Introduction
Vanderbilt is a large hospital that has many locations, many patients and a lot of employees. Stakeholder analysis and value identification is therefore very important in order to assess the impact that the company has on the society at large and the ways in which different stakeholders may affect the company’s strategy (Demars, 2007). The Vanderbilt University Medical center mission statement is.
To bring the full measure of human knowledge, talent and compassion to bear on the healing of sickness and injury and the advancement of health and wellness through preeminent programs in patient care, education, and research. (Vanderbilt, 2010).
Enterprise Level Strategy
The enterprise level strategy also referred to as societal level strategy is the comprehensive strategy level that seeks to determine aspects such as the part the corporation plays in the society and the basic principles that the company stands for (Carroll & Buchholz, 2008). It mainly includes the development and expression of the organization’s public policy.
The Vanderbilt enterprise level strategy has been presented in its credo. The Vanderbilt credo states:
- We provide quality in education, healthcare and research
- We treat others as we would like to be treated
- We constantly assess and improve our performance
The credo guides the Vanderbilt staff and management team on how to deal with the various stakeholders who come into contact with the organization. To fulfill the organization’s credo, Vanderbilt has also specified the credo behaviors that govern all its employees including the higher level management team. The credo behaviors include:
- Giving the highest priority to those I serve
- Respect to privacy and confidentiality
- Effective communication
- Each employee has a sense of ownership and
- Commitment to fellow colleagues
The enterprise level strategy in Vanderbilt therefore includes a commitment by all employees to offer their best services to all the people it comes in contact with. The guiding principle in the medical center is to be aware of the inherent dignity, worth and uniqueness of all people.
Culture Type
The organizational culture describes the defined set of norms and values that people in a given organization share and that guide the way they interact together and with their various stakeholders (David, 2001). The culture in Vanderbilt is very strong as it aligns perfectly with the mission and strategy of the center. The organizational culture in Vanderbilt can be characterized by various factors. First of all, the employees at Vanderbilt have a sense of ownership.
This is exemplified by the employee dedication to solve any concerns, whether real or perceive. The employees are also very aware of the huge cost of education, healthcare and researches hence they try to optimize their resources while at the same time provide exemplary services (Vanderbilt, 2010). The second aspect of culture is that employees in Vanderbilt are committed to each other.
This is applied through proper and respectful treatment of fellow colleagues, appreciation of diversity, interdepartmental cooperation and strong communication between different levels of employees. The final aspect of Vanderbilt organization culture is the ability of the employees to participate in innovation and customer care in the healthcare industry.
The health industry organizational culture is arguably the noblest in all industries. The culture can be summed up by the quote “do no harm”. This quote is the guiding principle by which all healthcare practitioners and facilities conduct themselves (Beinhocker, 2006).
Should a hospital be in need of a specialized surgeon or doctor, other hospitals will always try to provide one if the can. If a hospital has no room or expertise to treat a patient, it will put the patient first over business interest and refer the patient to another hospital. The healthcare industry culture is thus based both on competition to improve services and cooperation to help all the stakeholders connected with the industry (Senge et al., 2008).
Integrated concepts from readings
The Vanderbilt mission entails incorporation of talent, compassion and knowledge to heal sickness and to advance the healthcare system by using the finest programs in research, patient care and education. Looking at the enterprise level strategies and the organizational culture in the medical center we can easily deduce that all these three factors are aligned.
The employees have a sense of ownership and act in a compassionate manner towards their patients fulfilling the center’s mission. According to the credo, employees respect their patients’ privacy and give them the highest priority at all time. This is also congruent with the center’s mission and overall strategy (Vanderbilt, 2010).
Evidence and Implications
The Vanderbilt University Medical center was voted as the 14th best hospital in the country. Last year alone, the center had over 1.5 million patient visits with more than 54, 000 patients admitted to the various Vanderbilt hospitals across the country (Vanderbilt 2010).
One of the main reasons the hospital was ranked so high is because its customer service is above par. The medical center also provided more than $320 in charity care and uncompensated care for all those who could not afford treatment. The center also offers various community services such as Adolescent rehabilitation for substance abuse, primary care to under-served communities and an outreach program in maternal-infant care.
