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Strategic Planning Discussion Guide

Strategic Planning Discussion Guide

Watch the Strategic Planning Webinar Here

Download the Session Slides Here

Prepared by
James A. Rice, Ph.D.
Brian E. Rice, MHA

Series Preface:

This discussion guide is part of an “ACHD Governance Toolkit” composed of a series of six recorded webinars organized by the Association of California Healthcare District (ACHD) to encourage and support healthcare district boards of directors to further enhance the performance of their governance models and practices. The six topics addressed are:

  1. Community Engagement
  2. Balancing Governance & Management
  3. Board Orientations
  4. Strategic Planning
  5. Board Self-Assessments
  6. Board Education Programming

The six programs consist of an approximately 15-minute video with a downloadable slide deck, and a short discussion guide to stimulate healthy conversations between the CEO and the board about practical ways they can collaborate for more effective and efficient board decision making in each topic. The programs are also intended to help encourage healthcare districts to consider the successful completion of ACHD Certification.

The ACHD Certified Healthcare District Program promotes good governance for healthcare districts by creating a core set of accountability and transparency standards. This core set of ACHD standards is known as Best Practices in Governance and districts that demonstrate compliance are designated by ACHD as a Certified Healthcare District for a period of three years. Find more information on our website.

Each of the six webinars can be optimized when the Board Chair and CEO collaborate to organize a five-step program of education for the coming year.

The five-step process for your board-CEO conversation to address these topics is suggested to be:

  1. The CEO and Board Chair reaffirm their shared commitment to the continuous enhancement of the board’s education and capacity development. Jointly express this commitment at the beginning of each year.
  2. Adopt a board policy of continuous board development that embraces:
    * Periodic CEO briefing materials on topics relevant to the strategic plans and challenges of the healthcare district.
    * A calendar of speakers in routine board meetings on hot topics to help the district’s vitality.
    * Organization of a “Symposium” on board best practices with other community organizations and associations for joint learning and community leader networking.
    * Participation in small groups of district board members at ACHD or other state conferences on strategic issues and trends.
    * Organization of customized educational readings or mentors for each board member based on their unique needs and requests.
  3. Organize a 30-minute educational session during a Spring and Fall board meeting to focus on one or more of the six Webinar topics. Ask one board member to team with a member of management and/or the staff to jointly present and help guide the discussion around the webinar and this Discussion Guide. This team approach helps build interest, ownership and shared responsibility among the board for its ongoing development.
  4. Encourage all board members to watch to the short video recording of the webinar before the scheduled discussion session. All should come to the discussion session ready to contribute in these ways:
    * Assess how well this topic is being addressed in your healthcare district;
    * Bring questions and ideas about how your district might better address this topic in the future; and
    * Bring some suggested resources that might help your healthcare district enhance its learning and planning for this topic.
  5. Conduct a collegial assessment of each program to see how its value to your district could best be optimized in the coming year. Share your ideas with the ACHD staff.

Thank you again for all you do for the people of your healthcare district, and for the enhanced performance of your healthcare district board work!

Contact ACHD staff at any time with questions, or contact us at

Let’s begin moving though this discussion guide.

Strategic Planning


Thank you for your interest in exploring how your healthcare district board might better understand and develop its capacity for enhanced strategic planning.

This discussion guide is not a stand-alone document. The guide is to be used in conjunction with the corresponding recorded webinar and slide deck. We see strategic planning as a collaborative process between the CEO, the Board, staff and the community.

We encourage your board and CEO to collaborate in conversations and shared strategic thinking and planning to support your board members, individually and collectively, to be more effective in establishing and nurturing new strategies and structures for board leadership in strategic planning.

This discussion guide is organized to answer these questions:

  1. What is “strategic planning”?
  2. Why is it important?
  3. Common issues or challenges?
  4. What can boards do to be more successful?
  5. Where to secure resources for further educational insights on this topic?

Within each of these five sections, we pose a series of questions to guide your conversations about how to best conduct strategic planning as a means to accomplish the mission of your healthcare district.

1. What is “strategic planning”?

Strategic planning is a structured process conducted in a formal way by a group/team of leaders to answer four deceptively simple questions:

  1. Where are we today? (Situation Analysis) SWOT Analysis
  2. Where should we go tomorrow? (Goal Formulation) Scenarios
  3. How shall we get there? (Resource Allocation, Budgeting) Roadmap
  4. Are we getting there? (Performance Management) Balanced Scorecard

The written answers to these questions establish the strategic plan that will guide the organization over a defined time horizon – typically three years.

