Competitive Strategy for Health Care Organizations Competitive Strategy for Health Care Organizations:  Techniques for Strategic Action
By Alan Sheldon and Susan Windham-Bannister
2002/11 - Beard Books
1587981351 - Paperback - Reprint -190 pp.

This is a practical book that provides sound guidance for health care managers and other professionals.

Publisher Comments

Category: Healthcare

This title is part of the Healthcare Administration list.

Of Interest:

Building a Health Care Organization: A Challenge for Physicians and Managers 

Competitive Strategy for Health Care Organization 

Evaluation and Decision Making for Health Services  

Fundamentals of HMOs

Hospital Turnarounds

Long-Term Care in Transition: The Regulation of Nursing Homes

Management of Hospitals and Health Services: Strategic Issues and Performance

Managing a Health Care Alliance: Improving Community Cancer Care

Managing Doctors

Partners: Forming Strategic Alliances in Health Care

The White Labyrinth: Guide to the Health Care System

This informative book presents the elements of competitive strategic action to assist managers of health care organizations in making sound decisions and implementing them. It leads, for example, to an understanding of the concept of change as a departure from past practices, skills and attitudes, and as a key ingredient to forming and carrying out strategy. The authors present a model for competitive strategy development and describe various competitive forces, detailing the critical steps leading to a desired advantage, such as product market analysis, collaboration, and restructuring.

From Francoise C. Arsenault, 
Nightingale's Healthcare News, Vol. 1, No. 6:

Competitive Strategy for Health Care Organizations: Techniques for Strategic Action is an informative book that provides practical guidance for senior health care managers and other health care professionals on the organizational and competitive strategic action needed to survive and to be successful in today's increasingly competitive health care marketplace. An important premise of the book is that the development and implementation of good competitive strategy involves a profound understanding of change. As the authors state at the outset: "What may need to be done in today's environment may involve great departure from the past, including major changes in the skills and attitudes of staff, and great tact and patience in bringing about the necessary strategic training." 

Although understanding change is certainly important in most fields, the authors demonstrate the particular importance of change to the health care field in the first and second chapters. In Chapter 1, the authors review the three eras of medical care (individual medicine, organizational medicine, and network medicine) and lay the groundwork for their model for competitive strategy development. Chapter 2 describes the factors that must be taken into account for successful strategic decision-making. These factors include the analysis of the environmental trends and competitive forces affecting the health care field, past, current, and future; the analysis of the competitive position of the organization; the setting of goals, objectives, and a strategy; the analysis of competitive performance; and the readaptation of the business, if necessary, through positioning activities, redirection of strategy, and organizational change. 

Chapters 3 through 7 discuss in detail the five positioning activities that are part of the model and therefore critical to the development and implementation of a successful strategy: scanning; product market analysis; collaboration; restructuring; and managing the physician. The chapter on managing the physician (Chapter 7) is the only section in the book that appears dated (the book was first published in 1984). In this day of physician-owned hospitals and physician-backed joint ventures, it is difficult to envision the physician in the passive role of "being managed." However, even the changing role of physicians since the book's first publication correlates with the authors' premise that their model for competitive strategic planning is based exactly on understanding and anticipating change, which is no better illustrated than in health care where change is measured not in years but in months. These middle chapters and the other chapters use a mixture of didactic presentation, graphs and charts, quotations from famous individuals, and anecdotes to render what can frequently be dry information in an entertaining and readable format. 

The final chapter of the book presents a case example (using the "South Clinic") as a summary of many of the issues and strategic alternatives discussed in the previous chapters. The final chapter also discusses the competitive issues specific to various types of health care delivery organizations, including teaching hospitals, community hospitals, group practices, independent practice associations, hospital groups, super groups and alliances, nursing homes, home health agencies, and for-profits. An interesting quote on for-profits indicates how time and change are indeed important factors in strategic planning in the health care field: "Behind many of the competitive concerns…lies the specter of the for-profits. Their competitive edge has lain until now in the excellence of their management. But developments in the past half-decade have shown that the voluntary sector can match the for-profits in management excellence. Despite reservations that may not always be untrue, the for-profit sector has demonstrated that good management can pay off in health care. But will the voluntary institutions end up making the same mistakes and having the same accusations leveled at them as the for-profits have? It is disturbing to talk to the head of a voluntary hospital group and hear him describe physicians as his potential competitors."

