Strategic Map for Hospital Management: Perspectives and Priorities

IntroductionIt seems certain that there will be more changes in the healthcare industry in the next 15 years then there has been in the past 15 years. Why? What is the source of change? First of all, healthcare institutions continue to face a turbulent, confusing, and often threatening environment. It means that one of the most well described source of the change is external (Luigi et al., 2014). Legislative and policy initiatives, changes in demographics, increasing prevalence of chronic diseases, changes in lifestyles, consumers' lack of trust in traditional health systems, demand for more sophisticated, convenient, transparent, affordable and personalized service as well as increasing costs on healthcare (as % to GDP) have great impact on healthcare institutions Rudawska & Pctlak, 2013). This trends are well described in literature, and continuously researched by organizations and institution like: PWC (2014, 2015), CDC (Bernstein et al., 2003), Premier Healthcare Alliance, individual scientists (Rudawska & Urbanczyk, 2014) and practitioners.But there are also other sources of change. Nowadays, healthcare institutions change in the way every organization does (Rudawska, 2013). One issue of this change is especially important for healthcare institutions because of their specificity. It is sustainable development. The concept of sustainable development represents a shift in understanding of humanity's place on the planet (Hopwood et al., 2005). Why it is so important for management of a healthcare institution? Mostly, because these organizations are predestinated to implement sustainable development in some parts world-wide. In some parts they are doing it already. The UN have identified 17 goals and 169 targets of sustainable development (UN, 2015). One of the main goals is to ensure healthy lives and promote well-being for all at all ages. Some of the targets are obvious: reduce the global maternal mortality ratio to less than 70 per 100,000 live births or preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births. But some of them need additional effort. In particular, the epidemics of AIDS, tuberculosis, malaria and tropical diseases; combating hepatitis, water-borne diseases and other communicable diseases by the end of 2030 or reduce by one third premature mortality from non-communicable diseases through prevention and treatment and also, promoting mental health and well-being. Summarizing, healthcare institutions in future should become more open for the society, and more cooperative in fulfilling these goals.For hospital management it becomes increasingly difficult to adapt to the pace of policy changes and reforms while balancing economical considerations, social responsibility to provide high-quality health care to the community served and, finally, ecological concerns (Glouberman, Mintzberg, 2001). In this context, hospital management focuses on understanding the interconnections on the macro level - between society and the ecosystem - and changing its strategy to optimize the outcomes for these systems.Sustainable development concept requires managing hospitals on three different fields using three different value systems. Economic aims requires economic calculation of revenues, costs, incomes and expanses. Social aims in hospital management requires considering social reflections i.e. impacts of various diseases on society (epidemiology). Ecologic aims requires also different calculation. Ecologic calculation is focused on hospital impact on the environment. It is connected with waste management, drugs usage, as well as bioethics issues (Fig. 1). Between economic, social and ecologic aspects here there is an obvious conflict. The main source of this conflict is the lack of resources, especially financial ones (Urbaniec, 2015). …