STRATEGIC PLANNING IN HEALTH CARE, Physician Leadership Modules

Welcome to the Strategic Planning in Health Care for physician leaders module!!

 

This is one of several fully online, self-directed learning modules for Physician Leadership. For many of you this will be your first exposure to organizational strategic planning. I hope you will find the content useful and the format and design engaging. The module is designed to be completed in 2 hours. This includes any pre- and post-assessment or learning activities, required readings and the actual content.

 

Strategic planning is a commonplace, yet very important, activity in the field of health service administration. To use a travel analogy, organizations without a well-developed strategic plan, including a clear mission statement and goals, run the risk of “getting on their horse and riding in every direction”. Without a clear roadmap, how can you know where you are going? How will you know when you have arrived? My goal with this module is to introduce you to various aspects of strategic planning as they apply to the field of health care management, with a particular focus on your role as a future physician leader in the strategic planning process.

 

Over the years, I have led or been a participant in many strategic planning initiatives in health care organizations and professional associations. I have seen the benefits of effective strategic planning and can attest to what it can accomplish. I have worked in organizations where the strategic plan (SP) was a living document built from widespread consultation and deliberation at all levels of the organization. It served as the roadmap that Board members, managers, physicians, and staff consulted on a regular basis for guidance. I have also been a part of organizations where the strategic planning process was something that was limited to the senior managers and the Board with minimal engagement of physicians, staff and stakeholders. In these organizations SP was viewed more as an unpleasant task to be endured. These SPs sat on the shelf and gathered dust. These organizations often encountered organizational problems that could be traced back to a lack of an effective and meaningful SP.

 

To be effective, the SP process and outcomes have to be embraced and viewed as an essential management tool to achieve organizational goals and objectives.

 

Participants are encouraged to read the required readings prior to beginning the module.

I look forward to reading your discussion postings. If you have any questions please send me an e-mail.

 

Victor Maddalena, MHSA, PhD 

[email protected]

Let's start talking about Strategic Planning

Objectives

Objectives

By the completion of this module, participants will be able to:

  • Discuss the benefits of strategic planning (SP) as a management and leadership tool;
  • Demonstrate the basic processes involved in initiating, planning, implementing and evaluating an organizational and departmental SP; 
  • Explain the role of SP in directing organizational change
  • List some of the common barriers and enablers encountered in successful SP.

This module has been designed to consider the CanMEDS Physician Competency Framework, including the roles of: Medical Expert, Communicator, Collaborator, Health Advocate, Manager, Scholar and Professional.

Introduction

..................Teacher's Comment

In this module you will learn the fundamentals of organizational strategic planning and how these processes can guide health service planning and decision-making. The module will consist of pre-training, training and post-training activities and is designed to be completed online.


Pre-training

Please complete the online Pre-module Test and Survey coming up next. These will enable you to reflect on your current knowledge in the subject matter area and help inform the design of the in-person training activities. The Pre-module Test and Survey follow this section in the course contents.

References

The readings and articles listed below should be reviewed in preparation for this module. (Some of these may open in your computer's 'download' folder, dependent on which browser you are using.)

  1. Bryson, J. (2004). Strategic Planning for Public and Non-Profit Organizations: A Guide to Strengthening and Sustaining Organizational Achievement. 3rd Edition. San Francisco: Jossey-Bass. Chapters 2, 3.
  2. Zuckerman AM (1998) Healthcare strategic planning: Approaches for the 21st century. Health Administration Press: Chicago, Illinois. Chapters 3, 5, 6.
  3. Roberts, C.C. et. al (March-April 1998). Core Responsibilities of Board Trustees. Journal of Health Care Management, 43 (2), 111-113.
  4. Clark CS, Krentz SE, (2006). Avoiding the pitfalls of strategic planning. Healthcare Financial Management, 60(11), 62-67. 
  5. Beckham, D. (June, 2010). Physician Involvement in Hospital Strategic Planning. Trustee, 63(6), 6-7. 
  6. Kaleba R (2006). Strategic planning: Getting from Here to There. Healthcare Financial Management, 60(11), 74-78
  7. Maddalena V (2012). A Primer on Project Management: The Cornerstone of Strategic Leadership. Leadership in Health Services. 25(2), 80-89.


