C H A P T E R 5s T R A T E G I C P L A N N I N G A N D S W O T A ✓ Solved
C H A P T E R 5 S T R A T E G I C P L A N N I N G A N D S W O T A N A L Y S I S I s k a t e w h e r e t h e p u c k i s g o i n g t o b e , n o t w h e r e i t h a s b e e n . — W a y n e G r e t z k y K e y T e r m s a n d C o n C e p T s ➤➤ Force➤field➤analysis ➤➤ Opportunities ➤➤ Strengths ➤➤ SWOT➤analysis ➤➤ Threats ➤➤ Weaknesses 9 1 Excerpted from Essentials of Strategic Planning in Healthcare by Jeffrey P. Harrison (Health Administration Press, 2010). 9 2 E s s e n t i a l s o f S t r a t e g i c P l a n n i n g i n H e a l t h c a r e In T r o d u C T I o n Healthcare organizations must continually make adjustments to maintain optimal func- tion (Christiansen 2002).
A number of different techniques can be used to determine where adjustments need to be made. One essential technique involves a discussion of an organization’s strengths, weaknesses, opportunities, and threats, commonly called SWOT analysis. SWOT analysis has been used extensively in other industries but has not been widely used in healthcare (Kahveci and Meads 2008). SWOT analysis is a precursor to strategic planning and is performed by a panel of experts who can assess the organization from a critical perspective (Gibis et al. 2001).
This panel could comprise senior leaders, board members, employees, medical staff, patients, community leaders, and technical experts. Panel members base their assessments on utili- zation rates, outcome measures, patient satisfaction statistics, organizational performance measures, and financial status. While based on data and facts, the conclusions drawn from SWOT analysis are an expert opinion of the panel. de f I n I T I o n SWOT analysis is an examination of an organization’s internal strengths and weaknesses, its opportunities for growth and improvement, and the threats the external environment presents to its survival. Originally designed for use in other industries, it is gaining in- creased use in healthcare. sT e p s I n sWoT an a l y s I s The primary aim of strategic planning is to bring an organization into balance with the external environment and to maintain that balance over time (Sackett, Jones, and Erdley 2005).
Organizations accomplish this balance by evaluating new programs and services with the intent of maximizing organizational performance. SWOT analysis is a prelimi- nary decision-making tool that sets the stage for this work. Step 1 of SWOT analysis involves the collection and evaluation of key data. De- pending on the organization, these data might include population demographics, com- munity health status, sources of healthcare funding, and/or the current status of medical technology. Once the data have been collected and analyzed, the organization’s capabilities in these areas are assessed.
In Step 2 of SWOT analysis, data on the organization are collected and sorted into four categories: strengths, weaknesses, opportunities, and threats. Strengths and weak- nesses generally stem from factors within the organization, whereas opportunities and threats usually arise from external factors. Organizational surveys are an effective means of gathering some of this information, such as data on an organization’s finances, operations, and processes (Carpenter 2006). SWOT analysis an examination of an organization’s internal strengths and weak- nesses, its opportuni- ties for growth and improvement, and the threats the external environment presents to its survival Clearance Center at [email protected] C h a p t e r 5 : S t r a t e g i c P l a n n i n g a n d S W O T A n a l y s i s 9 3 Step 3 involves the development of a SWOT matrix for each business alternative under consideration.
For example, say a hospital is evaluating the development of an am- bulatory surgery center (ASC). They are looking at two options; the first is a wholly owned ASC, and the second is a joint venture with local physicians. The hospital’s expert panel would complete a separate SWOT matrix for each alternative. Step 4 involves incorporating the SWOT analysis into the decision-making process to determine which business alternative best meets the organization’s overall strategic plan. A practical example of Step 2 of SWOT analysis is illustrated in Exhibit 5.1. s T r e n g T h s Traditional SWOT analysis views strengths as current factors that have prompted outstand- ing organizational performance.
