Implementation, Context, and Complexity, Term Paper Example

Introduction

Analysis of Carson Valley Medical Center (CVMC), reveals a comprehensive community healthcare system that uses market focus as its primary generic strategy. Specifically, the hospital seeks to create sustainable superior performance by offering specialized health care services that meet the needs of residents of Carson Valley and surrounding areas (who are its market niche). The hospital concentrates on this niche market understanding dynamics of these markets, and unique needs of community living in these areas, and develops uniquely well-specified and tailored health care services suited for these markets. CVMC tend to build strong brand loyalty amongst the residents of Carson Valley and surrounding areas by offering quality health care services (CVMC, 2020).

A review of the strategic orientation of CVMC reveals the hospital is working on a 3-year strategic plan for the years 2020 through 2023. The strategic plan candidly defines CVMC’s five fundamental goals (alongside their Key Performance Indicators (KPIs) that the hospital seeks to achieve touching on people, quality, service, finance, and community. The purpose of this analysis is to critically assess how CVMC will successfully implement its strategy. Specifically, the report presents strategic analysis tools, challenges that may limit the successful implementation of planned actions that support the strategic goals, and how the hospital can overcome these hurdles and move the mark on the KPI’s for success. The report commences by looking at the directional strategies, as designed and envisaged in the strategic blueprint, and highlights tools and techniques that can be applied to this strategy.

Implementing the Strategy

A strategic plan itself is a written document, but there is a need for establishing a competitive process that will turn set strategies and plans into actions to achieve set goals and objectives. Basic features that need to be in place for successful implementation of CVMC’s strategic include very visible leader (who communicates excitement, vision, and behaviors necessary for success), performance measurement tools, and strategic map (which defines elements that will direct performance such as work environment, finances, operations, market, partners, and people).

Directional Strategies

These are plans that are aligned to the organization’s mission, objectives, and values; hence are the most complex as they must uphold an organization’s reputation. Directional strategies provide a framework that guides operational activities and decisions, and its most basic level, it defines what the organization seeks to achieve and what it stands for.

CVMC’s mission is, “to care for your health and wellness“. The hospital is guided by four values: respect, excellence, integrity, and compassion. Besides, the vision of CVMC is “To strengthen our community by providing accessible, affordable, high-quality healthcare to all” (CVMC, 2020)

Even though CVMC has a well-defined mission, vision, and values, performing the high-level environmental scan is critical to attaining these directional strategies. The scan looks for an external and internal business environment that considers stakeholders, mission, vision, and existing plans, structure, and people profiles. There are two strategic tools that CVMC can use to analyze the present state of its operating environment and map out its future – VMOST and SWOT analysis.

VMOST is an internal analysis framework that would help CVMC capture its current strategy and what it is trying to attain. VMOST looks at the Vision, Mission, Objectives, and Strategy, Tactics. As stated earlier CVMC has a well-defined vision. Mission, values, and goals, but the hospital need to ensure its tactical operations and linked to the strategy. VMOST will help to make this connection. CVMC can also use SWOT analysis to evaluate its strengths (such as strong leadership and financial position), weaknesses (such as gaps and bottlenecks in the health care services delivery model, opportunities (such as medical technology and partnerships), and threats (such as competition) (Ginter, Duncan & Swayne, 2018). This analysis will reveal the gap between the current state of CVMC and the desired state, and the formulation of strategies to seal this gap. SWOT would require CVMC to be candidly and offer an honest evaluation of its state of things (Johnson, Scholes & Whittington, 2011). This would be achieved by having a dialogue with stakeholders to obtain different points of view, and eventually focus on key issues.

Service/Product Strategies

CVMC products and services strategy are based on community health need assessments carried out in 2019 by Professional Research Consultants, Inc. the assessments highlight various areas for improvement in Douglas County. Key health concerns reported include cancer, diabetes, mental health and substance abuse, kidney failure, and access to health care services. In the three years plan, CVMC focuses mainly on addressing mental health concerns and other health care issues. The hospital seeks to ensure by 2023 they are positioned as Orthopedic Center of Excellence, have enhanced cardiology services, improve access to primary care & specialty care services, and design and effectively implement a patient-centered medical home model. This is aimed at helping the hospital become the Provider of Choice in our Community.

To provide the highest standard of care, the hospital needs to align its operations, services, and products with changes prevalent in the external and internal environment. This can be understood by employing such strategic tools as PESTLE analysis and VRIO analysis. PESTEL analysis looks at the prevalent external environment which could hinder effective delivery of the hospital’s mission. Specifically, these strategic tools look at political (political-inherent issues such as the current debate on best health care system and model), economic changes in economic, social, technological, environmental and legal issues. CVMC should understand changes in laws and regulations that touch on its service delivery model, social-cultural issues that impact on population health and behavior toward the hospital, and its impact on the environment to ensure useful relationship win ad interaction with the target community (Johnson, Scholes & Whittington, 2011).

