Eye On the Prize: Leveraging the Baldrige Excellence Framework to Develop a Winning Strategic Plan   

For any organization, strategic planning is a mission critical function, which helps prioritize resources and ensure employees and stakeholders are “moving as one” to meet primary objectives. Arguably, this activity is especially vital in the healthcare industry, which, in recent years, has faced devastating budget cuts in addition to the ever-present challenge of synchronizing employees across different disciplines to achieve uniquely high standards of reliability.

Despite how beneficial comprehensive strategic planning can be to healthcare organizations, however, it too often falls to the wayside as they feel compelled to focus on more short-term, “survival” activities. In fact, in a recent CompleteRx poll, more than half (60 percent) of those healthcare professionals surveyed said they consider their organization’s strategic plan to be only “somewhat effective.” While developing a winning strategic plan is admittedly a significant undertaking, it’s also the most surefire way to set an organization on a path toward consistent success.

Many organizations have leveraged the Baldrige Excellence Framework – a systems approach to improving organizational performance, developed by the Baldrige Performance Excellence Program (established by the Malcolm Baldrige National Quality Improvement Act of 1987) – to achieve this task. The framework is built upon core values and concepts within the boundaries of an organization’s “profile” (a snapshot of the organization, the key influences on how it operates, and its competitive environment), and consists of seven categories, including strategic planning, which in turn, features the inputs outlined below. Healthcare organizations should consider these inputs as they develop and evaluate their strategic plans to ensure the highest chance of success:

  • Key participants: Organizations must identify the participants and groups whose input will help ensure their plans are well rounded. In healthcare, these parties may include: senior leaders, physician clinical directors, board members, medical staff officers, physician group practices, nursing councils, residents (for teaching hospitals), patients, communities, payers, external experts, partners, and more. By casting a large net – via survey instruments, satisfaction surveys, and/or partner performance reviews – organizations may capture a variety of perspectives, and secure the most robust possible view of their operating environments.
  • Short- and long-term planning horizons: When developing a strategic plan, organizations must keep short- (within a year) and long- (within three to five years) term planning horizons in mind. Understandably, long-term planning horizons introduce a higher susceptibility for variation to their plans. 
  • Ongoing environmental analysis: Organizations may cope with this inherent variation by conducting ongoing environmental analysis, including consideration of competitive volumes and benchmarks; projected demand for services; disruptive ability of technology and innovation; tracking of performance dashboards; and more. Scenario planning, in which organizations look at trends – such as movement from the inpatient to the outpatient setting – is also included in this process. In this step, organizations predict the trend’s impact if it remained the same, increased, or declined, reviewing all three variations to determine a response to each one.   
  • Robust measurement systems: To ensure their strategic plan continues to meet their needs – despite a changing industry landscape (a well-known reality in healthcare) – requires organizations to enact robust and ongoing measurement via “Voice of the Customer” analysis, CMS and value-based purchasing, safety climate measurement, community needs assessments, and more. Organizations should also secure feedback from their collaborators to identify issues and concerns, potential areas for partnership, risks to future success, service delivery gaps, and other areas which may have been overlooked in the initial strategic planning process.
  • “Strengths, Weaknesses, Opportunities, and Threats (SWOT)” analysis: Many organizations leverage SWOT analysis to detect strategic challenges and advantages; however, too often, they don’t take the proper steps at the outset to assemble an ideal “team,” from which to secure input. Organizations should consider inviting parties from primary and secondary markets (including physicians, employees, and board members), and soliciting input from their workforce via survey instruments. SWOT may also be segmented by key groups to allow organizations to look at specific communities, departments, or stakeholders.
  • Risks to future success: Organizations must also consider potential risks to their plan’s success. In healthcare, one of the most common of these is changes to the regulatory environment. To understand these potential changes, organizations should conduct internal and external gap analyses, audits, and mock surveys, allowing them to better understand future reimbursement models and regulatory focus areas. For example, at this point, all healthcare organizations should consider the impact of the Affordable Care Act being repealed, considering the multitude of potential scenarios that would dramatically affect their business.
  • Work systems and competency: Most organizations can’t consider every work process in their strategic plan to be an internal core competency. Often, it makes sense for them to seek outside assistance for those work processes that are part of a potential partner’s core competency. In these cases, organizations should develop a defined approach for selecting partners and measuring their performance. For example, after evaluating their internal capacity and external factors, organizations may consider partnerships that will enhance their strategic advantage.

Again, while properly applying these inputs to a strategic plan can be massively time-intensive, organizations that do so find they’re able to realistically set much more ambitious objectives than they would otherwise be able to. As an example of these aspirations, many Baldrige organizations have sought recognition on the prestigious “Best Places to Receive Patient Care,” “Best Places to Work,” and “Best Places to Practice Medicine” lists, and in several cases, have reached their goals.

It’s important to remember, however, that while developing a winning strategic plan is a key piece of the puzzle, even the best laid plans have no value “on the shelf.” While it’s a topic unto itself, organizations that wish to be successful in achieving their goals must have a way to apply their limited resources to turn their strategies and plans into action. Check back next week for more detail on implementation – the equally important “stage two” of the strategic planning process.

Kenneth Maxik is director of patient safety and compliance for CompleteRx. He has more than 20 years of pharmacy operations and management experience and works with hospitals and health systems across the country to help their organizations stay ahead of current and imminent regulatory standards. The findings in this article are based on a thorough review – conducted by CompleteRx in partnership with the Kentucky Center for Performance Excellence, of which Ken serves as president elect – of organizations that won the Malcolm Baldrige National Quality Award from 2010-2015.

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