Part 1

There exists several internal and external factors that can impact hospital organizations. Those internal factors include the organizational culture, the organizational structure, and strategic resources (Ginter, Duncan, & Swayne, 2013). The organization’s culture should include shared assumptions, values, and behavioral norms. When these factors are in sync throughout the organization, value is increased for patients which benefits the organization. The organization’s structure should also have shared understandings throughout the different departments in order to function together towards organization policies. The strategic resources (i.e. finances, technology, etc.) must be available to the areas of the organization to properly impact the hospital in a positive way.

External factors that can impact hospital organizations include political, economic, demographic, technological, and competitive changes (Ginter, Duncan, & Swayne, 2013). A prime example is the recent passage of the Affordable Care Act. Hospitals must make the required changes due to the passage of this act which includes the usage of technology (i.e. electronic medical records). An organization should also monitor the social and demographic changes in its community to maintain positive patient care and also, stay ahead of competition.

Strategic management can help protect the integrity of a healthcare organization by planning to enhance the quality of care, control access to care, and contain costs (Ginter, Duncan, & Swayne, 2013). By enhancing the quality of care, strategic management can reduce medical errors that can impact the healthcare organization’s reputation in the community, the industry, and even national recognition. Medical errors make for good headlines but rarely do media outlets report on the many accomplishments that a healthcare organization makes every day. Controlling access to care is another factor that can effect the integrity of a healthcare organization. With the inevitable move towards electronic medical record (EMR) systems, it has become increasingly necessary to provide controls towards patients’ confidential information. Systems must be in place to check users of EMR programs prior to gaining access to these resources. Containing costs is essential for any business, including healthcare. Strategic management should always have this factor in mind when developing new steps to meet the mission and vision of the organization. Cost containment should be implemented throughout every level of the healthcare organization, from new hires to president and board members.

Part 2

The U.S. healthcare system is facing several external issues that threaten its future integrity. First, economically the insurance costs are increasing and consequently the number of uninsured people.Second, the government is requesting the implementation of electronic health records to meet the demand for high quality but, the application of these new technologies are increasing the healthcare costs. Finally, the public health may go away from primary care, and cover only core activities (Ginter, Duncan & Swayne, 2013).
All of these issues are bringing ethical, legal and financial dilemmas.For example, the use of EHR might contain legal, ethical and financial quandaries. Firstly, the overload of electronic health data may lead on an increment in legal responsibility and accountability.Secondly, the privacy and control of electronic information could be compromised with breached or unauthorized protected health information (PHI). Lastly, the implementation of EHR increases the health care costs and resources. (Sittig & Singh, 2011).
However, external environmental analysis under a visionary holistic point of view increases the possibility to face ethical, legal and financial dilemmas.

A strategic management can protect the integrity in health care quality and safety. A strong safety culture, and an action structure for integrity in healthcare are basic to protect the organization integrity.
Leaders of healthcare organizations need ensure that everybody recognizes their responsibility for quality and safety, encourage the reporting of quality and safety concerns, establish policies that protect data integrity, and implement effective action corrective plans (NAHQ, 2012).
Strategic management will try to minimize the ill effects of those surprises that are predictable, even if they are inevitable (Ginter, Duncan &Swayne, p.71, 2013).