Strategic Management in Healthcare: A 3-Year Roadmap - Assignment 2

This assignment analyzes the strategic plan of a healthcare organization, presenting a strategic roadmap for the next three years. The report, written from the perspective of an external Strategy Implementation Consultant, addresses key aspects of strategic management, including strategic thinking, planning, and momentum. The report proposes a continuum of care model, focusing on community-based nursing and chronic disease management. It also highlights the importance of interprofessional teamwork, stakeholder involvement, and the implementation of nurse-managed health clinics. The strategic vision emphasizes patient care, financial stability, and the empowerment of nursing staff. The assignment outlines steps for implementing the strategy, including accountable care units, network development, and community health initiatives. The report also examines the Wagner Chronic Care model, and steps for implementation.

Strategic Management in Healthcare - Assignment 2
1. Executive Summary
The days of conventional practices for the patients to come for treatment are
over by seeing the hospital sign outside the building. This applies in the same
way to hospitals which are not just able to have beds, emergency services, an
operation room and an intensive care unit. A strategic plan to move forward
now is essential. Hospitals and practices need a plan for success rather than
just survival (Read.qxmd.com, 2019).
The strategic perspective first created in the business sector and now
strategic management procedures have become almost widely adopted by
health organisations. Healthcare leaders have shown that strategic thought,
planning and management drive have become the clearest expression of
efficient governance for healthcare organisations to address the dynamics of
healthcare (Google Books, 2019).
The strategy specifically represents strategic management as strategic
thinking procedures, consensus building and documentation of this thought
into a strategic plan and strategic momentum management. New insights and
views arise through the leadership of the strategic plan and strategic thinking,
planning and management are initiated. Strategic executives, therefore,
become strategic thinkers who can assess the evolving environment, analyse
information, assumptions and create fresh thoughts. In short, strategic
executives need to be able to create and document an action plan through
strategic planning.

Once strategic planning has been established, executives retain the
organization's strategic momentum. As strategic executives, the strategic plan
tries to assess achievement, learn more about what it operates, and integrate
fresh strategic thinking (Wiley.com 2019). Managers may make the best of
their knowledge of the external setting and interpret their organization's
capacity using the analytical approach to create a strategy.
Once the strategy is implemented, fresh concepts and strategies can be
developed and ancient plans need to be changed (Wiley.com 2019). Prof.
Rosabeth Moss Kanter, from Harvard, found that pacesetter organisations
were not waiting for an ideal plan to be implemented, but rather creating a
plan by acting. Managers must, therefore, continue to be flexible and
responsive to new situations. The direction may not nevertheless be random
or unsystematic. It needs certain kinds of strategic meaning— an intuitive
feeling of the shape of the future, which transcends normal age (Wiley.com,
2019).
What is required is a kind of model, which gives strategic managers guidance
or direction, but incorporates learning and change. If it is possible to approach
strategy in a disciplined manner, then effective execution will be smooth. A
model for developing a strategy will assist organisations in viewing their
policies in a consistent manner. Unless the model has been used, executives
are in danger of being completely incoherent and confused in practice
(Wiley.com, 2019).
Schematic diagram on strategic thinking is shown in figure 1 Annexure 1.

A strategy may be established by the CEO. A strategy can be developed by a
distinct scheduling department. Such methods are nevertheless difficult to
implement since the plan or the related duties are not commonly understood.
Strategic planning is, therefore, a group process for an organisation. A
number of main respondents are involved in developing a strategy together
(Harvard Business Review, 2006). In this research, the CEO will manage
strategic planning but before implementing by CEO, cross-sector of key
individuals in the organisation should be involved before the plan is finalized.
It is, however, a fact that the planning process can not involve everyone. It is
hard to make decisions if everyone has a say in the planning. A few main
players are necessary to provide balanced and informed opinions such as
senior employees, top management or a management team. For better
participation of employees, human resources techniques, including the Quality
Circle, can be developed and a quality solution can arise (Harvard Business
Review 2006).
The gist of the strategy is to transform the hospital from the conventional style
of functioning like wait for the patient to come and serve, to a concept of a
continuum of care involving a number of new concepts including community-
based nursing care (Joseph and Huber, 2015).
2. Organizational Overview
Depending on the size of the unit, its complexity and the differentiation of the
service provided, the organizational level to which the strategic planning
method is applicable is relevant. This study is of a general nature and
includes chronic disease management. Chronic diseases, such as diabetes,

