Running head: STRATEGIC PLAN FOR THE MAYO CLINIC

Mayo Clinic: A Strategic Plan for the Cancer Center

Team 2: Laurence Weinreich, Alexandria Wilkinson, Tameka Wilson
A project submitted in partial fulfillment of the requirement for the degree Master of Arts
Siena Heights University
Southfield, Michigan
June 30, 2016

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Mayo Clinic

History of the Mayo Clinic

The Mayo Clinic was founded in 1883 as a temporary hospital after a tornado hit
Rochester, Minnesota. Once the tornado was cleaned up, Dr. Moes asked Dr. W.W. Mayo if he
would like to open a hospital. On September 30, 1889, a hospital was opened under the name
Saint Marys Hospital. A group practice was formed in 1892 which consisted of Dr. Will Mayo,
Dr. Charlie Mayo, Dr. Graham, Dr. Henry Plummer, Dr. Millet, Dr. Judd, and Dr. Balfour. The
practice idea was created by Dr. Plummer, and is still in effect today (Mayo Clinic, Commitment
to the Community, para.1). The Mayo Clinic has become the largest not-for-profit hospital in
Rochester, Minnesota. This hospital system is committed to clinical practice, education and
research, providing expert, whole-person care to everyone who needs healing (Mayo Clinic,
About, para.1). The Mayo Clinic has been built on word-of-mouth because of its high quality of
care and patient first approach. The Mayo Clinic in Rochester, Minnesota has been ranked as one
of the top hospitals in the nation, this may be attributed to the fact that physicians are the leaders
of the hospital system.
Directional Strategies
Directional strategies, the mission, vision, values, and goals of an organization are how
an organization sets the tone for what type of organization they want to be and the direction they
want head. The mission is the purpose of the company. The vision is the future of the company.
The values are the principles that the company stands for in the eyes of its employees. And their
goals give them something to works towards. Together these form the road on which the
employees travel as the company moves along and grows. Directional strategies can also give the
employees a sense of purpose and worth, which will make them work harder for the company
(Duncan, Ginter & Swayne 2010). The Mayo Clinic is a nonprofit medical organization

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committed to patient satisfaction, research, education, community, and healing. The following
highlights their mission, vision, values, and goals.
Mission
In its earliest days, one of Mayo Clinic's founders, Dr. William J. Mayo, stated, "the best
interest of the patient is the only interest to be considered (Mayo Clinic, The Mayo Clinic
Culture, para. 1). That primary value the needs of the patient come first has guided Mayo's
practice throughout its history. The Mayo Clinic, as a patient-centered entity, is committed to
providing the highest quality medical care and emulating that primary value during care and
treatment of the patient. The mission statement, to inspire hope by contributing to health and
well-being by providing the best care to every patient through integrated clinical practice,
education, and research (Mayo Clinic, Mission Statement, para. 1) reflects the value of the
patient.
Strategic thinking map: Mission statement. A strategic thinking map was utilized to
find key words in the current mission statement, and to determine additional words that embody
the mission statement. The new words were then used to create a new mission statement for the
organization.
Component:

Key Words Reflecting

Component

1. Target customers and clients:

The individuals and groups we attempt to
serve are Do not be limited to only the
obvious.

Every
patient

Communit
y

Employees

2. Principal services delivered:

The specific services or range of services
we will provide to our customers are

Health

Wellbeing

Happiness

Minnesota

United
states

World

3. Geographical domain of the service

delivered:

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The geographical boundaries within

which we will deliver our services to our
customers are
4. Specific values:
Specific values that constitute our
distinctiveness in the delivery of our
services to customers are

Respect

Compassi
on

Excellence

5. Explicit philosophy:
The explicit philosophy that makes us
distinctive in our industry is

The
patient

Their
families

Founders:
the original
Mayo
physicians
and the
Sisters of
Saint
Francis

Teamwork

Innovatio
n

Healing the
whole
person

6. Other important aspects of

distinctiveness:
Any other factors that makes us unique
among competitors are

Source: Strategic Management of Health Care Organizations, Ginter, Swayne, and Duncan, page 186

Key words or phrases in the mission statement included: every patient, inspire, hope,
health, well-being, education, practice, and research. Other words that covey the essence of the
Mayo Clinic include: happiness, respect, compassion, excellence, teamwork, innovation, and
healing the whole person. A reworked mission statement to reflect all of these terms goes as
follows: To provide respect and compassion to every patient we treat, and their families, by using
teamwork, innovation, and by following the values set forth by our founders, the original Mayo
physicians and the Sisters of Saint Francis, in order to heal the whole patient.
Vision
The Mayo Clinics vision statement is to provide an unparalleled experience as the most
trusted partner for health care (Mayo Clinic, Vision Statement, para. 1).

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Strategic thinking map: Vision statement. A Strategic Thinking Map was utilized to
find key words in the current vision statement of the Mayo Clinic, and then was used to create a
new vision statement for the organization.
Component:

Key Words Reflecting

Component

7. Clear hope for the future:

If everything went as we would like it to
go, what would our organization look like
five years from now? How would we be
different/better than today?

Excelling
in
healthcar
e

Using the
newest
technolog
y

Treating
the whole
patient,
not just
symptoms

8. Challenging and about excellence:

When stakeholders (patients, employees,
owners) describe our organization, what
terms would we like for them to use?

Relaxing
environm
ent

First rate
care

Leaving a
positive
footprint

Hope

Happiness

Well-being
of the
individual
and our
employees

10.Empower employees first:

How can we ensure that employees
understand and are committed to the
vision? What needs to be done to get
everyones buy in?