One of the major impacts is that the hospital has become popular all over the country and many patients and customers are increasingly being attracted to the center. The next important impact is that the medical center has attracted funding from investors and other parties. In 2010 the medical center received over $48.7 million from various philanthropists.
General Force Analysis: External-Remote Environment
The general force analysis involves assessing the external environment in order to identify various forecasts or trends that may affect the organization (Burgelman et al. 2004; Epstein, 2008). There are five categories of force in the external environment: economics, demographics / social / culture, government / legal / military, physical environment, and technology.
Economics: The main economic trend facing the health care system is the rate of growth of the GDP in the country. In 2010, the GDP grew by 3% with the GDP per capita being $50, 000. The GDP is a measure of economic growth at the moment it lags behind the growth in health care spending.
In 2010, the health care spending in the United States grew by 6.7% and now takes 16% of the GDP (DeNavas, Proctor & Smith, 2010). It can be seen than the growth in health care spending exceeds that of the GDP and this trend has been forecasted to continue up to the year 2017.
The health insurance costs in the country are also rising at a much faster rate than both inflation and wages (Wangness, 2009). The timeframe for this trend is immediate and it seems it will be continuously increasing hence it is a critical importance to the health care industry.
Another economic issue that may affect the health care industry is the increase in unemployment rates. Between 2009 and 2010, the unemployment rate rose from 15.9% to 17.1% (DeNavas, Proctor & Smith, 2010). The impact of unemployment poses an immediate impact on the health care industry as more people will be unable to pay for medical services.
The trend however is not expected to last as the government as instituted various recovery stimulus that will avail more jobs to Americans. This trend is therefore not critical and can be dealt with case by case.
Technology: The rate of change in technology is increase day by day. Medical technology has not been left out and various equipments are being developed in the industry. In 2006, 85% of global research and development spending in biotechnology came from the United States (Fiksel, 2009).
This trend has been increasing constantly throughout and is expected to carry on into the future. The impact on the health care system is high changing the manner in which most hospitals operate and treat patients (Fisher, 2009). This trend has a very long life time as more and more research institutes, medical centers and pharmaceutical companies are engaging in Research and development to develop better and better technology and drugs that will improve the US medical system (Cornish, 2004).
The importance of change in technology in the healthcare system is critical to the industry. Many diseases that could not be cured now have cures and some diseases that could not be managed now can be easily managed and people can life fulfilling lives.
Demographics/Social/Cultural: The United States in is the Middle of a cultural and demographic change that is generating new challenges in health care delivery (Garland, 2007). In 2008, the ethnic minorities in the country accounted for a third of the total population. It is however, projected that by 2050 they will become the collective majority.
This demographic change factors such as health insurance status, economic status and education attainment all pose several challenges to the health care system. A large percentage of the ethnic minorities are poor and have poor records of education attainment. A large percentage of uninsured persons are also from the ethnic minorities group. This trend has a very large impact on the health care system and is of critical importance to the industry. The trend is expected to carry on for a very long time to come (Hardley, 2003)
Another important social change has been increased health consciousness. A large percentage of the population has become very conscious about their health. More and more people are seeking medical service and living in a healthy manner. This trend has a high impact on the health industry and is projected to continue for a very long time to come. Its importance to the industry is important as it avails more consumers to hospitals hence a need for better services.
Government/Legal/Military: The main variable of interest from this aspect of the external environment is the Health care reform passed by the president on 23rd March 2010. The reform includes increasing the eligibility of Medicaid to comprise 133% of the Federal Poverty Level, subsidization of health insurance premiums, banning insurance coverage denial based on pre-existing conditions, and enticing corporations to provide health care benefits by offering incentives (Kaiser, 2011).
This has a very impact on the health care industry as more and more people can seek and afford services. The timeframe is immediate and by 4 years this bill will be in total compliance. The trend is of critical importance to the health care system because no one will be turned away due to financial matters or lack of insurance coverage.
Physical Environment: An important trend in this category has been changes in climate. Over the years, the change in climate has caused several diseases to increase in occurrence such as cancer. This trend is of medium importance to the health care system as it affects the way businesses run operations and imposes a responsibility to all.
