Wednesday, May 6, 2020

Healthcare External and Internal

Question: Create a mission and vision statement for your organization. Determine three specific strategic goals that align with the ideals in those two statements. Answer: External And Internal Factors Affecting Healthcare Organizations The present scenario for hospitals is very unpredictable, uncertain and complex. To sustain in the business of healthcare, organizations need to provide quality care to the patients, meeting their need and satisfaction. Patients satisfaction is associated with their loyalty and belief in the organization, adding up to the profitability. However, currently one of the major challenges to the healthcare system is the advent of patient protection and affordable care act- 2010 (PPACA), which further affects the internal functioning of hospitals. According to the act, hospitals and physicians will be altering their practices by demanding lesser fees and providing technologically and clinically efficient treatment for better health outcomes of patients. Thus, it has put an extra burden on these organizations to sustain their services, causing many of them to shut. Although being one of the most regulated industries, healthcare industry is getting weaker owing to this act, wherein underpayme nts to physicians has compromised the patient care. Hence, to provide quality care to the patients and remain financially solvent, strategic management has become a necessity. Internal and External Factors in Healthcare A clear understanding of antecedents to quality care can help develop a better strategy and framework for an organization to excel in medical services. Proper functioning of an organization is dependent on its productivity, profitability, and patients satisfaction. Hence, firstly it needs to identify the internal and external forces in their growth. (Templeton et. al., 2016) External factors. a) Government laws. Certain state and federal level regulations by government in favor of the patients negatively impact the healthcare organizations. The PPACA act in US has pressurized the healthcare systems to cut down the cost and increase the quality and technology of treatment. However, in small scale organizations like ours, due to lack of sufficient finance it gets difficult to implement the changes. Additionally, lowering down of primary physician fees and prescription of less costly generics as compared to innovators will ultimately affect revenue and profitability of the hospital. Thus, making it all the more complex in installation of advanced equipments and systems for patient control. The Medicares physician reimbursement further increases the burden by increasing the staffing cost to hospitals while decreasing reimbursements, thus, disturbing the balance within the organization as a result of decreasing quality of service (Fodeman, 2016). b) Availability of resources. Quality of services and profits are highly dependent on the availability of healthcare resources. Due to higher demand for advanced diagnostic equipments and effective medicines, the resources are becoming limited. Therefore, the problem of allocation of resources and funds arise, leading to insufficient infrastructure, limited access to new effective drugs and hence low quality service and patient dissatisfaction. As a consequence, it can cause poor patient reviews further leading to shutting down of the organization (Mosadeghrad, 2013). Internal factors. a) Job dissatisfaction. Changes in the regulations have led to an increase in job dissatisfaction among the physicians and nurses. Some of the factors crucial in job satisfaction are pay, management, policies in the organization, job security, promotions etc. With changes in laws, most of the healthcare providers are getting paid less in comparison to the amount of work and time they devote to patients. To maintain previous income they are forced to treat more number of patients. This, on the more is responsible for increased employee turnover in the organization. Thereby the organization to get its finance has to increase the number of beds with limited attention to the patients. Thus, the burden of this is faced by the patients, with decrease in face-time with doctors, compromised care, and quick discharges. The regressive environment of the hospital ultimately hinders the quality of care. Moreover, the promotion rules, being majorly based on the number of articles published, years in service and exams passed rather than quality of service provided and patients treated, have added to the dissatisfaction among the doctors (Scheppersa et.al., 2006). b) Physician competence and skills. Keeping all the other factors aside, for a hospital to have excellent quality of service, it is necessary to have competent physicians. Technically sound workforce, with knowledge, experience and capability is a key to success. No matter how adverse the other situations are, if a hospitals staffs and physicians are superior, patients will believe in its service. Additionally, being acquainted with recent therapies, treatments and discoveries in their field, the employees should also be well informed of the organizations culture and regulations. This necessitates the modification in the recruitment and management procedures of our