For this discussion use your critical-thinking skills to


Discussion Question

Strategic planning is an ongoing, comprehensive process designed to achieve the operational existence and purpose of the organization. Watch the short lecture "Fundamentals of Management" on Organizational Behavior.

As a health care manager, you will use your critical-thinking skills at various times throughout your career. For this discussion, use your critical-thinking skills to describe how organizational behavior in a health care organization is directly connected to:

1. Organization vision and mission
2. Creating and executing organizational goals
3. Organizational communication

As you create your discussion, remember that like most industries, health care organizations are diverse with an assortment of backgrounds. As a health care leader, you must be culturally competent. In your response, consider the following cultural question: How would you as a leader in your organization ensure you are reaching all staff and encouraging an environment where professionals (of diverse backgrounds) work together effectively through the vision and mission, organizational goals, and communication?

Cite reliable sources to support your answer.

Module Overview

The purpose, function, and application of strategic planning in health care administration is studied. Content includes strategic planning, situational analysis, strategy formulation, action planning, and metrics. Leader qualities are used in this module to effectively identify strategic issues, develop a team, and develop a plan of action for overall improvement. Organizational behavior is examined to view its impact on organization vision/mission, organizational goals, organizational communication, and the diverse environment of professionals in health care organizations.

Strategic planning models can offer a range of opportunities to an organization. The National Criminal Justice Association (2017) recommends the following strategic planning models:

Model One: The Basics

Organizations that are small, busy, and have not done much strategic planning before might want to start with this approach. Top-level management often carries out planning in this model rather than using a community-based approach. Basic strategic planning includes:

1. Create a mission statement. A mission statement describes why the organization exists (i.e., identifies its basic purpose). The statement should address both the types of communities or audience that the organization serves, and the services and products it will provide. The top-level management will generally develop the mission statement. The statement will change somewhat over the years.

2. Select the organization's intermediate goals. Goals are general statements about what needs to be accomplished to meet the purpose or mission and address major issues.

3. Identify approaches or strategies to reach each goal. Strategies are often what change most as the organization eventually conducts more robust strategic planning, particularly as external and internal environments are examined more closely.

4. Identify action plans to implement each strategy. Action plans list the steps that each major function (for example, a department or agency) must take to ensure that it is effectively implementing a strategy. Objectives should be clear enough to be assessed if they have been met. Ideally, top management will develop committees, each with their own work or set of objectives.

5. Monitor and update the plan. Planners regularly monitor progress towards goals and whether action plans are being implemented. Perhaps the most important indicator of success is positive feedback from customers.

6. Note that organizations may want to extend step 3 by identifying additional goals that help develop central operations or administration (e.g., implementing a new goal that strengthens financial management).

Model Two: Issue- or Goal-Based Strategic Planning

Organizations that begin with basic planning often evolve toward this more comprehensive and effective approach. This model will be the focus of recommendations for use as the preferred process in community-based planning.

1. Identify SWOT (Strengths, Weaknesses, Opportunities, and Threats). SWOT can exist both within and outside an organization.

2. Identify and prioritize major problems and goals. Go through the SWOT list and identify the organization's goals and the problems that might prevent goals from being reached.

3. Design major strategies (or programs) to address problems and goals.

4. Design or update the organization's mission statement (some organizations may do this step first).

5. Establish action plans (i.e., objectives, resource needs, roles, and responsibilities for implementation).

6. Create a strategic plan. A strategic plan contains all the documentation assembled so far. It also provides a record of problems, goals, strategies, updated mission statement, action plans, and any identified SWOT.

7. Develop a yearly operating plan. Decide which milestones the organization must reach by the end of each operating year.

8. Develop and authorize budget for the first year.

9. Conduct first-year operations.

10. Monitor/review/evaluate/update Strategic Plan.

Model Three: Alignment Model Strategic Planning

Because this model ensures strong alignment between an organization's mission and resources, it is useful for fine-tuning strategies or finding out why they are not working. An organization might also choose alignment planning if it is working to overcome a number of problems around internal efficiencies. Steps include:

1. Outline the organization's mission, programs, resources, and needed support.
2. Identify what is working well and what needs adjustment.
3. Identify how these adjustments should be made.
4. Include the adjustments as strategies in the strategic plan.

Model Four: Scenarios

This approach might be used in conjunction with other models to ensure planners undertake strategic thinking. Scenarios can be particularly useful in identifying strategic issues and goals.

1. Identify vulnerabilities. Select several external forces and imagine related changes that might influence the organization, such as a change in regulations or a change in demographics, for example. Scanning the newspaper for headlines often suggests potential changes that might affect the organization.

2. Imagine scenarios. For each change identified, discuss three different scenarios (including best, worst, and OK/reasonable cases) that might result. Worst-case scenarios often inspire participants to make significant changes in an organization.

3. Design responses. Suggest what the organization might do, or potential strategies, in each of the three scenarios to respond to each change.

4. Select common strategies. Planners soon detect common considerations or strategies that must be addressed to respond to possible external changes.

5. List the most likely problems. Select the most likely external changes to affect the organization over the next 3 to 5 years, and identify the most reasonable strategic responses available to the organization.

