Hospital A was a large, complex teaching hospital in the Middle East. Established in 1972 by a western US hospital company, the organization grew and prospered over the next 30 years. It grew to almost 800 hospital beds and received $900 million in funding per year. But the hospital never established a formal strategic plan or planning process. The government, which provided most of the funding, appointed the CEO. Strong governmental control and the local culture created a certain level of risk aversion in management’s actions and made the hospital’s top executives sensitive and reactive to governmental pressures and whims.

A new CEO—a general surgeon—was appointed five years ago. Aside from serving as a chair of a university department of surgery and as a deputy minister of health, he had little administrative experience, but he was well connected politically and through family ties. He did want to address the many challenges facing the hospital—including long wait times, complaints about quality, and increasing local and regional competition—and he was pleased that the outgoing CEO had hired the most prominent international strategic planning firm to create the hospital’s first written strategic plan. He met with the firm’s consultants and assigned the strategic planning process to one of his subordinates, Amir, directing him to move the planning process forward and to let him know when the CEO’s input was needed.

Amir wanted to make a name for himself and help craft the best strategic plan in the country. First, he and the consultants examined the strategic intent of the organization. Creating a mission and vision was easy; they simply adopted the governmental charter. The charter consisted of two pages of directives written 30 years earlier. Points of focus included the following:

• Provide the best specialized medical care services.

• Contribute to increasing the standards of healthcare quality in the country.

• Conduct scientific and applied healthcare research and implement collaborative efforts to advance and improve healthcare processes and procedures in general and medical subspecialties.

• Contribute to enhancing the level of awareness and health education in the community.

• Contribute to educating and qualifying staff in healthcare and health education programs.

• Issue medical and scientific journals and other publications.

Questions 

1. How did the CEO fail to provide strategic leadership?

2. What principles of delegation could have been practiced to improve the situation?

3. What could Amir have done to help the CEO implement better strategic thinking in the organization?

4. If you were the CEO, what would you have done differently?