14Jones Leadership(F)-ch 14 1/14/07 3:45 PM Page 223 chapter 14 Planning and Marketing for a Healthy Organization ESPERANZA VILLANUEVA JOYCE, EDD, RN PATRICIA MARTINEZ, MD CHAPTER MOTIVATION “A man who does not think and plan long ahead will find trouble right at his door.” Confucius CHAPTER MOTIVES ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ Define planning, project planning, operational planning, and strategic planning Describe the elements of the strategic planning process Recognize your organization’s mission statement Identify your unit’s/organization’s strengths and weaknesses Discuss the differences between threats and opportunities Discuss the relationship between goals and objectives Identify effective approaches in writing objectives Define marketing within the health-care setting Identify the components of marketing Identify specific marketing principles that transfer to the health-care environment 223 14Jones Leadership(F)-ch 14 224 1/14/07 3:45 PM Page 224 Skills for Being an Effective Manager T ■ he environmental challenges of providing health care in the 21st century require more sophisticated problem-solving solutions With shrinking fiscal resources and increasing demands in the work place, it is imperative that planning become a major element in any manager’s job description It is easy to lose sight of the big picture when we are so busy focusing on the small one In our daily nursing routines, we sometimes fail to understand overriding nursing administration goals and objectives We become so consumed with our shift’s activities that we cannot see beyond them As a result, we are not always prepared to deal with situations that arise, and we fail to anticipate situations that may have benefited from advance thought and planning Nurses are familiar with the process of planning Planning is an integral step in the nursing process We understand that without planning, our patients would not fare well We plan for patient care on a short-term basis, and we anticipate needs on a longterm basis Planning differs with the job A nurse at a unit level may be concerned with daily operations so the period for planning may be a few days, a week, or a month Middle managers generally plan for to years, whereas top executives plan for to years Middle managers, because they are involved at the unit level, plan for unit activities such as length of hospital stay, seasonal changes, staff assignments, and so on On the other hand, top executives plan for activities that involve the entire hospital (both physical and fiscal) operations, that involve larger sums of money, and that require longer time to complete At the unit level, a 1-day retreat devoted to planning may be sufficient In larger organizations, it may take weeks to accomplish all of the planning in various departments This chapter discusses various types of planning in an organization It explores elements of the strategic planning process and defines the components of marketing ■ ■ ■ ■ PROJECT PLANNING Project planning entails planning for a project Project planning involves a one-time effort, for example, to gather a team of nurses to conduct a community fundraising event Most unit managers will involve their staff in project planning This type of planning requires that one: ■ ■ ■ ■ Types of Planning There are various types of planning such as: ■ Business planning, to plan a business organization, plan to test a product, plan a budget Program planning, which involves a major internal or external function such as planning for the hospital’s 25th anniversary Career planning, which involves educational milestones for individuals or groups Performance planning, which involves development, implementation, and evaluation of job descriptions Disaster planning, which involves guidelines, protocols This chapter covers project planning, operational planning, and strategic planning ■ Identify the problem that the project will ultimately address Name the project Selecting a name for the project is important For example, if your department wants to recruit foreign nurses, you may want to name it the Foreign Nurse Exchange Project Choose a name that will help members quickly identify your project Once a project has been created, the name cannot be changed Determine the project goals Setting goals and measurable objectives will guide you through the completion of the project For example, if a goal is to decrease the vacancy rate of nursing staff, your objective may read: within months, staff will increase by 15% Specify tasks for each member Determine the size of the project team, and then distribute the necessary tasks For example, if you plan to recruit foreign nurses, you may want to designate a person to review the literature to specify which countries export the largest number of nurses Another project member may meet with the marketing department to start an advertising campaign Identify resources needed It is essential to list the resources needed, such as travel monies if the project manager is involved in interview- 14Jones Leadership(F)-ch 14 1/14/07 3:45 PM Page 225 Planning and Marketing for a Healthy Organization ■ ■ ■ ing staff nurses in another country or release time for all team members to be able to plan and monitor the project Indicate timelines for completion To keep all members aware of the progress of the project, it is advantageous to display a chart or