Contents

I. Public Hospital
A. History of Organization
B. Organizational Structure
C. Strategic Thinking Map or Strategic Management
D. Eternal !n"uences
E. Competiti#e A$#antage
%. Analyzing the !nternal En#ironment
&. Mission ' (ision Statement) *hilosophy an$ &oals of
Organization
H. De#eloping Strategic Alternati#es
!. S+OT Matri ,Strength) +eaknesses) Opportunities) ' Threats-
.. /nits in the C0Os ,Chief 0ursing o1cer- Domain
2. (alue A$$ing Support Strategies
3. Strategic plan
II. Private Hospital
A. History of Organization
B. Organizational Structure
C. Strategic Thinking Map or Strategic Management
D. Eternal !n"uences
E. Competiti#e A$#antage
%. Analyzing the !nternal En#ironment
&. Mission ' (ision Statement) *hilosophy an$ &oals of
Organization
H. De#eloping Strategic Alternati#es
!. S+OT Matri ,Strength) +eaknesses) Opportunities) ' Threats-
.. /nits in the C0Os ,Chief 0ursing o1cer- Domain
2. (alue A$$ing Support Strategies
3. Strategic plan
ORGANIZATIONAL ENVIRONMENTAL ANAL!I! "OEA#
VICENTE G$!TILO %I!TRICT HO!PITAL
I. Histor& o' t(e Or)ani*ation
Escalante City is a fourth class city in the pro#ince of 0egros
Occi$ental) *hilippines. Accor$ing to the 4565 census) it has a
population of 78)559 people. Escalante has a total lan$ area of
67)4:;.858 hectares ,<:);84.:= acres-. !t is locate$ on the
northeastern tip of 0egros Occi$ental) facing the islan$ of Ce>u. !t is
<7 kilometres ,85 mi- from San Carlos City an$ 79 kilometres ,97 mi-
from Bacolo$ City) the *ro#incial Capital. !t is >oun$e$ on the north
an$ ?est >y the City of Sagay) on the south >y the to?n of To>oso an$
on the east >y Ta@on Strait.
!n line ?ith the progression of Escalante) the hospital ?as >uilt in
the year 67;4 an$ ?as Arst locate$ in a 4Bhectare lot along the
pro#incial roa$ going to the Ol$ *o>lacion an$ 6 kilometer from the
heart of the city. Though the >uil$ing ?as constructe$ on 67;4) it ?as
on the year 67:< that it starte$ a$mitting patients for hospitalization.
The hospital ?as manage$ >y the Sisters of .ulie *ostel) a Catholic
religious or$er in Hollan$. They name$ their institution as Mag$alen
Hospital) a 655B>e$ capacity hopital.
On .anuary 6) 67=6) the Sisters of .ulie *ostel $onate$ their
Mag$alen Hospital to the national go#ernment. All of the ser#ices ?ere
then transferre$ to the national go#ernment an$ rename$ it (icente
&ustilo Memorial Hospital.
!n 6778) the hospital ?as $e#elope$ to the *ro#ince of 0egros
Occi$ental an$ rename$ it (icente &ustilo District Hospital.
(icente &ustilo District Hospital is presently locate$ at 3opez
Dri#e) Escalante Cty) 0egros Occi$ental. !t is <55 meters a?ay from
the national high?ay an$ 7; kilometers from Bacolo$ City) the
pro#incial capital.
(icente &ustilo District Hospital is a le#el 4 institution ?ith a 95B
>e$ capacity license$. +ith *hilhealth Accri$itation on a secon$ary
le#el ?ith <9B>e$ capacity accre$ite$.
The hospital is the core referral hospital of the interBlocal health
zone compose$ of the cities of San Carlos an$ Escalante an$ the
municipalities of Calatra#a) To>oso an$ Don Sal#a$or Bene$icto. !t also
caters to the patients coming from the a$Cacent cities of Sagay an$
Ca$iz.
III. !trate)ic T(in+in) Map or !trate)ic Mana)e,ent
IN%ENTI-IE% GAP!.
6. /pgra$ing of (&DH in terms of infrastructures) manpo?er an$
eDuipment
I%ENTI-IE% !OL$TION.
/. Rational $p)ra0in) o' VG%H
a. Construction of a ne? hospital >uil$ing
Cost of programE 6=5M
Success in$icatorE
health facility impro#e$
accommo$ate increase of $eman$ for health
ser#ices
>. Construction of staF houses) $octorGs Duarter an$ $ormitory
Cost of *rogramE 7M
Success in$icatorE
Timely response
%ast $ecisionBmaking
c. EDuipment AcDuisition
Cost of *rogramE 65M
Success !n$icatorE
Meet increasing $eman$ for Duality ser#ice
More ser#ices ren$ere$
More re#enues generate$
$. Manpo?er rationalization an$ a$$ition
Cost of *rogramE 6.=M
Success !n$icatorE
He$uce$ referrals
A#aila>ility of professionals ?ith specialize$
trainings
More clients ser#e$
!ncrease$ re#enues
I%ENTI-IE% GAP!.
