Faith Community Hospital: SWOT Analysis and Strategic Solutions

Introduction to Faith Community Hospital

The Faith Community Hospital case has been analyzed using a SWOT analysis in order to identify the pertinent issue and define the problems the organization currently faces. The SWOT analysis was also conducted with a view to developing solutions that take into consideration environmental factors, especially the interests of various stakeholder groups (see Appendix 1). However, prior to discussing the conclusions drawn from the SWOT analysis, it is important to briefly introduce the organization itself.

Faith Community Hospital is a not-for-profit organization established with the aim of promoting the health and well-being of the people in the communities it serves. While there may be several similar organizations in the healthcare industry, Faith Community Hospital is distinctive in having been built on a foundation of spiritual values. The hospital's spiritual heritage and values represent the single most important "point of commonality" among its Board and staff members, besides the organization's purpose of restoring the health and well-being of patients (Case Study, p. 2).

However, inferring from the CEO's briefing on Faith's current problems, it appears that the organization's emphasis on its spiritual heritage and values is generating conflict with the ethics of the medical profession, regulatory requirements, compliance with managed care and insurance providers, and the hospital's own operating procedures. A close examination of these conflicts reveals a common underlying pertinent issue.

Pertinent Issue: Faith Community Hospital's commitment to its spiritual heritage and values is apparent in the very manner in which this has been foregrounded in the organization's mission statement. While this indicates a clear set of organizational values and a strong culture, it also implies that Faith Community Hospital is an organization committed not just to its task but to the very idea of the organization. Unfortunately, this commitment has led to stakeholders who are more focused on the process of organizational action than on its product — which should properly be focused on the health outcomes of patients treated. It is this factor that has likely produced the existing conflicts between "ethics, laws, beliefs, oaths, etc." (Case Study, p. 2). The commitment to adhering to the spiritual and moral values of patients and staff has also generated several additional problems, particularly in the area of financial management. The SWOT analysis (see Appendix 1) clearly reveals the following problems, which Faith Community Hospital must address if it is to ensure its continued survival and grow its reputation and capacity to serve its communities.

Problem Definition

Widely varying interpretations of the mission statement have led to ambiguity in organizational goals. For instance, in any situation where there is a conflict between a staff member's or patient's religious beliefs and hospital procedures or medical ethics and law, the organization's mission is interpreted in a manner that allows spiritual values to take precedence over established policies and procedures. The confusion is amply illustrated in the anecdotes cited by the CEO — of staff members who refuse to provide certain medical services and who initiate or ignore "Do Not Resuscitate" directives in direct contravention of hospital procedures. It is therefore clear that the hospital needs to review its stated goals and, if necessary, reframe them to eliminate all ambiguity.

An over-emphasis on spiritual heritage and values in the organization's culture is placing the hospital at risk of action from governmental agencies and healthcare and insurance providers. This is evident in the cited case of Child Custody Services threatening to take custody of a child in the hospital's neonatal ward and to pursue action for failure to provide the right services. Similarly, differing values and decision-making styles among doctors have led to managed care and capitation providers experiencing a significant loss of authority. This could create further problems, particularly regarding decisions concerning a patient's "right to die" or refusals to treat uninsured patients. The former may lead to legal suits, while the latter could result in negative media coverage — especially damaging for a hospital known for its spiritual heritage. It is therefore essential that Faith Community Hospital take the necessary steps to clearly establish policies and procedures, both to avoid regulatory or legal action and to manage its relationships with healthcare providers and the media effectively.

Lack of financial controls in operational procedures is evident in the hospital's highly democratic and decentralized form of decision-making. If stringent financial controls were in place, it is unlikely that the hospital pharmacist could fill uninsured prescriptions or that doctors could decide to treat patients pro bono — guided solely by personal conscience and without authorization. The hospital also runs the risk of not being reimbursed even for insured patients if it continues to allow physicians the leeway to make unilateral decisions, as illustrated by the example of a doctor continuously ordering tests for terminally ill patients. It is therefore unsurprising that the hospital is facing rising costs per patient per day (from $217 to $240) given the apparent lack of financial controls. Faith Community Hospital must take a hard look at its financial management policies and procedures to avoid a situation in which it is forced into cost-cutting measures that could compromise the quality of healthcare services provided.

All of the preceding problems also indicate a lack of communication between management and staff. This inference is confirmed by the fact that the CEO is planning the first all-staff meeting in ten years. There also appears to be a communication problem among staff members, judging from incidents in which decisions were taken in spite of existing orders to the contrary. This could be due either to the absence of clearly defined organizational goals, policies, and procedures, or to a failure to communicate properly even where such goals or policies do exist. Organizational communication issues must therefore be addressed as well, to ensure that proposed solutions and changes are accepted and implemented effectively.

Strategic Alternatives

The analysis thus far leads to two possible alternative strategies.

Alternative 1: Given the conflicts caused by Faith Community Hospital's emphasis on its spiritual heritage and values, one option is to change the organization's focus to providing a range of quality healthcare services aimed solely at restoring patients' health and well-being. Such a course would eliminate all conflicts caused by widely varying religious and personal values and would facilitate adherence to clearly stated organizational goals. However, the disadvantage of this solution is the loss of a key strength that has historically allowed the organization to attract believers across its stakeholder segments. Faith Community Hospital would likely also lose the competitive edge that its spiritual values has provided. An additional risk is that Faith may lose the confidence and goodwill of the communities it serves, as well as backing from charitable trusts. This route is therefore too risky to follow, particularly since Faith Community Hospital is a not-for-profit organization.

Alternative 2: Achieve a balance between the practical need to manage the business side of the organization and the goal of fulfilling the spiritual needs of the stakeholders it serves. Such a balance, if achieved successfully, can not only resolve the hospital's current problems in the areas of ethics, regulatory obligations, and finance, but also strengthen its reputation and standing in the market (see SWOT Analysis, Appendix 1). However, achieving this balance will not be easy, and much will depend on management's ability to secure buy-in from all stakeholders on proposed modifications and additions to organizational goals, policies, and procedures. To begin with, all stakeholder segments would have to agree that the hospital's priorities must lie in safeguarding the interests of patients' health rather than in fulfilling spiritual or religious beliefs. Achieving a balance may be difficult, but it is not impossible — provided the following recommendations are implemented and managed well.