................Teacher's Comment

Participants are also asked to obtain and read a strategic plan from a health organization somewhere in Canada. A local organization, for example one of the Regional Health Authorities in Newfoundland and Labrador,, should be easily accessible. If possible, obtain a copy of any documents used in the preparation of the strategic plan (for example: environmental scans, summary documents describing the strategic plan, etc.).

Pre-module Test and Survey

Typically, the annual strategic planning process is initiated by:

  • Accreditation Canada
  • The Department of Health and Community Services
  • The Board of Directors of the RHA
  • The Chief Executive Officer

The Mission Statement of an organization defines:

  • the vision of the organization.
  • the community served by the organization.
  • why the organization exists.
  • all of the above.
  • none of the above.

The basic management decision-making algorithm is:

  • consult, decide, evaluate.
  • assess, plan, implement, and evaluate.
  • decide, assess, correct if necessary.
  • assess, implement, re-assess.

A Vision Statement defines the organization's

  • primary mandate.
  • future ideal profile.
  • values to guide decision-making.
  • mission.

Strategic plans should be monitored

  • at the next strategic planning retreat.
  • on an annual basis.
  • on an ongoing basis.
  • never.

In the following survey-type questions, select the option that best applies to your knowledge before completing the module. There is no correct or incorrect answers - they are for your own comparative purposes after you have completed this module.

I am confident in my ability to discuss the benefits of strategic planning as a management tool.

  • Strongly disagree
  • Disagree
  • Neutral
  • Agree
  • Strongly agree

I am confident in my ability to discuss the benefits of strategic planning as a leadership tool.

  • Strongly disagree
  • Disagree
  • Neutral
  • Agree
  • Strongly agree

I am confident in my ability to demonstrate the processes involved in initiating, planning, implementing and evaluating organizational and departmental strategic planning.

  • Strongly disagree
  • Disagree
  • Neutral
  • Agree
  • Strongly agree

I am confident in my ability to explain the role of strategic planning in directing organizational change.

  • Strongly disagree
  • Disagree
  • Neutral
  • Agree
  • Strongly agree

I am confident in my ability to list some of the barriers and enablers encountered in successful strategic planning.

  • Strongly disagree
  • Disagree
  • Neutral
  • Agree
  • Strongly agree

Strategic Planning

What is strategic planning?

“Strategic planning is a disciplined effort to produce fundamental decisions and actions that shape and guide what an organization (or other entity) is, what it does, and why it does it”. (Bryson, 2005, p. 6)

Bryson 2005


Strategic Planning:

  • enables organizations to focus on the “big picture” 
  • is visionary and proactive
  • serves as a guide to decision-making and resource allocation
  • enables the organization to move forward in a manner that is focused
  • allows organizations to fulfill their mission
  • must be action oriented and linked to finances and operational planning
  • allows the organization to address problems
  • is action oriented and linked to the business plan

Learner Activity

Obtain and read a strategic plan from a health organization (preferably one you are familiar with). If possible, obtain a copy of any documents used in the preparation of the strategic plan (for example, environmental scans, summary documents describing the strategic plan, etc.). 

Once you obtain a copy of your organization’s strategic plan, identify the organization’s mission, vision and values. Identify the key strategic goals for the organization and any timelines for achieving those goals. 

  • Is the strategic plan easily accessible? 
  • Is it easy to read? 
  • Is your strategic plan current/up-to-date?

Benefits of Strategic Planning

Some of the benefits of strategic planning include:

  • Increased effectiveness
  • Increased efficiency
  • Improved understanding and better learning
  • Better decision-making
  • Enhanced organizational capabilities
  • Improved communication and public relations
  • Increased political (public) support
  • Helps to create common goals for the staff

Reflection Activity

Are you able to identify the key components of the Strategic Plan? 

