Organizations have utilized strategic responses towards quality improvements, productivity increment, cut costs, and reorganize and establish culture. These are acts aimed at dealing with the firm's environment's difficulties. Therefore, they are building and employing various strategic responses that are dependent on the environment, capacity, skills, and resources. Despite these benefits, environmental volatility has hampered performance. It has drawn attention to the firms’ already delicate performance, which is heavily influenced by micro and macro environmental factors. Things have not been different for Reliance hospital. Hence, this study sought to understand what are the strategic approaches adopted by Reliance Hospital to improve performance especially during COVID-19? And how does the performance of the Reliance Hospital relate to its strategic responses. The study adopted a case study design. Data was collected using an interview guide the CEO, senior doctors, senior nurses, finance manager, and human resource manager. The findings of the study indicated that there are different internal and external environmental factor that influence the performance of the hospital. The respondent recorded political, economic and Socio-cultural factors. They also listed other factors like leadership, skills, knowledge and capabilities, human resource development, socio-demographic factors and patient involvement and cooperation. The respondents listed ways they tried to deal with turbulent environments changes. One was conducting a competitor analysis, having products for both high income and middle-income earners, attracting donor funding and adopting a customer relationship management strategy. Additionally, they are investing in increased technological innovations, improving its physical infrastructures, strengthening its financial management systems, and training employees to achieve quality patient care and satisfaction. The study concluded that the hospital is greatly affected to an extent by both external and internal factors. It recommended that the hospital's management need to use their brand names for cultivation of customer loyalty, use advertising and real time strategic responses that facilitate the hospitals preparedness in handling the impending issues and train their employees to reduce staff turnover. The hospital should also follow all government policies and regulations to the letter in order to avoid lawsuits which may harm the hospitals’ reputation. Lastly, the study concludes that has given the hospital an advantage in the industry.

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