Departmental Goal Setting and Resource Use, Explained

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Departmental Goal Setting and Resource Use

Healthcare Organization and Management · Chapter 8: Strategic Planning and Decision-Making in HealthcareSection 8.3 · lesson 50 of 1058 min · free with a free account

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In this lesson

Writing usable departmental goals and managing capacity without long waits.

  • Write departmental objectives with a measure, baseline, target, timeframe, and owner
  • Align goals upward and negotiate them with affected departments
  • Explain why very high utilization increases waiting time
  • Resolve competing claims on shared resources by stating trade-offs openly

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Transcript

Everything said in the video, section by section (1,063 words). Read along, or search it.

Opening Case

Three Goals in One Email

Vera Holm manages Larkfield's endoscopy unit. Her objectives for the year arrive in one email. Improve patient flow. Run the procedure rooms at ninety-five percent utilization. And cut waiting times by twenty percent. Two of these are badly written. And two of them can't both be achieved. Can you spot which?

Writing Objectives

Five Parts of a Usable Goal

Goal-setting theory, from chapter five, says specific, difficult goals beat vague or easy ones, if people accept them and get feedback. For a department, that becomes a writing task. A usable objective states five things. The measure, defined so precisely that two people would count it the same way. The baseline, without which nobody can judge the target. The target. The timeframe. And the owner: one named person, not a department, because a goal owned by a department is owned by nobody.

Rewriting Goals

Replacing Vague Verbs With Measures

Vera meets Priya Nair, the chief nursing officer, to rewrite them. Improve patient flow has an unmeasurable verb. Improve, ensure, enhance, strengthen: nobody can fail those goals, which is why they're popular. Nobody can act on them either. The rewrite: cut the median time from arrival to procedure start from ninety-five to seventy minutes by March thirty-first. Owner: the charge nurse. Cut waits by twenty percent has no baseline, and no definition of which wait. So: cut the median wait from referral to procedure from forty-one days to thirty-two by June thirtieth. A third goal from her unit plan, working with anesthesia on start times, has the subtler defect: no owner with authority on both sides. It becomes a daily joint review, a named lead each.

Quick Check

Which Scheduling Goal Works

Quick check. The outpatient clinic is drafting goals for its scheduling desk. Which of these is usable as written? Pause, and decide. The first. It names a measure, a starting point, a target, a date, and one person who owns it. Working with scheduling is tempting, because it sounds collaborative. But significantly isn't a target, there's no starting point or date, and nobody in particular owns it.

Goal Alignment

Upward Fit and Sideways Negotiation

Goals must also align. Upward: each one should serve something in the tactical plan. Ask which organizational objective it serves. Goals that survive from past years just because nobody removed them waste effort. Sideways is harder, and matters more. If Vera speeds her unit by moving patients to recovery sooner, she has simply handed work to the recovery nurses. So any goal that depends on, or affects, another department is negotiated before it's agreed. And the other manager gets to say what it will cost them.

Utilization

Capacity, Throughput, and Busy Rooms

Now utilization. Capacity is the most a resource can produce in a period. Throughput is what it actually produces. Utilization is throughput divided by capacity. High utilization isn't the same as productive use. Rooms running at ninety-five percent can still be full of repeat procedures, because the first bowel prep failed. Utilization measures how busy a resource is, not whether the work was worth doing. That's why it needs a paired measure.

Queueing Curve

Why High Utilization Lengthens Waits

Why does very high utilization increase delay? Work doesn't arrive evenly, and cases don't take the same time. With slack, a long case delays the next a little, and the day recovers. As utilization rises, that slack disappears, and each delay passes to everything behind it. Beyond roughly eighty to ninety percent, small increases bring large jumps in waiting. In the simplest queueing model, the average wait is utilization over one minus utilization, times the procedure time. At eighty percent, that's four times. At ninety, nine. At ninety-five, nineteen. The more variable the work, the earlier the curve turns. So comparing utilization across departments with different variability is meaningless. And past the turn, a utilization target and a waiting target are in direct conflict.

Quick Check

Cardiology at Ninety-Seven Percent

Quick check. A cardiology clinic runs at eighty-five percent utilization, with many unpredictable urgent add-ons. Leaders set a new target of ninety-seven percent. What will most likely happen to waits? Pause, and decide. They will rise sharply. Unpredictable work needs more slack, and ninety-seven percent removes nearly all of it. Barely change is tempting, since the jump sounds modest. But near full capacity, each extra point costs far more waiting than the last.

Managing Resources

Staff, Space, Equipment, and Time

Vera allocates four resources directly. Staffing: the largest, and the least flexible in the short term. Space: fixed, and often the constraint everyone has stopped noticing. Equipment: usually its availability, not its quantity, limits throughput. And time: protected time for improvement, supervision, and training goes to whatever's urgent, unless it's defended. Underused resources show in evidence: sessions ending early, unfilled slots, idle equipment. Overused ones show as queues just upstream, overtime in one place, and skipped breaks as routine. Two cautions. Compare utilization only where capacity is defined the same way. And an idle-looking resource may be the slack absorbing variation somewhere else.

Competing Claims

Sharing the Recovery Bay

Then a competing claim. Jamal Carter, the ED nurse manager, wants endoscopy's recovery bay to hold ED patients in the evenings. Vera needs it for late cases. Three steps keep both relationships intact. First, establish what each needs it for, the position-and-interest idea from chapter seven. Vera needs the bay until six. Jamal's surge starts at five. Second, put the trade-off in one document, so whoever decides sees what's given up. Third, escalate on organizational priority, not persistence. If the plan states no priority, report that gap. Suppressed conflict is worse. Two managers quietly chasing incompatible goals means one succeeds, and the other's failure looks like poor performance at year end.

