Flevy Management Insights Case Study
Customer Retention Strategy for Mid-Size Hospital in Competitive Healthcare Market


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TLDR A mid-size hospital experienced declining patient retention and high staff turnover. By implementing digital transformation and enhancing the Employee Value Proposition, it increased patient satisfaction by 10% and reduced turnover from 20% to 12%. This underscores the need to align tech and culture with organizational goals.

Reading time: 9 minutes

Consider this scenario: A mid-size hospital in a highly competitive healthcare market is facing challenges in patient retention and human resources management.

Despite offering quality care, the hospital has experienced a 5% decline in patient retention rates over the past year, attributed to emerging healthcare options and a 20% turnover rate among key clinical staff. The primary strategic objective of the organization is to improve patient retention rates while stabilizing its workforce to ensure consistent, high-quality care.



The hospital under review has encountered stagnation in patient growth, with a discernible decline in retention. This trend is likely due to the hospital's insufficient focus on patient experience and an uncompetitive employee value proposition leading to high staff turnover. The executive leadership is concerned that without immediate and strategic intervention, these issues could escalate, affecting the hospital's reputation and financial stability.

Competitive Landscape

The healthcare industry is witnessing rapid transformation, influenced by technological advancements and evolving patient expectations. The competition is becoming increasingly fierce as patients have more choices for their healthcare needs.

Our analysis begins by evaluating the primary forces shaping the competitive landscape:

  • Internal Rivalry: High, with hospitals and clinics vying for patients through quality of care, technology, and patient experience.
  • Supplier Power: Moderate, as hospitals negotiate with a wide range of suppliers from pharmaceutical companies to medical equipment manufacturers.
  • Buyer Power: High, due to patients' increasing access to information and alternative healthcare providers.
  • Threat of New Entrants: Moderate, given the regulatory and financial barriers to entry, but rising with the advent of telehealth services.
  • Threat of Substitutes: High, with alternative healthcare delivery models, including telehealth and outpatient surgery centers, gaining popularity.

Emergent trends in the healthcare industry include a shift towards personalized patient care, the integration of AI and digital health technologies, and an emphasis on outpatient and telehealth services. These trends indicate major changes in industry dynamics, presenting both opportunities and risks:

  • Increased demand for telehealth services: This offers the opportunity to expand service offerings but requires substantial investment in technology and training.
  • Growing emphasis on patient experience: Improving patient engagement and satisfaction can differentiate the hospital but requires a cultural shift and investment in patient-centric initiatives.
  • Technological advancements in healthcare: Adoption of AI and digital health technologies presents a significant opportunity for operational efficiency but poses a risk related to the substantial investment and potential disruption to workflows.

A PESTLE analysis reveals that regulatory changes, technological advancements, and evolving patient expectations are the key external factors impacting the hospital. These elements underscore the necessity for strategic agility and innovation in service delivery to remain competitive.

For a deeper analysis, take a look at these Competitive Landscape best practices:

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Internal Assessment

The hospital boasts a strong reputation for clinical excellence but faces challenges in employee retention and patient experience management.

Benchmarking Analysis against similar-sized hospitals in the region indicates that our hospital lags in employee satisfaction and patient engagement metrics, highlighting areas for immediate improvement.

A McKinsey 7-S Analysis reveals misalignments between strategy, structure, and systems, particularly in human resources management and patient engagement strategies. Streamlining these elements is crucial for enhancing operational efficiency and staff satisfaction.

Core Competencies Analysis identifies clinical expertise and a dedicated workforce as the hospital's main strengths. However, to leverage these effectively, the hospital must address weaknesses in employee engagement and patient experience.

Strategic Initiatives

  • Enhance Patient Experience through Digital Transformation: Implement a comprehensive digital health platform to improve patient engagement and care continuity. This initiative aims to increase patient satisfaction and retention by offering convenient access to healthcare services and information. The source of value creation lies in leveraging technology to meet evolving patient expectations, expected to drive higher patient retention rates. This will require investment in technology infrastructure and training for staff.
  • Employee Value Proposition Enhancement: Redefine the employee value proposition to include competitive compensation, career development opportunities, and a supportive work environment. This initiative seeks to reduce staff turnover and attract top talent by positioning the hospital as an employer of choice. The value creation comes from a more engaged and stable workforce, enhancing patient care quality. Resources needed include investments in human resources strategies and employee development programs.
  • Implementing a Patient-Centric Care Model: Restructure care delivery processes to focus more on patient needs and preferences. This initiative intends to improve patient outcomes and satisfaction, which are critical for retention. The value derives from differentiating the hospital in a competitive market through superior patient care. This will require changes in organizational culture, training, and potentially, staffing levels.

Human Resources Management Implementation KPIs

KPIS are crucial throughout the implementation process. They provide quantifiable checkpoints to validate the alignment of operational activities with our strategic goals, ensuring that execution is not just activity-driven, but results-oriented. Further, these KPIs act as early indicators of progress or deviation, enabling agile decision-making and course correction if needed.


What gets measured gets managed.
     – Peter Drucker

  • Patient Retention Rate: Measures the effectiveness of patient experience improvements and digital transformation initiatives.
  • Employee Turnover Rate: Tracks the impact of enhanced employee value propositions and workplace improvements.
  • Customer Satisfaction Score (CSAT): Gauges patient satisfaction and the success of patient-centric care model implementation.

These KPIs provide insights into the strategic initiatives' effectiveness, enabling timely adjustments to strategies and tactics. Monitoring patient retention and satisfaction helps in understanding the impact of patient experience enhancements, while tracking employee turnover offers a window into workforce stability and engagement levels.

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Human Resources Management Deliverables

These are a selection of deliverables across all the strategic initiatives.

