Strategic Planning in Health Services

January 26, 2001

Winter 1997
Class Meetings: Monday, 6:40 – 9:20 p.m., Lincoln Hall 205
Associate Professor of Public Health
Departments of Public Administration and Public Health Education
Office: Room 237, School of Urban and Public Affairs
Office Hours: Monday, 4:30 – 5:30: Tuesday, 2:30 – 3:30 Or by appointment.

Course Description
This course introduces general concepts, models and theories of strategic planning, and develops them in terms of applications in the health services industry. Through participation in a community-based strategic planning process, students will gain experience and some expertise in the planning, decision-making and conduct of strategic planning.

There are no formal prerequisites for this course. However, students are strongly encouraged to have taken PA 570: Health Administration or PA 510: Health Systems Organization prior to taking this class, as certain knowledge related to the delivery of health services acquired in these classes will be assumed for all students as a baseline of understanding. If you have not successfully completed either of these classes, please discuss this with me within the first week of the quarter. Certain work experience may be appropriate to provide the necessary baseline knowledge.

Learning Objectives
The learning objectives for each student to achieve by the completion of this class are:

-to understand basic concepts, models and theories of strategic planning:
-to apply these concepts, models and theories to health services delivery and gain an understanding of special applications to the health services industry:
-to develop proficiency in the application of these concepts, models and theories through participation in a community-based strategic planning project;
-to develop skills in working with a community partner to define and meet their needs with respect to the planning project;
-to develop or enhance skills in interviewing, synthesis of findings, and presentation of recommendations;
-to reflect on the role of community service in achieving professional goals;
-to develop or improve skills in working and learning in groups.

Methods of Evaluation
There will be multiple methods of evaluation that will determine both your course grade and the evaluation of the course itself.

1. Evaluation of Students
The course grade will be determined as follows:

Short assignments 40%
Group project and presentation 40%
Class participation and reflective journal 20%

2. Evaluation of Course and Professor
I am eager to receive your feedback on the class, and I will conduct brief process evaluations periodically throughout the class to solicit your input. On the basis of your comments, we will make "mid-course corrections" as necessary to ensure that the class meets your needs and is responsive to your suggestions, while still fulfilling the course objectives set out above.

As well, a final evaluation of the course and the professor will be conducted during the last class session. At the conclusion of the course, students will be asked to determine the extent to which they have accomplished each of the specified learning objectives in their own learning.

Required and Supplemental Readings
The required textbook for this course, available at the PSU bookstore is:

John M. Bryson. Strategic Planning for Public and Nonprofit Organizations: A Guide to Strengthening and Sustaining Organizational Achievement. Revised Edition. San Francisco: Jossey-Bass Inc.' Publishers, 1995.

You may also wish to purchase the workbook to accompany the text; this is available at the PSU bookstore and is optional:

John M. Bryson and Farnum K. Alston. Creating and Implementing Your Strategic Plan: A Workbook for Public and Nonprofit Organizations. San Francisco,: Jossey-Bass Inc., Publishers, 1998.

You are also expected to obtain a copy of the Oregon Benchmarks if you do not already have one. These are available by calling 502-8969 to request a copy.

One other book will be used extensively to supplement lecture material. You are not required to buy this book, but may wish to use it from, time to time for reference:

Henry Mintzberg. The Rise and Fall of Strategic Planning. New York The Free Press, 1 994.

Finally, a list of useful "core" books on strategic planning, is appended to this syllabus. You are encouraged to reference these hooks for additional information and relevant examples.

Description of Major Assignments

1. Short Assignments (40% of course grade)
There will be two short assignments to address material covered in the readings and in class. The first will focus on material covered in class to date, primarily drawing on the Bryson book and other material discussed in class. The assignment will be handed out in class on Januarv27, and will be due at the beginning of class on February 3. It will be returned on February 10. The second assignment will involve a structured critique of an article describing a strategic planning process. The assignment will be handed out in class on February 17, and will be due at the beginning of class on February 24. It will be returned on March 3.

