Middleville Regional Healthcare Case Study

The governing board’s role in these strategic initiatives

Several organizations, including Middleville Regional Health Care, expect their governing boards to be very active in strategy formulation. For this reason, companies have included in their codes of conduct, the specific responsibilities that the governing board are expected to play. For instance, Walker (2009) documents some of the governing board’s responsibilities as far as strategic development is concerned. He states that governing board should set the ultimate direction for the organization, leading it towards achievement of objectives. In addition, Walker (2009) states that the governing board should review, understand, assess, and approve specific initiatives and directions. Moreover, the governing board should be responsible for assessing and understanding the forces and risks associated with a company’s long-term performance. In reality however, the responsibilities of the governing board are more detailed than expected due to complexities of different organizations.

In the case provided, the governing board of Middleville has hired a consulting company to evaluate its strategic performance in the areas of Information Technology, Human Resources, Marketing, and Financing. The results obtained will be used in offering a new strategic direction for the company. As the management pressures for organizations continue to increase, the governing board is now deeply involved in creating an ongoing strategic role (Nadler, 2004). Currently, governing boards limit their involvement to approval of strategic proposals and monitoring the progress of the organization’s strategic goals. Most importantly, the governing board participates in developing the strategic direction of their organizations. Therefore, the governing board of Middleville is largely involved in strategy development, which requires a proper understanding of the company. It is for this reason that the board has hired a consulting company to evaluate its strategic performance (Nadler, 2004).

As the governing board continues to get involved in strategic development, it must distinguish between the different types of strategic activity including strategic thinking, strategic decision making, strategic planning, and strategic execution. As far as strategic thinking is concerned, the governing board must collect, analyze, and discuss information about the business models and the nature of competition in the health care industry (Nadler, 2004). Under strategic decision making, the governing board is concerned with making the directional decisions that determine how Middleville Regional Health Care allocates its resources. Identification of priorities, setting objectives, and allocation of resources to facilitate implementation of selected strategic directions is called strategic planning. The governing board must also identify priorities, sets objectives, and secures allocation of resources to ensure that strategic directions are properly implemented. With regard to strategic execution, the governing board of Middleville Regional Health Care implements and monitors results that are appropriate for corrective action (Nadler, 2004).

It is therefore clear that the role of the governing board differs dramatically in the above strategic development areas. During the early stages of strategic development, the governing board focuses on discussing issues surrounding competition in the healthcare industry. This is followed by making directional choices that are concerned with decision making. Once the governing board has made directional decisions, it will have to review and monitor progress that now becomes the primary focus of the organization (Nadler, 2004). The governing board of Middleville Regional Health Care, with the assistance of the consultant, will be able to participate in strategic thinking and strategic decision making on areas related to Information Technology, Human Resources, Marketing, and Financing (Walker, 2009).

Performances Middleville can use to measure its success in providing quality healthcare to the community

            The success of the governing board depends on its ability to select performance metrics that it can easily monitor in order to find out whether its Human Resources, Financing, Information Technology, and Marketing are functioning effectively. It is important that the board selects manageable performance metrics that touch into the four different areas and that can add value to the entire organization. The standards performance metrics should cover financial issues, operations, organizational issues, the position of the company in the market, and the nature of its relationship with stakeholders. When identifying the best performance metrics for Middleville Regional Health Care, it is useful to consider factors that will bring value to the organization both in the short run and in the long run (Nerenz and Neil, 2001).

The first performance that Middleville can use to measure its success in providing quality healthcare to the community is launching a new marketing strategy as a way of increasing its market share in the healthcare industry by 20 percent over the next three years. The governing board believes that by making the community aware of its quality services through a new marketing strategy, the number of admissions as well as that of outpatient visits will increase. Middleville will be able to measure this performance by finding out whether its market share will have increased by 20 percent in the next three years. Any value below 20 percent will indicate that the healthcare organization have not succeeded in providing quality healthcare to the community (Nerenz and Neil, 2001).

The second performance metric that Middleville can use to measure its success in providing quality healthcare to the community concerns returns on capital. The company should raise its returns on capital by 25 percent over the next five years. This performance metric is important because it will allow Middleville to compare the services it offers with those of its competitors before identifying areas of improvement. The best way through which the company will measure this performance is by finding out whether there is any profit generated within a period of five years and whether the change in profit can cause a 25 percent increase in returns on capital. An increase in profits is an indication of an increase in the number of patients who visit the hospital which can only occur if the organization is offering quality healthcare to the community (Nerenz and Neil, 2001).

