Running head: CASE STUDY 1

A Health Care Organization’s Case Study Manuscript

Karen Huacasi and Nicole Smith

University of San Diego

CASE STUDY 2

A Health Care Organization’s Case Study Manuscript

The selected health care organization is a leading healthcare system within San Diego

County in California. A private, nonprofit, $2.9 billion health system, it provides healthcare

services including preventative and maintenance medical care, and emergency services (Scripps

Health, 2018). In addition to its positive reputation within the community, U.S. News & World

Report and Truven Health Analytics ranked it as one of the top 15 hospitals in the United States

(Who We Are, 2018). The selected health care organization is committed to providing quality

care at every point of the health and wellness continuum and as a result has proven to be a

dynamic health system as a result.

Business Line

This organization offers healthcare and medical services. However, its efforts go beyond

simple medical treatments to incorporate health and wellness services for all ages and stages.

With over 3,000 physicians and 15,000 employees, this system consists of four hospitals with

five locations in Encinitas, La Jolla, Hillcrest, and Chula Vista (Who We Are, 2018). Of these

hospitals, only one of the two hospitals located in the La Jolla area do not provide emergency

services (Hospitals, 2019). All of the hospitals are part of The Leapfrog Group, an organization

that provides, according to its website, transparent safety ratings (The Leapfrog Group, 2018).

By taking part in The Leapfrog Group, the quality of care is visible to the public which creates

incentive to maintain the excellent care it currently offers and strive to have better ratings than

competing hospitals.

This organization also offers three urgent care locations in Rancho Bernardo, Vista, and a

24-hour location in La Jolla (Urgent Care, 2019). For conditions that do not require a visit to the

emergency room or urgent care, this organization has 14 walk-in HealthExpress clinics spread
CASE STUDY 3

throughout the county for conditions that may arise unexpectedly (Scripps HealthExpress, 2019).

It also features over 28 primary care clinics with hundreds of qualified providers to serve as

ongoing management for chronic conditions and preventative care (Who We Are, 2018). Aside

from basic medical services, it also offers an array of additional health and wellness services

including bereavement support, behavioral health, holistic care, and more (Services, 2019).

To provide superior specialty care, this organization partnered with a cancer center (MD

Anderson). This partnership will allow the organization to provide the best cancer care in the

country. For the cancer center, the collaboration allows it to increase the access of quality cancer

services across the country to support its mission (Powerful Cancer Care Partnership Taking

Shape in San Diego, 2018). The selected health care organization also collaborates with many

insurance providers including Covered California, Medicare, and many employer offered HMO

or PPO insurance options (Health Insurance Plans Accepted at Scripps, 2019).

History

The selected health care organization has a long history of serving the people of San

Diego. It recognizes Ellen Browning Scripps and Mother Mary Michael Cummings as its

founders (The Scripps Legacy, 2012). In 1924, philanthropist Ellen Browning Scripps

established Memorial Hospital and Metabolic Clinic in La Jolla (History, 2018). In 1890, Mother

Mary Michael Cummings founded St. Joseph’s Dispensary, which later came to be known as

Mercy Hospital. In 1995 Mercy Hospital and its eight healthcare centers joined the organizations

network (History, 2018). Since its inception, the selected health care organization has continued

to spread throughout San Diego county by providing a wide range of healthcare and additional

services to its community (History, 2018).

Organizational Structure
CASE STUDY 4

The selected organizations leadership is divided into five groups: (a) board of trustees, (b)

corporate executive team, (c) operations team, (d) accountable care organization (ACO) board of

directors, and (e) physician leadership cabinet. In 2017, the board of trustees included a variety

of community members, ranging from retired healthcare executives and clinicians to a retired

FBI agent and broadcast journalist (2017 Scripps Health, 2018). The president/chief executive

officer (CEO) is also a member of the board of trustees.

The corporate executive team is further divided into the executive team and the

leadership team. The president and CEO resides at the first level of the executive team. The next

level encompasses 10 corporate senior and executive vice president positions. They include the

chief financial officer, ACO, and chief operations officer (COO). The chief medical officer is the

only physician leader at this level. The corporate leadership team spans 15 positions and works

under the executive team. A registered nurse and three physicians hold leadership positions at

this level (Executive Team Bios, 2019).

