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How Should the Strategic Plan Align with the Five Pillars?


How closely should a hospital’s strategic plan align with the Pillars? Or can the Pillars themselves be used as the basis of the strategic plan?


The Pillars (People, Service, Quality, Finance, and Growth) should be the foundation of the strategic plan because they ensure that goals are balanced and help the organization set priorities to achieve those goals. From the strategic plan, the organization can set annual goals that then cascade down to leadership. That is what I call organizational alignment.

On another note, I think many organizations get confused between strategies and tactics. For example, if the goal is to be the best provider of choice in the market (strategy), the next step would be to set targets by Pillar that will be needed to hit the strategic goal.

Under each target are the tactics to get there. Here is an example of how to apply the process:

1. On an annual basis—at the very top level of management— establish and communicate one to two numeric goals for each of The Pillars. Some sample goals:

  • Growth—Gain market share in the eastern quadrant of the service area and/or increase outpatient volume 30%.
  • People—Reduce RN turnover four points and/or increase employee satisfaction for first year employees by five points.

The idea is that top management needs to study the statistics from management reports and determine what is important for the organization to focus on in the coming year to set goals that are clear, precise, and measurable.

2. Next, tactics are developed to meet these numerical strategic goals. Some sample tactics:

  • Growth—To grow market share, establish a primary care clinic, recruit a primary care practice in the eastern quadrant, or develop a new outpatient facility that focuses on customer service and technology.
  • People—Make changes in orientation, begin management rounding, do pulse checks at 30/60/90 days, or implement peer interviewing.

Here, the idea is that there are probably four to seven tactics that the organization can implement to help achieve the overall strategic goals. (Many more than that can’t receive proper implementation guidance by top management.)

3. Finally, ask individual departments to develop plans on how they can best contribute to implementing the tactic. Some examples:

  • The cardiology department may work with cardiologists to identify internists in the east who can be recruited, or help host heart screening events at the mall in the east to attract patients.
  • The radiology department may identify new equipment needs that would increase referrals from internists—an open MRI, for example.
  • The nursing units may develop a process to hardwire the pulse checks, and the HR department may designate “Interview Saturdays” to allow for peer interviews in slow periods.
  • All departments can be involved with this approach and all employees can understand the organization’s goals. This ensures the plan is monitored, comprehensive, and detailed.

Of course, the plan needs to be monitored and modified, the results celebrated, and lack of follow-through addressed, but with careful implementation, organizations will see success across all Five Pillars. Organizations that make the commitment to link The Pillars to strategic planning really start the flywheel turning.