The third performance metric that Middleville can use to measure its success in providing quality healthcare to the community is associated with the people in the organization who are responsible for the success of the formulated strategies. Middleville should implement new motivation strategies to help reduce the rate of employee turnover to below five percent over the next two years. This performance is important because employees can only be encouraged to remain in the organization if they are properly motivated. The best measurement indicator is either a constant number of qualified personnel or an increase in employee number which is directly associated with an increase in the number of admissions, outpatient visits, births, beds, and census in the long run (Nerenz and Neil, 2001).

Areas Middleville should focus on to maintain its competitive market share as well as continue to provide healthcare to the community in the 21st century

From the statistics provided, Middleville has 575 beds, 13,000 admissions, 350 census, 221,000 out-patient visits, 2,300 births, expenses amounting to 125,000 United States dollars, and 2,00 personnel. When compared to its two competitors Brierield and Greystone, it is clear that Middleville occupies the highest position in the market in almost all areas except in admissions and expenses. It order to maintain its competitive market share as well as to continue to provide healthcare to the community in the 21st Century, Middleville should find a way of increasing the number of admissions and increasing expenses while at the same time maximizing profits. First, Middleville should focus in rigorous marketing to make its services known to the community.

Second, Middleville should implement an Information Technology system for use in admissions, storing patients’ records, and maintaining its financial records. For instance, the healthcare organization should implement an Electronic Health Records system that will assist it in storing accurate patient data. The data will help Middleville to ensure that all patients are served within the shortest time possible by the right physicians. Additionally, Middleville should use modern computers for recording and storing its financial data and for maintaining its inventories. This will help the organization to ensure that accurate financial data is kept and inventories are kept up-to-date to avoid unnecessary expenses, minimize cost, and attract huge profits (Rivers and Glover, 2008).

Third, Middleville should hire qualified nurses and physicians to provide high quality services to patients, including expectant mothers. These professionals should be taken through the organization’s code of conduct to ensure that they maintain high levels of ethical standards. With the availability of qualified healthcare professionals in the organization, additional patients will be attracted to the hospital, which will even call for expansion of bed space. The moment Middleville begins offering higher quality services, attracting more patients, and making higher profits than Brierfield and Greystone, it will be able to maintain a competitive market share as it continues to provide healthcare to the community as required in the 21st century.

The costs and benefits associated with implementing EMR and associated health data systems

As earlier mentioned, Middleville Regional Heath Care should implement advanced technology systems as soon as possible in order to compete favorably in the market in the 21st century. The organization must be conversant with the costs are benefits associated with implementing an Electronic Medical Records and other health data systems before beginning the whole project. One of the benefits of implementing an Electronic Medical Records is that fact that it enables physicians to keep accurate data about a patient’s condition for accurate retrieval during the next visits. In addition, Electronic Medical Records reduces the duplication of diagnostics tests which helps to reduce expenses. Again, Middleville will be able to improve the quality of healthcare if it implements an Electronic Medical Records and associated health data systems (Smith, 2003).

However, the organization must be prepared for the high costs associated with implementing Electronic Medical Records and associated health data systems. The high costs involve equipment costs as well as training costs. However, Middleville must understand that successful implementation of an Electronic Medical Records and associated health data systems will result into huge profits for the organization, which will take care of the costs incurred (Smith, 2003).

The best plan for implementing an Electronic Medical Records and associated health data systems include; analysis and redesign of work-flow, modification of the facility in order to create space, selection and installation of hardware, configuration of software, development of a backup system, loading old patients’ data, transferring patient information from paper to the Electronic Medical Records system, and training employees to use the newly implemented system. By following this implementation plan, health care providers at Middleville will now begin to generate and process patients’ information electronically as they continue with health care delivery (Smith, 2003).

Promoting employee satisfaction

            According to Yazinski (2009), employee retention can be encouraged through application of effective motivation strategies. One of the methods of promoting employee satisfaction is through offering good pay depending on the complexity of work done by workers. However, Middleville is unable to apply this strategy due to economic constraints. Human resources should therefore seek to promote employee satisfaction by providing growth opportunities for all workers to enhance their goal-setting efforts. This involves providing employees with adequate job challenges to help them expand their knowledge. Additionally, Human Resources should use communication to build credibility among workers. The human resource manager should be ready to listen to employees’ concerns and address them as required. Since Middleville is currently unable to make salary increases, it will be able to promote employee satisfaction and retain experienced personnel by making workers to feel valued and cared for (Yazinski, 2009).


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