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


Goals and values
Receptive


Employee involvement
Communicates


Value of the employee
Encourages


Group members
Clarifies


Proactive rather than reactive planning
Influences


The number one driving force
To new and varied ideas
Role models

Proactive planning to employees
Management Functions

Knowledgeable


Demonstrates


Unit goals and objectives
Reviews


Unit assets and resources
Develops & Articulates


Unit level planning to be congruent with
organizational goals
Assess


Participation opportunities
Coordinates


Appropriate planning techniques
Organizes


Political, economic, and social
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


Inactivism


Another type of conventional
planning
Preactivisim


Occurs after a problem exists
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


Nursing


The concepts of holistic care, education, and research
Societal


Flows from the mission statement and defines the set of values
and beliefs that guide all actions of the organization
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


Process objectives


Identify how and when the
goal is to be accomplished
Are written in terms of the method to
be used
Result-focused objectives

Specify the desired outcome
Policies and Procedures

Policies


Implied policies


Plans reduced to
statements or instructions
that direct organizations in
their decision making
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


Lack of Flexibility


Plans should be specific, simple, and reasonable
Over- & Under-Planning


Manager should include in the planning process people
and units that could be affected by the course of action
Unrealistic Expectations


The plan must be flexible to reach a goal, and allow for
readjustment as unexpected events occur
Lack of Communication & Buy-in


The organization can be more effective if movement
within it is directed at specified goals and objectives
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.
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 organization’s external constituencies or
stakeholders, then determine their assessment of the
organization’s 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


The increasing number of seniors (baby boomers) will create
enormous demands on the healthcare system
Change in economics



Will result in elimination of duplication and provide immediate
access of information
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

Staff Levels





Access

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?


Cost

Baylor of Garland still uses paper charting -- because of this it is easier for medication errors
occur
Sample result oriented Goal: “Provide care to 15% more patients than we did last
year”


Analyze staff to patient ratios
Are nurses overworked?
What is the customer satisfaction level?
Baylor of Garland case study


Consider implementation of electronic charting/drug administration system
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?