Include
them in
decision
making

Evaluatio
ns based
on
mission
and vision
statement
s

Community
service

11.Memorable and provides guidance:

What types of words should be included
to ensure all organizational members
remember and behave in accordance with
the vision?

Inspiratio
n

Teamwork

Thoughtful
ness

9. Inspirational and emotional:

When we think about the kind of
organization we could be if we all
contributed our best, what terms would
describe our collective contributions?

Source: Strategic Management of Health Care Organizations, Ginter, Swayne, and Duncan, page 193

Key words or phrases in the current vision statement included: unparalleled experience,
trust, partner. Additional words or phrases that convey the vision for the future of the Mayo
Clinic include: excelling in healthcare, using the newest technology, treating the whole patient

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(not just the symptoms), provide a relaxing environment, first rate care, leaving a positive
footprint on the community, focus on the well-being of the individual and our employees,
teamwork, thoughtfulness, and inspiration. A reworked vision statement to reflect all of these
terms is as follows: Our vision for the future is to continually strive for excellence, by utilizing
the most up-to-date medical technology, in a calm and relaxing environment to the patient. We
will use teamwork and community service to inspire hope, happiness, and the well-being of our
patients, employees, and the community.
Values
The values of the Mayo Clinic include: respect, compassion, integrity, healing, teamwork,
excellence, innovation, and stewardship. The values for the Mayo Clinic are based on its strong
desire to provide the best care possible to each and every patient that is seen. These values,
which guide Mayo Clinic's mission to this day, are an expression of the vision and intent of their
founders, the original Mayo physicians and the Sisters of Saint Francis.

Respect; treat everyone in our diverse community, including patients, their

families and colleagues, with dignity.

Compassion; provide the best care, treating patients and family members with
sensitivity and empathy. Integrity; to adhere to the highest standards of
professionalism, ethics and personal responsibility, worthy of the trust their

patients place in them.

Healing; to inspire hope and nurture the well-being of the whole person,

respecting physical, emotional and spiritual needs.

Teamwork; value the contributions of all, blending the skills of individual staff

members in unsurpassed collaboration in an environment that fosters teamwork.

Excellence; to deliver the best possible outcomes and highest quality service
through the dedicated effort of every team member.

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Innovation; to infuse and energize the organization, enhancing the lives of those

that they serve, through creative ideas and unique talents of each employee.
Stewardship; to sustain and reinvest in their mission and extended communities
by wisely managing human, natural, and material resources (Mayo Clinic, Values,
n.d.).

Goals
Goals are important to an organization as they describe the organizations plans, provides
focus, motivates and inspires employees, and helps an organization evaluate its performance. The
goals of the Mayo Clinic are to understand human needs by focusing on the human experience in
order to identify these needs, design services, products, and business models. Another goal of
the Mayo Clinic is to provide innovative care that is easily accessible, affordable, and value
driven. The Mayo Clinic strives to foster open collaboration by enabling an environment of
innovation through internal and external collaboration. The last goal is to generate economic
value by demonstrating financial return from sustainable delivery models, services, and products
(Mayo Clinic, Mission, Vision, and Goals, n.d.).
External Environmental Analysis
General environmental analysis
External environment analysis includes the general environment, the industry
environment, and the service area of the organization. General environmental analysis is a way
of thinking, understanding, and planning for issues in the general environment which will effect
an organization. The general environment is constantly changing, which eventually will affect
all industries in some way, or other. Once the need for an external environmental analysis has
been established, goals must be set that identify sources to evaluate, classify the data found, and
a picture of issues that may affect the organization will begin to form (Swayne, Duncan, &

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Ginter, 2010). Categories of the general environment include (1) technological; (2)
legislative/political; (3) competitive; (4) regulatory; (5) social/demographic; and (6) economic.
A general environmental analysis of the Mayo Clinic was performed under the categories
social/demographic and economic.
Social/demographic. One aspect of the general environment under the
social/demographic category that can affect the Mayo Clinic includes the elderly and increased
lifespan of the aged. According to Chen (2014), the baby boomer generation is putting a strain
on Medicare. As more of the aging population move into retirement the numbers enrolling in
Medicare have increased significantly. In 2010, 47 million Americans enrolled in Medicare and
by 2020 that number is forecast to reach 61 million. The elderly require more frequent
healthcare visits, as well as more expensive medicines and treatments, than their younger
counterparts (Hosseini, 2015).
One question presents itself in regards to the increase in number of elderly patients that
could affect the Mayo Clinic; who is going to treat this influx of patients? Dall, et al. (2013)
estimates that the increase in numbers of the elderly demographic, in combination with increased
medical coverage under the Affordable Care Act, will lead to an increase in need of medical
providers and specialists. Its estimated that by 2030 there will need to be a ratio of 2.3 providers
per every Medicare patient (Chen, 2014). Common health issues that afflict the elderly include
hypertension, coronary heart disease, heart failure, diabetes, Parkinsons disease, Alzheimers
disease, and cancer. Primary providers aid in prevention and treatment of the elderly, but
specialists play an especially important role in diagnosing, treating, and monitoring elderly
patients with these and other afflictions. If the Mayo Clinic failed to hire and train enough
specialists to treat this population would result in long wait times for appointments, reduced