  • Strategic Plan Presentation (PPT)
  • Employee Value Proposition Framework (PPT)
  • Patient Experience Enhancement Roadmap (PPT)
  • Digital Transformation Financial Model (Excel)

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Enhance Patient Experience through Digital Transformation

The strategic initiative to enhance patient experience through digital transformation was underpinned by the application of the Service Quality (SERVQUAL) model and the Value Proposition Canvas. The SERVQUAL model, developed by Parasuraman, Zeithaml, and Berry, is a tool for assessing service quality gaps based on five dimensions: tangibles, reliability, responsiveness, assurance, and empathy. This framework proved invaluable in pinpointing areas where digital solutions could most effectively enhance patient experience. Following this analysis:

  • Conducted a comprehensive survey to assess patient perceptions across the SERVQUAL model’s five dimensions, specifically focusing on areas that could be improved through digital interventions.
  • Implemented targeted digital solutions, such as a mobile patient portal and online appointment scheduling, to address identified gaps in responsiveness and reliability.
  • Measured post-implementation patient satisfaction to assess the impact of digital enhancements on service quality.

The Value Proposition Canvas, a tool designed by Alexander Osterwalder, was utilized to align the hospital’s services with patient needs and expectations more closely. This framework facilitated a deeper understanding of patient jobs, pains, and gains, and how digital services could address them. The hospital proceeded to:

  • Map out patient profiles using the Value Proposition Canvas to identify key jobs, pains, and gains related to their healthcare experience.
  • Develop digital services, such as telehealth consultations and an AI-driven health advice chatbot, tailored to the specific needs and expectations identified.
  • Deploy feedback mechanisms through the digital platforms to continually refine and improve the digital service offerings based on patient input.

The combined application of the SERVQUAL model and the Value Proposition Canvas to the digital transformation initiative resulted in a marked improvement in patient satisfaction scores, with a 10% increase observed within the first six months post-implementation. The strategic focus on enhancing service quality and aligning digital offerings with patient needs led to a more engaging and responsive healthcare experience, contributing significantly to improved patient retention rates.

Employee Value Proposition Enhancement

For the strategic initiative focused on enhancing the Employee Value Proposition (EVP), the organization applied the Job Characteristics Model and the Organizational Culture Assessment Instrument (OCAI). The Job Characteristics Model, which outlines how job design impacts employee motivation, satisfaction, and performance, was instrumental in identifying areas for improvement in job roles to enhance employee engagement and retention. The following steps were taken:

  • Analyzed existing job roles within the hospital to evaluate how well they scored on the five core job characteristics: skill variety, task identity, task significance, autonomy, and feedback.
  • Redesigned job roles and responsibilities to increase autonomy and feedback, including the introduction of peer review systems and more flexible working conditions.
  • Monitored changes in employee satisfaction and turnover rates to evaluate the effectiveness of the job redesign.

The Organizational Culture Assessment Instrument (OCAI), based on the Competing Values Framework, was deployed to understand the prevailing organizational culture and identify shifts needed to support the enhanced EVP. Actionable steps included:

  • Conducted an OCAI survey to gauge the current organizational culture and identify desired cultural attributes aligned with the new EVP.
  • Implemented targeted cultural change initiatives, such as leadership development programs and team-building activities, to shift towards a more clan-oriented culture that values flexibility, teamwork, and employee well-being.
  • Measured the impact of cultural change initiatives on employee engagement and retention through follow-up OCAI surveys and HR metrics.

The application of the Job Characteristics Model and the OCAI led to a significant reduction in staff turnover, from 20% to 12% within a year, and a noticeable improvement in employee engagement scores. By focusing on job redesign and cultural alignment with the enhanced EVP, the hospital succeeded in creating a more satisfying and supportive work environment, which in turn contributed to better patient care and satisfaction.

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Key Findings and Results

Here is a summary of the key results of this case study:

  • Increased patient satisfaction scores by 10% within six months post-implementation of digital transformation initiatives.
  • Reduced staff turnover from 20% to 12% within a year through the enhancement of the Employee Value Proposition (EVP).
  • Implemented digital solutions such as a mobile patient portal and online appointment scheduling, addressing gaps in responsiveness and reliability.
  • Developed and deployed digital services tailored to patient needs, including telehealth consultations and an AI-driven health advice chatbot.
  • Redesigned job roles to increase autonomy and feedback for employees, leading to noticeable improvements in employee engagement scores.

The strategic initiatives undertaken by the hospital to enhance patient experience through digital transformation and to improve the Employee Value Proposition have yielded significant positive outcomes. The 10% increase in patient satisfaction scores and the reduction in staff turnover from 20% to 12% within a year are clear indicators of success. These results are attributed to the effective identification and addressing of service quality gaps through digital interventions and the alignment of job roles and organizational culture with the enhanced EVP. However, the results also highlight areas for improvement. The implementation of digital solutions, while successful, requires ongoing investment in technology and training to maintain and enhance service quality. Additionally, the reduction in staff turnover, though substantial, suggests that further efforts are needed to stabilize the workforce fully. Alternative strategies, such as more aggressive investment in cutting-edge technologies or partnerships with tech companies, could potentially accelerate improvements in patient care and experience.

For next steps, it is recommended that the hospital continues to invest in and expand its digital health services to keep pace with technological advancements and patient expectations. This includes exploring new technologies such as machine learning for personalized patient care and blockchain for secure patient data management. Additionally, to further reduce staff turnover and improve employee satisfaction, the hospital should consider implementing more robust career development programs and enhancing its feedback mechanisms to ensure continuous engagement and motivation among its workforce. These actions will not only consolidate the gains achieved but also position the hospital more competitively in the evolving healthcare landscape.

Source: Customer Retention Strategy for Mid-Size Hospital in Competitive Healthcare Market, Flevy Management Insights, 2024

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