timeline that provides the status of each activity and its completion Implement the project Once you have gathered all the data and know which group of nurses to target, your team will determine by whom and where the project will be implemented Evaluate the project It is important to assess the progress of the project so that evaluation becomes a natural step in the process Evaluation of the project should always go back to the objectives Were the objectives accomplished? For example, if you were successful with your recruitment, at the end of the 6-month period, your evaluation should read: 35 (15%) nurses from the Philippines were recruited One of the most common problems surrounding plans for projects is the potential for procrastination Some individuals tend to leave an assignment for the last minute Thus, it is extremely important to identify a leader when planning a project The responsibilities of the project leader include clarifying the purpose of the project to all project members, identifying the roles and responsibilities of each of the members, and keeping members on TABLE 14-1 225 track The project leader needs to facilitate and help the project members overcome barriers to the project’s success The leader is responsible for providing necessary financial and human resources to accomplish the project The leader should recognize members for a job well done OPERATIONAL PLANNING An operational plan is a detailed work plan for a coming year It is the blueprint by which the objectives of a unit, for example, are put into measurable actions It also describes the short-term (a fiscal year) organizational objectives (Table 14-1) Operational planning involves the day-to-day execution of objectives that assist in accomplishing the organization’s mission This plan is used to identify the responsibilities and resources needed to accomplish the department/unit priorities in the current fiscal year Operational planning focuses on sustaining the course of action and ensuring the employees’ ability to perform the designated tasks Middle managers generally get involved in operational planning Managers examine measures that can reduce the obstacles employees may encounter; this type of planning should not be considered a rigid process The manager must ensure that all aspects of the operational plan are implemented; the strategies to accomplish the plan may need to change over time Like project planning or strategic planning (discussed below), operational planning addresses questions such as: Operational Plan in a Medical-Surgical Unit Mission: To provide high-quality care to patients Vision: To become the leader in health care in the Southwest GOAL OBJECTIVES STRATEGIES OUTCOMES Improve patient satisfaction on West Within weeks, 85% of patients will report satisfaction with care provided Orient patients on admission to the unit Inform patients of the unit’s policies and procedures Answer patients’ call light within minutes 87% of patients in the unit reported satisfaction with care provided Improve unit staff’s cross training Within months, 50% of staff members will cross train to at least one other unit Provide a minimum of 30 clock hours of training in mental health, obstetrics, and pediatrics After training is completed, rotate two staff to identified unit for weeks 62% of staff cross trained to one unit 14Jones Leadership(F)-ch 14 226 1/14/07 3:45 PM Page 226 Skills for Being an Effective Manager TABLE 14-2 Gantt Chart WEEK 10 Recruit staff Market center Hire staff Assess staff’s strengths Train staff Order furniture and equipment Train staff Install furniture and equipment Install information system Prepare patient medical records Hold open house Admit patients ■ ■ ■ ■ Where is the unit/organization now? (assessment of the environment) Where we want to be? (goals and objectives) How we get there? (strategies) How we measure progress? (outcomes) To answer such questions, the middle manager must gather data (such as budget, patient, and quality improvement data) from both previous and current fiscal years The operational plan must link goals and objectives to the organization’s strategic plan and link the strategies to the performance indicators or outcomes Managers must ensure that employees at the unit/department level are involved in the operational plan This means that all employees determine together what objectives need to be accomplished in that particular unit and understand the strategies that need to be implemented in order to meet the unit’s goals A variety of tools, such as flowcharts, diagrams, and matrices, can assist managers as they create detailed operational plans These tools use arrows, lines, boxes, circles, and other symbols to communicate processes Some of the common tools that managers use to create operational plans include the Gantt chart (Finkler & Kovner, 2000), critical path method (Baker 2006), and program evaluation and review technique (McGuffin,1999), which is a variation of the critical path method Gantt Chart The Gantt chart is useful for planning and scheduling projects It allows the manager to assess how long a project should take, determine the resources needed, and lay out the order in which tasks need to be carried out Gantt charts help the manager monitor the project’s progress and stay on track Gantt charts help the manager plan out the tasks that need to be completed by scheduling times