Leaders in academic health centers (AHCs) must create a vision for their academic unit embedded in a complex environment. A formal strategic planning process can be valuable to help shape a clear vision taking advantage of potential collaborations and to develop specific achievable long- and short-term goals. The authors describe the steps in a formal strategic planning process and illustrate it with the example of the Department of Medicine at the University of Toronto Faculty of Medicine beginning in 2004. The process included the active participation of over 300 faculty members, trainees, and stakeholders of the department and resulted in broad-based support and leadership for the resulting plan. The authors describe the steps, which include getting started, committing to planning principles, establishing the work plan, understanding the environment, pulling it all together, shaping the vision, testing strategic directions, building effective implementation, and promoting the plan. Articulation of vision, mission, and values informed the plan's development, as well as 10 key principles integral to the plan. Challenges and lessons learned are also described. The final strategic plan is an active core activity of the department, guiding decisions and resource allocation and facilitating measurement of success or shortcomings. The process the authors describe is applicable to multiple academic units, including divisions/sections, departments, or thematic programs in AHCs.
Restructuring and large-scale organizational change have become facts of life in Ontario's health care sector in recent years. Nearly every jurisdiction in Ontario has undergone systemwide hospital restructuring studies, and individual hospitals have increasingly turned to large scale re-engineering processes to improve efficiency and effectiveness. One example of planning for significant change was a hospital restructuring study undertaken by the Metropolitan Toronto District Health Council between 1993 and 1995. This article provides an overview of key insights gleaned from the project, including an analysis of the effectiveness and utility of some of the major planning strategies and tactics employed to realize project objectives. Given the organizational, process and communications issues faced by the study, many of the insights provide will be relevant to other groups engaged in planning for large-scale change processes, who face tough decision making in similarly complex environments.
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