Luận văn chiến lược phát triển tại bệnh viện nhiệt đới trung ương tới năm 2020

LuẬN văn
Chiến lược phát triển tại bệnh
viện nhiệt đới trung ương tới năm
2020
THESIS TITLE
DEVELOPMENT STRATEGY
FOR THE NATIONAL INSTITUTE OF
INFECTIOUS AND TROPICAL DISEASES
TO 2020


STATEMENT OF AUTHORSHIP

Except where reference is made in the text of the thesis (Capstone Project), this
thesis contains no material published elsewhere or extracted in whole or in part from
a thesis by which we have qualified for or been awarded another degree or diploma.
No other person’s work has been used without due acknowledgement in the main
text of the thesis. This thesis has not been submitted for the award of any degree or
diploma in any other tertiary institution.

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CONTENTS
INTRODUCTION…………………………………………………………….……..8
Chapter 1: Theory …………………………………………………………….……11
1.1.

Concepts…………………………………………………………….…...11

1.2.

Stages in strategy establishment………………………………………...12

1.3.

Analysis of the operational environment of the business organization…15

1.3.1. Analysis of external environment…………………………………...16
1.3.2. Analysis of internal environment…………………………………....20
1.4.

Proper strategies for the organization……………………………………21
1.4.1. SWOT Matrix………………………………………….……..21
1.4.2. IE Matrix……………………………………………………..23

Chapter 2: Analysis and evaluation of the operation of the National Institute of
Infectious and Tropical Diseases…………………………………………………..29
2.1.

General introduction to the institute …………….………………….…..29

2.1.1. History…………………………………………………………….…29
2.1.2. The organization of the hospital……………………………………..30
2.1.3. Number of wards……………………………………….…………....32
2.2.

Analysis of External Environment..………………………………….….32

2.2.1. General environment…………………………………………….…..32
2.2.2 Industry environment (Medical environment)………………………37
2.2.3. Competitors’ environment…………………………………………..38
2.3.

Analysis of internal environment………………………………….…….42

2.3.1. Finance………………………………………………………………42
2.3.2. Organization and HR…………………………………………….......45
2.3.3. Infrastructure, facilities and technology………………………….….48
2.3.4. Image of the hospital and its brand………………………………….49
2.3.5. Training and research…………………………………………….….50
2.3.6. Leadership in the fight against infectious diseases………………….51

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2.3.7. International cooperation……………………………………………51
Chapter 3: Establishment of the development strategy of the hospital to 2020…...52
3.1.

Vision…………………………………………………………………...52

3.2.

Missions NIITD………………………………………………….……...52

3.3.

Bases on which NIITD sets up goals and objectives……………….…...52

3.3.1. Development estimates……………………………………….……..52
3.3.2. SWOT Matrix ……………………………………………………....55
3.3.3. Internal-External Matrix …………………………………………....56
3.4.

Establishment of development strategy……………………………..…..58

3.4.1. Strategy on working skills……………………………………….….58
3.4.2. Strategy on scope………………………………………………….....62
3.4.3. Strategy on structure and organization……………………………....62
3.4.4. Strategy on HR development………………………………………..66
3.4.5. Strategy on infrastructure and other facilities……………………….66
3.4.6. Financial strategy…………………………………………………....67
3.4.7. Strategy on professionalzing the services provision of the hospital…
69
3.4.8. Implementation roadmap…………………………………………….69
3.5.

