Strategic Planning Models and Guiding Principles, Explained

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Strategic Planning Models and Guiding Principles

Healthcare Organization and Management · Chapter 9: Goal Setting, Analysis Tools, and Strategic Alignment in HealthcareSection 9.1 · lesson 54 of 10511 min · free with a free account

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Earn 3 college credits for Healthcare Organization and ManagementRecommended for credit by NCCRS · Health 302 · self-paced · one payment, lifetime access
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In this lesson

Choosing a strategic planning model and the principles behind real strategy.

  • Compare goals-based, issues-based, scenario-based, and emergent planning models
  • Match a planning model to an organization's maturity, capacity, and volatility
  • Distinguish intended, deliberate, unrealized, and emergent strategy
  • Explain positioning and resource-based views of competitive advantage

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Transcript

Everything said in the video, section by section (1,405 words). Read along, or search it.

Opening Case

A Plan Overtaken by Events

Larkfield's executive team is three months into a thorough strategic plan: a mission review, a full set of goals, action plans, and a workshop every month for eight months. Then two things happen. A rival health system announces a new outpatient site inside Larkfield's service area. And Larkfield's largest commercial payer signals new coverage terms, for a procedure that brings in a big share of its surgical work. Helen Wu, the chief executive, sees the problem. The plan is being done well. It will describe a position Larkfield left in month two. So what should she do?

Why Models Exist

A Model Decides What Comes First

To see her options, start with why planning models exist. Strategic planning has no natural order. Every question depends on another. What Larkfield should do depends on what the environment allows, which depends on what Larkfield is trying to be, which depends on what it can do. A group left to sort that out circles for weeks, then settles on whatever its most confident member believed at the start. A planning model imposes an order and a set of questions. Its value is procedural: it decides what gets settled first, and so what the group can consider later. That makes the choice of model consequential. Yet it's usually made by default: whatever was used last time, or whatever the facilitator brought.

Goals and Issues Models

Goals-Based and Issues-Based Planning

Four models are common. The goals-based model runs from mission and vision, to goals, to strategies, to action plans. It suits a settled purpose in a fairly stable environment, and it produces a complete document. Its weakness: it assumes what it should test, and it's slow. The issues-based model starts with the few critical issues facing the organization, and works outward from each one. It's faster, and its plan is shorter and more usable. But an organization that's poor at spotting its issues will plan efficiently about the wrong ones. And it can neglect long-term questions that aren't causing pain yet.

Scenario and Emergent Models

Robust Moves and Strategy Through Action

The scenario-based model builds several coherent futures, and tests the organization's position against each. It doesn't produce one plan. It produces robustness: moves that work in every future, plus triggers that say which future is arriving. Its weakness is cost, and output that's hard to turn into commitments. The emergent model treats strategy as something that forms through action. Agree a direction and values, act, watch what works, then formalize the patterns. It suits young organizations and genuinely new work. Its weakness: unless someone really does the watching and formalizing, it looks exactly like having no strategy. So the commonest planning error isn't a model done badly. It's a model done well, under conditions it doesn't suit.

Choosing a Model

Maturity, Capacity, and Volatility

Three traits decide the fit. Maturity: a young organization, or a brand-new service, has no history to extrapolate and no settled purpose, which points to emergent or issues-based work. Size and planning capacity: a goals-based process eats months of senior time. Without that time, you get a poor version of it instead of a good version of something simpler. And volatility: the faster the environment moves, the shorter the process must be, which favors issues-based and scenario work. Proportion matters too. If a process costs six months of an executive team's time, the decisions it produces should justify that. Two clear decisions just need making well.

Quick Check

A Stable Rehabilitation Hospital

Quick check. Larkfield's rehabilitation hospital has pursued the same mission for 20 years. Referrals and payer terms barely change, and the executive team can give planning a full year. Which planning model fits this hospital best? Pause, and decide. Goals-based. The purpose is settled, the environment is stable, and the team has the time, which are the conditions this model assumes. Scenario-based is tempting, because it sounds thorough. But it earns its cost only where the future is truly uncertain, and here it isn't.

Intended vs. Realized

Deliberate, Unrealized, and Emergent Strategy

Under all four models runs one distinction, from Henry Mintzberg and James Waters in 1985. Intended strategy is what was written down. Realized strategy is what the organization actually did. The part of the plan that was actually delivered is deliberate strategy. The part never delivered is unrealized. And what happened without being planned is emergent. A big unrealized share means over-commitment or a failed assumption. A big emergent share means a responsive organization, or one that ignores its own plans. So an annual review asks two questions. What did we commit to and not do, and why? And what are we doing that we never planned, and should we formalize it?

Guiding Principles

Choice, Exclusion, and a Stated Criterion

Whatever the model, three principles separate a strategy from a wish list, and each follows from the one before. First, strategy requires choice. If every option is being pursued, no strategy exists, and real priorities get set later, by whoever wins the fight for resources. Second, choice requires exclusion. A choice that costs nothing isn't a choice. Write down what you won't do, rather than letting items quietly vanish from a list. Third, exclusion requires a criterion: mission fit, financial sustainability, workforce feasibility, or benefit to the population. Stated in advance, and applied the same way every time. Without one, an exclusion can't be defended. Whoever lost will reopen it, and next year it gets made differently.