that the tasks will be carried out and allocating resources When establishing a surgical center, for example, the manager’s ideal plan may include the timeframe in Table 14-2 The chart is also useful when working with multiple projects See Table 14-3 An advantage of the chart is the ability to review projects that are progressing in a timely fashion Critical Path Method The critical path method (CPM) is another tool that helps managers prepare a schedule and plan resources During the management of a project, the CPM allows a manager to monitor achievement of project goals and take remedial action if the project is not going well The CPM consists of diagrams that depict the activities and the time line required (Fig 14-1) The diagram shows the start event (step 1) and the completion of the task of recruiting staff and TABLE 14-3 Gantt Control Chart Cumulative weeks Project orientation SNII X Project orientation SNII Project SWOT seminars Project establish surgical center X X X X X X X X 14Jones Leadership(F)-ch 14 1/14/07 3:45 PM Page 227 Planning and Marketing for a Healthy Organization Step Assess staff strengths Step Step Step Orient staff Hire staff Recruit staff Market center Week Week Week FIGURE 14-1 Critical path method marketing the center (step 2) This activity should take week One activity cannot start until another is completed Assessing the staff strengths (step 4) cannot be done until completion of step (hiring staff) and step (orientation) In the event that the task is completed in less time, such as hiring staff, the time of completion can be adjusted in the diagram If you are not graphically oriented, this diagram can be difficult to draw without using commercial software Program Evaluation and Review Technique The program evaluation and review technique (PERT) calculates a realistic timeframe by using the shortest possible time each activity will take, the most likely length of time, and the longest time it might take Managers can input these figures into PERT to calculate the time to use for each project stage The formula follows: Shortest time ϩ ϫ likely time ϩ longest time ᎏᎏᎏᎏᎏᎏ Example: weeks ϩ ϫ12 weeks ϩ 24 weeks ᎏᎏᎏᎏᎏ ϭ 24 weeks Using the formula helps to bias time estimates away from the unrealistically short time scales often assumed Using a realistic timeframe is helpful when developing the strategic plan for your unit or department 227 Practice to Strive For 14-1 All nurses must be involved in the planning process in their organizations The daily routine activities, however, often cause nurses to devote little time to planning At the unit level, especially when patient acuity is high, nurse managers have little time to plan for the future Planning theory (Roussel, 2006) indicates that the higher a manager is in the organization, the greater the portion of time he/she should spend on planning Chief nurse executives should spend half their time on planning and innovation The proportion of time spent in planning becomes less and less as one moves down the ranks of nursing management Yet, managers must insist that all staff participate in the strategic planning process Thinking strategically is not reserved only for top administrators Strategic plan participation should be in all nurse managers’ job descriptions Nurse managers should play a significant role in the strategic planning process In their nursing area, the way the unit is organized to provide care, the way it establishes staffing patterns to maximize care, and the financial budgets it develops to get resources are all outcomes of a strategic process managed at the unit level The current emphasis should be on managers working to achieve the organization’s primary goal rather than just focusing on short-term objectives and day-to-day operations STRATEGIC PLANNING Strategic planning is a systematic process that emphasizes assessment of the environment (economic, political, social, and technological) both internally and externally It focuses on performance improvement and utilizes strategies to accomplish the organization’s desired outcomes Business organizations embraced the idea of strategic planning in the 1950s And in the last 20 years, even institutions of higher education have attempted to implement strategic planning out of a need to respond to challenges with finances, student attrition, and educational demands Strategic planning is a management tool that helps organizations set long-term goals It assures that the individuals working for the organization work together to accomplish set goals and objectives Executives in the organization are generally responsible for initiating the strategic planning process The current trend in business is to plan for to years Because of employee mobility and the changing economy, industry usually is not able to ... are so busy focusing on the small one In our daily nursing routines, we sometimes fail to understand overriding nursing administration goals and objectives We become so consumed with our shift’s... assignments, and so on On the other hand, top executives plan for activities that involve the entire hospital (both physical and fiscal) operations, that involve larger sums of money, and that require... should spend half their time on planning and innovation The proportion of time spent in planning becomes less and less as one moves down the ranks of nursing management Yet, managers must insist