The role of healthcare organizations in implementing the long-term nutritional program is to reduce inequalities in health caused by interrelated factors; external and internal to the health-care realm, such as ethnicity, education, geography, and socioeconomic status. This paper evaluates internal and external environments of a nutritional program, incorporates various strategic planning developments, and proposes strategic planning to adapt to the changing environments. The paper further applies analytical models and decision making methods to evaluate challenges and demonstrates ethical practices that lead to sound decisions making.
Changes in hospital market conditions, environment, and the aging population are bringing changes in management strategies(Hyun, Kang & Lee, 2015). Nutrition is a challenge in nursing homes as evidenced by up to 80% of elders suffering from malnutrition, and more than 30% child deaths and a fifth of total disease burden attributed to maternal and child under-nutrition(Hyun et al., 2015). The nutritional deficiencies are rarely recognized and form the base of major clinical outcomes despite the availability of opportunities to control undernutrition. According toGodamunne, Zamroziewicz, Luo & Hegazi, (2016), any form of malnutrition threatens human health and development, and a lot of it is characterized by persistent under-nutrition, overweight, and obesity.
The role of healthcare organizations in implementing the long-term nutritional program is to reduce inequalities in health caused by interrelated factors; external and internal to the health-care realm, such as ethnicity, education, geography, and socioeconomic status.There is a necessity to review and develop programs and strategies in efforts to improve availability and access to nutritionally adequate diet to the needy, using the best approach. The program has to be by the current international recommendations of nutrient composition and implement integrated and continuous educative and social communication strategies to promote general well-being. This paper aims at discussing the strategic planning and management of a nutritional improvement project, and key decisions needed to improve performance in the long run.
Healthcare industry is a unique environment faced with many challenges (Abdul Aziz & Idris, 2012). Leadership and teamwork in the organization are keys in meeting the challenges, with a constant evaluation process to identify factors affecting the performance of the organization. Various influences affect the performance of a healthcare program, categorized into internal and external environments. External factors causing distress in healthcare organizations are well recognized, but less is known about the adverse impacts of internal factors (Kotzian, 2016).
Leadership and Management
Effective healthcare management improves quality from the perspective of provider, managers, payers, and policymakers. According to Prince, (2017), treatment performance is affected by the management; people with a good idea for quality improvement fail to deliver satisfaction when management is poor. Public hospitals do not give their managers the ultimate power to make decisions, with extremely prescriptive national policies with limited considerations to local factors. The ministry of health should define indicators that are not dictated and ask their doctors to achieve them so that they can have more authority and execute decisions easily.
Resources and Facilities
The quality of healthcare services depends on the availability of resources, with limited facilities affecting the quality of overall work. Patient history record should be obtained, especially for evaluating the effectiveness of the treatment at all time. High productivity requires high-quality inputs, and a reduced employee’s job stress to perform duties at higher speed.
Managers and policymakers give priority to financial resources because they are the most vital factors influencing healthcare quality. Employees who are paid well and on time produce quality and organizations’ differences in financial resources affect their quality of service (Waheed, 2018).
Practitioner’s knowledge and technical skills determine the quality of a healthcare service. Factors that influence the quality of work are mainly knowledge, expertise, commitment, and the ability to examine patients properly. Education institutions are responsible for providing professional development opportunities for healthcare workforce. According to Knodel, (2013), medical professionals do not believe educational institutes are equipping their graduates fully since they tend to be practically incompetent and depend on hospitals to provide additional education and treatment to meet educational requirements.
Healthcare providers should have a character and personality that improves the quality of service. There should be a link between provider’s attitude and communication with patients, and their problems should not interfere with their output.
Political factors affect nutritional improvement programs when it comes to funding, affecting organizations that depend on government financial assistance. Changes in government policies are sometimes well notified and discussed, but can be changed without warning. Political factors lead to strong labor movements that directly improve work conditions. According to Jankovic, Mihajlovic & Cvetkovic, (2016), the environment of work and outcome of services are directly proportional; malnutrition, traditional-occupational diseases, accidents at work, and lifestyle factors at work have a role in good health. Policies ensure low socioeconomic and income inequalities. Income inequalities affect health as they interfere with psychological perceptions of a workplace, and improvement is vital for positive culture shifts and improved business ethics.
