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What is strategy?

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• Organization's game plan for growing business • " Without a strategy the organization is like a ship without a rudder."

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strategic management

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• Where are we now? - Current analysis of a company • Where do we want to go? - Vision statement • How will we get there? - Strategy • Strategic Management: integrated thinking to attain future organizational state • Strategic Planning: processes involved in the formulating, implementing and evaluating strategies

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strategy terms

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• Strategies are the ideas and actions that focus on securing a desired future for an organization. • Strategic management is a management philosophy that emphasizes thinking in terms of strategies. • Strategic thinking addresses the questions of what we should be doing and why we should be doing it. • Strategic planning addresses, in general, the questions of how and when we should take action.

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strategic analysis: environmental scanning

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• Analysis internal environment - Organization's resources (staff, facility) and reports • Analysis external environment - General environment: everything that affects healthcare (competitors, payers) - sector environment: More industry specific

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SWOT analysis

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• Internal Factors - Strengths: resources for taking advantage of Opportunities and dealing with Threats - Weaknesses: shortcomings for dealing with Threats and taking advantage of Opportunities • External Factors - Opportunities - Threats

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crafting the strategy

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• Start with strategic intent - Data collection and analysis: cost, revenue, referral sources, volume - Interpretation of results - Decision making: must make the call based on what knowledge you have

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types of strategies

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• Directional strategies • Adaptive strategies • Market entry strategies • Positional strategies • Operational strategies

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directional strategies

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based on foundational documents such as philosophy, vision, and mission statements

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adaptive strategies

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competitive moves the organization will take to progress towards the vision

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market entry strategies

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strategies to acquire other business or to seek additional investors

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positional strategies

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ways to differentiate between businesses of the same kind

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operational strategies

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strategies given to functional units or departments to carry out

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Hierarchy of goals

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• pyramid - company vision is at the top - middle is mission statements - bottom is strategic objectives

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company vision

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• defines business' ideal future • Massively inspiring • Overarching • Long-term • Driven by and evokes passion • Fundamental statement of the organization's - Values - Aspiration Goals • company mission and vision are the drivers - middle management incorporates strategies and communicates it to workers to meet company vision

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mission statements

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• Purpose of the company - purpose for business to exist • Basis of competition and competitive advantages • More specific than vision • Focused on the means by which the firm will compete

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strategic objectives

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• Operationalize the mission statement • Provide guidance on how the organization can fulfill or move toward the "higher goals" • More specific • Cover a more well-defined time frame

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strategic objectives: SMART goals

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• Specific • Measurable • Appropriate • Realistic • Timely • Challenging • Resolve conflicts that arise • Yardstick for rewards and incentives

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implementation and execution

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• Top level managers or leadership initiate strategy - executive leaders • Operational managers (middle and lower level management) deliver the service and carry out the objectives

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implementation

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"Vision without action is a dream. Action without vision is simply passing the time. Action with Vision is making a positive difference."

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performance assessment

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• Difference between what is and what should be - Gap Analysis • Gap= expectation - actual

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strategic issues

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• Quest for Competitive advantage - use gap analysis to know your business • Maintain sustainability - Difficult to replicate - Flexible - Perceived as excellent value

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strategic planning model

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• sources of input - mission, vision, and values - SWOT analysis - performance measures - input from organization - input from external stakeholders - input from industry experts • output - strategic goals - strategic objectives - detailed tactical action plans - monitoring and performance measurement

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core elements of a strategic plan

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• A mission statement • A vision statement • Strategic goals • Strategic objectives • Tactical action plans or operational plans • Implementation planning schedule • Outcome measures

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other desirable elements of a strategic plan

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To enhance clarity and facilitate efficient enactment of a strategic plan, the plan may include: • A value statement - describes the forces that motivates business and behaviors it promotes in employees • A list of critical issues - describe internal weaknesses or external threats that must be addressed

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strategic goals

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• areas of focus that, when addressed, will close the gap between the current and ideal state (the vision).

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tactical action plans

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• Objectives are achieved through tactical action plans. • Such plans: - Are specific - Have set timelines for achievement (implementation schedule) - Assign responsibility - Produce measurable outcomes

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implementation planning schedule

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• defines the annual planning cycle that will be followed - usually starts July 1st

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outcome measures

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• specific indicators of success for each implemented strategy

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balanced scorecard

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• A balanced score card is a management tool that can be used to share and report outcome measures. • A balanced score card can be used to measure the outcomes resulting from specific efforts - business wide - or for a specific business unit or department

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importance of pt experience

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• patient who has the perfect PT experience will tell about 3 people on average • patients who didn't like the experience will tell about 7 people on average

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leadership style models for strategic planning

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• Commander model (top management prescribes) • Change model • Collaborative model • Cultural model • Crescive model (bottom up direction, top level responds)

