Strategic planning in health care

Strategic Planning in Healthcare

In their article Relationships between organizational characteristics and strategic planning processes in nonprofit organizations, Crittenden & Crittenden (2000) present a brief literature review of strategic planning in nonprofit organizations followed by an analysis of their own research into which factors most influence the strategic planning process in these organizations. The authors contend that longevity of the strategic planning process within a nonprofit organization is a greater predictor of its continual use over both its financial and member size, leadership experience, or board of directors' influence. Ironically the authors also found that the larger the organization, the more manual the process. From the analysis presented it appears that larger organizations have more volunteers, potentially even greater discretionary budgets to spend on administrators to manually handle the planning process. Smaller organizations are more likely to use computer-based applications and tools to assist in the strategic planning process. Larger nonprofit organizations can afford to put more people on the planning process, not necessarily making it more efficient, just making the manual steps executed faster. It can be inferred that larger nonprofit organizations, by not taking a process-centric view of planning are speeding up mediocrity of results in many instances. The authors also point out the differences between expressive or internally focused organizations and instrumental organizations that are outwardly focused. Not surprisingly when it comes to the strategic planning process, the authors' results show that instrumental organizations generate consistently more detailed and precise strategic plans, and also have stable, more traditional organizational structures. While the authors do not state the correlation value of these two attributes (instrumental organizations and traditional organization structures) the assumption of these organizations having been involved in strategic planning for a long period of time could be made. The authors content that nonprofit organizations struggle with the efficient use of resources due to a lack of experienced leadership from the commercial sector as well.

Internal vs. External Focus: Expressive vs. Instrumental Organizations

The ability of any organization to effectively monitor and interpret events in their external environment has a direct influence on their ability to plan effectively in both the short- and long-term. In the case of nonprofit organizations' propensity to scan the external environment, Crittenden & Crittenden (2000) define the myopic, inwardly focused organization as expressive, and the outward-focused, instrumental. A key finding of their research states that nonprofits that are external in focus tend to more precisely organize their strategic planning process, and also engender a higher level of ownership for the strategic plan itself between boards of directors, staff, key donors, volunteers and members by circulating the plan internally for review. These externally oriented nonprofits also look at direct and indirect competitive programs to their own, concentrating on their served constituencies with what appears to be the same intensity a commercial enterprise looks at attracting, selling and serving customers. In can be inferred that this external focus of nonprofit organizations that centers on the needs of those served galvanizes departments, boards of directors, volunteers and members to a common set of strategic goals. As a result, all members have ownership of the strategic plan, and a byproduct of this ownership is a more formalized process. The research completed also shows that both subjective and quantified approaches to strategic planning for externally-oriented nonprofits also tend to create this inferred ownership of the strategic plan, its goals, and therefore increase its probability of success. Clearly having an external focus with a "customer" who is to be served is a highly effective aspect of a nonprofits' strategic planning process. Crittenden & Crittenden (2000) also make the point that nonprofit organizations researched have both instrumental and expressive tendencies at the same time, a deliberate strategy taken to make sure that individual constituencies' goals and objectives are met. This hybrid approach to strategic planning requires a nonprofit organization to be highly agile, informal, and collaborative in its information and knowledge management.

Assessing Strategic Planning in Nonprofit Organizations