Recommendations……………………………………………………….71

CONCLUSION…………………………………………………………………….73
REFERENCES……………………………………………………………………..74

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LIST OF ABBREV IATIO NS

National Institute

of Infectious and Tropical NIITD

Diseases
State Budget
National Goals
Projects
Medical Insurance

NSNN
CTMTQG
DA
BHYT

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LIST OF TABLES
Table 2-1: Description of wards……………………………………………………32
Table 2-2: Comparativeness and market share in 2008…………………………….38
Table 2-3: Number of patients when NIITD was a department
of Bach Mai hospital……………………………………………………………….41
Table 2-4: Number of patients after separation…………………………………….41
Table 2-5 : Financial figures over the past three years……………………………..43

Table 2- 6: Spendings over the years……………………………………………….44
Table 2-7 : Differences in revenue and spending…………………………………..44
Table 3-1: Estimates of patients to 2020…………………………………………...53
Table 3-2: Score table of internal factors…………………………………………..56
Table 3-3: Score table of external factors…………………………………………..57
Table 3-4: Human resources development plan……………………………………66
Table 3-5: Estimation of main financial sources up to 2020……………………….68

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LIST OF FIGURES
Figure 1 – 1: Comprehensive model of strategy management…………………….11
Figure 1 – 2: Model of the relations between business organization, external and
internal factors………………………………………… ………………………….15
Figure 1 – 3: Model of five competing forces according to M. Porter…………….18
Figure 1 – 4: SWOT Matrix…………………………………………………….….23
Figure 1 – 5: IE Matrix …………………………………………………………….27
Figure 2-1: Structure of NIITD…………………………………………………....31
Figure 3 - 1: Model SWOT Matrix…………………………………………….…..55
Figure 3 – 2: Model of IFE Matrix…………………………………………………58
Figure 3-3 : Gantt model of activities and their time frame………………………..69

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LIST OF CHARTS

Chart 2-1: Number of patients over the years……………………………………...41
Chart 2-2: Comparison of revenue and spending over the years…………………...43
Chart 2- 3: Distribution of human resources……………………………………….47
Chart 2- 4: Distribution according to education and qualifications………………...47
Chart 2- 5: Distribution according to ages………………………………………….48
Chart 3 – 1: Estimates of patients to 2020………………………………………….53

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INTRODUCTION

The system of state-run hospitals in Vietnam is considered vital part of health
care system in the country. State-run hospitals receive a big part of total medical
spendings of the state budget, accounting for 35.8%. Increases in the financial
resources and in the quality of services are those which should be paid attention to.
To do this, the goverment of Vietnam issued two important decrees No.
10/2002/ND-CP and 43/2006/ND-CP which gives state-run hospitals autonomy in
their financial policies. These two decrees are hoped to ease the operation of staterun hospitals by giving them a chance to increase their financial budget. In addition,
these are also hoped to give momentum for the whole medical system to increase
their service quality and increase the public health.
In recent years, tropical and infectious diseases such as HIV/AIDS, SARS,
different types of flu (H1N1) strike Vietnam heavily. The National Institute of
Infectious and Tropical Diseases (NIITD) is the leading medical organization in
Vietnam which is fighting those diseases. However, so far there is not a very
comprehensive development strategy for the hospital. In order for the hospital to

operate more effectively, it is necessary to establish a comprehensive development
strategy. This study is conducted with the hope to provide a development strategy
for NIITD to 2020.
Aims of this project:
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Provide a brief review of literature on the planning of development strategy.

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Provide some analysis, assessment and evaluation of the operations of NIITD
over the past three years and different kinds of factors (internal and external)
based on which the development strategy for NIITD will be built.

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Establish a developmental strategy for NIITD from 2010 to 2020.

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Work out measures and make some recommendations and suggestions for
NIITD to achieve its strategic goals.

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Subjects and scope of the study:
Analysing business environment of the hospital from 2007 to 2009 in order to orient

the business strategy for the period of 2010-2020.
Methodologies:
Data collecting methods:
Primary sources: personal meetings with those in charge and those who can provide
information (Board of Directors and staff).
Secondary sources: hospital’s reports, newspapers, medical magazines, Internet, etc.
Comparison, analysis and synthesis:
Make comparisons between different variables, between specific objectives, goals
and real business achievements, etc. Then the authors will analyse the differences
between variables, objectives and goals set up and those real achieved. After that,
they will synthesize and summarize the results.
Use of tables, figures and charts:
The authors will use the tables and charts to find out the common things or
differences or trends of those variables analyzed and reflection on them.
Connection with experts:
The authors of the papers consult with experts in the subject matter for further
understanding of the data and conclusions of the matters concerned.
SWOT method:
Idenitifying and analyzing strengths, weaknesses of the hospital, opportunities it has
and threats it encounters.