Some examples include the use of state-of-the-art medical equipment, investments in healthcare informatics, and a focus on community healthcare im- provement projects. Other strengths might include highly competent personnel, a clear under- standing among employees of the organization’s goals, and a focus on quality improvement. W e a K n e s s e s Weaknesses are organizational factors that will increase healthcare costs or reduce health- care quality. Examples include aging healthcare facilities and a lack of continuity in clinical processes, which can lead to duplication of efforts. Weaknesses can be broken down further Strengths • Outstanding Medical Staff • Strong Commitment to Community Mission • Excellent Hospital Facilities • Outstanding Healthcare Quality • High Level of Organizational Efficiency Weaknesses • Lack of Adequate Resources • Lack of Primary Care Network • Shortages of Critical Staff Opportunities • Growing Metropolitan Community • Increased Managed Care Business • Growing Community Healthcare Programs Threats • Reduced Government Reimbursement • Competition for Specialty Physicians • Increased Competition from Healthcare Provider Networks Helpful to Objective Harmful to Objective E xt er n al O ri g in In te rn al O ri g in exhIbIT 5.1 SWOT Matrix Strengths current factors that have prompted out- standing organizational performance Weaknesses organizational factors that increase health- care costs or reduce healthcare quality Clearance Center at [email protected] 9 4 E s s e n t i a l s o f S t r a t e g i c P l a n n i n g i n H e a l t h c a r e to identify underlying causes.
For example, disruption in the continuity of care often results from poor communication. Weaknesses also breed other weaknesses. Poor communication disrupts the continuity of care, and then this fragmentation leads to inefficiencies in the entire system. Inefficiencies, in turn, deplete financial and other resources. Other common weaknesses include poor use of healthcare informatics, insufficient management training, a lack of financial resources, and an organizational structure that limits collaboration with other healthcare organizations.
A payer mix that includes large numbers of uninsured patients or Medicaid patients can also negatively affect an organiza- tion’s financial performance, and a lack of relevant and timely patient data can increase costs and lower the quality of patient care. o p p o r T u n I T I e s Traditional SWOT analysis views opportunities as significant new business initiatives avail- able to a healthcare organization. Examples include collaboration among healthcare orga- nizations through the development of healthcare delivery networks, increased funding for healthcare informatics, community partnering to develop new healthcare programs, and the introduction of clinical protocols to improve quality and efficiency.
Integrated healthcare delivery networks have an opportunity to influence healthcare policy at the local, state, and national levels. They also have an opportunity to improve patient satisfaction by increasing public involvement and ensuring patient representation on boards and committees. Or- ganizations that are successful at using data to improve clinical processes have lower costs and higher-quality patient care. For example, healthcare organizations with CMS Hospital Compare quality scores above the 90th national percentile are eligible for CMS pay-for- performance incentives. (See Chapter 6 for information on CMS Hospital Compare). The greater the number of organizations achieving such scores, the greater patients’ access to quality healthcare.
Such scores also enhance an organization’s reputation in the community. T h r e a T s Threats are factors that could negatively affect organizational performance. Examples include political or economic instability; increasing demand by patients and physicians for expensive medical technology that is not cost-effective; increasing state and federal budget deficits; a growing uninsured population; and increasing pressure to reduce healthcare costs. fo r C e fI e l d an a l y s I s Healthcare organizations’ responsibility to implement change that is beneficial to the pa- tient, staff, and organization is increasing. The primary areas driving change in healthcare include quality improvement, customer satisfaction, improvement of working conditions, and diversification of the healthcare workforce.
Opportunities significant new business initiatives available to a healthcare organization Threats factors that could neg- atively affect organiza- tional performance Clearance Center at [email protected] Force field analysis (see Exhibit 5.2) takes SWOT analysis a step further by iden- tifying the forces driving or hindering change—in other words, the forces driving its strengths, weaknesses, opportunities, and threats. Forces that propel an organization to- ward goal achievement are called helping forces, while those that block progress toward a goal are called hindering forces. After identifying these positive and negative forces, organi- zations can develop strategies to strengthen the positives and minimize the negatives.