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access to care, and reduced quality of life. In addition to the social/demographic effects of the
Affordable Care Act on the Mayo Clinic, the Affordable Care Act also has economic issues that
affect the Mayo Clinic.
Economic. The Affordable Care Acts increase in Medicare and Medicaid coverage
presents an economic challenge for the Mayo Clinic; the environmental analysis leads the
question of fiscal sustainability (Chen, 2014, p.65). Both programs have low reimbursement
rates for hospitals, which results in healthcare organizations making shorter appointment and
treatment times, to try to make up financially for the low reimbursement rates. There is a 90-day
grace period for services rendered which leaves hospitals waiting for funds, along with fears the
patient will not pay at all (Crocker & Kahla, 2015). Based off of the findings from the general
environment analysis, the Mayo Clinic may try to save money in other ways: Wage freezes, lack
of raises, and/or reducing the workforce. It has already been discussed why a reduction in
workforce would not be a viable solution, so the focus will be on wages and income of
employees.
Hypothetically, if the Mayo Clinic tried to increase revenue by shorting their employees,
employees would lose morale, which would result in tardiness or not showing up to work at all.
The strain of being short-staffed would be on the employees that do show up, and patient care
would suffer. Eventually employees would look for work elsewhere. New hires would have to
be rushed through training and current employees would work double-duty as they train the new
hires (Crocker & Kahla, 2015). As a result of trying to save money, the Mayo Clinic would lose
money, as well as take a blow to their reputation.
Industry-Specific Environmental Analysis

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Within the healthcare industry, an environmental analysis can identify potential new
technologies or medical advances, social/demographic issues, legislative/political changes that
may affect healthcare, monitor competitors, and any changes in healthcare economy (Swayne,
Duncan, & Ginter, 2010). The focus for the industry-specific environmental analysis will be
competition and technological.
Competition. The Mayo Clinic is a leader in the healthcare industry and one of the
nations top ranked medical facilities. Even though they are one of the top facilities they still
face competition. Competition is anything that can take away the market share of the
organization. An area to highlight under competition is self-diagnosis.
If patients are self-diagnosing through websites such as webmd.com, they may feel that
they dont need to see a doctor, or that they can treat themselves at home. Luger, Houston, and
Suls (2014) found that searching online to interpret symptoms and misdiagnosis is becoming
increasingly prevalent. More specifically, the elderly are at the greatest at risk for misdiagnosis
due to their complex health histories and needs. If each of these patients thought that they could
treat their conditions or illness at home, and forgo the doctors office, that could potentially take
away from a lot of the Mayo Clinics revenue. Besides self-diagnosis, another area to perform an
industry specific environmental analysis is technology.
Technology. The Mayo Clinic strives to give the best possible care and treatment to
patients, and one way they are able to deliver on this goal is to use the newest technologies and
medical advances. While smaller hospitals may not be able to afford such technologies, the
Mayo Clinic can. An industry environmental analysis of technologies can reveal multiple
advances that will benefit the Mayo Clinic, its staff, and its patients. One such technology that
the analysis could identify is the use of telemedicine and telehealth.

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Telemedicine is the use of technology to assess, diagnose, treat, consult, monitor, inform,
and educate patients remotely; telehealth applies these technologies to aid patients in taking an
active part in their health (Kvedar, Coye, & Everett, 2014). One aspect of telemedicine that the
Mayo Clinic has already used is eReferrals. An eReferral is a service model for reduced waiting
times for referrals and consultations. Since the Mayo Clinic has implemented the use of
eReferrals, they have been able to reduce the number of in-person specialty visits, be better
prepared to treat patients, and have increased primary provider satisfaction of the interactions
with specialists (Kvedar, Coye, & Everett, 2014). The Mayo Clinic has already used this aspect
of telemedicine, but an industry specific environmental analysis yields so much more potential.
Circling back to the Affordable Care Act and the problem of not enough providers,
telemedicine is a cost effective way for providers to deliver quality care to more patients.
Telemedicine comes in many forms, from live interactive videos, to the transfer of information.
Medical information is easily exchanged to multiple sites, and for a hospital with multiple
facilities across the U.S. like the Mayo Clinic, the use of telemedicine would be a valuable asset.
Telemedicine would greatly increase access to care to those living in rural areas and/or semiisolated regions, as well as patients who are chronically ill and bedridden. Patients can see their
doctors from the comfort of their homes.
The general and industry specific environmental analyses allow the Mayo Clinic to
systematically think, understand, and plan for potential issues with may affect the organization.
The general environmental analysis aids an organization to form a picture of the future
improvements and challenges so they are prepared to deal with them, instead of being surprised.
Within the healthcare industry, its important for the Mayo Clinic to identify potential new
technologies/advances, social/demographic issues, legislative/political changes, competitors, and

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any changes in healthcare economy that will affect the organization so they can stay at the
forefront of patient care.
Service Area and Competitor Analysis
Service Area
The clinics multidisciplinary approach to care attracts more than a million patients a year
from around the world. The world traveling patients come for medical tourism which has been a
part of the local economy for years. The service area for the Mayo Clinic in Rochester,
Minnesota covers the entire state of Minnesota. A hospital with a reputation such as the Mayo
Clinic has a worldwide service area. The service area analysis will focus on the Rochester,
Minnesota area (Mayo Clinic, n.d.).
Population and demographics. The population in Rochester, Minnesota was 108,992 in
2012. This consists of 99% urban populations and 1% rural. There are 51.2% females and 48.8%
males in this demographic, the median age is a young 35.0 years. In 2012 the median household
income was $61,741 and the median house value was $160,300. Healthcare and social assistance
accounts for 27% of jobs, which is the biggest percentage of jobs in the county. The 8.9% of
residents are living in poverty. This means that close to 10% of the city will receive Medicare
and Medicaid Services at the Mayo Clinic. Following all of the Affordable Care Act rules, the
Mayo Clinic is considered a top priority and therefore receives full reimbursement from the
Medicare and Medicaid programs.
Demographics of the city of Rochester is as follows:

79.2 % White

6.8 % Asian

6.2 % Black

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5.2 % Hispanic

The top ancestries are:

28.8 % German

12.6 % Norwegian

8.9 % Irish

6.3 % English

4.0 % Swedish

2.5 % Sub-Saharan African

The marital status for those 15 and older are:

52.0 % Now Married

31.1 % Never Married

11.3 % Divorced

3.8 % Widowed

1.7 % Separated

The education level for Rochester, (ages 25 and older) is:

93.7 % High school or higher

41.5 % Bachelors degree or higher

16.1 % Graduate or professional degree (City Data, 2016).

