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3 Defining Organizational Vision, Values, and Mission

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Where there is no vision, the people perish. —Solomon

Proverbs 29:18

Learning Objectives

After reading this chapter, you should be able to do the following:

• Explain the importance of defining a vision statement.

• Identify organizational values or guiding principles.

• Describe the basic elements of an effective mission statement.

• Write effective vision and mission statements for an HCO.

• Discuss how to evaluate mission and vision statements.

Section 3.1The Importance of Defining a Vision Statement

Introduction This chapter focuses on the first step in the strategic planning process: defining an organiza- tion’s vision, values, and mission. Without clear and carefully considered statements of vision, values, and mission, all other stages of the planning process will be misguided.

3.1 The Importance of Defining a Vision Statement The first, and probably the most important, consideration when developing a strategic plan is to define the vision of the organization or any specific unit of the organization. This is usu- ally a difficult process because the statement describes where the organization is headed in the future. It does so by answering the question—In order to be successful, what should our organization be like 10 to 15 years from now?

Organizations need a clear definition of vision because it communicates to stakeholders where the organization is headed and provides a way to focus the energy of personnel in a common, shared direction. As the Reverend Theodore Hesburgh, president emeritus of the University of Notre Dame once remarked, “The very essence of leadership is that you have a vision. It’s got to be a vision you articulate clearly and forcefully on every occasion. You can’t blow an uncertain trumpet” (Zuckerman, 2006, p. 5). Vision statements are specific to each HCO and should avoid generalities or platitudes that sound good but do not give a sense of direction. According to John P. Kotter (1996, p. 3), a good vision statement has the following characteristics:

1. It looks forward and describes the strategic course management has carved out and the kinds of changes that will help the organization be successful.

2. It portrays the kind of organization it is striving to be in the future. 3. It is focused enough to give the administration guidance in making decisions. 4. It is flexible enough to allow changes as the operating environment changes. 5. It is achievable. 6. It is desirable in that it makes sense. 7. It easily communicates to stakeholders.

Clearly, if vision is defined casually or introspectively, the basis for how an organization goes about achieving its objectives rests on a shaky foundation. If we do not know what we are about, then anything we do, regardless of its true effectiveness, can be made to sound as if it were the best course of action. This can be self-deluding and self-defeating, taking us away from the basis for existence: meeting patients’ needs.

It is not always easy to formulate a statement of vision. The vision statement should embody the dream and vision of what the organization wants to be. Senior management and the board of trustees should try to visualize what they want the organization to be. If they can see where they are going and have an image of the real vision of the organization, the implementation of their plans will fall more easily into place.

It is important to understand this concept of vision to have a successful HCO operation. The vision unites the staff and spurs them to higher performance. Without a long-term perspective,

Section 3.2Organizational Values or Guiding Principles

an HCO will continually swerve off course instead of moving with steadiness and certainty toward its goals.

The dream for the HCO must be reflected in the vision statement, which sets the stage for all planning. A clear vision statement provides a starting point for determining goals and objec- tives as specific measures of organizational effectiveness.

Objectives, which are covered later in the text, must, by their very nature, contribute to achieving the goals of the vision statement. Without objectives, a vision statement becomes an empty platitude. Too often, this link is missed.

3.2 Organizational Values or Guiding Principles Many organizations develop values statements to demonstrate what values and guiding prin- ciples they emphasize in their operations. The statements express the core beliefs of the orga- nization and help the staff become aware of the goals and priorities that are most important. These statements help form the culture of the organization. The Mayo Clinic (2013, para. 2) uses terms such as respect, compassion, healing, teamwork, and innovation to underscore their core value: “The needs of the patient come first.”

Many organizations shy away from strong values statements, preferring abstract generalities that result in statements that are bland at best and empty at worst. Such values statements fail to adequately guide strategic planning and do little to differentiate the firm from its competi- tors. For example, values statements that tout teamwork, integrity, ethics, quality, and focus on the customer are too bland. While commendable values, they do little to guide employee behavior and fail to distinguish the firm from its competitors. One reason organizations avoid strong values statements is that such statements limit organizational freedom by requiring a certain level of behavior. Strong values statements may cause some employees to feel out of place if they do not subscribe to these values. Adding to their discomfort, employees are often evaluated in terms of these strong values statements. For example, Wal-Mart Stores, Inc. constantly reminds its employees of company values through computer-based training and its well-known morning meetings, complete with cheerleading (Lencioni, 2002).

