Running Head: CONDUCTING ENVIRONMENTAL ANALYSIS 1 CONDUCTING ENVIRONMENTAL ANALYSIS 2 Conducting Environmental Analysis Introduction External environmental as well as internal environmental factors have continued to influence how most activities are managed in an organization (Baskind, 2012). In this case we look at these factors in relation to Bridge HealthCare which is a hospital that offers healthcare services in Tennessee. This organization is operating in health industry which is a very dynamic and diverse environment. As a health care facility, Bridge is faced with several challenges and it is therefore very important for the management and staff to collaborate in order to meet the goals of the organization. It is important as an administrator to carry out an evaluation process that is important to identify the factors that affect the success of Bridge Healthcare. In this case we are going concentrate on those internal and external factors that are very influential when it comes to success of the organization. Determine two (2) specific forces in the external environment that will have the most impact on your organization There are several segments of the external environment that needs to be analyzed in order to determine the threats that an organization is faced with. There are five sectors that make up the external environment and they include social cultural forces, political forces, competitive forces and technological forces (Baskind, 2012). i. Changes that are seen in the political or legal segment In most cases, changes in political or legal segment can be reflected across the hospital through the payer mix. Payer mix is defined as that proportion of revenue which is realized from different payers. According to data in 2012 by Forster health care programs that are government funded made up 66% of the revenue that was acquired by most of health care providers. The remaining amount of revenue was provided by the local government, private payment, insurance companies, and voluntary non-governmental organizations (Baskind, 2012). Looking at the fact that the government made up the biggest percentage of payer, it means that financial liability of most organizations is dependent on funding that is provided by the federal government, and the partnership that the government had with state through the Medicaid plan. In any case the federal government enacts legislations that would lead to changes in the sources of finance, Bridge and other health care providers will be at risk of financial strain. Bridge hospital started to experience difficulty when there was turbulence in the legal and political sector when they created the TennCare program. The current model of reimbursement which is the TennCare started way back in 1994. Looking back since it was implemented funding per cover dropped to 57% from 65%. This was not the only instance where political factors in Tennessee affected the medical provision. The Federal Balanced Act i ...

1. Running Head: CONDUCTING ENVIRONMENTAL
ANALYSIS
1
CONDUCTING ENVIRONMENTAL ANALYSIS
2
Conducting Environmental Analysis
Introduction
External environmental as well as internal environmental
factors have continued to influence how most activities are
managed in an organization (Baskind, 2012). In this case we
look at these factors in relation to Bridge HealthCare which is a
hospital that offers healthcare services in Tennessee. This
organization is operating in health industry which is a very
dynamic and diverse environment.
As a health care facility, Bridge is faced with several challenges
and it is therefore very important for the management and staff
to collaborate in order to meet the goals of the organization. It
is important as an administrator to carry out an evaluation
process that is important to identify the factors that affect the
success of Bridge Healthcare. In this case we are going
concentrate on those internal and external factors that are very
influential when it comes to success of the organization.
Determine two (2) specific forces in the external environment
that will have the most impact on your organization
There are several segments of the external environment that
needs to be analyzed in order to determine the threats that an
organization is faced with. There are five sectors that make up
the external environment and they include social cultural forces,
political forces, competitive forces and technological forces
(Baskind, 2012).
i. Changes that are seen in the political or legal segment

2. In most cases, changes in political or legal segment can be
reflected across the hospital through the payer mix. Payer mix is
defined as that proportion of revenue which is realized from
different payers. According to data in 2012 by Forster health
care programs that are government funded made up 66% of the
revenue that was acquired by most of health care providers.
The remaining amount of revenue was provided by the local
government, private payment, insurance companies, and
voluntary non-governmental organizations (Baskind, 2012).
Looking at the fact that the government made up the biggest
percentage of payer, it means that financial liability of most
organizations is dependent on funding that is provided by the
federal government, and the partnership that the government
had with state through the Medicaid plan. In any case the
federal government enacts legislations that would lead to
changes in the sources of finance, Bridge and other health care
providers will be at risk of financial strain.
Bridge hospital started to experience difficulty when there was
turbulence in the legal and political sector when they created
the TennCare program. The current model of reimbursement
which is the TennCare started way back in 1994. Looking back
since it was implemented funding per cover dropped to 57%
from 65%. This was not the only instance where political
factors in Tennessee affected the medical provision.
The Federal Balanced Act in 1997 did give another blow to
facilities and it is understood that most cutbacks in most
hospitals were due to this law. This was an act that reduced the
amount of Medicare reimbursement that was given to healthcare
providers. Such reductions have a great impact on how different
events are run in Bridge as well as other medical service
providing facilities.
ii. Competition
Bridge being a small hospital in Tennesse has found it difficult
to compete against established health care providers such as

