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Case Study
Bloomington Hospital’s Open-Heart Unit
Case Notes Prepared by Charles M. Byles, Virginia Commonwealth University

Introduction
The case centers on the decision by the Bloomington Hospital (BH) board to add a cardiovascular (CV) surgery unit to its range of services. The CV decision came as a result of a strategic planning exercise by the board. Other additions to the services of the hospital were recommended in the decision, but none generated the level of criticism aroused by the CV decision. At the center of the crisis facing BH was the lack of confidence expressed by some key stakeholders in the BH board and in particular, its president, Roland Kohr. The criticisms were so deeply felt that the Monroe-Owen Medical Society (the local physicians’ organization) had called for the resignation or firing of Kohr and all the BH vice-presidents. The board was in a difficult position. Even if it was right in its decision to start a CV unit, the opposition to the decision probably eroded hospital president Kohr’s effectiveness as a hospital administrator. In addition, the physician’s practice (Schumacher and Isch) that was to provide the physician to offer the CV surgery was having doubts that the idea would work. At the conclusion of the case, the BH board faced three options: (1) it could go ahead and implement the program despite wide community opposition, (2) the board could drop the CV surgery plan, or (3) it could put the program on hold and investigate the pros and cons further. The case fits well with Chapter 1 (section on stakeholders), Chapter 2 (External Analysis), Chapter 3 (Internal Analysis), Chapter 4 (Business-Level Strategy), and 12 (Strategic Leadership).

Summary of Key Strategic Issues
1. Effect of opposition of key stakeholder groups in strategy implementation. (Chapter 1)
2. Importance of performing a thorough evaluation of opportunities and threats in the external environment. Did BH perform an adequate external analysis? Did

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