The document discusses strategies for VanGuard Health Services to improve. It recommends adopting a Strategic Thinking Map to assess strategies like market development and merger alliances. Specific strategies proposed include implementing telemedicine through a mobile app, and partnering with drug stores by setting up clinics in their locations. Other strategies discussed are benchmarking, assessing community needs, and evaluating organizational capacity. Barriers to effective strategy implementation in healthcare are also examined, along with ways to overcome them like clear communication, accountability, and including employees in the planning process.

1. Strategy to improve VanGuard Health Services
The healthcare sector is evolving at a faster rate
than ever, with convenience and access being the major driving
forces. With emerging technologies, health care providers and
centers are finding themselves with no option but adapting to
this technology (Shi, L. & Singh, 2010). For a healthcare
provider to survive and maintain itself as a leader and mentor
change has to be incorporated in the day-to –day normal
routine. For this institute to improve their quality of service
and care it’s important to cover all the drastic changes in the
health care industry.
One of the great ways for Vanguard center to
improve its scorecard is to adopt a Strategic Thinking Map
(Ginter, swayne, & Duncan, 2013). Some of the strategies to
consider in choosing this method include market development
and merger alliance. In using the first strategy market
development, the main healthcare priority is to dominate the
market with the service or product being introduced. A great
product at this period is telemedicine.
Telemedicine involves availing services to patients
on their mobile gadgets. In this day and age, almost everyone
has a mobile device from the old to school going, children. In
implementing telemedicine, a mobile app, SMS service, and a
USSD service are crucial ensuring every customer is covered
depending on their preferred modes of service access. The
mobile app will enable its users to see a doctor for minor
ailments. The telemedicine app is projected to help in expansion
strategy. The telemedicine will also appeal to all those who love
convenience.
In the current trend with apps such as telemedicine
patients can see the doctor for minor ailments without walking
into the center and also book appointments (Westfield, 2011)
. The people must be able to understand the trend and
technology on the market, hence the need to make it user-

2. friendly even for young patients (aged 9-12 who own mobile
devices). The people are looking for flexibility and solutions
that work for them which are influencing market trends, and
telemedicine is one of this solutions. Effective Marketing is one
that meets the needs and expectations of the target
demographic.
In approaching merger alliance, the healthcare
provider has to consider partners who share similar vision and
dreams (Ginter, swayne, Duncan, 2013). A great partnership is
to collaborate with major drug stores. The partnership will work
such that the health care organization will setup clinics in the
drug stores. This strategy will cover the patients who love to get
all their service in one place that is a clinic and drug store in
one place. The aim of this moves is to increase growth
regarding patients seeking the services of the healthcare center
(Shi, L. & Singh, 2010).
Analyzing the marketing techniques that could be
used to improve the marketing within different demographics.
Telemedicine apps.
The apps are essential to offer flexibility (Free, Phillips,
&Watson, 2013). The aim is to enable patients make
appointments and seek doctors for different minor ailments
without much ‘hustle’ of traveling to the center.
A variety of services.
The approach is to increase the services offered to meet the
needs of a larger demographic. The partnership between the
healthcare organization and drug stores is an added service,
where clinics will be set up in all major drug stores. These will
be a major shift from the traditional drug store business to
health checks ups and treatment.
The other way to improve in healthcare score card is
to implement Benchmarking techniques; community needs
assessment and capacity/organization assessment (Ginter,
swayne, Duncan, 2013). The benchmarking technique works by
identifying successful healthcare centers making plans to visit
and assess what they are doing and compare it to your

