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STRATEGIC PLANNING

Impo rt an c e of Strat e gi c Plann in g ........................................2

Role s an d Res po nsi bil itie s ......................................................3Governing BoardStra teg ic Planning Commit teeChief Exec tive !fficer "edical Staff #e pa r t m e n t $e ad sPat ien t s and Comm nit%Planner Cons l tants

&he Ste ps of Stra t e gi c Planni ng ............................................'Get ! rgani(edPer form an Envi ronmen ta l )ssessme nt

&he In te rna l )ssessmen t&he Externa l )ssessmen t

#evelop a *isionRevie+ the "ission S ta tem en t#eve lop S tra teg ies

Goal )pproac hCritical Iss es )pproach

Scenario )pproachPrepa re t he S tr a t eg ic Plan)pprove the PlanImplemen t t he Plan"oni tor and Eval a te the Plan

Reso rce s ....................................................................................,,

S mm a r% .....................................................................................,,

Refe renc e s ..................................................................................,2


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&he Gove rning Board of a hospi t al -hea l t h s%s tem is r espons ib l e fortha t hospi t al s p lanning p roces s. ) s tr a t eg i c pl ann ing p roces s m st bees tab li shed to pos it ion t he hosp it a l-hea l t h s%s tem in a r ap id l%chang ing envi ronmen t .

S tr a t eg ic pl ann ing is the proces s of det e rmining +ha t an organi ( a ti on+an t s to be in the f t r e and ho+ it +ill ge t t he r e . $osp it a ls t ha td ev e lo p a nd impl e m e n t str a t e gi c pl an s t en d to b e m or e s cc e s sf lt ha n th os e t ha t do n t.

S tr a t eg ic pl ann ing is d iff er en t from sho rt / t erm o r ope ra t i onal pl ann ing .!pe ra ti ona l pl ann ing s a ll% foc se s on an ann al c%cle and r e0 ir e sthe deve lopmen t of %ea r l% ob1ec ti ve s and pl ans . &hi s becomes par t oft he a nn a l b d g e ti n g p ro ce s s . !p er a ti o n al pla n s la % o t h o + t h ehospi ta l + ill move to+ard it s f t re d ring tha t %ear. &he f t re is

described in the hosp i tal s s tra teg ic plan.

S tr a t eg ic pl ann ing r e0 ir e s t ha t cho ice s be made abo t %o r hosp it a l sf t r e . &hese cho ice s conce rn %o r v ision and mi ss ion t he goa ls t o be

p rs e d +h at servi ce s +ill be offe red and to +h om th e re so rce stha t +ill be needed people faciliti es t echno log% mone% and4no+ledge5 and ho+ the% +ill be ac0 i red .

IMPORTANCE OF STRATEGIC PLANNING

) hosp i tal -hea l th s%stem sho ld plan for it s f t re to6

Improve the hosp i tal s performance #etermine the hosp i tal s f t re direc tion Provide high 0 al it% hea lth care se rv ices !ptimi(e reso rce allocat ion "eet a cc redi t a t ion and r eg la to r% re0 ir emen t s "ee t the hosp i tal s vi sion and miss ion s ta teme nt "aximi(e it s chances for s ccess

S tr a t eg ic pl ann ing is +idel% p rac ti ced b% 7ash ing ton hospi t al s andh e al th s%s t e m s . Str at e g ic pla n ni n g c an h av e a p o si ti ve eff ec t on ahospi ta l b t it is not the ans+er in a ll si t a t ions or to a ll p roblems.Before engag ing in s tr a t eg i c pl ann ing t he Gove rning Board needs to6

8nde r s t and +ha t s tr a t eg ic pl ann ing is and ho+ to do it #etermine if the hospital is stable . If the hospital is in a crisis 9 for

example in dange r of clo sing 9 t he cri si s m s t be deal t +it himmedia te l%

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Iden ti f% +he the r a need fo r change exi st s Be commi tt ed t o t he pl ann ing proces s and incl de t he par ti cipa ti on

of t he hospi t al admin is t r a ti on comm ni t% ph%sici ans and st af f #ec ide if t he hospi t al ha s t he capab ili t% r eso rce s and

co m mi t m e n t n ee d e d for th e pl an ni ng pr oc e s s

Pla nn in g t a4 e s ti me a nd m on e % . Bo th m s t b e a llo tt e d to t h e pr oc e s s.It is impor t an t to ma4e s r e t ha t t he neces sa r% reso rce s incl d ingBoard and s ta ff t ime a re avail abl e to p lan fo r the f t r e and 4eepopera t i ng in t he p re sen t .

