Strategic Planning for EMS

1. 2 Strategic Planning for EMS

2. Learning Objectives 2.1 Define strategic planning and the time frames that are incorporated in strategic planning. 2.2 Define the contingent planning model for strategic planning. 2.3 Use a multi-point plan to create components of a strategic plan. 2.4 Demonstrate how to prioritize strategic planning concepts and items.

3. Learning Objectives (Cont.) 2.5 Define the strategic planning items–and their purposes–that would be included in a fire or EMS plan. 2.6 Explain and incorporate the planning cycle for a strategic plan. 2.7 Discuss the various considerations for calculating the cost of EMS services.

4. Learning Objectives (Cont.) 2.8 Define or identify the stakeholders in EMS. 2.9 Identify management tools to conduct project planning. 2.10 Describe the primary components of an EMS budget. 2.11 Identify proactive approaches to EMS funding.

5. Learning Objectives (Cont.) • Apply costing out strategies to a variety of EMS system aspects. • Identify proactive approaches to EMS funding.

6. Strategic Planning • Strategic planning • Refers to the entire set of processes and behaviors that an organization uses to identify, prioritize, focus, and schedule action in order for it to remain viable in the future.

7. Strategic Planning (Cont.) • The most important task an EMS manager or leader can do is to conduct planning • Ensure that equipment, systems, and personnel are matched with needs of the community

8. Overview of a Strategic Plan • Developed by stakeholders • Move an organization forward • Define service delivery and development over time • A strategic plan has eight components: • Executive summary, problem definition, assessment of critical factors, intervention strategies, stakeholders, organizational objectives, budget, and plan evaluation

9. Strategic Plan: Executive Summary • S Generally written at the end of the development process • Identifies the key issues related to the plan • Goal is to hook the reader into reading further

10. Strategic Plan: Executive Summary (Cont.) • Failure to write a compelling executive summary may doom the plan • Should contain the program mission and vision statements

11. Strategic Plan: Problem Definition • Places information into a clear and concise definition of the issue and/or problem • Should demonstrate the issue, the impacts of the issue, and the potential outcomes of interventions • Should clearly identify the issue and its effects upon the target audience

12. Strategic Plan: Assessment of Critical Factors • Three critical factors of project management: • Time, costs, and performance • Should include identification of the dominant and weakest factors or project constraints

13. Strategic Plan: Intervention Strategies • Identify both the potential and selected intervention strategies

14. Strategic Plan: Stakeholders • Identify those involved in the plan directly or indirectly • Vested interests should be identified as potential adverse effects of the project

15. Strategic Plan: Stakeholders (Cont.) Internal System managers, chief officers, financial managers, planning, information technology employees External Hospital administrators, insurance company representatives, advocacy groups, homeowners associations, elected officials

16. Strategic Plan: Organizational Objectives • An overview of the strategies and measurable objectives that have been identified • Timeframes for completion should also be identified • Should include: • Overall strengths and milestones, objectives and corresponding tasks, financial and resource requirements, responsibilities

17. Strategic Plan: Budget • SWOT analysis • An evaluation of each component of the proposed budget, including strengths, weaknesses, opportunities, and threats • Summary should be included • Specifically, how strengths will be tapped into to correct weaknesses, and how opportunities will be explored while avoiding threats

18. Strategic Plan: Plan Evaluation • A comprehensive plan for monitoring progress • Comprehensive review, revision, completion, “bail-out” points • Each budget item or component of the strategic plan

19. Balanced Score Card • What get measured gets done • When measures are linked to the organization’s strategy, people will naturally adopt appropriate behaviors • Financial measures are not sufficient to manage the organization • Measures: • Financial performance, customers, internal business processes, clinical competencies, patient outcomes, personnel growth and learning

20. Contingency Model of Strategic Planning • Rational approach to planning incorporated into a multi-year budget cycle • Planning is contingent on a choice made by analyzing a model • Jim MacKay’s Strategic Planning Matrix Figure 2.2 Jim MacKay’s Strategic Planning Matrix. (Reprinted with permission of Berkeley Consulting Group)

21. Contingency Model of Strategic Planning (Cont.) • Rational strategic planning • Takes the steps: plan, act, and evaluate • Often useful for organizations that have stable demands and clear goals • Commitment planning • Search to find a common ground through a labor-management partnership or by stakeholder consensus building

22. Contingency Model of Strategic Planning (Cont.) • Incremental planning approach • Requires innovation, pilot projects, and experimentation • Involves scenarios planning and experimenting with possible future programs • Inspirational leadership • Requires charismatic leadership and new approaches to service delivery

23. Planning in Fire and EMS • Three planning models prevail: • Applied Strategic Planning Model • Dr. William Pfeiffer • National Fire Academy’s model • A nine-step process • Strategic Planning • John Bryson • Fire Department Strategic Planning Model • Mark Wallace • Twelve-step process

24. NFA Applied Strategic PlanningDr.J. William Pfeiffer • Plan to plan • Formulate mission statement • Perform strategic business modeling • Conduct a performance audit • Perform a gap analysis • Prepare a contingency plan • Create integrated functional plans • Implement actions

25. Strategic PlanningJohn Bryson • Initiate and agree on a strategic planing process • Identify organizational mandates • Clarify the organization’s mission and values • Assess opportunities and threats of the external environment

26. Strategic Planning (Cont.)John Bryson • Assess strengths and weaknesses of the internal environment • Identify the strategic issues facing the organization • Formulate strategies to manage the issues • Establish an effective organizational vision for the future

