Introduction To The Importance Of Strategy Management Tourism Essay

The purpose of this subdivision is to supply an debut to the importance of scheme direction. This chapter begins by supplying a brief definition of strategic direction so a reappraisal of bing strategic direction literature is provided, along with some theoretical accounts of strategic direction.

Following this, comes the reappraisal of the literatures related to strategic direction in health care sector followed by overview of the health care sector in Kuwait. Finally, a description of the research model used to place the strategic direction procedure in the Kuwaiti private infirmaries.The scheme construct has been in being for a really long clip ; really it was at that place since the Chinese military scheme. Theorists in concern started placing it from the 1960 ‘s ( Ansoff, 1980 ) . Harmonizing to the New Shorter Oxford Dictionary ( 1993 ) , scheme is “ The art or accomplishment of careful be aftering toward an advantage or a coveted endaˆ¦ ” while in concern theory scheme is “ … a program for successful action based on the reason and mutuality of the moves of opposing or viing participants ” ( The New Shorter Oxford English Dictionary, 1993 ) .

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Mintzberg et Al. ( 1998 ) says that scheme is: A program, way or class of action for the hereafter, scheme could be the placement of a merchandise in the market to guarantee that it meets the client ‘s demands, scheme is a tactical response to competition, it is what the organisation has been be aftering in the yesteryear and, scheme is the manner an organisation does its concern ( Mintzberg et al. , 1998 ) .Adapting strategic direction attack is believed by bulk of the research workers to profit the organisations by heightening the effectivity of the organisation. The relationship between strategic direction and effectivity was tested by many researches and was proven that there is a positive relationship between them.

The measuring of effectivity was chiefly by measuring the profitableness or the fiscal public presentation of the organisation ( Thibodeaux and Favilla, 1996 ) .Strategic direction is concerned with two major facets ; the first facet is the strategic direction procedure which includes external and internal environmental analysis, the planning preparation, execution and rating while the 2nd facet is the strategic content which deals with the result from the strategic direction procedure ( De Wit & A ; Meyer, 2004 ) .. This research will concentrate on the first facet which is the strategic direction procedure.


Harmonizing to Dess and Lumpkin ( 2003 ) , there are three ongoing procedures that are of import to the strategic direction procedure – scheme analysis, scheme preparation and scheme execution. These three procedures are reliable on each other, nevertheless, if one of the procedures was successful, it does non guarantee the prosperity to the organisation as a whole ( Dess & A ; Lumpkin, 2003 ) . ( Figure 2.1 )

Figure 2.1: Strategic Management Procedure

Strategic Analysis

Strategic Implementation

Strategic Formulation

Beginning: Adapted from Dess and Lumpkin, 2003Strategic analysis is considered by Dess and Lumpkin ( 2003 ) as the preliminary procedure to strategic direction procedure. This procedure consists of the analysis of the external and internal environment of the house which involves the designation of the organisation internal strengths and failing the external chances and menaces which is called SWAT analysis ( Hunger and Wheelen, 1996 ) .

Majority, if non all, research workers agreed that for an organisation to be able to be in harmoniousness with the environment that it is in, it should be able to analyse and/or learn from the internal and external environment.Besides, the presence of strategic program that is developed or emerged from this analysis and/or larning in add-on to procedure to accomplish this program would profit the organisation ( Harris and Ogbonna, 2006 ) .In order to confront the uncertainness that comes along with the hereafter, organisations have to explicate strategic programs.

Some of these benefits are the decrease of the uncertainness of the hereafter, the creative activity a competitory advantage, the focussing on the ends and aims and the creative activity of a theoretical account for decision-making. Besides, scheme depends on the construct of tantrum, allotment of resources and taking a position on money and hazard which suggest that strategic planning is about committedness of resources in a long term position ( Hamel & A ; Prahalad 1993 ) .A batch of literature in respects to strategic planning every bit good as scheme preparation and theoretical accounts are available. These literatures adapted assorted schools of idea in respects to strategic planning and preparation.

