Catherine Adams
bredaw
4.4_proactive.pdf
10/13/2016 Print
https://content.ashford.edu/print/AUHCA340.13.2?sections=sec4.4&content=all&clientToken=744ef70f9cce79746d8e1fd70e7f4241&np=sec4.4 1/7
4.4 The Strategic Planning Process: Implementaĕon An organizaĕon's strategic direcĕon requires the CEO or president, in combinaĕon with the top‐level execuĕve team, to work diligently on follow‐through, making sure any strategy chosen will be fully implemented. In larger organizaĕons, such as community hospitals, the board of directors follows a more formal or structured process to oversee the development and implementaĕon of strategies prepared by the CEO and execuĕve management team. In other seħngs, managers may prepare and carry out strategies without such oversight. As a standard planning pracĕce, implementaĕon can be directed by the "W's" and "H's."
Who will direct the implementaĕon of the strategy at the strategic, tacĕcal, and operaĕonal levels? A healthcare manager who decides to incorporate a new service (diversificaĕon), such as child care for visitors of paĕents on both weekdays and weekends, may not oversee the development of the unit. Instead, the manager may assign the task to the individual who will eventually manage that unit.
What is to be done? An implementaĕon program should carefully list and sequence all necessary outcomes. A goal‐seħng program or planning ĕme line can establish benchmarks for when each task should be completed.
When should the task start and end? The decision to undertake and implement a strategy only begins the process. Effecĕve strategic management assigns reasonable starĕng ĕmes and compleĕon dates for the major event. Again, a goal‐seħng program can help develop the ĕme frame for full implementaĕon. In some instances, the strategy may take years to fully complete.
Where are tasks to be performed? In many instances, the primary facility will be the only place involved. In other cases, however, a series of locaĕons may be part of the process. For instance, in The Snoring Center described at the beginning of this chapter, any new strategic acĕvity would be implemented at every locaĕon.
Why are these tasks needed? Effecĕve implementaĕon includes providing the raĕonale for the strategic choice to all publics. Each operaĕng unit should have the plan explained to it, along with the reasons for the choice. This provides an opportunity not only for quesĕons and feedback but also for buy‐in and parĕcipaĕon in the process. When this occurs, morale may increase as employees feel a greater sense of empowerment during implementaĕon.
How are things to be performed? This final element adds in all of the other details. Implementaĕon of a strategy involves the preparaĕon of tacĕcal and operaĕonal plans that seamlessly integrate with the strategic direcĕon top management has chosen to pursue.
Tacĕcal Planning
10/13/2016 Print
https://content.ashford.edu/print/AUHCA340.13.2?sections=sec4.4&content=all&clientToken=744ef70f9cce79746d8e1fd70e7f4241&np=sec4.4 2/7
A strategy outlines the major acĕvity or acĕviĕes the organizaĕon will pursue. Tacĕcs are the plans designed to support strategies (Reilly, Minnick, & Baack, 2011, pp. 41–43). For example, managers in a hospital who have chosen to diversify by adding a wellness center to the hospital's current services should then devise the tacĕcs that will support the plan and assist in its implementaĕon. In this example, tacĕcs could include:
Retaining an architect or faciliĕes manager to create the physical space needed
Hiring a manager to oversee the unit and unit employees (human resources)
Creaĕng guidelines that specify the types of wellness acĕviĕes involved (medical staff)
Coordinaĕng with other departments (radiology, laboratories, and physicians)
Establishing markeĕng programs to publicize the new program (markeĕng)
Seħng up fees and payment systems for those who use the program (accounĕng)
These acĕviĕes are carried out by managers in the various funcĕons noted above. Once the tasks have been assigned, first‐line supervisors can finalize the most specific elements as operaĕonal plans.
Operaĕonal Planning
Managers within each unit of a healthcare organizaĕon, no maĥer how large or small, devise operaĕonal plans to direct their units. An effecĕve strategic management program ensures that operaĕonal plans align with organizaĕonal strategies and tacĕcs. Three primary operaĕonal plans are budgets, projects, and programs.
A budget is an annual financial plan. Strategies o├en require addiĕonal resources or the redirecĕon of resources from one area, department, or acĕvity to another. The accounĕng manager works in conjuncĕon with managers at all levels to make sure adequate funds have been allocated to any new strategic endeavor. Accounĕng and finance programs receive addiĕonal aĥenĕon in Chapter 6 (hĥp://content.thuzelearning.com/books/AUHCA340.13.2/secĕons/ch06#ch06) .
A project is a plan for a one‐ĕme acĕvity. As an example, consider a gynecological pracĕce with three physicians. The organizaĕon's management team decides to diversify by adding urological services. Several tacĕcs would be part of such an expansion. A├er diversifying, however, the organizaĕon may discover that its parking lot requires more spaces to accommodate the addiĕonal number of employees and paĕents. The project involved would be the design, property acquisiĕon, and compleĕon of the new parking area. Once the lot has been finished, the project is complete. For that reason, projects are also referred to as single‐use plans.