3. Baptist Memorial Hospital (The medical fact book 2012). In
order to be competitive in the health care industry, it is
important that all service providers have important
technological facilities that will ensure that services are offered
effectively and efficiently. Bridge does not have adequate
technological facilities which would give it the needed cutting
edge in terms of competition against other service providers.
In such situation we find that most of the patients will register
in other hospital and forget about Bridge Hospital. When a
facility is not reporting a high number of patients, it also means
that they will have less amount of money in terms of
reimbursement from the payers. Bridge Hospital has struggled
in order to meet its budgetary allocation since the amount of
money that they receive in terms if reimbursement is not enough
to provide for administration costs as well as to buy new
facilities.
Determine two (2) specific internal factors that the
organization’s leaders need to consider in preparing for the
future of health care and the future of the organization
Internal factors are those factors that are within control of the
company, most decisions that are made by the management of
the hospital will influence the fact that the company succeeds or
fails. When we look at the internal factors of Bridge Hospital as
well as other players in the industry, there are several factors
that come to mind.
We look at the purpose of Bridge Hospital and determine
whether they are well equipped and staffed to meet the set
goals. We throw a glance at the human resource of the
organization to determine whether the organization is at a
position to meet the needs of the clients. We also must be
concerned with whether the employees are well trained in order
to handle the cases that are brought before them by the patients.
i. Competence in terms of knowledge and Skills
When we talk about the quality of health care services, it is
dependent on the knowledge as well as the technical skill of the
practitioner. It is important to ensure that all health care

4. practitioners in the facility have improved their competence in
order to provide high quality services. Bridge has actually
struggled in this regard as they have not been able to find the
resources to ensure that they can give their practitioners
specialized services. They are also not in a position to acquire
the best people in the market due to the fact that they may not
be able to pay them as other well established firms are paying.
ii. Resistance to Change and bureaucracy
Most health care providing facilities require high level of
restructuring in their operations. There are several instances
which indicate that there are several health care providers who
are highly resistant to change (Tulchinsky et al., 2012). It has
not been easy to find and recruit employees with the ability to
transform the organization; this has worked against the efforts
at Bridge Hospital to change the dwindling fate. Due to limited
budget, Bridge has been forced to employ most of its employees
on contractual basis and therefore it has become very difficult
to bring most of the employees on board when it comes to
important changes that are required by management.
Discuss the impact of both the identified internal and external
forces on the organization’s ability to develop a competitive
strategy
External factors
Political and Legal Factors
Political and legal factors in most cases have been on the nature
of payer mix. We have realized that reduction in the amount
allocated to health care facilities through Medicaid has
influenced the type of services that are being offered by most
health care facilities. Managed Care Act was introduced to
improve quality of services that are offered in most health care
facilities but what was not done by the state and federal
authorities is to ensure that all hospitals are provided with the
technology which would make them compete effectively. This is
what Bridge has continued to face as a health care provider (The

