Competing external stakeholders try to attract employees of the focal organization. These competitors may be direct competitors for patients or they may compete for qualified personnel. Patients fill the role of those seeking care. They demand that they receive quality care across the organization and that the care is consistent. Patients play a role in the organization because the organization needs patients to run the facility. The organization provides a service that patients need and demand. The source of influence of external stakeholders comes from the control of strategic, material, labor and resources