Strategic Planning“In the absence of clearly defined

goals, we are forced to concentrate on activity and

ultimately become enslaved by it.” -Chuck Conradt

By: Miranda Fleming, Kelley Ellis, & Stephanie Cordell

Leadership Roles and Management Functions Associated with the Planning Hierarchy and Strategic Planning

Skills needed by the leader-manager to implement the planning hierarchy and strategic planning.

Leadership roles in management functions involved in developing, implementing, and evaluating that hierarchy.

Leadership Roles

Assesses The number one driving force

Demonstrates Proactive rather than reactive planning

Influences Group members

Clarifies Value of the employee

Encourages Employee involvement

Communicates Goals and values

Receptive To new and varied ideas

Role models Proactive planning to employees

Management Functions

Knowledgeable Political, economic, and social

Demonstrates Appropriate planning techniques

Organizes Participation opportunities

Coordinates Unit level planning to be congruent with

organizational goals Assess

Unit assets and resources Develops & Articulates

Unit goals and objectives Reviews

If the goals are being met and if not, what changes need to be made

Participates In unit planning and organization

“Strategic planning is a management tool used by organizations to stay focused on the mission, to set priorities, and to foster growth and development.” –Cynthia M. Howe

“We must do a better job of preparing and supporting the development of nurse managers. These managers lead a huge part of our healthcare business, and it makes good sense to ensure they are as prepared and as competent as possible.” –Katherine Vestal

Funny Mishaps

Planning

Reactive Occurs after a problem exists

Inactivism Another type of conventional

planning Preactivisim

Future-oriented, technology driven Interactive or Proactive

Attempt to plan future of the organization

Planning Hierarchy

Mission

Philosophy

Goals

Objectives

Policies

Procedures

Rules

Mission

Mission Statement A brief statement identifying the reason

that an organization exists Vision Statement

Future oriented

California Pacific Medical Center Mission Statement

Our mission is to serve our community by providing high quality, cost-effective health care service in a compassionate and respectful environment, which is supported and stimulated by education and research.

California Pacific Medical Center

In an effort to involve the employees at the unit level in the organizations mission and long-term goals they created several programs.

Implemented a series of ten mandatory workshops for all of their 5,000 employees in an effort to improve client care and satisfaction.

The CEO hosts a brown-bag luncheon once a month allowing every employee to participate in voicing concerns about new or existing policies and suggestions for improvement.

In addition, those employees unable to attend were still given a chance to voice their concerns through a monthly newsletter that the CEO would then personally respond to.

An ongoing reward system was instituted to give recognition to exemplary employees.

Joel’s story:

Joel was an avid storyteller who was diagnosed with vocal cord cancer

The nurses created a calming environment, providing him with many resources and counseling

Because of his great experience at the hospital he was compelled to become an employee

Philosophy

Organizational Flows from the mission statement and defines the set of values

and beliefs that guide all actions of the organization Nursing

The concepts of holistic care, education, and research Societal

Sets of beliefs that guide their behavior, called values Individual

Values Shaped by the socialization process experienced by that person

Value criteria 1. It must be freely chosen from among alternatives only after due

reflection 2. It must be prized and cherished 3. It is consciously and consistently repeated (part of a pattern) 4. It is positively affirmed and enacted

Goals

Goal The ends toward which the organization is

working The desired result toward which effort is

directed Measurable and ambitious, but realistic

“Goals are quantifiable ways stations we aspire to as we attempt to fulfill our mission. Objectives are shorter-term but equally measurable activities required to reach ones goals.” –Paul Willging

Objectives

Objectives Identify how and when the

goal is to be accomplished Process objectives

Are written in terms of the method to be used

Result-focused objectives Specify the desired outcome

Policies and Procedures

Policies Plans reduced to

statements or instructions that direct organizations in their decision making

Implied policies Not written or verbally expressed, and

usually developed over time Expressed policies

Delineated verbally or in writing

Procedures

Procedures Plans that establish customary or

acceptable ways to accomplishing a specific task and outline a sequence of steps of required actions.

