Strategic Planning in Health Professions Education: Scholarship or Management?

Strategic Approaches for the Health Science Educator: Understanding Strategic Planning, Strategic Thinking, and Continuous Process Improvement and Their Impact

ABSTRACT

With continued demand for health science institutions to find solutions to deliver on heightened student expectations despite smaller budgets and fewer resources, the utilization of organizational improvement techniques is pervasive. Academic health care leaders are seeking effective modalities to overcome obstacles, modernize, and become more efficient. Three of the commonly used approaches for improvement are strategic planning, strategic thinking, and continuous process improvement (CPI), and these concepts have been used in a variety of forms throughout industry, higher education, and health care. However, their definitions are often not well understood, and their processes are misconstrued in practice. With the increased expectation of health care institutions with undergraduate, graduate, and continuing education to consider strategic processes in organizational improvement, it is important for leadership to understand the differences in these three approaches. In this article, we explain the concepts of strategic planning, strategic thinking, and CPI through an overview of their history, definitions, and the benefits and pitfalls as observed by researchers. Furthermore, we reduce the noise in the existing literature into three concise definitions for each approach. And finally, for those seeking where to begin, we explain one tool in each category recommended for the novice strategist: the Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis for strategic planning, the Goals, Objectives, Strategies, and Tactics (GOST) framework for strategic thinking, and the Pareto Chart for CPI.

Addressing Structural Racism Using a Whole-Scale Planning Process in a Single Academic Center

Purpose

The murder of George Floyd in 2020 prompted a national demand for cultural transformation to confront the systemic racism prevalent in the country. Academic medical centers were not exempt from this urgent call. This article evaluates the efficacy of a strategic process in fostering cultural transformation within an academic medical system.

Methods

A whole-scale strategic planning process was implemented over 13 months, involving multiple working groups representing key stakeholders from each entity across the system, an anonymous survey, a communication plan, and a balanced scorecard to monitor progress. More than 5500 voices, 160 recommendations, 122 data gathering sessions, and town hall meetings contributed to the creation and implementation of vital action items and a strategic framework. The Diversity Engagement Survey (DES) was administered 18 months following the process launch.

Results

Of the 45,554 employees, students, faculty, and trainees, 96.5% completed unconscious bias education within the fiscal year and 76% of action items, termed "Just Do Its," were completed. Mission, vision, values, and strategic priorities were crafted to serve as a framework for intermediate and long-term actions. The DES revealed improvement in the "respect" attribute of an inclusive culture, and 64% of respondents confirmed that action for cultural transformation is addressing racism both within and outside of the institution.

Conclusion

Implementing a shared purpose, engaging multiple working groups representing key stakeholders, and empowerment of stakeholders to implement changes, in conjunction with the development of a strategic framework addressing structural racism, resulted in the completion of vital action items to initiate cultural change.

Simulation-Based Operations

Simulation pedagogy and the operations of simulation-based experiences have become an integral part of healthcare education. Academic and healthcare institutions constructed simulation centers or dedicated simulation spaces to provide simulation-based experiences for multiple health professions. Architectural designs resemble acute care settings that have the flexibility to change or include virtual reality and enhanced technology. Professional organizations have standards of best practice, credentialing requirements, and accreditation standards that support the need for high-quality, high-fidelity simulation experiences. Within healthcare education, simulation operation has become a specialty in itself that requires knowledge and experience of healthcare, education, and simulation pedagogy (INACSL Standards Committee, 2017). Simulation center administration needs an understanding of personnel management, including standardized patients (SPs), staff, faculty, and learners, as well as knowledge of budgeting, revenue streams, and technology. Personnel with unique skills and knowledge in engineering, healthcare, or information technology are required to support the simulation activities. Resources that manage inventory, supplies, equipment assets, and audiovisual requirements will increase efficiency and enhance fiscal responsibility. Technology assets such as high-fidelity human patient simulators can be used to enhance high-quality simulation, while audiovisual and data capturing software can be used for assessment, evaluation, and quality improvement. Simulation operations provides the infrastructure that supports the daily activities of simulation-based education.

Does Strategic Planning Matter?

In this Invited Commentary, the author examines the history, use, and effectiveness of strategic planning in higher education, academic medicine, and nonprofit settings. Strategic planning is a process by which an organization differentiates itself from its direct or emergent competition to achieve its mission. This form of planning is distinct from operational planning, in which an organization identifies the ways in which it will continuously improve. Many organizations employ a combination of strategic planning and operational planning but use the former term to describe their planning process without a clear definition or conceptual framework.The empirical literature across disciplines has not demonstrated that strategic planning leads to positive organizational outcomes. Over the modern history of academic medicine in the United States, strategic planning may have had limited impact on organizational outcomes because of favorable environmental circumstances that catalyzed growth and innovation regardless of planning efforts. In the current environment, organizational and departmental leaders need to define trade-offs between the various opportunities that they confront; allow for both planned and emergent strategy formulation; avoid platitudes and fluff; and focus on operational excellence.Theories from anthropology suggest that strategic plans may be more important for what they express than what they produce. Repetition of the themes and language of strategy in formal and informal discourse can have a decisive effect on the culture of the organization. Strategic planning, therefore, matters for its effect on organizational values, rituals, and ability to move the organization in new directions.