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IE method:
Giving points and score to work out the direction for development of the hospital.
The authors of the papers will also try to use the data collected to reflect on theory
in the area of developmental strategy and use the ideas in the theory to evaluate the

operation of NIITD.
Organization: Three chapters
Chapter 1: Theory
Chapter 2: Analysis and evaluation of NIITD operations
Chapter 3: Establish the developmental strategy for NIITD to 2020

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CHAPTER 1:
THEORY
1.1. Concept
There are many different definitions of business strategy. Many of them claim
that business strategy is to do with art of implementation and monitor of business
activities in order to achieve long-term goals of a business organization. Here are
some:
According to Alfred Chandler (1962), strategy is the “determination of the basic long
term goals and objectives, and the adoption of courses of action and the allocation of
resources necessary for carrying out goals…”

“Corporate strategy is the pattern of decisions in a company that determines and
reveals its objectives, purposes, or goals, produces the principal policies and plans
for achieving those goals, and defines the range of business the company is to
pursue, the kind of economic and human organization it is or intends to be, and the
nature of the economic and non-economic contribution it intends to make to its
shareholders, employees, customers, and communities.” (Andrews, 1980).
“Strategy is the direction and scope of an organisation over the long-term: which
achieves advantage for the organisation through its configuration of resources

within a challenging environment, to meet the needs of markets and to fulfil
stakeholder expectations”. (Johnson and Scholes, 1992)
Bateman and Zeithaml pay attention to the psychological context of strategic
decision making, to its incremental nature, the role of historical antecedents and
individual biography, and the extent of convergence between personal and
organizational goals (1989).
In general, the definitions of strategy include the following features:
1. Clearly developmental goals measures in each periods.
2. Strategic directions which guide the activities of the business organization
and ensure the success of the organization in the constantly changing

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environment.
3. Mobilization of all the resources of the business organization and utilization
in the most effective way both in the medium and long term and grasp of
opportunities in order to become more competitive and successful.
4. Business strategy should be built with the philosophy that enables bold steps
which enhance success in the business environment.
5. Business strategy should be built for a long period rather than short term
(e.g. often 3-10 years at least).
Business strategy helps the business organization to:
1. realize clearly the goals and objectives in doing business.
2. seize the business opportunities and make the best use of those opportunities
to actively overcome threats and difficulties in the business environment.
3. increase the effectiveness of the use of the business’s resources with a view
to ensuring sustainable long-term development of the business organization.

4. create solid bases on which business policies and decisions are made so that
the business organization can survive and develop in the competitive and
constantly changing environment.
1.2. Stages in strategy establishment
According to Fred R. David, strategy management includes the following three
stages:
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Strategy formulation

-

Strategy implementation

-

Evaluation of the implementation of the strategy.

Stage 1: Strategy formulation
In this stage, the business organization has to establish the business goals and
objectives, to examine the strengths and weaknesses, opportunities and threats that

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the organization has to encounter. Based on the analysis of the strengths,
weaknesses, opportunities and threats, the business organization can set up its longterm goals and measures to achieve those goals, select its strategy and work out
alternative strategies. More specifically, the business organization has to consider

the following issues: what to penetrate, what to skip, how to allocate resources,
expand operations or diversify, enter international markets, merge or form joint
venture, avoidance of hostile takeover, etc.
Stage 2: Implementation of strategy
This second stage can also be referred to as action stage of strategic
management. Four activities often carried out in this stage is: (1) set up annual
goals, (2) make policies, (3) motivate employees and (4) allocate resources. This
stage is most difficult. It is to do with the mobilization of human resources
(managers and other staff) and other resources to carry out measures to achieve the
goals. In this regard, interpersonal skills and consensus on pursuing goals are
critical.
Stage 3: Evaluation
This last stage in the process often includes the following activities: (1)
review the bases for the present strategy which includes internal review and
external review, (2) measure the achievement of the goals and objectives or
performance measurement and (3) make adjustments to pave the way for
sustainable future development or corrective action.
This process is of great importance because present success does not means
the business organization will continue success in the future. So it is important for
the business organization to evaluate the present success comprehensively and to
learn lessons from the current success and failure so that it can succeed in the
future. It is also important for the organization to know that success creates new
and different problems and thus complacency will lead to demise.

