Setting the Tone for TONL through Agile Strategic Planning

By Nelson Tuazon, DNP, DBA, RN, NEA-BC, CENP, CPHQ, CPPS, CPXP, FACHE, FNAP, FAAN
Vice President And Associate Chief Nursing Officer, University Health
Director, TONL District 8
 
Antoine de Saint-Exupéry, a prolific writer and pioneering aviator, once said, “A goal without a plan is just a wish.” As the Texas Organization for Nursing Leadership (TONL) and its chapters welcome their new board members, let’s take this opportunity to take stock of what the organization has accomplished and plan for the future. As we all recognize, planning lets us set a vision for the future that would likely increase the achievement of our goals. The American Organization for Nursing Leadership (AONL, 2022) stipulates that the ability to strategically plan for the future of our organization is a necessary skill in today’s rapidly changing healthcare environment. Ulrich (2021) reminds us that planning for the future should not detract us from the work of the present, especially as we continue to recover and transition from the pandemic of the last couple of years.

Not All Plans are Alike

It is helpful to review the types of plans that are necessary to successfully run an organization. “One size fits all” does not apply to organizational management and governance. These different types of plans have particular functions. The most common types of plans include strategic, operational, and business plans. Driven by the mission, vision, and philosophy of the organization, data is critical in measuring the success of the plans, especially in goal-directed, outcomes-driven, and metric-focused organizations. Additionally, these plans should be based on standards and evidence. Regardless of the type of plan, the planning process should ensure that everyone has a voice and that all voices are heard. The planners should create an environment that promotes open communication. The plan should also reflect the priorities that help advance healthcare into the future (Ulrich, 2021).

Strategic plans provide a blueprint for organizations to define their future. The allocation of resources, including human resources and capital, is outlined in a strategic plan. The mission, vision, values, and philosophy of the organization serve as a foundation for the strategic plan. Data supports the plan. This plan should address the priorities for the coming year (or years) and include programs and services. In the current healthcare environment, strategic planning must involve all levels of the organization (Wright, 2020). In the case of TONL, strategic planning involves collaborative efforts among the board members, the chapters and districts, and committees and task forces. Operational plans are working plans that are developed from strategic planning. If strategic planning is the vision of an organization, the operational plan is how the vision is achieved. Operational plans should include specific activities to be undertaken, timetables, responsible person(s), individuals affected, and data to be obtained. Business plans or proposals are developed when something new is being proposed. They can range from the purchase of a new piece of equipment to the implementation of a new service. In addition to the costs being addressed, a business plan should include data about the proposal and a rationale for the plan.

Strategic Planning Process

Strategic planning is a “thoughtful systematic process of determining a direction and course of actions for achieving a desirable envisioned future” (Weston, 2020, p. 54). Broome and Marshall (2021) describe the important steps in strategic planning. These include a) collecting relevant data, perspectives, benchmark information, and scans of the external environment; b) engaging a representative group of individuals to develop a draft vision, mission, and values statement; c) gaining input from the larger community in the organization; d) developing strategies and metrics, and e) implementing the strategic plans.

Collaboration: Hallmark of Strategic Planning

The first step in the strategic planning process revolves around initial assessment including forming a team, performing an internal assessment, and soliciting input. The assessment should encompass human and material capital that is necessary to achieve the desired goal of the organization. Critical to this initial assessment is a scan of the mission, vision, and values of the organization (Langan et al., 2019). Include key stakeholders including front-line members and influencers. Seek input from diverse populations including users, customers, facilitators, and supporters (Lal, 2020; Ridling et al., 2021).

The second step involves scanning the external environment and performing an analysis of the gaps surrounding the issues or problems being addressed. The gap analysis requires a look at the current state, the vision of the main strategies required to address the identified issues, and the resources needed to achieve the desired goals. Through a SWOT (Strengths, Weakness, Opportunities, Threats) or SOAR (Strengths, Opportunities, Aspiration, and Results) analysis, the assessment will determine if there are existing individuals or teams that are working on similar issues (Lal, 2020; Langan et al., 2019). This step also requires a synthesis of ideas gathered from the assessments and the identification of common themes (Ridling et al., 2021).

The third step takes into account both the internal and external assessments in establishing goals and assigning leadership accountability and decision-making (Lal, 2020; Langan et al., 2019; Ridling et al., 2021). It is critical to establish goals that are high-level with time limits and ways of measuring achievement and success (Lal, 2021). Executive leaders, managers, and decision-makers should be identified early on to ensure that the appropriate material, human, and capital resources are allocated. The alignment of the goals with the mission, vision, and values of the organization will be contingent upon the drive, direction, and determination of the stakeholders.

The fourth step encompasses the implementation plan that involves determining objectives and specific tactics to achieve the desired goals. After developing and vetting the actions, interventions, and measures by the stakeholders, the plans are executed (Langan et al., 2019). The members of the team, committees, or task forces need to understand the expectations by keeping them informed and focused on the specific metrics and tactics (Lal, 2020; Ridling et al., 2021).

