GHANA INSTITUTE OF MANAGMENNT

AND PUBLIC ADMINISTRATION-GIMPA

PRACTICE OF ENTREPRENUERSHIP
COURSE ASSIGNMENT
A CONSULTING REPORT ON FOCOS
ORTHOPEDIC HOSPITAL BY FOCAL CONSULT
GROUP 8

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TABLE OF CONTENTS
Company’s Description..................................................................................................................................................3
Mission.......................................................................................................................................................................4
Vision..........................................................................................................................................................................4
Core Value..................................................................................................................................................................4
Corporate Objective....................................................................................................................................................4
Company’s Location..................................................................................................................................................4
Service Description........................................................................................................................................................4
Objectives........................................................................................................................................................................5
Methodology...................................................................................................................................................................6
Situational Analysis.......................................................................................................................................................6
SWOT Analysis of FOCOS Orthopedic Hospital.....................................................................................................7
PESTEL Analysis of FOCOS Orthopedic Hospital..................................................................................................8
Market Trends..........................................................................................................................................................10
Target Market...........................................................................................................................................................10
Competition..............................................................................................................................................................11
Competitive Advantage............................................................................................................................................11
Key Managerial Issues.................................................................................................................................................12
Recommendations........................................................................................................................................................12
Implementation Plan....................................................................................................................................................13
Recommendation 1 (Fundraising)..........................................................................................................................13
Recommendation 2 (Partnership with NGOs)........................................................................................................14
Recommendation 3 (Increase IGF Generation).....................................................................................................14
About Us- Focal Consult.............................................................................................................................................14
Team members.........................................................................................................................................................14
Benefits.........................................................................................................................................................................15
References....................................................................................................................................................................15

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Company’s Description

The Foundation of Orthopedics and Complex Spine (FOCOS) is a non-profit organization,

established in 1998 in the United States and Ghana by Dr Oheneba Boachie. He was the Chief of

the Scoliosis Service at the Hospital for Special Surgery New York, and Professor of Orthopedic

Surgery at Weill-Cornell Medical College of Cornell University.

FOCOS is sustained by donations and sponsorships through fundraising in the USA and Ghana

and has been able to realize about twenty million dollars ($20,000,000.00) from over 11,000

donors since it started operating. FOCOS has been able to use the funds to support patients and

the construction of the current FOCOS Orthopedic Hospital, here in Accra, Ghana. The 70bed

FOCOS Orthopedic Hospital, commissioned in 2012, is fully accredited to operate both inpatient

and outpatient departments. Some facilities on campus include state of the art Radiology,

Laboratory and Physiotherapy departments and the services offered include Emergency,

Ambulance, Pharmacy, Cafeteria and Laundry services. The hospital is also preparing towards

accreditation by the Joint Commission International (JCI), the internationally recognized body

for the accreditation of hospitals. A JCI accredited hospital stands for optimal quality of care.

Since its establishment in 1998, FOCOS has seen over 55,000 patients in clinic visits and

conducted close to 3,000 complex spine, joint replacement and other surgeries on patients

needing treatment for various musculoskeletal diseases. These conditions include various forms

of spinal disorders, joint disorders and other neurological conditions affecting the spine, bone,

nerves, muscle and joints.

FOCOS has hosted over 500 international volunteers from all over the world including surgeons,

nurses and physical therapists.

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Mission
The mission of FOCOS Orthopedic Hospital is to provide comprehensive, affordable orthopaedic

care to those who would not otherwise have access to such treatment.

Vision
FOCOS seeks to enhance access to optimal surgical and non-surgical care for patients with

disabling musculoskeletal disorders including complex spine deformities and pediatric

orthopaedic problems in underserved regions.

Core Value

FOCOS Orthopedic Hospital has its core values as;

 P- Passion and Purpose

 R- Respect and Compassion

 E- Excellence in Performance

 P- Patient Safety, Quality Care and Protocols

 A- Attitude of Trust, Integrity and Honesty

 R- Responsibility

 E- Efficiency and Teamwork

Corporate Objective

FOCOS Orthopedic Hospital is passionately working towards a world where everyone has the

opportunity to stand tall. To date, nearly fifty thousand (50,000) patients have been served.

Company’s Location
FOCOS Orthopedic Hospital is at 8 Teshie Street, Pantang Accra, Ghana.

