
recent years, due to an ever-increasing opioid epidemic, nonpharmacological
means of pain management are on the forefront of discussions and service
development within healthcare systems. Sections within this text outline several
techniques and strategies that aid in the development of music therapy
programming in a broad spectrum of diagnosis, while continuing to focus on pain
and stress management. In addition to the previously highlighted recourses, this
book provides an excellent overview of treatment philosophies currently being
implemented.
Evans, D. (2002). The effectiveness of music as an intervention for hospital patients: a
systematic review. Journal of Advanced Nursing, 37: 8–18.
This article provides a systemic analysis of music therapy programs efficacy in
the medical setting. The article is noted to be written and distributed by medical
clinicians outside of the music therapy profession, which in the case of validity
and credibility, is an important point as this may avoid criticisms of bias
reporting. Through rigorous analysis and strict inclusion criteria, this article found
that music therapy was shown to be impactful in managing emotional needs of
hospitalized inpatients and specifically cites the benefit of music therapy
programming in treating and reducing anxiety. This article may serve as a strong

14

tool to communicate music therapy literature and documented clinical impact with
administrators and medical staff.
Gallo, C. (2014). Talk like ted: the 9 public-speaking secrets of the worlds top minds.
New York: St. Martin’s Press.
The book “Talk Like Ted” offers several strategies for incorporating
emotional intelligence into presentations and discussions, while also
developing key skills to aid teaching, inspiring and means of fostering
connections with your target audience. This book has been a “Wall Street
Bestseller” that links passion and presentation goals to allow the presenter a
means of connecting on emotional levels through suggested techniques
combining information sharing with storytelling. Given the often analytic and
non-personal disposition of many business climates, connecting
meaningfully using a humanistic approach is an extremely important aspect
of developing medical music therapy programming with administrators.
Hanser, S.B. (2016). Integrative health through music therapy: accompanying the
journey from illness to wellness. USA: Palgrave Macmillan.
In this book, strategies for practicing music therapy in the ever-changing
health care field are provided. With the observed shift in patient treatment
that has left medical clinicians searching for additional means to provide
holistic healthcare options that address complex patient needs, this text
outlines and encompasses several strategies to approaching music therapy
practice in an integrative health context. When operating in a paradigm that
views healthcare as an ongoing process of finding a patient’s optimal health,
it is crucial that music therapy program developers retain a depth of

15

understanding that is up-to-date while reaming mindful of the practice’s
philosophical progression to current treatment trends like this book offers.
McKee, A., Boyatzis, R., Johnston, F. (2008). Becoming a resonant leader. Boston:
Harvard Bussiness Press.
This book outlines tactics and strategies for leading teams effectively and
utilizing your own skillsets as well as the skillsets of those around you
through the use of emotional intelligence. The reading helps an individual
identify emotional intelligence and provides concrete strategies for
improving on this, while continuing to work toward career goals and
professional development. In particular, this book encompasses several
successful individual’s philosophies in order to offer guidelines to a
successful career path. Considering the sometimes-intimidating business
climate medical music therapists practice in, learning to work with and
inspire change in the work place is an important skillset and this book offers
strategies for doing so.
Patterson, K., Grenny, J., McMillan, R., Switzler, A. (2012). Crucial conversations. New
York: McGraw Hill.
This book offers training in communication, goal setting and persuasion
while providing examples to learn from. The text goes on to increase the
reader’s skillset in identifying situations in conversations and gives
suggestions for ways to maneuver critical and difficult issues tactfully. Often
in the business climate, first impressions and ongoing dialogs may dictate
future proposal success and merit the study of conversation and furthered
emotional intelligence training. This book has been on the “New York Times

16

Best Seller” list and remains a critical and informative tool that is both
insightful and progressive.
Tzu, S. (2014). The Art of War. London: Arcturus Publishing Limited.
In this book, guidelines for strategic thinking are offered along with examples
of developing plans for success when working in competitive climates. This
book and set of lessons has been passed down through generations dating
back to 5th century China. It has become a corner stone in both military and
business training courses as it sets a baseline of knowledge while also
building a basic skillset of strategic thinking. These strategies include topics
of planning, tactics, resource allocation, maneuvering politics and general
diplomacy. Throughout history, the majority of prominent military and
business leaders have made reference to this book and recommend its
reading and the integration of its philosophies.

