Current State of Quality: Internal Dynamics

What are some of the variables that can affect your hospital internally and externally? Would you hire a marketer or a website developer to improve your hospital website? Or would you recommend expanding your quality and what are some of the internal dynamics that can be used to build a successful brand or mission for the hospital? Make sure your initial post is a minimum of 250 words or more and responses to your peers should be at least a minimum of 100 words.