The first assignment will be a focused critique of material covered to date; you will be asked to respond to specific questions, using course readings and class notes. No additional research will be required. The second assignment will involve choosing one of a set of specified articles to critique, and then following an assigned format for the analysis. It will involve choosing the article you wish to critique and obtaining a copy of the article (from either the PSU or OHSU libraries), and then drawing upon course readings and class notes to complete the assignment. Each assignment response should be typed, double-spaced using a 10 or 12 point font, proofread for spelling and grammar, and 4-5 pages in length. Late assignments will result in marks being deducted. Each assignment is worth 20~c of the course grade.

2. Group Project (40% of course grade)
For this course this year, we will be working with Legacy Health Systems as our primary community partner, and through its office of Community Programs we will assist a number of community-based agencies loosely affiliated with Legacy. There are over 25 of these agencies which have an affiliation with the Legacy system, and are housed on one of their campuses. The goal of this project is to help to plan a process for assessing the effectiveness of Legacy's partnerships with these organizations. This process will provide information which will help the organizations and Legacy itself in determining the nature and scope of their continuing affiliations. You will work with your partner organization to determine their specific goals depending on their mission and needs, and within the context of their current affiliation with Legacy.

The class members will form teams of two or three, and in the second class session you will choose the organization you will work with. One team will work directly with Legacy's Director of Community Programs to plan the corporate-level project, while all others will work with a specific community-based organization. The available organizations will be described in class on January 6, you will have the opportunity to identify your working partner and your preferences for organization, and group assignments will be made by the professor and handed out in class on January 13. This group project will provide an opportunity to apply material covered in a class to an actual strategic planning project. It also provides an opportunity to provide service to a community partner and to reflect on this service as part of your professional activities.

Each class group will determine the process to be used in completing this project, develop interview questions for key informants (or other mechanisms for information collection), prepare a standardized interview protocol, conduct key informant interviews, and as appropriate prepare documentation to assist the community partner in its planning. You will have the opportunity to discuss your group's process in class on a number of occasions. You will probably need to meet with the community partner at least three times: at the beginning of the project to obtain baseline information, during your work to verify progress and obtain additional information, and at the end of the project to present your findings. You will then need to review your findings, synthesize them, and prepare 2 products: a group presentation to the class and a group paper.

The 40% of course grade will be allocated as follows: 15% for the group presentation, and 25% for the group paper. Presentations will be made in class on March 3 and March 10. Each presentation will be 15 minutes in length, followed by 15 minutes of discussion. Presentations should address the focus of the group and identify the organization assisted in the process, review the planning process used by the group, identify individuals interviewed, present key themes emerging from the interviews, outline the content of the group's findings, and make recommendations for the organization for next steps in planning. A particular emphasis should be given to how the individual plan will fit into the overall plan to accomplish the goal of this project. Group members will complete a confidential peer evaluation for 5%, and 10% will be an evaluation of the group presentation as a whole by the professor (all students in a group will receive the same value out of the 10%).

Papers are due in my office by 4:00 p.m. on Thursday, March 13. One paper will be submitted for the entire group, and all group members will receive the same grade. The paper should be typed, double-spaced using a 10 or 12 point font, proofread for spelling and grammar, and no more than 20 pages in length (not including appendices). The paper should be a narrative expanding material covered in the presentation. References should be used as appropriate, but the majority of information will be derived from data collection and class content. Each student will also be expected to write a one to two page statement reflecting on their own experience in this project providing community service h~ the context of academic and professional responsibilities; these reflection statements should also be appended to the group paper.

3. Class Participation and Reflective Journal (20% of course grade)
Twenty percent of the grade will be allocated to class participation and the completion of a reflective journal. The class participation component includes preparation for each class session, active participation in discussions, and general involvement in class activities. Participation in the class sessions is an important part of your learning — to reflect on the reading and thinking you are doing related to the course content, to engage in discussions with your classmates and professor, and to ask questions and seek answers from all participants in the class.