5. medical market fact book, 2012).
It is not easy for this organization to compete against well
established firms and therefore it continues to get less in terms
of state and federal reimbursement. Lower reimbursement
means that Bridge has to do away with most of provisions in the
budget and run on the little that they have. This is a catastrophe,
the hospital is not able to reduce on the number of readmission
and patients continue to lose faith in its services as day go by.
The federal and state governments have to ensure that the
legislations that they pass are able to meet the needs of both
small hospitals as well as large hospitals. Facilities are very
important when it comes to ensuring that any hospital is in a
good competitive position
Stiff Competition
Since the introduction of Managed Care Act, it is evident that
the level of competition has been taken a notch higher and that
hospitals that do not have a huge capital outlay will continue to
suffer in terms of competing with the so called big hospitals.
Government will continue to reimburse on the basis of
readmission rate, yet the small companies have no option due to
less technical and technological application (Tulchinsky et al.,
2012). It is difficult for smaller hospitals such as Bridge to buy
sophisticated machines and hire the most qualified physicians in
the market. This means that even as the government continues
to advocate for quality and low cost health care service, low
budget hospitals continue to suffer in the face of high costs of
facilities and health care providers.
Internal factors
Competence and Skills
Bridge has not been able to invest in the best medical
practitioners that can be found in the industry due to the
financial constraints that the hospital is facing. It is important
to have proper foundation in terms of primary care, but this is
not possible due to the shortage in number of available primary

6. care physicians. Data provided by Health Resources and
Services Administration in 2012 indicated that there was a
shortage of around 6000 healthcare providers (Frech, 2013).
In such a case the health care providers are a rear commodity
that is very expensive to acquire meaning that Bridge has had to
do with less skilled physicians. This has led to lower patient
intake since most of the patients would prefer other hospitals
with more competent care providers. The less skilled employees
have also meant that the levels of returns by patients are high.
The hospital has had to do with lower reimbursement due to the
provisions of managed care which discourages high levels of
patient return. When reimbursement is low, definitely most of
the operations of the organization will be affected negatively
Bureaucracy and resistance to change
In most cases, implementing most of the changes that would
give Bridge competitive edge would lead to significant level of
disruption when it comes to the organization’s operation. One
important example that can be used is the introduction of
Electronic Medical Records (EMR) which did affect the flow of
work pattern in the hospital and therefore affected the level of
productivity (Frech, 2013).
The other element which is bureaucracy is understood to be a
hindrance to implementation of several changes that are very
necessary in the organization. There are certain times when
lower level employees have come up with very important
proposals that have the potential to change the fortune of the
company, but they have been left hanging due to the protocol
procedures which may be difficult to follow up.
Recommend one (1) strategy that involves the organization’s
managers in implementing and maintaining the momentum of
the strategic plan
There are strategies which have been used in order to develop
most of health care providing facilities. These approaches in
most cases are multifaceted and can be looked at from both the
macro and micro point of view (Frech, 2013). The most

7. important thing that should be used as recommended here is that
any strategy created must address issues that are external, fix
competitive disadvantages and keep the whole organization
within the provisions of the mission as well as values and move
the hospital towards achievement of its strategic goals.
This is the only means that can be used by Bridge since it is
trying to align the long term strategic goals and at the same
time managing the effects of changing environment in the
industry. With the changes that are taking place, it is important
for any health facility to come up with strategies that are long
range, this can go up to around ten years before any significant
changes can be required.
Before moving into the next face of expansion, it is important
for management at Bridge to determine the strengths and
weakness as well as the threats and opportunities. This will
enable the company to see the resources that are available,
evaluate implication to alternatives and access the risks and
barriers. This will be important in understanding the strategic
posture of the organization which is very vital when looking
into long term future.
Conclusion
This research material has sought to put forward information on
various factors that characterize the environment for most
hospitals. It is a paper that has provided an overview of the
health care industry, as well as the challenges that are faced in
the industry and lastly the strategies that can be applied in order
to ensure that these organizations meet the set goals and
missions.
The key challenges and attributes which relates to external and
internal environment have also been highlighted. It is right to
state that health care providers and in particular hospitals have
the potential to transform in the country, and this is only
possible when there is better utilization of resources, and
resources transfer across the health care industry. If most of the
issues are addressed and management make use of the set
strategies, it means that most of the organizations will be able

8. to cut on costs and run on better competitive platform than they
have done previously.
References
Baskind, P. (2012). Environment analysis: Requirements and
monitoring procedures. Halway House.
Frech, H. E. (2013). Competition and monopoly in medical care.
Washington, D.C.: AEI Press.
Livermore, M. A., & Revesz, R. L. (2013). The globalization of
cost-benefit analysis in environmental policy. New York, NY:
Oxford University Press.
The medical market fact book 2012. (2012). Chichester:
Espicom.
Tulchinsky, T. H., Varavikova, E., Bickford, J. D., & Fielding,
J. E. (2012). The new public health.
Running Head: STRATEGIC APPROACH
STRATEGIC APPROACH
2