Mintzberg ( 1994a ) has summarized many of these schools based on ideas which focused on scheme formation. One of these schools is the formal strategic planning or the “ design school theoretical account ” which stressing on the presence of a formal written program that depends on the analysis of the external environmental menaces and chances and the organisational internal strengths and failing. It suggested that if these factors are analyzed, hereafter can be predicted and the organisation can be after for the hereafter consequently ( Andrews, 1971 ; Ansoff, 1988 ; Mintzberg, 1994a ) . Mintzberg ( 1994b, 1998 ) argued that this theoretical account has three false beliefs ; foremost, events in the hereafter can non be predicted, 2nd, strategic thought can non be separated from operation direction and 3rd, analysis, techniques and difficult informations can non bring forth fresh schemes.

Mintzberg, Lampel and Ahlstrand ( 1998 ) described the pros and cons of this theoretical account as follows: it can put an action program for the organisation but it can besides demo that the organisation is against external alteration ; it focuses on organizing attempt but so it limits vision ; it defines the vision for the employees in the organisation but the definition could be simple to do it alone from other organisations and ; scheme is usually put in topographic point for consistence and order and this does non promote creativeness.On the other manus, other research workers adapted another theoretical account called the “ emergent theoretical account ” which depends on “ test and mistake ” and organisation acquisition and it implies that the decision-making will consolidate strategic way ( Burgelman, 1988, 1996 ; Mintzberg, 1994b ) . The pick between these two strategic planning procedures was believed to be alternate and reliable on the environmental complexness, where formal planning is appropriate to concern that has stable and less complex environment while emergent procedure can be applied to complex and unpredictable environment ( Mintzberg, 1983, 1990 ; Powel, 1992 ) . However, resent articles have demonstrated that the formal planning is effectual in unstable environment ( Hopkins and Hopkins, 1997 ; Andresen, 2002 ) . Some researches examined the integrating between the two procedures and argued that they are complement, non alternate, to each other ( Hart and Banbury, 1994 ; Andresen, 2004 ) .As mentioned above, strategic direction procedure includes, in add-on to environmental analysis and planning, the execution of the strategic program which trade with the inquiry of the how the organisations will execute to accomplish their aims.

Most researches stated that effectual execution is of import to the prosperity of the strategic program and that bulk of the organisation can non efficaciously implement their schemes ( Beer et al, Bourgeois et al. , Deloitte and Touche cited in O’Regan and Ghobadian, 2002 ) . It is every bit of import for the organisation to be able to explicate and implement the strategic program ( Thompson& A ; Strickland, 1998 ; Vanconcellos, 1990 )In order to do certain that the strategic program will take to the accomplishments of the coveted ends and aims, the rating and control procedure is conducted. Harmonizing to Band and Scanlan ( 1995 ) , they identified the importance of the strategic control as a procedure that gives warrant to the direction that the processs and actions taken will consequences in the accomplishment of the planned aims and ends and leads to consistent organisational behaviour with specific propose, in add-on to supplying an uninterrupted monitoring and rating of organisational scheme ( Band and Scanlan, 1995 ) .


Harmonizing to Zallocco ( 1984 ) , he stated that the strategic planning techniques used in infirmaries are really much similar to that used in concern organisation.

Besides, Longest ( 1996 ) mentioned that the strategic planning procedure in health care organisations consist of a circle with three-stages: first phase is the scheme preparation, in which the organisation determines its way. Second phase is the scheme execution, in which the programs are carried out. Third phase is the strategic control, in which public presentation and the results are measured utilizing qualitative and quantitative techniques. Beckham ( 2010 ) explained that strategic planning in infirmaries involves several things: one, finding the most of import things needed to progress the quality of service in the infirmary ; two, planing a “ systematic procedure ” that helps take seamlessly to the hereafter. Strategic planning forces direction to do picks and that is what makes strategic be aftering “ aˆ¦both so hard and so good ” because it “ generates focal point ” ( Beckham, 2010 ) .Some theoretical accounts for the strategic planning procedure have been suggested in both healthcare strategic direction text books ( e.g. Begun and Heatwole 2004 ; Griffith and White 2002 ) and in academic articles ( e.

g. Champagne et Al. 1987 ; Zuckerman 2002 ) . These theoretical accounts, as in other concern sectors, are adapted from formal construction, emergent schemes or the integrating between both in one theoretical account.Research workers emphasized on the presence of some extra elements in the planning procedure which, in their sentiments, will better the health care public presentation.