Does your organization’s strategic plan identify how it can benefit the organization in the ways listed above?

Desired Outcomes

What do you hope to do with your strategic plan?

  • Reaffirm or set a new Mission?
  • Set organizational direction?
  • Inform staff and stakeholders of your directions or intentions?
  • Use the SP as a business planning tool?
  • To leverage funds or support?
  • To resolve internal problems?
  • To meet accreditation standards?
  • All the above!

Learner Activity

If you were leading a strategic planning exercise for your Department/Unit/Organization which three of the above desired outcomes would be your primary focus?

ABCs of Strategic Planning


A.     Where you are?

B.     Where you want to be?

C.     How to get there?

The basic management algorithm is: 

  • Assess
  • Plan
  • Implement
  • Evaluate




SP is a common tool found in a manager’s toolkit. The process behind SP follows the same management decision-making process that all management functions employ: Assess, plan, implement and evaluate.

Overview of the Strategic Planning Cycle

  • Assess the need for SP
  • Plan the SP process
  • Establish mission and mandates 
  • Assess the internal and external environment
  • Identify strategic priorities
  • Formulate strategies and an action plan
  • Ensure adequate resources have been allocated
  • Implement and reassess the plan
  • Evaluation protocol (accountability)
  • Begin the cycle again

Strategic Planning: 10 Steps for Success!

10 Steps

Step One: Initiate and Agree on a Strategic Planning Process

Step Two:  Clarify Organizational Mandates

Step Three: Identify and Understand the Views of Key Stakeholders

      Surveying the Environment: External and Internal Communities

Step Four: Assess the Environment to Identify Strengths, Weaknesses, Opportunities and Threats (SWOT analysis)

Step Five: Identify and Frame Strategic Issues

Step Six: Formulate Strategies to Manage the Issues

Step Seven: Review and Adopt the Strategic Plan

Step Eight: Establish an Effective Organizational Vision and Values for the Future

Step Nine: Develop an Effective Implementation Process

Step Ten: Reassess Strategies and the Strategic Planning Process

Learner Activity

Examine the SP for your organization. 

Does your SP describe the planning process that was employed to conduct the SP?

Step One: Initiate and AGree on a Strategic Planning Process

Board of Directors will identify the need for strategic planning

  • Usually an annual event 
  • Required by accreditation standards

Senior management prepares for the planning process

  • Securing resources
  • Environmental scans (stakeholder consultations)
  • Building support within the organization
  • Planning the Board/management retreat

The Board (or department) hosts a SP retreat

  • Usually at an off site location
  • Typically a one or two day event
  • Attendance varies but generally in attendance:
  • Board members
  • Executive Management Team
  • Key leaders of ancillary organizations

Step Two: Clarify Organizational Mandates

What is your mission as defined by legislation or organizational policy?

  • The Mission Statement clearly defines the reason why the organization exists.  
  • The Mission Statement is the foundation of any organization. 
  • Departments within an organization can have their own mission, but it must be consistent with the mission of the organization..
  • Short, clear, “punchy” statement.


See examples of mission statements associated with the company/corporation logos below:



At the Coca Cola Company we strive to refresh the world, inspire moments of optimism and happiness, create value and make a difference.

Source:  http://www.thecoca-colacompany.com/ourcompany/index.html


Our mission is to be the world's premier consumer products company focused on convenient foods and beverages. We seek to produce financial rewards to investors as we provide opportunities for growth and enrichment to our employees, our business partners and the communities in which we operate. And in everything we do, we strive for honesty, fairness and integrity.

Source: http://www.pepsico.com/


NASA’s mission:

Is to improve life here, to extend life to there, to find life beyond. 

Is to pioneer the future in space exploration, scientific discovery and aeronautics research. To understand and protect our home planet, to explore the Universe and search for life, and to inspire the next generation of explorers... as only NASA can.