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Service Description
The cases that FOCOS Orthopedic Hospital treat are among some of the most severe in the

world, many that no other team of surgeons would dare touch. With the support of dedicated

staff, volunteers, generous donors and partners, FOCOS Orthopedic Hospital is is transforming

the lives of patients throughout Africa and the world. FOCOS Orthopedic Hospital covers a big

variety of medical services offering a comprehensive care in all areas of orthopedics, including

injuries, hand, foot and spine procedures as well as arthroscopy and minimally invasive

surgeries. FOCOS Orthopedic Hospital specialty is in the following areas

 Joint Replacement (Total & Partial Replacement)

 Sports Medicine (Advanced surgical techniques)

 Spine Surgery (Surgical and Non-Surgical)

This is further simplified into orthopedics (spine, arthroplasty, pediatrics, sports, trauma,

deformity, bone tumors), neurosurgery, plastics, neurology, rheumatology, family medicine,

general medicine, rehabilitation medicine/physiatry, pain management, anesthesia and critical

care, radiology, dietary/nutrition, orthotics and emergencies.

Objectives
This report is a tool that provides an overall assessment of the FOCOS Orthopedic Hospital. It

seeks to provide evidence on the SWOT and PESTEL analysis of the hospital. The report could

help FOCOS Orthopedic Hospital promote an effective and efficient service in order to attain its

vision of making healthcare accessible to all especially to those who do not have the means. The

specific objectives of the report are:

1. To enable FOCOS Orthopedic Hospital identify its strength, weakness, opportunity,

threats and the PESTEL factors that affects its operations

2. To provide evidence and basis for areas of FOCOS Orthopedic Hospital business

operations that needs improvement.

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 3. To help FOCOS Orthopedic Hospital improve the efficiency of service delivery

Methodology
This section describes the methodology that was used to collect data. It provides a step-by-step

overview of the process of accessing and interpreting data collected from the staff of FOCOS

Orthopedic Hospital. This report’s reliability and validity depend on how the data is obtained,

measured, analyzed and interpreted (McCombes, 2019). The Qualitative approach is applied

when the researcher seeks to understand words, ideas and experiences (Scribbr, 2019). Data

is gathered through open-ended questionnaires, observation, interviews, focus groups and case

studies it can be analyzed using coding and categorizing, constant comparison, thematic analysis

etc. This report employs the use of the qualitative approach in data collection and analysis. This

is because the research questions would be thoroughly answered using methods of data

collection and analysis that show the opinions and experiences of people. An interview was

conducted with ten (10) staff across the organization including top officials, supervisors and

lower ranked staffs. Questions that were asked during the interview are listed below.

1. What is the Organization’s biggest risk?

2. What is the biggest challenge the organization has encountered in relation to its Human

Resource Management?

3. What are some of the challenges the organization faces in terms of operations?

4. What is the current financial situation of the organization?

Situational Analysis

Orthopedic hospitals fall under the Specialty Hospitals Industry and this industry includes

companies that provide treatment for bone related accidents, diagnostic and medical treatment to

inpatients with a specific type of disease or medical condition. Specialty hospitals include

hospitals that primarily provide long-term care for the chronically ill and those that offer

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rehabilitation, restorative and adjunctive services to physically challenged or disabled people.

FOCOS’ situational analysis involves unique needs assessment to analyze the institution’s

internal and external environment. Situational analysis helps institutions understand progress in

comparison with its competition (Clark, 2021). Also FOCOS will analyze its services and

understand market strategies, goal alignment and factors to consider to improve its services in

order to remain highly competitive. FOCOS have both internal and external factors that impact

the stakeholders that are involved within the organization. The most important factor to be taken

into consideration is the institution’s mission statement which is to provide comprehensive,

affordable orthopedic care to those who would not otherwise have access to such treatment.

following this mission statement, stakeholders involved can make FOCOS a beacon of hope in
the orthopedic industry. stakeholders that impact the institution internally are the healthcare staff,
human resource and all other departments within the institution. These groups are in more
control of the day to day operations of the hospital. The external factors or stakeholders that
impact the operations of FOCOS would be Ghana Health Service, Ministry of Health, Donors,
Sponsors, Volunteers, NGOs as well as licensing authorities within the orthopedic industry.
Having the input from the internal and external factors can help develop a strategic position to
strive for continuous success at FOCOS.