COPD and CVD, are managed. The unit leader is the individual who
encourages the scheduling process, a key and essential component.
The strategic design process is programmable, systematic, rational and
holistic and incorporates the short, medium and long-term aspects of the
organization, which enables it to focus on meaningful and sustainable future
transformations (Rodríguez Perera and Peiró, 2012). The interprofessional
teamwork encourages professionals of healthcare to work together with
patients and caregivers to discuss their care and to make choices to improve
patient care and results. Currently, the hospital is treating admitted patients.
The changed perspective does not cover in-house therapy but also call-based
therapy in line with community-based nursing.
In addition, the Wagner Chronic Care model will be pursued (Robusto et al.,
2018). In the head strategic plan, the details of the strategic plan will be
described. There are three physicians specialized in chronic disease
treatment in the department. They have had more than five years of
experience and work in this clinic. Support personnel, including five nurses,
are supported. This configuration is mainly due to the absence of coordination
among medical experts, thereby putting the reputation of the hospital at risk.
Figure 2 in Annexure 2 depicts the strategic planning at various stages of the
organisation.
3. Strategic Vision
The strategic vision has been designed to take our organization forward in the
next three years. The pros and cons of the strategic plan will be described
with detailed discussion. It is good that the hospital has an adequate number

of trained nursing staff to take the quality of care and meet the demands of
the patients. But it has been studied that our nursing staffs are affected by the
financial crisis which leads to occasional turnover and burnout of the staffs.
The dissatisfaction among the nursing staff can hinder the work environment
of our hospital, many of them are employed on a casual basis and have not
got fair benefits of incentive (Strategic Planning: Why It Makes a Difference,
and How to Do It, 2009).
On the other hand, the changing scenario in the socio-economic pattern
makes the elderly and hapless people lonely. People suffering from
degenerated disease or injured receive minimal health care and check-up. It
is the crying need for health care and healing service in distant and remote
places (Courtin and Knapp, 2015).
Based on different issues relating to healthcare assessment along with the
motivation of the nursing staff with extra financial support I beg your attention
to the initiatives taken by our health promotional units to implement the
concept of continuum and accountable care program for the patients suffering
from degenerated diseases. According to our plan, nurses of our hospital
would not only be confined to our hospital, but they would work outside the
hospital setup. They can play a significant role in consistent and continuous
nursing with affiliation and agreement (Marrelli, 2013). Nurses can heighten
their personality and profession through community nursing. This strategic
plan would be persisted for a long course of time (Healthcare Administration
Degree Programs, 2019). The strategy is based on the concept of a
continuum of care. Continuum of Care is a concept involving a system that
guides and tracks patients over time through a comprehensive array of health

services spanning all levels and intensity of care. The Continuum of Care
covers the delivery of healthcare over a period of time and may refer to care
provided from birth to end of life. The continuum of care is important to
caregivers and patients alike, and it leads to an improvement of the
satisfaction level, reduces costs and improves health. Usually, there are four
levels of care in these communities: independent living, assisted the living,
nursing home and skilled nursing (Healthcare Administration Degree
Programs, 2019). As people age, they may deal with issues commonly
associated with ageing, and so anticipated in these facilities, and with acute
onset of new issues that must be addressed in the patient care (Satariano,
Scharlach and Lindeman, 2014). A senior residing in the independent living
apartments or homes may be unable to perform strenuous yard care but
otherwise is able to care for himself and his environment. With time, he may
experience various issues such as memory loss that necessitate someone
helping with daily life activities. At that point, he might transition to assisted
living, or remain in his apartment, but receive help with medications and other
things through a visiting nurse. Eventually, the patient may transition into
skilled nursing care. All along the way there is a team of caregivers who
communicate with one another, with medical facilities and with the patient and
his family to ensure the transition is smooth and all issues are addressed
(Healthcare Administration Degree Programs, 2019).
That team approach allows a holistic and thorough approach to health care
over time. Information from the Agency for Healthcare Research and Quality
states that continuum of care can reduce the readmission rate for elders,

