Subject Organization: A Catholic-sponsored health system in the Midwest, centered on a new regional medical center with a total of 421 beds that had been formed through the merging of two previously independent hospitals and several other providers of outpatient services and extended care.

Project Type: Comprehensive, highly participative, strategic planning project.

(Note: In the narrative below, Accord and DGA are companies that provide strategic planning consulting services to healthcare organizations. They are not themselves healthcare providers.)

Challenge: The previous strategic plan had been achieved with the opening of the new regional medical center. The board of trustees (i.e. governing board) and the new Chief Executive Officer (CEO) wanted to identify the next steps in the system's evolution as a 'revolutionary and futuristic health care delivery system based on patient-focused care.' They also wanted to use the strategic planning process to understand and prioritize issues that had surfaced as a result of combining previously separate independent provider entities (i.e. hospitals, outpatient service centers, extended and long term care facilities, physician groups) into one healthcare system. In addition, the CEO was interested in building relationships with the system's physicians and employees, major employers in the service area, community leaders, and other key stakeholders.

The ACCORD / DGA Approach and Results: ACCORD and DGA (the two consulting companies) teamed up with the CEO and the Vice President of System Development (VPSD) at the health system to design and facilitate a comprehensive strategic planning process. The process began with the careful selection of a Planning Work Team (PWT) that included the Health System Leadership Council (made up of key system executives and department directors), physician leaders, and board members. The PWT provided oversight as ACCORD secured input from key internal and external stakeholders such as representatives from the sponsoring congregation, physicians, the entire middle management group, the board's strategic planning committee, and over 25 other external community leaders. In total, hundreds of individuals provided input on their vision for the system, the strengths, weaknesses, opportunities and threats, and priority actions for the short-term.

Simultaneously, DGA prepared a comprehensive, data-based, market, financial, and environmental assessment for the organization. The assessment resulted in key findings regarding the market area/service area definition, the health services purchaser market (demographics and behavior of the service area population), the competition, the physician supply, and the financial status of the subject health system itself. DGA and ACCORD partnered closely with the VPSD to ensure that strategic-level trends and findings were displayed clearly, concisely, and graphically. That material was provided to the PWT prior to a day-long retreat in which DGA and ACCORD led the PWT through an assessment of the internal and external environments. This enabled the PWT, and ultimately other key stakeholders, to identify the critical strategic questions facing the system over the next five years.

ACCORD then facilitated two additional PWT retreats as well as a series of group feedback sessions with many of the same stakeholders who had participated in the input sessions. The result was a complete, 5-year strategic plan that included a mission, core values, a five-year vision, three-year goals, and one-year objectives.

At the conclusion of the engagement, the CEO commented that the strategic planning process had resulted in both a clear direction for the future and a unified culture. Those who had come from four different organizations now shared the same vision of what they could become together. They had also developed a common set of values to guide their behavior along the way. And, all of the key stakeholders became focused on four priorities for the short-term: system growth, market leadership, integrated infrastructure, and development of a supportive organizational culture.

A year later, the system saw marked increases in satisfaction scores for patients, employees, and physicians. Just as importantly, the system achieved the market leadership position within its region, which led to enhanced financial stability. As a result, they were able to accomplish both their mission and financial targets.

To begin the discussion, please identify several examples of effective planning methods and approaches that you find in this case. In other words, what do you think the participants, in this case, have done right as far as strategic planning is concerned.