The trend has been increasing slowly over the years and without drastic changes, it may become a very big problem to the health care system. The trend is of importance to the industry as we are also required to align our activities to be environmentally conscious to curb further changes in climate (Glenn & Gordon, 2009).
Implications of General Forces
The external trends listed above have various implications to the health care system and the way it operates.
Threats: The health care system is under an economic threat from the slow rate of growth of the GDP as compared to the rapid increase in health care spending. Another threat involves the demographic change being witnessed in the country where the minority group in rapidly increase in size.
The rate of growth of GDP determines the amount of money available for health care spending. If the economic growth is lower than health care spending, the amount of money released by the government will be insufficient to provide the necessary service required.
The increase in minority group is a threat since a large percentage of minority groups are not insured and most of them are poor. This means they might not be able to afford medical services or would be unable to pay for their services. Another threat is from the physical environment that has seen the climate change constantly over the years.
Climate change due to global warming is causing the increase in certain diseases such as cancer and other tropical diseases. Climate change therefore requires hospitals to recycle and embark on “going green”. Looking at the critical factors, demographic change and the slow rate of economic growth are the top threats to the industry as well as the Vanderbilt University Medical Center.
Opportunities: There are several opportunities to the health care industry stemming from the external environment. First, the rapid change in technology, research and development is critical to the industry. Another opportunity is the new health care bill that embarks on availing health care to as many people as possible. These two opportunities are critical for the industry and have an important impact on the Vanderbilt University Medical Center.
Porter’s Five Force Industry Analysis: External-Industry Environment
It is important to analyse the business micro environment in order to present a valid business marketing strategy. The Porter five forces are those forces that affect the ability of a corporation to make a profit or serve its consumers (Miles & Snow, 2003).
Barriers to Entry: One of the most important barriers to entry in the health care system is economies of scale. Small health care centers usually have a lot of problems acquiring equipments, expensive drugs and the best doctors. Big companies on the other had can easily acquire these items and they can also trade amongst themselves if a need arises. Economies of scale are a high level threat for new and upcoming centers.
The capital requirements for starting a new health care center are also enormous thereby restricting most new entrants. This is a high level threat in the industry. The access to distribution channel may be hard to get for new entrants as the need for drugs is high and most of the time the big centers are given the first priority. This is a high level threat in the health care industry.
Substitutes: The health care industry is all about service delivery. Substitutes in this industry either exist as voodoo or the belief in miracles. These substitutes however are of no real threat in the health care industry and very few people subscribe to them.
Bargaining power of Suppliers: The bargaining power of suppliers to affect profitability in the health care industry can be high. A hospital cannot function without drugs or equipments hence suppliers have a very strong control over the health industry.
The health care industry is however filled with drug manufacturers and suppliers. In most cases most of the drugs or equipment can be easily acquired but in certain cases, it can be quite challenging to acquire specific drugs especially for serious illnesses. In the past few years, there has been a drug shortage in the country also putting extra pressure on the health care industry.
Bargaining Power of Buyers: The bargaining power of buyers in the health care system is very high. Consumers have the ability to bargain for higher quality and a wider variety of services. The cost of health care however is seldom affected by buyers and competition is mainly in the form of customer service and in the ability to provide more services.
Competitive Rivalry: The competitive rivalry in the health care industry is a medium level threat. Competitiveness in the industry exists in the form of increasing the number of patient visits in the hospital.
This is through investing in the best doctors, investing in the best equipment and aligning the company with the largest drug suppliers available. In Tennessee Vanderbilt is the largest hospital and the threat from competitors is very low. The top three competitors are Takoma regional hospital, Centennial Medical Center, and the Baptist hospital.
These hospitals are however but a pale comparison to Vanderbilt hospital with regards to size, facilities, variety of service offered and overall performance. The three hospitals offer services all present in Vanderbilt and have a lower capacity the Vanderbilt Medical Center. In Tennessee, the Vanderbilt Medical Center has no equal in terms of consumer satisfaction, level and type of services offered or sophistication of available equipments.
