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Strategic & Operational Planning

Dr. Ali Saleh School of Nursing

The University of Jordan

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Planning

Planning: is deciding in advance what to do; who is to do it; and how, when, and where it is to be done.

A need to choose from among alternatives. Planning is a proactive, deliberate process required of all

managers. It:

Reduces risk and uncertainty

Encourages unity of goals

Directs attention to the objectives of the organization

Provides managers with means of control

Encourages the most appropriate use of resources

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Planning

Planning requires:

– Management skills

• Data gathering

• Forecasting

• Transforming ideas into actions

– Leadership characteristics

• Flexibility

• Energy

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Planning Modes

1. Reactive: past oriented

2. Inactivism: present oriented

3. Preactivism: predict the future

4. Proactive: create the future

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Reactive Planning

• Reactive planning occurs after a problem exists. Planning efforts are directed toward returning the organization to a previous, more comfortable state. reactive planning can lead to hasty decisions and mistakes.

• Reactive planning is an active attempt to turn back the clock to the past. The past, no matter how bad, is preferable to the present. And definitely better than the future will be. The past is romanticized and there is a desire to return to the "good old days." These people seek to undo the change that has created the present, and they fear the future, which they attempt to prevent.

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Inactivism Planning

• Inactivism: Inactivists consider the status quo as the stable environment and they spend a great deal of energy preventing change and maintaining conformity

• Inactive planning is an attempt to preserve the present, which is preferable to both the past and the future. While the present may have problems it is better than the past. The expectation is that things are as good as they are likely to get and the future will only be worse. Any additional change is likely to be for the worse and should therefore be avoided.

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Preactivism Planning

• Preactivisim: Preactive planners utilize technology to accelerate change and are future-oriented.

• Preactive planning is an attempt to predict the future and then to plan for that predicted future. Technological change is seen as the driving force bringing about the future, which will be better than the present or the past. The planning process will seek to position the organization to take advantage of the change that is happening around them.

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Proactive Planning

• Interactive or proactive: Planners consider the past, present, and future and attempt to plan the future of their organization rather than react to it.

• Is dynamic, and adaptation is considered to be a key requirement since the environment changes so frequently.

• Proactive planning involves designing a desired future and then inventing ways to create that future state. Not only is the future a preferred state, but the organization can actively control the outcome. Planners actively shape the future, rather than just trying to get ahead of events outside of their control. The predicted changes of the preactive planner are seen not as absolute constraints, but as obstacles that can be addressed and overcome.

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Proactive Planning

Changes in technology, resource availability, and other changes

Forecasting: involves trying to estimate how a condition will be in the future, using available historical patterns, and examining present clues and projected statistics to determine future needs and protects the organization against undesirable changes.

Knowledge of the legal, political, economic and social factors are needed

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Strategic Planning

• Strategic Plans (long-range): complex organizational plans that involve a long period (usually 3 to 10 years) Once or twice a year in organizations that changes rapidly

6 months at unit level is considered long range.

• Strategic planning forecasts organization’s success by matching organizations capabilities with external opportunities

• Strategic planning typically examines an organization’s purpose, mission, philosophy, and goals in the context of its external environment.

• Tools that assist in SP includes SWOT analysis and Balanced Scorecard

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SWOT Analysis

• One of the most commonly tool used in health care organization. Analysis includes:

• Strengths are those internal attributes that help an organization to achieve

its objectives.

• Weaknesses are those internal attributes that challenge an organization in

achieving its objectives.

• Opportunities: are external conditions that promote achievement of

organizational objectives.

• Threats are external conditions that challenge or threaten the

achievement of organizational objectives.

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SWOT Analysis

• Simple rules for successful SWOT analysis: – Be realistic about the strengths and weaknesses of

your organization when conducting SWOT analysis. – Distinguish between where your organization is today,

and where it could be in the future (clear goals). – Be specific of what you need to accomplish. Avoid

grey areas. – Always apply SWOT in relation to your competitors i.e.

better than or worse than your competitors. – Keep your SWOT short and simple. Avoid complexity

and over analysis

**SWOT is subjective.

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Balanced Scorecard

• Tool that highly assist in strategic planning

• Balanced scorecard involves

– Metrics (performance measurement indicators)

– Collect data

– Analyze that data from four organizational perspectives

• Financial

• Customers

• Internal business processes

• Learning and growth

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Balanced Scorecard • The BSC suggests that we view the organization from four

perspectives, and to develop objectives, measures (KPIs), targets, and initiatives (actions) relative to each of these points of view:

• Financial: often renamed Stewardship or other more appropriate name in the public sector, this perspective views organizational financial performance and the use of financial resources

• Customer/Stakeholder: this perspective views organizational performance from the point of view the customer or other key stakeholders that the organization is designed to serve

• Internal Process: views organizational performance through the lenses of the quality and efficiency related to our product or services or other key business processes

• Learning and Growth (Organizational Capacity): views organizational performance through the lenses of human capital, infrastructure, technology, culture and other capacities that are key to breakthrough performance 18

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Strategic Planning as a Management Process

1. Clearly define the purpose of the organization.

2. Establish realistic goals and objectives consistent with the mission of the organization.

3. Identify the organization’s external constituencies or stakeholders and then determine their assessment of the organization’s purposes and operations.

