Graduate School

Journal #3

Strategic management as adaptation to changes in the ecosystems of public hospitals in

Israel

Lior Naamati Schneider

Course:

Principles of Health Administration

Jennilyn P. Talavera-Nopueto MD
Masters in Hospital Administration
Strategic management as adaptation to changes in the ecosystems of public hospitals in
Israel

Lior Naamati Schneider

SUMMARY
All over the world, the healthcare system has seen rise in demand, with limited supply.
Hospital organizations are struggling to strike the balance between provision and generating
profit. As much as they want to provide for everyone who needs quality healthcare, the cost of
quality in the current surge that we are facing makes the management compromise and prioritize
the cost and finances to be able to maintain the organization running.

Such is the situation in Israel. In the previous years, the country has seen implementation
after implementation of reforms in its public health services. And while it is a sign of a progressive
and favorable legislation, the organizations struggle to keep up with the fast pace system.

This situation has led the researcher to evaluate and assess the state with which six (6)
hospitals in Israel were able to adapt, integrate and implement the changes in the system within
their own. The Ginter model of strategic management of hospital organizations was used.

According to this model, strategic management is divided in to three (3) phases.

The first one is strategic thinking, which focuses on identifying and recognizing external
changes, to be able to adapt to them in the most efficient way.

Strategic planning is the second stage in Ginter’s model. Once the external changes have
been identified, then the focus shifts to collecting data and information, analyzing them, and
brainstorming within the group to formulate and produce an action plan, where the details of how
the plan would be carried out; including delegation and assignment of tasks, and their time frame
within which the action should be completed.

The last stage is the strategic momentum stage, which deals with the actual
implementation of the previously developed plan. With its execution, continuous monitoring and
feedback is important to be able to successfully integrate the newly formulated strategies to the
previous ones.
 As was stressed in the paper, as much as the evaluation of the external environment is
important, it is imperative that the internal environment be assessed and evaluated as well. This
is because the implementation of the strategies is highly reliant on the attitude and values of the
staff and the management itself.

Reflection

The fast-paced healthcare ecosystem simply cannot keep up with the faster evolution of
the population and increase in its quantity. Its demands are overwhelming but is met with unstable
healthcare policies and practices which may be due to scarce resources and manpower.

The study portrayed how some of the key members of the organization viewed the
company as a profiteering body with less regard to the quality of care. One said that there exists
a considerable “pressure from management for full capacity, that there be more patients in the
hospital.” This is an evidence that the management is struggling to provide quality with the
increased demand and limited resources. It also compromises important activities and time for
staff support like mentoring and planning sessions.

One of the problems that surfaced during the interviews conducted was the boundaries
and conflict in the professional relationships of doctors and managers. A suggestion to have a
unique role of clinical leadership was brought up. This is to bridge the gap between the
relationships.

Communication is key within an organization. It is important that as healthcare managers,

we should keep in mind to look not only through the external factors which may exert pressure on
the different non-medical aspects of healthcare management, but also within the organization
itself, i.e., the internal factors, for implementation is null with no one who understands and commits
to it.

Application to profession

In the league of medical professionals such as among the doctors, nurses and other allied
health personnel, it has always been a problematic and gray area to unite the ideals of the said
groups of people with that of the management.
 This is largely due to conflicts of beliefs and interests.

The body of operations is concerned about the quality of care for the patients, whereas
the management is more focused on keeping its staff members well provided for as well as
keeping the hospital organization afloat.

Asking for full capacity and admitting even non admissible patients have been seen time
and again in private institutions. This practice, although not entirely illegal, is somewhat unethical
and unbecoming of the medical profession. Which is why there is almost always a drift between
the practitioners and the management.

Although running a hospital is largely based on the rule of economy of supply and demand,
it is also important to evaluate other factors such as the political aspects of maintaining the
organization, especially in the public health system which is usually overwhelmed with the volume
of clients that it should cater to.

Especially in a third world country like ours, resources are scarce, but the demands are
increasing in an exponential manner. Doctors and nurses are trying to keep up but without the
awareness, insight and support from the management, these professionals will ßcrumble, and the
health system would collapse.

A crucial step that we can undertake is to find time to formulate a strategic plan to
somewhat meet the needs of both parties. A comprehensive evaluation and analysis of the
internal environment or the struggle within the organization comes into play as we try to keep
everyone aligned with the organizations mission, vision and values. |