Sources of Advantage

Positioning and Resource-Based Views

Behind most strategy work sit two views of where advantage comes from. They complement each other. The positioning view, associated with Michael Porter, looks outward. Advantage comes from a defensible place: serving a population others don't, or holding a relationship with referrers or payers that's hard to displace. The resource-based view, from Jay Barney's 1991 work, looks inward. Is a resource valuable, rare, and hard to imitate? Barney later added a fourth test: is the organization organized to exploit it? That last test is where most claimed advantages fail. And for hospitals, the inward view is often more useful, because regulation, geography, and payer contracts limit the positions available.

Distinctive Capability

A Way of Working Rivals Can't Copy

That leads to distinctive capability: something an organization does reliably well that others in its position don't. It isn't a list of services. Most hospitals describe themselves by what they offer. That distinguishes them from nobody, because a comparable hospital offers much the same list. A real capability is usually a way of working: moving patients between two settings without loss, a pipeline that reliably trains a scarce staff group, or an improvement method that actually lasts. Here is an uncomfortable test. Name something a competent rival couldn't copy within about eighteen months. If you can't name anything, that's the finding, and the strategy should build one.

Community Involvement

Honest Terms for Public Input

One more principle applies to a community hospital. A strategy that affects a population's access to care is expected to involve that population, and involvement changes the result. Two failures recur. Consulting people on a decision already made is detected reliably, and it costs more than not consulting at all. And inviting people to generate options, then shutting them out of the exclusion decision, leaves them watching their ideas disappear without explanation. The honest arrangement is plain: say which stage the involvement is at, who decides what, and what the participants' input will and won't determine.

Quick Check

The Partnership a Rival Can't Buy

Quick check. Here are three statements from Larkfield's draft plan. Which one describes a distinctive capability? Pause, and decide. The nursing-home partnership. A relationship that survives three leadership changes was built slowly, and a rival can't buy it or copy it quickly. The service lines are tempting, because they sound strong. But any comparable hospital offers that list. And a scanner is an asset anyone with money can buy.

Case Resolved

Switching to Issues-Based Planning

Back to Helen. She stops the eight-month process and restarts with an issues-based plan, because the environment has moved twice in three months. The team names three issues. The rival's new site and the payer's coverage change are two of them. The plan is shorter, less complete, and ready in six weeks. She tells her board what's been given up. The old east wing needs major investment within a few years, and an issues-based plan won't address it. So she records it as a deferred decision, with its own process. An issue dropped without a record comes back later as a crisis.

Key Takeaways

Fit the Model to the Conditions

To recap. A planning model's value is procedural: it decides what gets settled first. Match goals-based, issues-based, scenario, or emergent planning to the conditions you face. Review what was promised and not done, and what was done but never planned. Choice requires exclusion, and exclusion requires a criterion stated in advance. Capability is a way of working that rivals can't copy quickly, not a list of services.

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.

Every lesson transcript is free on pages like this one, and the videos are free with a free UPI Study account. Enrolling adds a practice quiz after each lesson, the graded work and final exam that earn the credit, lifetime access, and an official transcript on completion. UPI Study has helped over 130,000 students with college credits. ACE and NCCRS have over 2,100 cooperating colleges that will consider accepting credits; the final decision is with the universities.

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Why take it here

Why students take Healthcare Organization and Management with UPI Study

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.
Credit at a fraction of the priceThe same 3 credits can cost $750 or more at a US college. Here it is one payment, self-paced, with lifetime access.
Finish your degree soonerTransfer credits reduce the courses you still owe, so you can graduate earlier or lighten a heavy semester.
Strengthen an applicationA completed college-level course on an official transcript shows admissions and scholarship committees you can do the work.
Study on your own scheduleNo start dates, no deadlines. Watch the lessons, practice, and take the final when you are ready.
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 Strategic Planning Models and Guiding Principles

What are the four common strategic planning models?
Four common models are goals-based, issues-based, scenario-based, and emergent. Goals-based planning runs from mission to goals to action plans and suits a settled purpose in a stable environment. Issues-based planning starts from a few critical issues and is faster. Scenario-based planning tests positions against several futures. Emergent planning lets strategy form through action, then formalizes what works.
What is the difference between intended and realized strategy?
Intended strategy is what was written down; realized strategy is what the organization actually did. Henry Mintzberg and James Waters drew the distinction in 1985. The delivered part of the plan is deliberate strategy, the undelivered part is unrealized, and what happened without being planned is emergent. An annual review can ask what was committed but not done, and what was done but never planned.
What is the resource-based view of competitive advantage?
The resource-based view, associated with Jay Barney's 1991 work, looks inward and asks whether a resource is valuable, rare, and hard to imitate. Barney later added whether the organization is organized to exploit it. For hospitals, this inward view is often especially useful, because regulation, geography, and payer contracts limit the market positions that the outward-looking positioning view, associated with Michael Porter, emphasizes.
What counts as a distinctive capability for a hospital?
A distinctive capability is something an organization does reliably well that others in its position don't, usually a way of working rather than a list of services. Examples include moving patients between settings without loss, or a pipeline that reliably trains a scarce staff group. One test is to name something a competent rival couldn't copy within about eighteen months.

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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