MOH SA Strategic Plan. v.3 Jan 2018

MOH
Saudi Arabia Quality Course

Strategic Planning
Balance Scorecard
© Copyright, Joint Commission International

Richard Wright, MD, MPH
Hyunok Do, RN, DNSc
JCI Consultants
Objective
• Understand the importance of strategic
planning
• Understand the basic strategic planning

model

• Understand how to use SWOT analysis
• Understand how to develop balance
scorecard
2
What is Strategy?
• The determination of long term goals

and objectives of an organization and
the adoption of courses of action and
allocation of resources for carrying out
these goals
– Alfred Chandler, 1962, The Visible Hand: The Managerial

Revolution in American Business
3
What is the Strategy?
• Strategy is defined as “the plans and

activities developed by an organization
in pursuit of its goals and objectives,
particularly in regard to positioning
itself to meet external demands relative
to its competition”

4
Strategic Planning
Purpose
• If you fail to plan, then you plan to fail –
be proactive about the future
•Strategic planning improves performance
•Counters excessive inward and short-term

thinking

• Solves major issues at a macro level
• Communicate to everyone what is most

important Matt H. Evans, matt@exinfm.com
5
• “Without a strategy the organization is
like a ship without a rudder, going
around in circles”.
• The road to quality improvement

begins with strategic planning.

Strategic Planning for Healthcare Quality: Guiding the Organization
6
Strategic Planning
Hoshin Kanri
• Japanese strategy for aligning
organization’s functions and activities
with strategic objectives
• Annual planning process and document
with specific goals, objectives, timelines,

responsibilities, and metrics
TOP DOWN AND BOTTOM UP PROCESS
7
Strategic Planning
Management Focus
• Strategy: The strategic initiatives
• Focus: Every resource and activity

aligned to strategic initiatives

• Organization: New organization-wide
linkages across departments, services.
8
Strategic Planning
Major Objectives
• Provide a framework for thinking about the
“business” to create a fit between the
organization and its external environment.
• Provide a process for coping with change
and organizational renewal.
• Foster anticipation, innovation, and

excellence.
• Facilitate consistent decision making
• Create organizational focus.
9
Strategic Planning
Critical Questions
•Where are we now? (Assessment)
•Where do we need to be? (Gap / Future End

State)
•How will we close the gap (Strategic Plan)

• How will we monitor our progress
(Balanced Scorecard)
Strategic planning is a quality management tool
Matt H. Evans, matt@exinfm.com 10

Strategic Planning
Requirements
1. Address critical performance issues
2. Create the right balance between what

the organization is capable of doing vs.
what the organization would like to do

3. Cover a sufficient time period to close
the performance gap
Matt H. Evans, matt@exinfm.com

11
Strategic Planning
Requirements
4. Visionary – convey a desired future end
state
5. Flexible – allow and accommodate

change

6. Guide decision making at lower levels
– operational, tactical, individual
12
Strategic Planning Model
Where we are Where we want to be How we will do it How are we doing
Assessment Baseline Components Down to Evaluate

Specifics
• Environmental • Situation – Past, • Mission & • Performance • Performance

Scan Present and Vision Measurement Management
• Background Future • Values / Guiding • Targets / • Review Progress –
Information • Significant Principles Standards of Balanced

• Situational Performance Scorecard
Issues
Analysis • Major Goals • Initiatives and • Take Corrective
• SWOT – • Align / Fit with
• Specific Projects Actions
Strengths, Capabilities
Objectives • Action Plans • Feedback
Weaknesses, • Gaps
upstream –
Opportunities,
revise plans
Threats Matt H. Evans, matt@exinfm.com
13
Assessment
Environmental Scan
• Situation analysis is a method managers use
to analyze both the internal and external
environments of an organization in order to
understand the firm’s own capabilities,
customers and business environment.

 5 Cs analysis
Porter five forces analysis
 SWOT analysis
 14
5 C Analysis
Environmental Scan
15

Environmental Scan
Porter’s Five Forces Analysis
16

Environmental Scan
17

SWOT Analysis
• Use and Capitalize on each Strength?
• Improve each Weakness?
• Exploit and Benefit from each Opportunity?
• Mitigate each Threat?