4. Clearly communicate the goals and objectives to the organizations constituents.

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Strategic Planning as a Management Process

5. Develop a sense of ownership of the plan. 6. Develop strategies to achieve the goals. 7. Ensure the most effective use is made of the

organization’s resources. 8. Provide a base from which progress can be

measured. 9. Provide a mechanism for informed change as

needed. 10. Build a consensus about where the organization

is going.

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Strategic planning is dynamic and interactive

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Who should be involved in strategic planning?

• Historically strategic planning has been accomplished by top level managers and the board of directors, with limited input from middle level managers.

• Others should be involved:

– First level managers

– Subordinates from all organizational levels

• Annual strategic planning conferences should involve all departments and levels

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The Planning Hierarchy

Mission

Philosophy

Goals

Rules

Policies

Procedures

Objectives

Planning components

General

Specific

Components

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Vision and Mission Statement

• Vision statement are used to describe future goals or aims of an organization. It is a description in words that shows a picture for all group members of what they want to accomplish together.

• Sample vision statement

– “County Hospital will be the leading center for trauma care in the region”

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Vision and Mission Statement

Mission statement (purpose)

• A brief statement (typically no more than three or four sentences) identifying the reason that an organization exists

Sample Mission Statement

• “James King Memorial Hospital is a full-service health care institution which provides a broad range of preventive and curative health care services: primary, secondary, and tertiary. James Memorial Hospital will strive to provide high-quality care at a reasonable cost and with a minimum of unnecessary duplication.”

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The Organization’s Philosophy Statement

• The philosophy flows from the purpose or mission statement and delineates the set of values and beliefs that guide all actions of the organization.

• The organizational philosophy provides the basis for developing nursing philosophies at the unit level and for nursing service as a whole.

• The nursing service philosophy should address fundamental beliefs about nursing and nursing care; the quality, quantity, and scope of nursing services; and how nursing specifically will meet organizational goals.

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Hospital Philosophy,

goals & objectives

Philosophy, goals & objectives of nursing

department

Philosophy, goals & objectives of ----

department

Philosophy, goals & objectives of ----

department

Nursing unit A goals

Nursing unit B goals

Nursing unit C goals

Unit A philosophy

Unit C philosophy

Unit B philosophy

Unit A objectives

Unit B objectives

Unit C objectives

Philosophical congruence in the planning hierarchy

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Societal Philosophies and Values

• Values are sets of beliefs that guide behavior.

• These values have profoundly affect healthcare policy formation and implementation.

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Individual Philosophies and Values

• Personal philosophies and values are shaped by the socialization processes experienced by that person.

Characteristics of a True Value

• Freely chosen from among alternatives

• Prized and cherished

• Consciously and consistently repeated (part of a pattern)

• Positively affirmed and acted upon

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Individual Philosophies and Values

• The nurse-leader must be self-aware and provide subordinates with learning opportunities or experiences that foster increased self-awareness.

• When a nurse experiences cognitive dissonance between personal and organizational values, the result may be intrapersonal conflict and burnout.

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Goals and Objectives

• A goal is the desired result toward which effort is directed; it is the aim of the philosophy.

• Goals, although somewhat global in nature, should be ambitious, but realistic.

• There are several dangers in using goal evaluation as the primary means of assessing organizational effectiveness: – Goals may be in conflict with each other – Publicly stated goals may not truly reflect organizational

goals – Because goals are global, it is often difficult to determine

whether they have been met.

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Goals and Objectives

• Objectives are more specific and measurable than goals because they identify how and when the goal is to be accomplished.

• Goals usually have multiple objectives. • Process objectives are written in terms of the

method to be used. e.g.: – “100% of staff nurses will orient new patients to the

call-light system, within 30 minutes of their admission, by first demonstrating its appropriate use and then asking the patient to repeat said demonstration.”

• Result-focused objectives specify the desired outcome. e.g.: – “All postoperative patients will perceive a decrease in

their pain levels following the administration of parenteral pain medication within 5-10 min.”

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Goals and Objectives

Objectives Should

• Include a specific time frame for completion.

• Be stated in behavioral terms.

• Be objectively evaluated.

• Identify positive rather than negative outcomes.

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Policies and Procedures

• Policies are plans reduced to statements or instructions that direct organizations in their decision making. A policy is a statement of expectations that sets boundaries for action taking and decision making.

• For accreditation or internal control. • Implied policies, neither written nor expressed

verbally, have usually developed over time and follow a precedent. E.g. hospital implied policy that employees should be encouraged and supported in their activity in community, regional, and national healthcare organization

• Expressed policies are delineated verbally or in writing (consistency). E.g. dress code, sick leave..

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Policies and Procedures

• Procedures are plans that establish customary or acceptable ways of accomplishing a specific task and delineate a sequence of steps of required action. – Save staff time – Facilitate delegation – Reduce cost – Increase productivity – Provide means of control

• Procedures identify the process or steps needed to implement a policy and are generally found in manuals at the unit level of the organization.

• Review and revise policies

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Rules

• Rules and regulations are plans that define specific action or nonaction. Generally included as part of policy and procedure statements, rules describe situations that allow only one choice of action.

• Rules are fairly inflexible, so the fewer rules, the better.

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Overcoming Barriers to Planning

• The organization can be more effective if movement within it is directed at specified goals and objectives.

• Because a plan is a guide to reach a goal, it must be flexible and allow for readjustment as unexpected events occur.

• Include all people and units that could be affected.

• Plans should be specific, simple, and realistic. • Know when to plan and when not to plan. • Good plans have built-in evaluation checkpoints

so there can be a midcourse correction if unexpected events occur.

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