Strategic planning for health care organizations Healthcare is a dynamic and changing industry. Healthcare reform will signal significant impacts on many organizations in terms of daily processes, clinical operations, and financial sustainability. Strategic planning in health care organizations Need for SP: Increasingly informed, demanding and non loyal clients Increasingly professional and skilled competitors. Limited resources for production. Focus is shifted from the product or service to the client Size and complexity of the HO Strategic planning in health care organizations There should be a steering group within the HO to lead the development and implementation of a strategic plan This group should represent all interests and include people with leadership skills. Ideally, this group should be led by its chief representative, who will act as the driving force and display strong commitment to the project and should include someone who is familiar with SP methodology. The group must have real executive power to avoid being perceived as a mere planning entity. Strategic planning in health care organizations Applying the Mission, Vision and Values Mission This is a written statement that defines the final aim of the HO, that is, its reason for being. Vision: The vision statement is a written statement that presents the future image of the HO after the transformation process. Values are the set of principles, rules and cultural aspects governing the HO and determining their institutional behavior. They constitute the organization's ethical code that gives it its \"soul\" and \"character\". These values predict a specific response by the HO when a situation arises that must be immediately resolved. The values must be shared and widely disseminated. The real values of an organization are those that actually govern its behavior and decision-making processes, whether they are formally stated or not. Strategic planning in health care organizations Understanding External environment : Clients: it is essential that the HO identify its clients and what they can expect Competitors to understand cost and service efficiency Providers: the HO should characterize and differentiate their suppliers Owners: ownership equity of the HO. Strategic planning in health care organizations Analyzing the Internal Environment Resources: an analysis is made of the HO's available resources, including people, financial budgets, structural resources (and their degree of obsolescence, and organizational resources The legal situation: an analysis is conducted of the current regulations affecting performance, particularly those limiting or guiding it. Other power groups within the HO: trade unions, professional associations, internal decisionmaking bodies, clinical commissions, informal power groups Strategic planning in health care organizations Analyzing of internal environment (contd) Analysis of clinical care, training and research activity: without doubt, this is the part of the HO's internal analysis with the greatest scope. It is important that the analysis is conducted over a long enough period to detect trends that may motivate taking strategic decisions. This analysis has to be addressed from the perspective of the quantity, quality and cost of production; comparing the HO's data to standard data and data from competitors is of maximum utility. The analysis of activity should not simply produce an avalanche of data but must be synthesized to highlight what is relevant and bring out any need to take strategic decisions. Strategic planning in health care organizations strategic plan steering group will now have a wealth of ideas about possible strategic actions that could be addressed in the strategic plan. Administrators have to perform the SWOT analysis, an acronym formed from strengths (S), weaknesses (W), opportunities (O) and threats (T), which classifies the results of the analysis. This enables them to understand the kind of planning that has to be carried out Strategic planning in health care organizations Strategic Alternatives : Throughout the process developed so far, the planning team has been able to generate numerous alternative strategic actions. All these proposals are now formally entered in a document, without judgment regarding their feasibility or relevance, and where no idea is rejected without due consideration. Armed with this set of proposals, the strategic plan steering group begins a process which classifies and groups them into more or less defined areas of action. These areas of action are also simultaneously identified and named depending on the type of proposals they contain. Based on the various discussions that have identified them, the strategic action selection process is fine-tuned; some proposals are discarded whereas some are linked to other proposals, thus better defining the fields of action each time. At this stage, the wide range of options for action that were originally suggested are narrowed down to some extent, leaving aside those that clearly do not meet the minimum conditions of feasibility or do not have the desired scope. The strategic plan steering group concludes this stage with a set of no more than 20 areas of action, which constitute the strategic optiions Strategic planning in health care organizations Does the formulation provide a strategic proposal that will lead the HO to a genuinely unique position compared to the previous position and to that of the competitors? Does it offer value in a different way? Have any decisions been taken that involve other actions being stopped? Will services be cut? When certain activities stop, does that change the way operations are performed? Are the strategic choices that have been made valid in the long term? Strategic planning in health care organizations Change management Are leaders willing to lead the way for change initiatives How are communication protocols within the HO Do the employees accept changes and what are mechanisms to resistances in changes How are conflicts handled How does administration deal with communication, team work and planning ? Strategic planning in health care organizations The e strategic plan should have the capacity to allow this change to occur, although the need for change should be compelling and the reason for change should be thoroughly documented. An SO should only be changed after deviations have been regularly observed over 1 year, or when significant changes, unforeseeable during the initial planning stage, have occurred in the environment or in the HO. Several SOs may undergo systematic failures in the same SA, leading to the possibility that the SA itself is incorrect or that it has been undermined by internal or environmental changes. Then and only then should the strategic plan steering group change that particular SA. These changes should be made as a last resort. Strategic planning in health care organizations Balanced score card Strategic planning in health care organizations The Balance scorecard will enable HO to look at the four different perspectives The financial perspective asks how the organization should appear to shareholders so that the company can succeed financially. This perspective indicates if the business is improving the bottom line, measuring items such as profitability and shareholder value. Financial objectives reflect economic consequences of actions already taken in the other perspectives. Strategic planning in health care organizations Balance Scorecard (contd) The customer perspective asks how an organization should appear to customers to achieve the organization's vision. Customer objectives identify customer and market segments where the business would compete and what performance would be expected for these targeted segments. The scorecard focuses on customer concerns primarily in four categories: time, quality, performance and service, and cost. Strategic planning in health care organizations Balanced Scorecard (contd) The internal business perspective asks what business processes the organization should excel at to satisfy shareholders and customers. This perspective measures the internal business processes, core competencies, and technologies that would satisfy customer needs. The innovation and learning perspective asks how the organization would sustain its ability to change and improve to achieve the organization's vision. The learning and growth perspective identifies the organization's infrastructure needed to support the other perspectives' objectives. This perspective measures a company's ability to innovate, improve, and learn, such as the ability to launch new products. Strategic planning in health care organizations Effectiveness of strategy formulation: Align external and internal environment towards patient delivery quality Set standards of high quality Put into practice meaningful use Administrate the different functions purposefully Use the four quadrants of Strategic focus to achieve objectives . Strategic planning in health care organizations Involve budgeting parameters with financial implications into planning process Ensure that Health care delivery brings in patient revenues Associate special standards to be competitive Select strategies that enable the HO to remain sustainable and competitive Use strategic planning reviews and audit processes that are aligned towards vlauesof the Health care organization . Strategic planning in health care organizations Bibliography: Caudle, Sharon. \"The Balanced Scorecard: A Strategic Tool in Implementing Homeland Security Strategies.\" Homeland Security Affairs 4, Article 2 (October 2008). https://www.hsaj.org/articles/115 Fernandez A, Trullenque F. Por quuna Direccin Estratgica?. Madrid: Enlaze3 Print Management;2010. p. 19-44 Gimbert X. Conceptos estratgicos clave, Deusto. Barcelona: Grupo Planeta;2010. p. 55-6 Ginter PM, Swayne LE, Duncan WJ. Strategic management of healthcare organizations. 4th ed. Boston: Blackwell;2002. 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