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Strategic management in health care

? What are some of the planning strategies that Russ might have used that would possibly
have positively affected the outcome of the strategic plan execution?
? Discuss some things Marvelous Marvin could have done differently as CEO in order
avoid the current situation?
? What political factors created bias and clouded judgments in this situation?
? Who’s to blame for the bad outcomes of this strategic plan?
? If you were one of the OR Director’s direct reports/managers, what should your
involvement in the organization’s strategy have been?

Case study: Last Chance Hospital

Strategic management in health care institution is crucial in determining long-term and
short-term performance. In most cases, effective measures are the ones that bring in short-term
success and sustain it in the long-term. However, there are situations where strategies may offer
varied outcomes for both short-term and long-term. For instance, they could result in unfavorable
short-term outcomes but end up being fruitful in the long-term. Likewise, strategies may at first
appear to yield much, only for them to end up being faulty in the long-run. This paper considers
the case of Last Chance Hospital (LCH). The hospital has been running a physician-centered
system for long. In the earlier days, the hospital had secured a desirable position in the market. In
a bid to increase the efficiency in operating rooms (OR), the hospital enhanced its physician-
centered system. Contrary to the expectations of the hospital, the move did not attract as much
surgeons, and to make it worse, it resulted in decreased number of customers.



Effective Planning on the Part of Russ

Russ stood an appropriate chance to direct planning strategies at LCH. There are some
strategies that he could have employed so as to land the hospital to prosperity. First, he could
have utilized his knowledge of the emerging patient-centered trends. On his part, Russ had made
a mistake by assuming that the senior management was right before questioning their awareness
of the recent trends. The strategic planner should have explored the trends further, collected
sufficient evidence either approving or disapproving the approach, presented it to the board and
advocated for its consideration. By so doing, Russ would have ensured that the organization
deeply understood patient-centeredness. According to Rhodes, informing an entire organization
about alternative strategies is a basic step for effective strategic planning (2010). Second, Russ
should have advised fellow planners at LCH to make their plans flexible. Such an approach
could have enabled the organization to shift timely and effectively so as to overcome the
presenting challenges. Russ could also have advised the organization to consider equally the
views of all parties rather than just those of a few leaders. This would have presented a better
position for contrary views that could have possibly been accepted by the organization. Again,
when conducting a SWOT analysis for the organization’s strategy, the planner should have
adequately considered the impending threats. Russ knew that other hospitals were focusing their
care on the patient. On the other hand, LCH was heading to the opposite directions. It was almost
unquestionable that the threats that the hospital was to face would have been severe. Lastly, the
planner should have used his position to protect the competitive advantage of the organization.
Shifting too much to physician-centeredness was definitely a deviation from competitiveness,
more so from the perspective of the patients.

Possible Effective Strategies that Marvin could have Applied


Hospital CEOs have the primary role to make strategies (Higginbotham & Church, 2012,
p. 295). Marvin’s plans to have LCH stick to its physician-centeredness did not yield to his
expectations. The executive made several mistakes in his projections. The greatest was an
obsession with the institution’s cultural strategies. The obsession with the old ways blinded him
so that he could not explore new approaches. The executive failed to notice the emerging trends
of patient-centeredness. It is for this reason that he passionately advocated for the enhancement
of physician-centeredness without any considerations for patient-centeredness. His obsession
with old culture and ignorance about the new strategies placed him at the risk of making
uninformed decisions. The other critical mistake that Marvin made was focusing on change
rather than a sound plan. The executive purposed to institute change in the organization without
necessarily fitting it to an efficient plan. For instance, Marvin pushed Graveyard to increase
efficiency in the OR but did not necessarily establish how effective increasing the number of
surgeons would have been in generating revenues for the institution. Considering that Marvin did
not have efficient plans, it was not surprising that the organization did not manage to increase its
surgeon staffing. Lastly, Marvin focused on short-term but did not address long-term problems.
She addressed the problem of having many patients by thinking about increasing the number of
surgeons. Definitely, sufficient surgery staffing meant facilitated service delivery to the
institution’s large number of customers. However, centering too much on physicians at the
expense of patients had certain long-term implications for the organization. First, the approach
would barely be in the favor of patients, and therefore, it would have compromised their loyalty
to the hospital. Again, the approach was contrary to that of neighboring hospitals. This meant
that the institution competitors would have used the cons of the strategy in securing a larger


market share. While advocating for the strategy, Marvin should have considered its impact on
other competitors.