Technological advancements create healthcare prospects both in terms advanced therapy systems, and provision of services. The most improved internet services improve information network and ease in evaluation when it comes to acquisitions and actionable factors. Online technology has contributed to direct patient communication, patient advertising, customized treatments, and social media healthcare.
Social factors include the aging population that offers a wide range of opportunities and threats to the nutritional improvement program. There is also the risk of obesity amongst the population and its associated risks. The current culture has improved patients and caregiver’s knowledge and awareness, changing their expectations to become more demanding. Public activism is also increasing through social media technologies, a challenge to healthcare organizations to meet consumer’s need without overstepping the regulatory boundaries.
Economic environment deals with issues like the global economic crisis that create reluctance of consumers to spend on healthcare programs. The increased growth in nutrition healthcare is a clear demonstration of how nursing services have been privatized to become a key business offering. Countries that use part-payment health insurance models have greatly been impacted by a reduction in consumer disposable income (Kallianiotis, 2015). Pricing becomes highly pressurized, although the market continues to grow to the aging population. The economic status of a healthcare organization leads to increased pressure from stakeholders causing consolidation of the industry, causing more mergers and acquisitions in future to add value.
The performance of the program is also affected by the many regulatory and legislative restrictions. Many countries have a litigation culture; therefore a company must focus on producing quality. Moreover, internet evolution is increasingly stretching legislative boundaries with consumers demanding more satisfactory rights in their healthcare programs.
The growing environmental degradation issues require key organization stakeholders to improve their awareness for their business to be more proactive. A comprehensive environmental scanning should be done to see how business and marketing plans are compatible with environmental issues. The program implementation should conduct an environmental impact assessment, to consider ways of preventing or minimizing environmental impact (Conservancy, 2015).
Strategic planning as a management tool is not greatly deployed in healthcare programs especially in third world countries. This is because of lack of appropriate internal incentives needed to formulate and implement strategies meeting the legal requirements of health ministry. Nutritional improvement program evaluation goes through planning, implementation, completion, dissemination, and reporting.
The phase of planning demands managers to determine feasibilities of evaluation, stakeholder identification, and goals specification. Stakeholder inclusion in planning increases reliability by creating a room for participation by the public, stakeholders, and policymakers. Once stakeholders are identified, a strategy is put in place to ensure their engagement in all evaluation stages. A two-way communication should be maintained between the evaluator and stakeholders to create room for ideas and suggestions. Communication establishes an advisory committee to run programs and evaluate activities in the community. Stakeholder involvement creates the need to understand and embrace cultural diversity.
The implementation phase is the formative and process evaluation examining whether the program recruits and retains the intended participants. It also ensures effective training materials are used and meet standards for accuracy and clarity.
Completion phase involves evaluation based to do an examination of outcomes in the short run or long-term impacts of the general performance. It provides summative, outcome, and impact evaluation; determining the degree to which changes in outcome can be ascribed to the program.
Dissemination and reporting phase ensure distribution and reporting of results to all available audiences comprehensively. The plan includes guidelines for the party presenting results, audiences, and those who record. This phase requires adequate resources and is time-consuming making community participation hard.
Strategic planning and administrative methods and strategies to cope with internal and external environmental factors
Organizations should respond appropriately to changes occurring in their respective environments to succeed effectively. Any organization that fails to take actions to align itself with the environment fails to survive and is forced out of the market.
The manager is required to have great attention to the many rapid changes that take place in an external environment containing resources the company depends on. An external analysis is performed to examine opportunities and threats that exist in the environment. This analyzes customers, competition, market, and environment with the aim of identifying external opportunities, threats, trends, and strategic uncertainties, customers, employees, and suppliers. Firms depend on suppliers for materials, labor and always take advantage of competition among suppliers to obtain lower prices, quality, and efficient deliveries. Healthcare organizations react to increase in competition by cutting services; cost, offering improved quality services and spending more on promotion cut costs such as employee’s redundancy.
Patients are the customers in healthcare, and managers must monitor the effectiveness of their services now and in the future. The must utilize the media to improve communication with both internal and external audiences and uphold a good reputation.
Employees agree to work for certain hours in return for wages and salaries. They should be
timely and fairly paid to uphold the good name of the institution and improve their morale.
Macro environment deals with factors like the economy and government policies controlled by the firm indirectly. Factors most likely to change and those with greatest impacts must be identified. Planning is said to be significant when there is a high probability that change will occur with greater impact. Managers develop strategies using strengths of the firm to exploit existing opportunities. They identify relevant factors and their importance then put in place strategies that provide a great combination of opportunities and strengths to implement the plan.