Source: http://www.nasa.gov/

McDonald's brand mission is to "be our customers' favorite place and way to eat." Our worldwide operations have been aligned around a global strategy called the Plan to Win centering on the five basics of an exceptional customer experience – People, Products, Place, Price and Promotion. We are committed to improving our operations and enhancing our customers' experience.

Source: http://www.aboutmcdonalds.com/mcd.html



To bring inspiration and innovation to every athlete in the world

Source: http://help-en-us.nike.com/app/answers/detail/a_id/113/p/3897



Google’s mission is to organize the world's information and make it universally accessible and useful.

Source: http://www.google.com/about/corporate/company/


Our guiding mission is to deliver superior quality products and services for our customers and communities through leadership, innovation and partnerships. 

Our vision is to be the quality leader in everything we do.

Source: http://www.timhortons.com/ca/en/about/faq.html

Our mission: to inspire and nurture the human spirit – one person, one cup and one neighborhood at a time.

Source:
https://www.thebalance.com/starbucks-mission-statement-2891826

The principal mandate of Regional Health Authorities is defined by:

  • NL Healtlh Boards Association
  • Minister of Health and Community Services
  • RHA Board of Directors
  • Regional Health Authorities Act
  • None of the above

Learner Activity

Select your favourite organization or product and:

  • Search on the Internet for the organization’s mission statement. 
  • Post the mission to the Discussion Board and discuss; and
  • Try and find the organization’s strategic plan. 
  • Discuss interesting features of the strategic plan.

Step Three: Identify and Understnd the Views of Key Stakeholders

  • Who are your key stakeholders/partners? (internal and external)
  • Who are the key users, partners or suppliers of your service?
  • What are their views of your organization?
  • Identify ways to survey your key stakeholders.
  • Survey your environment.  

Learner Activity

If you were doing a strategic plan for your unit or organization,(or for your favourite organization) who would you identify as your key stakeholders (internal and external)?

Of the stakeholders you have listed, identify ways that you could survey them for input on your unit or organizations future?

Surveying the Environment: External and Internal Communities

Who is your “Community”?

How do we begin to assess needs/wants of the community?

Identify ways to consult with your community. 

What do you do with the information now that you have gathered it? What are they telling you?

Separate “wants” versus “needs”.

Understand the politics of Internal and External Environment.

An environmental scan

  • surveys internal and external stakeholders.
  • assesses the key factors influencing the organization.
  • analyzes trends in utilization and finances.
  • involves all of the above.
  • involves none of the above.

Learner Activity

Identify ways you could seek input from physicians, staff, patients, and clients if you were conducting an environmental assessment of your organization’s strategic plan.

Step Four: Assess the Environment to Identify Strengths, Weaknesses, Opportunities and Threats (SWOT Analysis)

A SWOT analysis is one of several similar management tools to identify the strengths, weaknesses, opportunities and threats facing the organization. In a strategic planning retreat each of the SWOT sections would be discussed as a group or in small groups and written on flip charts and posted around the room. It can be a useful way to visualize the challenges and opportunities facing your organization.

Internal to organization

  • Strengths,
  • Weaknesses 

External to organization

  • Opportunities, 
  • Threats

Exercise

Conduct a SWOT analysis for your own work setting (e.g. class, division, department, organization.)

On four separate sheets of paper list your:

  • Strengths
  • Weaknesses
  • Opportunities
  • Threats

Learner Activity

What are some ways you could engage your peers, co-workers, staff, patients/clients in conducting a SWOT analysis?

Step Five: Identify and Frame Strategic Issues

In larger organizations much of the environmental scanning (e.g., stakeholder analysis, SWOT analysis, etc.) are done in advance of the Board and senior management retreat. The management team will often prepare a summary document outlining major issues for the Board and Executive to examine). In smaller organizations some of this work is done during the planning retreat. This information will help to set the context within which you will now establish your priority goals.

  • The Board must review the internal and external scans, understand the circumstances facing the organization and (with Executive Management) determine the key priorities for action.
  • You can not be all things to all people.
  • Focus on priority items of concern.