Case Resolved

Three Options With Written Consequences

Back to Vera's two goals that can't both be met: ninety-five percent utilization and shorter waits. She doesn't simply refuse the utilization target. She shows her own data. Last winter, when a surge pushed the rooms above ninety-three percent, throughput rose a little, and urgent patients' waits rose a lot. Then she gives Tom Brennan and Priya three options. Target utilization, and expect waits to rise. Target waits, and hold utilization near eighty-five percent, which she recommends. Or add capacity. Whichever they choose, she asks for it to be written down with its consequence, so her unit isn't later judged against the goal that wasn't chosen.

Key Takeaways

Write, Align, and Leave Slack

To recap. A usable goal has a measure, a baseline, a target, a timeframe, and one owner. Align goals upward, and negotiate sideways before you commit. Busy is not the same as productive, so pair utilization with another measure. Past eighty to ninety percent utilization, waits climb fast, and sooner for variable work. And name trade-offs openly, escalating on priority, not persistence.

About Healthcare Organization and Management at UPI Study

Healthcare Organization and Management (Health 302) is a self-paced online course of 105 video lessons in 18 chapters, from health systems and the law to ethics, leadership, teams, strategy, informatics, finance, quality, human resources, marketing and evidence-based practice. It carries a NCCRS credit recommendation for 3 semester credits.

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How hospitals and clinics are runHealthcare Organization and Management covers how care organizations are led and run: health law and ethics, leadership and teams, strategic planning, health informatics, budgets, quality improvement, staffing and marketing. It is a core course in healthcare administration and health management degrees.
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130,000+students helped with college creditsACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Where the credit goes

Universities that work with NCCRS

Healthcare Organization and Management carries a NCCRS credit recommendation. These universities work with NCCRS; some are UPI Study's signed partners. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

Thomas Edison State UniversityThomas Edison State UniversitySigned partnerUniversity of the PeopleUniversity of the PeopleSigned partnerCharter Oak State CollegeCharter Oak State CollegeSigned partnerStrayer UniversityStrayer UniversitySigned partnerColumbia Southern UniversityColumbia Southern UniversitySigned partnerIndiana TechIndiana TechSigned partnerPenn StatePenn StateWorks with NCCRSSouthern New Hampshire UniversitySouthern New Hampshire UniversityWorks with NCCRSSUNYSUNYWorks with NCCRS +many more cooperating universitiesFind my college →

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FAQ

Questions students ask us

About Departmental Goal Setting and Resource Use

What makes a departmental goal usable in healthcare?
A usable objective states five things: a measure defined precisely enough that two people would count it the same way, a baseline, a target, a timeframe, and one named owner. An example is cutting the median referral-to-procedure wait from 41 days to 32 by June 30, owned by a named person. Verbs like improve or enhance cannot be failed, and nobody can act on them.
Why does high utilization increase patient waiting times?
Work arrives unevenly and cases vary in length, so slack is what lets a schedule recover from a long case. As utilization rises, slack disappears and each delay passes to everyone behind it. In the simplest queueing model, average wait equals utilization divided by one minus utilization, times the procedure time: four times at 80 percent, nine at 90, and nineteen at 95.
What is the difference between capacity, throughput, and utilization?
Capacity is the most a resource can produce in a period, throughput is what it actually produces, and utilization is throughput divided by capacity. High utilization shows a resource is busy, not that the work was worth doing. Procedure rooms at 95 percent may be full of repeat procedures after failed bowel preparations, so utilization should be paired with another measure.
How should two managers settle a dispute over a shared resource?
They should first establish what each needs the resource for, since interests often clash less than positions do. Next, they put the trade-off in one document so whoever decides sees what is given up. Then they escalate on organizational priority rather than persistence, reporting the gap if the plan states no priority. Suppressed conflict can make one manager's failure look like poor performance later.

About the Healthcare Organization and Management course

How many college credits is Healthcare Organization and Management?
Healthcare Organization and Management (Health 302) carries a NCCRS credit recommendation for 3 semester credits. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.
How much does Healthcare Organization and Management cost and what is included?
$250, paid once, with lifetime access: all 105 video lessons, a practice quiz after each, the graded work and final exam, and an official transcript when you finish. Students who want several courses choose UPI Study PRO instead.
Which universities accept UPI Study credits?
UPI Study has signed partner agreements with universities such as Thomas Edison State University, University of the People and Charter Oak State College, and works with universities such as Penn State, SNHU and SUNY. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities. Use "Find my college" on this page to check yours.
How long does Healthcare Organization and Management take?
It is self-paced with no deadlines. The 105 lessons total about 17 hours of video; most students add reading and practice time and finish in a few weeks to a few months, on their own schedule.
How are the exams done?
Quizzes and assignments are online in the course. The final exam is taken online with proctoring; a person on the UPI Study team checks assignments, usually within two days.
How do my credits reach my college?
When the course shows 100% complete, request the official transcript from your dashboard. It is sent to the college you name, and you can send it to more than one. Check your college first with "Find my college" on this page, or ask Athena.

Ready for the full course? Earn 3 credits in Healthcare Organization and Management.

105 video lessons, a quiz after each one, and the graded work that earns the credit. Recommended for credit by NCCRS.

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