Implication of the five forces
The Vanderbilt hospital has very little threats in the Tennessee health care industry. It excels in most of the services offered, it has a very large economy of scale and consumer satisfaction is very high. The hospital has also been able to develop an effective distribution line whereby it can acquire drugs and equipments from various different trusted suppliers
Threats: The main threats affecting the Vanderbilt University Medical center are the Bargaining power of consumers and the bargaining power of suppliers. These threats are however low level threats as for a long time the center has built up its reputation in the society as the best hospital in Tennessee and one of the best in the country.
Consumer satisfaction is high and the perception of consumers is that the hospital is the best place to be treated in the state. The bargaining power of suppliers is quite low as the center has set up a network of trusted suppliers. The hospital can also buy drugs directly from the manufacturers as it is one of the biggest medical centers in the country
Opportunities: From the five forces we can identify several opportunities that the center can utilize. First, from the barriers to entry, we see that the company has a large economy of scale hence can capitalize by constructing more centers in different locations of the state and the country as a whole.
From the competitive rivalry force, we note that the company does not have any real competition in the state and that it is able to compete well in the national scale. The Center should therefore expand its operations to all states in the country, improve its visibility through advertisements and word of mouth and finally seek for more investment from large investors.
Detailed Value Chain Analysis: Internal Environment
Value Chain of Activities
Company Skills/Capabilities
The Vanderbilt University Medical Center is one of the biggest hospitals in the country. The Center operates over 55 satellite clinic in Tennessee and neighboring states. As of 2007, it has over 100 laboratories in which more than 700 researchers were working. During the year it conducted research worth more than $389 million from corporate sponsors and the federal government. The hospital has over 2000 beds in all its centers and has over 1,800 physicians and over 15,000 full time staff (Vanderbilt, 2010).
The Center also has a University and a research center. The Center was ranked 14h in a national poll of the best hospitals. Services provided include: a level 1 trauma center (only one in state), Neonatal Intensive care unit (level 4), Burn Unit (level 3), surgery, cancer center, Cardiac care and surgery, children’s care and many other services. The hospital also has five helicopters and an airplane for emergency services (Vanderbilt, 2010).
Implications for Competitive Analysis
From the competitive analysis, it can be seen that the medical center has no real threats. It however can utilize various opportunities availed to it.
Strengths: Under management, the company has a very strong management team that is not only part of the university fraternity but is also filled with members who have worked together for a very long time. Although the competition has a good management team, they are far from the level the Medical Center has.
Under research and development, the Vanderbilt University Medical Center is the only one that has a solid R&D department and enough funds to adequately carry out large scale projects. Another important advantage is the outbound logistics. The medical center has enough transport facilities to access consumers easily. The hospital also has ample room and a variety of specialties to provide services to the consumers. The company annual sales are also not comparable with its two top competitors.
Weaknesses: After a critical review of the competitive analysis, the medical center has no real weaknesses as of this moment.
Skills: Vanderbilt Medical Center has over 1800 medical practitioners and over 15,000 full time employees. It offers various services from intensive care to burn trauma. Its burn unit, trauma center and neonatal intensive care units are the only one in the state of Tennessee. It trains its doctors in its medical school hence has a large pool of talent. The Medical Center is also home to two Nobel Prize winners in different fields of medical science. Its research center is large and impressive unmatched by any other in the state.
Capabilities: The Center can hold over 850 patients in its main center and over 900 in satellite centers. The hospital has a lot of ambulance and several helicopters plus a plane. The medical center can thus access patients better than others can. The facilities in the medical center are also up to date and the other competitors cannot match its capabilities in this aspect also.
Detailed SWOT Analysis
SWOT Factor Matrix
The SWOT factor matrix is mainly used to match different strengths and weakness with the opportunities and threats in order to find a good mix that will help provide solutions to the organization’s problems (Pearce & Robinson, 2003).
SO Strategies: One of the main strengths of the medical center is its strong management team. The opportunity brought about by the new health care bill can be best exploited by the use of a strong management team. The new health care bill seeks to increase the number of consumers who can afford medical services. The presence of a strong management team allows for better planning of services and will enable the Medical Center to be able to cater for the influx of patients expected.
Another main strength of the center is its remarkable Research and Development team. The opportunity brought about by technological advancement avails the chance for the research team to embark on more intensive studies that may change the medical industry or the way the center operates. The use of the internet to contact consumers or to prescribe medicines is just but one of the means the R&D team in Vanderbilt has utilized this opportunity. In future, it expected that more and more results will be derived by the team.