Rules

Rules and Regulations Plans that define specific action or

nonaction Describe situations that only allow one

choice of action Least flexible

Overcoming Barriers to Planning

Omitting Goals or Objectives The organization can be more effective if movement

within it is directed at specified goals and objectives Lack of Flexibility

The plan must be flexible to reach a goal, and allow for readjustment as unexpected events occur

Lack of Communication & Buy-in Manager should include in the planning process people

and units that could be affected by the course of action Unrealistic Expectations

Plans should be specific, simple, and reasonable Over- & Under-Planning

Know when and when not to plan Failure to Execute the Plan

Have built-in evaluation checkpoints

Strategic Planning in the Organization

Strategic planning as a management process includes the following steps:1. Clearly define the purpose of the organization2. Establish realistic goals and objectives consistent with the

mission of the organization3. Identify the organization’s external constituencies or

stakeholders, then determine their assessment of the organization’s purposed and operations

4. Clearly communicate the goals and objectives5. Develop a sense of ownership of the plan6. Develop strategies to achieve the goals7. Ensure the most effective use of resources is made8. Provide a base from which progress can be measured9. Provide a mechanism for informed change as needed10. Build a consensus about where the organization is going

“The purpose of learning about the future is not to predict it but to understand the elements that shape it and to envision desirable circumstances, so that progress can be made toward a preferred future rather than a catastrophic one”

(Dickenson-Hazard,2003,p.4)

Forces Effecting Long-Term Plans

Changes in the future of the healthcare organization Change in information technology

Will result in elimination of duplication and provide immediate access of information

Change in patient demographics The increasing number of seniors (baby boomers) will create

enormous demands on the healthcare system Change in economics

US ranks 21st in life expectancy and 27th in infant mortality Cost of drugs is highest in the world

Changes in providers Nurses will continue to decrease in supply and some physician

specialties will increase in supply

Other factors influencing the future

The healthcare industry will be moving away from illness care to wellness care to reduce the demand for expensive, acute care services (health promotion)

There will be a shift from revenue building to cost management maximizing utilization of limited resources

Instead of professional independence there will be a move towards managed care

Providers will become increasingly responsible for the quality outcomes their patients experience

Transition from continuity of provider to continuity of patient information by having complete, accurate, and timely information that moves with the patient

The shifts and trends affecting healthcare are constantly changing it is very difficult to proactively plan for such change, so managers must take a broader approach in the strategic planning process.

Integrating Leadership Roles and Management Functions in Planning

Leader-Manager must be skilled in determining, implementing, documenting, and evaluating all types of planning in hierarchy

The leader should demonstrate a proactive rather than a reactive management style to employees

Manager draws on the philosophy and goals established to implement planning

Manager appropriately assesses the constraints, assets, and resources available for planning

Manager draws on leadership skills in creativity, innovation, and futuristic thinking to translate philosophies into goals, goals into objectives, and so on down the planning hierarchy

Leader-Manager will develop the interpersonal skills necessary for inspiration of employees

Leader-Manager must be receptive to new and varied ideas The Leader-Manager’s final step in the process involved

articulating identified goals and objectives clearly

Strategic Planning in a Clinical Setting

You are a nurse chosen to be on the board of a major county hospital, the board has begun the strategic planning process for the year…

Key issues to consider in developing the strategic plan:

Quality Sample result oriented Goal: “To reduce medication administration errors by 10%”

Information Technology Consider implementation of electronic charting/drug administration system

Staff Levels Analyze staff to patient ratios Are nurses overworked? What is the customer satisfaction level?

Baylor of Garland case study Baylor of Garland still uses paper charting -- because of this it is easier for medication errors

occur Access

Sample result oriented Goal: “Provide care to 15% more patients than we did last year”

Assess resources available to achieve the objective How much additional staff will be needed? How much additional space will we need?

Will we need new construction? New wing or modular building? How will we pay for the addition – seek funding, charity or debt financing?

Cost Sample result oriented Goal: “Increase the accuracy of billing for supplies by 5%”

Implement incentive-based motivation for staff to decrease wasted supplies Consider implementing a competition for the least amount of supplies wasted, winner gets first

right on holiday scheduling decisions Require supply charge to patient Consider implementing additional policies for supply uses? (Example: Mandatory workshops on

improving sterile technique)

Discussion

Would you be willing to have fewer healthcare choices if access could be granted to all?

Is it possible for access to be granted to all?

Do you think there should be universal coverage?

Do you believe the cost of universal coverage should be picked up by the consumer or by the employer?