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1. Govt. College Of Nursing, Rajnandgaon(C.G.) Subject: Nursing Management Seminar on: Strategic Plan SUBMITTED TO DR. MRS. UMA SHENDEY PROFESSOR DEPARTMENT O F CHILD HEALTH NURSING GOVERNMENT COLLEGE OF NURSING RAJNANDGAON (C.G.) SUBMITTED BY M R S. TIKESHWARI SAHU M.Sc. NURSING 2 ND YEAR GOVERNMENT COLLEGE OF NURSING RAJNANDGAON (C.G.)

2. introduction “Failing to plan is planning to fail”. Planning is a vital skill that organizations must practice on a regular basis, because it forms the basis of most other actions an organization must take. Planning is a deliberative, systematic phase of the nursing process that involves decision making and problem solving. In planning the nurse refers to the client's assessment data and diagnostic statements for direction and formulating client goals and designing the nursing strategies required to prevent, reduce or eliminate the client's health problems.

3. DEFINITIONS OF PLANNING Planning is a continuous process of making entrepreneurial decisions systematically and with the best possible knowledge for their future, organizing systematically the effort needed to carry out these decisions and measuring the results of the decisions against expectations through systematic feedback.   -According to Drucker Planning is a process of determining the objectives of administrative effort and devising the means calculated to achieve them. -According to Millet

4. Types of planning Strategic planning: Strategic planning is a process in which an   organization's leaders  define their vision for the future and identify their organization's goals and objectives. The process includes establishing the sequence in which those goals should be realized so that the organization can reach its stated vision. Operational planning:- Operational planning is a documented plan that outlines the goals and key objectives of an organization, and how they can be achieved. It ensures that team members understand their responsibilities as well as what they need to do.

5. STRATEGIC PLANNING

6. INTRODUCTION All things being equal, the institution that plans the best will perform the best.  Strategic planning is an ongoing process.  The strategic plan may look ahead five, ten, or even twenty years but it should be revisited yearly.  It is very important to review the strategic plan, the assumptions on which it is based, and include new internal and external information to maintain the validity information to maintain the validity of the plan. Strategic Planning seeks the answer for four basic questions : Q. Where are we? A. Sıtuatıon analysıs Q. Where would we want to be? A. Vısıon,mıssıon, goals Q. How would we reach ? A. Strategıes & actıvıtıes Q. How would we follow and evaluate our success ? A. Performance evaluatıon  

7. Definition  Strategy is a unified, comprehensive and integrated plan designed to ensure that the basic objectives of the enterprise are achieved. - Glueck and Jauch Strategic planning is the development of a competitive strategy or the planning that sets the long-term direction of the institution.  Its purpose is to guide the administration to attain its mission and to organize the allocation of resources.    OR   Strategic planning means to analyse the current and expected future situation, determine the direction of the firm, and develop means (resources) for achieving the mission. -Koontz & Weihrich

8. HISTORY 1970s- strategic planning in the healthcare industry mainly consisted of planning for new buildings and funding expanding services in response to population growth. Federal PPS (Prospective Payment System) – 1980s, the field of healthcare strategic planning received a transforming jolt as organizations scrambled to compete in an increasingly demanding environment. Today, hospitals and other healthcare organizations have come to embrace strategic planning as a valuable tool to evaluate alternative paths and held them prepare for the future. Healthcare managers at all levels need to understand the purpose of strategic planning, its benefits and challenges, the key factors for its success and their vital role in the process.

9. TYPES OF STRATEGIES According to William F. Glueck , there are following types of strategies:  Stability strategy. Where the environment is stable and the firm is doing well, it may follow the strategy of status quo. It may be satisfied with present products and market share. This is a less risky strategy but unsuitable in a changing environment. 2. Growth strategy. Many firms follow the strategy of expansion and diversification. It is risky and requires accurate forecasting and resource mobilisation . Growth must be properly planned. 3. Retrenchment strategy. It implies reduction in operations and personal It may be followed by struggling firms who want to survive sever competition and depression.

10. TYPES OF STRATEGIES 4. Combination strategy. It is often used by large firms who want to cut back in some areas and to expand in others.   5. Competitive strategy. It refers to a 'game plan' that is designed for outdoing the actions of the competitors: Formulation of a competitive strategy involves knowing the likely moves of competitors and then concentrating or overcoming those moves effectively.   6. Grand or master strategy. It determines the picture of the kind of enterprise that is envisaged. It is the overall strategy of an organisation . The purpose of grand strategy is to determine and communicate the probable shape with the organizations likely to take in future be designed to fight the general forces operating in an industry and the economy. For example, if management anticipates an economic recession, it may decide upon a strategy of reduced stocks, fewer staff, reduced expenses, etc.