Environmental impacts are countered by reducing the number of forces to reduce uncertainty. Examples include waste reduction, moves of competitors by middle managers, or availability of new strategies by top management. Organization structures are created to define roles, changing environments, and overlap of roles. Moreover, boundary spinning is crucial to gain access to information necessary to forecast future issues.
Analytical models require analytical skills to collect and analyze information, solve problems, and make key decisions in the workplace. Managers recruit employees with the ability to investigate problems and find solutions in timely and efficient manner. They must exhibit the ability to communicate effectively, be creative, have skills in data analysis, think critically, and be able to conduct research.
Conflicts in the workplace occur all the times and are opportunities to improve system and relationships. The seven-step model was formulated by Tim Hicks to help solve problems in the workplace as illustrated below.
Identify the issue: Managers need to be clear on the issue, putting in mind that different people have different views regarding the situation. A list of the issues is made defining why they are problematic, and problem identification should focus on behavior instead of personality.
Understand everyone’s interests: The interest that satisfies the interests of all should be selected. All the members should engage actively and respect opinions of others while putting down all individual differences to understand the intentions. The naming of interests is then separated from the listing of solutions.
List the possible solutions: This phase demands a lot of creativity and brainstorming. A possibility of ways to counter the problem is explored keenly to prevent offering solutions to problems that do not even exist. All ideas are noted no matter how absurd they are, and a variety of solution alternatives to particular problems identified.
Evaluation of options: This is the phase of determining advantages and disadvantages of options, and separating the evaluation of options from the selection of options. The pros and cons of every option identified in previous steps should be weighed.
Selection of an option or options: All the options are weighed, and the best is selected, and find possibilities of putting some options together to provide a more satisfactory solution. The manager thinks of the options that highlight positive impacts to the organization, and the solution that would produce the mildest impact. This phase demands the creation of a timeline intended to achieve the organization’s ultimate goal before deciding on the solution.
Documentation of agreement(s): The selected option should be written down to help think through all details and implications. Memory should not be relied on.
Agreement on contingencies, monitoring, and evaluation: Contingency agreement should be prepared based on near future, in case of conditions change. The phase requires ways of monitoring compliance and follow-ups to be put in place. Opportunities should be created at this stage to evaluate agreements and their implementation. The seventh phase evaluates success and makes managers appreciate their decision-making skills while offering a learning opportunity to those who fail.
According to Uzonwanne, (2014), the model can be applied by one person, individuals, and even larger groups when faced with difficulties in making decisions. Decision-making maxims help reinforce the seven-step process regardless of whether they are related to problem-solving or not.
In examining the manner correlating to conducting the nutritional healthcare program and individually ascribed values, workers are impacted by their respective upbringing, social environment, and academic influence. According to Rao ( 2017), values are who we are, and they get us out of bed every morning, enable us to choose our jobs daily, the company we keep, groups we lead, and the relations we keep.
Managers should work to recognize, understand, and articulate their values because of the vital role they play in the workplace in decision making. This will assist in determining employees’ allegiance and performance by creating a powerful connection that creates vast opportunities for individual and organization growth.
Building loyalty and respect as a fusion of personal and organization’s values results in the development of a team that respects the firm. Firm’s resources are utilized effectively when workers have respect and are loyal to stand by the firm when need be. The current attrition crisis in the workplace creates the essence of generating employees’ enthusiasm and dedication to services offered to retain them and infuse passion. Employees believing in the work they do for their employers are driven to construct an environment that is safer, and valuable services with dedication, pleasure, and respect to purpose.
Managers should focus on demonstrating a history of fair dealing by performing certain due diligence to emphasize on worker appreciation and contribution. The company should create clean historical records on service delivery by providing desirable and necessary assistance to clients. Managers should ensure employees’ prospect of fair play and equity in treatment is upheld, and business reputation held high to meet the goals of the program. The company’s goals should be accomplished in manners that meet the required expectations by stakeholders, public, and environmental concerns realistically.
The organization should build trust, imperative, especially with new legislation to counter corruption and demand accountability in financial accounting standards. The managers should operate all the programs in an indisputable manner infusing trust to all business stakeholders and beneficiaries. They should manage labor concerns, stakeholder and public expectations, desirable products, and environmental preservation, and government scrutiny.