6. 3imite$ >u$get for me$ical supplies) la>oratory) Bray) $ental an$
me$icines
I%ENTI-IE% !OL$TION.
6. !ncrease >u$get for Maintenance an$ Other Operating Epenses
,MOOE-
a. 3o>>y for increase of MOOE >u$get
Success !n$icatorE
More re#enues
More clients ser#e$
*atients properly manage$
4. Hetention of *H!C re#enues
a. *assage of *ro#incial Or$inance for the retention of *H!C
re#enues.
Success !n$icatorE
3ess su>si$y
More clients ser#e$
8. Direct consignment scheme of procurement
a. %inalization of plan for the implementation
Success !n$icatorE
Timely $eli#ery of supplies an$ me$icines
A$eDuate supply
I%ENTI-IE% GAP!.
6. 3o? re#enue collections
I%ENTI-IE% !OL$TION.
6. !ncrease of collection
a. /n$ertake intensi#e information) e$ucation to patients
>. *roper social ser#ice classiAcation of patients
c. Encourage enrollment in *H!C
Success in$icatorsE
Decrease of in$igent patients
!ncrease of socialize$ insurance
Hesponsi>le patients
IV. E1ternal In2uences
/. Mar+et %e,an0
To >e a>le to meet the nee$s of their constituencies) the (&DH
ha#e to ha#e a clear un$erstan$ing of the nature of the
hospitalization reDuirements of the mem>ers of the communities
they ser#e. *atient $eman$ for hospital ser#ice increases un$er the
follo?ing con$itionsE
a- ?orsening $emographic an$ socioBeconomic con$itionsI
>- impro#ement in the health consciousness of the populationI
c- eFecti#e mass communicationI
$- eistence of Me$icare >eneAts an$ other health >eneAtsI
e- high employment rate an$ personal incomeI an$
f- high literacy
3. Net4or+in) an0 Re'erral !&ste,
The hospital referral net?orking system ena>les the hospital to
pro#i$e Duality patient care ?ithout straining its resources too much
>y linking ?ith other hospitals in the system. The net?orking
system co#ers the areas of patient care) training an$ research. The
most freDuent reasons for referrals are ina$eDuacy of >e$s) lack of
eDuipment an$ complications from the original illnesses ?hich the
hospital is illBeDuippe$ to treat
5. Healt( Care -inancin) Pro)ra,s
The *hilhealth speiAcally pro#i$e the hospital ?ith a lot of
patients. This coul$ mean a higher utilization rate of the hospitalJs
facilities an$ eDuipment. The *hilhealth to$ay is proCecting a rapi$
gro?th of the in$ustry. HMOs are looke$ upon as a ?ay of paying for
the rising health care cost >rought a>out >y in"ation) the high cost
of technology) an$ unrestricte$ fees an$ rate setting >y pro#i$ers.
6. Tec(nolo)&
Essentially) one might say that hospitals are technology $ri#en.
The technology has a critical role in the e1cient $eli#ery of health
care ser#ices. There are) ho?e#er) se#eral pro>lems relate$ to
hospital technology in the *hilippinesE
6- The malB$istri>ution an$ une#en $istri>ution of technology in
go#ernment hospitals
4- The rapi$ly changing technology an$ the rising costs of its
maintenance an$ the e#entual o>solescence of eDuipment ?hich
make it $i1cult for go#ernment hospitals to cope ?ith their
limite$ resources.
7. Govern,ent Policies
The *hilippine legislation aFects hospitals. The licensing
regulations ha#e great eFects since the re#ocation of hospital
licenses can >e $one.
The follo?ing go#ernment agencies ha#e >een man$ate$
to regulate the hospital operationsE
,6- Department of Health for licensing an$ Me$icare
insurance claims.
