Dr. Edwin T.

Caoleng
Professor

PREPARED BY: MURPHY M. MANLAPAZ,RN

Implementation strategies have been referred to by various terms.
Some organizations refer to implementation strategies as “tactical
plans,” while others may use “business plans,” and still others,
many in health care, have adopted the term “action plans.”
Action plans is the most descriptive term as it connotes the
actions required to carry out strategies and meet objectives.
The term action plans may also be applied to the several
different levels within organizations that must develop
implementation strategies and thus lessens confusion.
 The Level and Orientation of the Strategy

A large integrated health care system may develop strategy at a number

of levels – a corporate level, divisional level, organizational level, and a
functional level.

If the strategy has been developed at the divisional level, action plans will
be for individual institutions or organizations comprising the division,
such as a hospital (within the hospital division) or a long-term care facility
(within the long-term care division).
If strategy has been developed for an individual organization, such as a
hospital, the action plans will be developed by functional units within the
hospital (such as surgery or pharmacy).

Thus, strategies may be developed for large, complex organizations or

small, well-focused units; therefore, action plans to implement the
strategies will be developed at different levels as well.
 An effective action plan, regardless of level, consists of
objectives that specify how the unit (division, hospital,
pharmacy) is going to contribute to the strategy.

What actions will be required to achieve the objectives?

Within what time period?
Who is responsible for the actions?
The resources required to achieve the objectives?
How results will be measured?
 A good Action Plan it has to be SMART

Specific Goal- What you going to achieve? What are the steps?
Measurable- How will you know when you have achieved this goal?
Achievable- What is needed to achieve this goal? Skills, Knowledge, and Resources.
Relevant- How your goal relate to a strategic plan?
Timescale-When do you plan to implement this goal? Or estimated time achieve the goal?

These elements are required whether the action plan is for entire divisions as part of a complex
corporate-level strategic plan or for functional units contributing to the strategic plan of a
small organization.
“Failing to plan is planning to fail”
–Benjamin Franklin
 Action Plan Development Responsibilities

The development of the initial plan is usually the product of a relatively small number of
strategic thinkers.

Margaret Meade challenged us to “never doubt that a small group of thoughtful,

committed people can change the world; indeed, it’s the only thing that ever has!”

A small group of thoughtful, committed people can reshape even the most rigid
organization.

Perspective of Communicating Strategy

 1. “Manage Simply”

“Everything should be made as simple as it

possibly can and no simpler.”

Managers and those seeking to become managers should keep Einstein’s idea
in mind. Think of it as a manager’s vision – seek simplicity, if one confronts
complexity; work to simplify; lead to simplify; organize to simplify. Keep
simplicity a primary focus of management style.
• Less management is better than more management.
• Broad strokes are better than narrow strokes. Avoid micromanagement!
• Managers will never get it quite right. Objectives, needs, influences, solutions, and
systems constantly evolve. Interpret striving for perfection as continuous
improvement. Never make perfection a pre- requisite for progress.
• One size does not fit all. Although some order is necessary, blind application of one
solution or pat- tern leads to a dysfunctional workforce. When choosing between
centralization and decentralization, customize the solution to fit the circumstances.
• All solutions are temporary. Remember that “necessity is the
mother of invention” and because needs change, the requirement for
innovation is constant. Thus, no solution will last very long. Don’t
work so hard for closure to a problem; be open to and encourage
change and innovation.

• Do what is best for each individual and the organization will

prosper.
• Practice “one-level” management. Although someone must be
the boss, don’t make the organizational hierarchy seem important.
Everyone in the organization should be treated as a peer – this is
equality.

• Make the manager’s job harder and others easier. Identify and
satisfy internal customers. Remember that subordinates are
customers, too.
2. The level and orientation of the strategy “Stages of
Resistance to Change”

