Healthcare reform legislation has increased demands concerning quality, cost and efficiency of hospitals and health systems. One way to manage these expectations is to create a strategic plan that clearly outlines goals for the future and how to reach them. "Strategic planning is more important now than it's ever been," says James R. Trimarchi, director of strategic planning at Southwestern Vermont Medical Center in Bennington.
Although strategic planning can help hospitals manage changes from new rules and regulations, it presents its own challenges. "Strategic planning works best when the marketplace is either in a stable trajectory or a known trajectory. The current healthcare environment is neither," Mr. Trimarchi says. However, practices like frequent evaluation can help combat the uncertain future. Mr. Trimarchi offers five tips for creating a strategic plan in today's world.
1. Follow the strategic plan anatomy. The strategic plan establishes several strategies that help focus resources to better achieve mid-range goals that support the organization's mission and vision. A strategic plan has a cascading anatomy. The mission and vision serve as the touch stone and rarely change. Goals are three- to five-year targets that if achieved would move the organization towards its mission and vision. Strategies are specific actionable approaches. Measures monitor progress towards the goals and are the tool used to determine if particular strategies are working. If a measure indicates a strategy is not effectively moving the organization towards its goals, then the strategy should be discontinued and a different strategy should be launched. Adhering to this cascading anatomy (mission, vision, goals and strategies tracked by measures) helps hospitals avoid drifting away from the core mission and vision in uncertain times yet allows organizations to remain flexible enough to respond to changes in regulations and the marketplace by reallocating resources, Mr. Trimarchi says.
2. Push strategies close to the mission and vision. The larger the separation between strategies and the core mission and vision the more regulatory or marketplace changes can disrupt the relevance of the strategic plan. Choosing strategies closely linked to the mission and vision introduces a level of certainty to an otherwise vague future.
3. Focus on a few goals. Following the "less is more" philosophy is key to forming a successful strategic plan, according to Mr. Trimarchi. If the plan includes too many goals, "not only can you not keep them straight, but you dilute resources," he says. Instead of a list of 20 goals, Mr. Trimarchi suggests concentrating on the top five to six concerns. Hospitals can then reallocate resources to support and achieve the most important goals.
4. Be realistic. "Identifying the doable" is essential to strategic plans. Keeping goals and strategies realistic will help hospitals make real improvements in the organization, whereas spending time on impractical goals will stifle hospitals' progress. A common mistake people make when forming a strategic plan is including strategies or goals that are "too grandiose without enough capital or resources to accomplish them" Mr. Trimarchi says. Identifying feasible strategies may be particularly challenging in the current environment. "Ascertaining the doable is somewhat dependent upon your ability to predict the future," Mr. Trimarchi says. He suggests leaders honestly ask themselves whether they can actually implement a strategy to help ascertain whether a strategy is realistic.
5. Develop really good measures. One of the most important elements of an effective strategic plan is developing measures to monitor progress made towards the goals. Depending on what the measures show, hospitals may have to alter strategies to better reach their goals. "It is so important today to have really good measures to monitor where you're going because the environment is changing so fast and you may need to change strategies," Mr. Trimarchi says.
Mr. Trimarchi describes a measure Southwestern Vermont Medical Center used to assess progress in its goal of reducing CT scan utilization. SVMC wanted to lower CT use per patient because of the harmful effects of radiation. Simultaneously, however, the hospital was trying to open a new market. If the hospital measured the overall volume of CT scans, the numbers would show an increase because of additional patients from the new market. Instead, SVMC tracked the number of CT scans for patients from a particular zip code in the original market. This technique more accurately measured progress towards the goal of reducing CT scan utilization because it reflected CT use per person within a defined geography. As the overall use of CT scans increased due to an expanding market, the CT scans per zip code decreased, suggesting lower usage per person. This example demonstrates the complexity of thinking required to develop useful strategic measures.
The rate at which hospitals should measure progress depends in part on how fast hospitals anticipate meeting their goals, according to Mr. Trimarchi. A short-term goal will require more frequent tracking and evaluation of measures, such as monthly, whereas long-term goals can be reviewed quarterly. Regardless of the frequency of review the question that should be answered is 'Are we making progress or do we need to change the strategies?' Mr. Trimarchi says.
Adhering to these five basic practices can help hospitals develop a strategic plan that is focused, effective and flexible. By leveraging measures to continually evaluate progress towards the goals the strategic plan becomes a living document that can guide an institution through uncertain times.