Some of these elements are the presence of strategic map and the balanced scorecard of Kaplan and Norton ( 2004 ) ( e.g. Urrutia, I. and Eriksen, S. 2005 ) and the engagement of the doctors in the planning procedure ( e.g. Cuellar, A.

E. and Gertler, P.J.

2006 ) .Many articles and researches was conducted to exemplify and analyze different factors that influence strategic direction in health care sector and to find which of these factors are straight or indirectly linked to strategic direction. Besides, some research workers try to happen a correlativity between the factors act uponing strategic direction and fiscal public presentation of the infirmary.A comprehensive hunt for strategic planning or strategic direction in the health care sector in Kuwait yield no individual academic article or research that addresses this issue or even the general scheme that is used in this sector.


In order to be after for the hereafter, one must cognize the past and the present to understand what may go on. External analysis means to research and analyze the factors that may impact the organisation which the organisation has no control over them. For an organisation to be able to be in harmoniousness with the environment that it is in, the people in it should be able to larn from the external environment.

Acknowledging environmental alteration early plenty is of import for the organisation to last ( De Geus 1988 ) .Consequence of dynamism: dynamism, as defined by Reeves et Al. ( 2003 ) is the grade of unpredictable alterations that occur in environment, will impact the infirmary ability to accurately foretell the hereafter. Some of the factors that are related to dynamism are the engineering, political state of affairs, economic system and client demand. The more dynamism nowadays in the environmental factors, the more hard for the organisation to be after for the hereafter. In varies literatures, dynamism was referred to as instability, variableness or turbulency.

External ill will: the external ill will, or sometimes called the largess in the environment, means the grade of aggressiveness of the external environment in which organisation operate has. This includes how aggressive the competition is, the figure of regulative limitation and the deficits of inputs ( Reeves et al. , 2003, Miller and Friesen, 1984 ) .

Internal civilization

After cognizing the external environment, the organisation must place its internal strengths and failings to cognize its civilization so that it can adequately correlate its strengths and failing to the environmental chances and menaces. The chief purpose is to place the footing on which the organisation will vie and find the competitory advantage for the organisation. The organisation competitory advantage can be achieved by accommodating schemes that emphasizes on the organisation strengths and avoid the organisation failings ( Swayne, Duncan and Ginter, 2006 )



Strategy preparation is the development of long term programs to accomplish the strategic aims and recommendations. The pick of the schemes used to carry through the strategic aims has to be resulted from the environmental analysis in add-on to any emergent scheme evolved during the reappraisal of the old strategic rating. Strategic plans must place the specific stairss that will be taken to accomplish the aims by replying the inquiry of who will make what, how and when it will be done.

Being of strategic program:

Begun and Kaissi ( 2005 ) have examined the presence of the strategic program as a variable in finding the extend infirmaries perform strategic planning. Besides, Kaissi et Al.

( 2008 ) have argued that the presence of written strategic program genuine the organisation in forepart of its stakeholders. They concluded that the presence of strategic program significantly affect the fiscal public presentation of the infirmaries in a positive manner.

Time skyline of strategic program:

In their research, Harris and Ogbonna ( 2006 ) concluded that the relationship between the longer-term orientation of the strategic program of the infirmary and the likeliness of successful induction of strategic planning procedure has statistically important direct correlativity.

Whereas, Reeves et Al. ( 2003 ) mentioned that the clip frame used by infirmaries in strategic be aftering which they called “ future of determinations ” can be a related variable of the strategic constellation of the infirmaries.

Review frequence of strategic program:

The reappraisal frequence of the strategic program can be considered as index of the gait with which the infirmary is able to acknowledge divergence from the program. Delgado et Al.

( 2009 ) found that the strategic program review frequence is statistically important related with fiscal public presentation ( the higher the frequence, the higher the fiscal public presentation ) .

