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Analysis of the external and internal environment of a medical organization. Factors in the internal environment of the organization. Introductions Medical organization - an organization operating in the field of healthcare or the provision of medical services

The effective functioning of an enterprise in a market environment depends on internal and external factors.

The internal environment of an organization represents situational factors within the enterprise that require the constant attention of managers.

all its constituent elements, connections and relationships between them regarding production and management.

Variable factors of the internal environment of the organization include:

structure,

technologies,
staff.

Goals are specific end states or desired result that the organization strives to achieve.

Industrial enterprises usually have several goals: gaining market share, developing new products, improving the quality of services, minimizing costs, increasing productivity, profitability, etc. Since most enterprises have several production units with their own set of goals, the task of management is to to prevent a mismatch between these goals and the goals of the enterprise.

The structure of an organization is a logically constructed relationship between management levels and functional units in a form that allows the most effective way to achieve the goals set.

The management structure of a particular enterprise is influenced by the features of the horizontal and vertical division of managerial labor. Depending on the scope of control (the number of persons subordinate to one manager), a distinction is made between “high” (2-3 subordinates) and “flat” (4-6 subordinates) management structures. The smaller the sphere of control (controllability norm), the more levels of management.

A task is a prescribed job, a piece of work or a set of jobs that must be completed in a predetermined manner within a given time frame. Tasks are not set for specific employees, but for positions.

One of the important characteristics of tasks is their repetition. Machine operations may be repeated many times during a shift. Management operations can be both highly repetitive and unique. Solving unique problems is usually much more difficult.

Technology is a combination of skilled skills of workers, equipment, infrastructure, production processes, relevant technical knowledge necessary for the transformation of raw materials, materials and information.

There are several classifications of technologies: technology of single, serial and mass production; technology of discontinuous and continuous production (geological exploration and oil refining); multi-link technologies (well construction); intermediary technologies (banking services, employment offices), etc.

Personnel are the main factor in any management model.

Employees of an industrial enterprise can be characterized using mainly qualitative criteria: abilities; predisposition to perform a certain job; physiological and psychological needs; expectations regarding business and personal goals; perceptions of any events; relations to other employees and their groups, etc. It is important for an enterprise that all the advantages of each person are revealed most fully, which will bring a certain effect to the enterprise.

The internal environment of an organization is a single whole consisting of interconnected parts.

An enterprise as an open system depends on the external environment in relation to the supply of resources, energy, labor, product consumers, competitors, etc.

The most important characteristics of the external environment are:

complexity (the number of factors to which the enterprise must respond, as well as the level of variation of each factor);

mobility (the speed with which changes occur in the environment of the enterprise);

uncertainty (a function of the quantity and quality of information on the basis of which decisions are made).

External factors are divided into two groups: direct factors and indirect factors.

Management depends on an infinite number of factors. All factors influencing the management process are often divided into controllable and uncontrollable. In a number of cases, we speak not about absolute, but about relative controllability/uncontrollability of certain processes. More or less directly controllable variables are classified as factors in the internal environment of the organization. Those that are less subject to the manager's control are considered as environmental factors.

TO internal environment of the organization include such factors as goals, objectives, personnel, structure, technology. In the previous topic, attention was paid to the analysis of the structure of the organization. In this section, we turn to a consideration of the essence and significance in the organization of its goals and objectives.

Staging goals– the most important starting point of the management process. Organization is complex multi-purpose system, closely connected with the surrounding world and having a comprehensive impact on it. Managing such a system requires defining the entire set of goals and objectives that it must solve in its daily activities; the products it will produce and the markets it will serve; necessary resources to implement planned goals and ways to achieve them.

The main point of intra-organizational goal setting is the formulation of the mission of a given organization, which reflects its characteristics, reasons for existence and its future role in society. Mission- this is a general (strategic) goal that cannot be specified by quantitative parameters, but characterizes purpose And philosophy which should this organization. The mission presupposes the presence of certain values, rules and techniques that the company uses in its activities. This is the microculture of the company, its traditions, the approach of managers to decision making, that is, the uniqueness that makes the organization unique and different from others. The mission, on the one hand, provides information about the organization to its employees and possible applicants for work in this organization, on the other hand, it forms an appropriate opinion about itself in the eyes of the external environment. As a rule, the mission of the organization is formed over the years, honed and rarely changes.

The concept of “mission” is new to our economy. Under the conditions of the planned structure, it was automatically set through the structure of directive indicators from higher authorities. In a competitive environment, the mission becomes of great importance. A mission statement details the status of an organization and provides guidance for defining goals and strategy at various organizational levels.

The formation of the mission is influenced by:

– owners of the organization, developing the organization in order to solve their life problems at the expense of profit;

– employees of the organization who directly create the product, organize the receipt of the necessary resources, ensure (through marketing) the sale of products and thus solve their life problems and interests;

– buyers of the company’s products, using their financial resources to purchase products to satisfy their needs and interests;

– business partners of an organization who provide it with certain commercial services in their own interests.

When forming the mission of the organization, it is necessary to take into account the interests of all these subjects, each of which influences in different decisions different influence. A clearly stated mission differentiates an organization from others like it. To do this, it must be formulated the following characteristics organizations:

– the organizational philosophy chosen by the company administration for organizing work;

– the sphere of activity of the organization, the consideration of which is necessary for the selection of resources and products;

– a system of its goals, showing what the organization strives for;

– technological capabilities of the organization.

Thus, a mission is not a specific instruction about what to do and in what time frame. It only forms general direction movement of the organization, taking into account its external and internal conditions. This is a very important statement from management, reflecting the socially significant intentions of the organization, as well as giving an idea of the scope of activity, key goals and operating principles.

The mission of the organization to a certain extent influences the forecast of the company's actions, which is determined by market conditions and the chosen period of existence of the company. This is where the managerial content of the mission is revealed, since the mission is a set of strategies that the company’s administration develops to achieve global goals.

When developing a mission, i.e. set of strategies, not only the external environment (geopolitical, economic and social conditions), but also the systemic characteristics of the organization, the totality of resources, production or organizational processes, and products are studied.

The mission must be clearly formulated and communicated to every employee so that it is understood by them, since the goals and objectives of the organization will flow from the mission.

Management science has not developed any universal rules used in formulating a mission. There are only some general guidelines that management should consider. Among them:

– the mission is formulated outside the time frame, which allows us to consider it “timeless”;

– the mission should not depend on the current state of the organization, forms and methods of its work, since it is aimed at the future and shows where efforts will be directed and what values will be the most important for the organization;

– in the mission it is not customary to indicate making a profit as a goal, despite the fact that profitable work is the most important factor in the life of any commercial organization; but focusing on profit can significantly limit the range of development paths and directions considered by the organization, which will ultimately lead to negative consequences;

– the mission is formulated by senior management, which is responsible for full responsibility for its implementation by setting and implementing the organization’s goals;

– between the organization’s mission and more common system, of which it is a part, there should be no contradictions.

There are many approaches to defining the mission and its content, reflecting the assessment of the role and significance of the organization primarily by decision-makers. As already noted, the central point is the answer to the question: what is the main goal (purpose) of the organization? At the same time, it is preferable to put the interests, expectations and values of consumers (today and future) first.

An example is Ford's mission statement as “providing people with affordable transportation.” It clearly defines the area of activity - transport, the consumers of the product - people, as well as the focus on a wide range of consumers. Such a mission can have a decisive influence on the company's strategy and tactics, as well as public support for its activities. However, it lacks something that companies began to pay attention to later - this is a focus on the fundamental differences of a given company from others, as well as on its desire to reveal the talents of the people working in it.

Management specialists and leaders of many large companies believe that organizations should identify themselves in a mission not by a manufacturing product or service, but by a key purpose, that is, by definition: who we are and how we differ from others. In other words, what matters is not what a company produces, but what it stands for and what it will do in the future.