,4- Department of 3a>or for the implementation of the
3a>or Co$e for hospital personnelI an$
,8- Department of !n$ustry) speciAcally the Boar$ of
Hospital !n#estments to encourage the pri#ate sector to
put resources in the hospital in$ustry through ta
incenti#es ,e.g.) ta allo?ance for in#estment) capital gains
ta eemption) incenti#es to hospital >enefactors-
V. Co,petitive A0vanta)es
/. P(&sician ali)n,ent
(&DH >elie#e that strong physician alignment is the most
impactful competiti#e a$#antage to support Duality an$ costB
structure initiati#es. The hospital has a surgeon an$
anesthesiologist a#aila>le $uring emergency operations. The
resi$ent physicians ha#e their o?n specialties that make
colla>oration at ?ork easier. Strong alignment >et?een a
hospital an$ its me$ical staF can ser#e as an eFecti#e >arrier
against a competitor.
VI. Anal&*in) t(e Internal Environ,ent
A. E1istin) E8uip,ents
6. Emergency Hoom
Emergency Cart
E2& Machine
Computer Machine
4. O*D
Basic (ital Assessment EDuipments
Tele#ision Set
%illing Ca>inet an$ Ta>les
8. Operating Hoom
Suction Machine ,Hea#y Duty-
OH !nstruments) ta>les) an$ lights
Hesuscitator
/tility Cart
<. KBray Section
KBray Machine
KBray Cassette
9. 3a>oratory Section
Bloo$ Bank Hefrigerator
Electric Microscope
;. *harmacy Section
Computer Machine
AirBcon$ition
:. Dental Section
3ight Care /nit
/ltra Sonic Sealer
Dental Chair
=. O1ces ' Hecor$ Section
AirBcon$ition
Computer Set
9. :ell Traine0 Healt( Care Personnel
B Compose$ of 6 Chief of Hospital) 6 Me$ical O1cer () :
Me$ical O1cer !() 6 0urse !() 6 0urse !!!) 6 Dentist !!) 4
Me$ical Technologist !!) 6 0urse !!) 4 *harmacist !!!) 64 0urse !)
4 Mi$?ife !!) 6 Ha$io EDuipment Technician !!) 4 0ursing
Atten$ant !!) 65 0ursing Atten$ants !) 6 Dental Ai$e) 8
3a>oratory Ai$e !.
C. !et;up
B 3e#el 4) &eneral Hospital consisting of Emergency Hoom) O*D)
Operating Hoom) +ar$s ,Me$ical ' Surgical-) Hecor$s Section)
KBray Section) 3a>oratory Department) Dental Section)
*harmacy Department) O1ce) Maintenance Department)
3aun$ry Department ' 2itchen Department.
VII. Mission !tate,ent< Vision !tate,ent< P(ilosop(& an0 Goals
o' t(e Or)ani*ation
Mission !tate,ent
Make a#aila>le) accessi>le) customerBfrien$ly) aFor$a>le Duality
health care ser#ices ?hich can satisfy the nee$s of 0egrenses.
/pgra$e an$ impro#e the capa>ilities of health ?orkers thru
trainings) seminars an$ interactions ?ith other sectors.
Strengthen $ynamic partnership ?ith all organizations) the
pri#ate sectors an$ the community) >y sharing a#aila>le
resources in implementing health relate$ ser#ices.
Vision !tate,ent.
Provincial Vision
An ecologicallyB>alance$) peaceful) progressi#e 0egros
Occi$ental) characterize$ >y an empo?ere$) healthy an$ selfB
reliant citizenry ?ith a glo>allyBcompetiti#e) agroBin$ustrial)
$i#ersiAe$ economy anchore$ on sustaina>le go#ernance
promoting gen$er eDuity an$ social Custice share$ >y a $ynamic
ci#il society.
A)enc& Vision
A healthy an$ pro$ucti#e life for the empo?ere$ 0egrenses
especially the lessBpri#ilege$ thru team?ork) pro#i$es an
eFecti#e) Duality health care in partnership ?ith other sectors for
pu>lic ser#ice ecellence.
VIII. %evelopin) !trate)ic Alternatives
To meet goals of impro#e$ Duality an$ re$uce$ costs in
to$ayJs changing healthcare en#ironment) hospitals are >eing
force$ to >e creati#e an$ "ei>le in their strategies. As part of the
transformation to #alueB>ase$ care) many hospitals are >eginning
to focus strategies on population health management) one of the
core goals of healthcare reform. Managing population health ?ill
reDuire close relationships ?ith physicians) partnerships ?ith
organizations in the community an$ epansion into pre#entati#e
an$ outpatient care.
The follo?ing are the alternati#e strategies of (icente &ustilo
District Hospital Duality health management an$ other Duality an$
cost goals.
/. -or,in) relations(ips 4it( p(&sicians
HospitalBphysician relationships ha#e change$
$ramatically in recent years in the (&DH. The hospital is
>eginning to le#erage this relationship for a #ariety of
initiati#es. Currently) the hospital ha#e 7 resi$ent
physicians. The surgeonsE Dr. $el Carmen an$ Dr.