One method of writing meaningful values statements is to organize values into four catego- ries: (Mayo Clinic, 2013) core values, aspirational values, permission-to-play values, and accidental values.

1. Core values represent the organization’s fundamental culture and can never be com- promised. These are the values that set the organization apart from its competition.

2. Aspirational values are values that a company may need to acquire in the future to be successful in a changing market or industry. This is certainly the case in health- care, where mergers and acquisitions are taking some HCOs into areas with which they are not familiar. Despite the need for new values as conditions change, aspira- tional values should never dilute core values.

3. Permission-to-play values represent the values common to most organizations and are the minimum level of behavior accepted by society. Thus, permission-to-play val- ues do not differentiate an organization from its competitors. For example, honesty

Section 3.3Basic Elements of an Effective Mission Statement

is a permission-to-play value. While an organization may have a strong commitment to honest dealing with the public, so do many other organizations.

4. Accidental values arise over time, resulting from the common experiences of the organization’s employees. These values, which are not directed by management, are good when they foster teamwork and a shared purpose. They can be harmful, how- ever, if they shut out new ideas.

Table 3.1 provides examples for each of these four categories of values.

Table 3.1: The four categories of values

Values Category Example

Core values The decision by Chick-fil-A® to close on Sunday

Aspirational values Commitment to work–life balance

Permission-to-play values Using values statements that include the isolated usage of the words integrity or customer-centered

Accidental values Lack of diversity, resulting from a start-up that initially hires employees who all think alike

Creating a values statement is not a process of consensus, involving everyone in the organiza- tion. Senior management, the board of trustees, and a few key employees form the best team to develop an organization’s values. As management consultant Patrick Lencioni (2002, p. 7) states, “Values initiatives have nothing to do with building consensus – they’re about impos- ing a set of fundamental, strategically sound beliefs on a broad group of people.”

Values statements define what the organization stands for and provide guidance in how the staff conducts themselves with stakeholders. A values statement might include some of the following statements:

As an organization, we adhere to the following values:

• Respect: We believe all individuals should be treated with respect and dignity. We embrace diversity.

• Caring: We believe in serving in a compassionate and empathetic way. • Integrity: We believe in doing everything under our control to keep our word.

Such statements are not only written to inspire employees but to provide guidance in speech and behavior. They express how the organization wants to view others and be viewed by them.

3.3 Basic Elements of an Effective Mission Statement A mission statement differs from a vision statement in that a vision statement is focused on the future of the organization while the mission statement is focused on the current organiza- tion. A mission statement answers the following three basic questions:

Section 3.4Writing Vision and Mission Statements

1. What do we do? (What services or delivery methods do we provide?) 2. Whom do we do it for? (What are our patient markets?) 3. How do we do what we do? (What are our technologies?)

In developing a mission statement, several basic elements describing the HCO should be reflected: the history, distinctive competencies, needs, segments, and technologies of the HCO, as well as its operating environment. Every organization has a history that includes past problems, accomplishments, objectives, and policies. The mission statement should reflect the historical significance of such characteristics.

Distinctive competencies identify what the organization is uniquely equipped to do because of its location, personnel, resources, or historical position. While most organizations can do many things, they can do some things so well that they have an advantage over competitive organizations in certain areas.

The mission statement must reflect what we will do (needs met or value received by clients); for whom we will do it (patient/client groups or segments to be served, because we cannot be all things to all people); and the technologies that will be used (how needs will be met). Also, each organization operates in an environment that dictates the opportunities and threats that must be dealt with when a mission statement is developed. Laws structuring insurance poli- cies and fear of transmittable diseases are examples of environmental factors that influence an organization’s ability to achieve its mission.

It is not unusual for an organization to work on a mission statement for months or even years before deciding that it really portrays the ultimate aim of the organization. Once developed, the mission statement is not a once-and-forever document. As the HCO adapts itself to the demands of a changing environment, the mission statement should reflect this adaptation. It must be reviewed periodically and updated as appropriate to continually reflect the HCO’s fundamental mission. This reevaluation is a difficult and thought-provoking process when approached correctly, but it must be done. What an organization does (objectives and strate- gies) should flow from what the organization is (vision and mission).