9. Developing a Strategic Approach
Mission Statement
The organization in question is Bridge Healthcare which is a
hospital that offers its services mostly within the regions of
Tennessee. The organization operates in the healthcare industry
and as it is known, the industry is characterized by both
dynamism as well as diversity.
Existence of this healthcare organization serves a great purpose
towards the residents of Tennessee. Being the major hospital
around the area, the residents are set to enjoy quality healthcare
offered by professionals of different medical fields employed
there. It therefore anticipated that the health standards of the
residents will improve and thus contributing towards social
sustainability. Other than just benefiting the residents by
offering quality healthcare standards, the organization is also
set to benefit residents by offering employment opportunities
that require less or no skills. This includes factors such as
cleaning of the hospital and also maintaining the outside
physical environment of the hospital. Existence of this
organization will therefore benefit the residents both
economically and socially.
Bridge healthcare is also very crucial to its employees. The
employees include all those people with relevant skills within
the medical field employed by this organization. Other than just
enjoying the job opportunities offered unto them by the
hospital, the organization is also focusing upon maintaining

10. them across wholly. This includes psychologically, emotionally,
physically, economically among other fields in ensuring they
also provide quality care to the patients. Lastly, existence of
this business around this area will also be very beneficial to the
owners. The organization is a private institution meant to
provide quality healthcare to individuals. The owners, who are
the major shareholders of this organization will therefore
benefit in terms of profits that are likely to be earned during
most operations in which the organization will be involved in
(Brian, 2000).
Vision Statement
Bridge Hospital is at the verge of growing bigger and better in
the coming years of operation. The organization is aiming at
improving its services to the community by for instance
improving emergency systems within the organization. This will
involve the purchase of large numbers of ambulances as well as
various emergency systems normally required in catering for
patients in emergency conditions.
The organization is also aiming at developing a medicine
factory that will be involved in the manufacturing of the
different medicines in which patients need for their treatments.
This will go hand in hand with the establishment of a chemist
which will be used for the purposes of selling the medicines.
Greater involvement of healthcare issues is also another major
aim in which the company is visualizing in the near future. The
organization is aiming at reducing infections among people
within the community. The best way in which this can be done
is by enhancing ways upon which the healthcare organization
can reach the community members and make them aware of
various things concerning their health statuses. This will
therefore go hand in hand with public campaigns around this
locality in order to improve the healthcare standards around
Tennessee region.
Lastly, the organization is also aiming at growth and
development of its infrastructure. This will include the
technology used in treatment as well as the physical premises.

11. The organization is aiming at developing more buildings in
order to increase the capacity of the hospital especially in the
ward section. This will be done in order to eliminate a lot of
congestions that has always been associated with this healthcare
facility.
Strategic goals
In order to meet the above vision and mission statement, it is
paramount for Bridge Hospital to focus on various strategic
goals. There are three major strategic goals in which the
organization needs to put in line with these statements for their
successes. The first strategic goal will be based upon operations
management. This focuses upon capitalizing on physical
infrastructures as well as facilities in general. For the
organization to grow and develop, it must invest on the physical
infrastructure. This goal will therefore ensure the hospital is
able to grow in terms of its capacity as well as its location
(Jude, 2005).
The second strategic goal will be focusing upon technology
management. The goal is meant to improve the kind of
technology in which the hospital uses in the administration of
treatment to its patients. With an enhanced technology across
all areas and departments within the hospital, it is anticipated
that the organization will be able to achieve both its mission as
well as the vision it holds. Improvement in technology generally
means enhancement of efficiency within the hospital. It also
translates to better healthcare delivery.
The third and last strategic goal will be based upon customer
management. Despite the fact that this is a healthcare facility
and should give first priority in providing treatment to patients;
profit gaining is also an important factor to figure out. For
Bridge hospital to continuously gain more profits, it is very
important to give focus upon the customer side. The
organization should ensure the customers are satisfied with the
services in which they receive. If customer satisfaction exists, it
is a true reflection that the organization is bound to gain more
profits since there will be customer loyalty. Having loyal