The reflective journal is intended to provide you with additional opportunities to consider how community-based learning experiences shape your own learning as well as contribute to your personal and professional development. Three journals will be submitted, on January 22, February 10, and March 3. Each journal entry should be between two and four pages in length, and should be typed and proofread. Specific guidance about the focus of the journal will be provided in class. The journal entries themselves will not be graded; rather, the development of reflective skills as evidenced in the journal will contribute to the grade for class participation.

We will also do group reflection as a class in the final two sessions. These will facilitate discussions about your own observations on community-based learning as well as considering the role of planning in health services in the future based on your experiences in the community.

You are expected to attend all class sessions; the proportion of course grade allocated to class participation will reflect your level of participation and demonstrated learning. Readings listed for each session should be completed before that session so that you may draw upon them in the class discussions. If you must miss a class, please let me know in advance so that we may discuss how you may catch up on missed material.

A course syllabus can be considered as a contract between the professor and the students. This syllabus includes all expectations for performance in the class, and you should now understand what is required of you, and the deadlines for assignments. If you have questions about any of these expectations I encourage you to discuss them with me sooner rather than later. Any changes in the course requirements or schedule will be communicated in class. I will try to be accommodating of personal crises that affect attendance or submission of assignments in terms of working out suitable and fair arrangements for grading but also wish to be fair to all students in the class.

Course Schedule
The following is a schedule of class topics readings and assignments. All readings are from the required textbook.

January 6
Course overview
The nature of planning
Definitions of strategic planning
Overview of group projects

January 13
Models of the strategic planning process
READ: Chapters 1 and 2 Resource D
Getting started with planning
Clarifying missions and mandates
Establish working groups and determine group process

January 20 No class; Martin Luther King holiday: Journal due to my office by Wednesday, January 22nd 6:00 p.m.

January 27
Leadership roles
Environmental assessment
Assumptions about planning
READ: Chapter 3 4 5 Resource A
Assignment #I handed out; Journal # I returned

February 3
Identification of strategic issues
Stakeholder management
READ: Chapter 6 11 Resource B
Assignment # 1 due

February 10
Formulating strategies and plans to manage and respond to the issues
Challenges to the planning process
READ: Chapter 7 Resource C
Journal #2 due
Assignment #l returned

February 17 Establishing a vision Linking planning and improvement efforts READ: Chapter8 Resource E Assignment #2 handed out Journal #2 returned
February 24
Overcoming barriers to strategic planning
Relating planning to daily work
Pitfalls in strategic planning
Implementation of plans
Next steps after the plan is adopted
Assignment #2 due
READ: Chapter 9

March 3
Group presentations
Group reflection: Is there a future for planning in health services?
Assignment #2 returned
Journal #3 due

March 10
Group presentations
Group reflection: Is there a future for me in health services planning as a career direction?
Course evaluation
Journal #3 returned

Group papers are due in my office by 4:00 p.m. on Thursday, March 11th. Graded papers and final marks will be available after March 19th.

Supplemental Books on Strategic Planning,
This is an introductory list of books; many other fine works exist which you may also find useful for reference purposes.

Duncan, W. Jack, Peter M. Ginter and Linda E. Swayne. Strategic Management of Health Care Organizations. Second edition. Cambridge, MA: Blackwell Publishers, l990.

Hyman, Herbert Harvey. Health Planning: A Systematic Approach. Rockville, MD: Aspen Systems Corporation, 1982.

Nutt, Paul C. Planning Methods for Health and Related Organizations. New York: John Wiley & Sons, Inc., 1984.

Quinn, James Brian, Henry Mintzberg and Robert M. James. The Strategy Process: Concepts. Contexts and Cases. Englewood Cliffs' NJ: Prentice Hall, 1988.

Shorteil, Stephen M., Ellen M. Morrison and Bernard Friedman. Strategic Choices for America's Hospitals: Managing Change in Turbulent Times. San Francisco: Jossey-Bass Inc., Publishers, 1990.

School: Portland State University
Professor: Sherril B. Gelmon, Dr.P.H.
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