3. organization to learn areas of improvement and what you can
copy and improve to work for you. For example, in
implementing the telemedicine app, the hospital could review an
existing telemedicine app that has had success in services
delivery. Reviewing the system will help identify strong points
and weakness in the system and uncovered areas which they can
improve to out-do the competitors.
The community needs assessment aim to identify
wants of a given demographic regarding sanitation, disease
control and health care gaps within the identified community
(Ginter, swayne, Duncan, 2013). For example, in identifying a
health care gap, this would serve as a new service or product to
introduce into the market.
The last strategy is being able to identify
organization capacity regarding the ability to start, maintain and
improve its adaptive strategy. For example, can this
organization initiate a research project and be able to finance
and sustain it over the long-term. The organization could also
identify community projects that it can support and fund them
as a way to give back to the community. An example is setting
up free medical checkups. Such a service will also give the
community a good impression of the organization and higher
chance of seeking their services when sick. In conclusion a
sound Strategic Thinking Map, Benchmarking techniques,
community needs assessment and capacity/organization
assessment are crucial in improving the healthcare score card
and also establishing it as a major healthcare provider.
References
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2013). Strategic
Management Of Healthcare Organizations 7th Edition.San
Francisco.
Shi, L., & Singh, D. (2010). Major characteristics of US health
care delivery. Essentials of the US health care system. Sudbury,
MA: Jones and Bartlett Publishers, 1-25.

4. Weisfeld, V. D. (2011). Jonas and Kovner's health care delivery
in the United States. A. R. Kovner, & J. R. Knickman (Eds.).
Springer Publishing Company.
Strategy Implementation is the processes of managing activities
that take place within an organization during the execution of a
strategic plan (Chang, 2016). Due to the competition and
complexity in the healthcare market, healthcare providers must
find a way to add value to their services. This is only achievable
through value added service delivery strategies which include;
pre-service, point-of-service, and after service.
These value added service delivery strategies are critical to the
success of a healthcare firms and the positioning of the
healthcare organization in the market environment by creating a
competitive advantage. Strategic managers play a crucial role
here because they are responsible for developing and managing
the strategic plan and making sure that the delivery strategies
are compatible.
The pre-service delivery plan entails the planning process and
carrying out of activities that enable an organization to
determine its targeted customers and the services to be offered
to them. It involves various activities such as; market and
marketing research that will enable the healthcare organization
to determine its appropriate customers and the type of services
it will deliver to them. This is achievable by gathering data
about the available market, the potential customers, their wants,
and needs, what will satisfy them, and finally, the customers’
habit regarding healthcare (Swayne et al. 2012). It also mainly
for example in a big city like New York City a private clinic has

5. to cater to a demographic of patients who are a younger
population in a working midtown city area. The practice I work
in is in a busy office building where people tent to schedule
their appointments during lunch time. The healthcare facility
would have to possibly cater to these demographics.
Two, developing a design service such as long-term care and
emergency medication or segmentation that will provide
satisfaction to patients, and physicians. Three, branding
services that imply trust, consistency, and a defined set of
expectation in the mind of the patients. Four, selecting a
moderate pricing strategy that matches the quality of the
services offered. Five, choosing a strategic and convenient
location for patients to access satellite offices and the hospital
branches. Lastly, advertising and personal selling of the
healthcare services on the media and shows (Swayne et al.
2012).
The point-of-service delivery strategy revolves around patients’
care and clinical service delivery. It involves various activities
such as; mass customization where physicians have a
responsibility of capturing a friendly physician-patient
relationship for long-term benefits. Two, maintaining quality
medical operations and ensuring that no medical errors occur.
Three, coming up with new systems, and ways of improving
performance and patient care. Lastly, redesigning service lines
by enhancing the patient experience rather than considering
financial aspects of delivering care (Hicks et al. 2015).
After service activity is the final contact the patient has with
the healthcare company till the next appointment if
recommended by the physician. Several activities take place
during this stage. First, the healthcare organization is supposed
to undertake follow-up activities which include; calling out
patients to ask if they are progressing as expected or more
prescriptions are needed, and conducting patient satisfaction
studies to know how they felt about the treatment process
(Hartgerink et al. 2015).
Second, during the billing activities, the company should avoid

