The main objective of the hospital is to provide medical care to the community within the available resources and to the bet of the satisfaction of the professionals and patients, and the community at large. The challenges being faced by the hospital administration can be elaborated as follows:

1. Extensive division of labour:

   There are many departments, staff, offices, and positions and also coordination of tasks, functions and interactions. The hospital is a highly labour-intensive organisation. The work of the hospital cannot be accomplished by a single person. It is always as a result of the Total Efforts of All Members (TEAM), the Operation Theatre (OT) and the Intensive Care Unit (ICU) are perfect examples of team work. Those who are familiar with the working of the hospital will appreciate that the members of the team in ICU and OT work in close knit and the task performed is of joint nature and the responsibility is also shared.

2. High interdependence of services:

   Nobody whether professional or non-professional can work in isolation, everybody is dependent upon somebody else for completion of tasks. The clinical services departments, diagnostics, therapeutics, support and utility services are all interdependent and interrelated. The work of one department and the workers of that department certainly affect the work of the other departments. If the CSSD people are negligent in their duties, it is going to affect the work of the OT. Same is true about all other departments.

3. A mix of autocratic and democratic style:

   The hospital at times behave in a very democratic way like working in team. At other times it is very autocratic like in emergency situations, there is a strong hierarchy in the medical organisation, and it reflects itself in relatively sharp patterns of superior-subordinate relationship, in expectation of strict discipline and obedience. 

4. Authoritarianism:

   Despite of modern management techniques and professionalization, much of the authority is still exercised in the hospital like the traditional senior-junior relationship of the college life. It has a great influence in the administration of the medical professionals, which is rarely observed in other professions.

5. Public demand of efficiency: There is an increasing concern about the efficiency of the hospital operations. As the hospital has become the resource for all the members of the community, the public expects of its best medical and nursing services that can be offered. On the contrary these services are becoming costlier due to the rising expenditure on the cost of materials, equipment, manpower, energy, information technology, etc. The public is becoming disappointed with the sharp rise of the cost of medical treatment.

6. Needed coordination:

   Much of the control is exercised with the help of coordination. The hospital is a sub-system of the larger social system. The hospital is a system in itself comprised of many sub-systems. The work of these subsystems is to be coordinated perfectly by the hospital administrator, for effective and efficient functioning of the system as a whole. Due to high degree of specialisation and functional independence found in hospital, coordination of skills, tasks and activities is indispensable. The coordination is an essence of hospital administration.

7. Professionalization:

   it is another distinct feature of hospitals. The majority of those who hold therapeutic or non-therapeutic positions in the hospitals are trained as professionals. They adopt certain values, attitudes and behaviour in their lives as professionals; this sometimes becomes difficult for the non-medical administrators to exercise authority over the professionals. Same is true about the nursing professionals.

8. Complimentary expectations:

   The high degree of professionalism among doctors and nurses has the effect if inculcating many complimentary expectations and common norms and values, expectations that are essential in the integration of the organisation. These are norms of giving good medical care, devotion to duty, loyalty, selflessness, discipline and hard work.

9. No single line of authority:

   The hospital is closely related to the professionalization and specialisation. There is no single line of authority. The authority in a hospital is shared by the governing body, the administrator and the doctors. There is no unity of command and no single line of authority. People have to work under multiple commands. For example, the nursing personnel working in the wards. They have to work under the heads of the unit i.e., nursing administrator and the administrator of the hospital.

10. Delicate balance of power:

    Multiple lines of authority make it very difficult for the balance of power in the hospitals.

11. Financial challenges and hospital productivity: Hospitals are the second most energy-intensive buildings after restaurants, and globally, healthcare costs are on the rise. These financial challenges— in addition to an aging world population and increasing energy costs—are putting pressure on healthcare organizations to do more with less without compromising quality of care.

12. Maintaining patient safety:

     Every year an estimated 20,000 people in the U.S. and 5,000 in the U.K. die from an infection they received while in the hospital. Reducing the risk of infection, as well as other potential risks, such as power failures, is crucial in ensuring a high quality of care and maintaining the organization’s reputation.

13. Regulatory standards and emerging energy mandates:

     Noncompliance with regulatory standards can lead to a disruption in operations, poor quality of care, safety issues, and substantial fines. At the same time, as energy demand rises, many countries are requiring healthcare facilities to reduce carbon output and meet mandates for energy reductions.

14. Hospital security:

     Healthcare facilities are often open 24/7, and those visiting are often under a great deal of stress when life and health are at stake. Violence, infant abductions, patient wanderings, and theft of drugs and hospital assets are major concerns.

15. Patient satisfaction:

     The well-being of patients is a key to reducing length of stay and preventing readmissions. According to the American Society for Healthcare Engineering (ASHE), in green hospitals, patients are discharged an average of 2.5 days earlier compared to traditional hospitals. Additionally, patient satisfaction can also affect a hospital’s revenue. If the systems are operating poorly or not at all, quality metrics such as Hospital Consumer Assessment of Healthcare Providers and Systems can be adversely affected.

Threats and Strategies to overcome them

Types of strategies:-

• Corporate strategies: – Brand extension by opening medical college and school.
• Business strategy: – Focus on improvement revenue and cash flow by enhancing neuron and other department. Enhancing the facilities in cardiac department focus on high end health care services by the use of minimum invasive surgery.
• Functional strategies: – Use of strong HIS back bone and PACS technology to safety transmit patient information. Use of HL7 and DICOM standard for telemedicine purpose. Self-defining and self-expiring password for maximum privacy.
• Miles and snows strategy theory: – It is analyzer type of strategy. High level of standardization, routineization and mechanization for efficiency is used. it is also flexible in reaching to increased competition and changes in the market. According to this strategy high formulization, mordantly centralized controlled is used in the hospital structure.