Creating the right directional strategies leads to improved organizational performance. They are defined by the vision, mission, and values and must be created after extensive research and analysis of the internal and external environment. This study provides a directional strategy for the Defense Health Agency (DHA), a healthcare organization dedicated to delivering medical care to the army, navy, and air force in the United States. The organization’s current vision is defined as “unified, reliable, and ready” (Military Health Service, 2022). Its mission is to “support the national defense strategy and service military department by leading the military health system as an integrated, highly-reliable system of readiness, medical training, and health” (Military Health Service, 2022). Its values are pegged on the aspects of empowering and caring for employees, optimizing operations in the military health system, promoting optimal outcomes for patients, and delivering solutions to combatant commands. The TOWS analysis reveals that the company can attain optimal performance by addressing the threats and weaknesses, and leveraging on available opportunities and strengths. Accordingly, this paper analyzes DHAs directional strategies, recommending necessary changes to achieve overall goals.
Effectiveness of the Existing Directional Strategies
From TOWS analysis, the Defense Health Agency (DHA) can achieve its vision and mission because it has built a robust capacity in its operations. The organization employs skilled and experienced employees to deliver its services, ensuring that it achieve its vision of providing accessible and reliable services (Daniels & Reese, 2020). Various programs are availed to train providers, including internships, fellowships, and residencies. The use of technology and new equipment also aligns with the elements of readiness and reliability in the mission statement. The high success rate is indicative that its clients are satisfied with the service delivery process and outcomes. A series of checklists are used to track medical personnel readiness, leading to superior organizational performance. Data is also used to measure worker’s productivity against various benchmarks.
Even so, the company cannot achieve optimal results if it does not address the problem of undesirable patient-to-staff ratio. Although approximately 9.6 million people depend on the agency for services, the number of healthcare providers employed annually is few (The United States Government Accountability Office, 2020). More so, the motivation to improve service delivery is also less compared to the private sector. The company also faces stiff competition from the private sector, making it difficult to implement its mission of offering integrated medical care to its clients. Existing security breaches and budget constraints threaten its ability to market its services as reliable. It must strike a balance between the mission of readiness with delivering safe and quality care at a sustainable budget. The organization must address these issues to expand its scope of service delivery to underserved populations and form relevant partnerships in the healthcare sector. Cost-effectiveness is worth considering in this case; the management could restructure the agency to replace some health care services with purchased care. It is also worth noting the TRICARE program is not designed to respond to the rapid changes in the healthcare environment. The programs are designed to develop a network of civilian providers to meet the objective of offering high-quality and accessible care. However, the organization is not structured to adequately replace the agency’s providers through purchased care (Daniels & Reese, 2020). The quality of care offered through purchased care is not well-documented to determine the effectiveness of such programs. It points to the conclusion that forming public-private partnership must be preceded by extensive data assessment and analysis.
Notably, government policy continues to impact the defense health agency’s capacity to attain its growth goals and mission. For instance, the agency has been required to restructure and realign its operations to support its mission and vision of readiness. While this may improve patient outcomes, the agency has been forced to decrease capabilities of some units and increasing others. It may affect the agency in the long-run if the management does not strategically align itself to compete with the private sector amidst of policy changes. In any case, the agency does not account for the economic and political analysis while making strategic decisions. The country’s political stances are bound to change, depending on the ideologies adopted by the current and future governments. Economic instabilities may also affect the agencies’ ability to employ workers and technologies needed to drive its readiness agenda (The United States Government Accountability Office, 2020). The management must understand the risks involved in delivering healthcare and account for alternative assumptions to prepare accordingly.
DHA’s culture does not match its current directional strategy. While the agency aims at providing unified and integrated services to its clients, it does not employ the right organizational culture to attain its goals. Daniels and Reese (2020) indicate that the employees are not empowered to make decisions and instead, a hierarchical organizational structure exists. Sharing ideas and fostering creativity or innovation in decision-making are unlikely to prevail in such a setting. If anything, a collaborative effort is needed to deal with the competitive pressure from the private sector. The organizational structure is not adaptive enough to recognize and mitigate disruptions associated with political and economic instabilities (The United States Government Accountability Office, 2020). It has also failed to take advantage of the available technologies to prepare for unforeseen events. For instance, it does not utilize data analysis tools to predict unforeseen issues such as inflation in the US economy. Attaining growth and sustainability is uncertain in this regard.