11. Importance of Strategic Planning Helps in facing environmental challenges Provides Direction Optimum utilization of resources Facilitates coordination and control Competitive strength Strategic planning is an ongoing process It determines the institution’s directions and helps it to plan for contingencies; the greater the planning, the better an institution performs.  The further the institution projects into the future, the better it will be.

12. Fiction Versus Fact about Strategic Planning 1. Fiction – Strategic planning is a linear and smooth process. Fact: Rather, it proceeds in fits and starts, revisiting earlier steps in some situations and skipping ahead in others.  Strategic planning should be considered as having a feedback loop at every stage, whereby new information requires previous assumptions to be reviewed for relevancy. 2. Fiction – Strategic planning should only be developed by upper management and selectively shared. Fact – “Little the actual development of the plan can be delegated, but it must be a product of extensive listening and the gathering of inputs from all levels of the institution. 

13. Fiction Versus Fact about Strategic Planning 3. Fiction – Strategic plans are the same as operational effectiveness. Fact – “Improvements in operational effectiveness make institutions closer together as they compete with other institutions using similar management techniques, which are easily imitated.  Strategic changes, by contrast, seek to differentiate from rivals to improve sustainability and profitability.” 4. Fiction – Nonprofit institutions do not need strategic plans. Fact – “At the sector level, it is clear that nonprofit institutions are vulnerable to the same environmental changes that are having an impact on public and non-profit institutions.  At the institutional level, a strategic planning process can be a valuable tool for demonstrating improved performance. 5. Fiction – Every institution needs a strategic plan. Fact – “Strategic planning is not for every institution.  You probably don’t need it if you are satisfied that your institution is stable and yielding a satisfactory living for you and your family.  It’s a lifestyle question”.

14. areas for STRATEGIC PLANNING INTERNAL ENVIRONMENT: Philosophical environment: consisting of mission, values, and long term goals of organisation. Managerial environment: consisting of managerial hierarchy, quality of managerial talents etc. Structural environment: consisting of rules, policies and procedure of organisation, communication network etc. Production environment: consisting of availability of resources, techniques of production etc. Financial planning: consisting of working capital management, capital budgeting etc

15. areas for STRATEGIC PLANNING Marketing environment: consisting of advertisement and sales promotion techniques, marketing research procedures etc. Personnel environment: consisting of type and nature of manpower planning, quantity and quality of manpower, system of training, promotion etc. Human relation environment: consisting of industrial relations, public relations etc. EXTERNAL ENVIRONMENT Socio-cultural factors Competitive factors Political factors Technological factors Legal factors

16. FEATURES OF STRATEGIC PLANNING ( i ) Strategy is a contingent plan as it is designed to meet the demands of a particular situation.   (ii) Strategy provides the direction in which human and physical resources will be deployed for achieving organisational goals in the face of environmental pressures and constraints. It is a guideline for future course of action   (iii) Strategy relates an organisation to its external environment. Strategic decisions are primarily concerned with external forces.   (iv) Strategy is an interpretative plan formulated to interpret and give meaning to other plans in the light of specific situations.   (v) Strategy is the right combination of different factors. Strategy-making is largely the responsibility of top management.   (vi) Strategy is forward looking.

17. FEATURES OF STRATEGIC PLANNING (vii) It is a means to an end not an end in itself. It is a means of coping with changes in the external environment.   (viii) It is generally formulated at the top level of management.   (ix) It is generally long term in nature.   (x) It is flexible and dynamic.   (xi) It involves assumption of certain calculated risks.   (xii) It is action-oriented.

18. FEATURES OF STRATEGIC PLANNING (xiii) It may involve contradictory action. For example, a manager may adopt a particular course of action today but he may revise his action tomorrow due to changes in the situation. (xiv)It is a broad or comprehensive programme concerned with the entire organisation . (xv) It determines company’s survival and growth. (xvi) It is prepared on the basis of resource ability of the organisation .

19. Characteristics of an effective strategic plan The most effective strategic plans are: readable clear well-written well communicated   If written clearly, it will be understandable by a high school graduate; otherwise, it’s probably too jargon-filled or vague.

20. Essentials of a Good Strategy Internal consistency Consistency with environment Appropriate time horizon Realistic Acceptable degree of risk Feasibility Social sanction

21. Developing a strategic plan depends on the following Leadership, Organizational culture, Complexity of the organization’s environment, Size, Expertise of planners, etc.