For example, Motorola defined its core mission as “using technology to benefit people,” rather than emphasizing that it makes network televisions or premium TVs. This formulation may seem quite broad and meaningless, but it provides specific choices about what to produce and to whom to sell. And this allowed the company to develop in directions that its competitors could not imagine, and thereby develop market immunity.

Many companies include provisions in their mission that emphasize value orientations, stimulate the work of staff and fill daily activities with meaning and awareness of its noble purpose for the benefit of people.

Thus, in the value system of the American company 3M there is an eleventh commandment, which reads: “Thou shalt not kill the idea of a new type of product.” And the mission statement of one Japanese company emphasizes such universal principles as “achieving excellence in all areas - in our goals, products, services, people and our lifestyle”; it emphasizes that “quality is an integral part of our products, our work environment and people”; its characteristics such as “honesty and openness, work in a single team, free exchange of information” are revealed. It makes an important statement: “We want people to be able to say that our company is a great place to work and that it supports and recognizes individual achievement.”

The mission forms the foundation for establishing the goals of the organization as a whole, its divisions and functional subsystems, each of which sets and implements its own goals, logical, arising from common goal enterprises.

Goals organization - the direction in which its activities should be carried out. This is the state in which organizations want to be. The goals of the organization are usually called operational goals. The goals set for the management system are the starting point for planning. In essence, planning is the development of the goals and objectives of the company, found specific expression in long-term and current plans. Goals are always formed by those who manage key resources in accordance with the value system of the owners of these resources. The top management of an organization represents such a resource. The value structure of leaders always influences the structure of goals. The formulation of goals is always influenced by the interests of a number of subjects:

– owners and managers;

– employees;

– business partners represented by suppliers and consumers;

– local authorities, which the organization helps to solve certain problems;

– society as a whole (local population, which may have different attitudes towards different organizations).

If we consider a goal as a desired result, then we must recognize that there are many goals - different depending on the type of organization. Some organizations are engaged in business, providing services, etc. – they always operate within specific constraints. Their goal concerns making a profit, reducing costs, i.e. indicators such as profitability, etc.

Other organizations (founders) - non-profits - operate in the service sector and do not receive profit as such, but they are concerned about costs, since they operate within budgetary constraints. The goal of the enterprise should take into account such areas of activity as market share, development of new types of products, quality of services, etc. Non-profit organizations also have various purposes, but they pay more attention to responsibility. In other words, in different organizations, as a rule, we have to deal with a set of goals. The task of the head of an organization at any level is to be able to take into account the variety of factors influencing the functioning of the organization, correctly assess the situation and choose the optimal solutions.

At each level of the organization, some private goals arise, and only their totality needs to be considered as a certain goal of a certain level of management. The goals of the organization form a hierarchy, i.e. they are in a relationship of hierarchical subordination. Goals top level are always more important and broader in scope than lower-level goals. Hence the need arises to build a tree of goals, which links the goals of various levels of management of the organization and in various areas of activity.

In the management structure of an organization, goals perform a number of actions (functions):

1) reflecting the philosophy of the organization’s activities and development, goals ultimately determine the nature and characteristics of this organization;

2) goals always reduce the uncertainty of current activities, since they are considered as guidelines, allow you to adapt to the environment, concentrate on achieving the desired results, and therefore regulate appropriate actions and behavior;

3) goals form the basis of criteria for highlighting decision-making problems and evaluating results;

4) goals always allow (regardless of their reality) to rally enthusiasts around them, take on additional responsibilities, and make efforts to fulfill them;

5) even the official proclamation of a goal is a confirmation of the need for the legitimacy of the existence of a given organization in the eyes of the public, even if this organization’s activities cause adverse consequences.

Goals are important from the point of view of the organization’s existence; they must satisfy a number of requirements:

a) must be specific, formulated in quantitative terms (as a rule);

b) must be real (in given specific conditions, otherwise there will be no effort to achieve them);

c) must be flexible (capable of transformation and adjustment in accordance with changing conditions);

d) must be compatible in time and space, so as not to disorient the performers in their actions (incompatibility leads to conflicts);

e) must be consistent and consistent with other goals, as well as with the resources required to achieve them;

e) must be recognized.

Goals are usually achieved through a combination of the overall goals of the organization and the personal goals of managers. Some compromise must be found: leaders must recognize and recognize the organization's goals as their own personal goals. Only in this case will they be interested in achieving results.

The goals of the organization are structural character, that is, they imply a certain classification:

- the goals of the organization are strategic, tactical and operational. The first ones are key, they are focused on solving long-term (5–10 years) problems; the latter are more specific and focused on more short period(from one to three to five years). Still others represent the specification of strategic and tactical goals to the level of tasks that specific performers must solve in their daily work (within a year, six months, quarter, month, working day);

– based on the period time, necessary for implementation, are distinguished: long-term(more than 15 years), medium term(1–5 years), short-term(1 year) goals;

– grouping goals by content built on the diversity of interests of the organization: highlight technological, economic, social, production, administrative, marketing etc. goals;

- in my own way level The goals of the organization are divided into are common And specific. Are common reflect the concept of development of the organization as a whole in the most important areas. And specific ones are developed in individual divisions of the organization and determine the main direction of their activities in terms of achieving common goals. TO specific goals include operational and operational. The first are the goals that are set for employees; the second are the goals that are set for a separate unit. The process of setting goals, depending on the characteristics of the organization, can take place centralized or decentralized. In the first case, they can be imposed, which can lead to resistance from lower levels; in the second case, they can be implemented from the bottom up;

– goals can be to quality And quantitative. If quantitative goals can be assessed in a single equivalent, for example in monetary terms, in years, in tons, etc., then assessing qualitative goals in quantitative terms is very difficult and requires the use of a method known as method expert assessments , which allows you to select the goal of operation, determine the priority of goals and their importance.

The expert assessment method is defined as a “procedure” that takes into account subjective opinion in order to determine quantitative relationships between variables when these relationships cannot be established from theoretical considerations or on the basis of accumulated statistical data. Consequently, the task of formulating the goals of an organization’s functioning using expert assessments is the task of obtaining an objective result based on the individual subjective opinions of a group of experts.

The value of the result obtained using the expert assessment method largely depends on the competence of the specialists involved in the experiment. Creating conditions for the fruitful activity of experts who select operational goals means the need to organize the most effective system of contacts between them, allowing:

– create conditions under which a specialist can actively interact with other experts;

– have free access to relevant information;

– exclude the possibility of incorrect interpretation of the opinion.

This method is the simplest, but has a number of disadvantages caused by the excessive influence of psychological factors. Recently, methods have been developed with which it is possible to overcome these difficulties by eliminating direct communication between specialists or by taking into account the qualifications of experts and weighing their opinions.

There are other classifications. For example, by importance goals are divided into especially priority(key), the achievement of which is associated with obtaining the overall result of the organization’s development; priority, necessary for success and requiring management attention; rest, also important but non-urgent goals that require constant monitoring.

I. Ansoff calls the allocation of goals by priority management based on the ranking of strategic goals and proposes a scheme for establishing ranks. To do this, all tasks are divided into four categories: a) the most urgent and important tasks that require immediate consideration; b) important tasks of medium urgency that can be solved within the next planning cycle; c) important but non-urgent tasks that require constant monitoring; d) tasks that represent a false alarm and do not deserve further consideration.

Each organization is connected by a variety of communications with other organizations that make up its business environment, influencing it directly or indirectly. According to this criterion, all goals are divided into internal goals the organization itself and for purposes related to its business environment (external).

Objectives of the organization. Based on the goals, the organization formulates tasks, which are pieces of work that need to be completed in a specified manner within a given time frame. Problems are a certain set of issues to be solved, as well as the conditions necessary for this solution. From a technical point of view, tasks are not assigned to the employee, but to his position. Based on management decisions about the structure, each position has a specific range of tasks that are considered as a necessary contribution to achieving the goals of the organization. It is believed that if tasks are completed in a given way and within a given time frame, then the organization is successful. Therefore, tasks compared to goals are more specific, because they have not only qualitative, but also quantitative temporal and spatial characteristics.

