Internal and External Factors of a Healthcare Institution.
Hospital Cooperation of America is a for-profit organization that provides healthcare services in large part of America. The cooperation happens to be one of the largest of its kind in America and extends its services to other parts of the world. HCA was founded in the year 1968 by three renowned American doctors: Thomas Frist Jr., Thomas Frist Sr. and Jack Massey (Becker’s Hospital Review, n.d). At first, Dr Frist Snr built the Park View Hospital Nashville together with a team of other physicians. Later on, they teamed up with the other doctors to expand the hospital but eventually ended up creating a hospital management company known as HCA. Through the years, HCA has undergone major transformations, mergers and transactions to improve their services. The changes have seen the cooperation transform many hospital managements in America and other regions. One of the company’s biggest achievement happened in the year 1994 when they merged with the government of Colombia. During the time HCA had more than 300 hospitals and 145 ambulatory surgery centres which were the largest at the time. The following years saw the restructuring and reorganization of the company with some of the hospitals being sold.
In the year 2006, Bain Capital, and Dr Frist Jr. family and other stakeholders completed a leveraged buyout worth $33billiion (Becker’s Hospital Review, n.d). The company further gave the public an offer of $4.6 billion. KKR and Bain are the two main shareholders of the company. As of the end of the year, 2013 HCA had 165 hospitals, 115 surgery centres across 20 states of America and in London UK. The organization has close to 42,896 hospital beds and more than 200,000 employees. Most of its hospitals are concentrated in Texas, Virginia, Tennessee and Florida (Becker’s Hospital Review, n.d). HCA competes with LifePoint and CHS as major for-profit health organizations in America. Though the competition exists, there is a difference in operational strategy that makes HCA unique as compared to the other organizations.
Aside from having hospitals and surgery centres, the company has subsidiaries in other healthcare businesses. The subsidiaries act as alternative revenue productions for the company. Parallon is one of the biggest subsidiaries, which is an outsourcing firm giving services such as workforce management, revenue cycles operations and supply chain management for the for-healthcare facilities. Parallon works closely with Health Trust, whose functions are healthcare cost management. H2U is another subsidiary whose focus is clinical services in low-cot areas. HCA has managed its operations effectively, and in every 22 cases of use of the emergency room services, a hospital working with HCA must be included. HCA hospitals attend and manage over 20 million patients annually and deliver more than 200, 000 babies (Becker’s Hospital Review, n.d). This explains how the general public has given the trust to those hospitals. In the year 2006, HCA started hCare a project that created an Electronic Health Record system for all the hospitals and surgery centres. The plan saw the operations of patient management become easy since all patient information was stored digitally; hence monitoring of patients became easy.
Like any other business, the healthcare business is one that is influenced by a lot of external and internal factors. These factors determine the operations of the hospital, the recruitment of healthcare professionals, service delivery and other critical factors. To begin with, Patient sociodemographic variables is a major internal factor in any healthcare facility setting (Mosadeghrad, 2014). This is a major internal factor that affects HCA directly and indirectly. Social-demographic variables refer to the interactions between the patient and the healthcare professionals and extensively the quality of the healthcare service. The language barrier is one of the challenges that medical practitioners face. In a study by Ali Mohammed, he indicated that one doctor asked a patient not to take sausages and pickled cucumber as they were not good for their pharyngitis condition (Mosadeghrad, 2014). After some few minutes, the doctor saw the patient with a can full of sausages. This is typically what happens to many other patients. The language barrier makes it difficult for healthcare professionals to give medical orders to their patients.
With the language barrier, it is difficult for the medical professional to identify patients’ culture and norms (Mosadeghrad, 2014). This creates an uncomfortable environment which makes the patient not to communicate effectively. This then affects diagnosis as some of the vital signs and symptoms are not identified first-hand. The patient’s possession of medical knowledge is also an important variable in sociodemographic. When a patient has a bit of medical knowledge, it is easier for the medical officer to interact with the patient. The patient can explain themselves easily while the doctor can give instructions with an assured that their instructions will be obeyed. The patient’s attitude and behaviour towards caregivers creates a good environment for healthcare professionals to provide quality service (Mosadeghrad, 2013). Patient Illness is another internal factor that affects doctors and healthcare professionals directly. The changing trends of diseases and infections give the doctor’s job challenges in a bid to manage and fight the infections. Other internal factors that affect health care facilities include physician and doctor’s knowledge and their motivation and satisfaction in their jobs.