12. customers will in turn provide a chance of getting new market
and therefore dominate the market share. In this way, the
organization will have grown and developed in terms of market
share which will also influence other development sectors
within the organization.
Adaptive strategy that would be effective in ensuring the
organization achieves its strategic goals
Most organizations are currently using adaptive strategy as a
way of surviving competition. In other words, adaptive strategy
is a way in which organizations are using towards obtaining a
competitive advantage against other organizations within the
same industry. Adaptive strategies are usually used by
organizations in order to adapt to various changing conditions.
The current business world involves lots of changing conditions
which require businesses to adopt measures of adapting to
various situations. Adaptive strategies are highly applicable for
changes which the organization has no control over. Various
adaptive strategies have been developed by various theorists.
For Bridge Hospital to achieve its strategic goals described
above, it must use two major adaptive strategies.
The first adaptive strategy that would be suitable with this
healthcare organization is the sprinter strategy. This is an
adaptive strategy that works for business environments with
moderate rates of competition as well as changes. The
healthcare industry is never faced with great competitions and
this is from the fact that hospitals are meant to ensure people
get treatment before trying to figure out the amounts of profits
in which an individual has earned. In this adaptive strategy,
Bridge Hospital can put more focus on quickly optimizing the
business models that currently exist. This is done in order to put
in order to keep track of the business environment and its
likelihood to change.
The second major adaptive strategy in which this healthcare
facility should use is the migrator. The strategy is also very
suitable for organizations which experience moderate levels of
competition. In this case however, the degree of change is

13. usually very high. The idea of migration comes from the fact in
which organizations need to migrate from a certain technology
to another in order to remain relevant to its target market. In
this way therefore, Bridge Hospital will be able to attain its
strategic goals and therefore remain relevant to the customers
and at the same time obtain profits.
Three service delivery and three support components necessary
for the organization’s value chain
For the organization to be successful in its operations, it must
include various service deliveries to the patients. For instance,
the organization should increase the workforce which will be
able to effectively cater for the large number of patients within
this organization. With more healthcare professionals employed,
this will translate into better treatment which will be very
efficient and fast. The second major service delivery in which
the hospital needs to focus upon in its value chain is the
interaction of healthcare professionals with the patients. This
interaction is very crucial to the organization as this is always
the main place in which customers can praise or destroy the
reputation of a business. The healthcare professionals should
therefore be educated on ways in which they can handle patients
in the best way to improve service delivery within the
organization. The organization also needs to employ the use of
cloud based technologies in its patient support system. The
world is turning into a technological world; it would therefore
be wise if Bridge Hospital offers online and mobile based
services. This would include non-emergency issues and also
issues to do with minor consultancy on the issue of interest.
The organization should also focus on various support systems
that will be very necessary for the value chain. The first support
system which is also very crucial is the flow of funds.
Generally, an organization cannot work without having funds.
All the service deliveries mentioned above require some amount
of funds for the services to operate successfully. Funds
therefore form a major support system required by the value
chain of this organization. Secondly is leadership which is very

14. important towards ensuring there is some sort of direction
towards the delivery of services as well as carrying out of other
operations within the organization. Good leadership will also
ensure resources are utilized correctly and therefore resulting
into success of operations within the healthcare facility. The
final major support system that is very crucial to this
organization’s value chain is information technology. This is
highly important especially in the delivery of online services to
patients.
Approach to maintain the adaptive strategy selected
In order to maintain the adaptive strategy selected it is
paramount for Bridge Hospital to instill it within the culture of
the organization. Once a strategy has been fixed within the
culture of an organization, it becomes easier to practice it and
make it part of the organization. Culture is practiced daily
especially when one is within the workplace and its environs.
Once the organization does this, it will therefore succeed upon
maintaining the adaptive strategy that has been discussed above
(Duncan, 2000).
References
Jude, K. (2005). Strategic Planning for Nonprofit Organizations.
Second Edition. John Wiley and Sons.
Duncan, M. (2000). Simplified Strategic Planning. Chandler
House.
Brian, T. (2000). The 100 Absolutely Unbreakable Laws of
Business Success. Berrett, Koehler Publishers