Political Factors that Influenced Decision-Making

The judgment developed at LCH concerning the strategy to adopt was impaired by
political determinants. For instance, the influence of executives was too much and it was
unbalanced with that of other stakeholders. The opinions of leaders counted more to decision-
making than those of their juniors. An excellent illustration is the case of Marvin and Graveyard.
Marvin was senior to Graveyard and he directed Graveyard to execute the plans of orienting
service delivery to physicians. The interaction reveals that Graveyard’s opinions did not count as
much as those of her senior. Another instance of political influence in the case is the position of
Russ compared to that of the senior management. Though Russ had information about an
alternative approach to service orientation, the weight of his opinion is compromised by the
event that his seniors opted to stick to their old ways. Eventually, the strategic planner had to
make a decision that impressed LCH senior staff by going by their opinion in undertaking his
planning role. Al-Sawai noted that though leaders are expected to make strategic decisions for
their firms, there is a need for them to do so upon considering the thoughts of their juniors (2013,
p. 86).

The Blame

Different departments are charged with varied responsibilities in health care institutions
(Al-Sawai, 2013, p. 85). In LCH, it could be argued that Russ and his department were charged
with coming up with strategies for the hospital. However, there were other stakeholders playing
within including Ms. Graveyard and her department. Russ was reporting to the hospital CEO


through the COO. As such, the role of strategic planning was not placed on Russ solely, but Ms.
Graveyard and Marvin counted more or less equally. On his part, Russ suggested a possible
alternative that was the trend in running services in hospitals. However, the planner did not push
enough to convince the management to buy his proposal. The case presents Marvin making
uninformed decision, yet Russ had information concerning the patient-centeredness. It was upon
Russ to gather sufficient evidence and advocate for patient-centeredness. In addition, the
strategic planner should have informed the organization about the threats associated with their
physician-centered approach. On her part, Ms. Graveyard was not proactive in determining the
logic of implementing Marvin’s strategies. She should have evaluated the effectiveness of the
approach in facilitating service delivery at the hospital as well as its possible impact on patients.
Ms. Graveyard was heading service delivery and she should have been an advocate for the
patients. Marvin is also to blame. As Farbrot noted, CEOs have the greatest impact on
determining whether organizations would fail or not (2010). Marvin was too much obsessed with
the old ways that he failed to appreciate the suggestions made by Russ. The CEO should have
welcomed contradictory views and encourage their substantiation.
OR Director’s Direct Manager’s Involvement

Direct report employees are essential for efficiency of management in organizations. In
the case scenario, direct report personnel to OR directors could have worked actively in helping
managers implement their strategies. This would have involved giving instant feedback on
adopted strategies and timely pointing out their shortcomings and strengths. This would have
helped directors to learn the need to reconsider their strategies early enough and avoid heavy
losses. The direct reports would also have facilitated interactions between managers by
encouraging consultations. The move would have created high chances for the development of


effective opinions. Direct reports would also have been involved in emphasizing the strengths of
their directors. For instance, they could have pointed out strategies adopted by their managers
that would most likely benefit their organization. In so doing, direct reports would have let their
mangers know their strengths and how such strengths apply to specific tasks (Adkins, 2015). For
the case of LCH, such strengths include advocating for patient centeredness.


Adkins, A. (2015). Only 35% of US managers are engaged in their jobs.
Al-Sawai, A. (2013). Leadership of healthcare professionals: where do we stand? Oman Medical
Journal, 28(4), 285–287.
Farbrot, A. (2015, May 7). CEOs take credit for successful mergers but blame failures on culture.


Higginbotham, E. J., & Church, K. C. (2012). Strategic planning as a tool for achieving
alignment in academic health centers. Transactions of the American Clinical and
Climatological Association, 123, 292–303.
Rhodes, M. (2010). Five essentials of an effective strategy.

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