3.4 Writing Vision and Mission Statements While vision statements can be a valuable tool in pointing the organization toward the future, they are sometimes written in such a way that they could apply to any HCO and thus provide little guidance in decision making. According to Hugh Davidson (2002), problematic vision statements have one or more of the following characteristics:

1. Too reliant on superlatives, which make them vague or incomplete and say little about the HCO’s strategic course.

2. Not forward-looking or indicative of how management could alter its current course. 3. So broad that the HCO could head in any direction. 4. Uninspiring and too bland to provide motivation for employees. 5. Not distinctive enough to provide unique organizational identity.

Section 3.4Writing Vision and Mission Statements

A vision statement seeks to focus on the aspirations of the organization. It identifies and clari- fies what the organization hopes to become as it fulfills its mission. While the vision state- ment should be anchored by the firm’s heritage and current capabilities, it should move beyond current reality. An organization’s vision describes basic future characteristics of the firm. It focuses on the “stretch” the HCO is looking for in its operations to be broader than they are now; the vision statement should identify broad, long-term goals that the HCO hopes to achieve and link its mission with its measurable objectives.

But the HCO’s mission must also have the right combination of ingredients if its vision state- ment is to create this connection. An example of a mission statement lacking essential ingre- dients might read like this one: Oak Grove Hospital is a local community healthcare provider for Smith County committed to our employees, patients, and citizens. Oak Grove’s mission is to improve our citizens’ health by offering superior patient care and quality of life.

This mission statement is very broad, too bland to be inspiring, and does little to motivate employees. Contrast this mission statement with that of Cleveland Clinic: “The mission of Cleveland Clinic is to provide better care of the sick, investigation into their problems, and fur- ther education of those who serve” (Cleveland Clinic, 2014, para. 1). In this context, the vision statement represents a bridge between the mission statement, which expresses the ongoing fundamental reason for which the organization exists, and strategic objectives, which provide specific benchmarks for measuring progress toward mission fulfillment.

Sometimes an organization already has a mission statement but has not yet developed a vision statement. It is possible to use the mission statement to craft the vision statement. Answering the following three questions is a good starting point for drafting a vision statement:

1. What kind of organization are we? What services or methods of service delivery do we offer that make us unique among our competitors?

2. What kind of organization do we want to be? This question deals with what we aspire to be as a service provider as opposed to what we currently do. For many organizations, this distinction is important because a performance gap often exists between what we actually do and who we truly are versus our view of what we hope to become and eventually accomplish. Answering this question is the basis of our HCO’s vision for the future.

3. What kind of organization should we be? This final question is perhaps the most important of the three when we consider the possibility that our responses to what we are and what we hope to be as an organization could both be wrong. In chang- ing environments, who we are and what we do must continually adapt to achieve continued organizational vitality.

The following set of guidelines offers helpful tips on writing and evaluating a mission state- ment. This process is especially meaningful if different employees or departments develop a mission statement independently and then compare what they have written.

Determine the Fundamental Reason for Being If an HCO is under development, this means expressly determining the need satisfaction that will be offered to its clients. If the HCO is currently operating and not a new start-up, this means moving the organization’s thinking beyond what it does now. Specifically identify what

Section 3.4Writing Vision and Mission Statements

the need satisfaction should be for the HCO. Identifying the basic mission also means wres- tling with the need satisfaction that the HCO may be offering in the future.

One outcome of these considerations should be a section of the statement that is specific enough to offer guidance to the HCO’s staff in the near term. However, there should also be a general aspect that looks to the future and provides “stretching room” for the HCO to adapt and grow with future needs. Done effectively, these aspects of the mission statement serve as a touchstone, reminding the HCO staff of why they do what they do.

Identify Principal Methods for Delivering Need Satisfaction This issue focuses on the basic activities and functions the HCO will employ to meet the needs of its clientele. Verbs are the key here. Produce, provide, market, offer, and serve are all action words representative of basic delivery activities. Here, the HCO must deal with the issue of the extent to which it will develop products or services in-house as opposed to acquiring them from outside sources and then coordinating their delivery in a way that provides value to the client.

Determine the Scope of Mission Determining the scope of mission involves determining the markets that the HCO intends to serve. Proper deliberation here focuses attention outside of the nuts and bolts of internal activities. It forces managers to consider the intended recipients of the HCO’s functions. At a practical level, scope identifies the breadth of delivery—local neighborhood, community- wide, regional, national, or international. If the HCO is part of a larger organization, the parent organization becomes part of the clientele served because the HCO’s mission should support the parent organization’s mission on the one hand and be accountable to it on the other. In effect, you are writing a mission for your unit that delivers on the larger organization’s mis- sion, and for a constituency that is smaller than that of the parent organization. For instance, the mission of a large hospital chain is to serve an entire nation, but a local hospital within the network should define its mission by applying the national mission to a specific constituency, such as the local community.