17

APPENDICES
Materials to support implementation of program plan

Appendix A. Sample Music Therapy Programming and Breakdown

Time Allocation & Focus
Environmental
sound
10%
Community
10%
Outpatient
10%

Inpatient
50%

Staff Initiative
20%

•
•
•
•
•

Time Allocation Sections Defined
Inpatient Programming- hospital floor rounding, session planning and
charting
Employee Engagement- Education, recreational drumming, instrumental
workshops and relaxation interventions
Outpatient- Identified outreach programming, songwriting groups,
instrumental workshops
Community Outreach- Healing Harmony musician volunteer program and
local community involvement
Environmental Sound Initiative- Onboarding, environment of healing
assessment and noise mitigation strategies
18

Appendix B. Sample Rounding Schedule

Time

9-10am

Monday

Tuesday

Wednesday

Thursday

Pt. team
huddle

Pt. team
huddle

Pt. team huddle

Pt. team huddle

Pt. team
huddle

Pt. rounding

Pt. rounding

Pt. rounding

Pt. rounding

Pt.
rounding

Lunch break

Lunch break

Lunch break

Lunch break

Lunch
break

Repertoire &
Session
Planning

Repertoire &
Session
Planning

Repertoire &
Session
Planning

Repertoire &
Session
Planning

Repertoire
& Session
Planning

Pt. follow up
Rounds

Pt. follow up
Rounds

Pt. follow up
Rounds

Pt. follow up
Rounds

CLINICAL
or MUSIC
meeting
(bi-weekly)
or pt. follow
ups

Pt. Rounding
Continued

Pt. Rounding
Continued

Pt. Rounding
Continued

Pt. Rounding
Continued

CIHN team
CLINICAL
or MUSIC
meeting
(bi-weekly)
or pt.
rounding

Charting and
administrative
time

Charting and
Supervision

Charting and
administrative
time

Charting and
administrative
time

End of
week wrap
up and
report out

10am12pm

12pm12:30pm

12:30pm
-2pm

2pm3pm

3pm4pm

4pm5:30pm

Friday

19

Appendix C. MT Rounding Cue Sheet
Use with newly admitted patient
1. Introduce Music Therapy and team treatment modalities
“Helping you find your best path to optimal health”
2. Discuss benefits of music therapy and explanation through rack card
3. Assessment of Anxiety, Distress, Pain, Depression or other
Ask patient
• “What are your goals while you are here?”
• “How do you plan to optimize your health holistically while with us?”
• “How can I help you do that?”
Things to keep in mind:
• Am I listening more then I talk?
• Am I looking at this person as a whole?
• Am I aligning myself with this person’s chosen goals?
• Offer Treatment Time and receive pt. referral
4. Introduce Noise Awareness Initiative and prep expectations
Key Phrase: “We know hospitals can be noisy, but we care deeply about your
wellbeing and offer this ear wear to help assist your comfort. We want to
empower you with the ability to control your perceptions of environmental
noise.”
Appendix D. Sample Assessment
Pre/Post Music Therapy Pain & Stress Assessment
Name_______________________

Room_______________________
Pre-Pain Score
1----2----3----4----5----6----7----8----9----10
Date_______________________
Post Pain Score 1----2----3----4----5----6----7----8----9----10 N/AReason_________________
Pre Stress Score 1----2----3----4----5----6----7----8----9----10
Post Stress Score 1----2----3----4----5----6----7----8----9----10 N/AReason_________________
Mood State Pre ________________________ Music Preference ______________________
Post________________________ Music/ leisure History___________________
Suggested Intervention: __________________ Goal(s):_______________________________
Session notes and functional outcome

20

Appendix D. Sample Monthly Report

Jane Doe

Music Therapy at CIHN
Monthly Report
Music Therapy September 2016

Long term professional goals:
•
Grow a well- respected music therapy program and establish IDT rounds
•
Pioneer new ways to incorporate innovative techniques into pain
management and noise management in pursuit of a visible change in HCAHPS in
regards to pt. satisfaction in multiple domains
Accomplishments/highlights/notable happenings of the past month:
•
•
•
•
•
•
•

Completed CPI training
Held quietness team meeting
Participated in interview for CIHN
Completed Iprocurement training MSC
Implemented Medical Music Therapy Binders
Revamping and focusing on MT program- Richmond
Increased pt. satisfaction in environment of care

Patients/Family Seen for Music Therapy:
Richmond Inpatient:
15pts, 10family
Richmond Geri/Adult Psych Unit
95 pts
Age-well Be-well Ukulele Outreach:
4 pts
Staff out Reach- (Presentations and On-boarding) – Richmond and Bedford
44 staff members
Total= pt: 114 Family:10 Staff: 44
Final number does not include meetings held or presentations to management
given.

21

Appendix E. Sample Environmental Noise Audit

Environmental Noise Audit
Date:________________________
Time:________________________
Observer:____________________

UHRMC

East Nurse
Station

East Halls

West Nurse
Station

West Halls

ICU

Quiet? y/n

Loud? y/n

Notes: IE
Staff loudness,
machines
or carts,
voices in the
hallway?

22