Strategic planning is an ongoing process where organizations prioritize operations to align with their values. This can involve prioritization, resource allocation, and process refinement, always backed by solid data and collaborative efforts from all affected areas of the organization. In healthcare, value is defined by Dr. Porter as health outcomes achieved per dollar spent. Strategic plans for healthcare service organizations (HSOs) must achieve optimal health outcomes with the least net cost to the patient.

Understanding the Inpatient Setting

In the inpatient setting, commonly called hospital care, patients receive care when admitted, generally for severe or life-threatening conditions. Inpatient facilities typically have access to a wider range of specialists than outpatient settings. The organizational strategy may determine which non-life-threatening patients are directed to inpatient settings due to the availability of outpatient surgical centers. Most inpatients enter through a referral or the emergency department. Challenges in inpatient care include the complexity and severity of illness, overcrowding, emergency department dysfunction, staffing issues, patient engagement, compliance, and quality of care.

The Strategic Planning Process

The AJHCS Strategic Planning Process, developed specifically for hospitals, is based on the United States Government’s strategic planning process.

Step 1: Environmental Analysis

The environmental analysis for HSOs can be complex and must be tailored to the organization’s needs. It considers both external factors and their impact on the organization. Key external factors for inpatient facilities include population demographics, geographical location, severe weather events, local healthcare infrastructures, insurance coverage patterns, transportation and accessibility, public health policies and resources, and socioeconomic factors. To conduct this analysis, gather data from government reports, health department statistics, academic studies, and industry reports, aligning it with your internal data. Conduct a SWOT analysis with a collaborative team, engaging stakeholders such as hospital staff, local health authorities, community leaders, and patients to develop strategic priorities.

Step 2: Situational Analysis

The situational analysis focuses inward, evaluating the organization’s inherent capabilities, processes, and culture. Key internal factors include operational efficiency, clinical quality and safety, human resources, technology and infrastructure, financial health, and organizational culture and leadership. This introspective approach aims to uncover strengths to leverage and weaknesses to address, enhancing operational efficiency and healthcare delivery.

Step 3: Strategic Vision

With a clear understanding of where you are, consider where you want to be. Collaborative decision-making involving all stakeholders, including physicians, maintenance staff, IT staff, nurses, technicians, and patients, is essential. Set realistic yet challenging goals aligned with the organization’s guiding principles and mission. Patients should express their goals and ideas before clinical and administrative leaders, fostering adaptability throughout the process.

Step 4: Metrics

Metrics help track progress toward the desired outcome. Look back at your strategic goals and mission to develop relevant and specific metrics. Avoid choosing metrics that show progress without meaningful impact. Instead, focus on metrics that align with your organizational vision and provide actual data. For example, prioritize metrics like hospital readmission rates over less meaningful ones like the number of daily hospital visitors.

Step 5: Timeline

Creating a flexible timeline is crucial. While compliance requirements may dictate deadlines, it’s important not to compromise excellent initiatives to meet externally imposed deadlines. Use metrics to identify ways to complete processes faster or in different orders, maximizing efficiency and patient care.

Step 6: Implementation

The final and perhaps most critical step is implementation, transforming strategic plans into actionable initiatives. Key strategies include developing detailed action plans, engaging stakeholders, allocating resources, providing training and development, monitoring progress, maintaining communication, and celebrating milestones. Successful implementation requires continuous evaluation, learning, and adjustment to respond to the dynamic healthcare environment.

Case Studies

Christus St. Michael Health System engaged Tiller-Hewitt Healthcare Strategies LLC to enhance partnerships, recruitment, onboarding, integration, and retention of top providers. The strategy involved comprehensive stakeholder engagement, leading to the launch of a formalized hospitalist onboarding, navigation, and mentorship program. Results showed improved recruitment, retention, operational performance, and a significant reduction in turnover. The initiative also led to CHRISTUS St. Michael being recognized as one of the nation’s top hospitals by IBM Watson Health.

Conclusion

Effective strategic planning in healthcare involves a comprehensive process that includes environmental and situational analyses, developing a strategic vision, setting metrics, creating flexible timelines, and implementing actionable initiatives. By adopting innovative strategies and engaging stakeholders, healthcare organizations can enhance service quality, streamline operations, and improve patient outcomes.