The operations team, led by the COO, is divided into northern (three hospitals) and

southern (two hospitals and ancillary care) regions. Each region has a regional chief executive.

Each hospital is run by a chief operations executive and a physician operations executive. In

2017, three registered nurses held four chief operations executive positions and all physician

operations executives were physicians (2017 Scripps Health, 2018).

Analysis of Mission, Vision, and Values

The themes of caring, patient-centered, and quality service are consistent throughout the

mission, vision, and values statements, as shown in Tables 1-3. These strong, effective

directional strategies guide it towards a successful future by establishing a basis for being and a

future vision to work towards.

CASE STUDY 5

Mission

This organization’s mission (2018) is as follows:

The Scripps mission is simple and heartfelt. Scripps strives to provide superior health

services in a caring environment and to make a positive, measurable difference in the

health of individuals in the communities we serve. We devote our resources to delivering

quality, safe, cost effective, socially responsible healthcare services. We advance clinical

research, community health education, education of physicians and healthcare

professionals and sponsor graduate medical education. We collaborate with others to

deliver the continuum of care that improves the health of our community. (para. 1-3)

While lengthy, the mission statement is all-encompassing and includes all essential

components. The statement strengths include the appeal to customers and clients, services

delivered, values, and philosophy. As shown in Table 1, the key words caring environment,

quality, and safe are important to a consumer seeking healthcare and highlight the organizations

strength in providing patient-centered care. One weakness of the mission statement is the

reference to communities rather than a specific geographical domain. Another weakness is a

vague description of medical services provided, which could be due to competitors in the area

that provide similar services. Instead, the rationale for the mission statement is to showcase the

full scope of its operations including community partnerships and extensive education and

research. A challenge of this mission statement is the organizations ability to consistently

maintain the quality of care they strive for that is also cost-effective for patients.

The mission statement is broad enough that it will endure over time, but it also allows the

organization to stay committed to its core purpose. The value of the statement is that it acts as a
CASE STUDY 6

guiding principle for healthcare delivery for the organization. It has accomplished its mission

through all of the services it provides, which makes the mission effective overall.

Vision

This health care organization (2018) has a vision statement that showcases its dynamic

future goals:

Scripps will continue to be the leading health care delivery system in the greater

San Diego community, as evidenced by the highest clinical quality, patient safety,

and patient, physician and employee satisfaction. This will be achieved through

unending focus on patient-centered and compassionate care, cost-effective

operations, research, advanced technology and innovation. (para. 4)

The vision statement encompasses past and present services that have grown over the

years, current external opportunities for growth, and an understanding of the organization’s

capabilities to succeed in accomplishing the vision. As shown in Table 2, the words that stand

out within the vision statement and encompass multiple components are leading, highest clinical

quality, and advanced technology. This shows insight into the future of healthcare focusing on

enhancing patient care through leading technology and quality practices. Based on the current

state of healthcare, these are likely characteristics for a superior health system in the future,

which makes the vision believable and obtainable. The vision is extremely determined yet seeks

to accomplish a multitude of subjects. While the organization may already be accomplishing

many of these things, it wishes to do them better than any other healthcare system in San Diego.

The rationale for the vision statement is to provide an inspirational guide for patients and

employees that will allow them to understand the intended growth of the organization and focus

areas. As a healthcare organization, it must maintain patient satisfaction through quality care,
CASE STUDY 7

which is accomplished with skilled and committed employees using the most up-to-date

methodologies and equipment. Overall, the vision statement is inspirational, relevant,

memorable, and empowering and will serve as a guide to the organizations future in the

healthcare sector.

Values

The selected health care organization lists three values that build on and support its

mission and vision. The values are as follows: “We provide the highest quality of service…. We

demonstrate complete respect for the rights of every individual . . ., [and] We care for our

patients every day in a responsible and efficient manner” (Scripps Health, 2018a, para. 5-7). It

demonstrates its commitment to these values by elaborating on how each one is implemented. As

shown in Table 3, the desired behaviors and organizational norms revolve around maintaining

patient satisfaction and creating a healing environment by providing the highest quality of care in

a way that is respectful to every individual (Scripps Health, 2018a). The organization’s beliefs

and fundamental principles reflected in these values include putting the patient first, and using

human, fiscal, and ecological resources responsibly and efficiently while maintaining a passion

for quality (Scripps Health, 2018a).

