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3.5 STRATEGIC PLANNING FOR COMMUNITY HEALTH: MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS Mobilizing for Action through Planning and Partnerships (MAPP) is a strategic planning process for improving public health services and outcomes in local communities. Similar to the organizational strategic planning model in Figure 3–1 (http://content.thuzelearning.com/books/Fallon.9852.17.1/sections/24#�ig31) , MAPP is a community-wide strategic planning tool developed speci�ically for public health by the National Association of County and City Health Of�icials (NACCHO) and the Centers for Disease Control and Prevention (CDC). A work group of local health of�icials, CDC representatives, community representatives, and public health experts developed MAPP between 1997 and 2000. MAPP “helps communities improve health and quality of life by identifying and using their resources wisely, taking into account their unique circumstances and needs, and forming effective partnerships for strategic action” (NACCHO 2010).
The MAPP process assesses all levels of organizations, including public, private, and voluntary organizations, as well as individuals, involved in public health activities in the community. This assessment creates a complete picture of the resources available to the local public system. MAPP is based on a community-driven and community-owned approach designed to assess and enhance a community’s strengths, needs, and desires, which will in turn drive the strategic process (NACCHO 2010).
Compared to the strategic planning steps outlined in this chapter, the MAPP model places a greater emphasis on the external environmental assessment in order to identify opportunities for public health organizations to more effectively secure resources, align needs and assets, respond to external circumstances, anticipate and manage change, and establish a long-term direction for improving the health of the community. MAPP uses assessment tools to determine the health status and community perceptions of health needs.
MAPP Process
The MAPP process includes six steps (NACCHO 2010):
1. Organizing for Success: This step involves organizing the planning process and developing partnerships.
2. Visioning: The visioning step engages stakeholders in a collaborative, creative process of developing a shared community vision with common values.
3. Conducting Community Assessments: Four community assessments provide information about internal and external environmental trends relevant to the community:
• Community Themes and Strengths Assessment: Identi�ies local community interests, perceptions about quality of life, and assets.
• Local Public Health System Assessment: Appraises the capacity of the local public health system to conduct essential public health services.
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• Community Health Status Assessment: Analyzes data about health status, quality of life, and risk factors.
• Forces of Change Assessment: Identi�ies changing external forces and dynamics of the community and the local public health system.
4. Identifying Strategic Issues: Similar to the “identi�ication and evaluation of major strategic issues and options” step in the planning model presented earlier, in this step, participants develop a prioritized list of the most important issues facing the community based on the results of the four MAPP assessments and the shared community vision.
5. Formulating Goals and Strategies: In this step, participants take the strategic issues identi�ied in the previous phase and formulate goal statements and broad strategies for addressing issues, resulting in the development and adoption of an interrelated set of strategy statements.
6. Action Cycle: In this �inal step, the local public health system develops and implements an action plan for addressing priority goals and objectives. The plans are implemented and evaluated, with ensuing adjustments in the earlier steps as necessary. The �inal step in the MAPP process is similar to operations planning and implementation in an organization.
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CONCLUSION Strategic planning is a formal process used to establish an organization’s goals and the strategies for achieving them. Strategic planning involves an assessment of an organization’s status, a de�inition of where it wants to be, and a de�inition of the set of actions needed to implement change (or maintain its current position). Organizational missions or visions should create stretch goals for organizations to signi�icantly improve the quality of their outputs and/or their performance. The strategic choices made by a health organization must be consistent with its mission, vision, and values. Once the strategic choices are made, they become the basis upon which to develop operational plans. As a result of the strategic planning process, strategies are developed to ensure that all of the efforts of the health organization and its resources are aligned to serve the identi�ied needs. Healthy People 2020 helps public health organizations align their strategic priorities with those of the US government. MAPP is one strategic approach that is useful in public health planning at the community level.
Systems Thinking about Strategic Planning Strategic planning can work well when the future is somewhat predictable. What about when the environment is so complex or dynamic that managers are unable to see very far down the road?
Under such conditions, strategic planning in its traditional form may not be useful, but organizations are not helpless. To the extent that the future is emergent rather than predictable, McDaniel, Jordan, and Fleeman (2003) urge that organizations cultivate creativity and learning. To do so, scenario planning is one popular technique. Scenario planning means imagining a range of different futures that are plausible and thinking through strategic responses to them. Although each scenario is plausible, no single speci�ic scenario is actually likely to ensue. However, the scenario planning process alerts the organization to build �lexibility into its strategic actions.