Competitor Analysis
In the city of Rochester, Minnesota there are two hospitals which can be considered
competitors, Olmsted Medical Center, and Rochester Methodist Hospital. The world-renowned

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Mayo Clinic in Rochester contains laboratories, education areas, and research laboratories. The
hospital also operates a hospice and a sports medicine clinic.
Olmsted Medical Center. According to Medicare.gov (2016), Olmsted Medical Center
is an acute care hospital which provides emergency services. The ten question survey of patients
experience shows that Olmsted exceeds the Minnesota and national averages in five out of ten
surveyed areas; however, it is below average in two of the ten areas surveyed. Olmsted ranked
high in the amount of patients who would recommend the hospital to others. They were weak in
having quiet rooms at night. Olmsted Medical Center did not have enough data under timely and
effective care for heart attack care. They were below average in pneumonia care, and below
average in all areas of surgical care. In emergency care Olmsted has a higher wait time, 266
minutes, then the state average of 199 minutes, but did have a lower wait time than the national
average of 274 minutes. There was not enough data to compare stroke care. Readmissions,
complications, and deaths were no different than U.S. national rate (Medicare, 2016).
Mayo Clinic Methodist Hospital. As printed on the U.S. Governments Medicare
website (2016), the Mayo Clinic Methodist Hospital, once called the Rochester Methodist
Hospital, is an acute care hospital which provides emergency services. The survey of patients
experiences shows that Mayo Methodist exceeded the Minnesota and national averages in nine
of ten surveyed areas; but was below average in one of ten surveyed areas. Methodists, like
Olmsted, also ranked high in patient recommending the hospital to others. They ranked low in
room and bathroom cleanliness.
Under timely and effective care, Methodist Hospital did not enough data in heart attack
care, pneumonia care, emergency wait times, and timely stroke care. Methodist Hospital ranked
at or above the state average in timely surgical care. There was not enough data to compare four

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of eight measures on readmissions, complications, and deaths, but for those areas they were no
different than U.S. national rate (Medicare, 2016).
Mayo Clinic. The Mayo Clinic uses a new approach, a creative, problem-solving
approach that the center uses to revolutionize the experience and delivery of health care by going
beyond process analysis and quality improvement (Mayo Clinic, What We Do, para 1, 2016).
This design has several areas the Mayo looks at:

What is our product?

Are we delivering it in a way that makes the consumer feel good about the
experience?

Are we providing a service that wont become obsolete?

This new way of thinking helps to push the Mayo Clinic ahead of its competitors.
Internal Environmental Analysis
Service Delivery
The Mayo Clinic in Rochester, Minnesota is a nonprofit organization committed to
clinical practice, education and research, providing expert, whole-person care to everyone who
needs healing (Mayo Clinic, n.d.). The Mayo Clinic offers an array of services from full service
healthcare options to local neighborhood, ranging from primary to highly specialized care. For
specialized care people from all over the country travel to the Mayo Clinic to receive care and
treatment.
Strengths. There are several strengths associated with the Mayo Clinics point of service.
To start the Mayo Clinic has an egalitarian culture, all the Mayo doctors collaborate their
knowledge and efforts, and all of the Mayo Clinic doctors, no matter the specialty, are engaged in
some form of research (Mayo Clinic, n.d.). Furthermore, after the first five years of

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employment, all physicians in the same department are paid the same salary. Some of the other
strengths are Mayo Clinics dedication to research, innovation, and their state of the art facilities.
The Mayo Clinic has specialized in cutting edge research and technology since 1889 (Mayo
Clinic, n.d.). Research at Mayo Clinic involves thousands of medical professionals who are all
searching for answers to complex medical problems in order to improve quality of life for
millions. At the Mayo Clinic physicians and healthcare practitioners combine their skills and
experience in team fashion to help solve medical problems in a way that puts the patient first
(IDEO, 2004). The Mayo Clinic offers patient-centered care that is focused and organized around
the healthcare needs and expectations of the patient.
The Mayo Clinic has a healthy living program that is unlike any other. The state of the art
facility offers spa services, certified health coaches, state of the art gym equipment, and a vast
majority of healthy living classes and events (Mayo Clinic, n.d.). Another strength of delivery are
the innovations in education, which help inform all appropriate parties of new information with a
focus on improving clinical care. According to Olsen and Dacy (2014), Mayo Clinic has taken a
strong stance nationally that medical reimbursements should pay for value, not volume.
Assessing and improving value is taken seriously and is defined by outcomes, quality, safety, and
service divided by costs. Lastly, Mayo offers the most advanced, innovative diagnostic and
therapeutic technology and techniques.
Weaknesses. One weakness of the Mayo Clinic is that it does not participate with
Medicare Part B (Mayo Clinic, n.d.). This fact is a big deal in and of itself as Minnesota is filled
with baby boomers. The baby boomers 1.5 million strong in Minnesotawill lead the way.
The 65 and over population is currently the fastest growing age group (Minnesota Department of

