Strategic management in healthcare

Strategy Health Care

First student: There are many barriers to the implementation of strategy in health care organizations. One barrier is that the organizational structure, including chains of command and communication, may pose barriers. This barrier reflects that strategy needs to be communicated effectively, in order to the implemented effectively (Heide, Gronhaug and Johannessen, 2002). Managers must be aware of this, and ensure that there are channels for communication that will allow the strategy to be properly disseminated and understood throughout the organization.

Another barrier to implementation will be inertia/vested interests, wherein different people throughout the organization do not want to have a new strategy. The perceive that they will lose out of there is change, so the resist change in order to defend the organizational turf they have staked out (Pardo & Fuentes, 2003). A third barrier is related to these two, in that there are people within the management of the organization who do not buy in. Many studies have supported the idea that management buy-in is essential to the implementation of strategy, because managers are going to deploy resources and exert influence in the direction of that strategy. Without buy-in, a strategy implementation is more likely to fail (Al-Ghamdi, 1998).

Because management buy-in is directly related to communication, to organizational structure and to inertia and resistance, the solution seems to begin with ensuring that there is full and complete buy-in from the company's management. Bringing management into the strategic decision-making process is perhaps the best way to do this. If they have contributed to the strategic planning process, they are more likely to support the outcome. But there is more that a company can do. Having a communication plan is essential to success, in part because it will illustrate how the rank-and-file of the organization understands and perceives the new strategy.

The third aspect of this is organizational design. This includes things like IT systems, which influence the flows of information throughout the organization. It is necessary that if the strategy requires changes to core elements o the business that the design of the organization is set up to facilitate that. In health care, where there is often a structure based on different facilities, or different specialties, it may be necessary to examine the structure and ensure that it is still aligned with the strategy that the organization is seeking to undertake.

Student 2: There are many barriers to strategic implementation that can arise. Normally, people within the organization may lack motivation to change, or feel that their division does not need to change. This may especially be true in health care, where many divisions might operate basically as silos within the organization, with their own budgets and decision-making. Kaplan and Norton (2001) introduces the idea of the balanced scorecard.

They note that the strategy has to be translated to the operational level in order that it is accepted, but that silos can prevent divisions within the company from adopting a given strategy. There is a particular challenge with respect to building and maintaining motivation within all divisions, where the strategy maybe is something that transcends that one divisions' issues. Kaplan and Norton recommend that strategy needs to be everyone's everyday job within the organization, not just something for a few top managers. As such they recommend that everyone within the organization understands what their role is with respect to the strategy. If there are pockets of resistance, from managers who maybe are in a silo, it is senior management's job to tear down the barriers and remove the resistance, so that there is total buy-in from management with respect to the new strategy that is being undertaken.

Student 3: There are several barriers to the implementation of strategy. Communication, resistance from management, and lack of resources can all undermine strategy. Many of these issues come right back to the role of management. Senior management needs to buy into the strategy and offer it full support. The senior management time sets the tone for the organization with respect to the strategy. Just as important as the image is that senior management plays a role in communication of strategy, and it plays a role in ensuring that there are enough resources to properly execute the strategy. For this reason, the most important factor in overcoming strategy implementation barriers is to get the most powerful people within the organization to support the strategy. They should be involved in creating the strategy, or at least have a strong commitment to supporting the strategy, and a knowledge of what they can do to support the strategy.

Where there is consensus, strategy is implemented faster, more accurately, and more successfully, because senior management puts its weight behind the strategy (Dooley, Fryxell & Judge, 2000). This shows that commitment is probably the most important thing in implementing strategy. Most forms of resistance can be overcome where there is managerial commitment -- the old adage that where there is a will there's a way has been proven empirically with respect to strategic implementation, and the drive to overcome barriers.

For example, if an organization needs to shift resources around in order to better execute a strategy, this is easier to do where there is total organizational commitment. Those internal barriers sometimes exist in the compartmentalized world of health care can be removed with strong commitment, acceptance of trade-offs, and a senior management team that is willing and able to make tough decisions. Where that is the case, success is more likely to follow.