Physician engagement in strategic planning:

Physician engagement in decision-making procedure does non merely increase committedness to the strategic determination but besides heighten the quality of determination ( Parayitam, S. Phelps, L. and Olson, B. , 2007 ) . Besides, physician partnering in the strategic planning procedure is cardinal component for strategic planning to maneuver the organisation to success ( Alexander, K.

, 2006 )However, other research workers argued that the full integrating between the infirmary and the doctors leads to higher monetary values particularly in less competitory market ( Cuellar, A. and Gertler, P. , 2006 )

Centralization of strategic decision-making:

Centralization of strategic decision-making as defined by Reeves et Al. ( 2003 ) is ‘the extent to which the power to do long-run, strategic determinations is distributed throughout the organisation or is centralized in top direction ‘ ( Reeves et al.

, 2003 ) . Andresen ( 2004 ) has argued that organisations with decentralized decision-making have higher fiscal public presentation than those with centralised determination devising ( Andresen, T. , 2004 ) .


After the planning stage come the execution stage where the organisation tries to set its strategic programs into action. If the strategic program was clear and good prepared, its execution will confront less obstructions and will be, to some extent, easier to be executed. Wells et Al.

( 2004 ) have demonstrated that the absence of processs for the execution procedure will impede the effectual execution of the strategic plans.

Resources handiness for execution:

The handiness of resources needed for execution of strategic programs is considered an of import facet in accomplishing effectual execution. Harmonizing to Reeves et al. , ( 2003 ) , they defined resource handiness as ‘The sum of available stuffs, labour, capital, installations, and other resources that attributes to the organisation, non to the environment ‘ ( Reeves, T. , 2003 ) .

Internal communicating:

It was defined by Reeves et Al. ( 2003 ) as ‘the easiness and fidelity with which all sorts of information are dispersed throughout the organisation ‘ ( Reeves et al. , 2003 ) .

The presence of good communicating within the infirmary will ease the airing of the strategic program and its execution throughout the organisation. It besides increases the committedness degree to the organisational ends and aims by the staff ( Tourish, 1997 ) .



Strategic rating and control should be adapted to guarantee that the strategic program is implemented successfully and the desired results are produced. However it is of import to measure both the short and long term results of the strategic program, Wells et Al. ( 2004 ) have demonstrated that there is a deficiency of effectual techniques to mensurate the long-run results of the strategic program that leads to diminish in effectual strategic direction on the long tally.

Use of rating & A ; public presentation indexs:

The public presentation can be evaluated in infirmaries through three chief groups of indexs, the fiscal result indexs, the operation result indexs and the clinical result indexs ( Delgado, R. et al. , 2009 ) . Delgado et Al. ( 2009 ) found that bulk of infirmaries they examined use the fiscal indexs such as net income and budget discrepancy much more than the operation and clinical indexs.The most celebrated technique used to measure public presentation is the Balanced Scorecard which was developed by Robert Kaplan and David Norton in 1996.

The importance of the Balanced Scorecard comes from measuring the organisation public presentations and associating them together. Kershaw ( 2001 ) has developed a balanced scorecard theoretical account for infirmaries that can be used to implement and command schemes in health care sector where he mentioned that ‘the scorecard should steer the day-to-day actions of the unit staff to accomplish the infirmary ‘s mission of supplying patient focused attention ‘ ( Kershaw, R.,2001 ) .

Hospital Accreditation:

Hospital accreditation has been seen as a manner to command, better quality and heighten the direction system by adhering to the specifications and processs of the commissioned organisation. Accreditation is considered a strategic tool to incorporate procedure, invention, efficiencies, answerability, and sustained betterment in daily infirmary operations ( Ratcliffe, R. , 2009 ) .

Use of Information System:

The presence of information system provides the top direction with informations that can be used to measure the schemes used and authorise them to better apprehension of the internal environment. The usage of sophisticated information system will significantly heighten the continues quality betterment ( Lee et al.