27. Fire Department Strategic PlanningMark Wallace • Identify the department’s values • Plan to plan strategically • Select and recommend a strategic planning process • Identify the department’s mandates • Develop the mission of the department • Create a philosophy of operations

28. Fire Department Strategic Planning (Cont.)Mark Wallace • Assess the opportunities and threats of the external and internal environments • Identify the strategic issues of the department • Create strategies for strategic issues • Create the department’s ideal future • Conduct operational planning from a strategic perspective

29. Plans • Operational plans • Short-term plans • Range from 3 to 5 years • Master plans • Long-term plans • Range from 10 to 20 years • Consideration should be given to population trends, tax base, planned development, and trends in the industry

30. Clearly Defined Mission and Vision • Vision statement • Sets the direction of the division or organization • Provides a futuristic look • Objectives and action plan should be consistent with the vision statement • Should build loyalty through involvement, commitment, and a need for change

31. Clearly Defined Mission and Vision (Cont.) • Values statement • Should be positive and inspiring, providing a focus to the organization • Communicates the leader’s beliefs, values, and outcomes • Is base for organizational culture • Establishes core values • Used as a basis for decision making

32. Clearly Defined Mission and Vision (Cont.) • Mission statement • Should address what you are going to do and for whom you are doing it • Defines a focal point • Provides direction • Defines the reason that the organization, committee, or group exists • Should be no more than two sentences

33. FIGURE 2.5 North Las Vegas Fire EMS Vision, Mission, and Values Statement.(Reprinted with permission.) Vision, Mission, and Values

34. Brainstorming • Method of shared problem solving in which all members of a group spontaneously contribute ideas • Generates a variety of possible solutions • Encourages creative ideas, solves problems, motivates and develops teams

35. Brainstorming Process • Define and agree on the objective • Brainstorm ideas, and have an agreed upon time limit • Categorize/condense/combine/refine • Assess/analyze effects or results • Prioritize options/rank list, as appropriate • Agree on actions and timeframes • Control and monitor follow-up

36. SWOT Analysis • SWOT analysis • Internal characteristics: strengths and weaknesses • What advantages does the organization have? • What does the organization or its resources do well? • What relevant resources do you have access to?

37. SWOT Analysis (Cont.) • Internal characteristics: strengths and weaknesses • What do other people see as the strengths in such a program? • What current operations could be improved? • What is the program or organization doing badly? • What should you avoid?

38. SWOT Analysis (Cont.) • SWOT analysis • External characteristics: opportunities and threats • Where are the good opportunities for the program? • What are the trends in the field?

39. SWOT Analysis (Cont.) • External characteristics: opportunities and threats • What are the changes in technology and markets on both a broad and narrow scale? • What are the changes in government policy related to your field? • What are the changes in social patterns, populations, industry? • What are the local, state, and national events?

40. SWOT Analysis (Cont.) • External characteristics: opportunities and threats • What obstacles do you face? • What are other agencies doing? • Are the required specifications for the job, products, or services changing? • Is changing technology threatening your position? • Could the weakness seriously threaten the agency or operations?

41. Clearly Defined Goals and Objectives • Major component of a successful plan • SMART method: • Specific • Measurable • Attainable • Realistic • Tangible

42. Clearly Defined Goals and Objectives (Cont.) • Objectives • Should define what you intend to accomplish as specifically as possible • Expected outcome over an identified period • ABCD format: • A= Audience: Who will do it? • B= Behavior: What must be done? • C= Conditions: By when, where, and how? • D= Degree: What is the quantity and quality expected?

43. Prioritizing Objectives • Oval Mapping Technique • Collaborative approach to help set the goals of the organization • Goals and aspects of the leader’s vision are placed on a wall • Post-it notes are placed on the wall near the specific goal, with each group discussing and linking the issues and establishing priorities

44. Costing Out the Planning Process • Personnel costs • Each pay scale, base salary, certification level, and incentive pay category needs to be calculated • Others: • FICA, retirement, life and health insurance, workers’ compensation, disability insurance, clothing allowance, specialty pay, educational incentives

45. Economies of Scale • An increase in efficiency of production as the number of goods or services being produced increases • Two types of economies of scale: • External • Cost per unit hour depends on the size of the industry • Internal • Cost per unit depends on the size of the individual department or agency

46. Economies of Scale (Cont.) • Poor economies of scale have both financial and operational impacts • Low call volume, financial impact, unit costs go up • Management looks to reduce unit costs • Maximizing the economies of scale helps agencies fund specialty teams- fleet programs, and reduces medical supply costs by buying in bulk

47. Workload Indicators • Formulating the cost of goods and services starts with a review of the workload indicators FIGURE 2.10 Workload Indicators for EMS

48. Capital Expenses • Often large portions of budgets • Include the cost of: • New or replacement vehicles • High-dollar equipment • New facilities • Computer technology • Depreciation schedules

49. Operating Expenses • Fixed expenses • Aspects of service that continue to be the same, regardless of the level of activity • Salaries, depreciation, preventive vehicle maintenance, training • Variable expenses • Change with activity • Unscheduled vehicle maintenance, station repair, medical supplies, linen, fuel, office supplies and reports, accounting and legal expenses

50. Problem Research Techniques • Gathering information on issues is a lengthy task • Issues on internal operations • Community problem • A very personal process • Contact with a variety of people is required • A collaborative approach with labor management can avoid delays in the approval process and bring valuable resources to the table