Organizational

Planning
Reported by; Jhomaliah Dait
✣ … In the absence of clearly defined goals, we are forced
to concentrate on activity and ultimately become
enslaved by it.

-Chuck Conradt

… he, who fails to plan, plans to fail

-Anonymous

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 LEARNING OBJECTIVES
: Identify contemporary paradigm shifts and trends impacting health-care organizations.
: Analyse social, political, and cultural forces that may affect the ability of 21st –century health-care organizations
to forecast accurately in strategic planning.
: Describe how tools such as SWOT analysis and balanced scorecards can facilitate the strategic planning
process.
: Describe the steps necessary for successful strategic planning.
: Identify barriers to planning as well as actions the leader-manager can take to reduce or eliminate this barriers.
: Include evaluation checkpoints in organizational planning to allow for midcourse corrections as needed.
: Discuss the relationship between an organizational mission statement, philosophy, goals, objectives, policies,
procedures and rules.
: Write an appropriate mission statement, organization philosophy, nursing service philosophy, goals, and
objectives for a known or fictitious organization.
: Compare the social values regarding access to and payment of health care in the United States and at least one
another country .
: Discuss appropriate actions that may be taken when personal values are found to be in conflict with those of an
employing organization.
: Recognize the need for periodic value clarification to promote self-awareness
: Describe personal planning style. 3
Introduction
✣ Planning is critically important to and precedes all other management
functions. Without adequate planning, the management process fails and
organizational needs and objectives cannot be met.
✣ In effective planning, the manager must identify short-and-long-term goals
and exchanges needed to ensure that the unit will continue to meet its goal.
Identifying such short-and-long-term goals require leadership skills such as
vision and creativity because it is impossible to plan what cannot be
dreamed or envisioned.
✣ Likewise, planning requires flexibility and energy-two other leadership
characteristics. Planning also requires management skills such as data
gathering, forecasting, and transforming ideas into action.

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 Leadership Roles and Management Functions
Associated With Organizational Planning
✣ Leadership Roles
1. Translates knowledge regarding contemporary paradigm shifts and trends impacting health
care into vision and insights which foster goal attainment.
2. Assesses the organization’s internal and external environment in forecasting and identifying
driving forces and barriers to strategic planning.
3. Demonstrate visionary, innovative, and creative thinking in organizational and unit planning,
thus inspiring proactive rather than reactive planning.
4. Influences and inspires group members to be actively involved in both short- and long-term
planning
5. Periodically completes value clarification to increase self-awareness
6. Encourage subordinates toward value clarification by actively listening and providing
feedback
7. Communicate and clarifies organizational goals and value to subordinates
8. Encourage subordinates to be involved policy formation, including developing, implementing,
and reviewing unit philosophy, goals, objectives, policies, procedures, and rules
9. Is respective to new and varied ideas
10. Role models proactive planning methods to followers
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✣ Management Functions
1. Is knowledgeable regarding legal, political, economic and social factors affecting health-care
planning
2. Demonstrate knowledge of and uses appropriate techniques in both personal and
organizational planning
3. Provides opportunities for subordinates, peers, competitors, regulatory agencies, and the
general public to participate in organizational planning
4. Coordinates unit-level planning to be congruent with organizational goals
5. Periodically assesses unit constraints and assets to determine available resources for
planning
6. Develops and articulates a unit philosophy that is congruent with the organizational
philosophy
7. Develops and articulates unit goals and objectives that reflect unit philosophy
8. Develops and articulates unit policies, procedures, and rules that put unit objectives in
operation
9. Periodically reviews unit philosophy, goal, policies, procedures, and rules and revises them
to meet the units changing needs
10. Actively participates in organizational planning, defining, and operationalizing plans at the
unit level

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 Looking to the Future
✣ Because of health-care reform, rapidly changing technology,
increasing government involvement in regulating health care, and
scientific advances, health-care organizations are finding it
increasingly difficult to identify long-term needs appropriately and
plan accordingly.
✣ The health-care system is in chaos, as is much of the business
world. Traditional management solutions no longer apply, and a lack
of strong leadership in the health-care system has limited the
innovation needed to create solutions to the new and complex
problems that the future will bring.

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✣ Further consolidation of hospital/systems, medical groups, ancillary services, health
plans, and postacute providers is expected.” Most consolidation will be driven by the
need for critical mass, to fill gaps in the continuum of services offered, to reduce
operating cost per unit, to streamline transitions in care, and to expand geographic
outreach”.
✣ Robotic technology and the use of prototype nurse robot called nursebots will serve as
an adjunct to scarce human resources in the provision of health care.
✣ Biomechatronics, which creates machines that replicate or mimic how the body works,
will increase in prominence in the future. This interdisciplinary field encompasses
biology, neurosciences, mechanics, electronics, and robotics to create devices that
interact with human muscle, skeleton, and nervous systems to establish or restore
human motor or nervous system function.
✣ Biometrics, the science of identifying people through physical characteristics such as
fingerprints, handprints, retinal scans, voice recognition, and facial structure, will be used
to assure targeted and appropriate access to client records.
✣ Point-of-care testing will improve bedside care and promote more positive outcomes as a
result of more timely decision making and treatment