The rationale for the selection of each value statement is clear when the values are

compared to the mission and vision. The value of providing the highest quality of service is

embedded in the vision. Valuing the demonstration of respect for the rights of every individual is

vital to the provision of patient-centered and compassionate care as described in the vision.

Furthermore, the inclusion of both patients and employees in the value statement about respect

shows that this organization cares about its employees as well as its patients. Finally, valuing the

delivery of responsible and efficient care advances the portion of the mission that focuses on
CASE STUDY 8

devoting resources to provide effective, socially responsible healthcare services. Analysis of the

of the value statements revealed a missing component, especially relevant to the third value

statement, safety. Although it is important to care for patients in a fiscally responsible and

efficient manner, it is important to emphasize that patient safety will not be compromised.

Situational Analysis

The directional strategies are interconnected in a way that an element of each value

statement can be found within the mission and vision statements. They align well with what

should be expected from a healthcare system and provide a guiding path for This organization

and its leaders. The situational analysis cannot be done without an understanding and reliance on

the directional strategies. Identifying unchangeable external factors and internal goals as part of

the situational analysis allows for the development of a cohesive and structured plan.

External Analysis

Analyzing the external environment and predicting imminent or future changes is

imperative to the organization’s strategic plan to ensure continued success in executing its

mission, vision, and values (Ginter, Duncan, & Swayne, 2018). By completing a thorough

environmental analysis, it can identify new opportunities or revolutionize current processes to

support its vision in remaining the leading healthcare system within the area (Ginter et al., 2018).

Without an external analysis, it will not be able to react appropriately as issues arise and

ultimately may not survive external changes that impact the organization.

To predict these future changes, the following areas were analyzed: legislative/political,

economic, social/demographic, technological, and competitive and their impact/influence on the

general, healthcare, and service area environment (Ginter et al., 2018). Within the general

environment, rapidly emerging technologies can innovate healthcare delivery. Choosing to

CASE STUDY 9

purchase and implement the newest technologies will be a large upfront cost to the organization

but could ultimately result in better diagnostics and treatment. This supports the values of the

organization in providing high quality services in the most efficient manner. Porter’s five forces

framework was utilized to examine service area external issues and the competitiveness of the

healthcare industry (Table 4). The results determined that there is existing high rivalry with low

threat of entry into the market. However, there is a threat of substitutes and high bargaining

power of customers. Based on these findings, this organization should maintain its current

services as it does not need to worry about incoming competition, but it should look for ways to

continually enhance the quality of care it provides to keep patients satisfied.

Another measure of the external environment is the Community Health Needs

Assessment (CHNA) that was conducted in 2016 to understand local health needs as well as the

barriers to health improvement (Scripps Health, 2018b). The selected organization is a private,

nonprofit hospital and is required to create a CHNA report and implement a strategy plan based

on the issues and social determinants of health (Scripps Health, 2018b). The top health needs

identified from the report were behavioral health, cardiovascular disease, Type 2 diabetes, and

obesity (Scripps Health, 2018b). These issues must be incorporated into the strategic plan for this

organization to adequately address patient needs.

Internal Analysis

The goal of an internal analysis is to identify an organization’s current and potential

competitively relevant strengths and weaknesses to determine what sets it apart from its

competitors (Ginter et al., 2018). One such pre and point-of-service delivery advantage is that it

is nationally recognized for providing high quality care (see Table 5). In 2018, the U.S News and

World Report combined the programs at two hospitals to rank them number one in the San Diego
CASE STUDY 10

region and among the best in the nation in seven specialties (Awards and Recognition, n.d.).

Another advantage is its state-of-the-art facilities and technologies, including the Prebys

Cardiovascular Institute, the most advanced heart care institute on the West Coast in 2015

(Scripps Health, 2015). A final advantage is the organizations documented commitment to

identifying and addressing community health needs in San Diego county, especially through its

focus on cancer, cardiovascular, and diabetes care (Scripps Health, 2018b). Additionally, the

organization provided $398 million in community benefit services in fiscal year 2017 (Scripps

Health, 2018b).