Determine What the Individual Unit Is Accountable For While the national chain’s mission might include many services, such as managed care, help in ending chemical dependency, and psychiatric care, a local hospital’s capabilities within the chain may be more limited, focusing on traditional acute-care services. The mission state- ment should reflect these differences where they exist.

Prepare a Rough Draft of the Mission Statement With a working strategic-planning team, made up of administrative staff, board of directors, and other stakeholder groups, a rough-draft mission statement can be developed at an all-day meeting, using an outside facilitator who is familiar with communication techniques, group

Section 3.5Sample Mission Statements

processes, and the concept of mission statements. The meeting can begin with each individual jotting down his or her version of the mission statement. When these drafts are all assembled, the group can review each one for clarity and understanding. Finally, those portions that are similar are combined, so that only areas of wide disagreement are left. At this point, negotia- tions can be carried out among members of the group until there is general agreement on all points in the statement. The final result is the rough draft of the mission statement.

3.5 Sample Mission Statements It is helpful at this point to examine mission statements prepared by various HCOs (see Table 3.2). While these statements vary in their comprehensiveness, they all attempt to reflect the uniqueness of the organizations in terms of their reasons for being, and they also serve as guidelines for what the organizations should be doing. These statements would have been developed through a process involving many people. The initial drafts of mission statements are revised many times to add specificity and clarity to the words chosen by each organiza- tion to define mission.

Table 3.2: HCO mission statements

Type of HCO Mission Statement

Large, multiple-hospital consortium

A working partnership committed to improving the health status of people in our communities. The alliance exists to help partners and their allies succeed in carrying out this commitment by: providing sustained leadership for the positive transforma- tion of health services organization and delivery; transferring knowledge and experi- ence relating to health services delivery, and developing new methods and knowledge; supporting the linkage of efforts and integration of services in networks, so as to serve communities better; and providing cost-effective resources for the improvement of health status (Lencioni, 2002).

Large, metropoli- tan, not-for-profit hospital

To provide medical and hospital services for the sick and disabled of any race, creed, color, or nationality, and to carry on such educational, philanthropic, and scientific activities and functions as are a part of efficient, modern hospital service.

A small, rural, not-for-profit hospital

To improve the quality of life of all we serve through excellence in healthcare delivery emphasizing compassionate, personal care.

A nursing home (single facility)

We are passionately committed to making a difference in people’s lives by providing service of the highest quality and value in a supportive environment, promoting the health, independence and social interaction of seniors.

A nursing home chain

Heritage Enterprises will be a leader in providing high quality health care services. Heritage is dedicated to providing a continuum of care options to meet the identified needs of elder and/or infirm populations and to consistently deliver superior care with the greatest dignity and comfort possible. A key focus and specialization will continue to be long-term care. Heritage will concentrate its resources upon those services that it can provide both competitively and profitably, thereby enhancing Heritage’s position of leadership in the communities we serve. Heritage will also provide management services to non- owned facilities. In continuously striving to implement its vision of success, Heritage will benefit residents, customers, employees, owners and the communities it serves.

(continued)

Section 3.5Sample Mission Statements

Type of HCO Mission Statement

A home health- care agency

Our mission is for clients and their families, to offer a wide range of services designed to keep the client in the comfort of his/her own home while decreasing the stress on family members and/or significant others; for referral sources and contracts, to offer convenient one-stop shopping to referral sources and contracts that include: (1) speedy response time, (2) high-quality care, (3) customer satisfaction, (4) a wide range of services, (5) competitive pricing; and for our employees, to offer a mentally healthy environment where employees are encouraged to grow and develop their talents (Kaplan & Norton, 2008).

A regional office of the Depart- ment of Veterans Affairs

Our mission is to administer benefits to veterans and their families and provide quality services to our customers in a timely, compassionate manner. Our vision is to be recog- nized as the finest provider of benefits and quality service in Veterans Affairs—always striving to achieve a higher level of excellence and to earn the trust and respect of veterans, their families, and other customers, in a diverse environment that cultivates the full participation of all our employees (Kaplan & Norton, 2008).

