Comprehensive , Thoughtful, Well-Placed Planning
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A method to assess and adjust the
departments direction in response to a
changing environment
A tool to focus energy and resources
A tool that allows more adaptation than
long range planning
A plan to help increase possibility
A method to build your story about the
future
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To increase awareness about:
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The organization
The department
Their environment
Their future
The relationships between them
What is our culture
What is our competency
Builds awareness
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Learning
Increasing possibility
Setting “True North”
Discovering
Telling compelling stories about the future
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Don’t be concerned with the “perfect way”
Some common activities
◦ Build a mission and vision statement
◦ SWOT analysis
◦ Identification of what must be done about major
issues and opportunities
◦ Action planning
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Responsibilities and timelines
Tactics
Operational plan
Budget
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Those directly involved with planning
Those who provide key information
Those who will review the plan
Those who will authorize the document
Have as many stake holders as possible in the
planning process
Facilitator
Director
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Take time from “fire fighting” to think
Stand back and take a hard look at what we
want to accomplish
Figure out how you want to accomplish it
Change “busyness” to making progress
Recognize the real benefit is the process. Not
the document
Understand it is a series of small moves
Things are not usually as bad as you fear or
as good as you’d like
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Forces combination of intellect to make
decisions about future direction and
prioritization
Helps focus team to invest energy in the
collective direction
Team gains understanding of what we
currently know and what skills need to be
obtained
Gives hope and restores faith in leadership
Builds excitement about future possibilities –
imagine- what if
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Are we doing what we should be doing?
Are we the right people to do the job?
Are we adding value to the organization?
Are our systems efficient?
Do we have rework in our systems?
Do we use our space most efficiently?
Are we challenging the status quo?
What is our purpose, mission and vision?
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Should be carried out frequently when in an
industry of rapid change
Once or twice a year
Pay attention to:
Mission
Vision
Values
Goals
STEEP – Society, Technology, Environment,
Economics and Politics
◦ Customers, markets and competitors
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Mission and Vision
SWOT analysis
Strategy Formulation
Strategy Implementation
Evaluation and Control (Process Improvement)
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Purpose – why do we exist
Is our mission relevant to the organization
Mission statement describes the
department’s unchanging values
Forward looking visionary goals
How will we know we have accomplished our
goal
The Christ Hospital will be the leading hospital
for our region providing the finest experience in
personalized health care while advancing clinical
excellence, technology, and education
The Respiratory Care Practitioners of The
Christ Hospital will be leaders in the delivery
of respiratory services and be nationally
recognized for our clinical excellence and
innovation in delivery
of
progressive
pulmonary care. The focus of our mission is
to act as the advocate for the patient’s lungs,
quality of life and fulfill the needs of the
patient as described by them.
We support and want to fill the vision of
The Christ Hospital:
The Christ Hospital will be nationally
recognized for clinical excellence and will be
an innovative leader in progressive care and
healing.
 To
make every patient encounter one that
improves the patient’s outcome
 To harm no one with our technology
 To “hardwire” safety in all we do
 To provide protocols, strategies and clearly
defined expectations to decrease the
variability in our services
 To
advance the practice of respiratory care
 To practice using the most recent evidence
 To use our technology to its fullest
potential
 To educate colleagues in our area
 To recruit the finest or grow the finest
 To provide career advancement to the
therapists who decide to make The Christ
Hospital home
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Excellence
Compassion
Efficiency
Leadership
Safety
What do these look like in respiratory care
 Protocols
 Audit
tools
 Proper staffing
 Physician collaboration and
respect
 Demonstrative competency in all
modalities, little variability
amongst therapist
 Use latest therapeutic techniques
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Be a valued contributor of the healthcare
decision-making team
Leaders in innovation
Participation in research, research
laboratory
Present or publish at the national or
international level
They have programs to educate other
therapists as is a side business
Career and personal advancement
Competitive pay
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Dyspnea is the “pain” of lung disease
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Cause no harm
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Liberation from ventilation
◦ We don’t assess it
◦ We don’t see if we make it better
◦ Swallowing assessment
◦ Lung protective strategies
◦ Protocols
◦ To life or death
◦ Palliative care team, much like a “stat team,” we
have no medication for dyspnea
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Teaching nursing staff and PCAs how to manage a
patient who is short of air
Using our finest assessment skills in a check list format
to make sure we are always looking for everything,
every time
Helping those with respiratory limitations live as though
they have none through disease management
Early recognition of pulmonary disease by progressive
diagnostics
Contributing to the advance of respiratory care through
research and innovation of technology
Teaching children in our community about tobacco
awareness
Aggressive smoking cessation programs, inpatient and
outpatient
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Providing our therapeutic modalities with methods
that don’t just give the medication, but really
delivers
Aggressively treating exacerbations and referring
to the Lung Health Center, a method, not a place
(decrease recidivism)
Having only the technology we need and utilize it
well
Put systems in place for patient safety, talk about it
everyday, how can we do this better, safer
Do everything in our power to reduce lung injury
by our modalities (decrease LOS in critical areas)
Becoming experts in non invasive ventilation
(decrease VAP rate if never intubated)
