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The Link Between Critical Planning Issues and Vision

We recently received the following question from an attendee during our ACHE Cluster session, Strategic Planning from Formulation to Action, in Phoenix:

What is the link between the critical planning issues established in the environmental assessment and the vision established in the organizational direction phase of the strategic planning process?

In order to best address this question, it is helpful to start with a common set of definitions.  For the purposes of strategic planning, the critical issues are defined as the highest priority strategic issues for the organization to tackle over the next three to five years.  The vision describes the desired future state – what the organization wants to be in the next five to 10-plus years.  The most important link between the two is that the critical issues must be central to achievement of the vision, and therefore these strategic issues cannot be addressed easily or in the near-term.

As is described in more detail below, a preliminary set of critical issues emerge from the first phase of the strategic planning process – the environmental assessment, whereas the vision is crafted in the second phase of the strategic planning process – organizational direction.  A crucial characteristic about the strategic planning process generally is that it is dynamic and not linear.  So, while these two components emerge in different phases of the planning cycle, it is important to build two-way bridges from each planning phase to the next, using this bridge to go back and test the preliminary set of critical issues against the vision, and then refining or revising as appropriate, before proceeding into strategy formulation.

Moving on to the specifics of critical issues.  First, they are the last of the three outcomes derived from the environmental assessment.  They are the product of the other two environmental assessment outcomes: a) a comprehensive SWOT analysis and b) development of a complete set of future environmental assumptions.  Critical issues emerge from the SWOT summary of competitive advantages and disadvantages and are refined by educated speculation of the most impactful trends and changes that will define or redefine your market and/or industry in the next five years.  Critical issues are critical for a reason – they must be central to the future of the organization’s sustainability and success.  Stated another way, it must be demonstrable that addressing the identified issues will in fact move the organization closer to the vision.

To this end, critical issues need to be explained and an appropriate context provided.  For example, “quality” is not a critical issue because it provides no context as to the current organizational performance and position on quality, nor the assumptions about why quality will be important, nor any evidence that quality will support vision achievement.  However, “demonstrated clinical quality, as defined by objective CMS process and outcomes metrics, is core to improving our regional competitive position and exemplifies readiness to thrive under value-based contracts incentives,  both of  which will contribute to our vision of becoming the leading population health manager”, does provide context, incorporates future assumptions and ties directly to the vision.

How does your organization reconcile its strategic priorities (critical planning issues) with its overall direction (vision)?