improve the quality of life for patients and reduce the per-patient cost by 37
per cent per year (Healthcare Administration Degree Programs, 2019).
We shall be obliged if the respected CEO would evaluate the effectiveness of
the program and provide all types of help for remodelling the healthcare
delivery system.
Implementation of the Strategy
The steps for strategic planning is depicted in Annexure 3.
To implement this strategy with a collaborative and comprehensive approach,
we have to build an accountable care unit for continuity of service. Firstly, we
spread our innovative plan to develop the integrated health service network by
opening a few nurse-managed health clinics at various localities for the
accessibility of stakeholders (Colla et al., 2016). Our unit will encourage
nurses to become more professional and their service will be more exciting
and challenging. Our nurses and other health professionals would foster a
network of partnership and sharing health practices. Community people also
embrace this innovative idea of health promotion and disease prevention
through continuum care and nursing. The cross-continuum operation would
be driven by different types of stakeholders (health professionals, nurses and
other caregivers, community people) to disseminate the concept of
personalized and continuous care of the ill and injured people of the
community through mutual understanding and agreement (Ghasabeh and
Provitera, 2018). Community health nurses would have a significant role and
responsibility. They should be known as they would respond to different types
of healthcare reforms in the community. Many people in the community are

deprived of minimal care due to busy life schedule. Nurses through their
continuous care can give the healing touch to the individuals, families and
communities in practice (Christopher, 2014). They can impart their valuable
advice, promote a healthy lifestyle all over the community. The patients
having a chronic illness or serious health condition would continuously care in
their home with the presence and supervision of certified nurses. It would be
advantageous if nursing staff could analyse patient’s illness on the basis of
epidemiology, family history, socio-economic condition and other aspects. The
different social factors and determinants have a great impact on the health of
individuals. Based on this data collection, nurses would be well informed
about different health-related issues (Andermann, 2016). They can take a
more comprehensive approach showing their inherent leadership in making
social transformation giving proper guidance on lifestyle changes, taking up a
healthy diet and exercises, time to time immunization through proper
screening and surveillance. The nursing profession would also be empowered
as their working area would be expanded including hospital set up as well as
community setup.
Nurses can focus on strengthening their financial situation with a more
professional and positive outlook and gain sustainable and competitive
advantage.
Once the strategy of inter-professional teamwork and sharing partnership
would be settled, the demand for nurses would increase and they would face
stiff challenges in and out of the hospital. The advancement of nursing career
would lead to the anticipated changes in the management system. In order to
get maximum utilization of the healthcare delivery system, nurses would be

empowered with the representation in the medical board (Institute of Medicine
(US) Committee on the Robert Wood Johnson Foundation Initiative on the
Future of Nursing, 2019). Clinical nurses and caregivers would foster a team
approach that would encourage sharing health practices and feel an
attachment to their workplaces. As they would be tight-scheduled with heavy
workload rescheduling their service time and type of work is necessary. The
nursing profession would be more credential and responsible as they would
not be confined to clinical care delivery system including medical check-up
and giving remedies but also to drive the network of integrated health service
in different communities.
Stakeholder group would take the effort to communicate with the people,
promote health awareness with a view to empowering the nurses for taking
control over the healthcare delivery system. It would help in reducing nurse’s
turnover, ensuring alignment of nursing resources with cross-continuum
health care delivery.
It is also relevant to say that nurses would be properly educated with nursing
management and nursing informatics. A new campus should be set up for the
teaching and training purposes to enhance their skill and self-efficacy.
Accountable care system also educates nurses in case management studies
so that nurses could tackle the unfavourable situation.
But to some extent, this strategy could not completely ensure social security
measures of the nurses. The various difficulties related to demography,
ageing or being aloof from the accustomed environment, violence etc. can
hinder their work sprit but through education and experience, they can

mitigate all challenges faced by them. Several safety measures like duress
alarm for staff members, hidden cameras should be provided by our hospital
authorities to tackle the situation. The safety of the nursing staff due to
workplace induced injury or illnesses may also hamper their work spirit while
on the job. When nurses are found to be at risk, they can be co-related with
one another creating a bridge between various care events for emphasizing
the ways of treatment and necessary steps are taken. The innovative
technological approaches like remote monitoring and telemedicine functions
would develop the continuum of care strategy. Patients suffering from chronic
illnesses like diabetes, stroke and hypertension can get relieved as they are
continuously being cared for by the disease management and health
information system at the right time.
It is my suggestion to restructure the healthcare delivery system to responding
to the emerging needs and helpful services. Our health organization would
invest enough in educational and technical advancement for the sake of our
hospital’s reputation. Empowerment in nursing can produce more committed
nurses resulting in a better working environment with lower rates of turnover
and burnout and provide cost-effective continuous care for better patient
outcome. It is my request that our CEO will evaluate the effectiveness of the
program, his recommendation is the priority to implement this kind of strategic
and sustainable program.
Benefits of Strategic Management
Three phases of strategic management— strategic thinking, strategic planning
and strategic momentum management— provide health organizations with