ROLES AND RESPONS IBILITIES

G!*ER:I:G B!)R#

&he Govern ing Board has the princ ipa l respons ib ili t% for st ra teg ic planning . &he Board g i des th e develop m e n t of th e plan co nsis te n t+ith the hosp i tal s miss ion philosoph% and val es . &he role of theGovern ing Board in s tra teg ic planning process incl des6

)pproval of the hosp i tal s vi sion miss ion s ta teme nt and goals S gges t ion and conside ra ti ons of s tr a t eg i e s )pproval of the s tra teg ic plan and it s implemen ta t ion "oni to ring and pda t i ng t he pl an and its implemen ta t i on

&he cha ir of t he Gove rning Board appoin t s t he St ra t eg i c PlanningCommittee.

S&R)&EGIC P;)::I:G C!""I&&EE

&he Stra teg ic Planning Commit tee is respons ib le for6 !rgani (ing the planning process Sched ling and cond c ting mee t ings


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r espons ib l e fo r ca rr%ing o t t he st ra t eg i c pl an a ft e r it is approved b%the Board .

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) cons l t an t c anno t s b s ti t t e for t he Board s ni0 e 4no+ledge ofthe hosp it a l and it s mi ss ion . &he cons lt an t is no t t he pl anne r.

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THE STEPS OF THE STRATEGIC PLANNING

&he s teps of t he s tr a t eg ic pl ann ing p roces s s a ll% incl de6

Get organi(ed P erf or m a n e nv ir on m e n t a l a ss e s s m e n t #evelop a vision #eve lop t he mi ss ion s ta t eme n t #evelop s tra teg ies Prepa re t he s tr a t eg ic pl an )pprove the plan Implemen t t he pl an "oni to r and pda t e t he pl an

Each Gove rning Board sho ld des ign a proces s t ha t is r ea li st ic andt ha t +o r4 s for its h o sp it al . St ep s c an b e c om bi n e d a nd co mp le t e d a t

t he s am e ti me . &h e% m a% b e c o mp le t e d in a diffe re n t ord e rdepend ing on the pl ann ing p roces s. Planning sho ld foc s on t hecri ti ca l i ss es tha t +ill de te rmine the hosp i tal s f t re s ccess orfail r e . )s %o design %o r s tr a t eg ic pl ann ing p roces s ans+e r t he se0 est ions6

7hat is the Governing Board s exper ience +i th planning 7ha t is t he Board s commi tmen t t o s tr a t eg ic pl ann ing $o+ m ch ti me a nd re so rc e s a re n ee d e d fro m t he Bo ar d

adminis t ra t ion and s ta ff

#o es th e Bo ar d or h o sp it al h av e a 4n o+l e dg e a b l e p er so n to g i dethe pl ann ing p roces s 7hat t echnica l o r po li ti ca l is s es ma% ari se

Str at e g ic pla n s h av e b ee n co mp le t e d in a o ne / d a % re tr e a t . $o+ ev e rit is more li4el% to ta4e > to ,2 ho rs of ac t a l S tra teg ic PlanningCo mm it t e e m e e ti n g ti me . &h e le ng t h of ti me d ep e n d s o n th eavail abili t% of needed info rma t ion the expe r ti s e of t he St ra t eg i cPla nn in g Co mm it t e e a nd t he st af f a n d r es o r c e s allo ca t e d to th e

pro ces s .

&+o to s ix ho r s is a good leng th for S tr a t eg ic Planning Commi t t eem e e ti n g s. "e eti ng s s ho l d b e l on g e no g h to d is c s s iss e s a ndsho ld occ r a t le a st once ever% t+o +ee4s nt il t he pl an iscomple ted .

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7ith th e r ec e n t ra pi d ch an g e s in th e h ea lt h c ar e e nv ir on m e n thosp it a ls ma% +an t t o deve lop a t+o/ t o t hr ee / %ea r st ra t eg i c pl an +it ha n a nn al p da t e an d revi e+ .


