Cascading strategy in a large health system: Bridging gaps in hospital alignment through implementation.

Abstract

Using any number of open system strategic frameworks, the planning process follows a fairly consistent trajectory: formulation, implementation, and evaluation. Most agree that the formulation and evaluation phases are the most straightforward, yet successful implementation remains elusive. If done thoughtfully, taking advantage of a complementary framework suitable for aligning facility-level initiatives with system priorities presents a feasible opportunity for health systems interested in cascading enterprise-wide strategy successfully. This study provides lessons learned from: (a) consulting literature addressing barriers to implementing strategy effectively, and (b) analyzing insights from a participatory action research study designed to overcome impediments to aligning hospital-level initiatives with enterprise-wide goals and objectives. The analysis provides a baseline examination of hospital alignment efforts that underscores best practices and exposes gaps in both process and evaluation. Results suggest specific tools may function to effectively engage internal stakeholders in a cooperative process capable of yielding preferred strategic outcomes, particularly through the implementation and evaluation phases.