External Forces Journal
Once an organization has defined its mission, vision, and values and assessed the environment, it needs to take a look at the external forces that affect it. These external forces will impact how the organization implements its strategic plan. In this journal activity, you will analyze your case study to identify how external forces impact the situation.
You will review your case study again and develop a journal assignment that explains how external forces impact strategic planning by addressing threats from different market and service area competitors. In the assignment, be sure to address the following:
Courtney Roberts
May 7, 2023
Journal 1-2: Case Study Selection
The Huntington Hospital case study was the one I picked to consider. This nonprofit
regional medical center with 625 beds is situated in the Californian communities of Pasadena and
the San Gabriel Valley. It has almost 125 years of service in this region. They take great delight
in having accomplished their organization’s mission and vision. All patients receive
compassionate and great care from them since they place a high priority on patient-centered care
and cutting-edge technology (Huntington Hospital, 2021). Healthcare technology has advanced
over time, and as a result, HH leadership believed they could streamline their operations and
billing procedures. Jim Noble, HH’s VPCOO/CFO, chose to concentrate on the Business
Services office first. His objective was to improve their systems for communication. He looked
for remodeling experts whose vision matched his own. Kim Markey, whom he assigned the duty
of renovating the Business Services office, proved to be this. Due to poor communication and
department leadership’s propensity to concentrate exclusively on day-to-day difficulties in the
absence of a clear direction, hospital administration understood that more than just a physical
makeover was required. To create a long-term plan for the department’s success and to make sure
HH remains competitive, profitable, and able to serve the community for years to come, Markey
conducted a six-step external study.
Within the Business Services unit, Kim Markey worked to put new ideas into practice.
She evaluated the departmental procedures, the revenue cycle system, and the effects of each
step in the billing process as part of this strategic strategy. External audits or organizational
analysis will provide a different viewpoint for developing fresh strategies and establishing a
productive culture around the revenue process. Markey used this kind of analysis to identify
opportunities to enhance internal procedures, reduce patient obstacles, and alter the department’s
perspective. The crucial steps in this process are the following six:
• Step 1: Organize the external analysis process and develop an issue template
• Step 2: Scan the general environment, healthcare system, and service area
• Step 3: Observe and validate external issues
• Step 4: Observe and validate external issues
• Step 5: Assess external issues
• Step 6: Complete an issue map (Ginter, et al., 2018
Kim Markey used the six-step method to concentrate on identifying departmental growth
potential, aspects that could be obstacles to long-term goals and how to get rid of them, and
enhancements to revenue cycle management. Markey first concluded that billing metrics needed
to be addressed in order to shorten the length of the billing cycle. The hospital would be
implementing a new electronic health record (EHR) system, thus existing departmental
procedures needed to be evaluated and changed. Staff needed to be notified of the change and
trained on it. The Business Services office income collection would be hampered during
implementation since they would need to be trained and practice new abilities at first. The EHR
could take up to a year to be fully implemented in the hospital. The measures that need to be
performed include developing software, preparing the healthcare organization to switch to the
new procedure, and staff training (Drabkin & Soule, 2015). Unfortunately, a longer deadline
would probably lead to slower billing and productivity.
The second task Markey had to complete for this research was to comprehend the current
environment, the healthcare system, and the service sectors. She began by looking at the revenue
cycle. This analysis heavily relied on the 80/20 rule. This indicates that 20% of the patient
accounts had 80% of the funds. She centered her efforts on shortening the accounts receivable
billing cycle. Markey had to take care of any patient obstacles and improve the department’s
outlook at this stage. This was crucial so that patients would feel comfortable approaching
competent personnel with any billing-related inquiries.
Markey spent some time in the third phase keeping an eye on and validating external
difficulties. She accomplished this by working together with the Business Service office workers
and office managers to obtain their thoughts on the environment and procedures of the
department. Pilar DeMonica, Armine Kalanijan, and several other workers pointed up some
places that needed repair. DeMonica, a senior lead biller/collections, observed that the
management style did not foster a positive workplace culture and a connection between
employees and those in higher positions. The current manager’s rigidity and lack of
approachability have been reported by the workers. When people thought they weren’t
performing to their fullest capacity, they found it challenging to. Kalanijan was the next person
Markey had a conversation with. She had been employed by the company for eight years and had
billing and collections experience. She made remarks about the low staff morale and the
generally tense and uneasy atmosphere in the office. The office personnel as a whole agreed with
these views and added that the procedures they had to follow were inadequate and unclear. They
were unable to successfully carry out their employment responsibilities as a result.
In the fourth step, the Business Services office’s environment and culture were the
primary areas of forecasting or anticipation. In her evaluation, Markey identified a lack of
direction and inadequate communication between the existing management and their personnel.
Coworkers were unable to speak with one another directly due to the lack of communication, and
had to approach the management in order to speak with another employee. Another issue arose
from the procedures & guidelines being unclear to the department’s team because each manager
had different ideas and approaches to how thins should be done, resulting in inconsistency and
inefficiency (Drabkin & Soule, 2015). The current culture of the office is not conducive to
positive employee engagement & morale, innovation, employee satisfaction and loyalty, and
instead may result in negative employee experiences.
Markey examines evaluating external factors in the sixth step. She examined the
techniques needed to execute each activity as well as how people interacted with one another
while at work. She was aware that concentrating on tiny adjustments would enable her to be
open and approachable for the workers. As she implemented changes, it would be crucial to
establish trust with them. She altered this right away after noticing that staff members frequently
appeared to be micromanaged and extensively observed at every turn. She altered the amount of
time workers were permitted in the office before the start of their shift, as one illustration of her
modifications. They were initially only given a 5-minute advance time, which made them feel
hurried and ill-prepared. By giving his employees 30 minutes to get ready for the day, Markey
noticed an improvement in staff morale. Markey will be able to raise output and office morale by
being aware of outside factors that have an impact on this division and its personnel.
In the sixth stage, a problem map is finished to demonstrate what needs to be done to
raise office morale, streamline billing procedures, and eventually increase revenue collection.
making of the map They were able to create a written and visual plan of the things that needed to
be completed to boost overall performance thanks to Markey and the leadership at HH. The
mapping technique is helpful in demonstrating the causal link between management and
employees, current concerns and action plans, and how the objectives are interconnected and
affect the culture and departmental environment.
The Nominal Group Technique (NGT), which addresses the problems posed by the
Huntington Hospital Business Services office, is the strategic thinking framework that would
perform best in this circumstance. This method of group brainstorming encourages participation
from all team members using an analytical approach (American Society for Quality, N.D.). The
premise is that every person’s opinion is equal and that none is more important than any other.
The ideas generated by this kind of brainstorming are listed collectively, debated by the group,
and then ranked individually (Ginter et al., 2018). This approach will be useful in giving them a
platform to offer their thoughts without fear because there is a communication problem and
many team members in this department feel their voice is not heard at work.
Leadership inside the hospital must use external analyses to help understand departmental
challenges and to improve the office dynamic and processes if the Business Services office at
Huntington Hospital is to fulfill its goals in terms of the mission and vision. Before the new EHR
was implemented, Kim Markey worked to build a strategy to boost growth by identifying the
problems and developing a road map for success to solve them. Working together Markey and
HH leadership can generate clarity for processes that will increase a positive work environment,
productivity, and revenue cycle management now & in the future.
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