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GE& !RG):IFE#

Ev er %o n e n e ed s to b e co m mi t te d to t h e pla n ni n g p ro ce s s . #o n t b e gi n+it ho t th e co m mi t m e n t of Bo ar d m e m b e r s th e CE! an d th e m e di ca ls ta ff . ;e arn abo t s tr a t eg ic pl ann ing and ho+ %o r hospi t al c an s e it.#is c s s +ha t s tr a t eg ic pl ann ing can accompli sh an% conce rns Board

m e m b e r s h av e a nd + ha t pr ob le m s m a% occ r. #e ci de if o t si de h el pis neede d . ! t line the planning s teps %o r hosp ita l +ill t a4e .

It is imp or t a n t n ot to d es ig n a pla n ni n g pr oc e s s th a t t a4 e s m or e ti methan can r ea li st ic a ll% be expec t ed from s ta ff o r t he Board .

!ne s tep in s tr a t eg ic pl ann ing is a t horo gh ob1ec ti ve envi ronmen t a la s se s sme n t . &his incl des a r eali st ic a sse s sme n t of the hospi t al shis to r% and p re sen t si t a t ion its s tr eng ths +ea4nes se s oppo r t n i ti e sand threa ts S7!&5. &he res lt of this anal%sis is a list of cr it icaliss e s fo r the f t r e . &he hospi t al f nc ti ons in t+o envi ronmen t s 9ext e rna l and in te rna l.

&he In te rna l )ssessmen t

Revie+ %o r hospi tal s his tor% incl ding its beginning original mission

and s ervi ce s an% s ignifi can t even t s ma1or changes s cce s se s o rfail res and val es or t rad i tions .

Revie+ the hospi t al s p re sen t envi ronmen t incl d ing s ervi ce s pro d c ts progra ms staff ing financial posit ion and c rren t plans.$is torical and pro1ec ted tili(a tion s ta t i st ics pa tien t o rigin da ta andfinancia l repor t s as +ell as medical s ta ff p rofiles and pa tien t opinion


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polls are instr c ti ve and sh o ld be gath er e d . &his informa tion prep ar e d b% co ns lt an t s or administr a t ive st aff pr ovide s a sense ofho+ the hosp it a l ha s evo lved .

&hro gh its S tr a t eg ic Pl anning Commi t t ee t he Gove rning Board pro bes and asse s s e s the insti t tion s c rr en t internal positi on. &hisa ss e s s m e n t of str e n gt h s a nd + ea 4 n e s s e s m a% b e diffic lt or e ve n

np le a s a n t . ) c an di d e va l a ti o n p er fo r me d a t t hi s s ta g e is ne c es s a r %to posi tion the hosp i tal fo r a s t rong f t re .

&he Externa l )ssessmen t

Ever% hospi tal f nc t ions +ithin a la rger se tt ing and is affec ted b%s r ro n di n g forc e s. &h e e xt e rn a l a ss e s s m e n t foc s e s o n de m o g r a p h icda t a poli tic al tr ends soc ia l change t he economic clima te comm ni t%

percep tions and co mp e ti tive pr oviders . Pa in ti ng sc en arios of ho+ th ehosp it a l might be aff ec t ed is helpf l in explor ing t hr ea t s oppo r t n i ti e sand pot en t i al s tr a t eg i e s .

#E*E;!P ) *ISI!:

Str a t eg ic pl ann ing is abo t being r ead% fo r the f t r e. It is al so abo tc rea t ing %o r hosp it a l s f t r e . &he v ision s ta t eme n t de sc ribe s t he+a% %o +an t t he hosp it a l t o be in the f t r e . #isc ss ions abo t t hehospital s vision incl de6

Clarif icat ion of the organi(at ion s val es )gr eemen t on t he ba si c beli ef s t ha t g ide t he hosp it a l Explo rin g +h at id ea s a nd tr en d s co l d ch a ng e th e + a% th e h os pi ta l

is doing b sines s Id en ti f%i ng +h a t n e ed s a re e m e rg i ng a s a re s lt of d e mo g r a p h i c

technological economica l poli ti ca l and reg la tor% t rends Ident if%ing +ho is needed to ma4e the vision poss ible

RE*IE7 &$E "ISSI!: S&)&E"E:&

&h e m is si on st at e m e n t pr ov id e s th e p r po s e or r e as o n s for t he

hosp it a l s ex is t ence . It exp re s se s phil osoph% comm ni t% servi cer esea rch or ed ca t iona l commitmen t s affili ati ons and ma1or f nc ti onso r s ervi ces off er ed b% the hosp it a l.