Identifying an organization’s competitive disadvantages is also critical to the internal

analysis (see Table 6). One such short-term disadvantage is the organization wide launch of the

new electronic health record (EHR), Epic. During the first quarter of 2018, the organizations

operating income dropped 94.1%, due in part to the one-time cost of the 3-year Epic installation

and implementation (Haefner, 2018). An additional risk is the general state of the organization’s

finances. Although it saw an increase in net assets from $3.7 billion at the end of 2017 to $3.98

billion at the end of 2018, according to the consolidated statements of operations, the

organization experienced a reduction in excess of revenues over expenses attributable to

controlling interests, from $350.2 million to $225.5 million during the 2018 fiscal year as

compared to 2017 (Ellison, 2018; Ernst & Young, 2018). These reductions may limit future

acquisitions.

Organizational Strategies

Systematic classification of strategic alternatives can help leaders process and envision

how their decisions will affect the organization (Ginter et al., 2018). Adaptive, market entry/exit,
CASE STUDY 11

and competitive strategies were selected upon review of the organizations internal environment,

external environment, and directional strategies.

Adaptive Strategies

A strategic position and action evaluation (SPACE) that incorporates factors determining

environmental stability, service category strength, competitive advantage, and financial strength

was used to determine the organizations strategic profile (Ginter et al., 2018). As shown in

Figure 1, The strategic profile that resulted from this analysis was “competitive,” which affirms

that this organization competes fairly well in a service category where there is much

environmental uncertainty. Therefore, the most appropriate adaptive strategy was enhancement.

This organization must continue to set itself apart from the competition, but it must also

improve its financial position by maintaining its scope and enhancing the programs it has already

acquired. For example, it launched a new EHR system called Epic in 2017 “to support improved

patient care, clinical outcomes, and efficiency” (Scripps Health, n.d., p.1). Although health

information technology can improve quality of care, reduce inefficiencies, and lower health care

costs, many organizations struggle with the implementation process because of the extensive

changes required (Ginter et al., 2018). A focus on enhancement, involving improving processes

within information system departments, and providing added support would help maximize the

benefits of the new EHR system. Epic is highly customizable, so it will need to be continually

tailored to meet the organization’s needs.

Market Entry Strategies

Evaluation of market entry strategies led to the selection of the development strategy,

reconfiguring the value chain. It was chosen because the external condition required the

organization to adopt new technology to compete with other organizations. A review of internal
CASE STUDY 12

resources, competencies, and capabilities revealed that it had new technology available, Epic,

and the capability to rearrange its value chain. The selected strategy more easily supports

organizational goals because it offers the greatest degree of control over design, production, and

operations (Ginter et al., 2018).

A development strategy was selected because the organization decided to enter a new

market, organization wide Epic adoption, by using internal resources to reconfigure the value

chain. After launching Epic, it had to and will need to continue to reconfigure the value chain by

changing processes and operations. In other words, it needs to think of ways in which the EHR

system can be used to perform activities that were not previously possible (Ginter et al., 2018).

This affects and changes how value is delivered to physicians, employees, and patients. This

strategy will help This organization create a new model tailored to meet its customers’ needs.

Competitive Strategies

To identify the organizations strategic posture, the external environment, variable market,

competition, resources, competencies, capabilities, and the directional strategies were evaluated

(Ginter et al., 2018). This evaluation led to the selection of an analyzer strategy based on the

moderately changing environment, technological and regulatory change, and new market

opportunities (Ginter et al., 2018). The HITECH Act which required hospitals to implement an

EHR along with increasingly sophisticated vendors on the market provided an opportunity for it

to enter the market at that time (Compliancy Group, n.d.). By waiting to implement Epic rather

than rushing into the market during beginning stages, the organization demonstrated

characteristics of an analyzer.

An internal analysis of this organization shows that it has a skilled strategic planning

team through the successful management of a large, complex health system. Although the
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leadership team consists of individuals with diverse backgrounds, they still exhibit effective

management and communication skills. This is shown through the high rankings and awards it

has received for the quality of care it provides.