Our experience shows that the process of conducting a strategic planning exercise is more important than the plan, especially when you engage key stakeholders and enable thoughtful dialogue in answering the four questions. Higher engagement leads to greater buy in and support for the finalized strategic plan.

In addition to the process, a successful strategic plan also includes a robust implementation, monitoring and actions for measurable results.

To strengthen your thinking in this area, please try to address these questions:

  • How has your board developed a policy and calendar for your annual strategic planning process that drives your budgeting process?
  • How can your planning process best engage key stakeholders and bring their insights into the discussion and prioritization?
  • How has your process considered industry trends and market dynamics as the context for your planning?

2. Why is it important?

At its core, the strategic plan sets the roadmap to pursue your mission and enable organization vitality. The establishment of the plan is an essential role of the board to help ensure the mission of the organization is being pursued and aligned with its top priorities. The planning process should enable strong partnerships with the CEO and key stakeholders that considers the population health needs (community health needs assessment), market dynamics and prudent targeting of scarce resources that position the organization for success.

How would you address these questions to improve your strategic planning process?

  • How has your board emphasized the value of working collaboratively with your community in developing and following your strategic planning process?
  • How can you best ensure that your strategic plan is easy to understand and communicate across your diverse audiences? How might you summarize your plan in a picture/graphic to communicate the plan?

3. Common issues or challenges?

Though there are four deceptively simple questions to address, the strategic planning process can be challenging to effectively complete. Our experience advising organizations with planning efforts has identified several obstacles that can limit your ability to establish a robust, well-articulated, integrated plan, such as:

  • Inexperienced participants
  • Lack of credible data and information
  • Lack of diversity of thought and perspectives
  • Lack of broad stakeholder engagement/ownership
  • Lack of accountable road-mapping & accountabilities
  • Lack of balance inside-out and outside-in planning
  • Lack of transparently celebrating progress to plans

What do you see as the key challenges to completing a strategic planning process and a prioritized plan to guide your healthcare district? Here are additional questions to consider to support your ongoing enhancement of your planning process.

  • How have you identified factors in your last planning process that may have constrained how well stakeholders were engaged, or how effective these participants judged the value of their participation?
  • How might your use of multiple tools/approaches and/or ideas from other industries help you address the above obstacles to a great strategic planning process and plan?
  • How integrated is the strategic plan with your capital and operating budget processes?

4. What can boards do to be more successful?

Your healthcare district board can take a proactive approach to strengthen the value and results from your strategic planning. Your work can begin with a commitment to continuously improve the process by ensuring stakeholder engagement; the use of updated tools and techniques to identify priority actions and the establishment of a measurable implementation plan for the management team to pursue. Key elements we suggest considering include:

  • Prioritize the work of strategic thinking & planning
  • Invite education, insights and ideas from other hospitals, clinics, community health centers, hotels, service industries, and public utilities
  • Map the process to calendar & budget cycle
  • Balance inside-out and outside-in planning
  • Consider the use of a “charrette” style of strategy retreats
  • Transparently celebrate progress to plans

Engage with the CEO to explore how you can best address these related questions:

  • How much time and resources should you dedicate to the planning process and subsequent performance measurement of defined goals?
  • What techniques have you found effective in engaging stakeholders to share their input into the planning process? Are there approaches you have experienced in other settings that could be utilized for the healthcare district?
  • How might you adapt and enhance the “strategic performance pillars” style of summarizing your plans provided in the webinar slide deck?
  • How might you best engage with the media to brief them about your plans, and the value of informing the public about how the board and CEO are inviting key stakeholders into the implementation of the plan?

5. Where to secure resources for further educational insights on this topic?

We encourage you to have a conversation about where you can turn for ideas and resources to enhance your strategic planning processes that further engage board members, management and key community stakeholders. Our suggested sources are:

What do you find as even better resources to use in your strategic planning efforts?

Thank You

Thank you again for all you are doing to enhance your strategic planning in pursuit of the mission of the healthcare district.

Please reach out to ACHD staff for comments or suggestions to improve this board development discussion guide and webinar.

And thank you for all you do for the people you exist to serve in your healthcare district!




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