Decisions in the organization should be based on values rather than beliefs. Beliefs should be used to formulate responses and not to make decisions because they reflect history in dealing with similar conditions (Franklin, 2016). Beliefs are believed to be steeped in humans’ past histories, habits, and traditions, therefore, not adaptable to new situations and are not equipped to handle complexities of emerging issues. Decisions based on values align with future expectations and engage both contexts and experiences favorable to make tough decisions in complex situations.
Organizations produce quality services when they gain team member and customer commitment. Organizations working in unity with employees and all stakeholders under a shared set of values are less bureaucratic, more flexible, and less hierarchical. The company’s performance is great when all the personnel share a similar vision and core values increasing reliability. Trust in a business entity is a core foundation for establishing relationships with customers and team members.
The management at all level should stimulate vision and inspire others. Leaders should inspire the workforce so that they can get passionate about their performance, and possess the great energy to spark excitement crucial in achieving results.
Value-based leadership should be upheld in the organization to achieve great heights in our competitive global economy. Values offer support in environments where change can be bewildering, and connect with powerful forces to dictate our actions. The instilling of value in firms deeply dictates existence by preserving principles, and every decision generates respect from others and preserves the integrity of the firm.
Programs in healthcare need to make enough capital to cover their expenses and stay in business long enough to provide sufficient care to patients. Leadership and management are not well taught in medical schools. Thus managers need to apply strategic management to retain and attract physicians in competitive environments. The paper has identified some of the factors that influence achievement in decision making among organization leaders because decisions are the most dynamic challenging and ongoing concept in every organization. Decision making is an ongoing process in every organization and requires future research on leadership decision making in response to organization success.
Abdul Aziz, S., & Idris, K. (2012). E-Government Application: The Challenges in Malaysia. SSRN Electronic Journal. http://dx.doi.org/10.2139/ssrn.2184632
Conservancy, L. (2015). The Conservator.
Franklin, J. (2016). P-values and decision-making: discussion of ‘Limitations of empirical calibration of p-values using observational data’. Statistics in Medicine, 35(22), 3889-3891. http://dx.doi.org/10.1002/sim.6984
Godamunne, K., Zamroziewicz, M., Luo, M., & Hegazi, R. (2016). Malnutrition and healthcare-acquired infections: the need for policy change in an evolving healthcare landscape. Journal of hospital Infection, 93(1), 9-11. http://dx.doi.org/10.1016/j.jhin.2016.02.003
Hyun, K., Kang, S. and Lee, S. (2015). Population Aging and Healthcare Expenditure in Korea. Health Economics, 25(10), pp.1239-1251.
Kallianiotis, I. (2015). The European Economic Crisis in a Global Context and its Originator. Archives of Business Research, 3(4). http://dx.doi.org/10.14738/abr.34.1407
Khalatbari-Soltani, S., & Marques-Vidal, P. (2015). SUN-PP245: Malnutrition Almost Doubles the Risk of In-Hospital Death in a Swiss University Hospital. Clinical Nutrition, 34, S114. http://dx.doi.org/10.1016/s0261-5614(15)30396-4
Knodel, L. (2013). Practitioner Application: Healthcare Employers Policies on Nurse Education. Journal of Healthcare Management, 58(6), 410-411. http://dx.doi.org/10.1097/00115514-201311000-00006
Kotzian, P. (2016). External Drivers, Internal Agents. On the Role of Environmental Factors and Agents for the Integration of Business Reporting. SSRN Electronic Journal. http://dx.doi.org/10.2139/ssrn.2831461
Prince, T. (2017). Behavioral Finance and the Business Cycle. Business Ethics And Leadership, 1(4), 28-48. http://dx.doi.org/10.21272/bel.1(4).28-48.2017
Rao, M. (2017). Values-Based Leadership. The Journal of Values-Based Leadership, 10(2). http://dx.doi.org/10.22543/0733.102.1185
Uzonwanne, F. (2014). Leadership styles and decision-making models among corporate leaders in non-profit organizations in North America. Journal of Public Affairs, 15(3), 287-299. http://dx.doi.org/10.1002/pa.1530
Waheed, Z. (2018). Facilities management and the business of managing assets. Facilities, 00-00. http://dx.doi.org/10.1108/f-08-2017-00