The fifth step involves evaluation by following up and measuring outcomes, reviewing progress, and communicating results. To sustain the achievement of the desired goals, these should be communicated clearly and integrated into the operations of the organization. The members of the teams, committees or task forces should have the tools and resources required to achieve the objectives and should receive appropriate direction and motivation (Lal, 2020). The plan needs to be evaluated based on the processes, structures, and strategies set out in alignment with the mission, vision, and values of the organization (Langan et al., 2019).

Practical Applications of Strategic Planning

Wright (2020) offers a strategic planning model that can be used by nursing leaders. This model emphasizes collaboration among the planners and key stakeholders. As transformational leaders involved in strategic planning, it is essential for the board members and officers to explore the organization's culture, market positioning, and prospects for the expansion of programs and services.

Key Take-Aways

1. Align the mission and vision of the organization. The mission statement serves as the framework within which all operations of the organization align while the vision statement outlines the future goals, narrows the mission statement, and provides quantifiable goals.

2. Utilize the results of the Strengths, Weaknesses, Opportunities, Threats (SWOT) or Strengths, Opportunities, Aspirations, Results (SOAR) analysis to assess internal and external factors that affect the operations of the organization.

3. Analyze and synthesize data and results of the analysis of the internal and external factors to formulate a draft of the strategic plan with identified focus areas and priorities.

4. Communicate and disseminate the draft of the strategic plan – containing the mission and vision statements, strategic goals and objectives, and the measures upon which the success will be monitored and evaluated – to constituents and stakeholders for comments and feedback.

5. Review and revise the initial strategical plans using the feedback from the constituents and stakeholders to ensure alignment with the mission and vision and the strategic goals and objectives.

6. Upon approval by the board of directors, distribute the finalized strategic plan – with designated leaders and champions – to all constituents and stakeholders for communication and execution.

7. Monitor and evaluate the progress of the plan within the designated intervals using established metrics through appropriate scorecards or dashboards.

Leadership Agility: Planning in Complex Organizations

A strong and unified strategic plan is critical to the successful growth and advancement of an organization, especially amid the dynamic structures and processes in a complex healthcare system. Ridling et al. (2021) offer pragmatic approaches to developing a nursing strategic plan involving a large number of nurses. TONL could benefit from their recommendations. These include gaining meaningful feedback, conducting a thematic analysis and synthesis of a large amount of feedback, and promoting collaboration among all levels of nurses in leadership, clinical, and advanced practice roles. Langan et al. (2019) describe the complexities in developing a framework for effectively managing and leading disasters. TONL has not only survived but thrived during the pandemic. They highlight the critical roles of nursing leaders in large-scale public health emergencies. Weston (2020) posited that the rapid changes that are evolving in the current healthcare environment require a systematic and thoughtful strategic planning process. Leaders must have a clear understanding of the confluence of emerging trends, forge a vision for a positive future, formulate a clear direction for success, and execute actions to achieve desired outcomes.

References

American Organization for Nursing Leadership (AONL) (2022). AONL nurse leader competencies. AONL Nurse Leader Competencies | AONL

Broome, M. E., & Marshall, E. S. (2021). Transformational leadership in nursing: From expert clinician to influential leader (3rd ed.). Springer Publishing Company

Lal, M. M. (2020). Why you need a nursing strategic plan. The Journal of Nursing Administration, 50(4), 183–184. https://doi.org/10.1097/NNA.0000000000000863

Langan, J. C., Lavin, R. P., Griffin, A. R., Veenema, T. G., & Dobalian, A. (2019). From brainstorming to strategic plan: The framework for the society for the advancement of disaster nursing: A work in progress. Nursing Administration Quarterly, 43(1), 84–93. https://doi.org/10.1097/NAQ.0000000000000335

Ridling, D., Rejto, N., & Easley, S. (2021). One team—Many voices: Developing a nursing strategic plan with more than 2000 nurses. Nurse Leader, 19(5), 499–507. https://doi.org/10.1016/j.mnl.2020.10.005

Ulrich, B. (2021). From the editor-in-chief. Focusing on today, planning for tomorrow. Nephrology Nursing Journal, 48(1), 7. https://doi.org/10.37526/1526-744X.2021.48.1.7

Virkstis, K. N., Boston-Fleischhauer, C. M. J., Rewers, L. B., Critchley, N., Whitemarsh, K. B., Paiewonsky, A., & Gerstenfeld, R. (2022). 7 Executive strategies to stabilize the nursing workforce. JONA: The Journal of Nursing Administration, 52(4), 194–196. https://doi.org/10.1097/NNA.0000000000001129

Weston, M. J. (2020). Strategic planning in an age of uncertainty: Creating clarity in uncertain times. Nurse Leader, 18(1), 54–58. https://doi.org/10.1016/j.mnl.2019.11.009

Wright, P. (2020). Strategic planning: A collaborative process. Nursing Management, 51(4), 40–47. https://doi.org/10.1097/01.NUMA.0000654860.02889.d3