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Health, n.d.). Fortunately for the Mayo Clinic, but unfortunately for the purposes of this section,
there are not many published weaknesses associated with the Mayo Clinic.
The following weaknesses will be strictly based on hypothesis. There were reviews on
various forums where patients were not satisfied with the level of service or care that they
received. Those patients seem to have had very high expectations of the Mayo Clinic and the
Clinic did not meet their expectations. This can be viewed as a weakness as the reputation of the
Mayo Clinic can precedes itself. Another weakness can be location, Minnesota may be difficult
for some people to travel to for treatment, additionally Minnesota has harsh winters and short
summers.
Point of Service
Strengths

Weaknesses

Facilities

Reputation

Research Programs

Climate

Health Living Program

Does not participate with Medicare Part B

Dedication to Patient Care

None

Technology and Innovation

None

The resources of the Mayo Clinic are of high value, in 1864 the Rochester Mayo Clinic
started the first and largest integrated nonprofit medical group practice in the world. Today, as a
nonprofit the Mayo Clinic owns and operates two other facilities in Florida and Arizona, along
with medical, graduate, and health science schools. However impressive, the resources of the
facility are rare. Mayo Clinic's operating income rose 55 percent from $395.4 million in fiscal
year 2012 to $612.1 million in 2013. It saw total revenue of $9.42 billion last year (Becker

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Hospital Review, 2014). Given the Mayos Clinics long history and dedication to research and
high quality, the services provided by Mayo Clinic are not easy to imitate.
The Mayo Clinic, over the last one hundred and fifty years has proven its sustainability
by being ranked one of the top nonprofit facilities in the country several years in a row. Their
longevity and presence in Minnesota speaks to the sustainability. The Mayo Clinic is also
expanding their research facility. The expansion would add 30,000 jobs and double Rochester's
100,000 population (Davis, 2016). Collectively, the skills and knowledge possessed by
employees of the Mayo Clinic are high; the Mayo Clinic is one of the largest and best teaching
hospitals in the country. Because of the Mayos dedication to research, education and
innovation, as well as the large volume of patients with both rare and common diseases the
Mayos physicians diagnostic and treatment skills continuously improve. Due to the experience
with common diseases with unusual variations makes many of the employees skill set at the
Mayo rare.
Point of Service
Resources

Competencies

Capabilities

Value (High or Low)

High

High

High

Rare (Yes or No)

Yes

Yes

Yes

Imitability (Difficult

Easy

Difficult

Easy

Yes

No

Yes

or Easy)
Sustainability (Yes or
No)

Organizational Structure

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The Mayo Clinics organizational priorities are aimed at ensuring that patient-centered
focus permeates the entire organization, in every department at every location (Mayo Clinic,
n.d.). The Board of Trustees is the governing body of Mayo Clinic. It has responsibility over all
charitable causes, clinical practices, scientific and educational aspects, and the mission and
purpose of Mayo Clinic as set forth in its Articles of Incorporation and Bylaws (Mayo Clinic,
n.d.).
The organizational structure of the Mayo Clinic is a physician led governance, promoting
a patient-centered culture. The resources related to the organizational structure and learning
environment are high. The resources of Mayo are rare because the employees use information
technology and systems engineering to learn from each other and improve care in tandem with
clinical practice (McCarthy, Mueller, & Wrenn, 2009).
Strengths. The strengths of Mayos organizational structure involve patient-centered
care. To drive integration, Mayo Clinic restructured reporting relationships so that all nurses
regardless of settingreport directly up to the senior-most nurse leader (Mayo Clinic, n.d.).
Mayos model of integrated care is one of multidisciplinary practice with salary-based
compensation that fosters team-oriented patient care and peer accountability, a supportive
infrastructure allowing physicians and other caregivers to excel at clinical work, and a physicianled governance structure promoting a patient-centered culture (McCarthy, Mueller, & Wrenn,
2009). Review and teamwork for high-value care providers (including nurses and other members
of care teams), both within and across settings, provide accountability where they review each
others work, and collaborate to deliver high-quality, high-value care (McCarthy, Mueller, &
Wrenn, 2009).

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Weaknesses. The organizational structure lacks weaknesses, as the Mayo Clinic made
changes to their organizational structure in 2012. Before the reorganization a weakness was that
ambulatory nurses at Mayo Clinic reported through operational, non-nursing leaders. Still feeling
the effects today, this structure created two challenges for Mayo Clinic. First, it contributed to
nursing practice variation in the ambulatory setting. Second, inpatient and outpatient nursing
lacked clear communication channels, which could affect the level of care provided to its
ambulatory patients (Mayo Clinic, n.d.).
Organizational Structure
Strengths
Physician Led Governance
Patient Centered
Integrated Care

TYPE: Physician-Led Governance

Weaknesses
None
None
None

When evaluating the competitive relevance of the Mayos organizational structure, the
resources of the organizational structure are of high value and rare. The value is high because of
the physician led structure, designed with patient care in mind, and the clinics reorganization of
their structure. The structure is rare because most organizations are governed by a board of
directors. When evaluating the imitability of the structure, for a new facility it would be easy.
For an already established facility with an organizational structure in place it would be difficult.
The organizational structures sustainability is low because of the previous need of restructure.