VRIO model looks at the capability and resources of CVMC especially give its focused differentiation strategy. The model would help the hospital identify how valuable, rare, imitable, and organized its resources (such as knowledge and skills, health care services, business model, and delivery framework) is.

Support Strategies

Value chain and value system analysis can help to identify the strength of support strategies. The value chain would help recognize activities that are most valuable to the hospital and ones that could be improved to strengthen competitive advantage. Analyzing the primary and support activities which add value to CVMC would help increase differentiation. Based on the 1985 value chain analysis by Michael Porter, CVMC should look at its primary activities (outbound and inbound logistics, operations, services, and market and sales) and support activities (technology, firm structure, human resources management, and procurement). CVMC drives its competitive advantage mainly from its accessible, affordable, and high-quality healthcare (which falls in the primary activities domain). CVMC can also derive competitive advantage from support services such as innovations in business models or processes and technological improvements. Support activities such as R&D, information system, and general management of the hospital could be a key source of CVMC differentiation, while primary activities may be a source of cost advantage. CVMC should use value chain analysis to identify customer’s value activities with its business model, assess the differentiation strategies for improving the value of the customers, and then establish the best sustainable differentiation.

On the other hand, the value system would help the hospital understand the level of co-joint-ness between its structure, task structure, and personal value systems. The tool would improve understanding of how the hospital can select personnel who have a value system, which is co-joinable with organizational structure and tasks. CVMC has core values (respect, excellence, integrity, and compassion) and hires personnel who have a value system that is in line with these overall values. The task of responsibilities, such as suppression, management, and head of different departments should be assigned based on the extent to which the selected individual aligns himself with the set values of the organization. Besides, CVMC should use organizational structure (Hierarchy) that will promote the achievement of its goal and should address all the bottlenecks in the hierarchy (Ginter, Duncan & Swayne, 2018). For example, the hospital should not adopt a long-hierarchical structure because it will limit communication and corporation between different levels of people in the hospital. Instead, adopting a short structure would promote “family-like” ties and help it achieve the goal of becoming the leading community hospital.

Strategic implementation challenges

The expected challenges in the implementation of directional strategies have much too different from a lack of understanding of an organization’s current affairs in comparison with plans. As such, the strategic team may have difficulty organizing milestones to fit the desired progress of the medical center in the stipulated time. Additionally, while the strategic plan for Carson Valley Medical is comprehensive and accommodates multiple areas of improvement, the same property can be its downfall since it makes the implementation tedious. However, there is hope in the incorporation of evidence-based practice since one of its strengths is to supplement efforts of healthcare organizations towards ultimately improved quality of care (Warren et al., 2016, p. 19). By adhering to national and international standards of improvement in healthcare delivery, an organization can also quickly improve its performance.

Overlap of roles and responsibilities is a challenge that can be fatal to the process of strategic implementation as it affects accountability. However, a potential solution lies within the Normalization process theory, which highlights the role of sociology in incorporating strategies into everyday activities (Gould et al., 2016, p. 379). As compared to the implementation systems that utilize force, rewards, and punishments to instill changes, this process minimizes the likelihood of rejection of new strategies or stressors. Pre-service, point of service and after-service components of service strategies ensures that the delivery is comprehensive. Since this organization’s strategic plan is comprehensive and multidimensional and considering the timeline of intended implementation as three years, management must consider the dedicated staff. They will be actively involved in improving the healthcare system and delivery while also incorporating technological innovation and community integration. This process can be overwhelming hence should take on a gradual change approach to limit culture shock

Issues affecting the implementation of support strategies may involve finances or the burden of the strategic office. This office acts as the main resource in the process thus in addition to their supplementary assets forms a solid foundation for strategic resources. Regarding finances, the connection is clear since most changes, especially operational ones, require a high level of commitment towards investing in better systems and infrastructure. The problem of the burden on a strategic office is often undermined, although it plays a significant role in influencing the timeline of implementation. Often, healthcare organizations will use this office to address smaller projects not related to the execution of strategy and cause wastage of resources while distracting them from intended goals (Shomali and Peeples, 2018). Finally, the tension between the center’s internal and external environment may not be ignored in considering the surroundings as a support system. A medical center largely relies on community support and vice versa; thus, the two must coexist in a mutually beneficial environment. If the society around Carson Valley is hostile to the center, then programs such as community outreach and employment opportunities could be affected, and the strategic plan compromised.