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commander model

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thinking is done at the top without input from lower level management or those doing the work - this model is characterized by CEOs who are powerful and able to command performance

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change model

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based in behavioral science methods and engages other managers in the process to increase the chance of success

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collaborative model

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employs a group process and techniques such as brainstorming to get broader input and inclusion of differing management opinions - as each of these models limits input from frontline workers, they often encounter limited success and are difficult to implement

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cultural model

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expands on the collaborative model and includes input from all levels of the organization - requires more planning but is more effective during implementation

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crescive model

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invites strategy to flow from the operating core (direct service and clinical providers) of the organization - encourages a higher level of innovation and places the CEO in the reactive role of selecting from the strategic proposals that come from others - requires more planning but is more effective during implementation

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scope and complexity models for strategic planning

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• levels that differ depending on the size of the organization; the diversity of its customers, services, and products; and geographical markets, regulations, and competitors. - Mitzenberg: organization structures is more complex as the business grows, regardless of what leadership style you have • Basic model (planning done by top management) • Issue-based model • Alignment model • Scenario model • Organic model (all organizational levels participate)

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basic model

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• a top-down model that is best suited to small businesses with little strategic planning experience • 5 chronological steps - development of a mission statement - setting goals - developing operational strategies - setting tactical or action plans - monitoring success and updating the plan

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issue based model

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• expands on the basic model to include: - design or update of mission, vision for the future, and values - an assessment of internal and external factors that have the potential to impact success - identification of major issues and goals - design of major strategies - develop tactical or action plans - document planning in the form of a strategic plan - develop yearly operating plan - develop an annual financial plan (budget) - monitor annual performance - update plan on an annual basis based on performance measures

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alignment model

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• focused on alignment of resources and efforts to achieve the stated mission • suited to organizations that need to refine strategies that are not achieving the desired outcomes or address significant internal inefficiencies • steps: - creating an outline of current mission, programs/services, current resources, and areas in need of support - identification of areas in need of improvement - determination of how improvements should be achieved - add these as refinements to the strategic plan

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scenario model

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• incorporates the results of environmental scans into the development of "what if" scenarios • scenarios for the best, worst, and most reasonable cases are used to develop possible response or contingency strategies • organization is asked to determine the most likely scenarios and implement protective strategies

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organic model

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• organization should: - focus on its mission and values - engage in frequent dialog around these values - share its reflections about the organization's current processes • these discussions identify the changes needed in the process that will bring the organization closer to its shared vision for the future • this method requires considerable time and is more of a learning endeavor than a planning model - not like traditional cause and effect approach to planning

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characteristics of a strategic plan

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• It has to be: - Realistic: 77% of pts come because dr told them to, so have a good relationship with dr - Consumer focused - Easy to communicate - Understood by those who enact it - Flexible: Information gathering and analysis are ongoing, and plan revisions are made cyclically.

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business organizational structure

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• Organization structure = the legal designation assumed by a business • Many businesses are incorporated (i.e., they are corporations) • Corporations have an elected board of directors (BOD). • The BOD is ultimately responsible for strategic planning. • The BOD employs the corporation's senior leadership officers to manage the business.

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partnership

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• has simple structure and ability to move assets • unlimited liability for the partners - with corporations, people if they sue can only go after assets of organization

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support to develop a strategic plan

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• An organization's internal support varies by organizational size: - Large = likely to have trained resource personnel capable to do all or some of the planning and use consultants - Small = likely to have to use low-cost consultants - There are private consulting firms, government agencies, and volunteer groups who provide consultation.

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getting started

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• Solidify mission statement • Formulate vision statement • Determine the disparity between where the business is now and where it wants to be (gap analysis) - External factors seen as opportunities and threats - Internal factors seen as strengths and weaknesses - Consideration of these 4 factors is known as a SWOT analysis.

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SWOT analysis questions

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• How can we take advantage of opportunities to achieve our goals? • How can we protect the business against potential threats? • How can our strengths be leveraged to achieve our goals? • How can our weaknesses be eliminated or, better yet, turned into future strengths?

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PEST analysis of external environmental factors

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• Political environment - tax rate, price regulation • Economic environment - state of economy, interest rate - how much people have to spend, ability to get loans to open a practice • Social environment - market demographics, attitudes • Technological environment - new devices, infrastructure

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publicly available information for PEST analysis

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• Annual reports • Announcements in trade journals • Presentations by top-level managers to customers or community stakeholders • Government reports • Consultant reports • Customer feedback • Purchased databases • Human resources reports • Information technology reports • Investor groups • Market research

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strategic plan vs business plan

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• Strategic plan is global; a general road map • Business plan is derived from the strategic plan and provides more specificity regarding how the business will be operated. • Key elements of the business plan include: - Marketing plan - Operations plan - Financial plan

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large scope vs small scope

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• The external environment of an international health service corporation is broad (multinational), has specialist managers, and has assets to purchase help. • A single-owner, single-site private practice has a relatively narrow scope of external influences, has limited assets, and often has to personally do the scanning while continuing to treat clients to stay in business.

