Question

Can you explain to me what the characteristics of goal writing and setting as related to strategic planning for health IT?

Answer 1

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Answer:

INTRODUCTION

Every organization, regardless what type or size, should have a strategic plan in place.

Strategic planning is an organization's process of defining its strategic direction and making decisions about how to allocate its resources to pursue that direction.

In order to determine the direction of the organization, it is necessary to understand its current position and the possible avenues through which it can pursue a particular course of action.

Purpose of Strategic Planning

The purpose of strategic planning is to help an organization establish priorities to better meet its mission. Strategic planning allows an organization to collaboratively align with its mission in a high-quality, meaningful way in order to create a strategic vision of what the organization is, what it wants to be, and how it can change with times.

In short, strategic planning helps an organization project its desired future. An organization’s mission is its purpose and reason for being. It serves as a guiding light.

It has no timeframe. If crafted correctly, it can remain the same for decades.

An organization’s strategic vision is an image of the future that the organization seeks to create. It is a graphic statement of what the organization wants to be and how it will get there.

The strategic vision should reach beyond the organization’s current grasp. Yet, it should be concrete enough that the organization can use it to take action.

The strategic vision should be revisited regularly.

Characteristics of an Effective Planning Process

An effective strategic planning process should not be rushed. The planning process could be simple, but it must also be practical. It should:

• Result in a flexible, sustainable and integrated strategic vision framework for the years ahead.
• Develop a defined list of strategic goals and objectives, as well as initiatives to position the organization for the near-term and long-term.
• Be an inclusive, collaborative and outside-in exploration and decision-making process.
• Generate high-impact strategic vision, goals and objectives to which the team is strongly committed and aligned.
• Illustrate the organization’s strategic vision and objectives through data-driven strategic business plans.

very strategic planning process is uniquely designed to meet a specific need. Good strategic planning develops through an outside-in process, during which the organization moves from “divergence” to “convergence.”

Divergence includes the following:

• An external environmental scan, which identifies trends and uncertainties, as well as external forces of change.
• An analysis of market groups, customer characteristics and competitive structures that includes benchmarking of the organization’s key competitive capabilities.
• An “as is” assessment of the organization’s current competencies/strengths, culture and values.
• Articulation of key success factors and opportunities/capabilities required to help the organization bridge gaps and become a successful, high-quality service provider to the targeted population in the future.

Divergence is followed by convergence, a process that includes:

• Generating a strategic vision for the future, as well as near-term, mid-term, and long-term strategic options to achieve that vision.
• Synthesizing and clarifying the organization’s direction by identifying strategic initiatives that provide a framework for moving forward.
• Developing a detailed business plan for each initiative. These business plans should estimate the magnitude of the economic opportunity, resources, investment and timeframe required to execute the strategic initiative.
• Prioritize and approve the strategic initiatives. Identify resource investments and integrate these investments into the organization’s operating and capital budgeting processes.

Linking Technology with the Strategic Plan

How does an organization go about linking technology with the strategic plan and business operations goals?

Here are some key steps:

• Establish clear objectives and define the role of technology for the organization. Does the organization want technology to be just a utility-like service with a short-term value? Does it want technology to enable business opportunities that add value to its services over the long term? Or does the organization want technology to be an integral part of its business success and long-term strategic planning?
  Begin this discussion by conducting some initial benchmarking of your technology strategies and spending levels with peers that are leaders in technology adoption.
• Articulate a “future state” technology vision. This vision should be aligned with your strategic plan and should map out which technology areas need to mature in order for your organization to reach its desired “future state.” Those areas might include infrastructure (data, voice and networks); applications (clinical, financial, service and administrative); and training.
  For example, replacing current applications could provide an opportunity to re-evaluate, standardize and redesign clinical, financial, service and administrative processes to take advantage of the technology’s capabilities. In addition, training should become part of the organization’s culture as it prepares the workforce for change.
• Identify IT process/services and IT governance. You may want to identify a professional organization to select, implement and maintain your complex portfolio of technology solutions.
  In addition, decide on the process you will use to make informed decisions and assure the disciplined, effective and efficient implementation of your technology investments, direction and utilization. It is very important that the organization’s board/governing body is committed to making required IT investments.
• Assess gaps in technology. Thoroughly evaluate the organization’s current state of technology and the gaps that exist between this current state and the organization’s desired “future state.”
• Identify strategic options for filling the gaps. Make a qualitative assessment of these gaps using specific criteria. Those criteria might include your desire to:
  • Provide strong support for unmet user needs
  • Assume minimum risk.
  • Achieve a reasonable time-to-value ratio.
  • Experience minimum conversion trauma.
  • Incur the lowest possible cost.
• Select your best options and outline implementation projects. Estimate onetime and ongoing costs. Map projects over a multiyear timeframe with the understanding that investment budgets and decisions would come in multiple “leaps.”
  • Foundational.
  • Operational excellence.
  • Innovation.
• Set guidelines for software initiatives. Broadly define your guidelines for building software initiatives internally or buying them externally. Factors influencing this decision:
  For example, it’s necessary to build a foundational infrastructure (Leap 1) before investing in operational excellence (Leap 2) or implementing technology innovations to differentiate yourself in the market (Leap 3). Your 4-year technology roadmap should be organized into 3 leaps:
  For software solutions, you’ll need guidelines to help you determine if the system should be housed in the organization’s internal data environment or a web-hosted (cloud) environment. A number of factors will influence this decision, including:

• Staff capabilities.
• Customization needs.
• Development vs. procurement costs.
• Implementation timeframe.
• Support needs.
• Maintenance costs.
• 1.The stability of internal environment.
• The criticality of the application.
• The redundancy and stability of Internet data lines.
• Measure the benefit. The governing board should have a comprehensive discussion about how to measure the benefit of technology investments. Numerous studies identify three factors that are needed to realize economic value from technology:
  • IT should not be an end in itself. Instead, it should enable strategic goals and objectives.
  • Technology must have an added value. It should not be pursued if the organization’s strategic goals can be achieved in an unplugged, paper-based environment without such added value.
  • It is critical to measure strategic goals and objectives before and after technology deployment and to hold management accountable for results.

Most aging services organizations engage an outside consulting firm/consultant to lead them through the eight steps described above.

Providers are advised to engage firms that have strong IT expertise, knowledge about aging services, and a track record in long-term and post-acute care.

CHARACTERISTICS OF GOAL WRITING AND SETTING:

Many organizations recognize the importance of S.M.A.R.T. goals. The acronym can take on many meanings to fit specific organizations’ needs.

Here are a few suggestions from Visioning, Goal Setting, and Strategic Planning for EHR and HIE, a toolkit from Stratis Health that was developed for Aging Services of Minnesota:

• Specific: Goals should identify who, what, where, when and why. They should be well defined and clear to anyone who has a basic knowledge of how the organization works. Some experts suggest that the goals also need to be Significant enough to make the investment in achieving the goal and that they should Stretch the organization to continuously strive for improvement.
• Measurable: Goals should answer the questions “how much?” and “how many?” That way, you can determine when a goal has been accomplished. To be measurable, goals must contain specific Metrics, be Meaningful, and be Motivational.
• Attainable and Agreed upon: The “A” in S.M.A.R.T. can refer to the need to develop attitudes and abilities to reach goals. However, it’s also critical to gain consensus on Acceptable goals and commit to Achieving those goals.
• Realistic, Relevant, Reasonable, Rewarding and Result-oriented: Goals must reflect the availability of resources, knowledge and time so they can be achieved.
• Timely, Tangible and Trackable: Devote time necessary to acquire and learn to use health IT to achieve goals. Once you’ve determined what time is adequate, assign target dates to key deliverables so the project has a sense of urgency as well as a transparent way to track progress toward meeting goals.