2002 ) and accordingly will develop the effectivity of the strategic direction procedureHenderson ( 1992 ) explains that when infirmaries are encompassing a strategic alliance of their engineerings, direction needfully must inquire the undermentioned inquiries: a ) how the infirmary gets its staff to utilize the information system? B ) What are the 2 or 3 “ emerging information engineerings ” that are critical to the infirmary ‘s scheme? degree Celsius ) What back uping applications, architectures, and communicating capablenesss does the infirmary demand to do the strategic program to the full functional? And vitamin D ) what preparation will the professionals need to do certain that the infirmary has the accomplishments to to the full use the information system? ( Henderson, 1992 )


Overview of the Healthcare System in Kuwait

The health care sector in Kuwait is divided into governmental sector and private sector. The governmental sector provides the health care service through primary health care clinics ( PHC ) , general infirmaries and specialised infirmaries while the private sector consists of private infirmaries, private clinics and private poly-clinics.

The governmental health care is divided geographically into 5 wellness zones ( Asma, Fahaheel, Hawally, Farwaniya and Jahra wellness zone ) . Each zone contains one public general infirmary and in each residential or industrial country inside the wellness zone, there is at least one PHC. The locals are entitled to have the medical service and the medicine free of charge, while the exiles have to pay an obligatory wellness insurance every twelvemonth. In add-on, expatriates pay fees for each visit to the doctor of about 3-6 $ US and gets some research lab trials and some enlisted medicine for free.

Merely the local doctors are authorized to open private clinics while the private infirmaries and the private polyclinic must be owned by Kuwaiti individual or organisation.With the exclusion of the KOC ( Kuwait Oil Company ) infirmary and the Defense infirmary which provides the health care service merely to the employees in the oil sector and in the Ministry of Defense severally, all the private infirmaries are for-profit organisation.The entire outgos on wellness in 2005 were 3.9 % of the state GDP and US $ 552 per capita where the populace sector represents 78 % of the entire wellness outgos ( WHO, 2006 ) .


The research theoretical account applied in this research ( figure 2.

2 ) used the theoretical account of Hunger and Wheelen ( 1996 ) as a anchor taking into consideration the formal planning theoretical account of the design school ( Ansoff, 1980 ) and Mintzberg ‘s ( 1994 ) emergent scheme theoretical account. The theoretical account implies that the strategic direction procedure begins with the environmental analysis which includes external environmental analysis to larn from the external environment and acknowledge environmental alteration early to better program for the hereafter ( De Geus 1988 ) . The environmental analysis besides includes analysing the organisation from inside to find what its capablenesss and restrictions.After the analysing the environment, the consequences of this analysis are used to explicate a alone strategic program that will give the organisation an border over its rivals ( Ansoff, 1980, O’Regan, N. and Ghobadian, A.

2002 ) .The following measure is the execution of the strategic program in which the organisation tries to efficaciously execute the action programs mentioned in the strategic program utilizing different tactics.The concluding measure includes how the organisation will command the execution of the strategic program to guarantee that the coveted result will be achieved. It besides includes the rating of the results of the implemented strategic program to find the prosperity of the schemes used and if there is a demand to modify or alter the scheme which will be taken into consideration in the following strategic program preparation as an emergent scheme.The pick of the variables used in this theoretical account was adapted from old researches turn toing different facets of strategic direction procedure on health care sectors ( Ttable 2.1 ) .


External & A ; Internal Environmental Analysis

Consequence of dynamism

External ill will

Internal civilization

Strategic Planning Formulation

Being of strategic program

Time skyline

Review frequence

Physician engagement


Strategic planning Execution

Handiness of resources for execution

Internal communicating

Strategic Evaluation & A ; Control

Evaluation & A ; Performance indexs

Foreign accreditation

Use of information system

Strategic Managementgure 2.2: The research Model

Table 2.1





Environmental analysis

Dynamismthe grade of unpredictable alterations that occur in environmentReeves, Duncan and Ginter, 2003




Hostilitythe grade of aggressiveness of the external environmentReeves, Duncan and Ginter, 2003



Miller and Friesen, 1984Internal civilizationA The strengths and failings within the organisationSwayne, Duncan and Ginter, 2006

Planing preparation

Being of strategic programthe being of written formal strategic program ABegun and Kaissi, 2005Kaissi, Begun and Hamilton, 2008Time skylinethe clip frame the strategic program coverHarris and Ogbonna, 2006



Begun and Kaissi, 2005



Reeves, Duncan and Ginter, 2003Review frequencethe frequence by which the strategic planning is reviewedDelgado and Langabeer II, 2009


Begun and Kaissi ( 2005 )Doctors ‘ engagementthe engagement of doctors in strategic planning procedureParayitam, S. and Phelps, L.