A community health center

The primary mission of the Center is to provide quality community based family health and medical services. Our goals are “To Be the Best We Can Be” and to provide patient satisfaction in all aspects of our service. The Center is in the business of car- ing—caring for our patients, caring for our communities, and caring for our staff. We provide care for individuals of all ages and incomes, regardless of ability to pay, who reside in the southeastern part of our state. Services provided are carried out in a friendly, prompt, cost-effective, and caring manner. The Center is an organization which values its communities, its employees, and its patients. The Center supports an environment for professional growth and develop- ment, based on shared values of its community, Board members, and staff toward the delivery of community healthcare. The Center offers a range of primary health and medical care services, including health education, social services, transportation, and information services, which support the philosophy of keeping the person as independent and close to home as practical and clinically indicated. Practitioners provide continuity of care from outpatient through inpatient hospital follow-up, and social and nutritional services. The Center is committed to continuing high standards of service delivered in a cost- effective manner. This requires the maintenance of financial integrity and appropriate utilization of resources. The Center plays a leadership role in addressing and responding to state, regional, local health and related needs. The foundation and orientation of the Center comes from strong relationships with the communities it serves. This includes policy setting by community members of the Board of Directors, Advisory Committee input and sup- port, and responsiveness to the needs of our patients and users of all programs.

A drug abuse program

To provide high quality, innovative and comprehensive treatment by a multi-disciplin- ary team to those affected by chemical abuse and dependence and mental illness in a caring, empathetic and professional manner, by assessing clients in a manner that helps them develop a life plan which is satisfying, effective, and in concert with their ability and talent.

The American Heart Association

Our mission is to build healthier lives, free of cardiovascular diseases and stroke.

(continued)

Table 3.2: HCO mission statements (continued)

Section 3.5Sample Mission Statements

Type of HCO Mission Statement

A recreation center for the physically limited

The goal of this corporation is to enable persons over the age of five with physical dis- abilities in the metropolitan area to enhance their lives. To this end, we offer opportu- nities for growth and self-fulfillment in a recreational setting.

In recognition of the fact that this commitment to the quest for a fuller life by persons with physical disabilities cannot be met solely within the confines of our program or facility, we additionally recognize our responsibility for becoming aware of and addressing the issues important to persons with physical disabilities within the com- munity as a whole. To accomplish this aim, while concentrating on our primary pro- gram of growth through recreation, we will seek to participate in cooperative efforts with other groups and agencies actually and potentially representing and/or serving citizens with physical disabilities.

A regional Arthri- tis Foundation chapter

The Arthritis Foundation’s mission is to improve lives through leadership in the pre- vention, control and cure of arthritis and related diseases.

Area Council on Alcoholism and Drug Abuse

The Area Council on Alcoholism and Drug Abuse is an education and information agency providing health and wellness programs that helps build capable, responsible, independent people, thereby reducing the risk and the incidence of the dependencies of alcoholism or other drug abuse. The goal of ACADA is to help each client develop healthy perceptions and the skills that produce capabilities of self-confidence, judg- ment, responsibility, and self-esteem, and therein increase his/her capacity to love and care for themselves.

In summary, a mission statement needs to be built around several points. The first of these involves internal operations and functions. Typically, this includes a description of the funda- mental activities the HCO engages in; specifically, the basic services provided, such as inpatient acute care, outreach clinics, managed-care systems, wellness programs, health education and training, and so forth. This aspect of the statement thus answers the What do we do? question.

A second point that should be reflected in the mission statement is external clientele. This part of the statement focuses on identifying the customers/clients/patients served by the HCO. This may include descriptions of demographic characteristics (such as the needy or the homeless) as well as geographic boundaries (such as the Dallas, Texas metropolitan area). This aspect of the statement emphasizes answers to the Whom do we serve? question.

A final point that should be addressed is needs served. The emphasis here is on the needs of constituencies that will be met. These are the ultimate ends we hope to achieve, such as better preventive healthcare, more comprehensive acute-care services, improved access to health- care services for the region, and so forth. This aspect of the statement identifies who we are and hope to be, giving our staff an identity to hold on to in uncertain times and the leeway to stretch toward new services and greater goal-attainment of existing ones.

A number of actual mission statements are included in Table 3.2 as examples to demonstrate variety in actual practice. Many of the examples do not contain all the elements that constitute a well-written mission statement. However, for an example of a fairly comprehensive state- ment, refer to the mission statement of the drug abuse program included as an HCO in Table 3.2. The detail in this mission statement identifies what is to be done and for whom it is to be done. The references to prevention, education, and problem solving related to drug abuse

Table 3.2: HCO mission statements (continued)

Section 3.5Sample Mission Statements

identify key success areas for the development of objectives and strategies. Target clientele are also specified in the statement—young people and their families.

