This issue sees the introduction of From the Officer’s Desk, a new bimonthly column aimed at EMS leaders.
Mr. Donovan, recently promoted to an executive EMS officer role, is now responsible for leading and managing a busy department. With his promotion he knows one of several key priorities will be to establish an organizational strategic plan.
The new chief understands that initiating new projects, realigning work groups, addressing department policies, and approving SOPs and SOGs are all important and need to be addressed, but first he must clearly define the organization’s purpose and direction.
So Chief Donovan gathers his senior leadership team and work group-level supervisors, along with some frontline district chiefs, EMTs, and paramedics, and creates a strategic planning team. His first priority is to ensure that all team members understand exactly what a strategic plan is, since for most it’s their first time participating in such a project. In addition he wants to review all the steps involved in developing a strategic plan framework and the actions to be taken as the plan is implemented.
Chief Donovan stresses during the first meeting that a strategic plan may take several months to complete. It will require a lot of work and time, he says, but once complete the plan will be extremely beneficial to the organization.
Once the team is established and understands its expectations and the reason for having a strategic plan, it will meet twice a week until the plan is completed. Chief Donovan is committed to the plan and the team and will be heavily engaged throughout the process, but he lets it be known that this will be everyone’s plan, not one driven by him exclusively.
What Is a Strategic Plan?
A strategic plan is essentially a road map designed to lead an organization from where it is to where it wants to be. It includes the organization’s mission and vision statements, values, and purpose. In addition the plan articulates goals and objectives, as well as strategies and tactics to achieve them. It determines benchmarks to help team members stay on course while executing the plan—for example, a strategic plan may include specific benchmarks at the one- or three-year mark or anywhere in between.
In addition, plans must be clearly articulated, concise, easy to follow, and shared with all team members. Functional work groups from sections within the organization may also create plans related to specific sections, but these must support the overall organizational strategic plan. The strategic plan is essential for organizational growth and created with the goal of improving core business activities.
Lastly, the strategic plan must be disseminated and posted where employees can refer to it and it can serve as guidance to help everyone understand their role in helping the organization move forward. This is a win for employees and leaders alike because the plan is always available to anyone and presents the leader’s message at all times. As leaders, how can we expect employees to know where their organization is headed and what’s expected of them if there’s no plan in place?
It’s important to note there’s no one set way to complete a corporate strategic plan. Organizations may choose to develop their own approach to and formal framework for it. However, the following approach has proven to be beneficial and easy to follow and has some key building blocks plans require.
During the initial meeting, the team leader must ensure team members understand their roles and what’s expected of them. In addition it’s important that the focus remain on the strategic plan and not veer off course. Once members are oriented, the team will begin reviewing and articulating the organization’s mission, vision, and purpose.
Second, they must spend time brainstorming about what needs change or improvement. As part of the brainstorming session, the team must look into each core business priority; for example, units within the organization can review their processes and systems and evaluate quality methodologies, performance outcomes, and financial objectives. This is a great opportunity for the strategic team to evaluate the organization’s current state and begin to chart a course toward its vision.
Third, the team will use a SWOT (strengths, weaknesses, opportunities, and threats) analysis as it moves toward the fourth phase of determining the organization’s goals, objectives, strategies, and tactics. Having a systematic approach will help keep the team focused and add value to the process.
The first step in putting the plan together is to determine if the organization’s purpose, which must be included within its mission statement, is clearly defined and articulated. The mission statement should clearly explain why the organization exists.
The team must also clearly express the organization’s vision statement, a vital component to any strategic plan that articulates what the organization aspires to be in the future. Once the team has a clear understanding of the organization’s mission and vision, it can proceed to the next phase: brainstorming.
The team must determine how the organization is currently performing in its core business activities and collect performance-metric data that shows it. If organizational leaders aren’t measuring performance outcomes, they won’t know what needs improving or how well the business is performing. An in-depth review of the following five business priorities may help cultivate key information or ideas that can be analyzed further:
People (internal and external stakeholders)—Is the organization doing everything possible to meet and exceed both internal and external customers’ expectations? What systems are in place to meet or exceed them? Do the internal stakeholders have the tools to get the job done? Are the organization’s employees engaged or disengaged? Does the organization conduct customer surveys?
Strategic objectives—Does the organization have a well-defined strategic plan, and are its objectives being met? Is the organization preparing to address changes in technology, markets, politics, and environment as part of its plan?
Financial objectives—Is the organization meeting its financial obligations? What budgetary constraints are present, and how are they worked around? Does the organization have enough money for capital purchases and improvements? Is there a plan to increase revenue and decrease spending by becoming a lean organization?
Learning objectives—Are employees encouraged to seek formal and/or continuing education through a tuition-reimbursement program? Do the employees have the training they need to do their jobs? Are you providing the training employees need? If not, are employees leaving the organization to seek better development opportunities?