18
State
Current
SWOT Analysis
State
Future
19

SWOT Analysis Assessment
Internal Assessment: Organizational

assets, resources, people, culture,
systems, partnerships, suppliers, . . .
External Assessment: Marketplace,

competitor’s, social trends, technology,
regulatory environment, economic
cycles .

SWOT SWOT
Good Points Possible Pitfalls
• Easy to Understand • Needs to be Analytical
• Apply at any and Specific
organizational level • Be honest about your
weaknesses
20
Assessment
Strength’s
•Strength’s – Those things that you do well, the high
value or performance points
•Strengths can be tangible: Loyal customers, efficient

procedures, very high quality services, excellent
financial condition
• Strengths can be intangible: Good leadership,

strategic insights, customer intelligence, solid
reputation, high skilled workforce
•Often considered “Core Competencies” – Best leverage

points for growth without draining your resources
Assessment
Weaknesses
•Weaknesses – Those things that prevent you from
doing what you really need to do
• Since weaknesses are internal, they are within

your control
• Weaknesses include: Poor leadership,

unskilled workforce, insufficient resources,
poor product quality, slow distribution and
delivery channels, outdated technologies, lack
of planning, . .
Assessment
Opportunities
• Opportunities – Potential areas for growth and
higher performance
•External in nature – marketplace, unhappy

customers with competitor’s, better economic
conditions, more open trading policies
• Internal opportunities should be classified as

Strength’s
•Timing may be important for capitalizing on
opportunities
Assessment
Threats
• Threats – Challenges confronting the organization
• External in nature
• Threats can take a wide range – bad press

coverage, shifts in consumer behavior, substitute
products, new regulations,
•May be useful to classify or assign probabilities to

threats
•The more accurate you are in identifying threats, the better

position you are for dealing with the“sudden ripples” of
change
24
Baseline Baseline
Purpose
•Puts everything about the organization into a
single context for comparability and planning
•Descriptive about the company as well as the

overall environment
•Include information about relationships

customers, suppliers, partners
• Preferred format is the Organizational Profile

Baseline
Organizational Profile
1. Operating Environment
2. Business Relationships

3. Key Performance Categories
26
Baseline
Operating Environment
•Products and Services – Suppliers, Delivery Channels,
Contracts, Arrangements.
•Organizational Culture – Barriers, Leadership,

Communication, Cohesiveness.
•Workforce Productivity – Skill levels, diversity, contractor’s,

aging workforce, . . .

• Infrastructure – Systems, technology, facilities, . .
•Regulatory – Product / Service Regulation, ISO Quality

Standards, Safety, Environmental, . . .
Baseline
Business Relationships
•Organizational Structure – Business Units, Functions,
Board, Management Layers.
• Customer Relationships – Requirements, Satisfaction,

Loyalty, Expectations.
•Partner Relationships – Alliances, long-term suppliers,

customer partnerships.
•Supply Chain – Relationship between everyone in the

supply chain.

28
Baseline
Key Performance Categories
• Customers
• Operational – Quality and Patient Safety
• Financial
• Human Capital
• External (Regulatory Compliance)

The Framework for Balanced Scorecard

29
Baseline
Gap Analysis
Baseline / Org Profile Challenges / SWOT

Gap = Basis for Long-Term
Strategic Plan
30
Components
Strategic Plan Document
Major Components
Strategic Plan
Action Plans
Mission Why we exist
Evaluate Progress
Vision What we want to be
Goals What we must achieve to be successful
Objectives O1 O2 Specific outcomes expressed in

measurable terms (NOT activities)
Initiatives Planned Actions to

AI1 AI2 AI3 Achieve Objectives
Measures Indicators and

M1 M2 M3 Monitors of success
Targets T1 T1 T1 Desired level of
performance and
timelines 31
Components
Mission Statement
1. Captures the essence of why the organization
exists – Who we are, what we do
2. Explains the basic needs that you fulfill

3. Expresses the core values of the organization
4. Should be brief and to the point
5. Easy to understand

6. If possible, try to convey the unique nature of
your organization and the role it plays that
differentiates it from others
32
Mission Statements Components
Examples
NASA
To Explore the Universe
and Search for Life Does a good job of expressing the
and to Inspire the core values of the organization. Also
Next Generation of
Explorers conveys unique qualities about the
organization.
Walt Disney

Too vague and and unclear. Need more
descriptive information about what makes the
To Make People Happy
organization special.