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Organizational Structure
TYPE: Physician Led Governance
Resources
Competencies
High
High
Yes
Yes
Difficult
Difficult

Value (High or Low)

Rare (Yes or No)
Imitability (Difficult
or Easy)
Sustainability (Yes or

Yes

Yes

Capabilities
High
Yes
Easy
Yes

No)

Strategy Formulation and Evaluation

Overview
The Mayo Clinic in Rochester, Minnesota has a renowned Cancer Center that uses multispecialty cancer teams and cutting-edge research. The oncologists treat virtually every type of
cancer, from the most common, to the rarest forms. The Mayo Clinic has been known for state
of the art cancer treatments and clinical trial, where the patient is cared for by a team of experts.
Currently the Mayo Clinics Cancer Center in Rochester has 10 major cancer research programs.
Discoveries in cancer research, therapies, and treatments include the areas of cancer
immunology and immunotherapy, cancer prevention and control, cell biology, developmental
therapeutics, gastrointestinal cancer, gene and virus therapy, genetic epidemiology and risk
assessment, hematologic malignancies, neuro-oncology, and women's cancer (National Cancer
Institute, 2015, para 3). Personalized care is aimed at diagnosis, pain reduction, and healing.
Medical professionals from all over are able to refer and follow patients progress (Mayo Clinic,
n.d.).

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The strategic plan of the Mayo Clinics Cancer Center will go as follows: first the
adaptive strategy will be identified, then market entry strategy will decide how the adaptive
strategy will be implemented, and lastly the competitive strategy will determine how and will
define how the market entry strategy will be carried out (Swayne, Duncan, & Ginter, 2010).
Adaptive Strategy
It has been decided that the best adaptive strategy for the Mayo Clinic is to maintain the
current scope of the Cancer Center. The decision to maintain the current scope of the Cancer
Center at the Mayo Clinic will impact the market entry strategy, and competitive strategy. After
the adaptive strategy is discussed and evaluated, the other strategies will be discussed, evaluated,
and analyzed in regards to maintenance.
The adaptive strategy, maintenance, was picked for the Cancer Center because it is
believed that past strategies have been working well and little changes are needed. The
maintenance scope of this adaptive strategy will focus on enhancement. The Cancer Center at
the Mayo Clinic is doing well in achieving and embodying its directive strategies and goals, but
there is always room for improvements. Enhancements that can be made include quality
programs, such as Continuous Quality Improvements (CQI) or Total Quality Management
(TQM). These programs are aimed at efficiency through cost reduction or improving processes
(Swayne, Duncan, & Ginter, 2010). One process that can be improved upon, due to the research
aspect of the Cancer Center, is to improve the way that clinical results are evaluated. We decided
not to expand because we felt if the Cancer Center got even bigger we wouldnt be able to staff
the facility with enough people and still be able to provide our patients with personal care. We
chose not to contract because we want to be able to continue treating the amount of patients we
currently see, so patients from all over the world will still be able to receive first rate care. The

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adaptive strategy was evaluated using the Strategic Position and Action Evaluation (SPACE), and
the TOWS (threats, opportunities, weaknesses, strengths) matrix.
Strategic Position and Action Evaluation. The Strategic Position and Action
Evaluation (SPACE), was used to evaluate the adaptive strategy maintenance, to see if
enhancement is a good fit for the Cancer Center. The following shows the results of the SPACE
matrix for the Mayo Clinics Cancer Center:

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The Cancer Center has a Competitive profile, due to the strong service category strength,
financial and environmental stabilities. An organization with a competitive profile should use an
enhancement adaptive strategy (Swayne, Duncan, & Ginter, 2010).
TOWS. The TOWS matrix was also used to evaluate to evaluate the adaptive strategy
maintenance, to see if enhancement is a good fit for the Cancer Center. The results of the TOWS
matrix are as follows:

The TOWS matrix shows that enhancement is a good choice for the Cancer Center. Even though
the adaptive strategy maintenance through enhancement was chosen, the Cancer Center could
also use the adaptive strategy of expansion if they decided they need more room to treat higher
numbers of patients.
Market Entry Strategy
The adaptive strategy selected for the Mayo Clinic is to maintain the scope. According to
Duncan, Ginter, & Swayne (2010), often organizations pursue maintenance of scope strategies
when management believes the past strategy has been appropriate and few changes are required.

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Maintenance of scope does not necessarily mean that the organization does nothing; rather,
management believes the organization is progressing appropriately. This adaptive strategy was
selected based on the limited amount of weaknesses in the areas of service delivery and
organizational structure which proves that past and current strategies have been successful.
Although maintaining the scope has been the chosen direction, enhancements will be performed
to improve upon the products and services offered by the Mayo Clinic. The following will
highlight the major enhancement selected for the Mayo Clinic based on information gathered on
the strengths and weaknesses of the Mayo Clinic.
The Mayo Clinics primary value is the needs of the patient comes first (Mayo Clinic,
n.d.). The hospital is currently recognized for its education, research, innovation, and dedication
to patient care. The Mayo Clinic will focus on enhancement, which according to Duncan, Ginter,
and Swayne (2010), enhancement is when an organization is progressing towards its vision and
goals but need to do things better. Typically, enhancement is all about taking steps to improve on
aspects like quality, efficiency, and customer service.
The Mayo Clinic can enhance their service delivery by focusing on the needs of the
patient. This enhancement will place the focus on patient scheduling by reducing the length of
time one patient has to wait for an appointment, and by reducing the wait times in the patient
waiting rooms. The Mayo Clinic can achieve this by hiring more staff, cross-training employees,
and developing a new scheduling system.
In an effort to evaluate the fit of the market entry strategy maintenance of scope,
enhancing the needs of the patients, Kotters 8 Step Change Model was utilized. Kotters 8 Step
Model was chosen because it provided the steps and structure needed to lead the Mayo Clinic to
accomplish its enhancement. Furthermore, Kotters 8 Step has all the steps needed to address the