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 Four Planning Modes:
Reactive planning
-occurs after a problems exist. Frequently, in reactive planning, problems are dealt with
separately without integration with the whole organization. In addition because it is done in response to a
crisis, this type of planning can lead to hasty decisions and mistakes.
Inactivism
-is another type of conventional planning. Inactivists seek the status quo, and they spend their
energy preventing change and maintaining conformity. When change do occur, they occur slowly and
incrementally.
Preactivism
-preactive planers utilize technology to accelerate change and are future oriented. Unsatisfied
with the past or present, preactivists do not value experience and believe that the future is always
preferable to the present.
Interactive or Proactive Planning
- planners who fall into this category consider the past , present and future and attempt to
plan the future of their organization rather than react to it. Because the organizational setting changes
often, adaptability is a key requirement for proactive planning.

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Strategic Planning at the Organizational Level
✣ Organizational plans that involve in long period (usually 3 to 7
years) are referred to as long-range or strategic plans. However,
strategic planning maybe done once or twice a year in an
organization that changes rapidly. At the unit level, any planning
that is at least 6 months in the future may be considered long
range planning.
✣ Instead of focusing on the external environment and the market
place, health-care organizations will need to look closely at their
competencies and weaknesses, examine their readiness for
change, and identify those factors critical to achieving future goals
and objectives.

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✣ (Jarousse, 2012) This assessment should begin with
gathering data related to financial performance,
human resources, strategy, and service offering as
well as outcomes and results. Feedback from senior
leadership, the medical staff, and the board is then
needed so that consensus can be obtained from
stakeholders regarding the organization’s strengths
and weaknesses. Then an action plan can be created
that strengthens the organization’s infrastructure. The
assessment concludes with an evaluation of how well
the organization is achieving its goals and objectives
and the process begins once again.

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 SWOT Definitions

✣ Strengths are those internal attributes that help an organizational 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 condition that challenge or threaten the
achievement of organizational objectives.

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 SWOT Analysis

✣ There are many effective tools that assist organization in strategic

planning. One of the most commonly use in health-care
organization is SWOT analysis (identification of strengths,
weaknesses, opportunities, and threats) SWOT analysis, also
known as TOWS analysis, was developed by Albert Humphrey at
Stanford University in the 1960s and 1970s.
✣ The First step in SWOT analysis is to define the desired end state
or objective. After the desired objective is defined, the SWOTs are
discovered and listed. Decision makers must then decide if the
objective can be achieve in view of the SWOTs. IF the decision is
no, a different objective is selected and the process repeat.

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 Example of Abbreviated SWOT Process
✣ Strengths
1. Local schools of nursing offer online baccalaureate and master’s degrees at affordable cost for
working nurses.
2. Hospital Z offers generous professional development funding opportunities to staff..
✣ Weaknesses
1. Recent high turnover rates have resulted in tight staffing and request by nurses for reduced
workloads to return to school would be difficult to honor.
2. At present, there is no role differentiation for nurses at Hospital Z based on a nurse’s educational
level.
✣ Opportunities
1. Current research evidence suggest that increasing the number of nurses with baccalaureate or
higher degrees in the staffing mix would positively impact quality of care.
2. Hospital Z could consider application for Magnet status if more nurses held higher degrees.
✣ Threats
1. Local schools of nursing have impacted enrolments, so not all nurses who want to return to school
can be accepted.
2. An impending national nursing shortage could further exacerbate current staffing shortages.
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 Simple Rules for SWOT Analysis

✣ Be realistic about the strengths and weaknesses of your

organization.
✣ Be clear about how the present organization differs from
what might be possible in the future.
✣ Be specific about what you want to accomplish.
✣ Always apply SWOT in relation to your competitors.
✣ Keep SWOT short and simple
✣ Remember that SWOT is subjective.

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 Balanced Scorecard
✣ Balanced scorecard, develop by Robert Kaplan and David Norton in
the early 1990s, is another tool that is highly assistive in strategic
planning. Indeed, Jax Works (2014) notes that the Harvard Business
Review calls balanced scorecard one of the most significant ideas of
the last 75years.
✣ (Jax Works, 2014) Strategic planners using a balanced scorecard
develop matrix (performance measurement indicators), collect data,
and analyse that data from four organizational perspective: financial,
customers, internal business process (or simply processes), and
learning and growth. These measures align individual, departmental,
and organizational goals and identify entirely new processes for
meeting customer and shareholder objectives.

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 Strategic Planning as a Management Process

✣ Although SWOT and balanced scorecard are different; they are also similar in that they
can help organizations assess what they do well and what they need to do continue to be
effective and financially sound. Regardless of the tool(s) used, strategic planning as a
management process generally includes the following steps:
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 organization’s constituents.
5. Develop a sense of ownership of the plan
6. Develop strategies to achieve goals.
7. Ensure that 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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Who Should Be Involved in Strategic Planning?