The directional strategies demonstrate a commitment to embracing change as it enhances

patient care in innovative ways. To fulfill the directional strategies and organizational goals, the

selected organization needed to identify the best market to enter that would maintain its scope

but allow for enhancement to enable it to reconfigure the value chain. These decisions and

strategies were accomplished through its strategic posture of analyzer.

Implementation Strategies

To determine how to fulfill the adaptive, market entry, and competitive strategies,

implementation strategies are included in the overall strategic plan. This planning is developed

through the value adding strategies including service delivery and support strategies.

Support Strategies

For this organization, the support strategies are focused on the support activity of

strategic resources including the information systems and technology. It strives to provide

superior health services and make a measurable difference, as well as devote resources to

delivering quality, safe, cost effective care. Its vision is to be achieved through cost-effective

operations, and advanced technology and innovation. These are accomplished with a high-

performing information system, Epic, through patient care, decision making, and administrative

operations (Ginter et al., 2018). On review of the external analysis, the top need identified in the

community is cardiovascular care. To address that need, the state of the art Prebys

Cardiovascular Institute and advanced technologies are available and utilized. While Epic brings

many features to benefit the organization, the initial launch was very expensive which has
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compromised its financial health. Because of the financial status and analyzer posture, this health

care organization prefers to maintain its scope through the enhancement of Epic and related

processes.

After comparing the value-adding support strategies with the directional strategies and

situational analysis, it was decided to maintain support strategic resources, specifically the

clinical information systems. Clinical information systems will be maintained through continual

evaluation of growth needs, development of upgrade plans, and the addition of a skilled

information systems team. Customized tailoring of Cupid, a cardiovascular specialty application,

can be done through workflow analysis and review of the organization specific activities,

procedures, and treatments. It can then reconfigure the value chain by using Epic to perform

activities that previously could not be done. The customizations will also allow for integrated

data management and reporting to understand how it is impacting cardiovascular disease in the

community compared with competitors. Successful maintenance of the information system also

requires additional staff who are capable of managing the more complex and detailed needs of

the upgrade. Proper maintenance of current information system resources will help to carry out

the organizational strategies by supporting each department and operation. End-user training,

communication, and IT support are ways it can ensure staff understand how to use Epic to

effectively assist in the care they provide. This support helps to fulfill its vision statement

through physician and employee satisfaction and advanced technology.

Unit or Service Line Action Plans

An action plan, including a clear and specific list of actions at the unit or department

level, is needed to move the organization toward achieving its strategic goals. After reviewing

this organization’s directional, situational, organizational, and support strategies, a specific,

CASE STUDY 15

measurable, achievable, relevant, time bound goal was created that was tailored to the functions

of the cardiovascular care line and information systems department. The goal is for information

systems department to optimize the EHR system through successful implementation of a system

upgrade containing Cupid module customizations for physicians that support the cardiovascular

care units by May 13, 2020.

The action plan identifies six activities that need to be completed to accomplish the

selected goal (See Table 7). Each activity is accompanied by a completion due date, the specific

individual or group that has been assigned to the activity, and the resources needed to accomplish

each activity. The measurement of success and financial implications of these actions are

detailed in the action plan as well. For example, the first action is to hire one experienced Epic

Cupid analyst by the end of the first quarter. The human resources division and information

systems lead are responsible for hiring the Epic Cupid analyst. The resource needed is funding

for one full time employee. The action will be successfully completed when one experienced

Cupid analyst is hired. This will cost about $80,000 a year. Successful completion of an action

plan that reflects the organization’s priorities will bring This organization closer to fulfilling its

mission and vision.

Conclusion

The selected organization is a dynamic healthcare system that aims to provide high

quality, patient-centered services through advanced technology, innovation, and cost effective

operations. The situational analysis supported the need of a sophisticated EHR, Epic, based on

rapidly emerging technologies and to enable it to remain competitive. An internal analysis

demonstrated that it was not in a position to expand into a new service area and instead decided

to maintain the scope through enhancement. This will be accomplished by reconfiguring the
CASE STUDY 16

value chain by improving processes and adding support to maximize the benefits of Epic. These

decisions and strategies showcase a strategic posture of an analyzer based on careful evaluation

and planning before deciding to implement Epic. After Epic was implemented, support activities

should be aimed at maintaining the strategic resources, specifically the information systems and

technology. Adequate maintenance of Epic will support the organizational strategies and ensure

the upfront costs are recovered so that the selected health care organization can accomplish its

vision to continue to be the leading healthcare system in San Diego.