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Process of strategy development

Feedback

External audit

Identify
current
missions
and
visions

Set up longterm goals

Set up
annual goals

Measure
and
evaluate
performa
nce

Allocation
of
resources

Finalize the
business
goals

Internal audit

Choose the
appropriate
strategies

Set up
policies

Feedback
Formulate
strategy

Carry out
strategy

Evaluate
strategy

Figure 1 – 1: Comprehensive model of strategy management

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Because the focus of this paper is placed on the establishment of the
strategy, the authors will concentrate on the period of planning the strategy.
1.3. Analysis of the working environment of the business organization
In order to establish the strategy for the business organization, it is necessary
for the organization to consider all the factors that can exert influences on the
operation of the organization. In this regard, it is important to focus on external

factors (e.g. general circumstances, the field in which the organization is operating,
competitors) and internal factors (e.g. the organization history, staff, etc.)
The relationships between the factors are presented in the following figure:

Demographic

Economic
Threats of
Potential Entrants

Political
/
Legal

Bargainin
g
power
of
suppliers

Industry Competitors
Rivalry among
existing firms

Bargaining
power
of buyers

Global

Threats of
substitute products
or services
Technological

Socialcultural

Figure 1 – 2: Model of the relations between business organization and
external and internal factors

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The above model shows us the influence of the external and internal factors exert
on the operation of the business organization.
1.3.1. Analysis of external environment
General environment:
The influence of the demographic environment:
Demography in the macroscopic environment has a connection with: Population;
Structure of age; Distribution of geography; Ethnic Community; Distribution of
income
The influence of the economic environment:
The condition of macroscopic economic environment determines the
wholesome and prosperousness of the economy. It also has an effect on businesses
and industries. Economic environment defines the essence as well as orientation of
economy in which buisiness operates. The influences of economy on a company can
make a change in making value and its income.
Here are four important factors of macro-economic environment:

•

Rate of growth of economy,

•

Interest,

•

Exchange rate,

•

Rate of inflation.

The influences of polical and legal environment :
The political and legal factors also have a considerable effect on opportunities and
threats from the environment such as: The related and new policies of the
government, Law, Industries the organization chooses to operate in, the fields in
which the managing policies of the State can influence on the orgnainzation’s

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activities and profits.
On global scale, companies have to face a series of noticeable matters about politics
and law as: Trade policies, Traditional barriers of protection set up by different

countries
The influences of cultural and social environment:
Social attitude and cultural Value create Social foundation, Changes,
Technical conditions, Political–Law, Economy and Demography. The social change
also creates opportunities and threats.
The influence of technnonogical environment:
Technology is a very active factor. It is changeable. For this reason,
technology brings businesses many oppotunies as well as threats. It is the fact that
few industry and business do not use or do not depend on Technology. It is sure that
a lot of advanced technology will be invented and come out into society. This
creates chances or threats for businesses and industries. The development of the
new technology can make a new market and as multiply many kinds of new
products as a result. Also, new technology can create a change in competitive
relationships in industries and make the existing products become backward and
their quality does not meet requirement of society. Changing in technology
influences on many parts of society.
Technology includes the activities which are related to creatation of new knowledge,
application that new knowledge in creating: new products, processes and new
materials. In short, Changing technology includes creativeness and extermination,
opportunities and theats. Changing technology can have an effect on the height of
the barrier and reorient the structure of industries at the root.
The global environment:
Global markets, existing markets which are changing, important international –