Tasks are more individual because they can include elements that are attractive to performers.

Two others important points in work: the time required to complete it; frequency of repetition of a given task. A machine operation, for example, might consist of performing the task of drilling holes a thousand times a day. Each operation takes only a few seconds to complete. The researcher performs varied and complex tasks, and these may not be repeated at all during the day, week or year. Some of the tasks require a researcher to complete several hours or even days. In general, we can say that managerial work is less monotonous, repetitive in nature and the time required to complete each type of work increases as managerial work moves from lower to higher levels. In a calm environment, tasks are repeated with a certain frequency, solutions are worked out for management big problems don't imagine. The situation is much more complicated in a dynamic environment, when new tasks arise all the time, the methods for solving them are not always obvious and the time for their implementation is unknown. These variables affect the quality of management primarily through the organizational structure, which must be rebuilt to solve a new range of problems.

Tasks, like goals, are subject to the principles of construction and functioning of large systems: they can be subjected to decomposition, they are characterized by the properties of synergy, non-addativeness, emergence, etc. "Task tree" characterizing the task as big system facing the socio-economic system is also an important element of program-targeted management.

The category of a task should be distinguished from the category of a problem, a problem situation. The problem can be considered as the main contradiction between the situation and the goal and as the main link in changing the situation towards achieving the goal. The category of a problem as a whole is much broader than the category of a task. The task is more related to the activities of managers, needs and interests, and the problem is more related to the correspondence of the situation and the goal. The same problem can generate an abundance of tasks. For example, the problem of overcoming the crisis state of the economy gives rise to tasks for every economic entity, for every producer and consumer. Solving problems involves the need to perform a complex network of procedures, during which material, labor and financial resources are set in motion. This sequence is implemented in the process of making and implementing management decisions.

Approaches to task classifications depend on the goals of the analysis and subsequent management decisions. Let's consider the two most promising approaches. At first of these, tasks are classified according to characteristics related to technological division of labor. Tasks of this type include the following:

1) actual management tasks related to operational management and leadership, implementation by managers of management functions, distribution of rights and powers;

2) organizational and economic tasks related to ensuring the unity and organizational integrity of socio-economic systems, achieving the required technical and economic parameters of systems, maintaining financial discipline, etc.;

3) ideological and educational tasks related to the formation of moral and ideological criteria and ideals corresponding public views and attitudes, needs of socio-economic development;

4) socio-psychological tasks, related to the improvement of diverse relationships between team members, the formation and development of the psychological climate in the team, management style, motivation of spiritual incentives, self-affirmation and self-expression;

5) scientific, technical, technological tasks, related to the provision of research, design, and technological solutions.

To one degree or another, each manager must have a wide range of knowledge in order to competently solve all these types of problems (or organize their solution), as well as have the appropriate legal levers and incentives. Naturally, there are no sharp, impassable boundaries between the content of tasks; on the contrary, these boundaries are quite mobile, conditional, and changeable. Typically, the problems to be solved are determined by experts.

The challenges facing managers can be classified as tasks of functioning and development. The solution of the former is intended to ensure the cyclical nature of the activities of production systems, the implementation of planned tasks, and the functioning of the activities of enterprise services. The second tasks (development) are associated with the inclusion of new elements and factors of production, new factors of scientific, technical and social nature, which requires constant updating and qualitative improvement of the entire management system.

Thus, achieving the set goal requires the preliminary solution of a set of specific tasks. Since the task represents the unity of questions and conditions for their resolution, a logical chain is formed: goal - tasks - result, in which tasks can be presented for simplicity as a sequence of questions and conditions.

The achieved result is compared with the previously set goal and serves as the basis for setting a new, refined goal, solving problems and obtaining a new result, etc. This process continues continuously: individually - as long as an individual person exists, socially - as long as society exists.

It is very important that this process is accompanied by self-education - goals are formulated and set more clearly, definitely, specifically; tasks were identified in full; the most favorable conditions were created for their solution. In many cases, it is useful to decompose goals, objectives, and results. It is generally accepted that the overall goal has been achieved if the main partial goals have been achieved, the main tasks have been solved, and the result deviates from the goal within acceptable limits.

TO internal environment of the organization include such factors as goals, objectives, personnel, structure, technology. In this section, we turn to a consideration of the essence and significance in the organization of its goals and objectives.

Staging goals– the most important starting point of the management process. An organization is a complex multi-purpose system, closely connected with the surrounding world and having a comprehensive impact on it. Managing such a system requires defining the entire set of goals and objectives that it must solve in its daily activities; the products it will produce and the markets it will serve; necessary resources to implement planned goals and ways to achieve them.

The main point of intra-organizational goal setting is the formulation of the mission of a given organization, which reflects its characteristics, reasons for existence and its future role in society. Mission- this is a general (strategic) goal that cannot be specified by quantitative parameters, but characterizes purpose And philosophy which this organization follows. The mission presupposes the presence of certain values, rules and techniques that the company uses in its activities. This is the microculture of the company, its traditions, the approach of managers to decision making, that is, the uniqueness that makes the organization unique and different from others. The mission, on the one hand, provides information about the organization to its employees and possible applicants for work in this organization, on the other hand, it forms an appropriate opinion about itself in the eyes of the external environment. As a rule, the mission of the organization is formed over the years, honed and rarely changes.

The formation of the mission is influenced by:

– owners of the organization, developing the organization in order to solve their life problems at the expense of profit;

– buyers of the company’s products, using their financial resources to purchase products to satisfy their needs and interests;

– business partners of an organization who provide it with certain commercial services in their own interests.

When forming the mission of the organization, it is necessary to take into account the interests of all these subjects, each of which has different influence in different decisions. A clearly stated mission differentiates an organization from others like it. To do this, the following characteristics of the organization must be formulated:

– the organizational philosophy chosen by the company administration for organizing work;

– the sphere of activity of the organization, the consideration of which is necessary for the selection of resources and products;

– a system of its goals, showing what the organization strives for;

– technological capabilities of the organization.

Thus, mission– this is not a specific indication of what to do and in what time frame. It forms only the general direction of the organization’s movement, taking into account its external and internal conditions. This is a very important statement from management, reflecting the socially significant intentions of the organization, as well as giving an idea of the scope of activity, key goals and operating principles .

When developing a mission, i.e. a set of organizational strategies, not only the external environment (geopolitical, economic and social conditions), but also the systemic characteristics of the organization, the totality of resources, production or organizational processes, and products are studied.

The mission must be clearly formulated and communicated to every employee so that it is understood by them, since the goals and objectives of the organization will flow from the mission.

Management science has not developed any universal rules used in formulating a mission. There are only some general guidelines that management should consider. Among them:

– the mission is formulated outside the time frame, which allows us to consider it “timeless”;

– the mission is formulated by senior management, which bears full responsibility for its implementation by setting and implementing the organization’s goals;

– there should be no contradictions between the mission of the organization and the broader system of which it is part.

When formulating a mission, it is preferable to put the interests, expectations and values of consumers (today and future) first.

Goals organization - the direction in which its activities should be carried out. This is the state in which organizations want to be. The goals of the organization are usually called operational goals. The goals set for the management system are the starting point for planning. In essence, planning is the development of the goals and objectives of the company, which have found concrete expression in long-term and current plans. Goals are always formed by those who manage key resources in accordance with the value system of the owners of these resources. The top management of an organization represents such a resource. The value structure of leaders always influences the structure of goals. The formulation of goals is always influenced by the interests of a number of subjects:

– owners and managers;

– employees;

– business partners represented by suppliers and consumers;

– local authorities, which the organization helps to solve certain problems;

– society as a whole (local population, which may have different attitudes towards different organizations).

In various organizations, as a rule, we have to deal with a set of goals. The task of the head of an organization at any level is to be able to take into account the variety of factors influencing the functioning of the organization, correctly assess the situation and choose the optimal solutions.

