Health care is learning a lesson on instability. For decades, health systems benefitted from relative stasis—incremental market disruption, a policy landscape that favored the status quo, and ingrained clinician and patient preferences and behaviors that tilted their loyalties toward incumbents. Yes, innovation and disruption happened, but at a (more) manageable pace.

How Hywel Dda hardwired flexibility into strategic planning

However, during the Covid-19 pandemic, each of these insulating factors eroded. This means the environment we are operating in is now fundamentally different—it is far more unpredictable and prone to impulses.

With this change in the health care operating environment must come a change in how we think about, set, pursue, and track against our strategic aims. In the old and stable world, systems benefited from three- or five-year strategic plans that barely required recalibration. Systems took a 'set-it-and-forget-it' approach. And that was okay because the environment didn't necessitate anything more.

During our team's research on organizational flexibility, we noticed that the idea of dynamic or 'continuous' strategic planning was an emerging trend. Health system leaders we spoke with talked about the realization of how efficient their governing frameworks were during the pandemic response and how they were hardwiring that flexibility into their strategic planning processes. They talked about a new strategic planning process that is continuous, iterative, and easy to recalibrate.

(Interestingly, many other industries started migrating toward this continuous approach years ago—we found organizations in banking, software development, consulting, and others that have been doing this since the early 2000's. As always, health care is the laggard.)

3 mindshifts to make the shift toward 'continuous strategic planning'

Our team has published work on this idea already and will be coming out with more case studies and insights on 'continuous strategic planning' in the coming weeks. But it's worth capturing, at a high level, the mindshifts that any leader interested in a more 'continuous strategic planning' approach will need to make.

We found three:

Strategic planning retreat toolkit

1. 'Continuous strategic planning' requires fundamentally different 'strategic operations' and infrastructure. In the old world, systems often pulled leaders off of their day jobs for a few months and tasked them with creating a five-year strategic plan. After that time, everyone went back to their desks and it was up to the C-suite and board to deliver on that plan. This is insufficient for 'continuous strategic planning.' Systems we spoke with that made this leap had to designate staff to constantly monitor the external environment, share information back to leaders, and recalibrate plans based on those analyses. They called this a 'strategic operations' function. They also clarified accountability and decision-making structures to make it easier to end some workstreams and pivot to others with minimal disruption when recalibrating their plans.
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3. To make the shift toward 'continuous strategic planning,' there must also be a shift in the organization's culture and attitude toward flexibility. To prime their organizations and people to embrace the unknown, we have seen providers introduce new narratives that talk about flexibility as a critical part of strategic planning. Some go further, adding new cultural values around flexibility into their employee handbooks and rewarding staff for certain behaviors during a recalibration phase or their annual review. The adage 'culture eats strategy for breakfast' is especially apt for this process shift.
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5. You can migrate toward a continuous model in a variety of ways and at different levels—you don't have to do it all at once. Since the pandemic began, we have seen systems throw out their long-term ambitions and completely change course, disrupting themselves entirely. We have also seen systems become more confident in their long-term path, and simply meet and recalibrate against original strategic plans every month instead of every six months or year. The point is to lead a migration toward a more continuous approach, at whatever pace your culture and environment allow.