, 2007


Alexander, K. , 2006



Cuellar and Gertler, 2006


Resource handinessThe sum of available stuffs, capital & A ; other resources that attributes to the organisation, non to the environmentReeves, Duncan and Ginter, 2003



Internal communicatingthe easiness and fidelity with which all sorts of information are dispersed throughout the organisationTourish, 1997


Reeves, Duncan and Ginter, 2003

Evaluation & A ; Control

Use of rating & A ; public presentation indexsthe figure of indexs & A ; techniques used to measure and command execution of strategic schemesDegado, R. et al. , 2009Kershaw, R.

,2001Hospital accreditationthe accreditation of the infirmary from external accreditation organisationRatcliffe, R. , 2009Information systemthe usage of information system in the strategic direction procedureLee et Al. 2002



Henderson, 2009


3.1 Introduction

In the old chapter, the chief procedures dwelling the strategic direction in health care sector were discussed and explained, besides the features of each phase was mentioned from many different beginnings. During the literature reappraisal, it was found that there is a deficiency in the articles concerned strategic direction procedure in infirmaries in the Middle East part and particularly in Kuwait.This chapter will discourse the design and methodological analysis used in this research and the grounds for taking such design and method. It will clear up the aims of the research and province the chief purpose of carry oning this research and what the research is intended to reply.


Strategic direction has been adapted by many organisations in different industrial sectors including the health care sector. It provides the organisation a tool to hold a competitory advantage over its rivals and assisting the organisation to better prepare for the hereafter.A comprehensive hunt in research articles revealed no individual one turn toing the strategic direction procedure in the health care sector in Kuwait either in private or governmental sectors. This absence of research particularly in the private health care sector makes the strategic direction procedure slightly obscure and ill-defined therefore the development of such organisations can non be done without cognizing what the current direction patterns in these organisations are.

It is beneficially to place the cardinal variables linked to the strategic direction procedure that is used in the Kuwaiti private infirmaries. Therefore, the conductivity of an explorative research turn toing the strategic direction procedure may assist in developing a more equal strategic direction.


The chief purpose of this research is to analyze the strategic direction procedure in the private infirmaries in Kuwait. This purpose will include the undermentioned aims:Identify the pattern of the strategic direction in private infirmaries in Kuwait.

This aim is taking to research how the strategic direction is conducted in the private infirmaries therefore giving better apprehension of the ways the strategic direction is performed in this sector.Assess the variables that influence the strategic direction procedure in the Kuwaiti private infirmaries.This aim will reply the chief inquiry of the research. The cognition of the variables taken into consideration in the procedure of strategic direction, will find the chief features of the strategic direction in the Kuwaiti private sector.Explore the differences between strategic direction procedure in Kuwaiti private infirmaries and in old literatures in the same sector.

It will be interesting to cognize whether the variables identified by the interviewee will fit that determined in the old literatures



The major inquiry this research will seek to reply is:How can we qualify the strategic direction patterns in Kuwaiti private infirmaries?The research inquiry is aimed to the characteristic patterns in the Kuwaiti private infirmaries when executing the strategic direction procedure. To reply the inquiry, the research will concentrate on the phases of strategic direction procedure instead than its content.



The minor research inquiries are:What is the strategic direction procedure in Kuwaiti private infirmaries?What are the variables act uponing the strategic direction procedure in Kuwaiti private infirmaries?What are the common features of the strategic direction procedure in Kuwaiti private infirmary?

3.5 Proposition

The strategic direction procedure described by many research workers and faculty members ( e.g. Mintzberg ( 1990 ) , Dess and Lumpkin ( 2003 ) and Harris and Ogbonna ( 2006 ) ) begins with environmental analysis which form the base for the strategic pick and counsel to the strategic decision-making, therefore it is proposed that:

Private infirmaries directions in Kuwait execute both external and internal environmental analysis.