✣ Long-range planning for health-care organization’s historically

has been accomplished by top-level managers and the board of
directors, with limited input from middle-level managers. To give
the strategic plan meaning and to implement it successfully, input
from subordinates from all organizational levels may be solicited.
There is increasing recognition, however, of the importance of
subordinate input from all levels of the organization to give the
strategic plan meaning and to increase the likelihood of its
successful implementation.
✣ All organizations should establish annual strategic planning
conferences, involving all departments and levels of the
hierarchy.

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 Vision and Mission Statements
✣ Vision statements are used to describe future goals or aims of an organization. It is
description in words that conjures up a picture for all group members of what they
want to accomplish together. It is critical, then, that organization leaders recognize
that the organization will never be greater than the vision that guides it.
✣ An organization will never be greater than the vision that guides it.
✣ The purpose or mission statement is brief statement (typically no more than three or
four sentences) identifying the reason that the organization exists. The mission
statement identifies the organization’s constituency and addresses its position
regarding ethics, principles, and standards of practice.
✣ A well-written mission statement will identify what is unique about the organization.
For example, Brozovich and Totten (2012) suggest that all hospitals want to have
high-quality, cost-effective care, but mission statements that include only this verbiage
do not differentiate.

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 Organizational Philosophy
✣ The philosophy flows from the purpose or mission statement and delineates the set of
values and beliefs that guide all actions of the organization. It is the basic foundation that
directs all further planning toward that mission. A statement of philosophy can usually be
found in policy manuals at the institution or is available upon request.
✣ The organizational philosophy provides the basis for developing nursing philosophies at
the unit level and for nursing service as a whole. Written in conjunction with the
organizational philosophy, 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, Frequently, the
nursing service philosophy draws on the concept of holistic care, education, and
research.
✣ The unit philosophy, adapted from the nursing service philosophy, specifies how nursing
care provided on the unit will correspond with nursing service and organizational goals.
This congruence in philosophy, goals, and objectives among the organization, nursing
service.
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 Societal Philosophies and Values
Related to Health Care

✣ Societies and organizations have

philosophies or sets of beliefs that guide
their behaviour. These beliefs that guide
behaviour called values. Values have an
intrinsic worth for a society or an individual.

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 Individuals Philosophies and Values

✣ Values have a tremendous impact on the decisions that people make. For the
individual, person beliefs and values are shaped by that person experiences.
✣ At times, it is difficult to assess whether something is a true value.
McNally’s (1980) classic work identified the following four characteristics that
determine a true value:
1. It must be freely chosen from among alternatives only after due to reflection.
2. It must be prized and cherished.
3. It is consciously and consistently repeated (part of pattern).
4. It is positively affirmed and enacted.
✣ If a value does not meet all criteria, it is a value indicator. Most people have
many value indicators but few true values.

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 Goals and Objectives
✣ Goals and objectives are the ends toward which the organization is working. All philosophies
must be translated into specific goals and objectives if they are to result in action. Thus, goals
and objectives “operationalize” the philosophy.
✣ A goal may be defined as the desired result toward which effort is directed: it is the aim of the
philosophy
✣ Although goals may direct and maintain the behaviour of an organization, there are several
dangers in using goal evaluation as the primary means of assessing organizational
effectiveness.
✣ Objectives are similar to goals in that they motivate people to a specific end are explicit,
measurable, observable or retrievable, and obtainable. Objectives, however, are more specific
and measurable than goals because they identify how and when the goal is to be accomplished.
✣ For the objectives to be measurable, they should have certain criteria. There should be a
specific time frame in which the objectives are to be completed, and the objectives should be
stated in behavioural terms be objectively evaluated, and identify positive outcomes 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. Thus policies direct individual behaviour toward the organization’s mission
and define broad limits and desired outcomes of commonly recurring situation while leaving
some discretion and initiative to those who must carry out that policy.
✣ Policies also can be implied or expressed. Implied policies, neither written or expressed
verbally, have usually developed over time and follow a precedent.
✣ All organizations need to develop facility-wide policies and procedures to guide workers in
their actions.
✣ Procedures are plans that establish customary or acceptable ways of accomplishing a
specific task and delineate a sequence of steps of required action. Established procedures
save staff time, facilitate delegation, reduce cost, increase productivity, and provide a
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 .
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 Rules
✣ Rules and regulations are plans that defence
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.
Existing rules, however, should be enforced
to keep morale from breaking down and
allow organizational structure.
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 Overcoming Barriers to Planning
✣ Benefits of effective planning include timely accomplishment of higher quality work and the
best possible use of capital and human resources. Because planning is essential,
managers must be able to overcome barriers that impede planning. For successful
organizational planning, the manager must remember several points.
● The organization can be more effective if movement within 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.
● The manager should include in the planning process all people and units that could be affected
by plan.
● Plans should be specific, simple, and realistic.
● Know when to plan and when not to plan
● Good plans have built-in evaluation checkpoints so that there can be midcourse correction if
unexpected events occur.

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Thank You!