Another useful management style in uncertain environments is mindfulness. Mindfulness means paying close attention to the way that events are noticed and interpreted as well as being open to new information and ways to notice and interpret. Encouraging an open system and listening to feedback from stakeholders, including employees and customers, are ways for managers to be more mindful of change in their organizational environments.
CASE STUDY RESOLUTION
Brett skipped lunch. Instead, he made a telephone call to a Dr. Lombard. Dr. Lombard’s Internet biography said that he directed the public health program at the university and was an expert in planning. After exchanging pleasantries, Brett asked Dr. Lombard the same question that he had posed to Stan and Ollie. The response he received was quite different. Dr. Lombard explained the MAPP process and its applications. He invited Brett to come to his of�ice to discuss how to use MAPP for designing his cardiovascular health program.
After spending the afternoon with Dr. Lombard, Brett returned to his of�ice.
He met Stan and Ollie in the hall. “How was your lunch?” asked Ollie as he left the building to go home.
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That night, Brett started his application for admission to Dr. Lombard’s public health program.
REFERENCES Begun, J. W., and K. B. Heatwole. 1999. Strategic cycling: Shaking complacency in healthcare strategic
planning. Journal of Healthcare Management 44 (5): 339–51. Fairview Health Services. 2010. Our mission, vision, and values.
http://www.fairview.org/About/Missionvisionvalues/index.htm (http://www.fairview.org/About/Missionvisionvalues/index.htm) (accessed December 6, 2010).
McDaniel, R. R., M. E. Jordan, and B. F. Fleeman. 2003. Surprise, surprise, surprise! A complexity science view of the unexpected. Health Care Management Review 28 (3): 266–78.
NACCHO. 2010. MAPP basics: Introduction to the MAPP process. http://www.naccho.org/topics/infrastructure/mapp/framework/mappbasics.cfm (http://www.naccho.org/topics/infrastructure/mapp/framework/mappbasics.cfm) (accessed November 24, 2010).
US Department of Health and Human Services. 2010. Healthy People 2020 brochure. http://www.healthypeople.gov/2020/TopicsObjectives2020/pdfs/HP2020_brochure.pdf (http://www.healthypeople.gov/2020/TopicsObjectives2020/pdfs/HP2020_brochure.pdf) (accessed December 6, 2010).
RESOURCES Periodicals
Begun, J. W., and A. A. Kaissi. 2005. An exploratory study of healthcare strategic planning in two metropolitan areas. Journal of Healthcare Management 50 (4): 265–74.
Ginter, P. M., W. J. Duncan, and S. A. Capper. 1991. Strategic planning for public health practice using macroenvironmental analysis. Public Health Reports 106 (2): 134–41.
Ginter, P. M., and L. E. Swayne. 2006. Moving toward strategic planning unique to healthcare. Frontiers of Health Services Management 23 (2): 33–7.
Kaissi, A. A., and J. W. Begun. 2008. Strategic planning processes and hospital �inancial performance. Journal of Healthcare Management 53 (3): 197–208.
Zuckerman, A. M. 2006. Advancing the state of the art in healthcare strategic planning. Frontiers of Health Services Management 23 (2): 3–15.
Books Harrison, J. P. 2010. Essentials of strategic planning in healthcare. Chicago, IL: Health Administration
Press. Mintzberg, H. 1994. The rise and fall of strategic planning. New York: Free Press. Porter, M. E. 1980. Competitive strategy: Techniques for analyzing industries and competitors. New York:
Free Press. Swayne, L. E., W. J. Duncan, and P. M. Ginter. 2008. Strategic management of health care organizations.
6th ed. San Francisco: Jossey Bass. Zuckerman, A. M. 2005. Healthcare strategic planning. 2nd ed. Chicago: Health Administration Press.
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Web Sites • American Public Health Association: http://www.apha.org/ (http://www.apha.org/) • Fairview Health Services: http://www.fairview.org/ (http://www.fairview.org/) • Healthy People: http://www.healthypeople.gov/ (http://www.healthypeople.gov/) • National Association of County and City Health Of�icials: http://www.naccho.org/
(http://www.naccho.org/)
• National Association of Public Hospitals and Health Systems: http://www.naph.org/ (http://www.naph.org/)
• SWOT Analysis: http://www.netmba.com/strategy/swot/ (http://www.netmba.com/strategy/swot/)