The healthcare system is a major external factor of health care and medical service quality. Most of the patients tend choosing a specialist over a General Practitioner. This is out of the notion that has been created that specialists are better than General Practitioners. On the other hand, the charges of seeing a GP and a specialist are separated by a small margin. Hence it explains why a specialist receives more patients than a General Practitioner, which should be vice versa (Mosadeghrad et al., 2011). The demand for resources and facilities is another external factor in the healthcare system. With the rise of cases of chronic infections, the need for specialists and equipped medical facilities has increased, therefore giving pressure to the few available medical facilities (Gray and Boshoff, 2004). This has induced so much pressure on the public hospital in terms of resource allocation, patient and medical professional’s management. Finally, collaboration and partnership development are major external factors of medical organizations. Collaboration and partnership determine the funding, donations and volunteers’ programs that can be steered by the medical facility. It also determines the nature and quality of the medical services that will be provided by the company.
The demand for resources and medical facilities is a major external factor that affects HCA healthcare. HCA Healthcare has invested a lot of its resources in supporting the healthcare industry, especially in the area of specialized medical treatment. Hence, a lot of patients visit HCA hospitals to get this treatment (Becker’s Hospital Review, n.d). The increased number of specialized treatment cases creates major patient traffic that needs to be resolved in a managerial way. The pressure on the facilities and the corresponding medical officers is high as they have to deal with a lot of patients. To curb this situation and prevent further damage in the future, the management needs to invest in specialized care treatment facilities. Just as the hospital invests in surgery centres, it should do the same on specialized treatment centres like cancer centres, kidney centres and heart centres. This will reduce the pressure that the hospitals endure on specialized treatment and will also increase the quality of the same.
If HCA decides to invest in specialist treatment centers, many of the employees at various levels of the hospital are likely to be positive. This is because the pressure on their workplaces will be reduced and at the same time the nurses and medical doctors will get an opportunity to further their studies and expertise through the use specialized treatment centres as research organizations (Ko et al. 2012). there will also be an increase in job promotion and new job opportunities as the facilities will need other new employees. The mission for HCA healthcare is to provide compassionate care and exceptional service to every person every day. My vision for change is providing specialized services to every patient. If HCA healthcare invest in specialized centres, early screening, testing, diagnosis and treatment will be provided to all patients. This will improve the health of patients and increase the revenue of the hospital by a great margin. The stakeholders of the company are likely to pose a question on the return of investment since there are already major and renowned specialized treatment centres. HCA is a company that has had a great reputation in the medical industry, and hence it advertises itself. Thus patients that were being referred or those who opted to go to other treatment centres will now get their services at HCA. Therefore the stakeholder’s worry should be how to get more specialized doctors and nurses to join their hospitals.
Reference.
Mosadeghrad A. M. (2014). Factors Affecting Medical Service Quality. Iranian journal of public health, 43(2), 210–220.
Becker’s Hospital Review. (n.d.). 10 things to know about HCA: Here are 10 things to know about HCA, headquartered in Nashville, Tenn. Becker’s Hospital Review – Healthcare News. https://www.beckershospitalreview.com/lists/10-things-to-know-about-hca.html
Ko, K. D., Kim, B. H., Park, S. M., Oh, S. I., Um, C. S., Shin, D. W., & Lee, H. W. (2012). What are patient factors associated with the quality of diabetes care?: results from the Korean National Health and Nutrition Examination Survey. BMC Public Health, 12(1), 689.
Gray, B., & Boshoff, C. (2004). The relationships between service quality, customer satisfaction and buying intentions in the private hospital industry. South African journal of business management, 35(4), 27-37.
Mosadeghrad, A. M. (2013). Obstacles to TQM success in health care systems. International Journal of Health Care Quality Assurance.
Mosadeghrad, A. M., Ferlie, E., & Rosenberg, D. (2011). A study of relationship between job stress, quality of working life and turnover intention among hospital employees. Health Services Management Research, 24(4), 170-181.
Mosadeghrad, A. M. (2014). Patient choice of a hospital: implications for health policy and management. International Journal of Health Care Quality Assurance.