Preparing for Strategic Planning & Business Planning

1. “How can you get to where you are going if you don’t know where you are?” Preparing for Strategic Planning & Business Planning Presented by Marsha J. Fountain, RN, MSN The Oncology Group, LLC

2. Learning Objectives • Know what information and data to collect • Know how and where to collect the information and data • Collect necessary information and data for strategic & business planning • Learn how to benchmark their information and data • Understand key strategic planning and business planning terminology • Learn how to write strategies, tactics and goals for program growth • Know how to interface with the planning people or consultants

3. Strategic PlanningYour Ticket to Your Destination • Where you are now • Where you are going • Mode of travel • Restrictions, if any • Departure time • Arrival time • Way-points Goals Strategies Vision

4. Business/Operational Planning: The Map and the Travel Details • The detailed travel map • Who is going with you • Short/long term goals • What you need along the way • How to fly the plane • How to keep process on track • Detailed financials • Contingency plans • Safety measures

5. What Information Do You Need for Strategic & Business Planning? • System Mission, Vision & Strategic Plan • System Financial Projections • System Priorities • Past & Current Organization Plans • Past & Current Cancer Program Plans • Past & Current Radiation Therapy Plans • National Trends Overview

6. Business Planning Terminology • Mission and Vision Statements • Strategies, Tactics and Goals • Action Plans • Implementation Plans • Budgets & Financial Projections • Organization Charts & Staffing Profiles • Equipment Inventories • Marketing Plans • Competitor Analyses

7. What Information Do You Need? • Market Share Analysis • Yours • Your competitors • Regional Tertiary/Quaternary Magnet Centers

8. Where Do Collect the Information? Market Share • Determine current market for your services • Based on population based cancer incidence from the State • Determine radiation therapy market (usually 60 – 65% of all cancer patients) • Determine your incidence and market share

9. Most Common Planning Errors • Looking at market share for inpatients • Most available data by hospitals • Not appropriate for cancer care as most care is outpatient • Assuming growing numbers mean growth in program • Being unrealistic in plans…need to base on hard decision points

10. Information Needed • Competitor Assessment • Market Share • Future Plans • Types of Equipment and Staffing

11. Where to Collect Competitor Information • Hospital/cancer program published annual reports • Web sites • City planning department • “jeans study” • Colleagues and friends

12. What to Collect about Competitors? • Analytic Case Volume • Breadth of program • Current Market Position • Clinical Research Participation • Points of Differentiation (such as stem cell program)

13. Is this your competitor or how your competitor sees you? NCI World Health Organization

14. Competitors • Equipment inventory • Inpatient care profile • Facility – profile, age, location, visibility • Mission / Vision / Goals • Patient volume statistics • Physicians – qualifications, reputation • Overall reputation, community good will

15. What Information Do You Need and Where to Collect for Your Facility? • Treatment Volumes – From department • By Site • By Procedure • Visits per Day • Types of Treatments • Payor Mix – From Finance • Staffing Profile

16. What Information Do You Need? • Referral Sources and Related Volumes • Revenues Analysis • By Procedure • By Site • Cost analysis • Financial Resources Assumptions • Capital Budgets • Philanthropy

17. Case Study A: Market Share Data

18. Case Study B – Market Share

19. Case Study B - Market Share • Treatments increased by 4% over 5 years • Population increased by 2% over 5 years • Assumption – We are gaining market share HOWEVER… • Population was aging significantly and cancer cases actually grew by 7.7%

20. Case Study B – Market Share

21. Case Study C – Referral Patterns • Patient referrals continue to grow HOWEVER… • With review, most cases come from 2 physicians – 1 surgeon & 1 medical oncologist • Surgeon responsible for 22% of all patients • 1 Medical Oncologist responsible for 25% of all patients

22. Problem? • Surgeon is being wooed by competitor • Medical Oncologist is retiring • How will you recover?

23. Typical referral patterns

24. Positioning • Need to understand where you want to position yourself • Equal to other providers? • Community leader in oncology care? • Regional referral center? • All affect strategies and tactics

25. Positioning Reis and Trout stated in “Positioning: The Battle for your Mind” • Minds are limited. To cope with the explosion of information and choices, people have learned to rank products and brands in their mind. • Minds hate confusion. People resist that which is confusing, and cherish that which is simple. They want to push a button and watch it work.

26. Positioning • Minds are insecure. Minds tend to be emotional, not rational. People buy what others buy; people follow the herd; they will often look to others to help them decide how to act; heritage and culture sway buying decisions. • Minds don’t change. People have attitudes on a wide range of issues. They seem to know what they like (and especially dislike) even regarding [issues] about which they know little. Perception is reality. Don’t get confused by the facts. • Minds can lose focus. Specialist “brands” make a huge impression on the mind.