Ensuring a culture of quality—Does the organization meet or exceed customer expectations? What are the most common errors identified by the quality management team? How often does the organization update its service-delivery system? Does the organization have a system in place to measure performance? Does it have a quality system in place—for example, Six Sigma, the Baldrige Excellence Framework, or ISO 9000, to name a few?
These bullet points may inform a broad approach that can prepare the team to dig deeper to determine where to focus improvement efforts. The information gathered here will be used during the next phase of creating a strategic plan.
After completing the brainstorming session and compiling information, the team can begin a SWOT analysis. When determining strengths and weaknesses, it must look inside the organization for answers. To discern opportunities and threats, the team will focus on external forces.
During the SWOT analysis the team leader will seek input from everyone to ensure all areas are analyzed and correlate with items identified during the brainstorming session. It is vital that the team seek input from other organizational members and review the organization’s performance outcomes prior to making any decisions. Essentially, core business activities that are fundamental to organizational sustainability must be discussed and evaluated. Team members can then focus on breaking these activities down further and begin to evaluate internal processes and opportunities for growth.
The team must make every effort to assess all possible business activities that impact the organization from both internal and external service-delivery and stakeholder perspectives. The idea in conducting a SWOT analysis is to determine the organization’s current strategic position and what goals must be established to ensure it moves in the right direction.
Once the SWOT analysis has been completed, the team must take the information gathered and begin to formulate goals. After the goals have been established (ideally no more than 3–5 at a time), they can be broken down into objectives that will be more specific. Once objectives are determined, the team will proceed to defining the strategies and tactics used to achieve them.
Goals and Objectives
Goals are commonly broad in scope and reflect an outcome the organization would like to achieve. Their timeframe for achievement is generally 1–3 years. When determining a goal, the team must ensure it’s SMART: specific, measurable, actionable, realistic, and time-bound—for example, “ambulance ED turnaround times must not exceed 15 minutes” or “EMS-to-balloon times will remain within nationally accepted guidelines.”
Objectives support the goal but are more specific and include measurable components. They must also reflect SMART characteristics. For example, “ambulance emergency department turnaround times will be less than 15 minutes 90% of the time” or “EMS-to-balloon times will be less than 90 minutes 100% of the time upon patient arrival at the hospital.”
Strategies and Tactics
Strategy is how an organization will accomplish the objectives set by the strategic plan team. For example, “crews will achieve an ambulance ED turnaround time of less than 15 minutes 90% of the time by offloading patients quickly and transferring care to the hospital staff immediately upon arrival” or “EMS-to-balloon times will be less than 90 minutes 100% of the time upon patient arrival at the hospital by having the EMS crew take the patient straight to the cardiac cath lab.”
Tactics are actions or tools used to execute a strategy. For example, “crews will achieve an ambulance ED turnaround time of less than 15 minutes 90% of the time by ensuring they notify the hospital of their ETA, having all necessary patient documentation ready for ED staff, and having one crew member stock the unit while the other completes the verbal report with the physician” or “EMS-to-balloon times will be less than 90 minutes 100% of the time upon patient arrival at the hospital through transmission to the hospital of a STEMI alert within 8 minutes of arriving on scene; transmission of a 12-lead EKG to the receiving facility within 5 minutes of arrival on scene; ensuring prehospital STEMI care has been completed according to protocol; and having the patient care report ready for the ED staff, all of which will expedite the EMS crew taking the patient straight to the cardiac cath lab.”
Once the team has created a formal document that clearly articulates the organization’s mission and vision statements, purpose, goals, objectives, strategies, and tactics, the group can begin disseminating the plan to the entire organization.
Implementation is an area where organizations often fall short. A plan is not complete until fully executed. It must be a living document, and every member of the organization must work collaboratively to ensure its success.
After implementation, the plan must be routinely monitored to ensure the organization is moving along as planned, the team is still on track to meet the strategic objectives, and the plan is still sustainable for the long run. Moreover, strategies must be fluid and adjustable to counter the internal and external business forces faced by the organization.
In summary, when working to develop a strategic plan, it is imperative to:
Meet with team members before, during, and after completion of the plan. The strategic plan must be a collaboration among all members of the organization.
Determine how often the plan will be evaluated after implementation.
Determine who will be responsible for monitoring performance outcomes and accomplishment of strategic objectives.
Never lose sight of the organization’s purpose and keep the strategy focused around it.
Compare performance outcomes to those of similar organizations.
A strategic plan must be a priority for organizational leaders. Look at it as a document created by change agents seeking to improve the organization’s business activities. The development of a strategic plan is a great opportunity to define the organization’s purpose and translate it into action.
Orlando J. Dominguez, Jr., MBA, RPM, is assistant chief of EMS for Brevard County Fire Rescue in Rockledge, Fla. He has more than 30 years of EMS experience and has served as a firefighter-paramedic, flight paramedic, field training officer, EMS educator, and division chief. He has authored two books, including EMS Supervisor: Principles and Practice, and is a certified Lean Six Sigma Green Belt. Follow him at @ems_officer.