MMHA 6999 Week 10 Three-Year Strategic Plan Example

Objectives That Could Fail, and a Review Date in the Document: Juniper Valley Health's Three-Year Strategic Plan

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Walden University

MMHA 6999: Strategic Leadership Management

Instructor Name

Month Day, Year

Objectives That Could Fail, and a Review Date in the Document: Juniper Valley Health's Three-Year Strategic Plan

How This Plan Differs

Strategic plans in health care often contain objectives no measure could disprove, such as "enhance community health," and no date by which anyone will check. Juniper Valley's plan, written for the invented rural system this capstone follows, keeps two rules. Every objective carries at least one measure that could show it has failed, with a threshold stated now. And the document fixes its own review date, so that the board cannot quietly let the plan lapse.

The plan rests on the work of the capstone: the environmental scan's shortlist of pressures, the position assessment's finding that the system's strengths lie in rural access, the decision to consolidate births with four protective commitments, the resourcing plan and the lessons of the county seat urgent care case.

Strategic Position

Juniper Valley Health will be the provider that is present where others are not: emergency care in every county it serves, an integrated primary care network and specialist support delivered at a distance. It will not compete on high-technology specialty services in the county seat. Porter (1996) located strategy in the trade-offs an organization is willing to make. The system's trade-offs are explicit: it declines a second surgical robot, a county seat office building and a duplicate urgent care, and it concentrates births where they can be staffed safely.

Objectives and Measures

Table 1

Objectives, Measures and Failure Thresholds

Every objective can fail visibly. If a failure threshold is crossed, the plan requires a board review of that objective within ninety days.

Why Failure Thresholds

Kaplan and Norton (1992) urged executives to stop steering by financial results alone and to read a short, balanced panel of indicators, a discipline this plan borrows for a rural health system's board. This plan follows that logic but adds a stricter requirement: each measure must be capable of showing failure. A target tells leaders what to aim for; a failure threshold tells them when to stop and reconsider. Without thresholds, poor results tend to be explained away one quarter at a time.

The leadership case on the county seat urgent care showed what happens without an exit rule. The center lost money for eighteen months partly because nobody had agreed beforehand on a visit count below which it would shut. Each objective here has that kind of rule.

Deliberate and Emergent Strategy

Not everything in three years can be planned. Mintzberg and Waters (1985) showed that realized strategy combines deliberate intentions with emergent patterns that form as organizations respond to events. The plan therefore reserves capacity for emergent choices, such as the rural emergency hospital decision at Stone Fork, and requires that any major new commitment be tested against the strategic position: does it strengthen presence where others are not, or does it imitate a competitor?

What the Plan Asks of Leaders

The plan asks three things of the executive team. First, to report failure as readily as success, including bringing a crossed threshold to the board before it is asked. Second, to test any new proposal against the strategic position before it reaches the budget, so that the board does not see another urgent care built to imitate a competitor. Third, to keep the commitments made to Alder Creek families even when pressure on the budget rises, in the order the resourcing plan set. These behaviors cannot be written into a measure, but the board can ask about them at every review.

Resources

The plan is funded within the current capital and operating budgets, using savings from consolidation for the four obstetric commitments and redirecting the declined projects' capital toward emergency readiness and clinic technology. The resourcing plan's protection order applies: if funds shrink, emergency obstetric readiness and the nurse navigator are protected first.

Governance and Review

The board strategy committee will review progress on every measure twice a year. The full plan will be reviewed by the board on the first regular meeting date after thirty-six months from adoption, which the board secretary will enter on the calendar at adoption. At that review, the board must either renew, revise or replace the plan; it may not extend it without review.

Risks

The main risk is that external shocks, such as Medicaid payment cuts, push the system off course. The financial objective's failure threshold of 60 days of cash would trigger review. A second risk is that the obstetric consolidation produces worse outcomes than expected; the plan's safety thresholds are set to catch that early. Rural counties losing obstetric services have seen more births outside hospitals (Kozhimannil et al., 2018), which is why the first objective is measured so closely.

Conclusion

This plan commits Juniper Valley Health to a clear position, presence where others are not, and to six objectives that can each be seen to fail. It fixes its own review date and ties its resources to its choices. Because this plan is able to fail in public, it is useful: when results arrive, leaders will know whether the strategy is working.

References

Kaplan, R. S., & Norton, D. P. (1992). The balanced scorecard: Measures that drive performance. Harvard Business Review, 70(1), 71-79.

Kozhimannil, K. B., Hung, P., Henning-Smith, C., Casey, M. M., & Prasad, S. (2018). Association between loss of hospital-based obstetric services and birth outcomes in rural counties in the United States. JAMA, 319(12), 1239-1247. https://doi.org/10.1001/jama.2018.1830

Mintzberg, H., & Waters, J. A. (1985). Of strategies, deliberate and emergent. Strategic Management Journal, 6(3), 257-272. https://doi.org/10.1002/smj.4250060306

Porter, M. E. (1996). What is strategy? Harvard Business Review, 74(6), 61-78.