My take on Healthcare Strategic Planning

When I think of Hospital Strategic planning I think of long term planning.  According to a Case study of Community Hospital Healthcare System: A Strategic Management  Case Study  of some of the operational aspects are a formulation of vision, mission statements, internal and external analysis, generating, evaluating and selecting appropriate strategies for a healthcare organization. ( Choudhary 2012)

The Steps in Strategic planning according to Nowicki are:

1.    Validate Mission and Strategic Interpretations

2.    Assess the External Environment

3.    Assess the Internal Environment

4.    Formulate the Vision

5.    Establish Strategic Thrusts

6.    Identify Critical Success Factors

7.    Develop Core Objectives

8.    Develop the Strategic Financial Plan (Nowiki 2011)

I think that Strategic Management in Hospitals when I look at the TCOs:

·         Given that healthcare is pluralistic in the way it is financed, formulate a plan to address the issues surrounding third-party payments: payment methodologies of government healthcare programs, complex receivables management, managed care requirements, and corporate compliance plans.

·         Given the trend toward creation of integrated health service systems, distinguish the rationale for merger, acquisition, and joint-venture activity among health service organizations. In specific case examples, identify the business and financial considerations of such decisions for the organizations involved.

I think that healthcare and third party payments are an evolving enterprise. According to an Article titled The Evolving Role of Third Parties in the Hospital Physician relationship. “The rising cost of healthcare and the changing technologies combined with population density. Rising costs have led public payers and managed care organizations to push for ambulatory care and more consumerism.”   (Burns 2007)

Secondly “Technological evolution and population density have allowed procedures once performed only in general hospitals to be conducted in surgical centers. This trend has split the market in competition for patients.”  (Burns 2007)

Step One: Validate Mission and Strategic interpretations

This mission statement of University of Oklahoma Health Sciences Center is as follows:

The mission of the University of Oklahoma Health Sciences Center, as a comprehensive academic health center, is to educate students at the professional, graduate, and undergraduate levels to become highly qualified health services practitioners, educators, and research scientists; to conduct research and creative activities for the advancement of knowledge through teaching and development of skills; and to provide continuing education, public service, and clinical care of exemplary quality. (OUHSC 2014)

Here are the strategic statements of University of Oklahoma Health Center:

·         Propel the OUHSC and the state to regional and national prominence in research and development

·         Bridge the gap between bench and bedside

·         Rapidly translate new discoveries into new treatments

·         Promote further economic development for Oklahoma and continue to meet the health care needs of the state.  (OUHSC 2014)

So when I look at the mission statement and the strategic statement I can see the progression of a research institute with a regional and national prominence. Secondly the idea of pushing research into new treatments is a factor.  The plan is a five year plan where four key areas; cancer, diabetes, neuroscience/vision and infectious diseases/immunology of research are targeted. The healthcare facility has over $377 million allocated towards capital projects. Just from viewing the website one can see the first two bullets in practice mentioned by the California Management Review. (OUHSC 2014)

Step two: Assess the External Environment

The external environment was assessed by the hospital as well as the Oklahoma City Chamber of Commerce. The comparative study evaluated Oklahoma City against Birmingham, Alabama; Dallas, Texas; Kansas City, Kansas and Missouri; Louisville, Kentucky; St Louis, Missouri and Illinois; and Saskatoon, Saskatchewan, Canada. This was completed by the Battelle Technology Partnership Practice in September 2005. The study was completed to analyze the biotechnology industry.  (GOKCC 2005)

According to Nowicki in Introduction to the Financial Management of Healthcare Organizations, “the first part of the external assessment should include national trends. The second part of the external environment assessment should include a determination on the direction of the local market.” (Nowicki 2011)

Step three: Assess the Internal Environment

Within the highlight of the about webpage there is a mention of how the University of Oklahoma has one fo the only primary centers in the world for genome studies, OUHSC is home to one of the few departments of geriatrics in the nation that conduct basic research in aging. (OUHSC 2014) According to the Bio Ready and Bio Strong highlights Oklahoma City out of the reports six cities was second in producing Bio Science degrees behind St. Louis.

