Situation analysis and strategic development in a public hospital.
Hospitals operate in a highly competitive and regulated market. Efforts are being made to shrink the health care system. This paper describes the experience of a public hospital in New York, one of the most regulated states in the country. This hospital, once a local charity care institution, evolved into the only regional medical center in its area. This was accomplished through support from local and state governmental agencies and implementation of new programs that did not compete with local community hospitals. Referral patterns were established to attract patients requiring tertiary care, who previously would have gone outside the region for these services. The paper describes the strategic planning process used to achieve institutional goals and identifies principles necessary to complete a reversal in institutional image, mission, market, and role successfully.