At each level of the organization, some private goals arise, and only their totality needs to be considered as a certain goal of a certain level of management. An organization's goals form a hierarchy: higher-level goals are always more important and broader in scope than lower-level goals. Hence the need arises to build a tree of goals, which links the goals of various levels of management of the organization and in various areas of activity.

Goals are important from the point of view of the organization’s existence; they must satisfy a number of requirements:

a) must be specific, formulated in quantitative terms (as a rule);

b) must be real (in given specific conditions, otherwise there will be no effort to achieve them);

c) must be flexible (capable of transformation and adjustment in accordance with changing conditions);

d) must be compatible in time and space so as not to disorient the performers in their actions (incompatibility leads to conflicts);

e) must be consistent and consistent with other goals, as well as with the resources required to achieve them;

e) must be recognized.

The goals of the organization are structural character, that is, they imply a certain classification:

– Organizational goals are strategic, tactical and operational. The first ones are key, they are focused on solving long-term (5–10 years) problems; the latter are more specific and focused on a shorter period (from one to three to five years). Still others represent the specification of strategic and tactical goals to the level of tasks that specific performers must solve in their daily work (within a year, six months, quarter, month, working day).

– Based on the period time, necessary for implementation, are distinguished: long-term(more than 15 years), medium term(1–5 years), short-term(1 year) goals.

– Grouping goals by content built on the diversity of interests of the organization: highlight technological, economic, social, production, administrative, marketing and other goals.

- In my own way level The goals of the organization are divided into are common And specific. Are common reflect the concept of development of the organization as a whole in the most important areas. And specific ones are developed in individual divisions of the organization and determine the main direction of their activities in terms of achieving common goals. TO specific goals include operational and operational. The first are the goals that are set for employees; the second are the goals that are set for a separate unit.

– Goals can be quality And quantitative. If quantitative goals can be assessed in a single equivalent, for example in monetary terms, in years, in tons, etc., then assessing qualitative goals in quantitative terms is very difficult and requires the use of a method known as expert assessment method, which allows you to select the goal of operation, determine the priority of goals and their importance. The task of formulating the goals of an organization’s functioning with the help of expert assessments is the task of obtaining an objective result based on the individual subjective opinions of a group of experts.

Tasks are more individual because they can include elements that are attractive to performers.

Two other important points in the work: the time required to complete it; frequency of repetition of a given task. A machine operation, for example, might consist of performing the task of drilling holes a thousand times a day. Each operation takes only a few seconds to complete. The researcher performs varied and complex tasks, and these may not be repeated at all during the day, week or year. Some of the tasks require a researcher to complete several hours or even days. In general, we can say that managerial work is less monotonous, repetitive in nature and the time required to complete each type of work increases as managerial work moves from lower to higher levels. In a calm environment, tasks are repeated with a certain frequency, solutions have been worked out and do not pose major problems for management. The situation is much more complicated in a dynamic environment, when new tasks arise all the time, the methods for solving them are not always obvious and the time for their implementation is unknown. These variables affect the quality of management primarily through the organizational structure, which must be rebuilt to solve a new range of problems.

Tasks, like goals, are subject to the principles of construction and functioning of large systems: they can be subjected to decomposition, they are characterized by the properties of synergy, non-addativeness, emergence, etc. The “task tree”, which characterizes the task as a large system facing the socio-economic system, is also an important element of program-targeted management.

1) actual management tasks related to operational management and leadership, implementation by managers of management functions, distribution of rights and powers;

2) organizational and economic tasks, related to ensuring the unity and organizational integrity of socio-economic systems, achieving the required technical and economic parameters of systems, maintaining financial discipline, etc.

3) ideological and educational tasks related to the formation of moral and ideological criteria and ideals that correspond to public views and attitudes, the needs of socio-economic development;

5) scientific, technical, technological tasks, related to the provision of research, design, and technological solutions.

The challenges facing managers can be classified as tasks of functioning and development. The solution of the former is intended to ensure the cyclical nature of the activities of production systems, the implementation of planned tasks, and the functioning of the activities of enterprise services. The second tasks (development) are associated with the inclusion in the reproductive processes of new elements and factors of production, new factors of a scientific, technical and social nature, which requires constant updating and qualitative improvement of the entire management system.

MUZ "Central City Hospital" is a non-profit organization, financed in whole or in part from the budget of the city of Cheboksary on the basis of estimates. It carries out its activities on the basis of the Charter as amended and supplemented, has an independent balance sheet, current and other bank accounts, forms, and a seal with the coat of arms of the Chuvash Republic.

The purpose of creating the Institution is to protect health and provide emergency and specialized medical care to the population of the city of Cheboksary attached to this institution, as well as provide trauma care. economic payment hospital

To achieve these goals, the Institution carries out the following types of activities: pre-hospital care, outpatient care, other work and services.

MUZ "Central City Hospital" dates back to 1960, when Cheboksary builders opened their clinic on the 1st floor of a hostel on the street. Engelsa, 24. Four years later, a hospital with 200 beds was opened in the same building. Subsequently, new buildings of the clinic were built, and another building was added to it at Lenin Ave., 47. The hospital capacity of the medical unit of the builders reached 480 beds.

In 2000, the hospital began to be called the MUZ "Hospital of Builders", and from 2001 to 2004 it was called the MUZ "City Hospital No. 3" in Cheboksary. In 2005, the Central City Hospital. Today the hospital is a complex of several buildings in the city center. There is a polyclinic here for 1200 visits per shift, which includes therapist departments (local, workshop), GP department, dental and orthopedic dentistry department, surgical, Women's consultation, narrow specialists, four diagnostic departments and departments rehabilitation treatment. Admission is carried out in 24 specialties.

Any organization is located and operates within the framework of external and internal environments. They predetermine the success of the company, impose certain restrictions on operational actions and, to some extent, every action of the company is possible only if the environment allows its implementation.

The external environment is the source that supplies the organization with the resources necessary to maintain its internal potential at the proper level. The organization is in a state of constant exchange with the external environment, thereby providing itself with the opportunity to survive. But the resources of the external environment are not limitless. And they are claimed by many other organizations located in the same environment. Therefore, there is always the possibility that the organization will not be able to obtain the necessary resources from the external environment. This can weaken its potential and lead to many negative consequences for the organization. The task of strategic management is to ensure that the organization interacts with its environment in a way that allows it to maintain its potential at the level necessary to achieve its goals, and thereby enable it to survive in the long term. External factors are divided into factors of direct impact and indirect impact. The direct impact environment includes factors that directly affect the organization’s activities:

a) Suppliers. Suppliers of the Central City Hospital are the budget of the city of Cheboksary, the Compulsory Medical Insurance Fund of the Chechen Republic, and the insurance company Chuvashia-Med. They provide cash funding on a monthly basis. Suppliers can also be called organizations that use the services of the Central City Hospital, suppliers of energy, materials, and equipment.
b) Labor resources. Without the necessary and properly qualified specialists, it is impossible to effectively use complex machinery and equipment.
c) State laws. Organizations are required to comply not only with federal, but also regional laws. State bodies ensure the enforcement of laws in their area of competence.
d) Consumers. Consumers of the services of the Central City Hospital are:
- -people to whom free (preferential) services are aimed;
- -people who buy the organization’s services;
- -organizations - consumers of services.
d) Competitors. Enterprise management must remember that unmet consumer needs create open market niches for competing organizations.

The indirect impact environment consists of factors that do not have a direct and immediate impact on the organization’s activities:

a) The state of the country's economy. The management of an organization, especially when entering the international market, must take into account the economic situation in that country.
b) Scientific and technological progress. Technical innovations increase labor productivity and improve the quality of services provided.
c) Sociocultural factors. This is, first of all, life values and traditions, customs, attitudes that have a significant impact on the activities of the organization.
d) Political factors. These include the economic policy of the administrative bodies of the state.
e) Relations with local population. The nature of the relationship with the local community is very important for accounting and planning in any organization.

