Strategic

The business sector represents one of the fundamental axes in the economy of a country. It contributes to
generate employment; development of the industrial, commercial and services sector. At the same time,
the participation of micro, small and medium-sized enterprises is noteworthy due to the large number of
organizations in this category. It is important to emphasize in the short life cycle of these companies and the
limitations that are present. Through a descriptive and a bivariate analysis, 113 micro-bakeries had been
studied in the province of Azuay, which are affiliated to the Ministry of Industries and Productivity (MIPRO)
of Region 6. The results show related behaviors between the average productivity per employee of the
microenterprises and strategic business management, their productive capacity, their degree of innovation
in machinery, the equipment and marketing systems and also on the requirement of additional financing
for the growth of business. However, it is considered that it is a sector with limited skilled labor that does
not allow an increase in productivity and competitiveness, which is a key factor in business development.

Abstract. This study aims to depict a failed strategic change initiative in a Turkish public hospital by means of an action research and it strives to explain critical factors underpinning the failure, thereby proposing how such factors should be tackled with for similar initiatives elsewhere. The study calls attention to the recent challenges ongoing in the environment of hospitals, which urge them to take on a more strategic focus. In this vein, we discredit accreditation based systems, which emphasize monitoring resources and propose a capability-focused strategic management model for hospitals. A hybrid action research protocol, which combines both traditional and participatory action research methodologies in its design, is employed to formulate and implement the model in a public hospital. The phases of the project and obstacles faced during these phases are discussed. The findings suggest that although the model offers significant potential for competitive success and better resource efficiency, path-dependent characteristics of the public sector governance in Turkey have impeded the adoption of the model in our case. Both macro-systemic characteristics related mainly to the Turkish national culture and management of public institutions and situation-specific characteristics, such as top management’s decision making orientation, professional norms and patronage relationships have blocked the way for the aspired transformation despite positive attitudes of and support from higher order public authorities and internal professional groups.

Keywords: Turkey, Public Hospital, capability, healthcare management, strategic management,