An effective mission statement creates a distinct sense of unity and mission and does not have an overly philosophical tone that, in essence, says, “We are going to do something good for someone out there somewhere.” If a mission statement is too general and all-encompassing, it is not meaningfully actionable, which is the ultimate purpose of a mission statement.

Evaluating a Mission Statement The following list can be used as a guide to evaluate the content of a mission statement while it is being developed. The purpose of the evaluation is to realize a mission statement that truly represents what the organization wants to be or should be to survive.

• Broadness and continuity of application—the statement should be broad enough to cover all significant areas of activity expected of the organization without a specific termination period indicated.

• Functional commitment—the nature of the work, tasks, or activities to be performed must be defined in terms that will determine clearly the validity of the group or organization.

• Resource commitment—the statement should include a commitment to the cost- effective use of available resources.

• Unique or distinctive nature of work—every unit in an organization should make some unique or distinctive contribution. If two or more units in an organization have identical mission statements, the risk of duplicated effort is obvious. The following considerations may be helpful in defining unit contributions:

– Description of services offered – Description of group(s) served – Geographical area covered

Sometimes it is useful to reference a series of questions to evaluate a mission statement after it is written. A response of no to a question means that the statement needs to be reworded to more clearly reflect the organization’s basic reason for being. The following list of questions may be helpful in evaluating a mission statement once it has been written:

• Does it contain all important commitments? • Does it clearly state the function? • Is there a clear determination of relationships to any parent organization? • Is it distinct from the mission statements of other groups in the organization? • Is it short, to the point, and understandable? • Is it continuing in nature? • Does it state to whom the organization is accountable?

While the word service often is included in the mission statement of many organizations, the mission statement needs to answer, specifically, the fundamental question of why the orga- nization is needed in the first place. Plenty of other organizations exist. For example, in light of the “Hospital Code of Ethics” adopted by the American Hospital Association in 1956, a

Section 3.5Sample Mission Statements

relevant statement of mission for a hospital system could include wording along the follow- ing lines:

Recognizing that the care of the sick is our first responsibility and a sacred trust, our hospital must at all times strive to provide the best possible care and treatment to all in need of hospitalization. Cognizant of our unique role of safeguarding our region’s health, we will seek through compassionate, scien- tific care and health education to extend life, alleviate suffering, and improve the general health of the community we serve.

In answering the for whom question, a mission statement can reflect whether the HCO wants to be local, regional, national, or international. For example, the mission statement of the Arthritis Foundation chapter included in Table 3.2 seeks to support the national organiza- tion’s goals on a regional basis.

Evaluating a Vision Statement Recently, the forward-looking aspect of an organization’s mission has received special empha- sis with the concept of a vision statement. A comprehensive vision statement captures not only the present identity of the organization but what the organization hopes to be in the future—what the organization should be when it matures.

More so than any numerical objective, the vision statement’s descriptions should be memo- rable and inspirational. The vision should be collectively challenging and motivational, mov- ing the staff to take initiative in those gray areas where no policy exists, because to do so expresses in a tangible way what you want to be as an organization.

An effective vision statement clearly and concisely describes what the organization hopes to become and how the organization will be viewed by its public(s). Fundamental to a vision statement are descriptions regarding excellence in certain operational areas. For example, a description of excellence included as part of a vision for a home healthcare agency might be constantly seeking the very finest quality home health service delivery.

Often a gap exists between an HCO’s vision and its capabilities to achieve that vision. One hospital with a vision of improved processes to increase patient satisfaction realized that it did not have the staff to understand or implement improvements. The solution was to send its senior leadership team to a Toyota factory to observe production systems. The hospital subsequently trained its entire staff on new patient-care delivery processes based on Toyota’s operations (Spear, 2005).

Also central to an HCO’s vision is its anticipation of its reputation for service with its stake- holders. A medical clinic might incorporate, as part of its vision, a statement such as to be known as the provider of choice in sports medicine in our region.