Model Five: Organic (or Self-Organizing) Strategic Planning

Strategic planning is sometimes considered mechanistic or linear; it is understood as general-to-specific or cause-and-effect in nature. For example, planners first conduct a broad assessment of the external and internal environments of their organization; conduct a strategic analysis (SWOT); narrow down, identify, and prioritize problems; and then develop specific problem-solving strategies.

Planning can also be compared to the development of an organism (i.e., a plan can grow in an organic, self-organizing way). Certain cultures, for instance, Native Americans, might prefer this unfolding and naturalistic understanding to traditional, mechanistic methods. Self-organized planning requires continual reference to common values, dialoguing around these values, and continual, shared reflection around the system's current status. General steps include:

1. Clarify and articulate the organization's cultural values. Use dialogue and storyboarding techniques.

2. Articulate the group's vision for the organization. Use dialogue and storyboarding.

3. Dialogue regularly. On an ongoing basis (e.g., once every quarter, discuss the processes needed to arrive at the vision and what the group is going to do next).

4. Remind everyone regularly that values are not goals. This type of naturalistic, values-centered planning is never really "over with"; rather, the group needs to conduct its own values clarification, dialogue and reflection, and process updates.

5. Be very, very patient. Group decision making-often by consensus-takes time, and results can emerge irregularly and without warning.

6. Focus on learning and less on method. Organic planning encourages spontaneous, unexpected results. In many ways, it resembles an experiment more than a machine.

7. Translate accomplishments into goals. Ask the group how it will portray its strategic plans to stakeholders and others who expect mechanistic, linear results. Be particularly aware of contract requirements for specific, measurable outcomes.

Model Six: Appreciative Inquiry

Appreciative inquiry (AI) is a breakthrough in organizational development, training, planning, and problem solving, generally. AI is based on the assertion that problems are often the result of personal perspectives and perceptions of phenomena. For instance, if a certain priority is viewed as a problem, then the ability to effectively address the priority and continue to develop in our lives and work can be constrained. The approach has revolutionized many practices, including strategic planning and organization development. AI is implemented through a continuous four-step process.

1. Discovery Phase. The core task in this phase is to appreciate the best of "what is" by focusing on peak moments of community excellence-when people experienced the community at its most alive and effective. Participants then seek to understand the unique conditions that made the high points possible, such as leadership, relationships, technologies, values, capacity building, or external relationships. They deliberately choose not to analyze deficits, but rather systematically seek to isolate and learn from even the smallest victories. In the discovery phase, people share stories of exceptional accomplishments, discuss the core life-giving conditions of their community and deliberate upon the aspects of their history that they most value and want to enhance in the future.

2. Dream Phase. In the dream phase, people challenge the status quo by envisioning more valued and vital futures. This phase is both practical, in that it is grounded in the community's history, and generative, in that it seeks to expand the community's potential. AI is different from other planning methods because its images of the future emerge from grounded examples of the positive past. They are compelling possibilities precisely because they are based on extraordinary moments from a community's history. Participants think great thoughts and create great possibilities for their community, then turn those thoughts into provocative propositions for themselves.

3. Design Phase. Participants create a strategy to carry out their provocative propositions. They do so by building a social architecture for their community that might, for example, redefine approaches to leadership, governance, participation, or capacity building. As they compose strategies to achieve their propositions, local people incorporate the qualities of community life that they want to protect and the relationships they want to achieve.

4. Destiny Phase. The final phase involves the delivery of new images of the future and is sustained by nurturing a collective sense of destiny. It is a time of continuous learning, adjustment, and improvisation in the service of shared community ideals. The momentum and potential for innovation is high by this stage of the process. Because they share positive images of the future, everyone in a community realigns their work and co-creates the future.

Reference:

Berry, L., Mirabito, A., & Berwick, D. (2004). A health care agenda for business. Sloan Management Review, 45(4), pp. 56-64.

Betancourt, J. R., Green, A. R., Carrillo, J. E., & Ananeh-Firmpong, O. (2003). Defining cultural competence: a practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports. 118(4), 293-302. doi: 10.1016/S0033-3549(04)50253-4
Brugha, R., & Varvasovszky, Z. (2000). Stakeholder analysis: a review. Health Policy and Planning, 15(3), 239-246.

Free Management E-Books. (2013). SWOT analysis.

Gershon, H. J. (2003). Strategic positioning: Where does your organization stand? Journal of Healthcare Management, 48(1): 12-14.

Harrison, J. P. (2012). Chapter 5: Strategic palling and SWOT analysis. Essentials of Strategic Planning in Healthcare.

Health Research & Educational Trust. (2013). Becoming a culturally competent health care organization.

Johnson, D. E. (2004). What is strategic management, planning? Health Care Strategic Management, February 22, 2:2-3.

Mickan, S. H. & Rodger, S. A. (2005). Effective health care teams: A model of six characteristics developed from shared perceptions. Journal of Interprofessional Care. 19(4), 358-370. doi: 10.1080/13561820500165142

Nagy, D. (2017). Lecture 3 - 1.3 Organizational Behavior.

van Wijngaarden, J. D., Scholten, G. R., & van Wijk, K. P. (2012). Strategic analysis for health care organizations: the suitability of the SWOT-analysis. The International Journal of Health Planning and Management, 27(1), 34-49.

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