6. errors, be ready to address complaints, explain service charges
and, use medical terminologies that patients understand.
Finally, the healthcare organization should offer follow-on
activities by giving room for further checkup services such as
home care nursing (Hartgerink et al. 2015). In conclusion, if an
organization can implement this value added services then it
will be sure of having a competitive advantage over the other
firms in the same market.
As a company grows there are alterations in strategies that
will lead to many changes and approaches to lead. Leaders are
tasked to recognize and adopt human resources strategies that
will fit employees and the organization. The main differences
identified in the human resources strategies are as subsequent:
expansion plans are human resources practices that have
diversified nature is mandatory to hire new personnel that have
skills and talents relevant to that of someone needed in the
company with similar skills. This strategy is encountered when
the company is in process of hiring new employees, and they are
required to increase the staff. However, critics have been raised
on the strategy as there is constant change in the company skills
at time and the human resource personnel keeps changing
depending on types of works and the advancement of an
organization. Consequently, the strategy differs with upkeep
scope as the people acquired this time may have different skills
in comparison to those to be received later. The strategy is
considered challenging as with the expansion of employees
come those who have different and unique skills and may be
difficult to manage the task force as compared to the current
workforce.
Contraction strategy differs from the human resource strategy
as it the incentives that the organization gives is assumed to
encourage the employees to tend to other jobs or is requested to

7. retire earlier than expected. Contraction may be achieved
through reduction of the workforce either through retrenchment
or laying off people (Eesley, Hsu, and Roberts, 2014).
Maintenance of scope strategy is pursued by the management
when they have believed that past strategy has been appropriate
and therefore very few changes are required (Hitt, Ireland, and
Hoskisson, 2012). Therefore, the management is noted to
exploit the recent strategies and only improve the status quo for
the already existing approved strategies. Thus, this strategy is
different from the expansion strategies as it relies on past
strategies experiences, and in the case of an error made, the
company is bound to suffer great losses.
The most challenging adaptive strategy to
implement in an organization is expansion plan. This is because
the procedure entails diversification, market development,
vertical integration, product development and diffusion. The
policy becomes a challenge as there is an additional workforce
which can be a challenge for both Start-up Company and n
already established the company. Furthermore, the approach is
very challenging when integrating the employees into the
enterprise. Often when new hires are brought into the
enterprise, there is the tendency of them not fitting in right
away, despite the training that is conducted to bring them up to
speed of the business operations, cases have been reported
where some employees note they feel like they are disrupting an
already existing employee’s environment (Pawlik and Neumann,
2015). This can be hard to handle as a large company leader
because it is based off each employee’s personal experience and
training knowledge.
Therefore, to ensure the new employees fit into the
organization, if they have been enrolled in high numbers, the
company is challenged to change their organization culture to
have one which also includes them (Eesley, Hsu and Roberts,
2014). Furthermore, for a service related organization like
health care, who typically have a unique culture, the new
employees are expected to adapt to the already practiced values

8. in the company. With the new service lines that are required for
the new skills and expertise, it may impact the organization
process and cultures either positively or negatively. In
summary when a company can maintain scope; the group is thus
able to handle motivation of employees, ensure the
compensation plans are okay and the company values are
maintained with succession plans in place.
Essay 1 (angela)
Implementation strategies in health care organizations can have
barriers that restrain the effectiveness of their plan. These
barriers can be due to lack of accountability, lack of
commitment, inadequate instructions to the employees, people
are not fully rewarded for executing of the plan, inadequate
directions are given by departmental managers, and changes for
responsibilities of employees were not clear (Latiff, Gohar,
Hussain, & Kashif, 2016).
Ways to eliminate or overcome barriers in an organization are
not done by just one person, but by many actions and everyone
in the organization has to be a partner to implementation
(Swayne, Duncan, & Ginter, 2013). The ways to remove barriers
is having each level of leadership have clear communication to
their employees of what their goals are and how they are to
achieve those goals. It is also important to keep employees
engaged and participating in the planning process. Make sure
their voices and opinions are heard through the planning
process. When employees are able to participate they are able to
better understand their roles and goals for the organization. It
is also necessary to hold employees accountable for their
assigned work tasks and set goals to achieve. If an employee is
not meeting their goals then this is putting the implementation
behind schedule or at jeopardy of being completed. It is
important that the employee or employees are aware that they
will be held accountable for their job performance. Another
primary reason implementation strategies are not implemented