GOAL SETTING

Goal-setting is fundamental to organisational management, yet not every manager knows how to do it well. A narrative literature review was done to explore current knowledge of definitions and classifications of goals, and principles of goal-setting in the healthcare sector. Online databases generated 65 relevant articles. Additional literature sources were snowballed from referenced articles, and textbooks. Most academic authors define ‘goal’ synonymously as ‘aim’ or ‘objective’, but there is evidence of hermeneutical confusion in general literature. Goal classifications are diverse, differing according to their contextual, structural, functional, and temporal characteristics. Many authors agree that goal-setting is problem-based, change-oriented, and can effectively motivate attainment if the goal statement is formulated with a specific and challenging or SMART framework. However, recent authors report varying definitions for SMART, and evidence of past studies that empirically examined the nature and efficacy of frameworks currently used for formulating goal statements for health programmes are lacking.

Initial theoretical statements regarding goal setting were made to determine how levels of intended achievement related to the actual levels of achievement (Locke, 1990). The goal-setting framework developed further provision that when an individual has specific goals to meet, their performance is more pronounced than in the absence of specifics. That is, setting clearly defined goals leads to better performance.

By the 1990’s the research into goal setting culminated in the theory of goal setting and task performance in which 5 key principles for successful goal achievement were suggested (Locke & Latham, 1990).

1. Commitment

Commitment refers to the degree to which an individual is attached to the goal and their determination to reach it – even when faced with obstacles. According to Locke & Latham (1990), goal performance is strongest when people are committed, and even more so when said goals are difficult. Given the commitment to a goal, if an individual discovers their performance is below that which is required, they are likely to increase their effort or change their strategy in order to attain it (Latham & Locke, 2006).

When we are less committed to goals – particularly more challenging goals – we increase the likelihood of giving up. In the presence of strong commitment, there is a significant association between goals and performance; we are more likely to do what we intend to do. (Latham & Locke, 1991).

According to Miner (2005), a number of factors can influence our commitment levels. Namely, the perceived desirability of a goal and the perceived ability of achieving it. Whether you are setting a goal for yourself or for others, in order to be successful you must possess the desire and a comprehensive understanding of what is required to achieve it.

2. Clarity

Specific goals put you on a direct course. When a goal is vague, it has limited motivational value. Research by Arvey, Dewhirst & Boling (1976) indicated that goal clarity was positively related to overall motivation and satisfaction in the workplace.

Set clear, precise and unambiguous goals that are implicit and can be measured. When a goal is clear in your mind, you have an improved understanding of the task at hand. You know exactly what is required and the resulting success is a further source of motivation.

3. Challenging

Goals must be challenging yet attainable. Challenging goals can improve performance through increased self-satisfaction, and the motivation to find suitable strategies to push our skills to the limit (Locke & Latham, 1990). Conversely, goals that are not within our ability level will not be achieved, leading to feelings of dissatisfaction and frustration.

We are motivated by achievement and the anticipation of achievement. If we know a goal is challenging yet believe it is within our abilities to accomplish, we are more likely to be motivated to complete a task (Zimmerman et al., 1992).

4. Task Complexity

Miner (2005) suggested that overly complex tasks introduce demands that may mute goal-setting effects. Overly complex goals that lie out of our skill level may become overwhelming and negatively impact morale, productivity, and motivation.

The timescale for such goals should be realistic. Allowing sufficient time to work toward a goal allows opportunities to reassess the goal complexity, whilst reviewing and improving performance. Even the most motivated of people can become disillusioned if the task’s complexity is too great for their skills.

5. Feedback

Goal setting is more effective in the presence of immediate feedback (Erez, 1977). Feedback – including internal feedback – helps to determine the degree to which a goal is being met and how you are progressing.

Unambiguous feedback ensures that action can be taken if necessary. If performance falls below the standard required to achieve a goal, feedback allows us to reflect upon our ability and set new, more attainable, goals. When such feedback is delayed, we cannot evaluate the effectiveness of our strategies promptly, leading to a potential reduction in the rate of progress (Zimmerman, 2008).

When we perceive our progress towards a goal as adequate, we feel capable of learning new skills and setting more challenging future goals.