(illanue#a) OBB&yneE Dr. Dionela) *e$iatricsE Dr. Bil>ao)
!nternal Me$icineE Dr. De .uan) an$ other resi$ents Dr.
Catot) Dr. 0a#a) Dr. Dolosa an$ Dr. 3ausa. The hospital also
has pri#ate physicians) Dr. Hinolan B !nternal Me$icine an$
Dr. (a"or L *e$iatrics. These physicians are on call if the
patients ?ant their ser#ices >ut ?ith etra charges for their
professional fee.
On a market share le#el) partnering ?ith physicians
gi#es the hospital the opportunity to epan$ the market
share) as physicians are typically the source of patient
referrals.
On a hospital Duality le#el) physicians can also help
hospitals increase Duality. Engaging physicians is crucial to
any Duality impro#ement proCect >ecause they are the
ones $eli#ering care $irectly to the patient. !n#ol#ing
physicians in lea$ership of the hospital can ensure
e#eryoneJs goals are aligne$ an$ that the focus stays on
Duality.
4. Maintainin) partners(ip 4it( PHIC
The (&DH is seeking to re$uce costs an$ impro#e
Duality health care ser#ices through seeking partnership
?ith *H!C to create payment mo$els that re?ar$ #alue.
The *H!C helps to align incenti#es for lo? cost) high Duality
care.
Through *hilhealth) the in$igents ?ere a>le to
recei#e the Duality health care they nee$ thus impro#ing
the health of the community an$ the hospital ?ill ha#e
high re#enues from *hilHealth.
8. Partnerin) 4it( t(e co,,unit&
!n a$$ition to partnering ?ith physicians an$ *H!C) (&DH is
also partnering ?ith other organizations in the community to
>etter coor$inate ser#ices for patients along the continuum of
care.
Colla>orating ?ith organizations in the community such as
City Health O1ce can help the hospital manage transitions of
care an$ impro#e population health.
The (&DH aim to >etter manage population health as ?ell
>y partnering to share $ata on patients throughout the
community to i$entify current pro>lems an$ strategize ?ays to
eliminate them.
<. -ocusin) on t(e outpatient 0epart,ent
Another strategy of this hospital is using to re$uce costs is
in#esting in outpatient care. !n this ?ay) Duality ?as increase$)
cost ?as $ecrease$ an$ population health ?as impro#e$. *atient
care to outpatient settings is less epensi#e. Hen$ering health
e$ucation to patient in our Outpatient Department ?ill promote
health a?areness to the community.
I=. !:OT Matri1 "!tren)t(s< :ea+nesses< Opportunities an0
T(reats#
!tren)t(s.
3e#el !! hospital
+ith OH facility
4< hours surgeon a#aila>le
O?n la>oratory $epartment an$ KBray
95 >e$ capacity >ut can cater up to 689 patients
Competiti#e staF nurses an$ personnel
Departmentalize$
!t has its o?n pharmacy open for 4< hours
*hilHealth accre$ite$ , 0OCH* an$ S+A-
3o?er cost of care compare$ to pri#ate hospitals
Strong hospital partners >ecause of eFecti#e referral system
3ocation of the hospital is accessi>le to the people
:ea+nesses
Manpo?er shortage
3ack of Hospital Supplies
3ack of Hospital EDuipments
He$uce$ >u$get for hospital technology impro#ement
Opportunities
%or the hospital) to increase its 95 >e$ capacity accre$itation
to 655 >e$ capacity $ue to its large allotte$ lan$ area.
*ro#i$e$ they ?ill meet all reDuirements for 655 >e$ capacity
accre$itation.
%or staF) increase manpo?er once accre$itation upgra$e$.
%or patients) (&DH is a core referral hospital of interBlocal
health zone cities an$ municipalities in times of out>reaks.
/pgra$e ne?>orn screening a1liation an$ facilities.
/pgra$e into tertiary hospital once all reDuirements met.
T(reats
Slo? procurement process lea$ing to slo? progress) lack of
man po?er an$ lack of a$#ance facilities.
!ncrease referral to tertiary hospital $ue to $elaye$ $eli#ery of
supplies an$ lack of facilities that ?ill hin$er (&DH to >e
upgra$e$ to tertiary hospital category.
/nsecure$ area $ue to lack of security. Thus prone to ro>>ery
an$ unnotice$ patients $ischarge ?ithout settlement of >ills.
