Week 15. Organizational Direction

strategic plan

- A formal, written document that guides an organization's actions and informs stakeholders about the organization's direction and future activities.

gap analysis

- A method of identifying the distance between the organization's current position and its desired position with regard to its mission, vision, and values.

3 phase process moving from vision to goals

1. Determine or affirm critical issues 2. Formulate strategic options and recommendations 3. Identify goals

Four P's

Four attributes that have traditionally been used to establish an organization's market posit: product, price, promotion, place

marketing

The activities involved in promoting products and services, including creating, communicating, and delivering offerings that customers value.

segmentation

the division of a market into subsets of consumers with similar needs and wants; enables marketers to focus their marketing efforts on consumers most likely to buy a pro duct or use a service

planning structure

the person(s) or unit with responsibility for strategic planning.

four typologies describing a hospital's strategic orientation (Miles and Snow)

- A 'prospector' is an organization that makes frequent changes in and additions to its services and markets; it consistently responds rapidly to market opportunities by being the first to provide a new service or develop a new market. - A 'defender' offers a fairly stable set of services to defined markets and tends to ignore changes that do not directly affect current operations, focusing instead on doing its best in the current arena. - An 'analyzer', like a defender, maintains a relatively stable base of services but selectively develops new services or markets the way the prospector does. However, the analyzer rarely is the first to provide new services or expand into new markets, choosing instead to monitor actions of others and follow with a well thought out, thorough approach. - A 'reactor' is an organization that does not appear to respond consistently to changes in the market and seems to lack a coherent strategy. The reactor may, on occasion, be an early entrant into a new market or service but usually is forced into action by external events or after considerable evidence of potential for success.

project charter

- A tool commonly used in project management that clarifies a project's key components, including scope, desired outcomes, participants, resources, time frames, and responsible parties, and ensures that the project's definition and desired outcomes coincide with the organization's strategic priorities and goals.

do vision statements do the followings?

- Does the vision place the organization on the correct path to where it wants to go? - Are the organization's current strategic actions consistent with the vision? - What needs to happen this year, next year, and in three years to achieve the vision? - Will achievement of the vision meet key stakeholders' needs? How? - Does the vision depict a future that will be challenging to achieve, yet is attainable?

identifying goals

- It is the strategic planning committee's job to select a goal that will constructively and creatively deal with the critical issue and contribute to achieving part of the vision - Goals should be stated in measurable forms, whenever possible, and as targets for the future. - Goals and objectives should be framed as ends to be achieved on the way to vision, leaving how to achieve them to be determined by the major initiatives and the tactical details in the action plan.

executive perception and stakeholder perception

- Joint negative perception of situation: Both executives and stakeholders seek change. Consensus is reached. - Joint positive perception of situation: Both executives and stakeholders seek to institutionalize status quo. Consensus is reached. - Misaligned perceptions of situation: Executives seek change, while stakeholders seek to institutionalize status quo. OR Executives seek to institutionalize status quo, while stakeholders seek change. Conflict results.

key components of marketing plan

- Mission and vision - Market research and analyses - Target market - Positioning strategies: - Marketing strategies - Marketing goals - Budget

contingency plan includes

- Shifting national and state policy priorities - Expedited transition from fee-for-service to value- or risk-based reimbursement, or a reversal of that trend - Market consolidation, including hospitals, health systems, insurance companies, and physician groups

3 strategies in business by Porter (1980)

- The 'overall cost leadership strategy' is achieved through a set of aggressive policies that ensure construction of efficient facilities, continuous pursuit of cost reduction, and systematic control of costs and overhead. - 'Differentiation' of a product or service offering means creating something that is perceived throughout the field as unique. - The 'focus' strategy centers on a particular buyer or geographic market. While low-cost and differentiation strategies aim to establish the organization as a leader across the field, the focus strategy aims to serve a particular target well, and policies are developed with this in mind.

questions for goal setting

- What is the outcome I want? - Why is it important to achieve? - Who needs to be involved? - When does it need to be completed? - How are we going to achieve it? - How and when am I going to measure the outcome?

does a strategic plan answer the following?

- Where is the organization now? - What needs to be done to achieve the organization's mission and vision more completely? - What avenues might the organization take to accomplish the mission and vision? - What specific actions should be taken? - How do we translate the strategic plan into action? - How do we know if we have achieved our objectives?