CASE STUDY 17

References

Compliancy Group. (n.d.). What is the HITECH ACT? HIPAA done right. Retrieved from

https://compliancy-group.com/what-is-the-hitech-act/

Ellison, A. (2018, December 17). Scripps sees annual operating income jump 25%. Becker’s

Hospital CFO Report. Retrieved from

https://www.beckershospitalreview.com/finance/scripps-sees-annual-operating-income-

jump-25.html

Ernst & Young LLP. (2018). Audited consolidated financial statements and supplementary

information Scripps Health and affiliates years ended September 20, 2018 and 2017 with

report of independent auditors. Retrieved from https://emma.msrb.org/ER1176568-

ER919670-.pdf

Executive Team Bios. (2019). Retrieved from https://www.scripps.org/about-us/executive-team

Ginter, P. M., Duncan, W. J., Swayne, L. E. (2018). Strategic Management of Health Care

Organizations. Hoboken, NJ: Wiley.

Haefner, M. (2018, February 9). Scripps Health’s Q1 operating income drops $38.9M: 4 things

to know. Retrieved from https://www.beckershospitalreview.com/finance/scripps-health-

s-q1-operating-income-drops-38-9m-4-things-to-know.html

Health Insurance Plans Accepted at Scripps. (2019). Retrieved from

https://www.scripps.org/patients-and-visitors/health-insurance-options/health-insurance-

plans-accepted-at-scrippsHistory. (2019). Retrieved from https://www.scripps.org/about-

us/who-we-are/history

Hospitals. (2019) Retrieved February 10, 2019 from https://www.scripps.org/locations/hospitals

CASE STUDY 18

Powerful cancer care partnership taking shape in San Diego. (2018, October 1). Retrieved from

https://www.scripps.org/news_items/6372-powerful-cancer-care-partnership-taking-

shape-at-scripps

Scripps Health. (n.d.). Frequently asked questions about the Scripps Epic electronic health

record for physicians and office staff. Retrieved from https://www.scripps.org/sparkle-

assets/documents/epic-faqs-for-physicians-and-office-staff.pdf

Scripps Health. (2018a). Mission and values. Retrieved from https://www.scripps.org/about-

us/who-we-are/mission-values

Scripps Health. (2018b). 2018 Community benefit report (pp. 1-246, Rep.).

Scripps Health Express. (2019). Retrieved February 10, 2019 from

https://www.scripps.org/services/scripps-healthexpress-walk-in-clinic

Scripps Health. (2015). Scripps Opens Most Advanced Heart Care Institute on the West Coast.

Retrieved from https://www.scripps.org/news_items/5167-scripps-opens-most-advanced-

heart-care-institute-on-the-west-coast

Services. (2019). Retrieved from https://www.scripps.org/services/

The Leapfrog Group. (2018). Compare hospitals. Retrieved from

http://www.leapfroggroup.org/compare-hospitals

The Scripps legacy then and now: 2011 annual report. (2012). Retrieved from Scripps Health

website: https://www.scripps.org/assets/documents/scripps_ar2012_web.pdf

2017 Scripps Health Annual Report. (2018). Retrieved from

https://www.bluetoad.com/publication/index.php?i=496485&m=32813&l=1&p=1&pre=

&ver=html5#{%22page%22:0,%22issue_id%22:496485}

Urgent Care. (2019). Retrieved from

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https://www.scripps.org/services/urgent-care

Who We Are - San Diego. (2018). Retrieved from https://www.scripps.org/about-us/who-we-are

CASE STUDY 20

Tables

Table 1

Mission Statement Strategic Thinking Map

Component Key Words Key Words Key Words

Target customers Caring Positive, Quality, safe, cost

and clients environment, measurable effective
simple, heartfelt difference

Principal services Superior health Cost-effective, safe, Advance clinical

delivered services, quality socially responsible research/education

Geographical Communities we Our community

domain of services serve
delivered

Specific values Care environment Cost effective, Improves the

socially responsible health, quality, safe

Explicit philosophy Positive, Advance clinical Deliver the

measurable research, education continuum of care
difference

Other important Caring Sponsor graduate Collaborate with

aspects of environment, medical education others
distinctiveness community health

