Strategic Management and Planning

Strategic Management and Planning


Simply put, strategic planning is the process by which an organization/nursing department or unit decides where it is going over the next year or longer and how it is going to get there. Typically, the process is organization-wide and the outcome of the process that, on an organizational level, cascades down to the patient care department and the individual units and employees. The strategic plan is the “map” of where the organization, department, or unit is going over the next year or longer.

Strategic management is the process of setting goals and objectives for the organization/department/unit, determining the resources that are necessary to meet the goals, creating an action plan, and evaluating progress towards meeting the goals.

Strategic planning used to be the domain of the financial managers of many institutions. This philosophy has changed, and strategic planning now includes all stakeholders of the organization. Nurse managers have an important role in the strategic plan of the organization and in the implementation of action plans at the unit level that assist the organization in meeting its goals.

Managers of an organization need to focus on a series of key questions as they begin the strategic planning process (Finkler, Kovner, and Jones, 2007, p. 216):

In answering these questions, the manager will find that the answers lead to other questions, such as, What are the strengths and challenges faced by the organization? What is its competitive status? Who are the primary stakeholders for the organization? How does the organization measure its performance? How does it learn from its performance?


The elements of a strategic plan include the following (Finkler et al., 2007, p. 217):


The first step in strategic management is the development of a mission statement for the organization. The mission statement focuses on the definition of what the organization does and aspires to do. The mission statement for some organizations is further divided into a vision, which tells the reader where the organization wants to be in the future. Many organizations also create a values statement, which includes the behaviors of importance within the organization. Some organizations include the mission, vision, and values statement in one document.

For example, the simple mission of North Mississippi Medical Center (NMMC) (2007) is:

The corresponding vision statement of this organization is:

And the values of this organization are:

According to NMMC (2007):

Some organizations use critical success factors as the organizing framework by which the mission, vision, and values are translated into the strategic plan. One commonly used framework is from the Studer Group, a health care consulting group that works with many health care organizations in the country. To continue with the example of NMMC:

These critical success factors are also called pillars by many institutions, and in some organizations a sixth pillar, COMMUNITY, is included (Studer Group, 2008).


As part of the strategic planning process, it is vital for an organization to be aware of its competitive environment. This is accomplished through strategic analysis. Sometimes, this is also called an environmental scan. This activity can include conducting a review of the organization’s environment (e.g., a review of the political, social, economic and technical environment). Planners carefully consider various driving forces in the environment, such as increasing competition, changing demographics, and so forth. Planners also look at the various strengths, weaknesses, opportunities, and threats regarding the organization; an acronym for this activity is SWOT. As nurse managers, you will participate in the patient satisfaction initiatives of your institution. Most nurses are aware of the performance of the other units in the hospital in relation to patient satisfaction, and some are aware of the performance of the similar units in the area. An example of changing demographics and their impact on hospital planning would be a population shift to large numbers of families moving into the local area served by the institution. This information from the environmental scan might result in a facility increasing the number of services for a pediatric population. An example of technical and regulatory changes occurring is the electronic medical record, which has been strongly recommended by the Institute of Medicine as a means of decreasing hospital errors.

Other information collected for the strategic planning process comes from past performance and information collected from all stakeholders through a variety of means. These involve satisfaction surveys (patient, employees, physicians, community), focus groups with members of the community to determine issues of importance, and other means of listening to the expressed desires of the local community.

The competitive strategy is the organization’s plan for achieving its goals. It states what services will be provided to whom. It is decided on as a direct result of the information provided by the strategic analysis and environmental scan. The organization evaluates its mission, vision, and goals in light of the information provided by the environmental scan, the identified strengths and challenges, and the demand for service. Based on this competitive strategy, the organization makes a plan that allows it to take advantage of the identified strengths and needs of the various stakeholders. The product of this process is conclusions about what the organization must do as a result of the major issues and opportunities facing the organization. These conclusions include the overall accomplishments (or strategic goals) the organization should achieve.


According to Carter McNamara, the long- and short-term goals are the overall methods (or strategies) to achieve the strategic goals of the organization. An example of a short-term goal of an organization might be to improve performance on the Core Measure for Cardiac Failure, increasing from 80% to 85% compliance by the end of the year. A long-term goal might be to consistently perform at 98% to 100% at the end of 3 years. Goals should be designed and worded as much as possible to be Specific, Measurable, Acceptable to those working to achieve the goals, Realistic, Timely, Extending the capabilities of those working to achieve the goals, and Rewarding to them, as well. (A mnemonic for these criteria is “SMARTER.”)

Action Planning

Action planning is the process by which the specific goals are matched with each strategic goal. The overall organization-wide strategic goals cascade down to all departments and units and, in some cases, the individual employees. Action planning requires specifying expected outcomes with each strategic goal. These outcomes then form the basis of the performance scorecards used in most organizations. The anticipated outcomes are usually based on the competitive strategy of the organization and are often benchmarked against “best in class performers” or to where the organization wants to be in terms of performance.

Often, each objective is associated with a tactic, which is one of the methods needed to reach an objective. Therefore, implementing a strategy typically involves implementing a set of tactics along the way—in that sense, a tactic is still a strategy but on a smaller scale.

Action planning also includes specifying responsibilities and timelines with each objective, or who needs to do what and by when. It should also include methods to monitor and evaluate the plan, which includes knowing how the organization will know who has done what and by when.

It is common to develop an annual plan (sometimes called the operational plan or management plan), which includes the strategic goals, strategies, objectives, responsibilities, and timelines that should be implemented in the coming year. These are the short-term goals of the organization. The difference between short- and long-term plans and objectives relates to the time expected to accomplish them. These times vary from institution to institution, but short-term plans usually extend up to 1 year. Long-term plans vary from 3 to 5 years.

Usually, budgets are included in the strategic and annual plan, and with individual departmental and unit plans. Budgets specify the funds needed for the resources that are necessary to implement the annual plan. Budgets also depict how the funds will be spent. (See Chapter 14 for information on budgets.)

The strategic planning process of NMMC is diagrammed in Figure 13-1, and an example of their broad strategic plan is shown in Figure 13-2. Note that the goals are formulated according to the critical success factors identified by the organization. The performance indicators list the measures that will be used to measure progress toward achievement of the goals. The benchmarks relate the performance of the competitors or “best in class,” and the targets are the short- and long-term goals.

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Dec 3, 2016 | Posted by in NURSING | Comments Off on Strategic Management and Planning

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