Characteristics of mission statement

- brief and fundamental statements of organizational purpose - clearly communicate to the board, employees, and other internal and external constituencies why the organization exists and what important purposes it intends to achieve - small enough to fit on a T-shirt - avoid 'how' an organization will proceed or act - describe the organization's competitive advantage: what the organization does differently or better than others

critical issues

- critical issues stand out as central to achieving the vision, have a deep potential impact on the organization, and cannot be addressed easily or resolved in the short term. - these issues deal primarily with concerns outside the realm of day-to-day operations. - 'process-intensive' approach (when initial list of issues is large or controversial) 1. each member of the strategic planning committee identifies the top three or so issues, and they compile a master list. 2. have some discussion of what each issue is and why it is important 3. committee members are asked to vote for the top three issues - Or, planning staff or a small group of members of senior management narrow the number of potential issues down to no more than ten and present the findings of its analyses to the strategic planning committee for review and modification

values

- defines the organization's desired culture and behavior - ethics that guide an organization's actions and processes - method for establishing an organization's values • obtain key stakeholders' expectations for the organization • identify common values among stakeholders • make values visible and tangible to employees. • keep values memorable.

Strategic plans ultimately should provide value to their organization by

- defining, developing, and sustaining a clear strategic advantage; - producing meaningful differences from competitors; - appropriately allocating and aligning resources; - creating understanding and commitment; - driving accountability and implementation

vision

- expresses ideals, standards, and desired future state (what the organization wants to be) - a vision should be • be part of an organization's strategic intent, • express what the organization wants to become • foster commitment and galvanize employees to action, • be short enough to remember and be understandable, and • show employees what they are striving for and give meaning to their work.

goals vs. objectives

- goals: broad results that an organization seeks to achieve - objectives: narrow "stepping stones" that quantifiably support and elaborate on goals

value statement

- in stable, successful health organizations, a values statement can be gleaned from organizational behavior. - for brand-new organizations, those with high organic growth, those in rapid organic decline, a values statement should be developed through a top-down process

If vision statements are to guide strategy development, they must be

- inspirational - aspirational - measurable

Good mission statements vs. bad mission statement

- language stakeholders use vs. jargon stakeholders do not use - stirs emotions and inspires vs. lacks emotions and feels inspiring - tells the 'why' vs. tells only 'what' or 'how' - is concise vs. is lengthy and rambling - moving spoken aloud vs. hard to verbalize - memorable vs. forgettable - actionable vs. hard to quantify - specific vs. vague

objectives vs. actions

- objectives: short-term targets in each goal area - actions: the principal tactics that need to be accomplished to achieve the objectives (and relate to parts of the major initiatives)

Well-crafted vision statement should include three components:

- quantified success indicator - a definition of niche - time line

guidelines for developing an effective organizational direction

- sharp, tailored, directional statements are most useful - for any complex, multi-entity organization, one vision and one direction are essential - organizational direction is the most critical part of the board's and CEO's contribution to strategic planning

strategic intent

- statements, including mission, vision, and values that describe an organization's perception of its purpose, direction, and acceptable conduct - strategic intent should aim to fulfill the organization's mission and should express the organization's values and the stakeholders' values. It defines what an organization does, how the organization accomplishes it, and what the desired outcomes are.

strategy vs. action plan

- the mission, vision, strategy, values, goals, and major initiatives constitute the 'strategic' portion of the plan, whereas objectives and actions are more tactical and operational.

common problems in direction statement

- wordiness - confusion of mission, vision, strategy, an values and a mixture of some - redundancy among statements - lack of precision - failure to be farsighted

format of a Strategic Plan

1. executive summary: A three- to five-page executive summary of the full plan precedes the plan document 2. Strategic intent: organization's mission, vision, and values and elaborates on these statements 3. Environmental analyses - Major market trends and their implications - Consumer profiles and demographics - Major service line data and analyses by service and payer - Competitor analyses - Major stakeholder data and analyses - Potential technological changes - Key quality indicators - Critical legal and regulatory issues SWOT analysis - Critical factors or driving forces 4. Strategic priorities and programs: key areas of focus. Environmental analyses, forecasts, and projections are presented as rationales for prioritizing or selecting these areas. 5. Strategic goals and objectives: desired outcomes of strategic activities, identifies who is responsible for each activity, presents key performance indicators, and lays out project timetables. 6. Appendixes: data referenced in the strategic plan, such as forecasted service volumes, performance targets, expected market shares, and financial projections.

positioning

Designing and promoting an organization's products and services so that they occupy a distinctive place in the market.