&he mi ss ion s ta t eme n t sho ld be a spec ific s ccinc t a rt ic l a ti on of+ha t t he Board +ishes t he hospi t al to be . )ltho gh the mi ss ions ta t eme n t define s +ha t a hospi t al is it al so s et s for th an% limit s orrest ric tions on a hosp i tal s ac tivi ti es . &he hospi ta l s a rt ic les of

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#E*E;!P S&R)&EGIES

&h er e ar e th re e m et h o d s +hic h ar e se d for d e v el o pi ng s tr a te g i e s forthe f t r e . S tr a t eg ie s t ell Hho+ to get t he r e . &hese a re6

Goal approach Critical iss es approac h Scenar io approach

Goal )pproac h

!nc e t he Bo ar d h as a pp r ov e d visio n a nd mi ssi on st a te m e n t sdevelopmen t and p rio ri ti( a ti on of goal s becomes t he nex t cha ll enge .) goa l iden ti fi es an end to +hi ch t he organi ( a ti on a spi re s +ha t ishoped to be ach ieved .


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&he r es lt of t he env ironmen ta l a s se s sme n t is a lis t o f criti ca l iss e s.&a4e thi s l is t and foc s on the fo r to e igh t is s es mos t c ri ti ca l to %o rhosp it a l s f t r e . Each is s e sho ld be s t a t ed in 0 e s ti on fo rm. P tthe cri ti ca l i ss es in a logica l o rder. Each iss e sho ld be di sc ssed

possible so l tio ns-opt ions iden tif ied and th e best sol ti ons sel ec t e d .

&he hospi t al s s tr a t eg% fo r the f t r e becomes cl ea r af te r a ll of t hecritic al i ss e s 0 e s ti o ns a re a ns + er e d . &h at str a te g % n ee d s to b erev ie+ed fo r cl ar it% and cohe rence . &he s tr a t eg ic pl an is thendeve loped .

Scenario )pproach

&h e sc e n ar io a pp r o ac h re 0 ir e s th e d ev el o p m e n t of s ev e r al pic t re s

scena r io s5 of +ha t %o r hosp it a l migh t be in one t+o or more %ea r s .Scena rio s sho ld be eva l a t ed in t erms of %o r hosp it a l s vision andmiss ion comm ni t% needs and financia l feas ibi li t%. Ident if% thea dv a n ta g e s a nd dis ad v an t a g e s of ea ch sc en a ri o a nd sele ct on e. &h ec ho s e n sc e n ar io m a % b e a co mb in a t io n of m or e th a n on e origi na ls cena r io . #et e rmine if t he s cena r io is fea sibl e and t hen tr ansl a t e itin to a s tra teg ic plan.

&he scena rio approach is pa rt ic l a rl% se f l +hen deali ng +it h ma1orchanges in hea lt h car e delive r% it s emphas i s or d ir ec ti on. It p rod ces

Hbig pict re thin4 ing is fairl% 0 ic4 and people find it inte res t ing .

&h e sc e n ar io a nd critic al iss e s a pp r oa c h e s c an b e se d +it h t he go alapproach . )ft er t he s tr a t eg% fo r %o r hosp it a l s f t r e ha s beenidenti fied sing the scenar io or c ri ti ca l i ss es approach speci fic goa lsc an b e d et e r mi n e d sin g th e g oa l a p pr o a c h .

PREP)RE &$E S&R)&EGIC P;):

#oc me n t a t i o n of t he d eci sio n s m a d e occ r s th ro g h p re p a r a ti o n ofthe st ra t eg i c pl an .


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te rm ob1 ec tiv e s en co ra g e s th e h os pi ta l to mo ve a he a d a ndspecif ical l% ident if ies the path for doing so.

#ec ide on t he forma t fo r %o r +rit ten s tr a t eg i c pl an and o tli ne +ha tit +ill loo4 li4e based on the needs of %o r hosp ita l . &he p lan mightincl de6

S mmar% of t he s tr a t eg i c pl ann ing p roces s $istor% of the hospi tal *ision s tatem en t "ission s tatem en t &arget pop la t ion Comm ni t% served b% the hospi t al < t re is s es facing the hosp ita l )nal%s is of st reng ths and +ea4nes se s incl d ing mar4e t sha re and

compet i t ion fac ili ti es p rograms and serv ices medical s ta ffope ra t ions and finances