Strategic priorities can:

  • carry different costs and benefits.
  • be short or long term.
  • be managed in a project management framework.
  • involve all of the above.
  • involve none of the above.

Step Six: Formulate Strategies to Manage the Issues

  • Strategic Priorities can carry different costs and benefits.
  • Each priority may take different time and human resources to achieve.
  • Some goals may be short term, some may be long term…costs and time commitment will vary.
  • Each goal will need to be put into a project management framework. 
  • Each strategic priority (project) will need to be evaluated.

Be realistic and practical: It is better to set three goals and do them well than to set ten goals and do them poorly.

Step Seven: Review and Adopt the Strategic Plan

  • After the key priorities have been identified, the Board will finalize a Strategic Planning document that will comprise the organization’s Mission, Vision, Values and Strategic Priorities for the coming 1, 3 and 5 years.
  • To enhance success: keep strategic goals simple and achievable.
  • Strategic priorities should move you closer to achieving your mission.

Exercise

Consider the following:

  • Is your organization’s SP easily accessible?
  • Is it well presented, easy to read, etc.? Does your SP come in more than one reader format? (eg., printed version, web-based version, summary document)

Step Eight: Establish an Effective Organizational Vision and Values for the Future

  • Some organizations identify their vision during the mission statement discussions, some do it after their SP has been developed.
  • Either way, the Vision Statement describes the “ideal”.
  • The vision answers the question: “If we were successful what would our organization look like?”
  • The “vision” is often used as a slogan: e.g. “Healthy People, Healthy Communities”.
  • Values Statements describe the values that will guide the organization’s decision-making.

Learner Activity

Consider:

Does your organization have a statement outlining their core values?

Step Nine: Develop an Effective Implementation Process

  • Ensure you approach your implementation using project management principles.
  • Ensure you have adequate resources (human, capital and financial) to implement your plan.
  • Establish benchmarks: How will you know if you have been successful?
  • Communicate your plan effectively to internal and external stakeholders.

Implementing the strategic plan is often where the “rubber hits the road”. It is easy to sit in a comfortable Board retreat setting and think about Mission, Vision and Values and identify strategic goals for the organization. The hard part comes when you have to take those goals and make them happen. Considerable effort and resources (human, financial, and time) go into planning and determining how each of the goals will be achieved. The implementation phase of the SP process is often when the SP process grinds to a halt. Keeping the forward momentum of SP requires considerable effort and commitment from management. The more realistic the goals (scope and time) the more likely they will be achieved.

Step Ten: Reassess Strategies and the Strategic Planning Process

  • Monitor your progress (establish milestones, benchmarks for success)
  • Constant monitoring…is your plan working?
  • Evaluation of budgeted costs against actual costs (financial and human resources)
  • Be prepared to make changes depending on external (uncontrollable) factors
  • If you were to do it again…what would you do differently?

Learner Activity

You have now reviewed your organization’s strategic plan. If you were to provide some advice to your administration on how to improve their SP process and outcome what would you recommend?

Additional Considerations

  • Know your audience
  • Involve stakeholders (those most affected by your program or organization)
  • Know your internal and external environment
  • Plan within your means (financial and human)
  • Keep your plan simple and “do-able”
  • Constantly re-evaluate your process and desired outcomes
  • Remember your staff are already busy

Communications and Success

Communicating Your Plan

Why do you want to communicate your Strategic Plan?

  • Achieving your mission
  • Build support, buy-in
  • Establish direction
  • Build unity

What are some ways that you can communicate your strategic plan to your internal and external stakeholders?

A completed strategic plan should be communicated to:

  • the staff.
  • external stakeholders.
  • the Department of Health and Community Services.
  • all of the above.
  • none of the above.

Keys to Successful Strategic Planning

  • Make sure you have Board buy-in.
  • Make sure you have staff buy-in.
  • Make sure your process is open and transparent.
  • Consult, consult, consult. (Strategic planning is all about communicating ideas.)
  • Make sure you follow-through with your plan - otherwise it will be hard to engage your staff in the future.
  • Be prepared to change and be flexible.