9. in health care organizations is, because there is no difference in
resource allocation and reward distribution (Swayne, Duncan, &
Ginter, 2013). People or employees concentrate on what they
believe to be important, which is things that effect their budget
or paycheck.
My hospital implemented Epic EHR system in October 2011 till
May 2014 (Monegain, 2013). This was a huge undertaking for
the health system and there was many people in my department
that had worked for the system for over 20 years that didn’t
want to have to learn a new system. They were a lot of
resistant’s to change, which is a common implementation
barrier. At the time I was working in the hospital billing
department for Wyandotte Hospital. The system not only wanted
to have all the billers change to the new system, but also have
all the billers housed in the same building, which would be an
additional 30 minute commute for most of us as well.
Some of the reasons there were setbacks was because the
organization created no incentives and did not allow the
employees to feel a part of the decision making process. They
did not inquire about their opinions or advice on anything.
Many of the employees were not learning the new system as fast
as the organization would have liked. There was also 4
employees that either retired or left the system. Obviously, the
EHR system was installed and runs very smoothly. It has been a
great addition to our health system, however it is important for
an organization to make all their employees feel valued and
important in the decision making process or either keep them
informed and motivated about the implementation strategies.
Essay 2 (Goran)
In healthcare, just like in many other business industries,
barriers exist when implementation of strategy occurs. One of
the most common barriers to the effective implementation of
strategies is the lack of support from leadership. Overcoming or

10. removing such barrier can be difficult solely because it
concerns the leadership. One way to remove such barrier is to
replace the leadership that is not supporting the implementation
of strategy. This solution can be rather difficult due to
replacement of leadership not being a simple task. As well,
there must be an understanding of the root problem behind lack
of support in order to not repeat the same mistake (Pexton,
2016). Another way to overcome this barrier is for workers to
assemble a multidisciplinary team from various departments to
carry out planning. Due to the lack of support from the
leadership, it is up to teams to execute new strategy
implementation. Adding combined experience, knowledge, and
skills can strengthen the planning outcomes with implemented
strategies (Nursing Times, 2015).
Common barrier when implementing a new strategy can
be a resistance or skepticism from staff. One way to solve this
barrier is to develop a stakeholder analysis and use a team-
based problem solving approach (Pexton, 2016). Another way to
remove this barrier is a strong leadership. Leaders must be able
to improve skills in leading employees and work teams
especially when implementing new strategies or influencing
change. Furthermore, leaders must demonstrate both, emotional
and behavioral intelligence in order to remove this barrier. This
is where the leadership game is won or lost; it is not enough to
have an understanding, but being able to show with actions and
communicate with words. Leaders must do everything in their
power to get the staff onboard with new strategy
implementation as they are ultimately the ones who will carry it
and contribute to it in major ways (Delmatoff & Lazarus, 2014).
Also, there can be hesitancy to invest time and money,
which will directly impact the effectiveness of new strategy
implementation. When the time comes to “pull the trigger”,
there might be some hesitancy to invest time and money
required to implement the strategy. It is important to remove
this type of barrier because it can create a lack of support from
certain leaders or individuals who are not able to see a value in

11. this investment. This barrier can be crucial and the best way to
remove it is by creating a case using real data. This will present
a clear picture as to why such strategy is favorable – in terms of
time and money – and since it is using a real data, it should get
everyone on the same page and onboard (Pexton, 2016).
Finally, uncertain roles and lack of accountability can
present a huge barrier when implementing a strategy in health
care. In order to remove this barrier, adopting management
systems and structures that clearly link projects and
performances with overall strategies can solve the issue
(Pexton, 2016). During strategy implementation lack of
accountability and not defining roles clearly can create massive
issues down to road in terms of overall strategy effectiveness. A
great example regarding barriers during the strategy
implementation was when electronic medical records (EMR)
were starting to get implemented. This change required
leadership support and clear understanding of each employees
role and accountability. Physicians and leaders were held
accountable and had deadlines in which they had to implement
the system. On the other hand, employees were held accountable
to complete training and be able to transition to the new
strategy (Rizer et al., 2015).