The internal environment of an organization is the situational factors within the organization. The manager forms and changes, when necessary, the internal environment of the organization, which is an organic combination of its internal variables. But for this he must be able to identify and know them.

Internal variables are situational factors within an organization. Since organizations are human-created systems, internal variables are primarily the result of management decisions. This, however, does not mean that all internal variables are completely controlled by management. Often the internal factor is something “given” that management must overcome in its work. The management mechanism is focused on achieving optimal interaction between all levels of management and functional areas of management for the most effective achievement of the intended goals. The main variables in the organization itself that require management attention are goals, structure, objectives, technology and people.

Goals are specific, end states or desired results that a group strives to achieve by working together. The main goal of most organizations is to make a profit. But the Central City Hospital is a non-profit organization and is not concerned about profit problems, but it is also concerned about costs. A non-profit organization has a variety of goals, but generally places a strong emphasis on social responsibility. The main goal of the Central City Hospital is to provide the population with high-quality medical services. Goals are developed by the company's management and brought to the attention of managers at all levels, who, in the process of coordinating joint activities, use a variety of means and methods to achieve them.

Tasks are defined work, a series of works, that must be completed in a predetermined manner within a predetermined time frame. Tasks are continuously becoming more complex as the scale of work grows, requiring the provision of ever-increasing amounts of resources - material, financial, labor, etc.

The structure of an organization is a logical relationship between management levels and functional areas, aimed at establishing clear relationships between the individual divisions of the company, distributing rights and responsibilities between them, built in a form that allows the organization’s goals to be most effectively achieved. It implements various requirements for improving the management system, which are expressed in certain management principles.

The organizational structure of the Central City Hospital is shown in Figure 1.

Rice. 1. Organizational structure of the Central City Hospital

The structure of an organization is closely related to its specific division of labor and the requirements for building a control system in the organization. Any organization has a labor organization, but not just a random distribution of work among all personnel of the organization, but a specialized division of labor. It means assigning a specific job to the person who can best perform it in the organization, that is, to a specialist.

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Introduction

7.1 Initial data

7. 4 Planning cost estimates

Conclusion

Bibliography

Introduction

Any organization is located and operates in an environment. Every action of all organizations without exception is possible only if the environment allows its implementation. The environment of any organization is usually considered to consist of three spheres: general (or macroenvironment), work (or immediate environment) and internal. It contains the potential that allows an organization to function, and, consequently, to exist and survive in a certain period of time. But the internal environment can also be a source of problems and even the death of an organization if it does not ensure the necessary functioning of the organization.

The external environment is the source that supplies the organization with the resources necessary to maintain its internal potential at the proper level. But the resources of the external environment are not limitless. And they are claimed by many other organizations located in the same environment. Therefore, there is always the possibility that the organization will not be able to obtain the necessary resources from the external environment. This can weaken its potential and lead to many negative consequences for the organization. The task of strategic management is to ensure that the organization interacts with its environment in a way that allows it to maintain its potential at the level necessary to achieve its goals, and thereby enable it to survive in the long term.

In order to determine the organization's behavioral strategy and implement this strategy, management must have an in-depth understanding of both the internal environment of the organization, its potential and development trends, and the external environment, its development trends and the place occupied by the organization in it.

Environmental analysis is one of the processes of strategic management. These processes logically follow (or follow) one from the other. There is a stable feedback and, accordingly, a reverse influence of each process on the others and on their entirety. However, environmental analysis is usually considered the initial one, since it provides both the basis for defining the mission and goals of the firm, and for developing a behavioral strategy that allows the firm to achieve its mission and achieve its goals.

In this course work we will consider the main factors of the internal and external environment, their impact on the activities of a medical institution, the main methods for analyzing factors of the internal and external environment, as well as the role of this analysis in the strategic planning process.

1. Factors of the internal and external environment of a medical institution: controlled and uncontrolled

The strategic planning process in an organization can be divided into several stages (Figure 1).

Figure 1 - Strategic planning process

Since strategy is not, in fact, the organization’s response to changes in the objective external and internal factors of the organization, the strategic planning process begins with the identification and analysis of critical environmental factors of the organization.

The environment of each organization can be defined as a set of three areas: the internal environment, the working environment (microenvironment) and the general environment.

The internal environment of an organization includes five key elements: production, finance, marketing, personnel management, and organizational structure.

The microenvironment or working environment (the environment of direct contacts of the organization) includes: consumers, competitors, intermediaries, suppliers, contact audiences.

“Contact audiences” mean organizations and institutions, as well as social groups, who are not direct business partners, but are of interest from the point of view of ensuring the entrepreneurial success of the company itself and are able to influence the implementation of its goals. Contact audiences include:

Financial circles: banking and credit organizations, funds, insurance, investment and brokerage companies, etc.

Mass media: television companies, radio stations, newspaper and magazine publishing houses, etc.

Government institutions: government and its apparatus, ministries and departments, state customs and tax services, state sanitary institutions, etc.

Public organizations: political parties, “green” societies, societies for the protection of consumer rights, etc.

Local authorities: city halls, prefectures, offices of presidential representatives, etc.

The general public, whose opinion, shaping the public image and prestige of the company as a whole, is capable of ensuring the success of its activities.

The company can have a corresponding impact on the microenvironment, i.e. These factors are controllable, in which an important role is played by the public relations department, which provides adequate information about the nature of the company’s activities.

In contrast to microenvironmental factors, they are more stable and, by their nature, are not susceptible to the influence of marketing activities (not controlled), forcing the enterprise to adapt to environmental conditions. Environmental factors include:

1) Demographic - age composition of the population, ratio of urban and rural populations, degree of migration, educational level, etc.

2) The state of the financial system, inflation rate, convertibility of the national currency, purchasing power of the population.

3) Natural - climate, availability of raw materials, energy sources, ecology.

4) Technologies - determine the level of scientific and technological progress and allow the production of new types of products, established standards of production and consumption, and thereby carry out effective marketing activities.

5) Sociocultural - cultural values, traditions, rituals, religion.

6) Political - socio-political system, alignment of political forces and social movements, features of the legislative system and its implementation.

7) International - individual international events (wars, regional conflicts, individual solutions international organizations), affecting global production levels natural resources, and so on.

Thus, from the factors of the micro- and macroenvironment it is necessary to identify only a limited number of truly significant factors (critical points) of the organization’s environment. The number of critical points depends on the size of the organization, the nature and goals of the activity and other features. In addition, in the short term it will be sufficient to confine itself to an analysis of the working environment, in the long term - the general nature of the external environment.

2. The mechanism of influence of internal and external environmental factors on the activities of a medical institution in the short and long term

Tactical planning occupies an intermediate position between long-term strategic and short-term (operational-calendar). Strategic planning is designed for a long period (10-15 years). However, in many enterprises the strategy is based on medium-term planning. Therefore, a strategic plan, as a rule, covers a period of no more than 5 years, a tactical plan - 1-2 years, and an operational plan - less than 1 year. It is not possible to draw up a tactical plan for a period of more than two years, since frequent changes occur in the external and internal environment of the enterprise. In addition, in the short term it will be sufficient to confine itself to an analysis of the working environment, in the long term - the general nature of the external environment.

Tactical planning is a means of implementing strategic plans. If the main goal strategic plan is to determine what the enterprise wants to achieve in the future, then tactical planning must answer the question of how the enterprise can achieve such a state. These types of planning differ in goals and means of achieving them.

Decisions made during tactical planning are less subjective. They are more specific and are always tied to the performance indicators of the structural divisions of the enterprise.

As is known, the state market economy influences organizations both indirectly, primarily through the tax system, state property and budget, and directly - through legislative acts. For example, high tax rates significantly limit the activity of firms, their investment opportunities and push them to hide income. On the contrary, lowering tax rates helps attract capital and leads to a revival entrepreneurial activity. And thus, with the help of taxes, the state can manage the development of the necessary areas in the economy.