SWOT Analysis of FOCOS Orthopedic Hospital

STRENGHT

OPPORTUNITY
THREATS

WEAKNESS

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  STRENGHT
FOCOS orthopedic hospital’s strength lies in the fact that it has a team of well qualified
healthcare professionals. The institution also possesses advanced technology for brain
tumor surgery, an endoscopy suite and Magnetic Resonance Imaging (MRI) machine.
FOCOS also have an ambulance service and state of the art facilities with excellent
customer service.
 WEAKNESS
Perhaps, FOCOS perceived weakness lies in the fact that the hospital has no marketing
plan, practices the autocratic leadership style, staff lacks motivation and not able to retain
staff.
 OPPORTUNITIES
The opportunities that are available to orthopedic hospitals are unlimited considering the
fact that there are fewer privately run specialist cum orthopedic hospitals in Ghana. Those
available to FOCOS include online booking, online consultation and there is enough
space at the hospital current location to undergo future expansion works.
 THREATS
One major threats FOCOS is likely to face is the presence of well-established orthopedic
hospitals and of course other players in the Hospital and Healthcare industry in the target
location that also offer similar services as FOCOS. Some other threats FOCOS is likely
to face is rising medical care prices, thus the high cost of medical equipment and
supplies, loss of key staff or associates (brain drains, and enticement of qualified
personnel by other hospitals), limited financial resources and lack of support from
sponsors and donors

PESTEL Analysis of FOCOS Orthopedic Hospital

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 Political

Legal Economic

Environmen
tal Social

Technological

 POLITICAL FACTORS
 New medicines are approved by the Food and Drugs Authority (FDA)
 FOCOS can enjoy financial subsidy from the government of Ghana such as tax
benefits and price subsidy
 Operations of FOCOS can be affected by policy makers
 Another major political factor that can impact the operations of FOCOS massively
is that the Ministry of Health and the Ghana Health Service many refuse to renew
FOCOS’ license to operate.
 ECONOMIC FACTORS
 Decreased purchasing power of consumers
 Increasing labour cost
 Skill level of employees can become obsolete to new practices if they are not
trained and retrained in their respective field of work

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  High fuel prices and interest rates do not help promote growth in market capacity.
 SOCIAL FACTORS
 The management committee of the hospital has been formulating the business
process management program with a view to satisfying patients' needs and
increasing their satisfaction level.
 The hospital provides scholarships to needy patients who are unable to pay hospital
bills
 The hospital organizes breast cancer awareness to the community
 The hospital goes to some preschools to diagnose children
 TECHNOLOGICAL FACTORS
 Invest in Research and development to identify new ways of help patients with the
same clinical issues.
 Invest in and purchase advanced and emerging technology
 New ways of sharing information and communication
 ENVIRONMENTAL FACTORS
 Rules and regulations to keep environment clean and unpolluted
 Waste disposal program to ensure effective and efficient disposal of health waste
 Recycling

 LEGAL FACTORS
 Employment laws
 Hospital regulation
 Occupational Health and safety

Market Trends
The specialist hospital industry is indeed a thriving and dynamic industry; with the aid of
technology, it is becoming easier to treat, manage and cure some bone and nerve related ailments
that before now are not easy to handle. The specialist hospital industry has recently begun
consolidating, largely due to the pressures of healthcare reform. The truth is that the demand for
specialist health care services has steadily grown over the past decade, as healthcare reform
legislation broadened insurance coverage and plummeting unemployment rate increased
disposable income. As an investor in the specialist hospital industry cum orthopedic hospital, in

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order to maintain an advantaged position in this competitive industry, you should source for the
most skilled and specialized orthopedic medical professionals. One thing about this industry is
that labor costs is on the high side. However, orthopedic hospitals have also faced nurse and
physician shortages and have struggled to recruit qualified personnel. Industry profitability has
generally risen over the past decade due to increase in service prices. No doubt the specialist
hospital industry cum orthopedic hospital line of business will continue to grow and become
more profitable.
FOCOS Orthopedic Hospital has been excellent in the market for its efficient service provision
and is therefore preferred by most people in Ghana. The facility has existed for over 24 years in
the market, hence has gained a good reputation that keeps in good competing edge as compared
to other health centers. To meet the changing medical needs, the organization has been involved
in a lot of research studies and embraces unique and advanced technology to keep abreast with
technology. Moreover, the firm has experienced financial stability with about twenty million
dollars ($ 20,000,000) from eleven thousand (11,000) donors since its inception, which makes it
a big health provider in the country.

