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

Demonstrates

The number one driving force Proactive rather than reactive planning Group members Value of the employee Employee involvement Goals and values To new and varied ideas Proactive planning to employees

Influences

Clarifies

Encourages

Communicates

Receptive

Role models

Management Functions

Knowledgeable

Demonstrates

Political, economic, and social Appropriate planning techniques Participation opportunities Unit level planning to be congruent with organizational goals Unit assets and resources Unit goals and objectives If the goals are being met and if not, what changes need to be made In unit planning and organization

Organizes

Coordinates

Assess

Develops & Articulates

Reviews

Participates

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

Another type of conventional planning Future-oriented, technology driven

Inactivism

Preactivisim

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 Future oriented

Vision Statement

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.

Joels 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

Nursing

Flows from the mission statement and defines the set of values and beliefs that guide all actions of the organization The concepts of holistic care, education, and research Sets of beliefs that guide their behavior, called values

Societal

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 Are written in terms of the method to be used
Specify the desired outcome

Process objectives

Result-focused objectives

Policies and Procedures

Policies

Plans reduced to statements or instructions that direct organizations in their decision making
Not written or verbally expressed, and usually developed over time Delineated verbally or in writing

Implied policies

Expressed policies

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

Lack of Flexibility

The organization can be more effective if movement within it is directed at specified goals and objectives The plan must be flexible to reach a goal, and allow for readjustment as unexpected events occur Manager should include in the planning process people and units that could be affected by the course of action Plans should be specific, simple, and reasonable Know when and when not to plan Have built-in evaluation checkpoints

Lack of Communication & Buy-in

Unrealistic Expectations

Over- & Under-Planning

Failure to Execute the Plan

Strategic Planning in the Organization

Strategic planning as a management process includes the following steps:

1. 2. 3.

4. 5. 6. 7. 8. 9.

10.

Clearly define the purpose of the organization Establish realistic goals and objectives consistent with the mission of the organization Identify the organizations external constituencies or stakeholders, then determine their assessment of the organizations purposed and operations Clearly communicate the goals and objectives Develop a sense of ownership of the plan Develop strategies to achieve the goals Ensure the most effective use of resources is made Provide a base from which progress can be measured Provide a mechanism for informed change as needed 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

Change in patient demographics

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

The increasing number of seniors (baby boomers) will create enormous demands on the healthcare system US ranks 21st in life expectancy and 27th in infant mortality Cost of drugs is highest in the world Nurses will continue to decrease in supply and some physician specialties will increase in supply

Change in economics

Changes in providers

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-Managers 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

Staff Levels

Consider implementation of electronic charting/drug administration system Analyze staff to patient ratios Are nurses overworked? What is the customer satisfaction level? Baylor of Garland still uses paper charting -- because of this it is easier for medication errors occur

Baylor of Garland case study

Access

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

Assess resources available to achieve the objective

Will we need new construction?

How much additional staff will be needed? How much additional space will we need?

Cost

New wing or modular building? How will we pay for the addition seek funding, charity or debt financing?

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?