Programs are sets of projects with an ongoing outcome. A wellness program includes the projects and tacĕcs noted earlier. When the individual projects have been completed (new physical space, adverĕsing
10/13/2016 Print
https://content.ashford.edu/print/AUHCA340.13.2?sections=sec4.4&content=all&clientToken=744ef70f9cce79746d8e1fd70e7f4241&np=sec4.4 3/7
© Digital Vision/Thinkstock
A policy is a sweeping guideline that affects the enĕre organizaĕon.
blitz), the wellness program can conĕnue in operaĕon. New projects associated with maintenance of the program may then arise over ĕme.
A strategic management program experiences the greatest chances for success when the three levels of planning—strategies, tacĕcs, and operaĕonal plans—align with each other. To achieve this outcome, managers must employ various methods that link the levels of planning.
Links Between Levels of Planning
To help ensure that an organizaĕon stays on course and avoids strategic dri├, managers must formulate various documents that express the organizaĕon's vision, mission, and values over ĕme. Policies, funcĕonal‐ area policies, and procedures assist in keeping the organizaĕon on course. Furthermore, various programs, including management by objecĕves and a means–ends chain, can help the organizaĕon maintain its strategic intenĕons.
Policies, Funconal‐Area Policies, and Procedures
A policy is a sweeping organizaĕonal guideline. As an example, a healthcare provider may establish the policy that the organizaĕon will seek to emphasize diversity in all of its hiring decisions and paĕent treatment pracĕces by trying to provide services to every element of a local community. Such a direcĕve influences human resources most directly, but also affects every other part of the organizaĕon.
A func─आonal‐area policy translates the policy to an individual funcĕon or acĕvity. The diversity program designated by a policy would translate into pricing and accounĕng pracĕces to help ensure that lower‐income groups have access to the facility. The markeĕng team would try to make sure that the organizaĕon transmits the policy clearly to all publics. Human resource efforts to reach minority groups in recruiĕng programs would become part of the effort to implement and maintain the policy.
Procedures, or task instrucĕons, carry out funcĕonal‐area policies in individual units. To ensure that low‐ income paĕents can afford medical care at a given facility, the accounĕng team might establish a specific pricing program based on the individual's annual level of pay. Markeĕng might include the statement "We are an equal opportunity employer" in every adverĕsement or communicaĕon piece.
Well‐managed strategic planning processes integrate strategies, tacĕcs, and operaĕonal plans with policies, funcĕonal‐area policies, and procedures. When these elements stay in sync, individual employees, units, and the enĕre organizaĕon can beĥer pursue the organizaĕon's ulĕmate objecĕves.
10/13/2016 Print
https://content.ashford.edu/print/AUHCA340.13.2?sections=sec4.4&content=all&clientToken=744ef70f9cce79746d8e1fd70e7f4241&np=sec4.4 4/7
Management by Objecves
Management by objecĕves (MBO) is a well‐established management system that has been used to integrate levels of planning. MBO creates an annual program designed to facilitate communicaĕon and goal seħng (Drucker, 1954; Anthony, 1978) and offers a parĕcipaĕve goal‐seħng program to organizaĕonal leaders. It begins with individual employees at each rank. The core of management by objecĕves consists of these steps:
1. The individual restates the primary emphasis of his or her job.
2. On an annual basis, the employee creates a list of goals for the upcoming year.
3. The employee's supervisor then creates a goal list for the employee.
4. The employee and supervisor meet and agree to the final goal list for the next year.
5. At regular intervals throughout the year, the supervisor and employee follow up to ascertain which goals have been met and which sĕll require aĥenĕon.
Many companies establish the goal‐seħng program using the calendar year, which means goals are set in December or January and results are examined 12 months later. Other organizaĕons set goals during off‐ season periods or on a fiscal calendar basis, which may begin in June or some other month. The key ingredient, in many ways, is the fourth step, in which the employee and supervisor meet and agree to a goal list. This par─आcipa─आve element can create a stronger bond between the two individuals and lead to greater effort to achieve the established objecĕves.
MBO integrates company acĕviĕes through the goal‐seħng system. Entry‐level employees meet with first‐ line supervisors to establish goals; first‐line supervisors negoĕate their goals with middle managers; middle managers finalize goals with top‐level execuĕves. Each level sets goals that mesh with the goals of those at higher ranks, which helps keep the strategic planning system on track. To aĥain the highest levels of success, the MBO program should follow the prerequisites or system requirements noted in Table 4.7.
Table 4.7 Prerequisites for successful management by objecĕves programs
Prerequisite Explanaĕon
Top management support
CEOs and top managers endorse and engage in the program.
Sufficient resources
Managers must be able to reward those who achieve their goals.
10/13/2016 Print
https://content.ashford.edu/print/AUHCA340.13.2?sections=sec4.4&content=all&clientToken=744ef70f9cce79746d8e1fd70e7f4241&np=sec4.4 5/7
A systemaĕc approach
Plans are set and goals are measured at the same ĕme each year.
A simple system
A small number of goals (usually fewer than 10) is set to make progress easy to track.
Quality objecĕves
Goals should be difficult but aĥainable, measurable, clearly stated, and revised when necessary.