All the variety of external factors is reflected in the consumer and through him influences the organization, its goals and strategy. The need to satisfy customer needs influences the organization's interactions with suppliers of materials and labor. Many organizations focus their structures on large groups of consumers on whom they are most dependent.

In modern conditions, various associations and associations of consumers are becoming important, influencing not only demand, but also the image of companies. It is necessary to take into account factors influencing consumer behavior and their demand.

The influence of such a factor as competition on the organization cannot be disputed. The management of each enterprise clearly understands that if it does not satisfy the needs of consumers as effectively as competitors do, the enterprise will not stay afloat for long.

Underestimation of competitors and overestimation of markets lead even the largest companies to significant losses and crises. It is important to understand that consumers are not the only object of competition among organizations. The latter may also compete for labor resources, materials, capital and the right to use certain technical innovations. The reaction to competition depends on such internal factors as working conditions, wages and the nature of relationships between managers and subordinates.

While the environmental factors described above affect all organizations to some extent, the environment of organizations operating in international level, is characterized by increased complexity. The latter is due to a unique set of factors characterizing each country. Economy, culture, quantity and quality of labor and material resources, laws, government agencies, political stability, the level of technological development varies from country to country. When carrying out the functions of planning, organizing, stimulating and controlling, managers must take such differences into account.

medical clinic strategic planning

3. Basic methods for analyzing environmental factors

Analysis of the external environment is an assessment of the state and prospects for the development of the most important, from the point of view of the organization, subjects and environmental factors: industry, markets, suppliers and a set of global environmental factors that the organization cannot directly influence.

In the course of studying the macro-external environment, so-called PEST analysis techniques are used. During the PEST analysis, the enterprise tries to identify favorable and unfavorable trends for each of the main factors of the “macro environment” (political, economic, social and technological), and on this basis decide on the continuation of its work (for example, investing in the development of a new product) or, conversely, about leaving this market. When conducting a PEST analysis, it is necessary to analyze the possible influence on the enterprise’s activities of four main factors of the macroeconomic environment: Political - political; Economic - economic; Social - social; Technological - technological. As information tools, an enterprise should choose the most complete and accessible data sources in the region. The impact of certain “macroenvironment” factors depends on the type of activity chosen, and it is not always necessary to take into account all these elements. The basis of PEST analysis can be schematically presented as follows.

PEST analysis is a tool designed to identify political, economic, social and technological aspects of the external environment that may affect a company's strategy. Politics is studied because it regulates power, which in turn determines the company's environment and the acquisition of key resources for its activities. The main reason for studying economics is to create a picture of the distribution of resources at the state level, which is the most important condition for the activity of an enterprise. No less important consumer preferences are determined using the social component of PEST analysis. The last factor is the technological component. The purpose of her research is considered to be to identify trends in technological development, which are often the causes of changes and losses in the market, as well as the emergence of new products.

The main provisions of PEST analysis: “ Strategic Analysis each of the four specified components must be quite systematic, since all these components are closely and complexly interconnected.” You cannot rely only on these components of the external environment, since real life much wider and more diverse.

4. Procedures for analyzing internal environmental factors

Having analyzed the external environment and received data on factors that pose threats or open new opportunities, management must assess whether the firm has the internal strengths to take advantage of opportunities and what internal weaknesses may complicate future problems associated with external threats.

The method used to diagnose internal problems is called management survey. A management survey is a methodical assessment of an organization's functional areas designed to identify its strategic strengths and weaknesses. The management survey includes five functions - marketing, finance, (operations) production, human resources, and corporate culture and image.

In order to get a clear assessment of the company's strengths and the market situation, there is a SWOT analysis.

SWOT analysis is the determination of the strengths and weaknesses of an enterprise, as well as opportunities and threats emanating from its immediate environment (external environment). Strengths - advantages of the organization; Weaknesses - shortcomings of the organization; opportunities (Opportunities) - factors of the external environment, the use of which will create advantages for the organization in the market; Threats - factors that could potentially worsen an organization's position in the market. To carry out the analysis you need:

Determine the main direction of development of the enterprise (its mission);

Weigh the forces and assess the market situation in order to understand whether it is possible to move in the indicated direction and how best to do this (SWOT analysis);

Set goals for the enterprise, taking into account its real capabilities (defining the strategic goals of the enterprise).

Carrying out a SWOT analysis comes down to filling out the SWOT analysis matrix. The strengths and weaknesses of the enterprise, as well as market opportunities and threats, must be entered into the appropriate cells of the matrix (Figure 2).

Figure 2 - SWOT analysis matrix

The strengths of an enterprise are what it excels at or some feature that provides additional opportunities. Strength may lie in existing experience, access to unique resources, the availability of advanced technology and modern equipment, highly qualified personnel, high quality of products, brand recognition, etc.

The weaknesses of an enterprise are the absence of something important for the functioning of the enterprise or something that is not yet successful in comparison with other companies and puts the enterprise at a disadvantage. Examples of weaknesses include a too narrow range of products, a poor reputation of the company in the market, lack of financing, low level of service, etc.

Market opportunities are favorable circumstances that a business can exploit to gain an advantage. Examples of market opportunities include the deterioration of competitors' positions, a sharp increase in demand, the emergence of new production technologies, an increase in the level of income of the population, etc. It should be noted that opportunities in terms of SWOT analysis are not all opportunities that exist in the market, but only those that can be exploited.

Market threats are events the occurrence of which may have an adverse impact on the enterprise. Examples of market threats: new competitors entering the market, rising taxes, changing consumer tastes, declining birth rates, etc.

The same factor can be both a threat and an opportunity for different enterprises.

5. Goals of strategic planning, main stages, specifics of strategic planning in a medical institution

5.1 Concept, goals and objectives of strategic planning in the activities of a medical institution

Strategic planning is a young activity. The emergence of strategic planning dates back to the 50s of the twentieth century.

Strategic planning is a set of actions and decisions taken by management that lead to the development of specific strategies designed to help the organization achieve its goals

The defined goals of the organization must be consistent with its vision and mission.

Vision is an ideal picture of the future, a state that can be achieved with the most unfavorable conditions. This is the level of aspiration in the strategic planning process.

The mission of a company can be defined as the long-term position of the company occupied in the market or the role of the company in the market, which has become widely known to customers, competitors, and the external environment.

On the practical side, a mission is a program statement, a document with which a company describes its area of activity, its value system, and sets out its guiding principles in relation to both economic and non-economic (social) indicators.

The mission is important for both the external and internal spheres of activity of the enterprise:

Within the enterprise, it reveals to the staff an understanding of goals and helps to develop a unified position that helps strengthen the intra-company culture. Knowledge of the company’s mission allows the company’s employees to work purposefully and meet the requirements and targets;

In the external sphere, it contributes to the creation of a holistic image of the enterprise, explaining what economic and social role in society it strives to play and what perception in general it seeks.

A firm's mission statement may include the following elements:

1) History of the company.

3) Priority goals and restrictions of both economic and non-economic nature.

4) Strategic claims (general policy in the base market and the role that the company wants to play in it).

The goals of the enterprise express specific areas of activity. IN modern theory planning, it is customary to distinguish eight main areas of activity, within the boundaries of which each enterprise determines its main goals. These are the organization's position in the market, innovation activities, productivity levels, availability of production resources, degree of stability, management system, personnel professionalism and social responsibility. Typically, the most significant market conditions are financial goals that determine the state of solvency and economic sustainability of the enterprise.

The main objectives of strategic planning are:

1) determination of necessary political decisions;

2) assessment of the future state of the economy and the need for these products;

3) assessment of the required production capacity in the future;

4) preliminary assessment of the size of possible capital investments.

Strategic planning includes long-term, medium-term and current plans.

Long-term plans are developed for a period of 5 to 15 or more years, medium-term - from 2 to 5 years, and current - for 1 year.