Using non invasive monitoring to manage life
support (decrease infection if no lines)
Recruiting excellent staff and keeping
the ones we have (stop agency use
and the cost of continually recruiting
staff)
 Using “down time” to audit, evaluate
and improve our practice
 Use the space we have to it’s highest
ability
 Bring business to The Christ Hospital
to offset the cost of this department
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Limit our supplies to the best and get
rid of the rest
 Only give therapy to those who need it
(40% misallocation)
 Don’t spend inordinate amounts of
time on small decisions, i.e. uniforms
– decide, move on
 Manage the education of caregivers in
a very cost effective way
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Train people to be leaders in the hospital
and the respiratory care community
Research and present scientific evidence of
our methodologies that improve patient
outcomes
Find and implement sound business
practices to the field of respiratory care
Work nationally to improve reimbursement
for respiratory services
Find innovative solutions to the “costcenter” model
Demonstrate the “soft stuff” matters to
respiratory care practitioners
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Strengths
Weaknesses
Opportunities
Threats
Internal analysis
Highlight current issues
A “clear eyed” look at the current situation
Analysis of the industry
External environment
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Using information from the SWOT analysis
and environmental scan
◦ Match strengths to opportunities
◦ Address weaknesses and external threats
◦ Develop a competitive advantage
The first year we identified 72 things
We were able to address 59 in the first year
We hired and oriented 58 new staff
therapists
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SWOT-group brainstorming
Issues
Charge
Leadership
Communication committee
Morale committee
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Use plan to prepare budget
Develop programs
Describe procedures
Organization of the department resources
Motivate staff to achieve objectives
Clear communication of strategy, we have a
calendar with plan mapped out by month
Leadership of department uses this “map” to
guide all decisions
Clear communication of reasoning behind it
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When we saw what we had before us, we were
utterly overwhelmed
Brake it up in little pieces
Make lists
Systematically checked things off
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One right as a leader of this department
“Not have you lead people away from me.”
“I will fully exercise this right.”
“We all have to be in the boat rowing.”
“Can you give me a time frame of when I might
expect you to start rowing.”
◦ “I need you to be the person I hired.”
◦ “This would probably be a good time for you to look
for another job.”
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Define parameters to be measured
 Define target values
 Compare measured results to pre-defined
standards
 Make necessary changes
 Select a team
 PI council
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Involve people who will be responsible for
implementing the plan
Ensure the plan is realistic
Break it down into smaller parts
Specify who is doing what
Detail first 90 days, lay out the rest of the year
Translate plan into job descriptions and
performance reviews
Be sure to distribute plan and with each decision
refer back to the plan
Have leadership support
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Look at the industry and rewrite it’s story
Weave stories about what it might be like in
the future
Here is ours…
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2007
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550 bed intercity community hospital
18 full time staff therapists
80% agency
Employees restless
Mass turnover
Underpaid
Overworked
Department a physical disaster, 30 years of clutter
Not enough equipment
Treatments missed, not tracking
Interpersonal attacks, bullying
No one wanted to work for TCH
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76 Therapists
All work for TCH, no agency
Best paid in community
Workloads evaluated and
adjusted every 4 hours
Department in a state of JCAHO
readiness 24/7
Adequate equipment
Missed treatments <2%
Few interpersonal problems
We have a therapist pipeline
Strategies in place for succession
planning
Councils to address issues facing
department
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Forming
Storming
Norming
Performing
Cycles
happen
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Is a stage in which a group of members are
clubbed together however, they are clueless
of what is expected out of them.
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As the name suggest this stage is full of
storming. It only talks about blame game &
always disregarding the other.
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In this stage team members become willing
to listen to each other & talk about solutions
rather than problems.
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This is the last &
the most
desirable stage
wherein teams
become
proactive,
collaborative,
enthusiastic, trust
worthy & self
motivated and
self directed.
◦ Copyright 2000, Creative Health
Management, Inc. Marie Manthey
Relationship Based Care (2004)
◦ Ed: Mary Koloroutis
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I will accept responsibility for establishing
and maintaining healthy interpersonal
relationships with you and every member of
this team
I will talk to you promptly if I am having a
problem with you. The only time I will discuss
it with another person is when I need advice
or help in deciding how to communicate with
you properly.
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I will not engage in the 3 B’s (Bickering, Backbiting, and Blaming) I will practice the 3 C’s
(Caring, Committing and Collaborating) in my
relationship with you and I ask you to do the
same with me.
I will not complain about another team
member and ask you not to as well. If I her
you doing so, I will ask you to talk to that
person.
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I will accept you as you are today, forgiving
past problems and ask you to do the same
with me.
I will be committed to finding solutions to
problems, rather than complaining about
them or blaming someone for them, and ask
you to do the same.
I will affirm your contribution to the quality of
our work.
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I will remember that neither of us is perfect,
and that human errors are opportunities, not
for shame and quilt, but for forgiveness and
growth.
Always treat coworkers exactly the
way you want tem to treat the patients
and families
 Role model respect/dignity
 Role model communication skills
 Role model caring
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Let’s get strategic about that!
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Thanks