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political events, the institutional particularities and culture of global market,

globalization of market creates both opportunities and threats, therefore should be
aware of the different particularities in culture, society and institution of global
markets.
Analysis of industry environment and competitive environment
The analysis of industry environment is very important to external environment
analysis. Here we will present Porter’s five forces model to analyse:

Threats of
Potential Entrants

Bargainin
g
power
of
suppliers

Industry Competitors
Rivalry among
competing firms in the
industry

Bargaining
power
of buyers

Threats of
substitute products
or services

Figure 1- 3 : Porter’s Five Forces Model

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Rivalry among existing competitors in the industry
Industry consists of a group of companies which supply same or alternative
products or services.
Pressure from competitors should be taken into consideration and analyzed carefully
because it can directly threatens the existing and development of all businesses
operating in the same industry. The following factors affect the level of
competitiveness of companies: number of competitors, degree of competitiveness,
the growth rate of the industry, differences in products and services provided,
diversity
Threats of potential entrants:
According to M-Porter, the potential competitors are businesses which have not
appeared yet but will influence on industry in the future. Whether there are more or
less competitors and how much the competitors influence, the industry depends on
the following factors: industry attractiveness and the barriers when joining the
industry. The more competitors, the more competitive and the less profits the
companies in the industry gain.
The entry of new competitors depends on the industry attractiveness. The
attractiveness itself depends on economic environment and the “future” of the
industry, whether it can be profitable in the future and how profitable it is.
The entry of new competitors also depends on barriers to entry. The more
barriers, the less competitors and vice versa.
Joe Bain (1956) claims that three factors that can influence a company’s entry to
a industry: initial capital requirements, threat of price cutting by established firms,
and product differentiation.

Bargaining power of buyers
Buyer groups are likely to powerful if: Buyers are concentrated or purchases are
large relative to seller’s sales; Purchase accounts for a significant fraction of

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supplier’s sales; Products are undifferentiated; Buyers face few switching costs;
Buyer’s industry earns low profits; Buyer presents a credible threat of backward
integration; Product unimportant to quality; Buyer has full information. And buyers
often compete with the supplying industry by: bargaining down prices, forcing
higher quality and playing firms off of each other.
Bargaining power of suppliers
Suppliers are likely to be powerful if: Supplier industry is dominated by a few
firms; Suppliers’ products have few substitutes; Buyer is not an important customer
to supplier; Supplier’s product is an important input to buyers’ product; Suppliers’
products are differentiated; Suppliers’ products have high switching cost; Supplier
poses credible threat of forward integration. And suppliers exert power in the
industry by: threatening to raise or to reduce quality. Powerful suppliers can
squeeze industry profitability if firms are unable to recover cost increases.
Threat of substitute products or services
This is to do with products with similar function that buyers can choose.
Clearly, more substitute products can limit the prices that firms can charge.
Competiveness is high when the relative price of substitute products declines,
consumers’ switching costs decline and competitors plan to increase market
penetration or production capacity.
1.3.2. Analysis of internal environment
Studying the internal environment helps businesses to define what they can do.

Businesses can create good value for themselves and expoilt resources effectively
by exploiting key capacity or competitive advantage.
Human resources:

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Human resource plays an important role in success of business. For
example, a company has an excellent strategy but its staff do not work effectively,
they can not carry out the strategy successfully and thus the company can not
become profitable and successful. So businesses should prepare a good human
resource in order to achieve the targets set up.
Financial resource:
Financil condition is often considered to be the best method of evaluating
value of competitive position. It is also the best condition to attract investors.
Analyzing financial index is the most popular method to define the strength
and the weakness of organization about business finance.
Facilities and Equipment:
Equipment and technology help business to raise the ability of competition. .
However, investing on equipment requires a careful calculation when deciding to
invest.
Some other resources of business:
It depends on each business industry. Each business can consider some factors in
internal business which affect the business result.
1.4. Selection of strategy for business
1.4.1. SWOT Matrix
SWOT Analysis is to analyze the outside factors which businesses have to
face (Opportunities and Threats) as well as the internal factors of business