“If you want to make enemies, try

to change something”
- Woodrow Wilson
Often people do not like change, and their first reaction may be to
resist any changes management may wish to make. When
instituting changes in an organization, whether it is initiating the
strategic planning process, changing the strategy, or attempting to
change the culture, manager find people in various stages of
resistance.
Stage One: Resistance
Often the first reaction to something new is to resist the change. Because
organizations have frequent changes and in many instances management has tried
several techniques before, employees may see a new program or management effort
as another fad that will soon go away (as have the others). Therefore they openly
resist (or even sabotage) the proposed change.
Stage Two: Passiveness
In stage two, employees are not resistant; they simply do not want to get involved.
These people do not like change and believe that if they bury their heads in the
sand (go about their usual work), the change will just go away. In many cases
these people do not understand the vision for the future, or they have never been
told about it or how they fit in it.
Stage Three: Convince Me
Some people in organizations are ready to change and will work hard if they believe it will
really improve the organization. These people will give it their best if management can show
them that the result will be worth their effort. In this stage, managers often hear such
comments as, “Show me that we can improve the way we work and I’ll be your biggest
supporter” or “Give me some indication that this can be an interesting and challenging place
to work, and I’ll give it a shot.”
Stage Four: Hope
Many people, especially when they start their careers, want to be a part of
something important – to make a difference. They have hope that they can make
the organization better and be a part of something significant. These people are
usually willing to try anything and want to be a part of meaningful change. In this
stage, managers often hear such comments as, “I don’t know if we can succeed but
look at the possibilities if we do” or “Wouldn’t it be great if we actually pulled it
off?”
Stage Five: Involvement
In this stage, people typically understand that the organization must change and
continually renew itself if it is to succeed. They are willing to get involved and be a
part of any change that will keep the organization viable. In this stage, managers
often hear such comments as, “I don’t know if this will work, but we have to try
something” or “The world is changing and we have to change with it.”
Stage Six: Advocacy
People in this stage believe not only that change is important in a changing
world but that this program can really make an important difference. They are
ready for a long-term commitment to the program or process and will lead and
be responsible for its implementation and progress. These people will convince
others to be a part of the change and will keep the process on track. In this
stage, managers often hear such comments as, “This is our chance for real long-
term success” or “I’m a believer; this can work if we stay committed over the
long term.”
 3. Performance Appraisal and Compensation

People in organizations do what they get rewarded for doing and ignore most other organizational dictates. As Steve
Kerr stated in a classic management article, often management expects “A,” but rewards “B,” and then cannot
understand why “A” never occurs. If strategic management is to become a philosophy or way of managing an
organization, people must see a connection between what they do and strategic management. Therefore, unless
strategic management is translated into individual efforts and acknowledged through the performance appraisal and
reward systems, it is unlikely that every- one will work for the strategic plan.

Just as organizational divisions and units must be linked to the strategic plan, so should the work of the individuals
involved.
After initiating a strategic planning effort, it is necessary to rewrite job descriptions and performance appraisal
standards. Every position, from secretary to CEO, should be linked back to the strategic plan.
 An effective way to redesign job descriptions is to
ask three strategic questions for each position:

1. To make the maximum contribution, what is this person not doing now that he or
she should be doing?
2. To make the maximum contribution, what is this person doing now that he or she
should not be doing?
3. To make the maximum contribution, what is this person doing now that he or she
should continue to do but in a different way?
Similarly, performance appraisal forms should be structured around the
strategic management processes. Then compensation may be tied directly to the
employee’s contribution to the strategy.

• Who will be responsible for accomplishing each action by the designated

time?
• What organizational resources will be required to accomplish each action in
a timely manner?
• How will results be measured?
4. The Balanced Scorecard
Manufacturers create value by managing tangible assets whereas modern knowledge-based
organizations create value by deploying intangible assets such as customer relations, innovative
services, high-quality and responsive operations, information technology, databases, and
employee competencies.

The Balanced Scorecard approach links the organization’s strategy to short-term actions. As the
concept evolved, four processes were identified for transforming the Balanced Scorecard into a
strategic management implementation system: the financial perspective, the customer
perspective, the internal perspective, and the learning/growth perspective.
First, if the Balanced Scorecard is to be an effective strategic management system it should be useful in
trans- lating the vision into an integrated set of objectives that, when accomplished, contribute to long-
term success.

Second, successful implementation relies on effective communication with, and linking to, the units that
comprise the larger organization.

Third, action plans allow the integration of strategic and financial plans.

And finally, feedback and learning are developed and nurtured such that consistent decisions are made
throughout the organization and resources are allocated in a logical and comprehensible manner
5. Plan and Re-plan
Strategic planning is important precisely because things change so rapidly. A decade ago a developing
trend in the Northeast might take a decade to be adopted in the South or Midwest. Today, it may happen
in months and managers do not have much time to prepare. Strategic planning should be a dynamic
process – not a once a year activity. Although the plan may look ahead for three to five years, it has to
be updated periodically and reviewed constantly. The plan must provide for flexibility to cope with rapid,
unexpected changes.