Related Articles on Strategic Planning:
Beating Your Hospital's "Personal Best": Q&A With Hospital for Special Surgery CEO Louis Shapiro
10 Best Practices in Strategic Planning for Hospital Practices
Strategic Medical Staff Development Planning: Going Beyond the Numbers
Although strategic planning can help hospitals manage changes from new rules and regulations, it presents its own challenges. "Strategic planning works best when the marketplace is either in a stable trajectory or a known trajectory. The current healthcare environment is neither," Mr. Trimarchi says. However, practices like frequent evaluation can help combat the uncertain future. Mr. Trimarchi offers five tips for creating a strategic plan in today's world.
1. Follow the strategic plan anatomy. The strategic plan establishes several strategies that help focus resources to better achieve mid-range goals that support the organization's mission and vision. A strategic plan has a cascading anatomy. The mission and vision serve as the touch stone and rarely change. Goals are three- to five-year targets that if achieved would move the organization towards its mission and vision. Strategies are specific actionable approaches. Measures monitor progress towards the goals and are the tool used to determine if particular strategies are working. If a measure indicates a strategy is not effectively moving the organization towards its goals, then the strategy should be discontinued and a different strategy should be launched. Adhering to this cascading anatomy (mission, vision, goals and strategies tracked by measures) helps hospitals avoid drifting away from the core mission and vision in uncertain times yet allows organizations to remain flexible enough to respond to changes in regulations and the marketplace by reallocating resources, Mr. Trimarchi says.
2. Push strategies close to the mission and vision. The larger the separation between strategies and the core mission and vision the more regulatory or marketplace changes can disrupt the relevance of the strategic plan. Choosing strategies closely linked to the mission and vision introduces a level of certainty to an otherwise vague future.
3. Focus on a few goals. Following the "less is more" philosophy is key to forming a successful strategic plan, according to Mr. Trimarchi. If the plan includes too many goals, "not only can you not keep them straight, but you dilute resources," he says. Instead of a list of 20 goals, Mr. Trimarchi suggests concentrating on the top five to six concerns. Hospitals can then reallocate resources to support and achieve the most important goals.
4. Be realistic. "Identifying the doable" is essential to strategic plans. Keeping goals and strategies realistic will help hospitals make real improvements in the organization, whereas spending time on impractical goals will stifle hospitals' progress. A common mistake people make when forming a strategic plan is including strategies or goals that are "too grandiose without enough capital or resources to accomplish them" Mr. Trimarchi says. Identifying feasible strategies may be particularly challenging in the current environment. "Ascertaining the doable is somewhat dependent upon your ability to predict the future," Mr. Trimarchi says. He suggests leaders honestly ask themselves whether they can actually implement a strategy to help ascertain whether a strategy is realistic.
5. Develop really good measures. One of the most important elements of an effective strategic plan is developing measures to monitor progress made towards the goals. Depending on what the measures show, hospitals may have to alter strategies to better reach their goals. "It is so important today to have really good measures to monitor where you're going because the environment is changing so fast and you may need to change strategies," Mr. Trimarchi says.
Mr. Trimarchi describes a measure Southwestern Vermont Medical Center used to assess progress in its goal of reducing CT scan utilization. SVMC wanted to lower CT use per patient because of the harmful effects of radiation. Simultaneously, however, the hospital was trying to open a new market. If the hospital measured the overall volume of CT scans, the numbers would show an increase because of additional patients from the new market. Instead, SVMC tracked the number of CT scans for patients from a particular zip code in the original market. This technique more accurately measured progress towards the goal of reducing CT scan utilization because it reflected CT use per person within a defined geography. As the overall use of CT scans increased due to an expanding market, the CT scans per zip code decreased, suggesting lower usage per person. This example demonstrates the complexity of thinking required to develop useful strategic measures.
The rate at which hospitals should measure progress depends in part on how fast hospitals anticipate meeting their goals, according to Mr. Trimarchi. A short-term goal will require more frequent tracking and evaluation of measures, such as monthly, whereas long-term goals can be reviewed quarterly. Regardless of the frequency of review the question that should be answered is 'Are we making progress or do we need to change the strategies?' Mr. Trimarchi says.
Adhering to these five basic practices can help hospitals develop a strategic plan that is focused, effective and flexible. By leveraging measures to continually evaluate progress towards the goals the strategic plan becomes a living document that can guide an institution through uncertain times.
Related Articles on Strategic Planning:
Beating Your Hospital's "Personal Best": Q&A With Hospital for Special Surgery CEO Louis Shapiro
10 Best Practices in Strategic Planning for Hospital Practices
Strategic Medical Staff Development Planning: Going Beyond the Numbers