Aligning Nursing Strategy and Health System Strategy

By Kelly Hancock, DNP, RN, NE-BC

With more than 15,000 nursing caregivers, the Stanley Shalom Institute for Nursing Excellence at Cleveland Clinic represents the health system’s largest caregiver group. Due to the size and importance of Cleveland Clinic’s nursing organization, it is critical to have solid organizational direction in place that is designed to deliver great patient care to ensure the best possible outcomes.

For our nursing team, strategic planning is the foundation for determining that direction. And through the years, one of the most important takeaways our leadership team has come to realize is that the determined strategy for nursing must successfully align with the determined strategy of our overall health system.

Objectives, goals, strategies and measures

There are various resources and tools available to aid nurse leaders in the strategic alignment process. When beginning your strategic mapping process, it’s important to find the tool that is most ideal for your organization.

Our leadership team has found that adopting the “OGSM” framework has brought us the most success – and has been the easiest to follow and implement. OGSM stands for objectives, goals, strategies and measures. It is designed to help define what you want to achieve and how you can achieve it by outlining broad objectives, fixed and measureable goals, strategies to guide actions, and specific measures for monitoring progress.

Here’s a quick breakdown of how we use the OGSM model for our strategic planning and how it may work for your organization:

Objectives

With OGSM, objectives are the starting point and the roadmap for everything else in your strategic plan. Your objectives should be thought of as the vision for what you need to achieve. For this level of strategic planning, they should be long-term objectives. So, think big. Where do you want to be in the future? What does success look like?

When determining your objectives, consider fundamental principles, your mission statement and values, and, of course, the objectives of your health system and/or hospital.

Goals

Aligning with your objectives, goals are your specific long-term targets. Goals should be measurable, achievable and compatible. View your goals as stepping stones for achieving objectives and again, take into consideration your overall health system and/or hospital goals.

Strategies

How are you going to meet your objectives? What specifically are you going to do? These are your strategies or where you are going to focus your efforts. They are the initiatives or programs you will implement, for example, and the details of how you will deploy resources to achieve these goals. How can you link your strategies with those of your health system and/or hospital?

Keep in mind that strategies don’t need to be concrete and can have some flexibility.

Measures

One of the most important – and overlooked – components of strategic planning is measurement. Often, organizations will enact great strategies, but neglect to monitor or measure them effectively. Measures, such as key performance indicators, are your qualitative and quantitative benchmarks for determining progress and they determine whether or not your strategies are working.

Utilize the measures your organization has in place, such as enterprisewide key performance indicators (KPI) dashboards, and combine them with specific nursing measures tailored to your nursing organization.

Apply a strategic planning framework to your organization

The OGSM framework works for us because it’s a simplified way of showing the importance of aligning strategy with goals and implementing measurement to make sure we are headed in the right direction and on track to meet objectives. And if we aren’t, it’s flexible enough to allow for tactical adjustments as needed.

Additionally, it’s a great way to ensure we are aligning our nursing plan with our health system plan. For example, by using the OGSM framework, we are able to map all that we do from a nursing standpoint, back to the Cleveland Clinic health system goals, which in a condensed nutshell, are:

• To always put patients first
• To focus on our caregivers
• To maintain fiscal accountability
• And to ensure sustainable, responsible growth

So, the health system strategy guides our nursing strategy and results in our Institute goals, which consist of four focal areas: clinical, caregiver, finance and impact.

These goals are integrated into everything we do and are prominently displayed and communicated to our nursing caregivers each day, from our Nursing intranet page to the outline for our leadership agendas. Every initiative or project we do in nursing must be tied back to one of our goals so we know it is something we should invest our time and resources in.

For example, when looking at the health system goal to always put patients first, one of our nursing strategies is to incorporate our professional practice model into daily nursing activity, which is part of our ‘clinical’ goal.

Our professional practice model is the model Cleveland Clinic nurses follow to deliver exceptional care. It is based on the philosophies of relationship-based care, thinking in action and serving leader. It is centered on the guiding principle of ‘Patients First,’ which is a core concept of nursing practice at Cleveland Clinic and the first overall goal of the Cleveland Clinic health system.

The methodology shown here used for each of our nursing strategies. If a proposed strategy doesn’t align well with a health system goal, we don’t consider it an executable strategy.

Alignment is key

Once you determine a strategic planning framework that is most ideal for your organization, make sure you thoroughly understand all stages of your chosen model – and, that each stage aligns with your nursing objectives, as well as with your health system and/or hospital goals and objectives.

Kelly Hancock is the Executive Chief Nursing Officer of the Cleveland Clinic Health System, and Chief Nursing Officer of Cleveland Clinic Main Campus.

Follow Kelly on Twitter at @kkellyhancock.