many advantages. However, because strategic governance is a philosophy or
management of the company, it is not always possible to assess its
advantages. Comprehensive strategic governance (Kourtit and Waal 2008):
• linking the organisation to a common sense of purpose and common
values;
• improving economic efficiency in many instances;
• providing clear self-conception, particular objectives, guidelines and
consistency of decision making for the organisation;
• helping executives to comprehend what is present, believe about what is
going on and acknowledge signals of change;
• requires a manager to share their experience both horizontally and vertically
and overall coordination within the organization is enhanced and
• Encourages innovation and change to satisfy requirements for vibrant
circumstances throughout the organisation and encourages them (Harvard
Business Review, 20 19).
Measuring the success of the strategy
How do we understand whether the strategic plan has been moving on track?
The benefits can be measured and quantified. This is the hard evidence that
our company is moving in the correct direction to achieve its objectives. The
measurement of progress is a feature of a successful company, and our
business strategy should list the measures that we will follow in the action
plan that is created. These could be split into milestones (completion at some
point of a job or project) and quantifiable performance measures (for instance,

sales and profit development) (Harvard Business Review, 2009). Certain
metrics such as profit, sales and cash flow will be financial. The development
of a strategy is always a gamble whose outcome is uncertain.
Although the technique and methodology may have been perfect, the process
remains unfinished due to various factors: (a) strategic choices may not have
been best; (b) some factors may not have adequately been assessed ; (c)
mistakes in execution may have been made ; (d) the anticipated impact of the
selected activities may not have been envisaged initially and e) the external
environment may undergo modifications during the execution of a strategic
plan which invalidates or alter the original assessment (Healthcare
Administration Degree Programs, 2019).
So it is an inseparable part of the Strategic Plan that the Steering Group plans
to monitor the degree to which the objectives were achieved. The tracking
process is carried out using an inner dashboard system to obtain data that
contains indicators as identified in the action plan (Shin, 2019). External data
should also be acquired in order to detect environmental changes which could
lead to significant data modifications used to identify strategic objectives.
During tracking, the steering group shall ensure that there is no overload of
information and that the indicators are grouped into the most integrated,
logical and consistent sets. The steering group must also design for each
leadership centre a suitable distribution tree of data and guarantee that the
data is accessible to each leader (Healthcare Administrator Degree
Programmes, 2019).

At least once per quarter, the strategic plan management team and each
working group should assess the outcomes of the strategic plan collectively.
Based on these evaluations, the Strategic Plan Steering group may propose
modifications to one or more of the initial plan and accept or reject these
modifications (Healthcare Administration Programs, 2019).
Reflecting and revisiting the strategy
The last section of the Strategic Plan relates to its ability to modify its strategic
objectives. If warnings exist about the need to change systematically
operational targets grouped around the specific strategic plan, it may be
explained that the strategic goal itself has failed to be selected. The strategic
plan should be able to enable this change, although there should be a strong
need for change and the reason for the change should be carefully recorded.
Only when there is the regular observation of deviations over 1 year, or when
important changes occur in the setting, which is unforeseeable during the
original scheduling phase (Healthcare Administration Degree Programmes
2019) a strategical goal should be altered.
Limitations of strategic planning
Clearly, strategic planning is no bed of roses. It is costly and may seem very
tedious or time-consuming, particularly in terms of the quantity of time
invested by employees at distinct organizational levels. Strategic planning can
reveal differences or conflicts that were more or less hidden and which the
members had learned to live with, thus making the situation during the
process seem worse than before (Healthcare Administration Degree
Programs, 2019).

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Annexure-1
Figure 1 Schematic diagram on strategic thinking
Annexure-2

Picture 2 Strategic planning concept flow chart
Appendix-3
Schedule of strategic Planning
1. Zero to six months – Orientation and training on strategic planning aspects
to the stakeholders like doctors, nurses and other healthcare professionals
2. Six months to one year- Select four experienced nurses, train them to
manage two self-managed nursing units. The remote places to be selected
where concentration of patients suffering from chronic illness like diabetes,
stroke etc. is more and where percentage of old people is more and they find
it difficult to come to the main hospital.
3. One year to two years – Review the performance of nurse-managed care
units and try to rectify any of the issues faced by the nurses like logistics,
medicines etc. Start community care service which includes home service.

4. Two years to three years – Based on the performance of the self-managed
care units, two more units can be opened based on the requirement of the
patients.