Target Market
FOCOS Orthopedic Hospital is in business to service a wide range of customers in and around
Ghana. FOCOS targets both self – pay customers (who do not have health insurance cover), and
those who have health insurance cover. The staff of FOCOS are well trained to effectively
service customers and give them value for their monies.
FOCOS’ customers can be categorized into the following;
 The whole residents within the area where FOCOS orthopedic hospital is located
 Injured Sports Men and Women
 Corporate organizations such as banks, insurance companies, manufacturing companies,
oil and gas companies, etc
 Schools
 Health Management Organizations (HMOs)

Competition
 St. Martins Orthopedic Hospital
o Location: Nsawam
 Brain Orthopedics Spine Centre
o Location: Agbogba

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  Chaba Orthopedic and Herbal Centre
o Location: Nungua
 Accra Physiotherapy and Sports Injury Clinic
o Location: Accra
This are major competitors of FOCOS Orthopedic Hospital. The competitors provide full
spectrum of medical healthcare for all patients. Understanding the competition’s strategy will
help FOCOS design a personal effective approach to gaining a competitive advantage. Majority
of these competitors set themselves apart through accomplished leadership, and personalized
treatment plans. Through combined full range of outpatient services, these competitors have the
ability to treat thousands of patients and maintain quality healthcare. Inherently, FOCOS
Orthopedic Hospital can borrow a leaf for this institution to enhance its quality of care through
personalized treatment. FOCOS’ competitors have set high standards of care, which promote
care delivery and accessibility.

Competitive Advantage
Aside from the competition that exist amongst various orthopedic hospitals, they also compete
against other healthcare service providers such as general hospitals, teaching hospitals, health
centers and standard hospitals that also provide treatment for bone and nerve related ailments and
accidents. To be highly competitive in the orthopedic hospital line of business means that an
institution should be able to deliver consistent quality service and should be able to meet the
expectations of patients at all time.
FOCOS Orthopedic Hospital facility is well positioned (centrally positioned) and visible with
state of the art equipment. The staff are well groomed in all aspect of healthcare service delivery
and all employees are trained to provide customized customer service to all patients. services are
carried out by highly trained professionals who know what it takes to give FOCOS’ highly
esteemed customers value for their money.

Key Managerial Issues

 FOCOS Orthopedic Hospital like all other healthcare centres in Ghana loses expertise
staff as most quality staff are leaving the country to seek greener pastures and better
conditions of service
 FOCOS relies on donations and sponsorship from donors and as a result do not have a
strong financial standing. This is because about 90% of funds needed for operations is
realized from donors as about the remaining 10% from Internally Generated Funds (IGF)

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 which is not enough to sustains the operations of the hospital in instances the hospital is
not able to secure the support of donors, volunteers and well-wishers.
 FOCOS is unable to meet the financial demands of its employees and as a result lose
quality staff.

Recommendations
With regards to the managerial issue of FOCOS relying heavily on funds from donations, this
issue can be handled by the following alternatives;
 FOCOS can organize its fund raising events twice a year thus every six (6) months
instead of the annual fund raising event. This can help the hospital access funds all year
round. So that if no donations come within the first half of the year, a fund raising event
will be organized during the second half of the year.
 Secondly, FOCOS can partner with more non-governmental organizations (NGOs) that
operates in the jurisdiction of FOCOS. FOCOS can write to these NGOs soliciting for
partnership and help.
o Bill and Melinda Gates Foundation
Guided by the belief that every life has equal value, the Bill and Melinda Gates
Foundation works to help all people lead health and productive lives
o Foundation for NIH
It raises private funds and create public-private partnerships to support the
mission of the National Institutes of Health (NIH)
o PanAfricare
Seeks to implement synergistic activities to improve the health, education and
productivity of communities in Africa for the benefit of present and future
generations
o UN Foundation
o Links the UN’s work with others around the world, mobilizing the energy and
expertise of business and no-governmental organizations to help the UN tackle
issues including climate change, children’s health, peace and security and poverty
eradication.
o Wellcome Trust
A global charitable foundation dedicated to achieving extraordinary
improvements in health by supporting the brightest minds.

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 Partnering with all these NGOs and foundations can be a massive source of income for FOCOS
to enable the hospital provide a quality and efficient service to patients.
 FOCOS can also put more efforts into generating funds internally. Management can sit
down with employees to identify and implement new ways of generating income
internally. Management can find ways of extending services to be able to generate more
income.