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DEPT SPACES

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• external environment analysis - includes PEST and more for additional guidance. • Demographic • Economic • Political • Technology • Stakeholder • Perceptions • Accountability • Competition • Ecology • Social

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Why use DEPT SPACES

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• may produce a more exact analysis of the external environment by identifying more variables to consider. • Variables can have an influence in more than one category; listing them in more than one category may make it easier to see each variable's breadth of influence. Identifying variables with cross-category influences can help in selecting and prioritizing the variables to focus on in the relevant portion of a SWOT analysis.

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D: Demographic environment

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• This is the statistical characteristics of a group of people. • Example data of interest to PTs in business: - Age groups - Education - Employment - Health - House location

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E: Economic Environment

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• Economic data includes how consumers, providers of services, producers of goods, and government chose to use their limited financial resources. • Example data of interest to PTs in business: - Income - Spending - Supply and demand - Employment and unemployment - Interest rate (borrowing cost)

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P: Political Environment

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• In the context of external environment, scanning is most often associated with the activities of government. • Politics involves. - Rules for the legitimate use of power - Behavioral expectations - Procedures for dispute resolution - Strategies to influence decisions • Examples of political issues affecting PTs: - Payment for appropriate services - Arbitrary annual cap on reimbursement - Referral for profit (referrers employing PTs) - Clients having direct access to PTs (no referral) - Clinical competence for relicensing

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T: Technology Environment

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• Technology is more than durable goods; it includes ideas, methods, and anything else that enhances human capabilities. • Examples relevant to PTs: - Computer-based products and services - Evidence-supported interventions - Consultant services - Manufacturers' websites

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S: Stakeholder Environment

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• Those who want to influence decisions because they have something to gain or lose depending on the decision are stakeholders. • Three kinds of stakeholders: - Internal stakeholders are members of the organization (staff). - Interface stakeholders are part of the organization but also have a legal identity outside of the organization (contract PTs). - External stakeholders are outside the organization (referrers).

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PT related external stakeholders

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• accreditation agencies • competitors • consumers (referral sources and patients) • labor groups • local community • regulatory bodies • special interest groups • suppliers • third-party payers

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P: Perceptions Environment

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• Perceptions means understandings that stakeholders and potential stakeholders have about an organization whose success they have a stake in. • Important perceptions are: - What the organization is - What it does - What it should do • Analysis of stakeholder perceptions can provide opportunities for the organization to: - Enact strategies to manage stakeholder perceptions - Provide information to counter misperceptions - Incorporate stakeholders' insights into strategic plans

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A: Accountability Environment

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• Accountability is - being answerable to someone or a group (who) - in some way (how) - for something (what) - sometime (when) • Key questions: - To whom does the organization have legal responsibilities? - What do the mission/values statements say about how we treat others? - With whom has there been proactive follow-up on unfinished business that the organization agreed to complete? - Are our public and private communications candid, clear, and truthful? - Has there been reasonable transparency in our performance data? - Have the needs of those in our service area been met?

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C: Competition Environment

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• Competition = when two or more individuals or groups seek the same thing(s), there are separate efforts to acquire the thing(s) of common interest • PT competitors = those who provide, intend to provide, or are thinking about providing similar services and products to the same target market(s) in the same service area(s).

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sources of competitor information

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• advertisements, board members, billing services, brochures, building permits, computer installers, construction workers, direct competitor contact, employment agencies, informational mailings, interviewees, internal and external networks, letter carriers, organizational publications, other competitors, patients, real estate agents, referral sources, search engine, suppliers/vendors

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E: Ecology Environment

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• Two environmental areas to look at are competitors' impact on: - Public health (e.g., disposal of waste matter) - Their neighborhood's natural and architectural environment (e.g., harmony, taste, quality)

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S: Social Environment

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• Social variables of a target population like age, base language, and lifestyle are important when choosing staff members, practice location, and equipment. • Examining competitors' practices for these same variables provides information helpful to choosing the mix of services to offer, marketing approach, and community efforts to support.

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where does DEPTSPACES fit into process?

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• use DEPTSPACES prior to SWOT analysis - managers need to learn what is out there that may help or hurt their business before they can determine the availability and adequacy of their resources to do something about their findings. • once data are collected for DEPTSPACES, a SWOT analysis can help organize the external environment information - prioritize Opportunities and Threats by severity and likelihood

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