For an organization to achieve success, the driving forces must outweigh the resisting forces (Baulcomb 2003). When this state is reached, organizations are able to move from their current reality to a preferred future. Effective force field analysis considers not only organizational values but also the needs, goals, ideals, and concerns of individual stakeholders. A case can be made that individuals who promote change are driving forces, whereas those who resist change are restraining forces. As a result, it is important to understand individuals, their attitudes, and the culture of the organization.
It is also important to identify the key stakeholders in an issue and to develop a plan to gain their support. Kurt Lewin, the renowned psychologist often recognized as the founder of social psychology, stressed the importance of counter- acting organizational inertia to maintain the status quo (the resisting forces) and creating C h a p t e r 5 : S t r a t e g i c P l a n n i n g a n d S W O T A n a l y s i s 9 5 Limited Financial Resources Poor Payer Mix with Low Reimbursement Marginal Patient Safety E q u ili b ri u m Low Healthcare Quality Lack of Motivated and Skilled Personnel Culture Opposed to Change Patient Perception of Quality Driving Forces Restraining Forces Culture of Innovation Adequate Financial Resources Profitability Highly Skilled Personnel Transformational Leadership High Low Change exhIbIT 5.2 Healthcare Model for Force Field Analysis Force field analysis an examination of the forces driving or hin- dering organizational change Clearance Center at [email protected] 9 6 E s s e n t i a l s o f S t r a t e g i c P l a n n i n g i n H e a l t h c a r e an environment that proactively supports future change (the driving forces) (Lewin 1951).
Such change is accomplished by modifying current attitudes (“unfreezing†an organiza- tion’s perspective on a particular issue), emphasizing the positive aspects of change, and then incorporating the new attitudes in the organization’s processes (“refreezing†the new attitudes so that they and their associated behavior patterns become entrenched in the institution). Many believe that a participative management style that solicits input from within the organization is important in implementing change. It also fosters the devel- opment of consensus within work groups, which helps to refreeze the new behaviors in the organization. ga p an a l y s I s To further refine planning decisions, SWOT analysis can be supplemented by gap analysis (see Chapter 4).
Research shows there are significant gaps in healthcare practice and that these gaps cause providers to make inaccurate assessments of patients’ conditions and provide the wrong types of care. The result is poor clinical outcomes. Gaps in healthcare include lack of knowledge, lack of motivation, poor access to information, variations in patient culture and education, lack of resources, and system barriers that limit teamwork. In one study, Robert Fleetcroft, honorary senior lecturer in primary care for the School of Medicine at the University of East Anglia, and his colleagues used gap analysis to measure the quality of healthcare services at 8,407 medical practices in England. Their research found significant gaps in clinical practice, quality indicators, and patient satisfaction across a wide range of outcome measures.
Their research was important because the United Kingdom provides pay-for-performance payments to providers based on these critical in- dicators. In many cases, performance gaps exceeded 25 percent, and there was evidence to support increased mortality as a result of poor performance among some of the outcome measures (Fleetcroft et al. 2008). Gaps also exist between the public’s expectation of high-quality care and situations in which they receive low-quality healthcare. Characteristics of low-quality healthcare include lack of responsiveness, marginal competence, unreliability, weak communication skills, and breaches of confidentiality.
Performance variations also result from trade-offs in the allocation of healthcare resources (Wicks and Chin 2008). For example, some healthcare organizations may lack the financial resources to purchase new equipment or hire additional staff when experiencing increased demand because they have allocated their resources for another purpose; as a result, patients experience excessive waiting times. The complex nature of the healthcare industry necessitates a unified, systems ap- proach to performance enhancement. For example, many patients receive only episodic care during periods of acute illness because they do not have a primary care physician. A system that requires patients to have a primary care provider would coordinate and give continuity to a patient’s healthcare services.