Measuring the success of the strategy 

Key Performance Indicators (KPIs) are the most enlightening measures of organizational change and, when compared to goals, provide a clear picture of the center’s efforts towards achievement of relevant milestones.  Some of the indicators include Average hospital stay, patient wait time, satisfaction and safety, readmission rates and treatment costs among others. The indicators are usually similar for most organizations with strategic plans, but it would help to expand on them to accommodate the nature of Carson Valley Medical Center. These added specifications ensure that the staff involved in processes of informing and implementing strategic changes can easily relate the measure to their daily routines. More so, specialization of KPIs enhances the measurement of success by understanding the networking between various complex systems such that an overall drop may still mean a significant improvement in another more valuable asset to a specific facility (Kitson et al., 2018, p. 231). In a way, evaluation by use of KPIs regardless of specialization may present a metric challenge that must be addressed comprehensively.

Currently, CVMC uses various metrics to show success towards strategic goals measured through the corporate scorecard. The hospital updates target metrics and KPIs annually. Aligning KPIs with a balanced scorecard would ensure the hospital evaluates its success in all aspects. The balanced scorecard would reinforce good behavior in CVMC by separating four areas that the hospital needs to look at. There are four primary functions of a business (also referred to as legs) are learning and growth, customers, business processes, and finance. CVMC should ensure there are consistent and well-thought learning and development within the hospital to ensure, the nurses, doctors, and other workers have the required knowledge to execute their mandate. Weak learning and development standards between the ability of the organization to deliver quality services, and the desired goals. Learning and development help to improve organizational capacity, internal process and leads to high-level strategy, and strategic initiatives.

Financial health is one of the central drivers of growth and development. CVMC should assess its liquidity, operating efficiency, leverage, and profitability, to understand how ell is it performing and positioned to whether through hard economic times. Financial analysis reveals operational and structural bottlenecks that can be addressed such as cost minimization, reducing waste, getting into better contracts with supplies, and reducing the cash cycle. Business processes involve all the internal processes that include supply chain, service delivery model, and organization culture, structure, and orientation. Finally, the BSC would help CVMC to identify the specific needs of the community within which it operates and tailor its service and products to suit those needs. Currently, the hospital relies on studies and research that have been carried out by third parties to develop a strategic plan that fits the identified need. This is important in ensuring that it meets customer needs. The hospital and also carry out a customer survey to identify the gap between the desired level of satisfaction and the level of satisfaction that the customers get from the services that it offers.

Reflection

Strategic plan implementation involves aspects of strong economic orientation such as described by the five forces concept. Additionally sociological through legitimacy influences the concepts on the allocation of responsibility, duty, and delegation. Opportunities for innovation in line with technological development enhance the Center’s capability to not only improve on product or service delivery but also to predict outcomes of future projections on organizational operations. There are also a variety of strategic choices available for use in healthcare organizations such as Carson Valley Medical Center which improve their ability to make the changes part of organization development. For instance, organic growth business strategies ensure that the planned development is sustainable and replicable in case of future improvements to the plan. Finally, conservatism in terms of strategic drift and organizational culture determines the allocation and efficient use of resources to enact strategic plans.

The four strategic lenses namely design, experience, variety and discourse highlight various environments that either encourage or delay the processes of strategic management. The designed lens has a sharp focus on logical processes of analysis and evaluation while the experience lens describes the methods of doing things that subsequently affect outcomes. Variety facilitates new ideas within and outside the center as a hub of new ideas which propel change and innovation faster while discourse affects communication flow in an organization along with managerial power identification and identity. The strategic implementation also highlights the role of political interest in an organization as a source of bias in a goal-based approach to improvements. More so, since the process is non-linear, the medical center must have provisions for how to handle different parts of the project simultaneously and not exactly in the order as long as the desired goals are achieved.

As part of the implementation, provisions for the development of a new strategy must define timelines and logistics. Two broad factors affect the creation of a new plan, mainly the ineffectiveness of the current one or completion of set goals and the need to create new ones. The inefficiency of an ongoing project must first be addressed by review and revision processes before it is declared null and void. On the other hand, once the goals of an existing one are achieved, a similar evaluation process to learn about useful tools and techniques for the foundation of the next plan.

CVMC Strategic plan 2020-2023> https://cvmchospital.org/sites/www/Uploads/files/2020%20-%203%20Year%20Strategic%20Plan.pdf

Quality improvement action plan

Goal: to improve health acre accessibility and quality at CVMC in order to strengthen differentiation

Strategy background: improving the internal processes, training and development of employee and using customer having found to be effective in improving differentiation (focusing on secondary processes)

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