It is possible to create vision statements that can be measured, at least to some extent. The more vague the vision statement, the more difficult it is to know whether the organization’s vision has been achieved. According to Robert S. Kaplan and David P. Norton (2008), a good vision statement has the following three essential components:

Summary & Resources

1. A quantified success indicator 2. A definition of niche or specific target market 3. A timeline for execution

A classic example is President Kennedy’s stated vision from 1961 for the U.S. space pro- gram: “To land a man on the moon and return him safely to earth before the end of the decade” (Kaplan & Norton, 2008, p. 3). This vision statement was easily quantifiable and had a definite timeline.

In a comparison of vision, mission, and objectives, vision statements cover the longest time frame and are the least specifically measurable. Objectives are more immediate and the most measurable. Mission statements are somewhere in between. Mission statements rarely have any numbers included in them. For instance, an objective might state that the organization wants to increase the number of services delivered by 10% within the next 12 months. A vision statement, in contrast, might say that taking care of our patients is everyone’s busi- ness. Act on this first. Beyond the objectives and even the mission, vision statements stand as touchstones to rely on in an otherwise turbulent environment for certain central aspects of the organization’s operation.

Summary & Resources

Chapter Summary The significance of verbalizing and putting in writing the vision that the leadership of an HCO has for its operation was covered in this chapter. By committing this vision to writing, man- agement has, in effect, expressly stated the unique reason for the organization’s existence. This provides the sense of identity, direction, and focus for what will be done. What an orga- nization does must be a function of who the organization is. Statements of mission and vision translate the firm’s long-run dreams and aspirations into tangible form and build a stronger foundation for their fulfillment.

Key Points 1. The first and probably most important consideration when developing a strate-

gic plan is to define the vision of the organization or any specific part of it. This is usually a difficult process because the vision statement describes where the orga- nization is headed in the future. It is like answering the question “What should our organization be like 10 to 15 years from now to be successful?” Organizations need a clear definition of vision because it communicates to stakeholders where the organi- zation is headed and provides a way to focus the energy of personnel in a common, shared direction.

2. Vision statements should be forward-looking and describe the strategic course that management has carved out and the kinds of changes that will help the organization to be successful. The vision statement should portray what the organization aspires to be and show a focused, flexible, and desirable message, to better communicate to stakeholders.

Summary & Resources

3. The basic elements of a mission statement are a determination of the organization’s fundamental reason for existing; the identification of the principal methods of deliv- ering need satisfaction; and the scope of the organization’s mission or the targets the organization will serve.

4. A good starting point in writing vision and mission statements is to provide answers, in writing, to these three basic questions: a. What kind of organization are we? In other words, what services or methods of

service delivery do we offer that make us unique among our competitors? b. What kind of organization do we want to be? This deals with what we aspire to

be as a service provider as opposed to what we currently do. For many organi- zations, this distinction is important because there is often a performance gap between what we actually do and who we truly are versus our view of what we hope to become and eventually accomplish. Answering this question is the basis of an HCO’s vision for the future.

c. What kind of organization should we be? This final question is perhaps the most important of the three when we consider the possibility that what we are and what we hope to be could both be wrong. In changing environments, who we are and what we do must continually adapt to achieve continued organizational vitality.

5. Ask a series of questions to evaluate a mission statement once it has been written. A response of no to one or more of the questions means that the statement needs to be reworded to more clearly reflect the organization’s basic reason for being. The following questions may be useful in evaluating a mission statement: Does it con- tain all important commitments? Does it clearly state the function? Is there a clear determination of relationships to any parent organization? Is it distinct from the mission statements of other groups in the organization? Is it short, to the point, and understandable? Is it continuing in nature? Does it state to whom the organization is accountable?

Key Terms accidental values The values that arise over time due to the common experi- ences of the organization’s employees and that are not determined or promoted by management.

aspirational values The values that the HCO needs to acquire to achieve the organi- zation’s vision.

core values Fundamental values that can never be compromised.

mission statement A written statement that communicates to the organization’s stakeholders the organization’s purpose and specific identity.

permission-to-play values The values that are common to most organizations and that are the minimum level of ethical behavior accepted by society.

values An organization’s principles and standards of conduct.

values statement A written document that outlines, to an organization’s stakeholders, the organization’s principles and standards of conduct.

Summary & Resources

Critical Thinking Questions 1. Explain how an organization’s values influence its mission and vision statements. 2. Explain the concepts of core values, aspirational values, permission-to-play values,

and accidental values. Which should be emphasized in the HCO’s mission statement? Why?

3. Select two of the mission statements from Table 3.2. Critique each of them in terms of how effective mission statements should be written.