&raft an$ corruption
(ine communication
3anguage >arrier
0urseB$octor relationship
0urseBnurse relationship
*olitical connection
=. $nits in t(e CNOs %o,ain
MaGam 3eah &arcia) H0 M0) is the Chief 0ursing O1cer of
(&DH an$ she is responsi>le for the $irection of nursing an$
other patient care ser#ices as assigne$. As a mem>er of the
senior management team) her position carries ultimate nursing
authority an$ responsi>ility for planning) organizing)
implementing) an$ e#aluating nursingMpatient care programs)
performance impro#ement acti#ities) infection control initiati#e)
an$ hospitalB?i$e planning an$ regulatory compliance acti#ities.
As a chief nurse) she has the authority to speak on >ehalf of
nursing $epartment to the same etent that other hospital
lea$ers speak for their respecti#e $isciplines or $epartments.
Nursin) !ervice %epart,ent
*lans) organizes an$ $irects hospital nursing $epartments as
assigne$.
Ensures appropriate nurse sta1ng an$ clinical care per
regulatory an$ hospital policies.
Esta>lishes an$ $irects the nursing mo$elI re#ie?s an$ e#aluates
clinical nursing proce$ures ?ithin the hospitalI $irects an$
o#ersees the $e#elopment an$ implementation of clinical an$
operational policies) proce$ures an$ stan$ar$s) inclu$ing Duality
assurance acti#ities) for assigne$ areasI initiates changes as
nee$e$.
Directs the $e#elopment an$ implementation of an inBser#ice
training programI confers ?ith e$ucation an$ training staF to
ensure that the e$ucation an$ training nee$s for staF in assigne$
areas are met.
May pro#i$e $irect patient care as nee$e$.
Hu,an Resource %epart,ent
Directs the personnel management acti#ities of assigne$ areasI
gui$es su>or$inate $irectors) managers an$ super#isors in the
selection) hiring) training an$ $e#elopment of staF as ?ell as
performance appraisal) $ocumentation of $eAciencies)
performance recognition an$ $isciplinary actionI $e#elops)
super#ises an$ appraises $irect su>or$inatesI plans an$
implements $isciplinary actions as nee$e$) ?orking ?ith Human
Hesources an$ legal staF as appropriateI makes
recommen$ations to the Chief Eecuti#e O1cer regar$ing the
e#aluation) promotion) transfer or $iscipline of nursing personnel.
Recor0s !ection
Directs the preparation an$ maintenance of nursing recor$s)
reports an$ statistics in accor$ance ?ith a$ministrati#e an$
nursing policies.
*repares or re#ie?s special stu$ies) reports an$ $ocumentsI
re#ie?s an$ ensures proper completion of reports) recor$s an$
other $ocumentation.
Laborator& %epart,ent
N Super#ise all me$ical an$ la>oratory ser#ices as per resi$ent
reDuirement.
Ot(er responsibilities.
N Confers ?ith other hospital management an$ super#isory
personnel to $iscuss management an$ patient care issuesI confers
?ith hospital a$ministrati#e an$ me$ical staF regar$ing nursing
program nee$s an$ a$ministrati#e matters.
N *articipates in hospitalB?i$e strategic planning acti#ities to
ensure the $eli#ery of comprehensi#e an$ coor$inate$ health
ser#ices.
N Monitors an$ e#aluates ne? or re#ise$ regulatory agency an$
in$ustry la?s) regulations an$ stan$ar$s applica>le to assigne$
areas an$ ensures that assigne$ acti#ities comply ?ith all
reDuirements.
N Hepresents assigne$ areas to other hospital $i#isions) other
County $epartments) an$ eternal agencies to coor$inate acti#ities)
i$entify issues) resol#e pro>lems an$ share information.
N Con$ucts an$Mor participates in a #ariety of staF an$ committee
meetingsI ser#es on task forces an$ commissions as assigne$.
N Directs an$ participates in the preparation an$ a$ministration of
0ursing Ser#ice) >u$gets) an$ capital outlay reDuestsI e#aluates
sta1ng) eDuipment an$ supply nee$sI prepares CustiAcations an$
cost >eneAt analysesI re#ie?s an$ recommen$s appro#al of
epen$ituresI o#ersees the procurement of supplies an$ eDuipment
for assigne$ areas.
=I. Value A00in) !upport !trate)ies
N Create training plan for ne? an$ current hospital staF to
maimize positi#e eperiences
,e.g. !ntra#enous Training) Basic 3ife Support) A$#ance Car$iac 3ife
Support-
N !nitiate ?eekly staF meetings to re#ie? issues ' recognize staF
for eemplary ser#ice
N Buil$ $irect lines of communication >et?een staF ' management
N %inancialE !n#estigate lo?Bcost options to meet goals ,interns)
#olunteers-