Components
Vision Statement
1. How the organization wants to be perceived in
the future – what success looks like
2. An expression of the desired end state
3. Challenges everyone to reach for something

significant – inspires a compelling future

4. Provides a long-term focus for the entire
organization

34
Visions Statement
• It is an emotional driver to some “big idea” or challenge

that drives those in the corporation toward it.
• It is not intended for those outside the company.
• It is not a goal, as they should be SMART, but rather it

can be a wild, crazy, and even unattainable idea, as

long as it provides a deeply emotional drive to
accomplish something great that those in the organization
can get behind and drive toward.
35
Components
Value Statement
Every organization should be guided by a set of values and
beliefs
1. Provides an underlying framework for making decisions –

part of the organization’s culture
2. Values are often rooted in ethical themes, such as
honesty, trust, integrity, respect, fairness, . . . .
3. Values should be applicable across the entire

organization
4. Values may be appropriate for certain best management
practices – best in terms of quality, exceptional customer
service, etc.
37
Value Statement
• Both internal and external consumption.
• They tell those in the company how things are
done and those outside the company why
they want to be associated with this
company.

• Best when few in number (between 5 and 10)
but high in meaning and lived daily.
38
Value Statement Components
Examples
We obey the law and do not compromise moral or ethical principles – ever!
We expect to be measured by what we do, as well as what we say.
We treat everyone with respect and appreciate individual differences.

We carefully consider the impact of business decisions on our people and we
recognize exceptional contributions.
We are strategically entrepreneurial in the pursuit of excellence, encouraging

original thought and its application, and willing to take risks based on sound
business judgment.
We are committed to forging public and private partnerships that combine diverse
strengths, skills and resources.

Components
Strategic Goals
•Describes a future end-state – desired outcome that is
supportive of the mission and vision.
•Shapes the way ahead in actionable terms.
• Best applied where there are clear choices about the future.
•Puts strategic focus into the organization – specific ownership

of the goal should be assigned to someone within the
organization.
•May not work well where things are changing fast – goals
tend to be long-term for environments that have limited choices
about the future.
Strategic Goals Components
Construction
•Cascades from the top of the Strategic Plan – Mission,
Vision, Guiding Principles.
•Look at your strategic analysis – SWOT, Environmental

Scan, Past Performance, Gaps . .
• Limit to a critical few – such as five to eight goals.
•Broad participation in the development of goals:

Consensus from above – buy-in at the execution level.
•Should drive higher levels of performance and close a

critical performance gap.
41
Strategic Goals Components
Examples
Reorganize the entire organization for better responsiveness to customers
We will partner with other businesses, industry leaders, and government agencies
in order to better meet the needs of stakeholders across the entire value stream.
Manage our resources with fiscal responsibility and efficiency through a single
comprehensive process that is aligned to our strategic plan.
Improve the quality and accuracy of service support

information provided to our internal customers.
Establish a means by which our decision making process is market and customer
focus.
Maintain and enhance the physical conditions of our public facilities.
42
Components
Strategic Objectives
• Relevant - directly supports the goal
• Compels the organization into action specific
enough so we can quantify and measure the results
• Simple and easy to understand
• Realistic and attainable
• Conveys responsibility and ownership
• Acceptable to those who must execute

• May need several objectives to meet a goal
SMART OBJECTIVES

43
Strategic Objectives Components
Examples
Develop a customer intelligence database system to capture and analyze patterns
in purchasing behavior across our product line.
Launch at least three value stream pilot projects to kick-off our transformation to a
leaner organization.
Centralize the procurement process for improvements in enterprise-wide

purchasing power.
Consolidate payable processing through a P-Card System over the next two years.