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enhancement to patient service. According to Alexander (2001), the Burke-Litwin model is

designed to serve as a guide to plan and manage organizational changes based on the 8 steps and
could also prove to be a successful model.
The enhancement to the Mayo Clinic is supported by the earlier findings of the Mayos
external conditions, internal resources, competencies and capabilities, and organizational goals
that make the facility what it is today. Based off of earlier findings, there was not a need to
expand or contract; additionally, the other option for maintenance, status quo, does not seem like
a good fit for the Mayo Clinic as it is known for innovation. According to Duncan, Ginter, and
Swayne (2010), status quo is often based of the assumption that the market has matured and
periods of high growth are over. For this reason, enhancement through status quo would never be
a good fit for the Mayo Clinic.
Competitive Strategy
Strategic posture. The strategic posture of the Mayo Clinic in Rochester, Minnesotas
renowned Cancer Center is to use the Prospector posture. The Mayo Clinic already treats every
type of cancer, at this time it was decided that would be best to concentrate on what the clinic
does best, treat patients. We have decided to pursue a prospector because we are cutting edge in
our scope strategy for the Cancer Center. This type of strategy is used when an organization uses
bold approaches and innovation; as prospectors major capability is finding the newest products
and opportunities (Duncan, Ginter, & Swayne 2008).
Strategic posture evaluation. The evaluation of the strategic posture includes an external
conditions evaluation, an internal conditions evaluation, and a competencies and capabilities
evaluation:

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External conditions evaluation. The strategic posture of the Mayo Clinic, prospector,
works well in our present external conditions of the ever changing Affordable Care Act. The
Affordable Care Act affords the necessary political and economic change combined with low
competitive rivalry locally, which fits well with the prospector posture (Duncan, Ginter, &
Swayne, 2008).
Internal conditions evaluation. Internally, the Mayo Clinic has the ability purchase,
develop, and use new technologies. Combine that with marketing, research, and development
experience results in the Mayo Clinic to remain successful using the prospector posture.
Competencies and capabilities evaluation. The differentiation strategies work well with
the prospector posture. This strategy is known for its marketing abilities, reputation for quality,
strong research capabilities, and long tenure, all of which are needed to move the Mayo Clinic
forward posture (Duncan, Ginter, & Swayne, 2008). When looking at the organizational
capabilities, this strategy has the prestige to attract highly intelligent, skillful employees
Strategic position. The decision to follow the prospector strategy also follows with a
differentiation strategy. This is because the market is unique and we can remain cutting edge
status as a leader in cancer care. This is a high tech image which gives us growth opportunities as
we have had in the past (Duncan, Ginter, & Swayne, 2008). According to Duncan, Ginter, and
Swayne (2008) a differentiation strategy is used to make the product or service different or better
from competitors products or services, or at least appear so to the consumer. Differentiation was
picked for the Cancer Center at the Mayo Clinic because they are considered unique by
consumer, which can be used as an advantage over the market. The Mayo Clinic already has a
high level of service and a reputation which makes it unique to the consumer with brand loyalty.
Summary and Conclusion

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The Mayo Clinic in Rochester, Minnesota is a world renown healthcare facility. From its
very first days the primary value of the organization has been focused on patient-centered care,
innovation, research, and education. The directional strategies of the Mayo Clinic set the tone
for the organization. In order to ensure continued success a strategic plan of the Mayo Clinics
Cancer Center. An external environmental analysis, service area competitor analysis, and
internal environmental analysis was done in order to outline and understand any potential issues
that may affect the Mayo Clinic, as well as plan for the future.
The analyses lead to the adaptive strategy maintenance of scope through the process of
enhancement for the Cancer Center at the Mayo Clinic. A SPACE and TOWS evaluation were
performed to see if this strategy was a good fit for the Cancer Center. The SPACE evaluation
places the Cancer Center in a competitive profile, which rightfully fits with enhancement. The
TOWS evaluation further concurred maintenance of scope through enhancement.
A market-entry strategy was decided to enhance service delivery of the Mayo Clinic by
focusing on the needs of the patient. To evaluate the fit of the market-entry strategy Kotters 8
Step Change Model was used. The findings conclude that enhancement to the Mayo Clinic is
supported by the Mayos external conditions, internal resources, competencies and capabilities,
and organizational goals.
The competitive strategies of the Mayo Clinic align with maintenance of scope. The
strategic posture picked is the prospector posture, and the strategic position is differentiation. A
Strategic Posture Evaluation was completed. The External Conditions Evaluation, Internal
Conditions Evaluation, and Competencies and Capabilities Evaluation all found that the posture
of prospector works well in the present external conditions of the Mayo Clinic.

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The Mayo Clinic should continually monitor and update all of the aforementioned
analyses in order to aid in giving the organization direction in choosing a strategy. Periodically
the chosen strategy should be reevaluated and updated as needed. If the Mayo Clinic continues
to follow the above mentioned methodology, they will continue to thrive, and patients of all
kinds can continue seeking quality care at the facility.