The Mission Statement Strategic Thinking Map identified the key words from The organization’s

mission statement that fall into each component. Each of the components is a piece that should

exist within a mission statement. Completing the Strategic Thinking Map helps to identify the

strengths and weaknesses using the components and can provide direction for the overall

strategic plan as the mission statement is the basis for the organization and guides what they do.
CASE STUDY 21

Table 2

Vision Statement Strategic Thinking Map

Component Key Words Key Words Key Words

Clear hope for the Continue, will be Leading healthcare Unending focus
future achieved delivery system

Challenging and Leading Highest clinical Advanced

about excellence quality technology and
innovation

Inspirational and Leading, patient Highest clinical Patient satisfaction,

emotional safety quality unending focus

Empower employees Physician and Patient-centered Advanced

first employee and compassionate technology and
satisfaction care innovation

Memorable and Leading healthcare Highest clinical Unending focus,

provides guidance delivery system quality cost-effective
operations

The Vision Statement Strategic Thinking Map utilizes the vision statement of This organization

and shows analysis of the statement divided into components that should be present in a vision

statement. The Strategic Thinking Map helps an organization to analyze its vision statement to

ensure it aligns with the mission statement and the rest of the strategic plan.
CASE STUDY 22

Table 3

Value Statement Strategic Thinking Map

Component Key Words Key Words Key Words

Desired Behaviors Provision of highest Respect Responsibility

quality of service

Organizational Norms Efficiency Healing Patient

environment satisfaction

Shared Beliefs/ Responsible use of Respect every Passion for quality

Philosophy resources individual

Fundamental Provision of highest Patient first Respect for all

Principles quality of services individuals

The value statement strategic thinking map highlights expected components of a typical value

statement. Key words from This organization’s value statement that correspond with each

component are listed as well. This analysis further demonstrates how well the value statement

aligns with The organization’s mission and vision statements.

CASE STUDY 23

Table 4

Porter’s Five Forces

Five Forces Forces Driving Competition Conclusion

Sharp Healthcare and UCSD both feature large

Intensity of High
healthcare systems with multiple hospitals and
Rivalry
clinics
Diverse competitors- mostly large organizations
but some small private practices
Competition for patient satisfaction scores,
hospital ratings

Threat of New Existing health systems have been in operation Low

Entrants for years
“Name recognition” would be hard to overcome
Majority of San Diego area covered by access to
a health provider

Threat of Telehealth and telemedicine Medium

Substitutes Complementary and Alternative Medicine

Bargaining Customers can choose where they wish to seek High

Power of medical care
Customers Customers value high-quality care
Choice limited by location and service need

Bargaining Large number of EHR suppliers Medium

Power of Use of EHR in reputable
Suppliers organizations speaks highly of
(EHR supplier
Vendors) EHR Functionality and customization options

Porter’s Five Forces is a service area structural analysis framework used to compare the

competitiveness of the industry as well as the attractiveness. This helps an organization to

CASE STUDY 24

understand what the biggest threats are and identify new opportunities that will set it apart from

its competitors. The strategic plan can be formulated after review of the environment and service

area.
CASE STUDY 25

Table 5

Strategic Thinking Map of Competitive Advantages

Strengths Value Rare Easy or Sustainable Implications

(High/Low) (Yes/No) Difficult to (Yes/No)
imitate
Long-term
Pre-service: H Y D Y competitive
Reputation- advantage.
nationally Brand
recognized recognition
(competency/ and trust
capability)

Point-of- H Y D Y Long-term
service: High competitive
quality advantage
service-
nationally
recognized
(competency)

Point-of- H Y D N Short-term
service: competitive
State-of-the- advantage
art facilities
(resource)

After-service: H N E Y No
Billing competitive
(capability) advantage

After-service: L Y E Y No
San Diego competitive
Health advantage
Podcast
(capability)
CASE STUDY 26

Culture: H Y E Y Short-term
Commitment competitive
to addressing advantage
community
health needs
in San Diego
(capability)