Step four:  Formulate the vision

Formulation of the vision is a process by which the facility is communicating a message both internally that is inspiring, clear, challenging, preparing for the future while honoring the past as well as easily translated into action. (Nowicki 2011) When I read the about webpage at the University of Oklahoma Health Sciences Center I see the evidence in their statements about where they plan to be.” The plan targets and builds upon existing research and clinical strengths to achieve a vigorous economy and healthier future for all Oklahomans. Previous research strategies boosted total sponsored awards at the OUHSC from $10 million in 1982 to $139 million in 2009.” (OUHSC 2014)

Step five: Establish Strategic Thrusts

Establishing Strategic Thrusts means setting goals, which are broad statements of significant results that the organization wants to achieve related to the vision. Based on the reports and the research of external factors I see the strategic thrusts at University of Oklahoma Health Sciences Center are: Building an OU Cancer Institute, the Harold Hamm Oklahoma Diabetes Center, and the College of Allied Health. (OUHSC 2014)

Step six: Identify Critical Success Factors

Critical success factors are organization specific, but most healthcare organizations will include critical success factors. Some of the critical success factors according to Nowicki are in the area of medical staff profiles and activity levels, accessibility indicators, or quality indicators. With the OUHSC the plan is to add 100 faculty members.  (OUHSC 2014)

Step seven: Develop Core Objectives

The seventh step is to develop primary, core objectives that support the strategic thrusts or goals. Across the OUHSC organization the objectives or strategic statements encompass the objectives. (Nowicki 2011) The objectives are to build the four areas of cancer, diabetes, infectious disease and immunology as well as recruit 100 faculty members.

Step eight: Develop the Strategic Financial Plan

The strategic financial plan is three to ten years out. It is the financial quantification of a series of strategic planning policy decisions that answer whether the organization can make progress toward accomplishing its strategic plan over the next few years. (Nowicki  2011)

Alternate views

According to California Management Review:

 Executing Strategic Change Strategy execution is concerned with firstly, creating a portfolio of change programs that will deliver strategy; and secondly, it involves attracting, allocating, and managing all the necessary resources to deliver these change programs.  It is becoming more critical to organizations’ long term success to excel at strategy execution: those that do will outperform their peers by a wide margin. (Franken 2007)

·         According to the article the first thing is that businesses have to be ready for the change of the business market, “according to customer wants, needs and priorities.”

·         The second reason is the, “increased complexity of organizations.”  Today’s organizations across multiple functional, organizational, and geographical boundaries.

·         The third reason is the demands of  successfully executing complex change programs with the demands of managing today’s performance are based on reward schemes based on today’s performance.  This means that managers have less time to dedicate time to one set of demands exclusively.

·         The fourth reason is the low levels of involvement of a large number of managers across all functions at an early stage of strategy execution.

·         The fifth reason is the difficulty of securing resources to execute the strategy. There are a large number of concurrent change programs. As such resources are limited and the competition for control and maintaining those resources is fierce. (Franken 2012)

According to Becker Hospital Review 70% of Hospital Strategic Initiatives Fail: How Hospitals Can Avoid Those Failures. The main contributor to the failure of strategic planning according to the article is due to communication.  (Becker 2012)

An alternate view asks Is Strategic Planning Still Relevant? Some of the problems that limit the effectiveness of strategic planning are:

·         Failing to involve the appropriate people

·         Conducting Strategic Planning Independently of Financial Planning

·         Falling Prey to Analysis Paralysis

·         Not Addressing the Critical Issues

·         Assuming that Established Objectives Take Care of Themselves

·         Failing to Achieve Consensus

·         Lacking Flexibility and Responsiveness to the Dynamic Environment

·         Ignoring Resistance to Change (Zuckerman 2007)

Technology Solutions

According to Digitizing the Healthcare System some of the newer benefits from healthcare digitization are:

·         More complete information available for treatment decisions

·         New and more efficient options for patient interaction

·         Enhanced ability to demonstrate performance consistent with regulations and recognized professional standards

·         Potential for reduced operational costs and more effective use of resources (Commission on Systemic Interoperability 2005)

When I look at the University of Oklahoma Health Sciences Strategic plan I did not see how the plan involved technology as a goal. This does not mean that technology has not been included in the strategic process. I believe this could be under the title of examining the external and internal environments. According to an HealthIT article some of the ways to include technology are:

·         Think about the patient experience

·         Consider best practices

·         Remember the staff experience

·         Don’t forget about social media

·         Employ integrative planning (McNickle 2012)

Conclusions

These two dynamics speak to TCO H or the integration of health service systems; I think a rationale is consolidation of care for the patients in a fragmented system. As the Technology merges and patient care needs, and wants are evolving. There is new legislation from the Government when it comes to healthcare that impact the way these healthcare organizations perform their strategies going forward meaningful use of electronic health records  and ICD10 codes come to mind.  The shifts in technology are changing the operational tasks of organizations as well as changing the dynamics of the relationships between traditional organizations and the patients.   The market of healthcare includes technology as component of delivery. According to HealthIT.gov some of the benefits include quality of care as well as a fewer deaths and fewer problems of care (HealthIT.gov 2014) If 70% of initiatives fail due to a lack of communication, improved integration of technology can help eliminate some of the barriers and improve communications.