Psychographic segmentation

Major category of consumer market segmentation that categorizes consumers by lifestyle, personality, or values

Behavioral segmentation

Major category of consumer market segmentation that divides consumers by their perception and use of a product or service, including their familiarity with it, attitude toward it, and response to it

Geographic segmentation

Major category of consumer market segmentation that divides customers by political and physical land units

Demographic segmentation

Major category of consumer market segmentation that divides customers into markets on the basis of such factors as age, gender, disease or diagnosis, payer type, and income

strategic priorities

The most important areas addressed by a strategic plan

strategy

identifies the principal means for accomplishing the ends (how to get there)

mission

reflects an organization's purpose

key challenges in healthcare

• availability of technical personnel; • new technology; • new or potential regulations; • financial capabilities; • market and competitive changes; • customer satisfaction, preferences, and demands; • capacity issues ( excess or constraints); • cost pressures; • relationships and affiliations with partners; • employee engagement and retention; and • access to capital.

task force composition to prepare strategic plans and recommendation

- Gain broad representation from potentially affected constituencies - Include enough diversity so that the task force is not biased toward any single perspective - Achieve relatively good chemistry among the members - Keep the group small enough that it is not unwieldy - Select members who are interested enough to participate actively - Choose a leader who will lead but not dominate

questions for preparing for strategic pan

- Is there a written policy for the process and activities of strategic planning? • Does it spell out who is responsible for which activities and how the different groups interact and coordinate with the governing body? • Are specific time frames established for each strategic planning component? - Does the organization have a plan for communicating the development of the annual strategic plan and its results? - Does the governing board use the strategic plan appropriately to set realistic, challenging goals? - Do strategic or tactical issues dominate board discussions? If strategic issues are not addressed the majority of the time, what can be done to increase the board's focus on them? - Is there a proper planning structure whose members appropriately represent the key stakeholders? If not, is there a means of obtaining periodic input from other stakeholders (e.g., task groups, focus groups, surveys)?

SMART goals

- Specific: clearly identify what is to be done, who will do it, whom it will be done for, where it will be done, when it will be done, and any related requirements or constraints. - Measurable: Metrics should be set to know when the goal is accomplished. Key performance indicators should be established for each key goal component. Quantifiable indicators are preferable. - Attainable: Goals should stretch the organization's capabilities but still be achievable. - Relevant: Goals should be pertinent and applicable to the organization's mission. Goals should correlate with the strategic priorities and the time frames associated with them. - Time bound: Target dates should be set for each goal and objective.

goal setting for strategic planning

- Strategic planning is, in essence, the process of making difficult choices among competing priorities and focusing the organization's limited resources on the areas that will yield the greatest payoff. - For many organizations, the most difficult part of strategic planning is moving from the vision to the next level of detail, the goals. - Identifying hundreds of goals that support the vision is tempting but should be avoided. - Healthcare organizations struggle with setting measurable, clear goals, tending instead to specify a series of activities or processes or a vague directional intent.

questions for gap analysis

- Which stakeholder groups' needs are not being met? - What key actions must be taken to attain the vision? - Which past goals were not achieved? How did this nonachievement affect the mission? - How is the organization living its values? What can be done to emphasize and more fully incorporate the values into daily work life? - What core weaknesses may be preventing the organization from living its mission? - What external threats have to be addressed to be able to continue providing mission-based products and services? - What is the organization's financial health, and how does it affect the organization's strategic position?

3 operational functions of organizational vision

- cognitive function to educate - emotional function to motivate - organizational function to coordinate

stakeholders

- individuals and groups that have some investment in an organization or obtain some benefit from it - Examples • program managers and staff; • local, state, and regional coalitions; • advocacy partners; • state education agencies, schools, and other educational groups; • universities and educational institutions; • local government, state legislators, and state governors; • privately owned businesses and business associations; • healthcare systems and the medical community; • religious organizations; • community organizations; and • private citizens

mission vs. vision

- mission is about purpose (why does the organization exist?): mission statements are not time limited - vision is about the future (what does an organization want to be?): vision statements refer to a particular future point or period and must be updated and revised with each complete strategic planning process

vision statements

- vision statements represent core strategy and unlike the mission and values, should be developed anew in virtually every strategic planning process - these statements progress beyond why the organization exists and describe what the organization wants to be and how the organization will get there. - it should be a vehicle by which to communicate a preferred state of the organization to internal constituencies - it should be aspirational given current circumstances and conditions, and it should represent such an exciting and desirable state of being that it motivates and energizes all elements of the organization through the ground-level strategies and actions that support it. - it should project far enough into the future that the point of unpredictability is reached

does the mission statement do the following?

1. Define the organization's products or services and the markets in which it competes 2. Communicate where the company is and where it is going 3. Define and express concern for its key stakeholders 4. Motivate employees and reflect actual daily practice 5. Discuss the organization's commitment to economic objectives of prosperity, growth, and profitability 6. Incorporate the organization's basic beliefs, values, aspirations, and philosophical priorities 7. Indicate the competence or competitive advantage that distinguishes the organization from its competitors 8. Suggest the level and nature of the organization's social commitment