Two types of objecĕves
Employees should establish (1) personal‐enhancement goals and (2) goals they pursue on behalf of the organizaĕon.
Paĕence MBO programs take ĕme to establish and refine.
Source: Adapted from Odiorne, G.S. (1979). MBO II. Belmont, CA: Pearson.
The ideal MBO system establishes quality performance incenĕves for all employees. The best programs make sure that personal‐enhancement goals mesh with organizaĕonal goals. For example, should an employee establish the goal to become fluent in Spanish, that individual becomes more valuable to the organizaĕon and should be rewarded accordingly. An employee who successfully achieves an organizaĕonal goal should also receive a reward for doing so. Many MBO programs have been successfully adapted to healthcare organizaĕons.
Means–Ends Analysis
Another program designed to foster organizaĕonal consistency is a means–ends chain. In the system, means are plans, and ends are goals. The ulĕmate end of an organizaĕon—its mission—drives the development of goals at the funcĕonal and individual levels, as displayed in Figure 4.1.
As the ends (goals) are finalized, managers then idenĕfy the means (plans) needed to reach those goals. The concept of top‐down/bo─⠇om‐up planning becomes the net result of a well‐designed means–ends chain. The mission is broken down into smaller and smaller unit goals. At the same ĕme, individual goals build to unit goals, which build to department goals, which ulĕmately seek to achieve the organizaĕon's mission. The corresponding top‐down/boĥom‐up process helps ensure the consistency of goals and plans at all levels in the organizaĕon.
Figure 4.1 A means–ends chain
10/13/2016 Print
https://content.ashford.edu/print/AUHCA340.13.2?sections=sec4.4&content=all&clientToken=744ef70f9cce79746d8e1fd70e7f4241&np=sec4.4 6/7
Source: Bedeian, A.G. (1986). Management. Chicago: Dryden Press, p. 140..
CASE Proacve Prevenon
St. Mary's Regional Health Center conducts numerous acĕviĕes as part of its overall strategic approach to healthcare. The main hospital offers emergency services, diagnosĕcs, and treatments of all types. The organizaĕon operates several faciliĕes in other locaĕons. Recently, St. Mary's management team, with the approval of the organizaĕon's board of directors, created a new path.
In the past, paĕents would travel to the hospital or its other faciliĕes when a health problem emerged. Someone who suspected he or she was experiencing heart or cardiovascular issues would be sent to the heart center, a paĕent diagnosed with cancer would be referred to the cancer treatment center, and so forth.
The top management team, a├er many long discussions, decided it was ĕme for St. Mary's to redefine itself. The concept was that members of the community and potenĕal paĕents of the system should become partners in the healthcare process. Rather than passively waiĕng unĕl an illness or injury occurs, ciĕzens of the area should be encouraged to proacĕvely prevent as many health problems as possible.
To help achieve this new strategic vision, the proprietors founded the St. Mary's Wellness Center. Among the direcĕves for the organizaĕon's new wing were the following:
10/13/2016 Print
https://content.ashford.edu/print/AUHCA340.13.2?sections=sec4.4&content=all&clientToken=744ef70f9cce79746d8e1fd70e7f4241&np=sec4.4 7/7
Provide low‐cost health‐screening tools, such as blood pressure tests and weigh‐ins.
Encourage healthy acĕviĕes by patrons, including watching diet, managing weight, and exercising.
Offer low‐fee programs to help individuals engage in healthy acĕviĕes, including clubs, exercise groups, and support groups.
Link physical wellness to mental well‐being.
Establish an immunizaĕon program at low cost for flu shots, shingles vaccinaĕons, and other similar prevenĕve steps.
Creaĕng this new partnership required more than public relaĕons acĕviĕes and a new building. Physicians in the community were contacted directly and asked to talk with their paĕents about the wellness program when giving rouĕne physicals and when other contacts took place. Adverĕsing the system and its benefits would take place for the next year. The St. Mary's Wellness Center would sponsor closed‐capĕoning of the news on two local television staĕons, which would provide daily reminders of its existence to viewers.
When explaining the new program to community members, two points were to be emphasized. First, real wellness, such as lowering blood pressure, eaĕng fewer faĥy foods, watching calories, engaging in mild exercise, and working to manage stress, offers direct benefits to the individual. As ĕme passes, a person who acĕvely engages in prevenĕve steps would be far less prone to suffer from diabetes, some forms of cancer, heart problems, and other maladies.
Second, the program should assist in cuħng healthcare costs. This benefit extends to both the paĕent and the hospital. When community members acĕvely work to maintain a healthy lifestyle, they can expect to pay less for healthcare and lose less ĕme to sick days away from work. The hospital benefits by reducing the need for expensive treatments and recoveries from various illnesses. As one board member put it, "This new vision for our organizaĕon creates a win‐win situaĕon."
1. Write a mission statement that reflects this new direcĕon for St. Mary's.
2. Write a vision statement reflecĕng the new mission statement.
3. What type of strategy did the leadership team at St. Mary's pursue?
4. Which organizaĕons in the community might view the wellness center as a new form of compeĕĕon?
5. What factors described in this chapter might affect the implementaĕon of this new strategy?