Closely related to poor organizational structure and culture at DHA is the element of inappropriate leadership style. The agency’s leaders are qualified, experienced, and ready to execute their mandate accordingly. However, the leadership style may hinder their capacity to inspire the followers to align their behavior and activities towards attaining the overall goals. An authoritarian leadership is adopted in the agency to achieve quick decision-making and control of the agency (Daniels & Reese, 2020). The style is inappropriate for the agency because it does not promote integration, readiness, and reliability. Indeed, it hinders the creativity required to create solutions in the dynamic and demanding healthcare field (Bomhof-Roordnik et al., 2019). A democratic style of leadership is needed to solicit team’s contributions and ideas. Failure to make such changes affects the organization’s objective of implementing effective internal controls and decision-making. The value of empowering and caring for the employees and other stakeholders will also be impacted adversely.
Recommendations
Defense health agency should consider three main changes to achieve its strategic plan. First, it must invest in research to obtain accurate and up-to-date data on the healthcare environment. The United States Government Accountability Office (2020) clarifies that the healthcare environment is subject to changes and providers must prepare in advance. The stakeholders also expect the management to make evidence-based decisions to attain optimal results. Data is necessary in evaluating the impact of an intervention, determine appropriate targets for programs, and monitor progress for the implemented programs. It is also necessary in identifying barriers to accessing care and patient perceptions toward available interventions. DHA must collect data to determine the right standards of care as proposed by the Centers for Disease Prevention and Control and other agencies. It is also vital to find relevant data on the extent to which the current organizational policy matches the mission of readiness and reliability of care. It is particularly important to use accurate data before making restructuring decisions and realigning its operations to deal with changes in the external environment and risks such as security breaches. Using the available technologies for research is recommended to achieve cost-efficiency.
Second, the management must form strategic alliances with the private sector to deliver quality and safe care to patients. The shortage of qualified workers will affect the agency’s ability to deliver services to the millions of clients depending on its services. The TRICARE program is also not designed to meet this gap. Accordingly, the management must find the right partners and networks to source more skilled and trained workers to achieve its strategic goals. Joudyian et al. (2021) explain that engaging the private sector is beneficial because public healthcare facilities can gain the expertise necessary to drive growth and sustainability. In healthcare, the private sector helps eliminate other issues, including inadequate quality and efficiency because of a lack of competition, inefficient organizational frameworks, and delivering services in remote areas. The flexible nature of the partnerships paves the way for adapting current structures to match emerging needs. Specific aspects that DHA must address include creating sustainable financial system that allows the agency to cover more patients, implementing capacity-building reforms suggested by the government, and dealing with the competitive pressure in the sector. It must also form partnerships to monitor performance to achieve the mission of increased utilization of its services.
Third, DHC must change its leadership approach to create room for shared-decision making, change of organization culture, and flexibility in operations. The current management structure is hierarchical and inappropriate for an organization operating in a dynamic environment. Bomhof-Roordnik et al. (2019) indicate that leaders and managers working in the contemporary world must acknowledge the emerging need for democracy and inclusivity in decision-making. Employee productivity and engagement cannot be achieved if leaders do not allow their followers to participate in making decisions and implementing changes in the workplace. DHA must be willing to restructure its operations to create a culture of openness, shared-decision making, and effective communication. Even more, the staff members should be motivated to achieve the vision and mission through coaching, training and development, and financial incentives. Lean management is also worth implementing to eliminate waste and attain cost efficiency (Po et al., 2019). In so doing, the organization will match the strategies employed by the private sector, leading to improved performance.
Conclusively, the Defense Health Agency’s directional strategies are achievable if the leadership addresses various threats and weaknesses such as a lack of adequate staff members and competition from the private sector. The company has made remarkable progress in achieving its vision of readiness and mission of integrated care. However, its internal and external environment is not stable enough to allow for uninterrupted growth and profitability. Being proactive by gathering accurate and current data is vital in mitigating risks and addressing current weaknesses. The management must also involve workers in decision-making and form strategic alliances with the private sector to deal with competitive pressure.
References
Bomhof-Roordnik, H. Gartner, F. R., Stingelbout, A. M. & Pietrse, A. H. (2019). Key components of shared decision-making models: A systematic review. BMJ Open, 9(12).
Daniels, J., & Reese, J. M. (2020). An Analysis of the Defense Health Agency transition plan concerning the impact on contracting operations within the military health system. Naval Postgraduate School.
Joudyian, N., Doshmangir, L., Mahdavi, M., Tabrizi, J. S. & Gordeev, V. S. (2021). Public-private partnerships in primary health care: A scoping review. BMC Health Services Research, 21(4).
Military Health Service, (2022). Defense health agency campaign plan.https://www.health.mil/About-MHS/OASDHA/Defense-Health-Agency/DHA-Campaign-Plan
Po, J., Randall, T. G., Shortell, S. M. & Blodgett, J. C. (2019). Lean management and US public hospital performance: Results from a national survey. Journal of Healthcare Management, 64(6), 363-379.
The United States Government Accountability Office, (2020). Defense health care: Report to congressional committees. https://www.gao.gov/assets/gao-20-371.pdf
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