22. LEVELS OF STRATEGIES chart

23. STRATEGIC PLANNING PROCESS Step II- Defining the future state Step III Create strategic plans to accomplish purpose and objectives STEP V Evaluate results and renew the strategic planning process as necessary Step IV Implement the strategic plans STEP I- Analysis of current state

24. STEP I- Analysis of current state Identification of current objectives and strategies Environment analysis Resource analysis

25. Step II- Defining the future state Defining vision, mission, goals Determination of extent of required strategic change: Define five to ten areas in which the association must be successful in order to accomplish its mission, based on customer expectations. Determine customer expectations Determine critical issues

26. Assessment of strengths, weaknesses, opportunities, and threats (SWOT) i ) Strengths: List the organizational attributes that promote the association's ability to meet its mission and vision. ii) Weaknesses: List those organizational attributes that hamper the association's ability to meet its mission and vision. Some examples include inadequate technology or use of technology, lack core competency training, poor service, and so forth. iii) Opportunities: List those factors, internal and external, that would enable the association to meet its mission and vision. Some examples include technological advances in needed areas, consolidating functions, etc. iv) Threats: List those factors, internal or external, that would hamper the association from meeting its mission and vision. Some examples include high rate of foreclosures, drawn out worker strike, change in developer focus, etc.

27. Step III Create strategic plans to accomplish purpose and objectives Identification of strategic alternatives. Evaluation of strategic alternatives. Selection of strategic alternatives.

28. Step IV Implement the strategic plans. Putting strategy into operations. Formulating operating plans. Implementation of plans. Monitoring and periodical review of strategy. STEP V Evaluate results and renew the strategic planning process as necessary

29. BASIC APPROACHES TO STRATEGIC PLANNING According to J. Mariotti (1998) there are three basic approaches to strategic planning.  These are the hierarchical approach, electric approach and the internal/external analysis approach. Hierarchical approach Electric approach Internal/external analysis approach

30. Hierarchical Approach Grounded by the vision Oldest approach Adds value Promoting oneness

31. Electric Approach Past and present activities Justification of past actions Internal/External Analysis Approach Requires evaluation Adaptability SWOT analysis

32. BARRIERS

33. BARRIERS If stakeholders are not ready for the strategy, it will not be executed by even the most tenacious of leaders. Lack of focus of the strategy. Strategies not appropriately funded and resourced, they cannot be executed, or if they result in competing priorities, the organization will likely be unsuccessful. Strategies have failed because the organization has fallen to temptation of new priorities, or they simply fail to resource the strategy over multiple years or time periods. Strong leadership is needed to maintain a long-term focus. Strategy cannot be implemented solely in the top layers of an organization. All stakeholders must be aware of and buy in to the desired future state and the path that leads them there in order to ensure the momentum necessary to achieve results.

34. Addressing Challenges in Strategic Planning in Nursing 1. Individual-level challenges arise from attitudes, fears, and resistance to change. Some of these include: Fear of unknown or ambiguity Poor readiness for change Lack of skill or knowledge

35. Addressing Challenges in Strategic Planning in Nursing 2. Team-level challenges involve issues related to cooperation, coordination, and communication within the nursing team. A few examples include: Team conflicts Absence of shared objectives Inadequate information sharing

36. Addressing Challenges in Strategic Planning in Nursing 3. Organisation -wide challenges touch on aspects at the institutional level that affect the entire nursing team. Such issues may include: Limited resources Inadequate support from leadership Culture resistant to change

37. APPLICATION OF STRATEGIC PLANNING IN HEALTH CARE SERVICES The AAMC outlines the following benefits of implementing strategic planning in health care organizations:   Defining an overarching vision  Identifying areas of excellence in which to invest  Acquiring necessary resources for new initiatives  Prioritizing critical issues  Aligning goals so stakeholders are moving in a common direction  Increasing motivation, commitment, and teamwork  Enhancing communication  Adapting more effectively to changing circumstances  Positioning an organization to be competitive  Developing shared criteria for evaluation 

38. Importance of Strategic Planning in Health Care First, it helps health care organizations adapt to changes in the health care environment. Health care is a rapidly evolving field, and  organizations that fail to adapt to changes are at risk of falling behind. By engaging in strategic planning, health care organizations can anticipate and respond to changes in the health care environment, ensuring they remain relevant and effective. Second, strategic planning helps organizations align their resources with their goals. Health care organizations have limited resources, and they must use them effectively to achieve their objectives. Health care organizations can identify their most critical needs and allocate resources accordingly, ensuring they achieve the greatest impact.  Third, strategic planning helps organizations set priorities and make difficult decisions. Health care organizations are often faced with difficult choices, such as deciding which services to continue to offer and which to discontinue. By engaging in strategic planning, health care organizations can weigh the pros and cons of various options and make informed decisions that align with their long-term goals.  