(Strengths and weaknesses). This is a hard job which requires plenty of time, labour,

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expenditure, ability to collect information, analyze and deal with it in the most
effective way.
A business organization has to identify opportunities and theats by analyzing data in
the following areas: Economy, Finance, Politics, Law, Society and competition at
the markets where businesses operate or intend to join in. Opportunities may include
potentiality of developing market, lack of markets, being located near to material
resource or cheap and skilled labour resource. Threats may include the limit of
market, more and more merciless competition, changes in strategy, politic
unstablility in key markets or the development of new technique which makes
existing equipment and facilities backward.
It is necessary for the business organization to analyse the internal factors including
strengths and weaknesses, for example skills, resources, technology, trademarks,
excellent managers and other advantages the organization has over its competitors
so that it can build a good image in the public and important or potential markets.
The weakness of business is shown by means of defects, weakness or skill, resource
or the factors which limit ability of competition of business. They are uneffective
distribution system, un-well labour relationship, shortage of experienced
international managers or backward products in comparision with the competitor...
SWOT is the abbreviation of:
Strengths - S
Weaknesses - W
Opportunities -O
Threats - T

SWOT Matrix helps us to develop 4 types of strategy:
• SO – strength– opportunities strategies: Use inner strength to make full
use of the outside opportunities.
• WO- weakness– opportunities strategies: Improving the inner weakness
in order to make full use of the outside opportunities.

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• ST- strength– threatens strategies: Use strengths to avoid or reduce the
effects of outside threatens.
• WT- Weakness - Threats strategies: Improving the inside weakness to
avoid or reduce the influence of outside threats.

SWOT Model

Opportunities (O)
Opportunities (S)

Weaknesses (W)

Threatens (T)

S+O

S+T

Use S to make full use

of O.

Use S to limit/avoid T.

W+O

W+T

Exploit O to cover with
O

Overcome W to limit T .

Overcome W to make
full use of O

Figure 1 – 4: SWOT Model

The result of analysis process of SWOT should be ensured to be concrete,
accurate, and satisfactory as business will use that result to develop the next actions:
establish strategy, strategic target, strategy and concrete system to control strategy:
Strategies are considered to be effective when they can make full use of outside O
and inside O and inside S as well as neutralize outside dangers, limit or overcome
the weaknesses of business itself.
1.4.2. IE Matrix

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IFE Matrix (IFE – Internal factors environment)

IFE Matrix summarizes and evaluates the important strengths and
weaknesses of the functional marketing part.
IFE Matrix is developed in 5 steps:
Step 1: Key internal factors
Conduct internal audit and identify both strengths and weaknesses in all
business areas. It is suggested 10 to 20 internal factors be identified, but the
more, the better. The number of factors has no effect on the range of total
weighted scores because the weights always sum to 1.0, but it helps to
diminish estimate errors resulting from subjective ratings. First, list strengths
and then weaknesses.
Step 2: Weights
Having identified strengths and weaknesses, the core of the IFE matrix,
assign a weight that ranges from 0.00 (unimportant) to 1.00 (very important)
to each factor. The weight assigned to a given factor indicates the relative
importance of the factor. Zero means not important. One indicates very
important. The weight assigned to a given factor indicates the relative
importance of the factor to being successful in the firm's industry.
Step 3: Rating
Assign a 1 to X rating to each factor. The rating scale can be per preference.
Practitioners usually use rating on the scale from 1 to 4. Rating captures
whether the factor represents a major weakness (rating = 1), a minor
weakness (rating = 2), a minor strength (rating = 3), or a major strength
(rating = 4). If the rating scale 1 to 4 is used, then strengths must receive a 4
or 3 rating and weaknesses must receive a 1 or 2 rating.
Step 4: Multiply
Now, multiply each factor's weight by its rating and we will have a weighted
score for each factor.

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