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Planning
1. Planning is deciding in advance what to do, who is to do it, how it is to be done, and when it is to be done.
2. Planning is a proactive, deliberate process required of all managers.
3. Because a plan is a guide to reach a goal, it must be flexible and allow for readjustment as unexpected events occur.
4. Planning is critically important to and precedes all other management functions.
5. Without adequate planning, the management process fails, and organizational needs and objectives cannot be met.
Operational Planning
1. Is more day to day.
2. Responsible for charting, med paths, and vital signs.
3. Charge nurse would be in charge of staffing and allocating resources.
Strategic Planning
Planning for the future, three to five days out.
Why Do Plans Fail?
1. Sound strategies not used.
2. Inadequate delegation of authority. Having an understanding of scope of practice on the medical team dictates what is delegated to who.
3. Not recognizing organizational goals and needs. All strategic plans should be included in your hospital's mission, vision, and values so that they support and align with that planning.
4. Planning too narrow in scope—not recognizing community, legal, and licensing requirements.
Organizations and planners tend to use one of the four planning modes
1. Reactive
2. Inactive
3. Preactive
4. Proactive
Reactive
Occurs after a problem has occurred and are usually made hastily.
Inactive
Seeks the status quo. Spend time and energy preventing change. Doing things the way they have always been done.
Preactive
Uses technology to accelerate change. They do not value experience.
Proactive
1. Most used style.
2. Its dynamic and adaptive.
3. A proactive planning style is always the goal.
Supply Chain Management: An Example of Proactive Planning
1. Refers to managing the flow of products and services to maximize quality, delivery, customer experience, and profitability.
2. Determine resources based on what the customer demand is and then choose suppliers to take.
Factors Influencing the Future of Health Care
1. Further consolidation of hospitals/systems, medical groups, ancillary services, health plans, and post-acute care providers.
2. The tension between "value" and "volume" is growing linkages between expected quality outcomes and reimbursement.
3. The transformation from revenue management to cost management. Diagnostic Related Groups (DRG). Ex. If a DRG says best practice proves that patients with congestive heart failure should not be hospitalized for more than one week, if the patient is discharged before a week, the hospital makes money, if they stay longer, they lose money.
4. Physician integration.
5. Scientific breakthroughs and technological advancements in precision diagnostics, precision medicine, patient monitoring, and drug discovery and delivery for targeted therapies.
More Factors Influencing the Future of Health Care
1. Technology, which facilitates mobility and portability of relationships, interactions, and operational processes.
2. The introduction and use of robotic pharmacists.
3. The rising cost of pharmaceuticals and ongoing drug shortages.
4. The movement toward managing populations rather than individuals.
5. Movement away from illness care to wellness care and the use of disease management programs.
6. Use of complementary and alternative medicine.
7. Need for interprofessional collaboration rather than professional autonomy
Other Factors Influencing the Future of Health Care
1. Robotic technology
2. Biomechatronics
3. Biometrics and smart cards
4. Point-of-care testing
5. Telehealth and the internet
6. Growing older adult population
7. Nursing shortages in acute care hospitals.
Principles of Organizational Planning
1. All plans must flow from other plans. Short-range plans must be congruent with long-range plans.
2. Planning in all areas of the organization must follow the mission, philosophy, vision, and goals of the overall organization.
3. Planning involves the same process regardless of the period involved.
4. The length of the plan is determined by what actions are necessary to make the plan successful.
5. All planning must include an evaluation step and requires periodic reevaluation and prioritization.
6. All people and organizational units affected by a plan should be included in the planning.
Strategies for Successful Planning
1. Start planning at the top.
2. Keep planning organized, clear, and definite.
3. Do not bypass levels of people.
4. Have short- and long-range plans and goals.
5. Know when to plan and when not to.
6. Keep target dates realistic.
7. Gather data appropriately.
8. Be sure objectives are clear.
9. Remember, interpersonal relationships are important.
Other Reasons Why Plans Fail?
1. False assumptions
2. Not knowing overall goal.
3. Not enough alternatives.
4. Inadequate time or other resources.
5. Low motivation levels
Strategic Planning
1. Generally, complex organizational plans that involve a long period (usually 3 to 7 years) are referred to as long-range or strategic plans.
2. Strategic planning typically examines an organization's purpose, mission, philosophy, and goals in the context of its external environment.
3. Unlike the 20-year strategic plans of the 1960s and 1970s, most long-term planners today find it difficult to look even 5 years in the future.
Strategic Planning as a Management Process Includes
1. The delineation of the agency's strategic goals and objectives, typically in a 3- to 5-year plan.
2. The development of strategies to achieve the goals.
Steps in Strategic Planning
1. Clearly define the purpose of the organization.
2. Establish realistic goals and objectives.
3. Identify external constituencies and determine their assessment of the organization's purposes.
4. Clearly communicate the goals to the constituents.
5. Develop a sense of ownership of the plan.
6. Develop strategies to achieve the goals.
7. Ensure that the most effective use is made of resources.
8. Provide a base from which progress can be measured.
Getting Input from Subordinates
There is increasing recognition of the importance of subordinate input from all levels of the organization to give strategic plans meaning and to increase the likelihood of their successful implementation.
SWOT Definitions
1. S: Strength
2. W: Weakness
3. O: Opportunities
4. T: Threats
SWOT: S
Strengths are those internal attributes that help an organization to achieve its objectives.
SWOT: W
Weaknesses are those internal attributes that challenge an organization in achieving its objectives.
SWOT: O
Opportunities are external conditions that promote achievement of organizational objectives.
SWOT: T
Threats are external conditions that challenge or threaten the achievement of organizational objectives.
Simple Rules for SWOT Analysis
1. Be realistic about the strengths and weaknesses of your organization.
2. Be clear about how the present organization differs from what might be possible in the future.
3. Be specific about what you want to accomplish.
4. Always apply SWOT in relation to your competitors.
5. Keep SWOT short and simple.
6. Remember that SWOT is subjective.
Forecasting
1. Using available historical patterns to assist in planning.
2. Examining present clues and projected statistics to determine future needs.
The Planning Hierarchy
1. Mission
2. Philosophy
3. Goals
4. Objectives
5. Policies
6. Procedures
7. Rules
Goals
the desired result toward which effort is directed.
Objectives
how the goal will specifically be achieved (includes time frame and is measurable).
Policies
plans reduced to statements.
Procedures
step-by-step processes.
Rules
plans that specifically define acceptable choices of action.
Rules as Part of the Planning Hierarchy
1. Because rules are the least flexible type of planning, there should be as few rules as possible in the organization.
2. Existing rules, however, should be enforced to keep morale from breaking down and to promote organizational structure.