27. SROA ASTRO ACR JCAHO MGMA ASCO ACE ACCC Consultants Benchmarking Your Data Data without benchmarking is similar to spending without a budget. Sources for national benchmarks

28. Departmental volumes Treatments per machine Treatments per patient Types of cancers treated Mix to treatments Financials Collection Percentage Margin Payor Mix Staffing Mix and numbers Referrals By Specialty Research Patients Technology Areas for Benchmarking

29. Strategic Planning Terminology • Mission • Vision • Strategies • Tactics • Goals • Action Plans • Implementation Plan

30. What is a Mission Statement? • Your purpose or reason for being • Usually a one-liner • Customer-focused • Tells the customer “What’s In It for You!” • Begs the question, “How do you do that?” • Answers the question, “Why are you doing this or that?” • Easy to remember

31. Difference between Vision & Mission • A vision is WHAT you want to become while a • A mission is WHY you want to become it

32. System & Service Line Missions • System Missions cover the waterfront of what all programs combined are trying to accomplish • Service Line Missions present what is their contribution to the System Mission • Service Line Missions usually mirror System Mission language to emphasize the tie-in

33. Sample Mission Statements – The WHY • To improve the health of all people in the communities we serve • To eliminate cancer. Achieving that goal begins with integrated programs in cancer treatment, clinical trials, education programs and cancer prevention. • Our mission -- the progressive control and cure of cancer through programs of patient care, research and education • Our mission is to provide a confluence of groundbreaking biomedical and clinical research, high quality educational programs, outstanding patient care to the entire Metropolitan Washington area, and effective outreach for our community.

34. Sample Mission Statements • To meet the challenges of cancer and associated treatments, enhancing the wellness and quality of life for the patient and the family. • To provide quality care to our patients in a sensitive, respectful and compassionate manner. • To provide Radiation Therapy Services to improve the wellness of our patients. • The mission of the Cancer Center is to provide a comprehensive range of oncology services to the people we serve.

35. What is a Vision Statement? • Conditions that will exist at a defined point in the future • Internally-focused • Usually several paragraphs to a page long • Usually denotes important/major changes • Tends to establish clear priorities for entity • Remember key words rather than the whole Vision Statement

36. Vision Statements • Remember, a vision statement should be bold. • And finally, a bit of Southern folk wisdom, "There are only two things in the middle of the road, yellow lines, and dead possums."

37. V • “Be fruitful and multiply." • "We the people of the United States, in order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.“ • "To explore strange new worlds, to seek out new life and new civilizations, to boldly go where no man has gone before." USS Enterprise, Federation Starship

38. System & Service Line Visions • Should show symmetry • Service line vision statements show clearly tie into the system or organization vision • Service line vision statements often use much of the same language but customize it to the oncology service line specifics • Senior management should be able to immediately understand how the service line vision supports the overall organization vision

39. Corporate Visions – the WHAT • We will be the leading healthcare company by • providing the best products and services for our customers around the world, • consistently emphasizing innovation, • operational excellence and the highest quality in everything we do. Baxter Healthcare Corporation. • To attain international leadership in the healthcare field. To provide excellence in healthcare. To improve the standards of healthcare in communities in which we operate. To provide superior facilities and needed services to enable physicians to best serve the needs of their patients. • Mayo will provide the best care to every patient every day through integrated clinical practice, education and research.

40. Sample Vision Statements – The WHAT • A team of dedicated healthcare professionals reaching out to the West Oahu Community to care for its members with compassion, respect and medical excellence. • A premier academic radiation oncology department committed to reducing the burden of human cancer. • Leading Cancer Care through… • A comprehensive cancer control system, including: prevention, early detection, diagnosis, treatment, and supportive care • The delivery of high quality, accessible, multi-disciplinary care • A network of partners • The recruitment and retention of a highly skilled & compassionate cancer care team • An outstanding program of research and education

41. Sample Vision Statements • XYZ Cancer Program will: • be recognized as the best cancer program in Southeast Wisconsin • be the patients’ and physicians’ first choice for cancer care • be a superb cancer program providing high quality, evidence-based care • have effective integration of the oncology providers with all elements in the cancer care continuum • foster pride in the caregivers who deliver services to our patients and their families

42. Reality Check forStrategies and Tactics!

43. 3 Criteria for Decision Making • We want to do it – more, we’re passionate about it. • We can do it – we have the competencies, capabilities and resources to do it, or we can get them in time. • The market will support us – service level demand, financial support, etc.

44. Decision Making In order to achieve our goals: • At What Processes Must We Excel? • What People, Systems, Structures, Technologies, Etc. Will Be Required? • What Actions Do We Need To Initiate To Move Forward? When? Who’s Accountabilities?

45. What is a “Strategy”? • A major change to the current conditions or projected conditions in the marketplace • A major change in direction, resources, products or services • A change that will improve current advantages or provide sustainable competitive advantage

46. Sample Strategies • Expand into new geographic markets • Add new services to fill out continuum • Build a new, larger, full service facility • Reposition/differentiate the service line • Reorganize with new admin/phys leadership • Joint venture between hospital/physicians

47. What is a “Tactic”? • A refinement of a strategy • Provides clarity to the direction that a strategy will take • Shows a stream of logic or intent in how a strategy will work for a given organization • Provides one example of how the strategy will be implemented – but it can easily be modified depending on the environment

48. What is a “Goal”? • It is a major step toward implementing the mission, vision and strategies or tactics • States the end condition you want to exist • Give a measurable outcome or target • Tells you when it must be completed • Indicates who has primary accountability

49. 2 Sample Strategy, Tactics and Goals

50. Sample Goal • The CEO and Medical Director will hire a cancer program director by January 2006 • End condition: director has been hired • Measure: person is on board • Time frame: January 2006 • Accountability: CEO & Medical Director