Monitor and address employee morale issues through an annual employee
satisfaction survey across all business functions.

44
Components
Goals vs. Objectives
GOALS OBJECTIVES
Very short statement, few Longer statement, more

words descriptive
Broad in scope Narrow in scope
Directly relates to the Mission Indirectly relates to the Mission

Statement Statement
Covers long time period Covers short time period (such 1

(such as 10 years) year budget cycle)

45
Down to
Strategic Action Plans? Specifics
• The Action Plan identifies the specific steps that will be taken to
achieve the initiatives and strategic objectives – where the rubber
meets the road
• Each Initiative has a supporting Action Plan(s) attached to it
• Action Plans are geared toward operations, procedures, and
processes
• They describe who does what, when it will be completed, and how the
organization knows when steps are completed
• Like Initiatives, Action Plans require the monitoring of progress on
Objectives, for which measures are needed

Objectives
Initiatives
Action 4
Matt H. Evans, matt@exinfm.com Plans
6
Down to
Strategic Action Plan Specifics
• Who, What, How, Where, and When
• Coordinate with lower level sections, administrative and

operating personnel since they will execute the Action
Plan in the form of specific work plans
• Assign action responsibility and set timelines

• Resource the project or initiative and document in the
form of detail budgets (may require reallocation prior to

execution)
• Monitor progress against milestones and measurements
• Correct and revise action plans per comparison of actual
results against original action plan
47
Down to
Action Plan Specifics
Measurements
•Measure your milestones – short-term outcomes
at the Action item level.
•Measure the outcomes of your objectives.

•Try to keep your measures one per objective.
• May want to include lead and lag measures
to depict cause-effect relationships if you are

uncertain about driving (leading) the desired
outcome.
• Establish measures using a template to capture
critical data elements
Balanced Scorecard Evaluate
A strategic planning and management

system that is used extensively in
organizations to:
1.Align business activities to the vision and strategy

of the organization

2. Improve internal and external communications
3.Monitor organization performance against

strategic goals
49
Evaluate
Balanced Scorecard
Continuous Monitoring
• Cascade and align from the top to create a Strategic
Management System
• Use the Balanced Scorecard framework to organize and
report actionable components
• Use the Scorecard for managing the execution of your
strategy

• Scorecard “forces” you to look at different perspectives
and take into account cause-effect relationships (lead and
lag indicators)
• Improves how you communicate your strategy – critical
to execution.
50
Balance Scorecard Evaluate
Development
1. Define the measurement architecture:
Apply it on the strategic business unit level but
interactions must be considered in order to
avoid optimizing the results of one business
unit at the expense of others.

2. Specify strategic objectives: Identify
Potential measures for each objective.
51
Balance Scorecard Evaluate
Development
3. Choose strategic measures: Select
measures that are related to actual performance to
evaluate progress made toward achieving
objectives.
4. Develop the implementation plan: Target

values are assigned to the measures. An

information system is developed to link the top
level metrics to lower-level operational measures.
The scorecard is integrated into the management
system.
52
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Four Perspectives
Translating Vision and Strategy
1. Financial : To succeed financially, how
should we appear to our shareholders?
2. Internal Business Processes : To

satisfy our shareholders and customers,

what business processes must we excel
at?
54
Four Perspectives
Translating Vision and Strategy
3. Learning & Growth : To achieve our
vision, how will we sustain our ability to
change and improve?
4. Customer : To achieve our vision, how

should we appear to our customers?
55
Process perspective
Goal : reduce readmission within 24 hours post
surgery
Measure : rate of readmission
Target: less than 1 %
Initiative : implement surgical checklist
Financial perspective Learning perspective

Goal : efficient utilization of Goal : Increase events’ reporting
ICU Measure: incident reporting rate
Foster
Measure: ICU Readmission Target : increase reporting by
rate
a more than 50%
Target: below 5% Culture Initiative: Staff training on
Initiative : implementation of of Reporting process
CUSP safety