Implementation Plan
Recommendation 1 (Fundraising)
Activity Start date End date Budget Responsibility Outcome
Management 21/11/2022 21/11/2022 800.00 HR manager Decision taken to host fundraising event
meeting with twice a year
board of
directors
Staff meeting 23/11/2022 23/11/2022 500.00 HR Manager Staff informed about management decision to
host fundraising event twice a year
Management 30/11/2022 30/11/2022 800.00 Management Date to host first fundraising of the year is set
meeting
Design flyer 1/12/2022 8/12/2022 1,500.00 HR Event’s flyer and invitation card ready for
and invitation Manager/Graphic distribution
cards Designer
Media 2/12/2022 7/01/2023 15,000.0 Management/ General public informed about the
Advertisement 0 Media Outlets fundraising event
Distribute 12/12/2022 26/12/2022 3,000.00 HR Manager Guests invited to fundraising event
flyers and
invitation
cards
Host first 7/01/2023 8/01/2023 20,000.0 Management/Staff Secured funds for 1st half of the year
fundraising 0
event for the
year 2023

Recommendation 2 (Partnership with NGOs)

Activity Start date End date Budget Responsibi Outcome
lity
Management meeting 11/01/2023 11/01/202 800.00 Manageme Decision on list and number of NGOs to
with Board of Director 3 nt partner
Search and acquire 12/01/2023 16/01/202 400.00 HR Mailing address of listed NGOs
mailing address of listed 3 Manager
NGOs
Write and approve 17/01/2023 20/01/202 200.00 Manageme Partnership letter to be sent to listed NGOs
partnership letter 3 nt
Distribute partnership 23/01/2023 27/01/202 1,500.00 HR Letters distributed to listed NGOs
letters to listed NGOs 3 Manager
Request for feedback on 1/02/2023 3/02/2023 200.00 Manageme List of NGOs agreed to partner with the
partnership letters nt hospital

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 Recommendation 3 (Increase IGF Generation)
Activity Start End date Budget Responsibility Outcome
date
Management meeting 8/02/202 9/02/202 800.00 Management Decision taken to extend
with board of 3 3 services
directors
Staff meeting 10/02/20 10/02/20 400.00 Management Staff informed on management
23 23 decision to extend service
Contract survey 13/02/20 20/02/20 1,500.00 Management Contracted expert to carry out
expert 23 23 survey
Carry out survey on 1/03/202 31/03/20 200,000.0 Management/staff/survey Type of services to be extended
service extension 3 23 0 expert
Management meeting 10/04/20 10/04/20 800 Management/survey expert Survey findings presented and
23 23 analyzed with board of directors
Procure tools, 19/04/20 19/05/20 10,000.00 HRM/Management Tools, equipment, expertise
equipment, expertise 23 23 needed for successful service
extension
Media advertisement 19/05/20 30/06/20 5,000.00 Media outlets/management Public sensitization & customer
23 23 awareness
Implement new 3/07/202 - - Management/staff Extended services to increase
service into business 3 IGF
operation

About Us- Focal Consult

Focal consult is a research and data analytics company, that combines data science, technology
and analysis to help clients make better decisions. Focal consult works with stakeholders
worldwide for commercial, social policy, corporate social responsibility and consumer protection
purposes converting data into evidence based action. With internationally recognized expertise,
focal consult provides clients with skill sets to inform real-world decision making and planning
through research, data insights and analysis.

Team members
 Senior associate Consultant Derick Kofi Nti 220011478
 Associate Consultant Ronny Osei Bonsu 219015384
 Consultant Sherifatu Yakubu 220022313
 Manager Sarah Afia Agyeiwaa 218036531
 Case team leader Gifty Addai Menkah 220016941
 Principal consultant Joseph Yinkal Frimpong 220028222

Benefits

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When FOCOS is able to implement these three (3) alternative course of actions, it will solve the
issue of losing quality staff to countries and competitors that offer better conditions of service,
have a strong financial standing as the IGF increases, the over reliance on donations will
decrease, empowering FOCOS to take charge of its own operations.

References
Clark, A. (2021). From grounded theory to situational analysis: What’s new? Why? How?
In Developing grounded theory, 223-266.
McCombes, S. (2019, June 13). how to create a research design. Retrieved from Scribbr:
https://www.scribbr.com/research-process/research-design
Scribbr. (2019, February 25). An introduction to research methods. Retrieved from Scribbr:
https://www.scribbr.com/category/methodology

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