A strategic thinking map of competitive advantages can help strategic leaders identify

competitively relevant strengths. These are determined by considering the value of the listed

strength, rareness, imitability, and sustainability. The combinations that result from each of the

four questions correspond to specific implications for each strength. Each listed strength has also

been identified by its position in the value chain and whether its valued as a resource, skill, or

competency.
CASE STUDY 27

Table 6

Strategic Thinking Map of Competitive Disadvantages

Weakness Value Common Easy or Can competitors Implications

(High (Yes/No) difficult sustain
/Low) to advantage
correct (Yes/No)
Reduction in net H N D N Short-term
income during the competitive
2018 fiscal year as disadvantage. Can
compared to 2017 limit acquisitions.

New EHR recently H N E Y Short-term

launched competitive
disadvantage. The
organization should
move quickly to
correct this weakness
because most other
competitors are not
weak in this area.

Pre-service: Diverse H Y D Y No competitive

care lines present disadvantage.
management Coordination
challenges challenges occur for
(capability) management

Community has a H Y D Y No competitive

hard time disadvantage.
understanding,
getting, and using
health insurance
when trying to
access health care
services

A strategic thinking map of competitive disadvantages can help strategic leaders identify

competitively relevant weaknesses. These are determined by considering the value of the listed
CASE STUDY 28

weakness to the patients and other stakeholders, whether or not they are common among

competitors, whether the weakness is easy or difficult to correct, and whether or not the

competitors can sustain their advantage. The combinations that result from each of the four

questions correspond to specific implications for each weakness.

CASE STUDY 29

Table 7

Action Plan

Actions Completion Responsible Resources Measurement of Financial implications

date persons needed success

Hire one Q1 HR division. Funding for One experienced About $80,000/ year
experienced Information one full time Epic Cupid
Epic Cupid systems Lead employee analyst is hired
analyst

Interview Q1 Information Conference List of requests Information Systems

stakeholders systems – room, staff agreed upon and staff will dedicate 45
(physicians, Cupid Project (stakeholder signed off by hours to interviews (5
administratio Team time) stakeholders and person team * 6
n) to address Cupid Project meetings * 1.5 hr long
their specific Team. meeting). Physician
requests for staff will dedicate 27
customization hours to interviews (3
. physicians per
meeting).

Build, Test, Q2 Cupid Project Conference Final build 1,040 Information

and Review Team and room, staff reviewed by and systems staff hours (5
(with end- new hire (stakeholder approved by person team * 3
users) the time) project team and days/week *12 weeks).
upgrades/cha stakeholders 36 physician hours (3
nges made to physicians * 12 weeks *
the Cupid 1 hr meetings).
module

Provide
training to all Q3 Principal Computer 25/25 physicians 100 physician hours.
appropriate Trainor and lab. completed (2-hour training
physicians. training team “Playground” training session per physician.
EHR Pay additional
environment physicians to cover
. Trainors. physicians receiving
Physician training). 36 total
coverage trainer hours (training
preparation = 26
hours) (5 sessions, 2
hours each = 10 hours
total teaching time)

Go-live. Q3 Cupid Project Cupid Cupid module Expect reduced

Launch Team Project Team launched by end productivity for first
customized of Qtr 3 week due to physician
Cupid module staff adjusting to new
workflow.
CASE STUDY 30

Provide post- Q4 Cupid Project Cupid 85% of Information systems

go-live Team. Project physicians report staff will spend
support. Reporting Team. adequate post- increased number of
analyst Reporting go-live support hours providing post-
analyst. in survey. go-live support.

This table describes six actions that will be taken to accomplish the established goal, as well as

completion due dates, persons responsible, resources needed, measurements of success, and

financial implications. The cardiovascular careline and information systems department will be

involved in completion of this project.

CASE STUDY 31

Figures

Figure 1

Strategic Position and Action Evaluation (SPACE) Profile of The selected organization

Strategic position and action evaluation were used to determine the appropriate strategic profile

for the organization. This graph helps analyze strategic alternatives based on four dimensions:

service category strength, environmental stability, competitive advantage, and financial strength.

A numerical value for each dimension was determined by assigning a number from 0 to 6 to each

factor within each dimension. These values were then plotted on the corresponding axis of the

graph. The competitive profile quadrant was the one with the largest area.