)ss mp t ions pon +hich t he pl an is ba sed Goals and ob1ec tives Implemen ta t i on s tr a t eg i e s !rgani (a t iona l s tr c t re planned for the f t re Plans for b ildings technolog% or renovat ion "ar4et ing plans @e% rel a ti onsh ips and ho+ the% +ill be main t ained improved o r

deve loped

!rgani (a t iona l polices for the f t re Plans for the Governing Board 9 s tr c t re ro le and respons ib ili ti es Contingenc% plans

#raf t %o r s tr a t eg ic pl an . It is e as ie r if one to t+o memb er s of theS tr a t eg ic Planning Commi t t ee p t t oge the r t he dr af t of the pl an .

)PPR!*E &$E P;):

&he S tr a t eg ic Planning Commi t t ee r ev ie+s t he d ra ft . &he d raf t pl ans ho l d als o b e r evi e+ e d b % o th e rs s ch a s st af f m e m b e r s int er e s t e dc om m n it % le ad e r s a nd p eo pl e +h o h av e a s ta 4 e in t he ho sp it a l sf t r e . &hen ma4e needed r ev is ions . It is impor t an t to deve lop a pl ant ha t c an b e nd e r st o o d a nd c ar ri e d o t. &h e Co mm it t e e s b mi t s t he

plan for Board approval.

I"P;E"E:& &$E P;):

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&he Board a tho ri ( e s t he CE! to initi at e t he implemen ta t i on p roces sthro gh polic% modifica tions hir ing s taff o r p rchas ing e0 ipme ntappoin ti ng speci a l t as4 fo rce s o r a llocat ing and b dge t ing f nds .

&he Boa rd the comm ni t% and t he med ica l and hosp it a l s ta ff sho ld be a+are of and nde rs t a n d th e plan. &he plan sh o ld becomm nica t ed t o all.

"!:I&!R ):# 8P#)&E &$E S&R)&EGIC P;):

Str a t eg ic pl ans sho ld be mon ito r ed con tin al l% and pda t ed ann a l l%.Given t he rapidl% changing heal t h car e env ironmen t 0 a r t e rl% r ev ie+sof pr oc e s s e s m a% b e n e e d e d . 8p da ti n g of th e str a te g i c pl an sh o ldo cc r b ef or e b d g e t d ev e lo p m e n t . 8pd a ti n g re 0 i re s re vi e+ in g th ehosp it a l s per fo rmance t he pl an s ob1ect ive s changes inoppor t n i ti e s t hr ea t s s tr eng ths and +ea4nes se s and cri ti ca l iss e s.

Re visio n s to th e pla n ar e th e n m ad e a nd incl d e d in t he b d g e t .

&h e s tr a te g ic pl an n e ed s to b e a d1 s t e d + he n co nd iti on s ch a ng e+ he n n e+ infor m a ti o n b ec o m e s a va il ab le or + h en th e h ea lt h c ar edelive r% s%s tem changes .

RESOURCES

"ore info rma t ion abo t s tr a t eg ic pl ann ing fo r heal t hca re organi ( a ti onscan be fo nd in t he follo+ing +ebs it e s and boo4s6, . Cen te r for $eal thca re Gove rnance6 www.amer i cangove rnance . com2. )merican $ospital )ssociat ion6 www.aha .org 3 . &he Gove rnance Ins ti t t e6 www.gove rnance in s t i t u t e . com>. $eal thca re S tr a t eg ic Planning 2 nd Edi tion b% )lan F c4erman


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REFERENCES

)llison "ichael and J d% @a%e Strategic Planning for Nonprofi t Organizations: A Prac tical Guid e an d Work ook! " nd edi tion! Engle+ood Cliffs :J6 John 7ile% K Sons2 ' .

)merican $ospi tal )ssocia tion #he Guide to Governance for $ospi ta l #rustees

Chicago I; , .

Bader Barr% HStrategic Planning +++.GreatBoards.org .


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L inn James Brian e t . a l . #he Stra teg ' Process Engle+oo d Cliffs :J6 Prentice $all, .

Short John "anaging Partner Phase II Cons lting Salt ;a4e Cit% 8&.

7al4er ;arr% President &he 7al4er Co. Gresham !R.

7hee len &homas and J. #av id $anger S trat eg ic -anagem ent and (us iness Poli c' ! 3rd edition! Reading ")6 )ddison/ 7esle% P blishing Co. , .

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