Other recommended changes include the Clearance Center at [email protected] implementation of evidence-based medicine in clinical processes (see Highlight 1.10), the creation of multidisciplinary healthcare teams, and the implementation of a continuous quality improvement process (Braithwaite et al. 2007). su m m a r y SWOT analysis is a precursor to the strategic planning process. Ideally, SWOT analy- sis includes a comprehensive review of the healthcare literature, in-depth data analysis, and input from a panel of SWOT analysis experts. Findings from the analysis are sorted into four categories: strengths, weaknesses, opportunities, and threats. Force field analysis supplements SWOT analysis by identifying the forces driving the strengths, weaknesses, opportunities, and threats.
To refine these analyses even further, gap analysis may be per- formed to determine where deficiencies exist in an organization’s delivery of care. Such analyses promote (1) a better understanding of barriers to change, innovation, and the transfer of knowledge to practice; (2) improved outcomes; and (3) more efficient alloca- tion of healthcare resources. 1.➤➤How➤does➤SWOT➤analysis➤set➤the➤stage➤for➤strategic➤planning? 2.➤➤➤Discuss➤the➤use➤of➤force➤field➤analysis➤in➤promoting➤change➤in➤a➤healthcare➤organization. 3.➤➤Provide➤examples➤of➤how➤gap➤analysis➤can➤be➤used➤to➤improve➤the➤quality➤of➤healthcare➤ services.
Co a s T a l me d I C a l Ce n T e r Ca s e: ex e r C I s e 5 Using➤the➤four➤steps➤of➤SWOT➤analysis➤discussed➤in➤Chapter➤5,➤create➤a➤panel➤of➤experts➤and➤ perform➤ a➤ SWOT➤ analysis➤ for➤ Coastal➤ Medical➤ Center.➤ Use➤ SWOT➤ analysis➤ to➤ identify➤ key➤ factors➤necessary➤to➤get➤Coastal➤Medical➤Center➤back➤on➤track➤and➤moving➤forward➤on➤a➤new➤ road➤to➤success. C h a p t e r 5 : S t r a t e g i c P l a n n i n g a n d S W O T A n a l y s i s 9 7 r e v I e W Q u e s T I o n s Clearance Center at [email protected]
Paper for above instructions
SWOT Analysis for Coastal Medical Center: A Strategic Planning FrameworkIntroduction
Strategic planning is an essential function within organizations to ensure they adapt to the ever-changing healthcare environment (Christiansen, 2002). A SWOT analysis assesses internal strengths and weaknesses as well as external opportunities and threats, providing a foundation for developing improvement strategies (Harrison, 2010). This paper will outline a SWOT analysis for Coastal Medical Center (CMC), providing a panel of experts and contextualizing the findings to guide CMC’s strategic direction for improved functionality and organizational growth.
Panel of Experts for SWOT Analysis
For an effective SWOT analysis, it is vital to assemble a diverse and knowledgeable panel of experts. The panel for CMC's SWOT analysis will include:
1. Executive Leadership: The CEO and senior executives will provide insights into the organizational vision, mission, and operational strategies.
2. Medical Staff: Physicians and nursing leaders will share perspectives on clinical practices, patient care quality, and staffing demands.
3. Financial Officers: The CFO and finance team will inform the analysis regarding budget constraints, funding sources, and financial performance metrics.
4. Patients: Adding a patient advocate will provide firsthand insights regarding patient experience and satisfaction levels.
5. Community Leaders: Local health department representatives or community organization heads will provide input on community health needs and partnership opportunities.
6. Healthcare Informatics Experts: Professionals knowledgeable in health information technology will assess the organization’s utilization of data analytics and electronic health records.
This panel can articulate a comprehensive view of CMC, enhancing the effectiveness of the SWOT analysis by leveraging expert insights based on key organizational performance data.
Step 1: Collection and Evaluation of Key Data
To begin with the SWOT analysis, CMC must gather relevant data from various sources, including:
- Population Demographics: Assessing patient data for age groups, prevalent health conditions, and cultural backgrounds within the community.
- Community Health Status: Reviewing health assessments to identify prevalent issues such as obesity rates, substance abuse, or chronic diseases.