From Booknews:

Originally published in 1984, this brief volume outlines the elements of competitive strategic action and presents a model of strategy development. Written for managers of health care organizations, it emphasizes principles of sound decision making and implementation. Chapters discuss the importance of strategy, the model, scanning, product market analysis, collaboration, restructuring, physician management, and case studies. Sheldon and Windham-Bannister are consultants. Annotation c. Book News, Inc., Portland, OR

Dr. Alan Sheldon had been an independent health management consultant. He had consulted, taught and written extensively on many aspects of health management with a specialty in competitive strategy, strategic planning and physician-management relationships. He was trained as a physician and psychiatrist in England and in public health at Harvard University. He taught at Harvard University for over 20 years in the Schools of Medicine, Business and Public Health. He was formerly director of executive programs in health policy and management at Harvard. Dr. Sheldon is now retired and lives in England.

Other Beard Books by Alan Sheldon

Susan Windham-Bannister is the Managing Vice President of the Business Research and Consulting division of an influential strategic research corporation. She holds a B.A. degree from Wellesley College, a Ph.D. degree in health policy and management from Brandeis University, and was a post-doctoral fellow at Harvard University's John F. Kennedy School of Government. She is the co-author of two books, has authored several articles on the implications of the new health care environment and provider competition, and is a frequent speaker and panelist at conferences on strategic marketing and competitive differentiation. 

1. Evolution of the Environment: Uncertainty and the Need for Competitive Strategy 1
The Three Eras of Medical Care: Individual Medicine--The First Era. Organizational Medicine--The Second Era. Network Medicine--The Third Era. Uncertainty and the Relevant Environment--The Concept of Positioning. Uncertainty, Values and the Need for Change.
2. The Model of Competitive Strategy 19
What Is Strategy Development?  The Strategic Process. Environmental Trends.  The Competitive Forces. Relevant Environment, Competitive Position, and Competitive Performance: The Relationship between Strategy, Business(es), State, and Performance. Organizational State. Positioning: Scanning,. Product Market Analysis. Collaboration.  Restructuring. Managing the Physician. Competitive Strategies: Maintenance. Focus. Differentiation. Diversification. The Mini-Health-System. Conclusion
3. Scanning 56
Benefits of Scanning. Who Should Scan? Information for Scanning.
4. Product Market Analysis 64
Traditional Approaches to Markets and Services.  A systematic Approach to Product Market Analysis. Marketing Quality of Care. Implications of this Approach: Designing a Market Research and Action Program: The Focused Target Program
5. Collaborations: Match or Miss 83
Why Collaborate? Making Collaboration Work: Rationale for Collaborations (Group 1 Factors). Forces for/against Collaboration (Group 2 Factors). Complementarity of Style (Group 3 Factors). Projecting the Transition.  Collaboration: How to Go About It: Stage 1: Forming the Multi-institutional System. Stage 2: Developing the Decision-Making Mechanisms.  Stage 3: Taking Concrete Action. Stage 4: Consolidation and Integration. Types of Multi-institutional Collaboration: Federation.  Consortium. Joint Venture. Shared-Service System/Management Contracting.  Hospital Chain. Health Corporation.  Holding Company.  Alliance/Super Groups. Consolidation. Hospital System. Merger. Advantages and Disadvantages of Forms of Collaboration. Collaboration and Paradigm Changes.
6. Restructuring 116
What Are Restructuring and Unbundling? When to Consider Creating SSUs. When is Unbundling Likely to Be Successful? Managing the Mix. Corporate Development and Restructuring.
7. Managing the Physician 130
Physician-Institutional Relationships: A Brief History of the Issues: Latent Conflicts.  The Conflicts Sharpen. The Physician and the Modern Hospital.  The Physician in Governance.  The Physician in Operations: Supplier and Marketer of Services: Contracting with Physician Groups: The Case of Midland County Hospital. The Physician in Marketing and Production.  The Physician in Institutional Strategy.
8. Issues in Competitive Strategy 150
A Case Example: South Clinic: Consequences of Strategy Continuation without Change:  The Likely Scenario.  Strategy and Values.  Possible Products.  The Strategic Alternatives: What Do They Look Like?  Sectors of the Industry. some General Strategic Issues. Postscript.
General References 169
Index 171

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