ST Strategies: One of the identified threats identified is the chance for increased number of ethnic minorities in the country who have no insurance cover or economic capabilities to pay for the services. The Vanderbilt management team that is one of its major strengths can thus plan on how to admit these patients and treat them without incurring a loss. The team can also decide on what cases to take and which to refer to other hospitals.
Another identified strength is the R&D capabilities of the center. The R&D center can be very useful in searching for solutions to deal with the bargaining power of suppliers. The R&D department should come up with drugs that can alleviate its dependence on external drug manufacturers and suppliers. Having developed a drug, the hospital can gain leverage on the suppliers and manufacturers in that they can strike a deal for constant supply at a steady price.
WO Strategies: After a critical assessment of the company competitive analysis, it has been shown that the center has no apparent weaknesses.
WT Strategies: After a critical assessment of the company competitive analysis, it has been shown that the center has no apparent weaknesses.
SCOT Factor Matrix
This matrix tries to fit the different aspects of the general force analysis and the competitive analysis. Aspects include Skills / Opportunities (SO), Skills / Threats (ST), Capabilities / Opportunities (CO, and Capabilities / Threats (CT) strategies (Harvard, 2005).
SO Strategies: The Medical Center has a large number of skilled practitioners in almost every type of specialty. This skill can be used to exploit the opportunity created by the new health care bill seeks to increase the number of people who can afford healthcare. Many people are expected to add to the hospital’s existing clientele therefore by proper utilization of this vast human resource, the company stands to improve its overall performance both financially and operationally.
The medical center also has a very strong research division and a good medical school at its disposal. Changes in technology can be taught in schools and studied in the research center in order to familiarize both the medical team with the changing technological tools and ensure that students are up to date and can contribute to the continuing technological innovation occurring in the medical industry.
ST Strategies: The Vanderbilt hospital can use its large number of medical practitioners and staff to provide medical services to the expected increase in uninsured ethnic minority. It can also use its research and development skills to fashion drugs, equipments and medical techniques that will reduce its reliance on medical suppliers. This will reduce the bargaining power of suppliers enabling the company to operate optimally.
CO Strategies: The medical center has a large capacity capable of holding a lot of patients. This is very advantageous as the center can exploit the opportunity brought about by the new health care reform bill to hold more patients than before.
The center also has good transportation capabilities such as the helicopters and the plane. This can be used as leverage for investors by displaying how the center is conforming to technological change and how further investments can be utilized to by better equipments at the hospital and also to retrofit the plane in order to have an air born medical center.
CT Strategies: The large nature of the hospital can be used as a means to control the large number of uninsured persons expected in the near future. The hospital has a large number of satellite clinics. It can thus convert a few of these clinics to serve those that are uninsured or those who have no money to pay for their services. The doctors will have to work in shifts in these clinics once in a while as Pro-Bono.
The transport capabilities that the clinic has can also be used to reduce the threats from investors. The center can use its helicopters and the plane to transport drugs and equipments directly from the manufacturers to the center without the need for middlemen. The center can also access different suppliers easily thus it cannot be held at gun point because there are few drug suppliers in the area.
Key Success Factor Matrix Analysis
The following 5 key success factors are critical for the sustainability of the Vanderbilt University Medical Center:
Presence of the medical school
The presence of the medical school within the center acts as the source for future practitioners. The Medical center can be able to train the students according to their mission and vision and by the end of the studies, the medical center has the first pick on who to employ. The medical school releases qualified doctors and nurses each year who have been studying with the Vanderbilt culture hence the medical center does not have to take long to orient new employees to the organization.
Strong Financial Position
The Vanderbilt Medical Center has a very strong financial position. This is very important in the medical industry as it determines how the company can invest and in what. The current changes in medical technology have resulted in better and more sophisticated drugs and equipments. By having a strong financial record the company cannot only direct acquire these goods but can also easily borrow from banks and other credit companies.
Strong Research and Development Team
One of the main success factors that the medical center can boost about is its strong research and development department. As of now, Vanderbilt has produced two Nobel winning projects from its R&D team and has also come up with various drugs and treatment methods that have improved its operations.