It was concluded that the presence of written strategic program is of import to steer the staff and act as a mention for how and when aims are conducted and besides, it significantly heighten the public presentation of the infirmaries ( Begun and Kaissi,2005 and Kaissi et al. , 2008 ) , therefore it is proposed that:

Private infirmaries in Kuwait have written strategic programs.

Most researches O’Regan and Ghobadian, ( 2002 ) stated that effectual execution is of import facet for the strategic program to be successful.

While Thompson& A ; Strickland ( 1998 ) and Vanconcellos ( 1990 ) argued that it is every bit of import for the organisation to be able to explicate and implement the strategic program. Besides it is useless if the strategic program is non implemented, therefore it is proposed that:

Private infirmaries in Kuwait have effectual execution procedure

Since the strategic rating and control as a procedure gives warrant to the direction that the actions taken by the material will consequences in the accomplishment of the coveted ends ( Band and Scanlan, 1995 ) , therefore it is proposed that:

Private infirmaries directions in Kuwait perform strategic rating and control.


The methods used in the direction research are qualitative method, quantitative method or combination of both. The quantitative method uses numerical informations in roll uping and analysing the informations, while the qualitative method uses non-numerical informations in roll uping and analysing the information ( Saunders et Al, 2009 ) . Neuman ( 2000 ) identified the differences between qualitative and quantitative methods. He argued that in quantitative method the hypothesis are determined and so it is tested, the informations collected and its analysis is in the signifier of Numberss and it uses statistical techniques to find the cogency of the hypothesis.

While in the qualitative method, there is no preset hypothesis, the informations collected and its analysis is in the signifier of word and uses non statistical techniques to come up with consistent portray ( Neuman, 2000 ) .This research used the qualitative method because of the demand for better apprehension in the country of strategic direction in the private health care sector. Besides, this method will let an in deepness research and more equal geographic expedition of this issue.


1 Research Model

The theoretical account identifies variables that are believed to be linked to the strategic direction procedure across its four phases. These variables were adapted from different old literatures conducted to measure the strategic direction procedure in health care sectors.The assessing of these variables will find the features of the strategic direction procedure in Kuwaiti private infirmaries. The research theoretical account is based on Hunger and Wheelen ( 1996 ) theoretical account and the variables are categorized into four phases which are: the environmental analysis ( external and internal ) , the planning preparation, the execution and strategic rating and control. The theoretical account ( figure 3.

1 ) was described in inside informations in subdivision 2.5.

External & A ; Internal Environmental Analysis

Consequence of dynamism

External ill will

Internal civilization

Strategic Planning Formulation

Being of strategic program

Time skyline

Review frequence

Physician engagement


Strategic planning Execution

Handiness of resources for execution

Internal communicating

Strategic Evaluation & A ; Control

Evaluation & A ; Performance indexs

Foreign accreditation

Use of information system

Strategic ManagementFigure 3.1: Research Model


As this research is taking to place the procedure of strategic direction through roll uping informations to measure the variables act uponing the procedure, therefore the research will accommodate the inductive theory attack, alternatively of the deductive attack, as the first includes aggregation of informations and development of theory as a consequence of analysing the information collected, while in the deductive attack, the development of theory and hypothesis is conducted and the research is taking to prove these hypothesis ( Saunders et Al, 2009 ) .



The research design, harmonizing to Robson ( 2002 ) , concerned in change overing the research inquiry and objectives into a research undertaking ( Robson, 2002 ) which is done through placing the intent of the research, the pick of research scheme, clip skyline and the method of informations aggregation that will be used in the research.


Harmonizing to Saunders et Al ( 2009 ) , research intent is classified into three classs, the exploratory survey, the descriptive survey and the explanatory survey.They argued that the explanatory survey is taking to setup informal correlativity between variables and explicating this correlativity through look intoing an issue or a job.