organization, wherein attitude, knowledge, skills, expertise etc. of a physician should be kept forth (Mosadeghrad, 2014). Competitive strategy development. For the care and services to prosper in the organization, it is essential to develop a strategic planning that recognizes and deals with the changes in external and internal threats. But targeting these factors with a single competitive strategy is a challenge for the management. Changes in government laws, job satisfaction and resource limitation are somewhere linked to each other. However, for efficient workforce development, approaches such as training programs and stringent recruitment procedures are required. These identified factors weaken the hospitals position in the external competitive environment, questioning its managerial system. With changing government laws, it is complex to balance between the finance/funds and services of the hospital, including payment to the staffs and physicians, which leads the employees to switch their job. As a result, the organization runs short of good healthcare providers and treatments. This will further hamper the strategy building process , as lack of good and satisfied staffing will make the strategy implementation even more difficult. Additionally, the factors identified make it complex for the management to decide whether to allocate funds on physicians salary, recruitment of excellent physicians and staffs or on advanced treatment procedures and resources for achieving quality care. Therefore, an efficient strategy needs to be built for minimizing the negative impacts of these factors (Rivers and Glover, 2008). Addressing threats with strategic planning. In the recent scenario, with all the new discoveries being made in the healthcare sector and introduction of new techniques, the competition has increased. This has further strengthened the impact of the above factors. Hence, for maintaining the momentum of strategic plan and becoming resilient to changes in the healthcare sector, the organizations goals should first be made clear with focus on limited number of services. Supplementary to this, a deep study of all the threats, their possible causes and consequences along with their relational perspectives must be done. To address the currently persisting major issues the management should utilize the factory approach i.e. focusing on specific diseases such as cancer, diabetes and heart diseases. This will minimize the resource allocation problem and increase efficiency of patient treatment and quality of care. It further solves the problems of job dissatisfaction among the physicians due to low pay, as the limited number of specialists for specific diseases can be paid higher. Additionally, narrowing down the scope paves way for patient-centered treatment approach that facilitates more attention to the patients rather than less face-time. This patient-centered approach, educating the patients about their health, and providing full freedom to participate in the decision making process, will make them more comfortable and satisfied (Kim et. al., 2015). Patients satisfaction increases their loyalty for an organization and helps in improving its reputation and profitability, because when it comes to health people opt for quality rather than paying less. Conclusion Although in the current scenario, with changes in external environment the internal hospital momentum is getting disturbed. However, with the application of several analytical models, these negatively impacting forces can be analyzed. The organization must not divert from the original goal, which is patients welfare, other requirements including profitability, employee satisfaction and resources will follow that ultimately. References Fodeman, J. The new health law: bad for doctors, awful for patients. The institute for healthcare consumerism. Retrieved January 13, 2016, from https://www.theihcc.com/en/communities/policy_legislation/the-new-health-law-bad-for-doctors-awful-for-patie_gn17y01k.html Kim, H.S., Kim, Y. H., Woo, J.S., and Hyun, S. J. (2015). An analysis of organizational performance based on hospital specialization level and strategy type. PLoS One, 10(7), e0132257. Mosadeghrad, A. M. (2014). Factors affecting medical service quality. Iranian journal of public health, 43(2), 210220. Mosadeghrad, A.M., Ferdosi, M., Afshar, H., Hosseini, N.M. (2013) The impact of top management turnover on quality management implementation.Medical archives, 67, 13440. Rivers, P.A., and Glover, S. H. (2008). Health care competition, strategic mission, and patient satisfaction: research model and propositions. Journal of health organization and management, 22(6), 627641. Scheppersa, E., Dongenb, E. V., Dekkerc, J., Geertzend, J., and Dekkere, J. (2006). Potential barriers to the use of health services among ethnic minorities: a review. Family practice,23(3), 325-348. Templeton, A.R., Young, L., Bish, A., Gnich, W., Cassie, H., Treweek, S., Bonetti, D., Stirling, D., Macpherson, L., McCann, S., Clarkson, J., Ramsay, C. (2016). Patient-, organization-, and system-level barriers and facilitators to preventive oral health care: a convergent mixed-methods study in primary dental care. Implementation Science, 1(1),5.

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