Groundbreaking goals and strategies can be developed by reviewing the long-term vision and mission of an organization. Strategic planning efforts should answer, Where is our hospital now? Where should we be going? and How are we going to get there?
An environmental assessment will address Where is our hospital now? Organizational direction and strategy will address Where should we be going? And implementation planning addresses How are we going to get there?
Strategic planning initiatives are designed to improve financial performance, market positioning and mission success. A decentralized, but integrated, process should challenge healthcare leaders to broaden their system-wide horizons and justify long-term implications of significant capital expenditures with long-term strategic positioning improvements. In the process, healthcare leaders will review financial, operational, clinical and marketing realities to identify the most valuable allocations of resources for success. Such forecasting models as volume projection, facility configuration, care delivery, functional capacity, physician resources, financial capacity, and others must be analyzed.
It begins with forming a process of regularly scheduled meetings with executives, physicians, administrators, service-line directors and functional leadership. Structured systems for compiling and reporting internal and external data will be necessary. Using nonlinear methods such as sophisticated modeling, scenario studies, financial analytics, operational, primary and secondary research, and knowledge management systems will keep the strategic planning efforts focused and knowledge-based. Information is imperative. As Sir Arthur Conan Doyle's protagonist said in The Adventures of Sherlock Holmes, "It is a capital mistake to theorize before one has data. Insensibly one begins to twist facts to suit theories, instead of theories to suit facts."
Strategic planning should be a flexible, continuous, "rolling" process that is dynamic in nature. The ability to adapt to a changing environment will allow for quick adjustments of external factors vital for developing a culture of continuous improvement within an organization. As naturalist Charles Darwin said, "Survival under conditions of intense competition and accelerating change depends on the ability to adapt and take advantage of the [changing] environment better than others."
Also critical is to assure the strategic plan accommodates a range of possible futures. What appears to be the best approach today may become less appealing as the world changes. The ability to make course corrections without having to overhaul the strategic plan needs to be preserved.
This advice may sound easier than it is done. The Society for Healthcare Strategy and Market Development of the American Hospital Association and Health Strategies & Solutions conducted a study in 2006 to gauge the sophistication of strategic planning in hospitals around the country. They found that although strategic planning seems to be well-adopted and used regularly in most hospitals, most leadership teams do not advance past vision and critical issues analysis as part of their process.
Suggested steps in the strategic planning process include:
Navigating through unclear health reform and unstable economic realities, hospital leadership works in an ever-changing, dynamic environment. The latest burning issue at hand draws focus from long-term vision. Pressure to produce quick results leads to short-term tactics—versus the ambitious long-term strategies that lead to the Cleveland Clinics of the world.
This is not to recommend turning a blind eye to immediate critical issues, but rather to begin each decision with the long-term vision of "who you want to be when you grow up" to align the planning efforts. Plus, properly setting priorities will help achieve the long-term vision and help prevent getting mired in the fires.
I urge you to keep the focus of this phase on the long-term vision of your organization. I would also recommend reading The Art of the Long View: Planning for the Future in an Uncertain World, by Peter Schwartz, and keep in mind you are planning for a range of possible futures, not a single solution. Begin with an understanding of Where is our hospital now? and Where should we be going? and How are we going to get there? An environmental assessment will address Where is our hospital now?
Internal Environmental Assessment
The long-term-vision stage begins with an environmental assessment, which examines mission, philosophy and culture. Through this exercise, the planning leadership should gain an objective assessment of past successes and failures. Understanding why former plans and implementation processes have worked and not worked will be invaluable when going into the coming stages of the planning process.