However, the descriptive survey is concerned with pulling a image of the incident before the aggregation of the informations. Meanwhile, the exploratory survey is turn toing the demand of lighting the apprehension of an issue when the exact nature of the job is ill-defined and explores what is traveling on to place new information about the issue being examined ( Saunders et Al, 2009 ) .Therefore, this research is considered as exploratory survey because the strategic direction procedure in the Kuwaiti private infirmaries is ill-defined due to the deficiency of literatures turn toing this issue.



The research clip skyline may be cross-sectional survey or longitudinal survey. In the longitudinal survey, the research is taking to look into the alteration or development of an issue over a period of clip. While in the cross-sectional survey, the research is look intoing an issue at a specific clip and it is chiefly used when there is clip constrains ( Saunders et al, 2009 ) .This research used the cross-sectional survey as it is analyzing the strategic direction procedure in the health care private sector now.

3.8.3 Target Population and Sampling Methods

The mark population in this research is the top, senior and in-between directors in the private for-profit infirmaries in Kuwait who are concerned with one or more stages of the strategic direction procedure. Twenty six top and in-between directors from nine private infirmaries who fit the above standards were contacted to execute a face-to face interview with them.

Merely 15 directors accepted to execute in-depth interviews with them. Those directors represent six private infirmaries ; the following tabular array shows the figure of directors interviewed per infirmary. ( Table 3.1 )

Table 3.1: Number of respondents per infirmary

Hospital Name

Number of Responders

New Dar Al-Shefa Hospital3Taiba Hospital3El Sief Hospital3Al Hadi Hospital2Royal Hayat Hospital2Al-Salam Hospital2


4 Data Collection

The informations aggregation technique used in this research was chiefly gathered through face-to-face interviews and secondary informations. The interviews were conducted with participants who have experience and are affecting in any portion of the strategic direction procedure. The participants were given the opportunity to uncover their feelings and positions. A program of research protocol was written to assist and steer the research worker during the interviews. The research protocol contains four subdivisions stand foring the four phases of strategic direction procedure described in the research theoretical account. The expected result was included in the research protocol to give intimations to the research worker of the needed result desired from the inquiry asked ( Appendix ) .The interview inquiries was developed utilizing different techniques. Some inquiries were adapted from old literatures turn toing, to some extent, similar aims ( Beguan et al, 2005 ) , other inquiries were developed in such a manner to garner the information needed to be obtained.

The informations collected from interviews are considered primary informations as it is coming from direct beginning. The interviews were recorded after the permission from the participants ; besides the verbal and verbal looks of the participants were taken into consideration by the research worker during the interview.The other technique used in informations aggregation was the external informations coming from literature reappraisal which included books, periodicals and research articles obtained from library and electronic databases available on the cyberspace. This reappraisal helped in building the anchor of the research and in concentrating in the type of information and information needed to be collected.



Harmonizing to Saunders et Al. ( 2009 ) , the qualitative informations analysis can be performed utilizing one or more of the undermentioned procedure: summarizing of significances, classification of significances and/or structuring of significances. The research worker used the classification of intending procedure in analysing the information collected.The classification was done depended on the research theoretical account which is divided into four chief subdivisions harmonizing to the phases of the strategic direction procedure. Each subdivision contains subdivision stand foring the variables act uponing this phase.

These subdivisions and subdivisions are summarized as follows:

External & A ; Internal Environmental Analysis:

Consequence of dynamismExternal ill willInternal civilization

Strategic Planning Formulation:

Being of strategic programTime skylineReview frequencePhysician engagementCentralization

Strategic be aftering Execution:

Handiness of resources for executionInternal communicating

Strategic Evaluation & A ; Control:

Evaluation & A ; Performance indexsForeign accreditationUse of information systemThe interview replies will utilize the same construction as above where the informations obtained from the respondents will be grouped together and categorized harmonizing to the above construction and the informations will be analyzed consequently concentrating on each variable to find the importance of these variables across all the respondents.

3.9 Summary

This chapter discussed the research the aims and the inquiries that the research is turn toing in add-on to the methodological analysis and design used in this research. The ground for accommodating a qualitative methodological analysis was highlighted. This research is considered to be an explorative and cross-sectional survey with an inductive attack.The methods for informations aggregation and analysis were besides discussed in add-on to the mark population and trying method used in the research.


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