39. Example of Strategic Planning in Health Care The American Heart Association (AHA) is an excellent example of an organization that used strategic planning to achieve its goals. As a nonprofit organization, the  AHA  has a clear mission: to advance the health of all individuals and communities. To achieve their mission, the AHA recognized the importance of setting ambitious goals and developing a comprehensive strategic plan.  In 2018, the AHA launched a strategic plan that set a clear direction for the organization over the next decade. The plan aimed to reduce the incidence of heart disease and stroke by 20% by 2020, improve the cardiovascular health of all Americans by 20% by 2020, and increase the number of people who receive CPR training and are prepared to respond to cardiac emergencies. These goals were ambitious, but the AHA recognized the importance of setting challenging targets to drive progress and improve outcomes for patients. 

40. Example of Strategic Planning in Health Care To achieve their goals, the AHA developed a comprehensive plan that included a wide range of activities. One critical aspect of the plan was funding research to better understand the causes and treatments of cardiovascular disease. By investing in research, the AHA could advance the field of cardiology and develop new therapies that could improve patient outcomes.  Another critical aspect of the plan was educating the public about heart health. The AHA recognized that many people were unaware of the risks of heart disease and the steps they could take to reduce their risk. To address this issue, the AHA developed educational programs that aimed to increase awareness of heart disease and improve health literacy among the general public.  

41. Example of Strategic Planning in Health Care To measure progress toward its goals, the AHA developed metrics to track the impact of each initiative. For example, the organization tracked the number of people who received CPR training, the number of public policies that supported heart health, and the incidence of heart disease and stroke. By tracking these metrics, the AHA could assess the effectiveness of its initiatives and make adjustments as needed to achieve its goals.  The  AHA’s strategic plan  also included a system for evaluating the effectiveness of each initiative. By evaluating the impact of each initiative, the AHA could identify what worked well and what could be improved in the future.  

42. STRATEGIC PLANNING IN NURSING SERVICES Creating a strategic plan for nursing care delivery ensures that nurses are used most effectively by tapping into their unique capabilities, providing the most direct and efficient patient care, and improving the safety and quality of that care. Create the Strategic Planning Team Administrators, nurse managers, pharmacists, physicians, IT professionals and front-line working nurses could be included. Clinical team members will be able to adequately test plans. Leaders understand the day-to-day activities that nurses undertake and technical team members can help design effective tools for nurses to use.

43. STRATEGIC PLANNING IN NURSING SERVICES 2. Set Nursing Care Goals The primary goals that should guide your plan are safety, effectiveness, timeliness, patient-centered, equitable and efficient. 3. Define Areas of Concern The areas targeted by the strategic plan are chosen because there is a problem, regulations require updating, or the team believes significant changes could improve the facility’s delivery of care

44. STRATEGIC PLANNING IN NURSING SERVICES 4. Choose Changes to Make Changes do not necessarily lead to improvements, but all improvements require some level of change, according to the Institute for Healthcare Improvement. Once facility needs have been identified and measurements placed to monitor the outcomes, the team must clarify the changes it will recommend.

45. Practical Application of Strategic Planning in Nursing Management A practical application may be developing a strategy to reduce hospital-acquired infections in a healthcare setting. The nurse administrator defines a clear mission (reduce infections), sets measurable objectives (e.g., reduce infections by 20% in the next year), formulates strategies (like training nurses on  infection control  practices), implements these strategies, and monitors progress regularly.  

46. STRATEGIC PLANNING IN NURSING EDUCATION A strategic plan for a college of nursing in India can include goals such as: Producing quality nursing professionals Developing teaching faculty Improving infrastructure Expanding programs and community projects Recruiting, supporting, retaining, and empowering faculty and staff Facilitating career advancement processes Developing management and leadership skills Applying leadership strategies Identifying and implementing changes to improve care quality

47. Strategic planning in nursing education can help an organization to: Look into the future in an orderly and systematic way Ensure that a hospital remains relevant and responsive to patient and community needs Provide a clear and consistent organizational focus Provide a basis for monitoring progress, results, and impact 

48. CONCLUSION Strategic planning involves a structure or framework, a set of procedures, and of course content. Strategic Planning simply introduces a formal “discipline” for conducting long-term thinking about an institution and for recognizing opportunities in and for minimizing risks from the external and internal environments. In today's highly competitive business environment, budget-oriented planning or forecast-based planning methods are insufficient for a large corporation to survive and prosper. The firm must engage in strategic planning that clearly defines objectives and assesses both the internal and external situation to formulate strategy, implement the strategy, evaluate the progress, and make adjustments as necessary to stay on track.

49. Recapitulation Q.1 What is strategic planning?(2marks) Q.2 Enlist the types of strategies. (2marks) Q.3 List down the process of strategic planning.(2) Q.4 Name the levels of strategic planning. (2) Q.5 Write any four barriers of strategic planning.(2)