- Financial Status: Evaluating funding and revenue streams, payer mix, and reimbursement rates to determine financial stability.
- Quality Metrics: Analyzing patient satisfaction surveys, clinical outcomes, and organizational performance metrics.
Once this data is analyzed, the strengths and weaknesses inherent to CMC can be comprehensively assessed.
Step 2: SWOT Analysis Categorization
The information gathered leads to the categorization of insights into strengths, weaknesses, opportunities, and threats as follows:
Strengths
1. Dedicated Medical Staff: CMC boasts a highly competent and motivated workforce, fostering exceptional care quality.
2. State-of-the-Art Facilities: The hospital features modern equipment and technology, supporting efficient patient care.
3. Community Engagement: Strong ties to local organizations enhance community trust and partnerships.
Weaknesses
1. Limited Financial Resources: Existing budget constraints hamper investment in upgrades and new programs.
2. Staff Shortages: Critical staffing gaps exist in nursing and specialist departments, impacting care delivery.
3. Poor Communication Systems: Existing communication gaps lead to delays in patient management and quality of care.
Opportunities
1. Growing Community Needs: An increasing population provides opportunities for service expansion to meet emerging health needs.
2. Advancements in Telemedicine: Embracing telehealth can attract a broader patient base and facilitate remote monitoring.
3. Government Grants: Potential funding from governmental initiatives aimed at improving community health can aid in overcoming financial constraints.
Threats
1. Competition: Other healthcare providers in the vicinity are increasingly vying for market share, putting pressure on CMC.
2. REGULATORY CHANGES: Evolving healthcare regulations and policies may affect reimbursement strategies.
3. Economic Factors: An economic downturn may lead to increased uninsured patient ratios impacting revenue.
Step 3: Development of a SWOT Matrix
Based on the categorization, a SWOT matrix can be developed, aligning internal strengths and weaknesses with external opportunities and threats:
| Strengths | Weaknesses |
|-----------|------------|
| Dedicated medical staff | Limited financial resources |
| State-of-the-art facilities | Staff shortages |
| Strong community engagement | Poor communication systems |
| Opportunities | Threats |
|---------------|---------|
| Growing community needs | Increased competition |
| Advancement in telemedicine | Regulatory changes |
| Availability of government grants | Economic instability |
This matrix provides clarity on how to leverage strengths to capitalize on opportunities while mitigating weaknesses to protect against threats.
Step 4: Integrating SWOT Findings into Strategic Planning
The final step involves tapping into the findings of the SWOT analysis to inform the strategic decisions CMC will pursue. Several actions can be derived based on the analysis:
1. Implementing Staff Development Programs: Address staffing shortages by creating partnerships with local nursing schools to develop internship programs, attract new talent, and upskill existing staff.
2. Enhancing Communication Systems: Invest in advanced health informatics systems to streamline communication and improve patient care coordination.
3. Exploring Telehealth Ventures: Develop telehealth solutions to expand service offerings, potentially tapping into new patient demographics, and leveraging government grants aimed at innovative healthcare delivery solutions.
4. Community Engagement Plans: Strengthen partnerships with local organizations and health agencies to develop programs that address growing health needs effectively, enhancing CMC’s role as a community health leader.
5. Market Position Enhancement: Establish an integrated marketing strategy to promote CMC’s strengths and unique services, highlighting its community ties and quality of care, thus counteracting competitive pressures.
Conclusion
A SWOT analysis serves as an invaluable tool for Coastal Medical Center in planning its future strategies and conducting a thorough evaluation of internal strengths and weaknesses against external opportunities and threats. By engaging a panel of experts, the organization can comprehensively assess its position and create actionable strategies for enhancement. By integrating these findings into a cohesive strategic framework, CMC can move towards achieving sustainable growth, improved healthcare delivery, and increased patient satisfaction.
References
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6. Harrison, J.P. (2010). Essentials of Strategic Planning in Healthcare. Health Administration Press.
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