Strategic Planning

1.   Joining/forming a larger system in pursuit of economic, clinical and contracting scale.

2.   Employing more physicians and transitioning the employed physicians towards a Multi-Specialty Group that will breakeven financially.

3.   Developing a coordinated approach to clinical integration that includes independent, employed and contracted physicians.

4.   Implementing an interoperable EMR while achieving "meaningful use" and evolving towards Stage Seven on the HIMSS adoption scale.

5.   Pursuing a Lean Six program (or equivalent) in order to improve quality, satisfaction & efficiency.

1.   Mission: the strategy process should clearly identify the core business and the manner in which other business lines relate to the core. Passive acceptance of the Mission Statement as inviolate runs the risk of focusing the organization on what is "good" to do versus what is "best" to do.

2.   Vision: a two or three sentence vision phrase may be an appropriate way to provide inspiration. A vision statement, however, should be a clear, pragmatic depiction of a desired state for the organization at a specified (five to 10 years out) period in time.

3.   External Assumptions: healthcare delivery is being transformed by ten megatrends, including global economics that have a synergistic impact on one another.  Consideration of healthcare reform alone is insufficient.

4.   Internal Assessment: hospitals must confront the brutal facts regarding their own capabilities and limitations. These must also be assessed relative to a defined set of criteria including nearby competitors as well as stretch goals (e.g., "the best in class”).

5.   Key Strategic Issues: "Great strategists get a few big things right” (Michael Porter). The organization with 30 strategic priorities is, by definition, focused on tactics and operations as opposed to strategy. Pillars are important but they are more operational than strategic.

6.   Resource Allocation: strategy can only be effective if it leads to a reallocation of cash and human capital to support defined priorities.

1.   Articulation of what the organization hopes to become (i.e. a Vision for the future).  For example, an Integrated Delivery Network.

2.   Identification of the assumptions underpinning the Vision.  For example, the shift to risk based contracting.

3.   Development of a pluralistic approach to inclusion of employed, independent and contracted physicians in the creation of a Virtual Multi-Specialty Group.

4.   Establishment of Leadership Councils for both the IDN and the Virtual MSG that are composed of leaders from a variety of constituencies.  And, creation of clear charters for these groups that establish areas of responsibility and accountability.

5.   Establishment of criteria for participation in the Virtual MSG.  For example, agreement to participate in clinical protocols, to utilize an interoperable EMR, to participate in performance based contracts and to utilize hospitalists, intensivists and an eICU.

1.   Rightsizing: to improve performance. An approach that addresses both the number of trustees and the functional composition of the entire board.

2.   Streamlining: the number of corporate entities within the organization based on the principle of “form follows function.”

3.   Clarifying: responsibilities between and among boards and committees.

4.   Specifying: the boundaries between the board and the CEO; clarifying the relationship between trustees and other members of executive management.

5.    Redefining: committee charges and the relationship of each committee to the full board.

6.    Restructuring: board meetings to improve communication, increase effectiveness and assist the board in focusing its energy on the "right".