6. Strategic Management Paradoxes

• The more chaotic (unpredictable) the external environment, the more strategic planning is needed.
Placid environments do not require a great deal of planning. However, where there is a great deal of
change, anticipating, recognizing the signals of change, and repositioning the organization are important.
• Strategic management is about defining the “big picture” and emphasizing the details. The
strategic management process defines the organization’s relationship with its environment and sets
direction. However, implementation involves coordinating numerous details.
• Strategic management concerns destruction and renewal. Sometimes in the process of reinventing
an organization, parts of the old organization must first be dismantled to put new processes in place.
• The rules for success are written outside the organization (in the environment), but competitive
advantage is created inside the organization. Opportunities and threats are external to the
organization. However, management must find the appropriate internal resources, capabilities, and
competencies to build sustainable competitive advantage.
 Seven deadly sins have been identified that doom
effective strategy implementation:

1. The strategy is lacking in terms of rigor, insight, vision, ambition, or practicality. If the strategy is
simply more of the same, comfortable, and incremental, it will not create the excitement needed
for successful implementation.

2. People are not sure how the strategy is to be implemented. Leaders are too impatient to make the
strategy happen so that communicating details about how implementation is to proceed is thought
of as time-consuming indecisiveness.

3. The strategy is communicated on a “need to know” basis rather than freely throughout the
organization.
4. No one is responsible for every aspect of strategy implementation. Failure to carefully see to all
aspects of implementation results in oversights and confusion.
5. Leaders send mixed signals by dropping out of sight when implementation begins. The absence
of leadership implies that implementation is not worthy of their attention and, therefore,
unimportant.

6. Unforeseen obstacles to implementation will inevitably occur. The responsible people should
therefore be prepared for these barriers and be encouraged to overcome them in creative and
innovative ways.

7. Strategy becomes all-consuming and details of day-to-day operations are lost or neglected.
Strategy is important but so are operations.
 Barriers to Implementation

Effective strategy implementation requires the same determination and effort that is devoted
to situational analysis and strategy formulation. If the barriers to effective implementation
are to be eliminated or overcome, a number of actions will be required.

Everyone in the organization has to be a partner in implementation. Strategies are

organization-wide and require inter-unit and cross-functional cooperation.

It is critically important that everyone understands and supports the strategy. Successful
strategies require a willingness to seek the good of the entire organization over any single
part.
Unit managers have to broaden their view and the organization’s leadership has to evaluate success based on
contribution to the whole rather than to a single unit.

Strategic managers are responsible for turning vision into a compelling strategy for the future. This compelling
vision elevates unclear strategies and conflicting priorities into a consistent pathway to success and makes it
“some- thing worth doing.” The message from visible and engaged leadership is clear strategy implementation is
important.

If strategy is important, it should be a part of the budgeting, performance evaluation, and reward system of the
health care organization. A primary reason why strategies are not implemented is because, in many health care
organizations, effective or ineffective implementation makes little or no difference in resource allocation and
reward distribution. People, therefore, concentrate on what they perceive as the important things – those things
that actually affect their budgets and their paychecks.
 Contingency Planning

Contingency planning may be incorporated into the normal strategic

management process at any level and is a part of managing the
strategic momentum. Contingency plans are alternative plans that
are put into effect if the strategic assumptions change quickly or
dramatically, or if organizational performance is lagging.
 Thus, alternative plans are the result of strategic thinking and
provide leadership with a different course of action until further
analysis can be undertaken and a different strategy more appropriate
for the changed environment adopted. The more turbulent,
discontinuous, and unpredictable the external environment, the more
likely it is that unexpected or dramatic shifts will occur and the
greater the need for contingency planning.
Sources:

1. Peter F. Drucker, Managing for Results (New York: Harper & Row Publishers, 1964), p. 95.
2. Quoted in Katie Sosnowchik, “A Fierce Momentum,”
green@work (March/April, 2002), p. 6.
3. Christopher A. Bartlett and Sumantra Ghoshal, “Building Competitive Advantage Through People,”
MIT Sloan Management Review 42, no. 1 (Winter 2002), p. 36.
4. Peter F. Drucker, Managing the Nonprofit Organiza- tion: Principles and Practices (New York: Harper-
Collins Publishers, 1990), p. 142.
5. Xiang Li, Cheng-Leong Ang, and Robert Gray, “An Intelligent Business Forecaster for Strategic
Business Planning,” Journal of Forecasting 18, no. 3 (1999), pp. 181–204. See also Alan M. Zuckerman,
“Growing Pains: The Difference Between Strategic and Nonstrategic Growth,” Healthcare Financial Man-
agement 58, no. 4 (2004), pp. 102–104.