Customer perspective
Goal: increase patient safety
satisfaction
Measure: patient safety index
Target: score of more than 90%
HIMS - May 3 2016 Initiative: engage patient (20 tips to
decrease medical error )
56
Evaluate
Performance Management
• Establish a regular review cycle using your balanced
scorecard
• Analyze and compare trends using graphs for rapid
communication of performance
• Don’t be afraid to change your metrics – life cycle
(inputs to outputs to outcomes)
• Work back upstream to revise your plans: Action Plans
> Operating Plans > Strategic Plans
• Planning is very dynamic – must be flexible to change

• Recognize and reward good performance results
• Brainstorm and change – take corrective action on poor
performance results
57
Potential Pitfalls of BSC
• Lack of a well-defined strategy
• Using only lagging measures
• Use of generic metrics

58
Strategic Planning
Helpful Hints
• The world’s best Strategic Plan will fail if it is
not adequately resourced through the
budgeting process
• Strategic Plans cannot succeed without

people, time, money, and other key
resources

• Aligning resources validates that initiatives and
action plans comprise the strategic plan support
the strategic objectives
59
Strategic Planning
Helpful Hints
• Integrate all components from the top to the bottom:
Vision > Mission > Goals > Objectives > Measures >
Targets > Initiatives > Action Plans > Budgets.
• Get Early Wins (Quick Kills) to create some momentum
• Seek external expertise (where possible and

permissible)
• Articulate your requirements to senior leadership if they

are really serious about strategic execution
60
Group exercise
• For your tables’ assigned projects, please
conduct SWOT analysis to identify your
strengths, weaknesses , as well as the
potential opportunities and threats.
• 40 min

• Select Table Report Out
61
Questions
62

‫ﺷﻛرا‬
63

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MOH

Saudi Arabia Quality Course

© Copyright, Joint Commission International

• Understand the basic strategic planning

© Copyright, Joint Commission International

• The determination of long term goals

© Copyright, Joint Commission International

• Strategy is defined as “the plans and

© Copyright, Joint Commission International

•Strategic planning improves performance

•Counters excessive inward and short-term

© Copyright, Joint Commission International

• Communicate to everyone what is most

• The road to quality improvement

© Copyright, Joint Commission International

© Copyright, Joint Commission International

TOP DOWN AND BOTTOM UP PROCESS

• Focus: Every resource and activity

© Copyright, Joint Commission International

© Copyright, Joint Commission International

•Where do we need to be? (Gap / Future End

•How will we close the gap (Strategic Plan)

© Copyright, Joint Commission International

Matt H. Evans, matt@exinfm.com 10

2. Create the right balance between what

© Copyright, Joint Commission International

Matt H. Evans, matt@exinfm.com

5. Flexible – allow and accommodate

© Copyright, Joint Commission International

Assessment Baseline Components Down to Evaluate

• Environmental • Situation – Past, • Mission & • Performance • Performance

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

© Copyright, Joint Commission International

Internal Assessment: Organizational

External Assessment: Marketplace,

© Copyright, Joint Commission International

•Strengths can be tangible: Loyal customers, efficient

• Strengths can be intangible: Good leadership,

© Copyright, Joint Commission International

•Often considered “Core Competencies” – Best leverage

• Since weaknesses are internal, they are within

• Weaknesses include: Poor leadership,

© Copyright, Joint Commission International

•External in nature – marketplace, unhappy

• Internal opportunities should be classified as

© Copyright, Joint Commission International

• Threats can take a wide range – bad press

•May be useful to classify or assign probabilities to

© Copyright, Joint Commission International

•The more accurate you are in identifying threats, the better

•Descriptive about the company as well as the

•Include information about relationships

© Copyright, Joint Commission International

• Preferred format is the Organizational Profile

Matt H. Evans, matt@exinfm.com 25

© Copyright, Joint Commission International

•Organizational Culture – Barriers, Leadership,

•Workforce Productivity – Skill levels, diversity, contractor’s,