References
Becker Hospital Review (2014). 12 Things to know about the Mayo Clinic. Retrieved from:
http://www.beckershospitalreview.com/lists/12-things-to-know-about-mayo-clinic.html
Chen, Y. (2014). On the state of the American health care: A discussion of the health care system
and the Affordable Care Act. The Journal of Applied Business and Economics, 16(6), 6368. Retrieved from http://search.proquest.com/docview/1647810153?accountid=28644
City Data. (2016) http://www.city-data.com/city/Rochester-Minnesota.html
Crocker, R. M., & Kahla, M. C. (2015). Management challenge: Obamacare. Journal of the
International Academy for Case Studies, 21(5), 59-62. Retrieved from
http://search.proquest.com/docview/1768629392?accountid=28644
Dall, T. M., Gallo, P. D., Chakrabarti, R., West, T., Semilla, A. P., & Storm, M. V. (2013). The
care span: An aging population and growing disease burden will require a large and
specialized health care workforce by 2025. Health Affairs, 32(11), 2013-20. Retrieved
from http://search.proquest.com/docview/1458313362?accountid=28644
Davis, D. (2016). Mayo Clinic to greatly expand research facilities in Rochester. Retrieved from
http://www.grandforksherald.com/news/region/4051124-mayo-clinic-greatly-expandresearch-facilities-rochester

MAYO CLINIC

30

Hosseini, H. (2015). Aging and the rising costs of healthcare in the United States: Can there be a
solution? Ageing International, 40(3), 229-247. doi:http://dx.doi.org/10.1007/s12126014-9209-8
Ideo (2004). Better service at a renowned healthcare institution. Retrieved from
https://www.ideo.com/work/patient-provider-service-for-mayoclinic#mQU8feKyhGtRb56c.99https://www.ideo.com/work/patient-provider-service-formayo-clinic#mQU8feKyhGtRb56c.99
Kotter Change Model. (n.d.) Retrieved from http://www.kotterinternational.com/the-8-stepprocess-for-leading-change/
Kvedar, J., Coye, M. J., & Everett, W. (2014). Connected health: A review of technologies and
strategies to improve patient care with telemedicine and telehealth. Health Affairs, 33(2),
194-9. Retrieved from
http://search.proquest.com/docview/1498231601?accountid=28644
Luger, T. M., Houston, T. K., & Suls, J. (2014). Older adult experience of online diagnosis:
Results from a scenario-based think-aloud protocol. Journal of Medical Internet
Research, 16(1), 117-128. doi:http://dx.doi.org/10.2196/jmir.2924
Mayo Clinic. (n.d.a). About Mayo Clinic. Retrieved from http://www.mayoclinic.org/aboutmayo-clinic
Mayo Clinic. (n.d.b). About Mayo Clinic. http://www.mayoclinic.org/about-mayoclinic/commitment-to-community/history
Mayo Clinic. (n.d.c). Mission, vision, and values. Retrieved from
http://www.mayoclinic.org/about-mayo-clinic/mission-values
Mayo Clinic. (n.d.d). Mission, goals, and approach. Retrieved from http://www.mayo.edu/center-forinnovation/what-we-do/mission-goals-and-approach

MAYO CLINIC

31

Mayo Clinic. (n.d.e). History. Retrieved from http://www.mayoclinic.org/

Mayo Clinic. (n.d.f). About Mayo Clinic. Retrieved from http://www.mayoclinic.org/about-mayoclinic/quality/rankings

Mayo Clinic. (n.d.g). Billing and insurance at the Mayo Clinic. Retrieved from
http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/acceptedinsurance/medicare/more-on-medicare
Mayo Clinic. (2016) What we do. Retrieved from http://www.mayo.edu/center-forinnovation/what-we-do
Mayo Clinic. (n.d.h) Governance and organizational structure. Retrieved from
http://www.mayoclinic.org/documents/governance-management-structure-pdf/doc20079617
Mayo Clinic. (n.d.i). Mayo unveils destination medical center plan. Retrieved from
http://www.mayoclinic.org/medical-professionals/clinical-updates/psychiatrypsychology/mayo-unveils-destination-medical-center-plan
Mayo Clinic. (n.d.j) Mayos primary values. Retrieved from http://www.mayoclinic.org/aboutmayo-clinic/mission-values
McCarthy, D., Mueller, K., & Wrenn, J. (2009). Mayo Clinic: Multidisciplinary teamwork,
physician-led governance, and patient-centered culture drive world-class health care.
Commonwealth Fund 27(1306). Retrieved from
http://www.commonwealthfund.org/~/media/Files/Publications/Case%20Study/2009/Au
g/1306_McCarthy_Mayo_case%20study.pdf
Medicare. (2016). Retrieved from http://www.medicare.gov/hospitalcompare
Minnesota Department of Health. (n.d.). Data and Statistics. Retrieved from http://www.health.state.mn.us/

National Cancer Institute. (2015a). Mayo Clinic Cancer Center. Retrieved from

MAYO CLINIC
http://www.cancer.gov/research/nci-role/cancer-centers/find/mayoclinic
National Cancer Institute. (2015b). MD Anderson Cancer Center. Retrieved from
http://www.cancer.gov/research/nci-role/cancer-centers/find/mdanderson
Olsen, K., & Dacy, M. (2014). Mayo Clinic - 150 years of serving humanity through hope and
healing. Mayo Sesquincentennial 89(1), 8-15. Doi:
http://dx.doi.org/10.1016/j.mayocp.2013.10.024
Swayne, L., Duncan, W. J., & Ginter, P. (2010). Strategic Management of Health Care
Organizations (6th ed.). West Sussex, England: Jossey- Bass.
Swayne, L. (n.d.) Maintenance of Scope. In Encyclopedia of Health Care Management.
Retrieved from http://dx.doi.org/10.4135/9781412950602.n467

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