The strategic plan is justified by quantitative indicators and relevant calculations. It is based on a forecast of socio-economic processes, which can be divided into a forecast of the external environment and a forecast internal activities enterprises.

5.2 Main stages of strategic planning

1) interactive-normative;

2) development and revision;

3) approval and implementation.

The interactive-normative stage begins with the formation of goals and determination of development guidelines. To do this, the existing potential of the enterprise is assessed and a forecast of the development of the external environment is given. The reference points are reports on the production and economic activities of the enterprise, as well as regulatory and instructional materials. These materials are the basis for the development of long-term or medium-term plans at the level of individual structural divisions, as well as proposals for the formation of development goals and guidelines. Coordination of planned figures, strategic approaches and alternatives is carried out at a conference or meeting of the strategic planning committee.

The latter is a means of consultation, information exchange and collective discussion. The Strategic Planning Committee analyzes the progress of the strategy, as well as, if necessary, its adjustment. The strategic planning committee is headed by the head of the company.

The development and revision stage is the most important. Here strategic planning is carried out according to the relevant goals and guidelines agreed upon at the first stage. At this stage structural units develop their strategies, long-term plans and social programs.

At the final, third stage, the established general goals and main economic indicators for the enterprise (company) as a whole are approved and implemented “from top to bottom”. At the same time, long-term, medium-term and current development plans for the enterprise are approved.

5.3 Specifics of strategic planning in a medical institution

The basis of the organization's strategic plan is a forecast of social and economic processes, which can be divided into a forecast of the external environment and a forecast of the internal activities of the enterprise.

When developing a strategic plan, interactive planning consists of the following three stages:

Interactive-normative;

Development and revision;

Assertions and implementations.

The current rate of change and increase in knowledge is so great that strategic planning seems the only way formal forecasting of future problems and opportunities. It provides senior management with a means of creating a plan for the long term.

Strategic planning of the organization:

Reasonable and conscious choice of goals and strategy for the development of the organization.

Constant search for new forms and types of activities to increase the competitiveness of the organization.

Ensuring compliance between the organization and the external environment that controls and is controlled by the subsystems and elements of the organization.

Individualization of strategy, where each organization has its own characteristics, determined by the existing composition of personnel, material and technical base, culture and other features, therefore, the development of strategies should be carried out taking into account these characteristics.

Clear organizational separation of strategic planning tasks from operational planning tasks.

6. The role of analysis of internal and external environmental factors in the process of strategic planning in a medical institution

Strategic planning is based on a thorough analysis of the external and internal environment of the company:

Changes occurring or likely to occur in the planned period are assessed;

Factors that threaten the company's position are identified;

Factors favorable to the company's activities are studied.

Processes and changes in the external environment have a vital impact on the firm. The main problems associated with the external environment are economics, politics, market, technology, competition.

Strategy is the starting point of theoretical and empirical research. Organizations may differ in the extent to which their key decision makers have committed themselves to an innovation strategy. If top management supports efforts to implement an innovation, the likelihood that the innovation will be adopted by the organization increases. As senior management becomes involved in the decision-making process, the importance of strategic and financial goals increases.

Environmental analysis refers to the process by which strategic planners monitor factors external to businesses to determine opportunities and potential threats to the firm. The study of the external environment provides the organization with the opportunity to respond in a timely manner to threats to the company that have appeared on the market, and gives the ability to develop business actions. These qualities allow the company not only to prevent these threats, but also to extract new profitable opportunities from the situation. From this perspective, the role of environmental analysis in the strategic planning process is essentially to answer three specific questions:

1) Where is the organization located now?

2) Where should the organization be located in the future?

3) What needs to be done for an organization to move from where it is now to where it should be in the future?

Adaptation to the external environment is of great importance, which covers all actions of a strategic nature that improve the enterprise’s relations with environment. Enterprises need to adapt to both external opportunities and threats, identify the most favorable options and ensure effective adaptation of the strategy to external conditions.

The nature and level of strategic planning largely determine the success of the enterprise's market activities. Some Russian firms at a certain stage are able to achieve certain achievements without spending much effort on organizing planning. Moreover, strategic planning alone does not guarantee success. At the same time, it is undeniable that the use of planned methods creates important, significant favorable preconditions for the development of the company. The current rate of change and increase in knowledge is so great that strategic planning is essentially the only way to predict future problems and opportunities. It provides the management of the company with a tool for its functioning for the long term. Strategic planning provides the basis for management decisions. Determining what a firm wants to achieve helps it evaluate the most appropriate course of action. Planning helps reduce risk when working in the market. By making informed planning decisions, management reduces the risk of choosing a less-than-optimal decision due to erroneous or unreliable information about the capabilities of the enterprise or the external situation. Planning, which serves to determine future actions in the market, helps ensure unity of common purpose throughout the organization.

7. Planning the main performance indicators of the allergy department of the clinic

7.1 Initial data

Estimated time norms for a diagnostic and treatment visit to an allergist:

When taken by adults 15.0 minutes;

When taking children 17.1 minutes.

The standard number of positions of paramedical and junior medical staff per 1 position of allergist:

Nursing staff 1: 0.5;

Junior medical staff 1: 0.5.

The working hours of medical personnel are presented in Table 1.

Table 1 - Working hours of medical personnel

	Indicator, unit of measurement	Meaning
	Duration working week, hours
	Outpatient doctor
	Doctor in a 24-hour hospital
	Outpatient office nurse
	Nurse in a 24-hour hospital
	Next vacation, days

	Nurses
	Number of shifts of staff (offices) in an outpatient clinic

The standard expenditure for soft equipment in the reporting period is 860 rubles per 1 position of primary medical staff per year.

The standard for medical expenses in the clinic in the reporting period is 36.8 rubles. for 1 diagnostic and treatment visit.

The coefficient of use of working time of the position is 0.923.

Coefficients for accounting for general institutional expenses in the estimate for paid medical services - 0.071

The planned volume of medical services is 11,953 diagnostic and treatment visits per year; 6394 medical examinations per year.

Time standards for 1 medical examination are 12 minutes.

The cost estimate for the clinic is presented in Table 2.

Table 2 - Cost estimate for the clinic, thousand rubles.

	Name		Meaning

	Payroll accruals

	Medical expenses
	Soft inventory
	Food
	Special payment fuels and lubricants
	Other consumables

	Payment for transport services
	Payment for communication services
	Payment of utility services

	Payment current repairs equipment
	Payment for current repairs of buildings and structures
	Other operating expenses
	Transfers to the population

	Capital construction
	Major renovation

Average salary of clinic staff (rubles per month):

Medical staff 15,000;

There are 7800 nursing staff.

7.2 Calculation of the planned capacity of the allergy department of the clinic

The basis of the potential of a medical organization is its capacity, that is, the maximum number of medical services that can be provided to the population. The capacity of an outpatient clinic is determined by the number of patient reception rooms and the number of visits per shift.

To determine the planned capacity of the allergy department of the clinic, the formula is used:

where NVP is the planned total number of visits in equivalent treatment-

diagnostic visits in clinic units;

C - shift work of the clinic;

D is the number of days the clinic is open per year.

D = 365 - 12 - 52 2 = 249 (days)

where - diagnostic and treatment visits;

Preventive visits;

Home visits;

Time spent on 1 diagnostic and treatment visit,

preventive, home visits respectively.

ORP = 11935 + 6394 (12/15) = 17050 (visits per shift)

17050 / 2,249 = 34 (visits per shift)

Thus, the planned capacity of the allergy department of the clinic will be 34.23 visits per shift.

7.3 Planning the number of positions in the allergy department of the clinic

Planning the number of medical personnel in an outpatient clinic based on the volume of work is carried out according to the formula:

where F is the planned function of the medical position.

F = B N (4)

where B is the working time budget of the position, hour/year;

N - load rate, number of visits;

Coefficient of use of useful working time (0.923).

