Strategy and Practice

Case for Alignment

Should every one have a strategy?Vision

Goals

ConstraintsTimeMoney

Competing forces

You are not alone

Management systems

Objectives

Likelyactions

Strategy

Desired actions

Controlsystem

Situation

Tasks

PeopleACTION

GAP

understand what is desired understand what is likely

Evaluate and compareK. Merchant, Modern management control systems

Public Health Management System

Objectives

everyactions

Mission

Desired actions

ControlSystems

FinancialRisk averse

SituationCrisis Mx

PoliciesToo vague

PeopleToo many

ACTION

GAPknow what is desired told what is likely

political impact decisionModified K. Merchant, Modern management control systems

Effectiveness vs Strategy

LOWHIGH

HIGH

LOW

Context and perspectivesWant to be a millionaire Busiest Emergency Department in KSANational center for transplantBest cardiac center in MEBest academic center Affordable tertiary studiesAffordable laser surgery day care centerLeadership InstituteWant to have a shisha on the beach every

weekend

Strategy aligned practice is beyond a SWOT analysis?

Strengths Weaknesses

Opportunities Threats

Strategic power house

CountryMedian

agePopulation

Birth rate

Death rate

yearsgrowth rate

%per 1000 per 1000

UAE 27.6 1.57% 18.48 4.02

Qatar 31.2 2.87% 15.68 4.43

Bahrain 28.8 1.61% 19.02 3.99

Oman 19.4 3.38% 37.4 3.97

KSA 18.8 3.27% 37.2 5.79

Kuwait 25.9 3.34% 21.8 2.45Australia

**36 0.93% 12.55 7.31

UAE

Qat

ar

Bahra

in

Om

anKSA

Kuwai

t

Austr

alia

**0%

15%

30%

45%

Chart Title

0

400

800

1,200

1,600

2,000

0.0%

3.0%

6.0%

9.0%

767

940

512

295

448

586

1,698

Expenditure per capita Expenditure % GDP

Strategy principlesEssential components of Strategy

Strategic Positioning = Good fitStrategic Design = Resource alignmentStrategic Model = Matching strategy to

environmentStrategic Rules = Efficiency and flexibilityStrategic Map = Strategic bet Strategic Leadership = Strategic sustainability

Principles of Strategic positioningCreate unique and valuable position

Involving different sets of activities Focus on needs of too many customers – Health insurance,

public service, primary health care, emergency services Comprehensive needs of select group, Specialist

healthcare, research and education, transplantsLook who is doing the same thing

Choose what NOT to do Choose activities that is compatible

Hospital management and hotel services within healthCreate a good fit amongst all your activities

Trauma services Day surgery hospital – high volume low occupancy Cardiac services

Strategic design

Matching business to environment Porter’s five forces model

Alignment with resources and capabilitiesVariety based: choose product rather than

customers , laser eye clinicsNeed based: choose particular group

(Women's, children) and serve ALL their needsAccess based target people who are accessible

in a town / large city / medical tourist

Area / Arena

Staging

Differentiation

VehicleEconomic

Logic

Geographic positionArea of SpecialisationLocal vs national vs regional Service level primary / tertiaryEtc etc

How can you achieve your objectivesPartnershipTechnology Contracts affiliations

Informed sequence and speedManage start-upsExpand established servicesEstablish new servicesEntering new markets following local reputation

High International standards.Cost effective.Highly specialised serviceThe best doctorsThe best treatment The shortest waitlistThe transplant hospital

Zero tax KSAGovernment guarantees?Durable sustainableAcceptable to customersAcceptable to funding bodies

Strategy rulesIn good times increase efficiency

In bad times increase flexibility

Rules must match strategy and environment

Rules tailored to a single process, not vague and make sense

Explicit and evolve with business development

Simple rulesThe how to rule

A process rule, all patients to be seen within 30 min

Boundary ruleDeal with referred patients from private onlyHave x no beds for overseas or insured

patientsPriority rule

Ranking opportunities in a timely mannerTiming rule

Review contracts, review special equipment, performance review

Exit ruleWhen to call it a day, service, sector,

partnership

Eisenhardt and Sull

Strategy MapsBest “Strategic bet” Hanson and Smith model

Educated guess to predict future events informed by knowledge, experience and learning

Financial perspectiveBalance revenue growth vs productivity improvement

Customer perspectiveRelationship, image distinct to you

Internal perspectiveBalancing operational and innovative processes

Learning and growthDefine skills, technology and culture that supports

strategy

Hanson and Smith model

Strategic leadershipTransform and renew visionProvide short term achievementsEnhance flexibility

Develop human capitalMaximize employee skillsCreate loyaltyPromote stability

Maintain competitive advantage

Reflections