Learner Activity

Engaging staff in strategic planning exercises can be challenging. Consider ways to make the strategic planning process more engaging for staff.

Resources

References

  1. Bryson, J (2004). Strategic Planning for Public and Non-Profit Organizations: A Guide to Strengthening and Sustaining Organizational Achievement. 3rd Edition. San Francisco: Jossey-Bass. Chapters 2, 3.
  2. Zuckerman, AM (1998) Healthcare strategic planning: Approaches for the 21st century. Health Administration Press: Chicago, Illinois. Chapters 3, 5, 6.
  3. Roberts, C.C. et. al (March-April 1998). Core Responsibilities of Board Trustees. Journal of Health Care Management, 43 (2), 111-113.
  4. Clark, CS; Krentz, SE (2006). Avoiding the pitfalls of strategic planning. Healthcare Financial Management, 60(11), 62-67. 
  5. Beckham, D (June, 2010). Physician Involvement in Hospital Strategic Planning. Trustee, 63(6), 6-7.
  6. Kaleba, R (2006). Strategic planning: Getting from Here to There. Healthcare Financial Management, 60(11), 74-78.
  7. Maddalena, V (2012). A Primer on Project Management: The Cornerstone of Strategic Leadership. Leadership in Health Services. 25(2), 80-89.

Post-module Questions and Survey

Typically, the annual strategic planning process is initiated by:

  • Accreditation Canada
  • the Department of Health and Community Services.
  • the Board of Directors of the RHA.
  • the Chief Executive Officer.

The Mission Statement of an organization defines:

  • The vision of the organization.
  • The community served by the organization.
  • Why the organization exists.
  • All of the above.
  • None of the above.

The basic management decision-making algorithm is:

  • consult, decide, evaluate.
  • assess, plan, implement, and evaluate.
  • decide, assess, correct if necessary.
  • assess, implement, re-assess.

A Vision Statement defines the organization's

  • primary mandate.
  • future ideal profile.
  • values to guide decision-making.
  • mission.

Strategic plans should be monitored

  • at the next strategic planning retreat.
  • on an annual basis.
  • on an ongoing basis.
  • never.

Post-module survey questions

How did your correct answers above compare to your pre-module questions?


In the following survey-type questions, select the option that best applies to your knowledge now that you have completed the module so you can guage your learning post-module.

I am confident in my ability to discuss the benefits of strategic planning as a management tool.

  • Strongly disagree
  • Disagree
  • Neutral
  • Agree
  • Strongly agree

I am confident in my ability to discuss the benefits of strategic planning as a leadership tool.

  • Strongly disagree
  • Disagree
  • Neutral
  • Agree
  • Strongly agree

I am confident in my ability to demonstrate the processes involved in initiating, planning, implementing and evaluating organizational and departmental strategic planning.

  • Strongly disagree
  • Disagree
  • Neutral
  • Agree
  • Strongly agree

I am confident in my ability to demonstrate the processes involved in initiating, planning, implementing and evaluating organizational and departmental strategic planning.

  • Strongly disagree
  • Disagree
  • Neutral
  • Agree
  • Strongly agree

Untitled single choice question

  • Put your answer option here
  • Put your answer option here

Assignment and Conclusion

Assignment and Conclusion

Assignment

Write a 750-1000 word reflection on how you feel strategic planning can be applied to your future practice, both clinical and administrative, or currently, as a student.

Submit to this D2L site Dropbox IN THE DROPBOX MARKED STRATEGIC PLANNING IN HEALTH CARE REFLECTION by the date indicated.


We hope you noticed improvement between your pre- and post-module questions and how many were correct/incorrect in the multiple-choice and your development of knowledge/confidence in the survey-type questions.


Finally, please complete the MODULE SURVEY - Strategic Planning in Health Care within these course website contents. 


You have now completed this module of Strategic Planning in Health Care for physician leaders.

Thank you for your involvement and participation!