B = ((365 - V - P - O) / 5) m - g (5)

where B - weekends;

P - holidays;

O - vacation;

m is the length of the working week in hours;

q - reduction of working hours on holidays, total hours/year

B = ((365 - 104 - 12 - 42) / 5) 38 - 12 = 1561.2 (hours)

N = 60 / 15 = 4 (min.)

Ф = 1561.2 4 0.923 = 5764

17050 / 5764 = 2.958 = 3 (positions)

According to the staffing standard, for 1 position of an allergist there is 1.0 position of nursing staff, hence:

1 = 3 (positions)

And the positions of nurses are established at the rate of 1 position for every 5 positions of allergists:

3 / 5 = 0.6 = 0.5 (positions)

Using the data obtained, we will draw up a staffing schedule for the allergy department of the clinic (Table 3).

Table 3 - Staffing table allergy department of the clinic

Since the number of doctor positions is less than 3.5, there is no head of the allergy department in this clinic. Accordingly, the head nurse, since the number of positions of senior nurses corresponds to the number of positions of department heads.

7.4 Planning cost estimates

The cost estimate of a budgetary organization is a consolidated plan of all expenses of a medical institution for the upcoming period of production and economic activity. It is drawn up in a uniform form approved by the Ministry of Finance. When drawing up estimates for budgetary health care facilities, costs are classified according to expenditure items of the budgets of the Russian Federation.

In the process of planning cost estimates in domestic practice, two main approaches are used:

1) summary method - by summation, that is, based on the summation of estimates of all individual departments;

2) estimate method - it is based on the calculation of expenses for the entire institution as a whole on the basis of other planning documents.

Let us first calculate the payment fund for the main medical personnel. Remuneration of medical personnel is presented in Table 4.

Table 4 - Remuneration of medical personnel

Thus, we found that the salary of the main medical personnel for the year is:

Salary main = 68400 12 = 820800 (rub.)

The calculation of remuneration for administrative, managerial and other personnel is made by multiplying labor costs by a coefficient for accounting for general institutional expenses.

Salary = 4489800 0.071 = 318775.8 rub.

Calculation of the planned annual wage fund:

Accruals for wages of medical personnel are made in the amount of 34% of wages, which will be:

N = 1270130 0.34 = 431844.2 (rub.)

From the initial data, in accordance with the coefficient for accounting for general institutional expenses, which is 0.071 for an allergist, we calculate the remaining lines of the cost estimate.

Payment for communication services:

40800 0.071 = 2896.8 (rub.)

Payment of utility services:

5526000 0.071 = 392346 (rub.)

Other operating expenses, including:

627600 0.071 = 44559.6 (rub.)

Payment for current equipment repairs

37200 0.071 = 2641.2 (rub.)

Other operating expenses

590400 0.071 = 41918.4 (rub.)

Major repairs:

877200 0.071 = 62281.2 (rub.)

Purchase of supplies, including:

Soft inventory

Mi = Mi AUP + Mi P + Mi D (6)

where Mi AUP is soft equipment for AUP;

Mi P - soft equipment for paraclinical services;

Mi D - soft inventory, based on the standard costs for 1 position

core personnel per year.

Mi AUP + Mi P = 17600 0.071 = 1249.6 (rub.)

Mi D = 860 6 = 5160 (rub.)

Mi = 1249.6 + 5160 = 6409.6 (rub.)

Medical expenses

M = M p + M d (7)

where M p - medications for paraclinical services;

M d - medicines based on the standard costs for 1 treatment

diagnostic visit.

M p = 2121000 0.071 = 150591 (rub.)

M d = 36.8 17050 = 627440 (rub.)

M = 150591 + 627440 = 778031 (rub.)

Special payment fuels and lubricants

85200 0.071 = 6049.2 (rub.)

Other consumables

285600 0.071 = 20277.6 (rub.)

The cost estimate for the allergy department of the clinic is presented in Table 5.

Table 5 - Cost estimate for the allergy department of the clinic, rub.

	Name		Meaning
	Remuneration of civil servants
	Payroll accruals
	Purchase of supplies, including
	medical expenses
	soft equipment
	Food
	special payment fuels and lubricants
	other consumables
	Business trips and official travel
	Payment for transport services
	Payment for communication services
	Payment of utility services
	Other operating expenses including
	payment for current equipment repairs
	payment for current repairs of buildings and structures
	other operating expenses
	Transfers to the population
	Purchase of equipment and inventory
	Capital construction
	Major renovation

7.5 Planning the cost and price of services

Using the values found above and the cost estimate for the planning period (year), we calculate the cost of the service using the formula:

C = P / OCP (8)

where P is the sum of all expenses for the year.

C = (3014825.2 - 62281.2) / 17050 = 173.17 (rub.)

Pricing for a medical service is based on the traditional method: cost plus profit.

C = S + P (9)

where P is profit, rub.

where is the rate of return in the price of a medical service (30%).

P = 173.17 0.3 = 51.95 (rub.)

C = 173.17 + 51.95 = 225.12 (rub.)

Thus, the price of one medical service from an allergist is 225.12 rubles.

Conclusion

Analysis of the internal and external environment is very important for developing an organization's strategy and a very complex process that requires careful monitoring of processes occurring in the environment, assessing factors and establishing connections between factors and those strong and weaknesses organization, as well as the opportunities and threats that exist in the external environment. It is obvious that, without knowing what is happening in the external environment and without developing its internal competencies, the company will very soon begin to lose its competitive advantage, and then may simply disappear from the market.

The planning process is a tool that helps in making management decisions. Its task is to ensure innovation and change in the organization to a sufficient extent.

Planning allows you to prepare to take advantage of future favorable conditions; improve coordination of activities in the organization; create the prerequisites for increasing the educational level of managers; distribute resources more rationally; improve control in the organization.

Based on the above, we can conclude that the only correct course of action for a company to achieve effective long-term functioning and successful development is to pay increased attention to the analysis of the external and internal environment. This implies a comprehensive analysis, which can be carried out using the above methods, which gives a fairly clear and objective picture of the company’s competitive position. Only under this condition can one count on the effectiveness of strategic and operational management decisions.

Bibliography

1. Efanova E. V. Planning at a healthcare enterprise: textbook. allowance / E.V. Efanova, S.L. Petrosyan. Voronezh: GOU VPO "Voronezh State Technical University", 2008. - 196 p.

2. Guidelines to implementation course work in the discipline “Planning in a healthcare enterprise” for full-time students of specialty 080502 “Economics and management in an enterprise (healthcare)” / E.V. Efanova, L.V. Shkurina, I.D. Fedorov. Voronezh: State Educational Institution of Higher Professional Education "Voronezh State Technical University", 2006. - 33 p.

3. Balabanov M. V. The financial analysis and planning of an economic entity: textbook. / M. V. Balabanov. - M.: publishing house "Third Rome", 2000. - 236 p.

4. Alekseeva M. M. Planning the activities of a company: textbook. manual / M. M. Alekseeva. - M.: Finance and Statistics, 2005. - 248 p.

5. Varakuta S. A. Planning at an enterprise: textbook. manual / S. A. Varakuta, Yu. N. Egorov. - M.: INFRA - M, 2001. - 176 p.

6. Ilyin A.I. Planning at an enterprise: textbook. / A. I. Ilyin. - M.: New knowledge, 2002. - 635 p.

7. Basovsky L. E. Forecasting and planning in market conditions: textbook. allowance / L. E. Basovsky. - M.: INFRA - M, 2006. - 260 p.

8. Goremykin L. A. Planning at an enterprise: textbook. / L. A. Goremykin. - M.: ESMO, 2001. - 168 p.

9. Shishkin A. Yu. Economics of the social sphere: textbook. allowance / A. Yu. Shishkin. - M.: INFRA - M, 2003. - 416 p.

10. Petrov A.N. Strategic planning of enterprise development: textbook. allowance / A. N. Petrov. - M.: UNITY, 2007. - 443 p.

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