The R&D team is a sustainable investment as it can always keep the hospital up to date with changes in the medical industry and can also provide a competitive edge by generating new ideas (Crossan, Fry & Killing, 2005).
Size and Distribution of the Medical center
The Vanderbilt medical center has a very large capacity and a large number of qualified practitioners. This is an important sustainability success factor as it can hold a large number of patients, provide a variety of service and has still room to expand. The fact that the Center can hold a large number of patients improves consumer confidence and perception about the Center. The ability to expand its organization is also very important as it allows for flexibility for the uncertain future.
Transport Facilities
One of the major areas in which many medical centers fail, is the lack of adequate transportation facilities. Consumers have no confidence in hospitals in which when one calls for help, the hospital is unable to access them. Vanderbilt has enough facilities to reach most parts of the state and even out of state.
The transport facilities can also be used to transport critical patients from one point to another. Apart from this, the transport capabilities can also be used to perform functions for the organization such as transport of drugs, doctors and equipments
Implications of Analysis
From this analysis, it can be seen that Vanderbilt is in a very strong position both in the external environment and the internal environment. The company has high level strengths and opportunities and only low level threats and no apparent weaknesses. The company is thus quite sustainable and by applying the various aspects highlighted above, the company can become fully sustainable.
Analyzing the Company Strategy
Vanderbilt strategy is closely linked to its mission statement. The company uses its full medical facilities to provide the best healthcare in the State. The company uses its Medical school to develop the best talent after which it utilizes its Research and Development team to come up with excellent projects that will change the medical profession.
After this, the medical center uses a combination of skill and good management techniques to develop a learning organization that provides all the services the people are searching for.
Supporting Argument
The company has been in the top list of the best hospitals in the past five years. Most of the employees in the medical center are from the Medical school and the organization culture is deeply ingrained in each employee as a result of being together for a long time. Vanderbilt is also responsible for developing some of the best medical techniques and drugs in the market a tribute to its excellent research and development team.
Analyzing the Company Strategy Moves
From the above analysis, I can conclude that the company is in a very good position and does not require a lot of change in its current strategy. One of the changes that I can propose is that the company should expand its operation to ore parts of the country.
Since the Center has a lot of potential employees and a strong financial position, it should strive to build more centers across the country to cater for a larger number of consumers.
Supporting Argument
This conclusion is the only viable direction forward as the company is now a nationally recognized center that competes with other large hospitals. To enhance its competitiveness, the center has to enter the national scene and become a national hospital. This will eventually improve its profitability and consumer perception.
Alignment and Goal Analysis
Retrieved from Harvard Business review, “Strategy-Create and Implement the best Strategy”
Unit goals, metrics and action plan
Supporting Statement
By increasing the number of clinic for the medical centers, the company requires more air transport to successfully navigate from one point to another. This is why I believe that investment in more Helicopters is a very good idea. Since the purchase might be difficult from the center’s revenue I propose investing some money in a different industry (chosen by the financial team) and save the returns until the center is capable of buying the helicopters.
Action Plan Analysis
The main action plan for the Vanderbilt Medical Center involves striving to expand its business into the rest of the country. The center is primarily based in Tennessee hence steps should be taken to infiltrate the rest of the country. In order to achieve this, the company must first be able to finance the expansion activities, the company should have enough equipment to furnish the new facilities and the company should have ample practitioners to operate these facilities.
The performance measures should include; total revenue per annum, Savings per annum, rate of increase in the employment of practitioners and the total number of transport facilities in the center.
Supporting Argument
The Vanderbilt hospital is one of the largest hospitals in the country. In the past few years the level of achievement of the company has been high and the company has been recognized as one of the best hospitals in the country. The Medical Center however mainly operates in one State in which it has virtually monopolized the health care system.
It is for this reason that I think expanding into other States may prove advantageous for the business. According to Werbach (2009), for a company to be truly sustainable it should be capable of handling current obligations while at the same time be capable have enough resources for the future and any uncertainty that may arise.
The medical center as per now has been operating as a State Hospital. In order to improve its profile in the health industry, it is time for the company to infiltrate the nation health industry and become a prominent member competing with the top national hospitals. This will not only improve its profitability but also the Center’s sustainability
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